Seriously? Just LISTEN Already and Quit Acting Shocked!

(Content Warning—going to talk about some of the issues of people abusing power, especially by victimizing women and marginalized groups.)

Over the last couple of weeks, all sorts of stories have been breaking about women, minorities, trans persons, and other vulnerable groups being harassed by people in power. I’m going to go ahead and echo a much more popular writer, Harris O’Malley, who goes by “Dr. Nerdlove” and spends most of his online energy helping socially awkward people understand relationships better. Marginalized voices have been screaming that they are being exploited, and they are being ignored. You want to do some good in the world? Start by listening to the people who are being victimized.

No, don’t talk over them. Don’t what-about them. Don’t accuse them of exaggerating. LISTEN.

Hear what they are saying. Do you want more evidence before you condemn someone for something that is likely to destroy that person’s life? I get that. Really, I do. False accusations can do real harm; but they are also pretty rare. You know why? Because being assaulted or harassed or even belittled is not something people brag about in most cases. In fact, they usually don’t want anyone to know. It’s a demeaning experience, and reliving it can be almost as awful as the incident itself.

Add to that the fact that if you make such allegations, you can be blacklisted from a whole community, including the one that involves your career. If you are the sole voice, you will be ignored; only once you are joined by a growing chorus of people, with the same story repeated over and over, will the public finally listen.

Then, once the person admits what he has done (it’s almost always a white guy, at least in the U.S., despite the fact I linked to the Cosby scandal above), many people will focus on the lack of criticism toward the attacker. This is what is happening with the current admission of Harvey Weinstein. Weinstein has been accused for years of harassing younger women who were eager to break into the Hollywood industry. His admission takes the usual form of “It’s not all true” combined with “I need help” that is meant to be more of an apologetic defense than a real statement of guilt. It’s disgusting on its own.

However, that’s when the cries of “What does Hillary Clinton have to say about this??” arise. Yes, that’s from FoxNews, but here’s CNN’s version. You see, what’s important here is not that a media mogul abused his power and harmed who knows how many women. What’s important is how OTHER women and minorities respond to this. Let’s be clear. Clinton, because of her past associations with Weinstein (he was a major campaign contributor) can’t win here. This is just another way to attack someone who is no longer even in the political spotlight. It’s a retroactive ‘told ya so’ from people who don’t really care about Weinstein’s victims at all.

(Edit: Since I published this, Clinton DID speak out and condemn Weinstein. The comments on social media confirmed what I suspected. Those calling on her to speak called her a hypocrite for condemning this when (according to them) she stood by her own husband during a scandal. In other words, she had no way to satisfy critics. Still, I’m glad she spoke out and condemned Weinstein.)

Again, they aren’t listening. They are using the moment to talk about something else.

In the same way, Buzzfeed’s recent reveal that (again, shockingly) Breitbart and its then-lackey, Milo Yiannopoulos, had ties to White Nationalist groups underplayed the ways in which Yiannopoulous and others have attacked women online, generating hate mobs that were meant to chase people out of the video game industry, for example.

Once again, many already knew this, and shouted it over and over and over. Nobody listened.

These misuses of power are all over our society, and the victims have been asking for help. If you didn’t hear them, it’s because you weren’t listening. It’s time that we all (myself included) do a MUCH better job.

ACA Repeal and Replace- Part 5 Gajillion

(Cassidy and Graham–Getty Images)

Congress has one last attempt in them to repeal the Affordable Care Act and replace it with something that will cause millions of Americans to lose insurance. It’s called the Cassidy-Graham Plan….just kidding! Lindsey Graham would never let anyone else put his or her name first. It’s called the Graham-Cassidy plan, and here’s how it “works”. As you can see, much of the plan can be summed up by saying that Federal subsidies for healthcare would be transferred to the states, which can then do what they wish with that money. It’s a States’ Rights approach…I guess. But in practice, it will mean that many Americans will lose healthcare. Why?

Reason One: By removing the Medicaid Expansion and leaving this up to the states, those states that are unable to make up the difference will need to decide whether to cut funding to certain people or find a way to come up with it. That could mean increased taxes, but that seems unlikely. Cutting people out of Medicaid is more likely. I’m not saying that out of pure cynicism. I have personally witnessed several people here in Ohio go through the process of trying to receive disability. The first application is automatically denied; you then go through an appeals process, which can take 6 months to a year. You are then VERY likely to be denied again, at which point you get another appeal. After a year and a half to two years (longer in some cases), you will finally get your verdict. States will do everything they can to deny you, but if you are lucky enough to receive the funding, after two years of waiting, you will need to continuously prove that you still deserve it. That’s under the current system. With less funding, things will be even harder.

Reason Two: The distribution of funds will be up to the states, which will allow them to decide who is eligible and who is not. In practice, this means eliminating pre-existing condition protection as well as federal guidelines for mental health, disabilities, etc. Some states do not recognize certain mental illnesses or disabilities as legitimate. People with those disabilities are very unlikely to have the money to move to another state. They will simply be left behind.

Reason Three: In fact, under this plan, states will be allowed to deny mental illness coverage altogether. There are several provisions of the ACA that specifically define mental illnesses, and even include issues like drug addiction. Under the new plan, the states could ignore those definitions, which in practice will mean that many of the people who now have coverage for mental illnesses will lose that coverage.

This leads me to the main issue that I want to raise here. Graham and Cassidy have defended the bill by stating that it does not remove the pre-conditions clause of the ACA. In other words, insurers will not be able to deny people with pre-existing conditions. When NPR suggested that in fact it would harm people with pre-existing conditions, Cassidy tweeted that this was false (FALSE!). People with pre-existing conditions would still have access to healthcare.

