Category Archives: Public Policy and Governance

They Run (for Office) and They Hide….

The unremitting chaos in Washington has triggered a number of Town Halls in which GOP members of Congress have faced rooms filled with angry constituents. As a result, a number of other Representatives have evidently decided against holding such events.

Not surprisingly, hiding from the people you represent hasn’t made those constituents very happy. Their reactions have varied.

I recently had an interesting conversation with a woman who lives in Indiana’s Fifth District, represented by Congresswoman Susan Brooks. She told me that she and several of her friends and neighbors had been frustrated by Brooks’ unwillingness to hold a Town Hall, so they decided that they would organize a meeting and invite her. If she wasn’t going to take the initiative, they would.

A meeting was organized via Facebook and word of mouth, and at 2:00 in the afternoon of May 13rth, approximately 120 5th District constituents gathered at the Sullivan Muncie Cultural Center in Zionsville.

Brooks declined to appear, nor did she send a representative, so the organizers set up an empty chair with her photo and proceeded to conduct a meeting without her.

According to her report, the voters who gathered at the Cultural Center were there primarily to voice their very serious concerns about the GOP Healthcare Plan, although  several other issues were raised as well.

Given the Congresswoman’s reluctance to attend either in person or through a surrogate, the organizers anticipated an effort to dismiss attendees as “agitators” or people from outside the district; in order to rebut any such claims, they prepared a “sign in” book in which those present provided their names, addresses and emails.  During the meeting, each voter was offered an opportunity to speak, to fill out a card with questions for Ms. Brooks, and to sign a large paper scroll expressing their views. The organizers plan to deliver these items to Brooks’ office.

The constituents who spoke at the nearly three-hour meeting shared stories of people with pre-existing conditions, children with ongoing medical needs, and people injured on the job who then saw those jobs eliminated. They  talked about the extent to which they and their families would be harmed by the repeal of Obamacare and its replacement by the current iteration of the GOP healthcare bill.  Some cried.

At the conclusion of the emotional meeting, those in attendance agreed to redouble efforts to meet face to face with Congresswoman Brooks. With or without the Congresswoman, however, they are determined to hold a series of Town Hall Meetings throughout the 5th District.

What is remarkable about this–at least to me–was the event’s genesis and spontaneity. I’ve complained bitterly over the years about Hoosiers’ civic apathy and lack of political engagement, our embarrassingly low voter turnout…Yet here in central Indiana, with no partisan sponsorship, no encouragement from activist organizations, no donations from any lobby or special interest group, ordinary voters got together and demanded to be heard.

It will be fascinating to watch this new democratic (small d) wave play out, not just in Indiana but in Congressional districts across the country. Will elected officials listen? If not, will they be voted out? How safe are those safe, gerrymandered districts?

What’s that old saying? They can run but they can’t hide….

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Making America Sick Again

With the introduction of its proposed budget, the Trump Administration has continued its effort to cut the ground out from under all but the wealthiest Americans–and especially from under the people who voted for Trump.

Fortunately, that budget displays the stunning ineptitude that is a hallmark of this Administration (Hey–what’s a two trillion dollar math mistake among friends..?) and is unlikely to pass.

We often hear exhortations to “follow the money,” or to “put your money where your mouth is.” Those phrases reflect an undeniable truth of human behavior: whatever our rhetoric, where we commit our resources shows our real priorities.  Trump’s budget not only makes his priorities painfully clear; it reflects his callous disregard for struggling Americans, including those who voted for him.

Time Magazine has detailed the consequences of the savage Medicaid cuts proposed by the Trump budget. Nearly one in four Americans–and 42 percent of Trump voters– rely on Medicaid. The budget assumes passage of the deeply unpopular Obamacare replacement passed by the House and currently pending in the Senate; that measure–which the CBO calculates would cost 23 million Americans their health insurance– cuts Medicaid funding by $839 billion over the next decade. The budget proposal reduces Medicaid by an additional $610 billion.

Those cuts endanger medical access for 74 million Americans.

Medicaid reaches far beyond able-bodied adults out of work, despite the proposal’s rhetoric. The elderly and disabled account for around 60% of Medicaid’s expenditures, with the disabled, including the mentally ill, accounting for a full 42% of spending.

The program is the country’s largest funder of long-term care expenses, covering 40% of the costs, as well as more than 60% of all nursing home residents. For Baby Boomers nearing or past retirement age, these funds are crucial: As MONEY has previously reported, nursing homes for the elderly cost an average of $80,000 annually, and those expenditures aren’t covered under Medicare, the health program for seniors over 65. In fact, because Medicaid absorbs high healthcare costs of people with expensive conditions like dementia, it has kept private insurance around 7% lower than they would be.

