Public Policy and Governance – Page 51

Time For A Realignment

Recent events have increased my belief that the U.S. is at a political tipping point.

In the past few weeks, in addition to the mass shootings that are now horrifyingly routine, we’ve seen Tennessee’s gerrymandered White Republican legislature expel two young Black Democrats who breached “House Order”–despite that body’s unwillingness to expel White Republicans accused of sexual misconduct and criminal activity.

Immediately after a jury found a defendant guilty of intentionally murdering a Black Lives Matter demonstrator, Greg Abbott vowed to pardon him.

Then, thanks to Pro Publica– in deeply-researched reports which have once again underlined the importance of a free and vigorous press–Americans learned that Clarence Thomas’ corruption extends well beyond his widely-criticized refusal to recuse himself from cases involving organizations with which his wife has been active. Not only did Thomas accept trips on yachts and luxurious accommodations worth millions from his “dear friend” Harlan Crowe (a “friendship” that began five years after Thomas joined the Court), not only did Crowe’s purchase of real estate from Thomas (at an evidently inflated price) go similarly unreported, we’ve also learned that Crowe’s creepy collection of memorabilia includes two pictures painted by Hitler and a signed copy of Mein Kampf.

We also learned that, early in their “friendship,” Thomas had reported some of those gifts, but when those reports generated criticism, rather than stop accepting them, Thomas stopped reporting them.

It isn’t just Clarence Thomas.

For years, the American public ignored the legal profession’s exhortations about the importance of the judicial branch, and the need to vote against lawmakers intent upon elevating ideologues to the bench. It’s not just Thomas and the rabidly conservative bloc that now dominates the Supreme Court; thanks to a rogue Texas Judge, a lot more people understand the importance of an intellectually honest, honorable and professionally competent judicial branch.

A federal judge in Texas issued a preliminary ruling invalidating the Food and Drug Administration’s 23-year-old approval of the abortion pill mifepristone, an unprecedented order that — if it stands through court challenges — could make it harder for patients to get abortions in states where abortion is legal, not just in those trying to restrict it.

Kacsmaryk’s ruling wasn’t unexpected. Since Trump placed him on the bench, this poster boy for judicial activism has been the choice of forum-shopping rightwing extremists who’ve responded to clear signals that he would ignore legal precedents that conflicted with his religious beliefs. Among other numerous legal deficits, this particular decision ignored a six-year statute of limitations, rules governing standing, and sound science.

Worse–as two hundred drug companies pointed out in a letter blasting the decision,

“The decision ignores decades of scientific evidence and legal precedent,” the drugmakers wrote. “Judge Kacsmaryk’s act of judicial interference has set a precedent for diminishing FDA’s authority over drug approvals, and in so doing, creates uncertainty for the entire biopharma industry.”

Should the decision be upheld, the consequences of second-guessing the experts at the FDA decades after the fact would threaten investment in all new medications, not just those related to reproduction.

Meanwhile, Rightwing activists and lawmakers are continuing their attacks on local school boards and libraries, and Republican legislators in Red states continue to focus mean-spirited and dishonest attacks on trans children and the medical professionals who treat them.

The narrow focus on transgender folks is strategic. Polling has confirmed that significant majorities of Americans now support same-sex marriage and anti-discrimination laws protecting LGBTQ+ citizens, making wholesale attacks on the gay community politically unwise.

Nearly eight in ten Americans (79%) favor laws that would protect gay, lesbian, bisexual, and transgender people against discrimination in jobs, public accommodations, and housing, including 41% who strongly support them.

Trans children are more vulnerable–in more ways than one.

As Jennifer Rubin wrote in the Washington Post

It is one thing to gin up the base on invented threats from critical race theory or the “great replacement theory.” But when the MAGA movement’s judges begin to inflict radically unpopular edicts on those outside the right-wing audience, that risks sparking a counter-response: a determined, broad-based movement insistent that the United States not turn the clock back on decades of social progress….

The more the Supreme Court diverges from overwhelming public sentiment on issues such as abortion, guns and voting rights, the more strength and more allies the progressive movement may gain.

Add to all this the ongoing antics of the buffoons in Washington whose behavior continues to prevent anything remotely resembling thoughtful governance, the constantly unraveling spectacle that is Donald Trump, and the increasingly overt racism and misogyny that pervades today’s GOP.