Here is the key point. Whenever you see the word ‘access’ you should recognize that you are being intentionally misled. Yes, intentionally. ‘Access’ is a buzzword among people who want to take something away from others, but don’t want to be caught doing so. In this case, Cassidy is right that the bill will not remove access to healthcare. In other words, insurers will not be able to deny people insurance simply because those people have a condition.

What is misleading here is that ‘access’ refers to a negative liberty that protects us from government interference in our choices. In other words, we will all be allowed to purchase insurance, regardless of existing conditions. However, there will be no controls on how much insurers may charge us for that access. This is a bit like saying that I have access to a yacht. No one is preventing me from purchasing a yacht. Of course, I don’t have the money to buy one; so that access is moot.

We all have access to healthcare at all times—if we can afford to pay for it. We don’t even need insurance. We can just purchase any procedures we need. Realistically, of course, that means nothing. Most people cannot afford the exorbitant costs associated with even minor surgeries, assuming we can even find out in advance how much it will be.

Graham and Cassidy know this. They know that removing government subsidies to offset insurance costs will effectively prevent people with pre-existing conditions from being able to afford the premiums of insurance plans that are unregulated.

Here’s one calculation of what that would mean, based on existing data.  Doctors have spoken out against the bill as well. Let me stress one important part of that last article. Some people, including some legislators, seem to think that healthcare is an individual rights issue, because purchasing it is like purchasing a car for yourself. It isn’t. Having a healthy society benefits all of us, as individuals and as a community. It’s not something we can choose to buy or not buy. When you need it, you must have it. There are no alternatives. There’s no public transportation option, like there is for cars. You can’t carpool on healthcare. Most importantly, you will use our healthcare system. If Republicans are so worried about the free rider problem, they would do well to keep that in mind.

Everyone will use healthcare at some point in life; most likely multiple points. This is as much of a social need as having a police force or fire departments or roads. In fact, it’s more important than all of those things. It’s literally life and death, and unlike the fire department, we will all need to use it.

It’s time to stop messing around with this issue and catch up to the rest of the world, which realized decades ago that a public system of healthcare is a basic right in today’s world, a positive right that should be provided in some way by the government.

The DACA- Is Trump Eliminating It or Codifying It?

(getty images)

This week, Americans are learning another acronym that most had ignored until it became media sensation. The letters DACA stand for Deferred Action for Childhood Arrivals. You can read more about it on Wikipedia, which has some of the history, criticism, etc..  But in basic terms, DACA was an executive order that President Obama enacted in 2012 when the DREAM act failed. Both the DREAM act and DACA aim at providing the children of undocumented immigrants to remain in the U.S. because it has become their home. In other words, the idea is that the children of such immigrants did not do anything wrong, and many (most) of them have become full members of U.S. society, contributing just like other members. Deporting them, according to Obama, would punish them unfairly.

President Trump has announced that he is cancelling the executive action, and this has rightly caused some controversy and confusion. What exactly will happen to the so-called Dreamers (people who were protected by DACA)? Will they be deported after all? Or does Trump really want Congress to pass a law that will ultimately protect them without using the executive order approach that he has often called unconstitutional (in practice, this seems to mean when Obama does it, since he hasn’t really rescinded Bush’s EOs and has made a few himself).

There are certainly some signs that Trump simply wants Congress to provide a permanent solution, which the DACA is not. One reason to be suspicious about this is that Trump has given no concrete path to such legislation. Another is that nothing prevented Congress from creating such a law while DACA was in place. In other words, he didn’t have to remove it in order for such a law to be passed. If anything, removing DACA means that if Congress does not act, then there will be no protection for these young persons.

Why does this matter? Well, there are nearly 800k people who are currently covered by the DACA. The DACA allows them to receive work permits, and almost all of them have jobs. These are not jobs that have been taken from ‘other Americans’ either. Furthermore, in order to keep these permits (and thus their jobs), they must keep a clean record. In other words, they are not criminals. While some might counter that being undocumented is a kind of crime, remember that these are people who were born in America. By law, that should make them Americans. However, since their parents are not documented Americans, they fall into a gray area here.

Still, we should remember that those of us who are Americans by birth have ancestors that weren’t, and that many of our families likely received citizenship basically by being born here. This is not new. What is new is the way that they are being protected in this case. President Trump says that he cares about these Dreamers. But he also campaigned on ending the DACA. This puts him in a tough spot. So tough that many feel that he’s essentially following Democrats here, rather than Republicans.

Whatever his motives, the process is very unclear right now, since there is no direction on how to create legislation. This leaves nearly 800k people facing an uncertain people, and many others are affected by what will happen. If the U.S. suddenly loses 800k employees that will be a huge hole to fill. And it’s not as simple as saying that other Americans can then just have those jobs. The U.S. has a skill labored shortage right now, which is leading to a lot of empty jobs with no one to fill them. So it will not likely provide an equal number of jobs for others. More likely it will simply leave a vacuum in our economy.

One additional piece of information about the process is worth noting. When Jeff Sessions, the Attorney General, made this announcement official, he claimed that it was a correction of the misuse of Presidential authority that Obama had used to create DACA in the first place. He even adds this choice quote:

“Societies where the rule of law is treasured are societies that tend to flourish and succeed. Societies where the rule of law is subject to political whims and personal biases tend to become societies afflicted by corruption, poverty, and human suffering.”