Slashing funds also disproportionately affects women and children: one-half of births in the U.S. are covered by Medicaid (that varies widely by state—in Louisiana, 65% of births are covered by Medicaid, according to the Kaiser Family Foundation). The Children’s Health Insurance Program, which covered more than 8.4 million children in 2015, would also see its budget significantly reduced, according to Joan Alker, Executive Director of the Georgetown Center for Children and Families. Medicaid also provides essential health coverage for low income women, particularly women (and children) of color.

And of course, the budget continues the Republican war on women and women’s health by defunding Planned Parenthood–effectively eliminating preventive care (pap tests, breast cancer screenings) for most poor women.

Pointing to the cruelty of this proposal is unlikely to move lawmakers for whom tax cuts for rich people are the highest priority, but you would think they might realize that such a wholesale assault on access to preventive care would wildly increase overall medical costs. (The old adage “penny wise, pound foolish, comes to mind.) Trump’s budget would throw people back to the tender mercies of the emergency room, return us to the days when medical costs and nursing home fees bankrupted families, and ensconce a system in which healthcare is simply a consumer good, available to those who can afford it and too bad for the rest of you.

Destroying Obamacare and slashing Medicaid aren’t even the end of the story: the proposed budget also “severely cuts funding for science and public health agencies, including a $1 billion cut to the National Cancer Institute.”

Notably, the National Institute of Health’s budget would be slashed from $31.8 billion to $26 billion. The Center for Disease Control and Prevention would face cuts of more than $1 billion, including a $222 million decrease in funding to the chronic disease prevention programs, which help people with conditions like diabetes, heart disease, and obesity.The National Science Foundation would face a decrease of $776 million.

Welcome to dystopia.

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“Those People”

Most of us have been in conversations that included someone’s dismissive reference to “those people.”

When I was growing up in Anderson, Indiana (with exactly 30 Jewish families in the whole town), the term was often applied to Jews. It was also–and remains–a favored euphemism when race is being discussed by people who don’t like to think of themselves as racists; they just substitute “those people” for the “n” word when discussing the “lower orders.”

“Those people” is also a term frequently applied to the growing number of poor Americans. And it is particularly harmful when used in the context of economic policy. “Those people” wouldn’t need health care if they didn’t eat junk foods and fail to exercise; “those people” wouldn’t need social welfare programs if they weren’t lazy; any benefits provided to “those people” must be closely monitored, because they will use food stamps for candy and/or booze…”Those people” are irresponsible.

Facts and evidence are inconvenient things. Most poor people, according to overwhelming evidence, work 40 or more hours a week. Most recipients of food stamps use them to buy food. And there is growing evidence that needy folks are anything but irresponsible when they are given cash in lieu of benefit programs that are strictly “monitored.”

A recent study conducted by the Roosevelt Institute describes that evidence.

Providing cash directly to individuals has often been met with criticism, suspicion, and fear: the thinking goes that people who need financial assistance are not to be trusted, as their financial position reflects a moral failing rather than a societal one. These objections to cash transfer programs are rooted more in myth than empirical evidence. As the debate about a universal basic income gains prominence, it is important to set the record straight about the behavioral effects of unconditional cash assistance.

In this evidence review, we explore how unconditional cash transfers affected the behavior of recipients in three major natural experiments. While the amounts dispersed and time periods were distinct in each experiment, each provided money without set conditions and without a means test. We synthesize data for the following outcomes: consumption; labor force participation (employment, hours worked, and earnings); education; health; and other social outcomes, such as marriage or fertility choices. Each of these programs shares different components of a universal basic income (UBI), a cash transfer that everyone within a geographic/political territory receives on a regular basis with no conditions on a long-term basis. By understanding the effects of these programs, we can generate answers to how an unconditional cash transfer program might affect recipients in the future.

We may well be transitioning to an economy that simply cannot provide jobs for those who want them. Automation, as I’ve previously noted, is rapidly making many jobs obsolete. Changes in the way we purchase items–especially consumer goods– is inexorably reducing the number of workers in retail occupations.

The transformation of the economic landscape is accelerating, and it is a huge challenge–one which we ignore at our peril.

A UBI–a guaranteed basic income– may or may not be a viable approach to the dislocations to come. But continuing to sneer at the behavior of “those people” and dismissing emerging evidence of the utility of new social welfare proposals is clearly less viable.

A lot of the people who use the phrase aren’t all that far from becoming one of “those people” themselves.

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What Do THEY Know??

The Trump Administration’s war on expertise continues to expand.

