Public Policy and Governance – Page 206

Trump’s “Perverse Miracle”

E.J. Dionne is always thought-provoking, but his column yesterday about the collapse of (small-d) democratic norms at both ends of Pennsylvania Avenue–and especially his description of the President’s current twitter storm attacking Jeff Sessions–was, as the saying goes, “dead on.”

Trump’s latest perverse miracle is that he has progressives — along with everyone else who cares about the rule of law — rooting for Sessions. The attorney general is as wrong as ever on voter suppression, civil rights enforcement and immigration. But Sessions did one very important thing: He obeyed the law.

When it was clear that he would have obvious conflicts of interest in the investigation of Russian meddling in our election and its possible links to the Trump campaign, Sessions recused himself, as he was required to do.

Trump’s attacks on Sessions for that recusal are thus a naked admission that he wants the nation’s top lawyer to act illegally if that’s what it takes to protect the president and his family.

My only quibble with this analysis is the assumption– implicit in the description–that Trump understands the difference between legality and illegality. His entire career calls into question his comprehension of law as distinct from power.

To the extent that his mental processes could be called “thought,” it appears that Trump approaches law as the ability to wield authority. The central notion of the rule of law–that no one is above the law, that rules are created in conformance with certain standards of fundamental fairness, and that they apply to everyone, irrespective of wealth or status–is clearly outside his comprehension.

Even Sessions–a contemptible bigot who has spent much of his professional life opposed to rational policies if they advanced equal rights–understood his obligation to remove himself from a situation in which he had an obvious conflict of interest.

Gail Collins summed up the situation with her usual mordant humor:

Now Trump wants Sessions gone so he can replace him with an attorney general who will fire special counsel Robert Mueller. Sessions can’t do it because he recused himself from all things Russia-related.

Mueller’s probe into the Trump camp’s relationship with Russia terrifies the president, especially if it involves an investigation of Trump family finances. So obviously, we are rooting for Sessions to stay right where he is … and, um, keep persecuting immigrants, ratchet up imprisonments for nonviolent crimes and maybe go back to his old dream of imposing the death penalty on marijuana dealers.

Well, I told you this was about irony.

In just over six months, Trump has the whole country rooting for the lesser of two evils….a “perverse miracle” indeed.

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I Do Love Juanita Jean..

Juanita Jean somehow gets wind of the most entertaining information. I hope I’m not violating fair use or some other copyright rule by sharing the bulk of this post to the World’s Most Dangerous Beauty Parlor:

Senator Susan Collins got caught accidentally (?) on a hot microphone about Blake Farenthold wanting to shoot her in a duel.

“Did you see the one who challenged me to a duel?” Collins asks.

“I know,” Reed replies. “Trust me. Do you know why he challenged you to a duel? ‘Cause you could beat the s— out of him.”

“Well, he’s huge,” Collins replies. “And he — I don’t mean to be unkind, but he’s so unattractive it’s unbelievable.”

“Did you see the picture of him in his pajamas next to this Playboy bunny?” she continues, referring to an infamous photo of Farenthold.

And it must have been Susan Collins ope mike night because she and Senator Reed continue, but about the president.

“I swear, [the Office of Management and Budget] just went through and whenever there was ‘grant,’ they just X it out,” Collins says. “With no measurement, no thinking about it, no metrics, no nothing. It’s just incredibly irresponsible.”

“Yes,” Reed replies. “I think — I think he’s crazy,” apparently referring to the president. “I mean, I don’t say that lightly and as a kind of a goofy guy.”

“I’m worried,” Collins replies.

“Oof,” Reed continues. “You know, this thing — if we don’t get a budget deal, we’re going to be paralyzed.”

“I know,” Collins replies.

“[Department of Defense] is going to be paralyzed, everybody is going to be paralyzed,” Reed says.

“I don’t think he knows there is a [Budget Control Act] or anything,” Collins says, referring to a 2011 law that defines the budget process.

Susan Collins is one of the few sane GOP Senators still serving, and one of an even smaller number willing to act on her convictions. (Unlike Mr. Much-Lauded “Maverick” McCain, who makes great speeches then obediently falls into line when it’s time to vote.) Collins is usually the soul of discretion, so the candid assessments were a departure for her . Whether the open mic was accidental or not, the exchange was illuminating.

As Collins–and undoubtedly a number of other Republican Senators–clearly understand, we have a President who has absolutely no idea how government works and no interest in finding out–for that matter, no interest in anything except twitter and self-aggrandizement. And he’s being enabled by a group of power-obsessed moral midgets, a significant number of whom are swaggering misogynists who can’t begin to match Susan Collins for balls.

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Pills and Profits

One of the many aspects of America’s mess of a healthcare landscape–a mess that the Senate GOP is trying to make much worse– is the issue of drug prices. Pharmaceutical companies defend that pricing by pointing to the significant costs of research and development.