He is correct, of course. However, as the article where I got this quote notes, this is the same person who has fought for a Presidential right to ban Muslims categorically from entering the country. Does this mean that the President has no say on whether people are allowed to remain in the country but has complete power to bar people from entering? That seems like a line that is hard to match with rule of law, which is about following Constitutional authority properly and not making up new rules on the spot. Trump has made up new rules all over the place, and removed existing precedents repeatedly. Personally, I would love to get back to proper separation of powers in the U.S. It’s a critical part of our political system. But having the President force Congress into an action that it doesn’t want to do seems like a pretty big misuse of authority.

On the other hand, if we read this as simply correcting a previous mistake (and forget the ways in which Trump has abused his own authority), then we can try to be generous and see this as an attempt to come up with a better way of dealing with young Americans (yes, Americans) who need more than just a system that allows them to stay but without the full rights of other Americans. If that is the goal of this process, I agree with it. What I don’t agree with is the particular path being taken to reach this goal. It carries too much uncertainty and it certainly smells like an attempt to deport a bunch of people who have done nothing wrong.

Of course, some states are already saying that they will offer sanctuary. In my own state of Ohio, Governor Kasich (a Republican, for those keeping score) has announced that the Dreamers can come here and he will not try to force them to leave the country. However, moving states is not easy, which is why I generally favor a federal solution to a state solution where rights are concerned (perhaps I’ll detail this a bit more in a future article). Many of those affected by DACA live in states like California and Texas, with large populations, both far from Ohio. Relocating your family is difficult, and doing so while under scrutiny of law even more so.

This is complicated by the fact that President Obama collected information from those protected under DACA in order to ensure that they would not be deported. Many worry that this same information might now be used to target people instead, which seems like a reasonable concern. However, if President Trump really does want to protect the Dreamers and is simply pushing Congress to make it an actual law, then they should have nothing to fear. I guess we’ll see soon enough.

The Ethics of Shooting Nazis

The other day, my partner arrived home from work, and asked me a simple question:

“What are you doing?”

“Shooting Nazis,” I answered evenly, as I concentrated on my computer screen.

“What?” she asked, this time a bit more interested.

“Playing Wolfenstein. I felt like shooting some Nazis. Seemed appropriate. Remember my last blog?”

She laughed, but also cocked her head in that way she does when she knows I’m half serious and agrees with whatever I just said. “Oh! Of course!”

The game in question, Wolfenstein: The New Order, is part of a serious of first person shooters that lets you fight Nazis. This one (like some of the others) takes place on an alternative timeline where the Allies did not win the war in 1945. Instead, it is now 1946 and things are not going well. I’m playing an elite commando badass of some sort (I’m always a badass in these games…cause I’m awesome!) single-handedly ruining things for Hitler by taking out all his elite troops.

The game is a bit cyberpunkish, with tech that didn’t exist at the time, like robot dogs that attack you and special weapons that don’t even exist today, much less in the mid 1940s. It’s all in good fun, right? I mean you are fighting Nazis, and who doesn’t know that they are pure evil. In this way, Wolfenstein allows gamers to indulge in violence with less moral ambiguity than many such games. It certainly has a different feel from Resident Evil V, where many people noted that killing African zombies felt more than a little racist at times.

But after the events in Charlottesville, where Neo-Nazis marched openly in the U.S., I’m feeling a strange sense of ambivalence. On one hand, I feel closer to the problem than ever, as though I’m battling a real evil, not just something I heard my grandparents discuss in hushed tones. Nazis still exist, and they still need to be fought! And they are literally killing people. Eat this grenade, Nazis!

On the other hand, a video game simulation of a fight with a fictionalized group of Nazis in an alternate time line feels a bit empty. There are real Nazis to fight.

Then I start to wonder…how do we fight them? What are we supposed to do in order to stop the Nazis in our own society? This is an ongoing debate right now. I see it on the forums I visit. I see it on FB and Twitter. I see people posting pictures of American Nazis getting punched, and I see others arguing against such violence because it will only fuel more.

I don’t know which is the correct approach to take when dealing with Nazis. I know I would forgive someone for punching a Nazi in the face when confronted with their rhetoric. But I don’t know if it does any good. What I do know is that Germans (and others) in the 1930s did not take Hitler and the Nazis very seriously. Some did, of course. But anyone with high school history can tell you that some politicians adopted a policy of appeasement toward the Third Reich, and this proved disastrous.

Turns out that Nazis don’t go away when you ignore them. They don’t just want attention, or for someone to hear their message. They want change. Nazism is an action movement, not a passive one. Nazis don’t wait for the world to move in their direction; they actively believe that the world needs them to make it better. That’s one of their priors—an assumption that only they can see the truth about the world, whether that means Zionist conspiracies or a need for harsh eugenics programs.

In my Biomedical Ethics class, I show the poster below, which was used in Nazi Germany, together with the translation.

Is this the kind of thing that we should ignore? Is it clownish? Is it buffoonery? Is it just trolling, as some alt-right members suggest, meant to get a rise out of people but not really meant to be serious? No. It is none of these things. None of us should be complicit in this. We must speak out, and we must realize that even if this seems like a fringe movement, it must be expunged from our society as the cancer that it is. You don’t ignore cancer. You shoot it with radiation.

Time to return to Wolfenstein and find a radiation gun…..

Literal Nazis Are Marching for White Power in the United States

I shouldn’t be writing this post; I mean it shouldn’t exist. There should be no need for me to talk about a rising movement of literal Nazis in the United States. But here we are. It’s 2017, and as I am writing this blog, there are people battling white supremacists in Virginia, on the University of Virginia Campus. A state of emergency has been declared, after violence erupted in the city of Charlottesville, VA. This includes an incident where a car seemed to intentionally drive into a crowd of people who were protesting the white supremacists, injuring many, and possibly killing at least one person (at the time of this writing, reports are conflicting, but the video is awful….I’ll be amazed if no one is at least seriously injured).