Walter Dean Burnham once argued that there’s a 30–38 year “cycle” of political realignments.

We’re overdue, but the signs are there.

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Tennessee, Clarence Thomas And The Corruption Of American Democracy

Question: What do Clarence Thomas and the Republican legislators in Tennessee have in common? Answer: They both epitomize the corruption of American democracy–a corruption that has led to a precipitous decline in public confidence in America’s governing institutions.

Several media outlets have reported on recent polling from Gallup that shows trust in the judicial branch at record lows. Only 47 percent of Americans have “a great deal” or “a fair amount” of trust in the federal judiciary– a drop of 20 percentage points from two years earlier. When asked about the Supreme Court, it was worse: 58 percent disapproved of the high court’s performance.

Those numbers are unlikely to improve following the most recent disclosures about Justice Thomas and his “dear friend” Harlan Crowe. The initial revelations about Thomas’ acceptance of luxurious trips were stunning enough, but the Justice’s argument that he hadn’t needed to report them since they were just “hospitality”–while unconvincing–left him some rhetorical wiggle-room.

The latest revelations don’t.

This time, Thomas directly received money from Crow — perhaps in excess of the market value of the Chatham County, Ga., properties that Crow purchased from Thomas and his kin. This is no longer about receiving “personal hospitality.” It’s about a financial transaction between Thomas and a GOP donor who has also subsidized his vacations.

There is no doubt that the sale of personal real estate to Crow should have been reported on the justice’s financial disclosure form for 2014, and there is no excuse for failing to do so. The most logical explanation is that Thomas, whose relationship with Crow had already been the subject of unflattering news reports, wanted to keep it from public view.

The linked article also notes that Thomas has failed to report his wife’s considerable income from Rightwing organizations–although the law clearly requires that income to be reported.

Inescapable bottom line: Clarence Thomas is corrupt, and his judicial decisions are compromised.

Then there is the emerging information about the Tennessee legislature–information that probably would not have been uncovered or widely disseminated had that body not over-reacted to a breach of House decorum by expelling two young Black Democrats.

Democracy Docket has taken a deeper dive into that gerrymandered legislature’s disdain for representative democracy. Tennessee, like Indiana, has a Republican super-majority–courtesy of gerrymandering–that routinely acts to disempower state Democrats.

Some examples:

Tennessee’s Democratic cities have come under a coordinated attack from lawmakers. In March, Gov. Bill Lee (R) signed a law that forces the Nashville Metro Council to reduce its membership by half. Two lawsuits were filed challenging the law and on April 10, a Tennessee court temporarily blocked portions of the law while litigation continues.

After the expulsion of Pearson, GOP legislators threatened to withdraw funding from important projects in Memphis’ Shelby County if Pearson was reappointed.

In the latest round of redistricting, the Legislature divided Davidson County, home to Nashville, into three separate districts, dismantling the city’s Democratic-held seat. The lawmakers also approved state legislative districts that entrenched Republican supermajorities in both chambers of the Legislature. (Notably, the recent expulsions were only possible because of GOP supermajority control.)

Tennessee denies voting rights to over 470,000 citizens with one of the strictest (and most complicated) felony disenfranchisement laws in the United States. The state disenfranchises 21% of its Black voting-age population, the highest percentage in the country.

Tennessee has restrictive voting laws, leading to a low democracy tally by the Movement Advancement Project. Instead of improving voting access, the Legislature’s priorities have included laws requiring state and local officials to consult with the legislative leadership before changing certain state election laws and prohibiting election offices from accepting any private grant for election administration.

And we wonder why Americans no longer trust our political institutions…why so many of us have moved from skepticism to cynicism.

Political trust is generally described as citizens’ confidence in their political institutions. As political scientists repeatedly warn, that trust is an important component and indicator of political legitimacy; its erosion is not something to be taken lightly.

As I used to tell my students, an enormous number of American laws depend upon voluntary compliance by citizens–everything from filing taxes to obeying traffic signals. The ability of the authorities to catch and punish scofflaws depends upon the fact that the rule-breakers are relatively few. When citizens no longer trust that those in power are following the rules, rising numbers of them will feel justified in breaking those rules as well.

And it’s all inter-related

A properly functioning Supreme Court would have outlawed the rampant gerrymandering that produced Tennessee’s –and other state’s–rogue legislature.