That argument seems persuasive–if we ignore the inconvenient fact that taxpayers fund a considerable amount of that research. As Fran Quigley recently wrote in the New York Times,

How’s this for a great deal? The United States government funded research and development of a new vaccine against Zika. But the Army, which paid a French pharmaceutical manufacturer for its development, is planning to grant exclusive rights to the vaccine to the manufacturer, Sanofi Pasteur, along with paying Sanofi up to $173 million.

Sanofi will be free to charge the United States American health care providers and patients any price it wishes. Although American tax dollars funded the vaccine, and the United States took the economic risks, history suggests that many Americans would not be able to afford it.

This is a negotiating strategy of unconditional surrender. Although President Trump said before taking office that drug companies were “getting away with murder” and had campaigned on lowering drug prices, his administration is doing the opposite. A draft order on drug pricing that became public in June would grant pharmaceutical companies even more power to charge exorbitantly. For example, it could shrink a federal program that requires companies to sell at a discount to clinics and hospitals serving low-income patients.

Another major problem is the fact that for-profit drug manufacturers have little incentive to produce medications for which there are no markets, so diseases that are widespread in poorer countries get little attention. Quigley notes that, of the 756 new drugs approved between 2001 and 2011, fewer than 4 percent targeted so-called “neglected” diseases, despite the fact that those diseases afflict one out of every six people in the world.

A new drug company intends to change that reality.

Pécoul and Doctors Without Borders decided to tackle the diseases that were killing the global poor. Doctors Without Borders dedicated its 1999 Nobel Peace Prize award money to providing seed funding for the Drugs for Neglected Disease Initiative, known as D.N.D.I. The aim was to see what could be accomplished when research priorities ignore questions of profitability, and the price of medicines is “delinked” from research costs, which are instead shouldered by public financing or philanthropy.

An immediate challenge was that D.N.D.I. possessed none of the required hardware for the expensive drug research and development process: It had no labs, no manufacturing facilities, and no distribution process. It fell to Pécoul to recruit partners, including private pharmaceutical companies he persuaded to share drug compounds that had been uncovered but abandoned because of lack of profitability…

D.N.D.I. has already delivered seven new patent-free, low-cost treatments for neglected diseases.

Interestingly, D.N.D.I. has created these seven drugs, with 30 more in testing, at a cost of $290 million to date. For-profit pharmaceutical manufacturers have long claimed that it costs them $2.5 billion to develop a single drug, although critics insist that the figure is an exaggeration intended to justify higher-than-necessary prices.

D.N.D.I. conducts “open source” research, and does not patent its drugs.

Pécoul and his D.N.D.I. colleagues say their biggest challenge now is securing sustainable funding for research — another illustration of the limits of a model with no profits to invest in research. But the government funds research all the time — it’s just often turned over to for-profit companies. The Zika vaccine is one example. The prostate cancer drug pacilataxel, the leukemia medicine imatinib and many mental health and H.I.V. medicines and vaccines can all trace their origins to government-funded research — only to be handed over to industry to charge what they want.

As the article makes clear, this model cannot replace for-profit drug manufacture. But if governments provide more resources to nonprofit companies modeled after D.N.D.I, their products, at least, would be available and affordable to everyone.

Some economists have argued that since Medicare and Medicaid are the leading purchasers of drugs (and Medicare is forbidden by law from negotiating on price), the money saved by buying from nonprofit drugmakers could easily replace all privately funded research and development. The increased public research dollars could then be applied, D.N.D.I.-like, to develop the medicines that would have the most significant public health impact.

Focusing tax dollars on the public good…what a concept!

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Democracy Vouchers

The outrage that followed the Supreme Court’s decision in Citizens United focused national attention on a problem that has long preceded that unfortunate ruling: the influence of money on democratic deliberation.

Even if we ignore the armies of lobbyists and the corrupting influence of “big money” campaign donations in Washington and our state capitals, anyone who is at all familiar with the way in which policy is made understands that our elected representatives respond to the constituents from whom they hear, and those constituents are highly unlikely to be poor people.

People who are struggling to make ends meet rarely have time or energy to visit legislative bodies, testify in hearings or participate in grass-roots lobbying efforts. And it goes without saying that they are not numbered among the donors to legislative campaigns. As a result, even the most conscientious lawmakers (and they do exist) simply do not hear the voices and perspectives of working class Americans.

Seattle has recently embarked upon an effort to change that dynamic, at least to a degree.

If money amplifies the voices of wealthy Americans in politics, Seattle is trying something that aims to give low-income and middle-class voters a signal boost.

The city’s new “Democracy Voucher” program, the first of its kind in the US, provides every eligible Seattle resident with $100 in taxpayer-funded vouchers to donate to the candidates of their choice. The goal is to incentivize candidates to take heed of a broad range of residents – homeless people, minimum-wage workers, seniors on fixed incomes – as well as the big-dollar donors who often dictate the political conversation.

This August’s primary is the trial run for the program. But before Seattle can crow about having re-enfranchised long-overlooked voters, it must contend with conservative opposition.