Let me start by noting that we should not equivocate here. These are people who believe in the ideals of the Nazi movement. The picture above is from this gathering, showing the Nazi salute. There are photos of people wearing Nazi symbols, or even T-shirts with Hitler quotes on them. Those are not literal Nazis are basically still Nazis. They believe in white power and in “taking the country back” from minorities. The people fighting against this group are not just as bad. They are not the other side of the same coin, unless you believe that the people who fought the Nazis in WW2 were just the other side of the same coin, too. Fighting against Nazis does not make you a Nazi. It makes you a decent human being, willing to stand up for the rights of yourself and others.

So how did we get to this point? It’s easy to point fingers at Trump, and I won’t completely refrain from doing so myself. Whether Trump is a believer in this cause or not, he definitely plays on the same fears that this movement represents—fear of the other, fear of difference, general xenophobia. I cannot tell whether Trump actually believes most of what he says, but I do know that his words have an effect on our country. They must. He is the President. When he says that Mexico is sending us rapists, he is playing on fears of immigration. When his son makes reference to a handful of Skittles filled with a few bad ones, he is asking us to consider all refugees as potential threats to our country, with no real way to distinguish them (despite the fact that our vetting is incredibly stringent). These statements play on existing fears, but they also play on fallacies of bias that are difficult to avoid.

Consider this analogy. Suppose that the first time you ever saw a dog as a child, it bit you. That was your first experience with a dog. Because dogs are so prevalent, however, you might get over that first impression. Your friends will have dogs, and you will eventually realize that most of them will not bite you. Your first impression was wrong. Now, suppose that one of your friends has a rat as a pet. Already, you might be thinking “That’s not a pet!” Well, for many people rats are great pets! But they are still pretty rare as pets, at least in the U.S. So, this might be the only one you encounter. Suppose it bites you. That will again be your first impression of this pet, but what will counter it? You may never see another pet rat again.

The same thing can happen in people who only live around others that are similar to themselves. If you live in a suburb, you might be in a neighborhood where, demographically at least, everyone is a lot like you. Maybe your suburb is filled with white, affluent people. But when you watch the news, you see persons of color. What are they doing? This will be your impression of them, most likely, because you won’t have much to counter it. For years and years, African Americans were shown in a bad light in the U.S. They were servants in films, and white actors dressed in blackface to portray stereotypes. Many were featured in racist ad campaigns.

Of course, that’s all in the past, right? Not really. The segregation of America is still happening, and what’s worse (for Nazis, not decent people) is that now there are many more groups of people that have gotten rights that they never had before. This outrages white supremacists who associate American exceptionalism with white people of European ancestry. Some of these people even become members of Congress! Others march in protests like the ones happening right now.

There were analysts that warned that Trump’s victory would be used as a signal to racist organizations that they could now come into the light, and openly say what they once only thought in secret. And here we are. This would be a good time to see how our still relatively new President will deal with the situation. Something must be done. So far, I haven’t been impressed. His first speech, which just happened a few minutes ago (as I write this), indicated the violence issues come “from all sides”, which is basically another false equivalence.

Are there examples of violence from the left? Of course, there are. This isn’t one of them, however, and I don’t recall conservatives trotting out the ‘both sides do this’ language when they were complaining about riots in Ferguson. In fact, here’s what Trump said at the time: “They’re going to riot in Ferguson no matter what”. Perhaps he believes the people of Ferguson are just inherently violent. He did not, however, point out that other people are just as violent, and he has not, yet, called the Nazis in Charlottesville ‘thugs’ as he did the people in Ferguson (and Baltimore, and Oakland….).

But maybe this open violence will finally change something; maybe as a nation we can come together to condemn literal Nazis. Is that too much to ask? LITERAL. NAZIS. Surely we can agree that they should be stopped.

Will Distrust of Colleges Increase Our Economic and Political Divide?

(photo courtesy of Nathaniel Givens…I think)

Since the 2016 Election, a lot of effort has been devoted to understanding why different groups voted the way they did and what it says about our society. That analysis is interesting, but incredibly complex, since so many factors play a part in why someone votes a particular way. For example, the key Midwest states that helped swing the election could have been decided based on a desire to bring back coal jobs, a general distrust of Clinton, or resentment that Obama didn’t do enough to address their concerns. Who knows?

What we can see is growing social divide in how people view themselves and the respective parties. This effect, known as polarization, can lead to extreme positions, which aren’t always good for making sound decisions. Polarization is created when a group of like-minded people find themselves isolated from external positions and drive the members of the group into a more extreme version of the mindset that caused them to enter the group in the first place. For example, if you took a room full of new mothers, some of whom believe that breast feeding is the best way to nurture a baby and others of whom believe using formula is fine, and separated them into groups based on their viewpoints, you would find the members of each group will push the group as a whole to more vehement versions of the initial viewpoints.

 

I want to focus on a particular version of this polarization that is manifesting in the U.S. right now, based on political affiliation. According to a recent survey, people who self-identify as Republicans are becoming more and more convinced that colleges and universities are having a negative effect on the country. Here is the chart of this shift:

Note the years. Up until late 2015, Republicans saw colleges as mostly a positive in American life. They were more suspicious (as a group) than Democrats, but seemed to acknowledge that higher education was a good thing, overall. A vocal minority, of course, has accused colleges of liberal indoctrination for at least as long as talk radio has been a thing, but only in the last couple of years has this mistrust surged.