As NASA might put it: Houston, we have a problem.

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Health And Wealth

Speaking of health…

When I was still practicing law, I did a fair amount of work for nonprofit organizations.

Most of the nonprofits for which I drafted articles of incorporation or amended bylaws, or those I simply represented in various transactions, were “true” nonprofits–everything from Little League teams to small “do-gooder” groups focused on addressing a social ill. I want to be clear that I am not talking about those organizations, or criticizing their tax-exempt status–a status that was intended to facilitate the provision of socially-beneficial goods and services.

But. (You knew there was a “but,” didn’t you.)

There are also far too many “nonprofit” organizations that are really cleverly-veiled for-profit business enterprises. So long as talented lawyers can describe the business with language indicating a charitable mission of some sort, these enterprises escape both income and property taxation, padding what would otherwise be the bottom line.

And about that bottom line–rather than sending what are actually profits to shareholders or other investors to be taxed, as for-profit enterprises do, sizable chunks of those dollars are used to inflate the salaries paid to management personnel (who–surprise!– often were the founders of the organization), transforming them into expenses of the enterprise.

Legal magic!!

Back in my lawyering days, this was one of the many things that royally pissed me off. I revisited that annoyance when I read a recent article by Michael Hicks in the Capital Chronicle. Hicks has periodically focused on the economic shenanigans of Indiana’s hospitals–all of which are theoretically nonprofit, and many of which actually are.

Hicks reminds us that the benefits bestowed by nonprofit status are in exchange for the “well established notion that nonprofits advance the public good.”

Today, nearly every hospital corporation in Indiana is a not-for-profit. I’m pleased to report, that insofar as I can judge from the data, most are focused on that well established notion of ‘advancing the public good.’

In fact, it would seem that only five or six of Indiana’s not-for-profit hospital firms have dispensed with any pretense of “advancing the public good.” Now, this doesn’t mean they aren’t doing good things that folks are willing to pay for. But, so do Walmart, J.P. Morgan Bank, Amazon, and McDonalds. One key difference is that we tax these for-profit firms.

Hicks then tells us that, in 2020, the nation’s largest for-profit hospital, HCA, reported a 7.3% profit. That same year, Ascension Health in Indiana reported a 41% profit, Community Health Network reported 23.3%, IU health reported 22% and Deaconess reported 13.8%. As he writes, this is flagrant misuse of the not-for-profit status.

If these were for-profit firms, their investors would’ve had a windfall. Instead, they put that money in money market accounts, or offshore investments. That money should flow back into Hoosier communities instead of leaving the state. The losses are startling. Roughly 60% of all the economic growth in Muncie over the last decade was swallowed just by the profits of IU Health and Ball Memorial Hospital.

The article then focused on Ascension St. Vincent, which recently announced plans to close 11 clinics in Indiana.

Now, I’m sure this was a random coincidence that had nothing to do with pending legislation aimed at their monopoly power. If reporting is true, most of these clinics were profitable. Of course, system-wide, Ascension is fabulously profitable. In the last year for which we have data, they reported making a profit of more than $308, 000 per employee, less than half of which was from healthcare services. Ascension Health is today a financial services firm that claims heritage from Catholic charities, but now only dabbles in healthcare.

The decision to close less profitable clinics would be a typical business decision of a venture capital firm. But, it is wholly incompatible with the “notion that nonprofits advance the public good.” Ascension is a ‘not-for-profit’ entity in name only. Its behavior is that of a large conglomerate. They are not alone. In 2020, IU Health reported a tad more than $4 billion in physical assets in Indiana. Their investment holdings were $7.8 billion. They also made $49,600 per worker in profits in 2020.

There is much more data in the article, all of which supports Hick’s thesis that “these big ‘hospitals’ are really just large financial services firms, who own construction firms, physician offices, restaurants and yes, hospitals.” If Indiana had a legislature that focused on the welfare of Hoosiers, that body might remove the nonprofit status of systems behaving like venture capitalists.

Removing the not-for-profit status would generate huge tax dollars for cities across Indiana, expose these hospitals to federal laws on non-compete and increase the probability of enforcement of anti-trust regulations.

Welcome to yet another aspect of privatized health care…It costs Americans a lot to reject the “socialism” of a national health system.

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Oh, Indiana…

I recently read that Indiana’s legislative overlords are taking time out from their attacks on women and trans children, and deigning to address an actual issue–the health of Hoosier citizens.