A Libertarian law firm has sued the city to stop the program, alleging that democracy vouchers violate the first amendment rights of homeowners because their taxes are funding vouchers that will be contributed to candidates they oppose. That case is pending, but constitutional lawyers consider its prospects dubious.

The program opponents appear to be in the minority; the voucher program and its funding mechanism (a 10-year, $30m property tax levy) were approved by voters in a ballot measure in November 2015. All registered voters are sent the vouchers automatically. Residents who are not registered or who lack a permanent address – such as homeless people – can apply by mail or in person.

Seattle’s proposal joins other efforts that have emerged in the wake of the Obama and Sanders campaigns, both of which demonstrated that significant funds could be raised through appeals to small donors–no one of whom, presumably, would have the same ability to influence policy as individuals contributing large sums.

Last fall, South Dakota voters approved a program similar to Seattle’s, joining more than a dozen other states with some form of public financing, usually a matching fund for small campaign donations. Cities such as Portland, Oregon, and Berkeley, California, also followed the public-financing trend last year.

Democracy Vouchers are unlikely to make much of a dent in current levels of inequality of political influence, but the effort is encouraging. It represents an acknowledgment of the disparity in political influence between the rich and the rest, and to the extent it encourages candidates to focus fundraising strategies on vouchers/small donors, it should add a (currently absent) perspective to the political conversation.

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Me and Thee…

One of most persistent–and pernicious–beliefs about inequality is the conviction that people “deserve” financial success or failure. If you are poor, the logic goes, that probably reflects some poor choices you made along the way, or your unwillingness to work hard, or perhaps a lack of innate capacity.

America’s approach to poverty owes a lot to the Fifteenth-century English poor laws that made it illegal to “give alms to the sturdy beggar.” Those laws, and subsequent policy approaches, categorized poor folks either as “deserving” (the widow and orphan) and “undeserving” (the sturdy beggar); that framework is ultimately responsible for the establishment and maintenance of a bureaucracy devoted to ferreting out the “undeserving,” and a political reluctance to provide an adequate social safety net since it might inadvertently benefit undeserving folks.

The Guardian recently reported on a group of scholars who are researching the basis of our very human tendency to see our own misfortune as just that–misfortune–while attributing other people’s situations to their character flaws. They are studying how rich and poor people alike justify inequality.

What these academics are finding is that the American dream is being used to rationalize a national nightmare.

It all starts with the psychology concept known as the “fundamental attribution error”. This is a natural tendency to see the behavior of others as being determined by their character – while excusing our own behavior based on circumstances.

For example, if an unexpected medical emergency bankrupts you, you view yourself as a victim of bad fortune – while seeing other bankruptcy court clients as spendthrifts who carelessly had too many lattes. Or, if you’re unemployed, you recognize the hard effort you put into seeking work – but view others in the same situation as useless slackers. Their history and circumstances are invisible from your perspective.

This belief is closely related to the myth that America is a meritocracy, and that with hard work, education and some “moxie,” anyone can get ahead. That perception was never really accurate (ask African-Americans or women), but America did once have much greater social mobility than it does today.

The research notes a widespread suspicion that “they” are abusing/misusing social welfare programs that “my” taxes support, and a corresponding resentment of “them.” (The article notes that this attitude was a prominent characteristic of Trump voters.)

Another aspect of this phenomenon is known as “actor-observer bias”. When we watch others, we tend to see them as being driven by intrinsic personality traits, while in our own case we know that, for example, we acted angrily because we’d just been fired, not because we’re naturally angry people….

In other words, other poor people are poor because they make bad choices – but if I’m poor, it’s because of an unfair system. As a result of this phenomenon, Pimpare says, poor people tend to be hardest on each other. He gives the example of a large literature in anthropology and sociology about women on welfare published since the 1980s. “It finds over and over again that some of nastiest things you ever hear about women on welfare come out of the mouths of women on welfare.”

Wealthier folks, of course, embrace the “deserving/undeserving” dichotomy because it justifies their more comfortable status.

The political consequences of this phenomenon are obvious: if even the people who stand to benefit most from a more equitable and generous safety net are convinced that it mainly rewards the non-deserving, we aren’t likely to see systemic reforms any time soon.

Breaking down these misconceptions won’t be easy, either, because the research underlines the importance of human contact. As we have learned with racial and religious stereotyping, integration and interaction are powerful weapons against demonization.

Intimate contact – such as the experience of teaching in the inner city, mentoring, other types of services that allow people to connect despite class difference – builds empathy. The more you engage with with people unlike you and learn about their lives and stories, the harder it is to see them as stereotypes or to dismiss their challenges as trivial.

In a society characterized by significant inequality, exclusionary zoning, gated communities and our voluntary segregation into enclaves inhabited by the like-minded–what Bill Bishop has dubbed “the Big Sort”–it is going to be very difficult to encourage that “intimate contact.”

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