What has changed? I’m not sure, and I’m guessing there are lots of theories. While there is some evidence that conservatives in the U.S. (again, not all, but a certain strain…this is the last time I’ll qualify this, but assume it in other cases) have intentionally undermined the very notion of science for largely political reasons. There is also a tendency to associate higher education with elitism, an idea that was certainly in play during President George W. Bush’s terms. Again, though, the chart above shows a dramatic shift in recent years; so we need to look at something more recent.

Perhaps it’s the Climate Change Denialist movement, which has presented science as a monolithic, agenda-based movement that is somehow involved in a vast conspiracy to kill coal jobs (for reasons unknown….big money from somewhere is the usual claim). Scientists are associated with universities, and so universities are bad? Or maybe it’s the fact that professors lean to the left, despite the fact that there is little evidence that this results in indoctrinating students. Still, even the perception could be the problem here.

Ultimately, the reasons don’t matter, because the view is what is important. The U.S. has a growing inequality problem. Wages have been in stagnation since the 1980s, though this story is a bit complicated. What is less in doubt is that there is an economic divide between rich and poor that is not improving. What we also know is that while college is no longer a guarantee of a well-paying, fulfilling job, it is still most often a necessary step to receiving such a job. Put in logic terms, it is necessary, but not sufficient for getting a job for the average person.

If Republican parents discourage their children from going to college in fear of some sort of liberal indoctrination, this will be a huge detriment to those children. I do not mean to suggest that college is a panacea for society’s ills. I could write a series of articles on problems with Higher Education and the ways in which it needs reform. However, it is still the best way to get ahead in life, especially if you come from a lower class background. That degree opens doors for you.

Many of the states that tend to vote Republican are among the lowest in the country in terms of education levels, quality of education, and percentage of higher education. A sharp rise in skepticism toward education will only exacerbate this issue, creating a deeper divide in the political tribalism that exists in the U.S.

So, how do we avoid this? I’m not sure. The best way, ironically, would be through education! Unfortunately, the current President does not seem to value universal education policies. The appointment of Betsy Devos doesn’t help. Her policies in Michigan were disastrous for the lower classes, and really the state in general. She is a proponent of privatizing colleges and universities, and even K-12 schooling, which tends to favor the wealthy who can afford the fees associated with privatization.

I would usually say that parents should encourage their children to get a college degree. Mine certainly did, and I was raised in a family where a secondary education was pretty much assumed. But if the only parents doing this are liberal parents, we will end up with a country in which conservatives are less educated and perhaps continue to resent those who are more educated. That’s not a good recipe for working together in the future.

Unfortunately, this article is based mostly on pointing out the potential for future problems in this area. If I had better solutions, I would offer them. If you have some, I’d like to hear them!

Healthcare Revisited- a new bill emerges

(image from readthebill.gop)

After the failure to repeal the Affordable Care Act in the early days of the Trump Presidency, the Senate is now considering a bill that will roll back many of the protections and regulations of the ACA. The LA Times has a nice comparison article that shows the differences being proposed. Here is a key quote from the article:

“The Congressional Budget Office score on the Senate version is expected in the next several days. The CBO’s score on the House version estimated 23 million fewer people would have insurance over the next decade. The report stated the hardest hit in the long run would be lower-income, older and sicker Americans.”

One thing to note is that the Republican proposal (which has no bipartisan support and as of today lacks unanimous support among Conservatives as well) does not literally keep these millions of Americans from having healthcare. It stops providing the means for them to have such care. For the “lower-income, older and sicker Americans” this will effectively mean the same thing. They will be unable to afford the healthcare they need, and they will not receive help in receiving such care. However, many of the people who will “lose” healthcare will do so because they have opted out of purchasing it, mostly by gambling that their current health status will remain the same. In other words, these will be younger, healthier Americans who decide that the cost of such care is not worth it for them.

While some of these people will lose this gamble, most will not. From their own perspective, it will be a rational choice to make. However, from the perspective of those who need health insurance in order to cover their bills, it will create higher premiums, and likely higher deductibles. The reasons are simple. When you remove the low risk members of an insurance pool, the insurance companies do not have income to offset their expenses from payments made to less healthy customers. In order to stay in business, they must raise premiums, deductibles, or both. This is pretty simple financing.

Republicans know this, of course, but they believe that the negative liberty  of allowing Americans to choose whether to insure themselves outweighs the need to keep rates lower for sicker Americans.

Politics is always a matter of trade-offs. The ACA traded liberty for security by forcing Americans to purchase healthcare or pay fines for not doing so. The new plan would trade security for liberty. In a vacuum, the values of liberty and security are roughly equal. You need a bit of both in order to have a good life. However, in a political system, these trades are made between groups, rather than being distributed equally. What does that mean, exactly?

In this case, it means that the wealthiest Americans will see a huge tax cut, just as they would have under the House’s proposed plan. The Atlantic covered this pretty well back in March. Basically, the ACA was funded in large part by higher taxes on the wealthy, especially capital gains taxes. Republicans believe that this is an unfair redistribution of wealth, where wealthier citizens are forced to finance those who are poor. That’s basically correct, too. I personally don’t see this as a problem. I think it’s part of living in a society with a social contract. However, many people disagree and do not see supporting the poor as their responsibility at all. Others do think they should help the poor, but not via government interference.

Wherever you fall on this debate over how to provide healthcare for the poor, the fact is that the proposed bill would deny healthcare to millions of Americans who have been given such care through the ACA. This removal will cause a great deal of suffering. I’ve noted before that I think there are many flaws in the ACA, especially with regard to how the marketplace works, who gets funding, how it gets distributed, etc. However, I do not think this is a good way to fix the problem.