Jeff Sessions (memorably identified by a Facebook friend as one of those Confederate monuments that should be removed) ignores 40+ years of criminal justice research and intensifies the drug war.  Betsy DeVos gives a feminine finger to the mountains of data rebutting her insistence that vouchers improve educational outcomes. Scott Pruitt spits on the 98% of climate scientists who agree that climate change is (a) real; (b) accelerating and (c) caused by human activity, especially fossil fuel use.

There is a reason that terms like “Know Nothings,” “Keystone Kops,” and “Gang that Can’t Shoot Straight” are being retrieved from past usage and applied to this sorry band of incompetents and theocrats.

When it comes to economic policy, Trump’s alternate reality isn’t limited to his belief that he invented the term “priming the pump.” As a column from the Washington Post recently reported,

President Trump’s administration says his tax cut will pay for itself. It turns out it’s really hard to find an economist who agrees.

The University of Chicago’s Booth School of Business regularly polls economists on controversial questions. In a survey the school published last week on Trump’s tax plans, only two out of the 37 economists that responded said that the cuts would stimulate the economy enough to cancel out the effect on total tax revenue.

Those two economists now both say they made a mistake, and that they misunderstood the question.

So there is not a single economist in the Chicago poll who agrees with the President that his proposed tax cuts would pay for themselves.

Not that the opinion of 39 out of 39 experts has a chance in hell of influencing a Commander-in-Chief whose residence in a very bizarre alternate universe becomes more apparent every day.

In Trump World–a world shared to varying degrees by the members of his spectacularly ignorant and incompetent cabinet–Trump knows more than those elitists who actually studied their subject matter. Sissies read books and conduct empirical research; superior beings (i.e. rich guys) surround themselves with lackeys and listen to their guts.

What did Stephen Colbert call it? Oh yes–Truthiness.

To use a term dear to the heart of our linguistically-challenged President, SAD.

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Jeff Sessions, Drugs and the Late Lamented GOP

Jeff Sessions is a poster boy for the contemporary GOP–a perfect example of its takeover by racists, misogynists and anti-intellectuals, and its retreat from (and misapplication of) its philosophical roots.

Nowhere is the intellectual and moral corruption Sessions represents clearer than in his enthusiasm for re-instituting the War on Drugs–a counterproductive effort that even the rank and file of the GOP has largely abandoned.

Whether Sessions’ determination to go after marijuana, as well as harder drugs, is a result of his inability or unwillingness to understand the research, or is prompted by investments in the private prison industry, as has been speculated, is beside the point. In either case, Sessions is an example of the division–the abyss– between thoughtful adherents of principled conservatism and the ideologues who appeal to a far less thoughtful Republican base.

Nothing makes those contemporary Republican divisions clearer than a recent issue of Policy Analysis, a publication of the Cato Institute. Whether one agrees with its positions or not, Cato is indisputably home to legitimate scholars who make principled and consistent arguments for a libertarian point of view that used to be widely accepted–albeit never dominant–within the GOP.

Unlike today’s Republicans, Cato does not confine its application of libertarianism to economic issues and the boardroom while cheerfully endorsing theocratic control of personal behaviors.

The Institute’s current research adds to the great weight of evidence against Session-like drug policy, as the introduction makes clear:

Proponents of drug prohibition claim that such policies reduce drug-related crime, decrease drug-related disease and overdose, and are an effective means of disrupting and dismantling organized criminal enterprises.

We analyze the theoretical underpinnings of these claims, using tools and insights from economics, and explore the economics of prohibition and the veracity of proponent claims by analyzing data on overdose deaths, crime, and cartels. Moreover, we offer additional insights through an analysis of U.S. international drug policy utilizing data from U.S. drug policy in Afghanistan. While others have examined the effect of prohibition on domestic outcomes, few have asked how these programs impact foreign policy outcomes.

We conclude that prohibition is not only ineffective, but counterproductive, at achieving the goals of policymakers both domestically and abroad. Given the insights from economics and the available data, we find that the domestic War on Drugs has contributed to an increase in drug overdoses and fostered and sustained the creation of powerful drug cartels. Internationally, we find that prohibition not only fails in its own right, but also actively undermines the goals of the Global War on Terror.

Right now, all eyes are on the harm being done to our nation by the embarrassing buffoon in the Oval Office and his cabinet of theocrats and incompetents. That harm is real. But an even greater and more long-term harm comes from the collapse of a once-respectable political party capable of articulating a serious, intellectually  challenging conservative philosophy.

Much as partisans like to believe it, no political party has all the answers to the dilemmas of modern society. Without the advantage of adult conversation and debate, without the ability to consider and evaluate contending good-faith approaches to our common problems, America can’t move forward.

As long as the GOP remains dominated by clones of Jeff Sessions — in thrall to a rigid ideology, bound to partisan litmus tests, and convinced that genuine consideration of probative evidence is tantamount to betrayal– we all lose.

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