The bill as it currently stands would freeze funding for Planned Parenthood for one year. PP is a kind of bogeyman for the GOP. They like to pain it as basically an abortion mill, even though abortions are a very small part of what Planned Parenthood does, and by law, those cannot be funded by federal funding anyway. Instead, a lot of people (especially poor women) will not be able to get needed services. These include birth control, which would help prevent the birth of more children who need healthcare and welfare services. But the Republicans have backed themselves into a corner on this issue due to strong rhetoric against the organization.

More critically, in the long run, the bill would reduce funding for Medicaid over time. This is the part that will save tax dollars. It’s also the part that will remove medical care for millions of Americans who saw Medicaid coverage expanded from the ACA. I personally know people who will lose coverage if this happens, and they are terrified. Some of them need that coverage for life saving medications. Others just want the security of knowing it is available. In both cases, the loss will produce more than just physical health issues. The added stress and anxiety will cause a ripple throughout society.

As the President noted, healthcare is very complicated. Assessing all the things this bill would or would not do can be difficult. That’s what Nancy Pelosi meant when she said that the ACA had to be passed before we would be able to determine all of its effects. Many of the effects of such legislation cannot be foreseen, and no doubt some of the more alarmist predictions will prove false as well. Still, the parts we can foresee, which include loss of coverage, looser regulations on what insurance companies must cover, and lessened protection against rising healthcare costs all seem scary enough to me!

At this point, though, Congress doesn’t have a lot of options. For years they’ve talked about how terrible the ACA is; how it is un—American and must be overturned. Now that the Republicans have all the power, they almost have to do something with it, even if they aren’t entirely sure whether their new plan will be good for healthcare in America. I just hope they slow down a bit and get it right.

Is Trump Rambling? Or just trying to say too much at once?

Apologies for the long period between blog updates. I’m in the middle of moving houses. I thought that taking a month off would not be a big deal. What could happen in a month?? Well, a lot has happened since Trump was inaugurated—far too much to deal with in a single blog post. So, I want to focus on just one thing: Why does Trump ramble so much when he talks to the press?

Let’s start with some examples of what I mean. I’m not going to focus on specific things that Trump has said that are questionable, such as asking a black reporter if she could put him in touch with Congress’s Black Caucus (a group of African American Congressional representatives). Yes, the belief that all black people know each other is a sign of casual racism, and yes there are many examples of similar slips (or even intentional ones, such as leaving out the word ‘Jew’ when talking about the Holocaust). These are easy to evaluate for anyone who notices them.

I want to focus on phrases like this, which are definitely made up of words, but not words that fit together into coherent thoughts. This is from his recent press conference:

“Now, again, maybe I’m not going to be able to do a deal with Russia, but at least I will have tried. And if I don’t, does anybody really think that Hillary Clinton would be tougher on Russia than Donald Trump? Does anybody in this room really believe that? OK?

But I tell you one thing, she tried to make a deal. She had the reset. She gave all that valuable uranium away. She did other things. You know, they say I’m close to Russia. Hillary Clinton gave away 20 percent of the uranium in the United States. She’s close to Russia.”

Ok, let’s try to figure this out. Trump is saying that he’d like to make a deal with Russia, because we are better as allies. Sounds good. Maybe he has a point. Russia is a powerful country, and certainly tensions with them haven’t been a great deal for either side, right? Then he adds that if he can’t make a deal, then he would be tougher on Russia than Clinton would have. Ummm….OK. Why is that good? You just said it’s better not to antagonize them. He continues that Clinton wanted to make a deal; she’s close to Russia. But he just said that getting closer with Russia is a good thing; so why is he attacking Clinton on this? Ah, I think I see.

I’m a college professor. That means that I deal with a lot of students who don’t know the answer to a particular question. This is especially problematic for in-class essays, where the student then has the option of leaving it blank (thus leaving half of their test points on the table and guaranteeing a failing grade for the exam), or trying to put down enough bullshit that I might be fooled into thinking they do know something.

One common technique when you don’t know what answer your audience might want is to try to play both sides. Suppose I ask a student whether we should be closer to Russia, but he’s not sure what he should think about this. So he says, “Well, I think we should be closer to Russia, as long as being closer to Russia is a good thing. And it probably is. But then, if it isn’t a good thing, then I definitely wouldn’t want us to be closer to Russia, and the people who would want us to be closer to Russia are very wrong about that!”

You would fail that answer, right? It’s incoherent gibberish. But let’s try to be super generous with Trump here. Maybe he’s saying he would try to make a deal with Russia, but if they would not agree to the deal, he would be super harsh with them. Ok, but then why attack Clinton for trying to make a deal? Perhaps it’s because she gave away uranium, which is basically just nukes, right?? Not really. Uranium can be used for lots of things, including power plants. But whatever. I think he’s trying to deflect here by saying that Clinton was both NOT tough enough on Russia, but also unable to broker a deal with Russia. I think. Maybe I’m being too hard on Trump, though.

So let’s look at a further set of claims in the same press conference (transcript linked again)

“Mike Flynn is a fine person, and I asked for his resignation. He respectfully gave it. He is a man who there was a certain amount of information given to Vice President Pence, who is with us today. And I was not happy with the way that information was given.

He didn’t have to do that, because what he did wasn’t wrong — what he did in terms of the information he saw. What was wrong was the way that other people, including yourselves in this room, were given that information, because that was classified information that was given illegally. That’s the real problem.

And, you know, you can talk all you want about Russia, which was all a, you know, fake news, fabricated deal, to try and make up for the loss of the Democrats and the press plays right into it. In fact, I saw a couple of the people that were supposedly involved with all of this — that they know nothing about it; they weren’t in Russia; they never made a phone call to Russia; they never received a phone call.

It’s all fake news. It’s all fake news. The nice thing is, I see it starting to turn, where people are now looking at the illegal — I think it’s very important — the illegal, giving out classified information. It was — and let me just tell you, it was given out like so much.

[some talk about Mexico and Australia phone calls.] The same thing happened with respect to General Flynn. Everybody saw this. And I’m saying — the first thing I thought of when I heard about it is: How does the press get this information that’s classified? How do they do it?

You know why? Because it’s an illegal process and the press should be ashamed of themselves. But more importantly, the people that gave out the information to the press should be ashamed of themselves, really ashamed.”

Those are Trump’s words. So let’s look at them. He starts by saying Flynn did nothing wrong. It’s fake news. There was no contact with Russia. Then, he repeats the claim that the news is fake. Then he complains that what the media reported came from classified calls. In other words, he’s upset that the media got access to the information about Flynn’s calls. Why is he upset about them receiving information he just said doesn’t really exist?

This is a classic case of someone being caught in a lie because he can’t stop talking. If you are a parent, you have probably seen this a few times. If you can get a child to talk enough, they’ll say something so inconsistent that the lie becomes obvious. Trump is saying that the media is making up all these terrible things about him, like Flynn’s call to Russia, or Trump’s own embarrassing dressing down of one of our own allies in Australia. But then he says those calls were classified, again implying that they happened in just the way the media is reporting.

The truth here is simple. Trump is doing these things. He’s upset that America is watching. The media’s entire job is to do this sort of thing. Many people today are too young to remember that it was the media that exposed the Watergate scandal. It was the media who gave us reports on the horrors of Vietnam. And yes, I’m too young to remember these things too. The media, with people like Walter Kronkite and Dan Rather, used to do real, investigative journalism. Go look it up. It’s great stuff!

Today, if the media isn’t on your side, you just accuse it of being fake news, or too biased to take seriously. This is a version of the circumstantial ad hominem fallacy (also sometimes known as the genitive fallacy), which basically says that you can’t trust any argument that a particular person makes if that person is in a certain circumstance. If you say that all conservatives are automatically wrong, because they are conservatives, then you are committing this fallacy. Similarly, if you say that anyone who works for a particular news channel is biased, you have the same problem. Now, you might be able to prove that a particular website, or even news channel, has a particular political agenda. But even if you could do that, it would not in itself invalidate every argument made by that source. At best, it would lead you to be extra cautious when evaluating the merits of the argument.

In any case, Trump has literally said that any poll that shows him in an unfavorable light is automatically fake. That’s a self-sealing fallacy. It can’t be wrong, because you’ve built the conditions in such a way that he wins either way. It’s like saying heads I win, tails you lose. It’s rigged.

This is not normal Presidential behavior, and that has nothing to do with my own views on Trump or his party. W Bush, who wasn’t overly Presidential at times, at least maintained the basic dignity of the position in most cases. Trump doesn’t care. He thinks he’s the CEO of America, and that he can simply fire anyone who disagrees with him. That’s the most dangerous kind of authoritarian thinking. It’s OK for a CEO, who is running a business. It’s unacceptable from a leading government official.

My Favorite MLK, jr. Quote

In today’s blog article, which I am writing on Martin Luther King, jr. Day of 2017, I’d like to take a moment to discuss my favorite MLK quote, which comes from the letter he wrote while serving time in a Birmingham jail for civil disobedience. Here’s the quote:

“First, I must confess that over the last few years I have been gravely disappointed with the white moderate. I have almost reached the regrettable conclusion that the Negro’s great stumbling block in the stride toward freedom is not the White Citizen’s Council-er or the Ku Klux Klanner, but the white moderate who is more devoted to “order” than to justice; who prefers a negative peace which is the absence of tension to a positive peace which is the presence of justice; who constantly says “I agree with you in the goal you seek, but I can’t agree with your methods of direct action;” who paternalistically feels he can set the timetable for another man’s freedom; who lives by the myth of time and who constantly advises the Negro to wait until a “more convenient season.””

Full disclosure: I am one of the white moderates that Dr. King is targeting here. At various points in my life, I have considered myself to be post-racial (“I don’t see race!”), fully supportive of efforts to fight racism (while doing nothing active to help the cause), and even judgmental towards those that I saw as fighting racism the “wrong way”.

The quote speaks to me because I recognize myself in it, and I am ashamed by it. When Dr. King wrote this letter, he addressed it to the white ministers in the southern churches that saw themselves as allies in the fight for civil rights, but disagreed with the way that MLK was conducting the fight. They would scold him when he used civil disobedience, pointing out that it made African Americans appear to be lawless or disrespectful toward the social order. They promised that a time would come (eventually), when all races were treated as equals, but that it could not be rushed.

It’s a message we see again and again when people are fighting for civil rights. Just wait until the bigots are gone, and things will get better. We can create change by appealing to the youth, and once they are in charge, things will improve. Such messages are well intentioned but dangerously out of touch. First, there is evidence that racism does not go away, so much as it changes in various ways.  Certainly, today’s generations are less likely to be openly racist than people were in the 1960s, but that’s because people like Dr. King made it unacceptable to be blatantly bigoted. That’s a good thing, but it is far from the end goal of an equitable society.

But even if time could eventually solve such social injustices, the people who are living right now do not have the time to wait. At the time when Dr. King wrote his letter, many of the laws preventing interracial marriages were still on the books. That’s right—fifty years ago, when your parents or grandparents were of an age to be married, they would not have been allowed to do so if their partner had been born with different color skin. How long would you have people wait for the basic right to marry someone they love? How long should they wait to be able to attend good schools, or receive services at restaurants.

Waiting is a terrible response to injustice. We cannot sit out the fight for equality. We cannot pretend to support a cause by passive approval of its goals.

Dr. King was right, and he is still right. Those who openly hate people for how they were born are relatively easy to spot. The KKK still marches through the streets, often without their hoods, openly calling for racial purity. In some cases, they have come up with new names, like the “Alt-Right”, but the message is the same, and it disgusts the moral people in our society who see it as an anachronism from darker times. But what are we going to do  about it?

Why Repeal and Delay Approach to ACA is a Bad Idea

(image owned by Vox.com, used via Fair Use)

Republicans have a very tricky problem right now. A big part of their election platform revolved around the idea of repealing the PPACA (also known as ‘Obamacare’), a legislative act that has granted insurance to millions of Americans since it was enacted. The Affordable Care Act (ACA from here on) was and is a flawed piece of legislation. Its goal was to slow the tide of rising healthcare costs on America while largely maintaining the existing system of private insurers. In other words, it was trying to combine the best of parts of private and public healthcare, and as a result ended up creating a kind of Frankenstein’s Monster of ad hoc policies put together by various contingents in an attempt to get both Democrats and Republicans to pass the bill while also trying to accomplish its main objections. Put more simply—it’s a bit of a mess.

On the plus side, the ACA has ameliorated one of the biggest problems with private insurance—the fact that pre-existing conditions are often outright denied because there is no profit in covering them. Insurance companies are businesses, which means they need to make profits in order to continue to exist. If you know someone has an existing chronic health problem, then you know that this customer will only drain your company and not add anything of value. So, you can either raise your prices for that customer until this drain is balanced, or you can deny that customer coverage altogether. The ACA disallows companies to deny the customer altogether. The price increase approach is too complex to deal with in this blog, but suffice it to say that the ACA did not altogether eliminate this practice.

Now, if you are going to force companies to cover people that are known drains on the system, then you need to balance that in some way. This is where the Individual Mandate comes into play. The Mandate was an idea that was first proposed by a Conservative think tank (yes, Conservative) known as the Heritage Foundation, as far back as 1989. By forcing all people to buy insurance, you spread the risk across a more varied group of people, many of whom are perfectly healthy. These healthy customers help offset the loss that insurance companies face when forced to cover risky customers. It’s a very practical solution to the problem, and if we consider the issue purely economically, it makes a lot of sense.

But this is where things get really tricky. Many people believe the Individual Mandate is a violation of basic rights. The government, they argue, should not be able to force people to buy a product. In other words, these people do not object to the economics argument, but to the government interference that it represents. While some people have countered this concern by noting that car insurance is required in many states, objectors can counter that you don’t have to own a car, if you want to avoid paying for car insurance. But there is no way around the healthcare mandate (other than to pay the fine, which is its own issue).

This is not the only problem people see with the ACA. I saw someone post on Facebook once that he resented the part of the ACA that requires companies to cover certain women’s issues, since that means he is paying for things he’ll never use (yeah, well women have to cover your prostate cancer, jerk!). Others believe the ACA is actually raising prices (despite evidence that in most years since the ACA was enacted, price increases in healthcare have slowed compared to previous years). Interestingly, many people actually agree with most of the provisions of the ACA, when asked about them individually, and yet still object to “Obamacare”, if it is phrased that way.

Ok, that’s enough background. Whatever you think about the ACA, the fact is that the GOP promised to repeal it if they were put in power, and now they are tasked with carrying out that promise, despite the fact that many Americans are now entrenched in the new system.

Right now, the plan being floated about among Republican circles is known as ‘repeal and delay’. It rests on a very simple premise: we promised to repeal the ACA, but we don’t yet have a plan to replace it; so we need to delay its actual removal. What this would mean in practice is that Congress could repeal the ACA (or most of it, since there is talk of keeping certain provisions, which I’ll get to in a moment), but delay its removal for two years, while they come up with a new and better plan.

Vox has an excellent article up right now on why this is a problematic strategy. That’s where I got the image above this blog post, and it contains a longer, more detailed argument than I will give here. It’s well worth reading.

But here is the short version. The ACA relies largely on insurance companies offering plan through the ACA marketplace, so that Americans are able to take advantage of the subsidies that the ACA provides and receive “affordable” healthcare. Without those marketplaces and the subsidies that drive them, the ACA effectively disappears, at least for the millions of Americans who have gained insurance from it.

Now, suppose you are an insurance company who offers plans through the marketplace. You know you will get some risky customers among the people who sign up this way, because many are people who could not get insurance before. However, others are people who simply could not afford it, or who elected to go without coverage and take their chances. The ACA’s subsidies now allow these people to sign up for your insurance, and you are pretty sure about getting the money, because the government is providing some or most of it. There could be good reasons, then, to keep a plan or two on the marketplace.

But now, Congress repeals the ACA. It won’t really be gone for two years, but you know it is going away. You don’t know what will replace it, because that plan doesn’t yet exist. You’ve heard about some of the proposals, but they are all different, and none are certain to pass. All you know is that the current system is going away, and there will be no more subsidies, perhaps no more marketplace of this sort at all. Why would you keep putting plans on the marketplace? You wouldn’t. It doesn’t make good business sense at all. You would just pull out of the system altogether and wait to see what happens, while focusing on your more traditional business (employment-based insurance).

This is almost certainly what will happen in the case of repeal and delay, and many people already see it. Senator Rand Paul (more of an independent libertarian than a true Republican) warned about the disaster that repeal and delay would represent. He is convinced that the only responsible approach is to replace the current plan with a new plan that promises something better. He’s right! The problem is that such a plan does not yet exist.

And Republicans have a promise to keep…..