I haven’t been following those health measures, and to be honest, I lack the background to properly evaluate them in any case, so I thought I’d pose a question to my new research assistant, otherwise known as ChatGPT.

Here’s what I asked:

Please locate Indiana’s relative performance in health related areas, especially drug and alcohol abuse rates, infant mortality, smoking statistics, suicides, life expectancy, and other wellness markers like mental health.

Here’s what I got:

Sure, here is some information on Indiana’s relative performance in health-related areas:

Drug and alcohol abuse rates: According to data from the National Survey on Drug Use and Health (NSDUH), Indiana has higher than average rates of substance abuse, particularly with regard to prescription pain relievers and synthetic opioids. In 2019, Indiana had the 9th highest rate of drug overdose deaths in the United States, with a rate of 27.5 deaths per 100,000 population.

Infant mortality: Indiana has one of the highest rates of infant mortality in the country, with a rate of 6.8 deaths per 1,000 live births in 2019. This is higher than the national average of 5.6 deaths per 1,000 live births.

Smoking statistics: Indiana has one of the highest rates of smoking in the United States, with an adult smoking rate of 21.1% in 2019. This is higher than the national average of 14.0%.

Suicides: Indiana has an above-average rate of suicide, with a rate of 16.9 deaths per 100,000 population in 2019. This is higher than the national average of 13.9 deaths per 100,000 population.

Life expectancy: Indiana’s life expectancy is slightly lower than the national average, at 76.7 years in 2019 compared to the national average of 77.3 years.

Mental health: Indiana has lower than average rates of mental health care access and high rates of mental illness. According to Mental Health America’s 2021 report, Indiana ranks 45th out of all states and the District of Columbia in terms of overall access to mental health care. Additionally, Indiana has the 5th highest rate of adult mental illness in the United States.

It’s worth noting that these rankings and statistics are subject to change over time and may vary depending on the specific sources and data used.

You might think that–given the sad state of Hoosiers’ health–healthcare might take priority over efforts to stymie DEI investing and destroy the state’s public schools–but of course, this is Indiana….Even a superficial look at General Assembly priorities is enough to demonstrate lawmakers’ utter disregard for public health.

In the wake of Dobbs, Indiana lawmakers couldn’t wait to ban abortion–despite overwhelming evidence that reproductive care–including abortion–is an essential element of women’s healthcare.

Then, of course, there’s the legislature’s ongoing love affair with guns, despite polling showing that a majority of Hoosiers (including a majority of NRA members) support additional regulation.

Perhaps the most direct evidence of our legislature’s lack of concern for the health of their constituents was this session’s mean-spirited denial of appropriate health care to trans children. I went back to ChatGPT for an explanation of the health consequences involved.

Denying appropriate medical care to transgender young people can have serious medical and emotional consequences. Here are some of the potential outcomes:

Delayed or absent puberty: Transgender young people who are denied appropriate medical care may not undergo puberty at the same time as their peers, or may not undergo puberty at all. This can lead to social isolation, low self-esteem, and feelings of dysphoria.

Increased risk of mental health problems: Transgender young people who are denied appropriate medical care may experience depression, anxiety, and other mental health problems as a result of the distress caused by their physical dysphoria.

Increased risk of suicide: Studies have shown that transgender young people who are denied appropriate medical care have a higher risk of suicidal ideation and suicide attempts.

Increased risk of physical health problems: Transgender young people who are denied appropriate medical care may be at increased risk of physical health problems related to their gender dysphoria, such as urinary tract infections or other complications from avoiding the use of restrooms that do not match their gender identity.

Reduced life expectancy: Transgender people who are denied appropriate medical care may have reduced life expectancy due to the physical and mental health problems they experience as a result of their gender dysphoria.

Overall, denying appropriate medical care to transgender young people can have serious and potentially life-threatening consequences. It is important for healthcare providers and society as a whole to recognize and respect the healthcare needs of transgender youth, and to provide them with the necessary medical care and support to live healthy and fulfilling lives.

Our legislative culture warriors don’t care.

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Gerrymandering And The Tennessee Three

I’ve repeatedly inveighed against gerrymandering on this blog. (Anyone who wants to revisit the multiple ills that flow from that nefarious practice need only put “gerrymandering” into the search box and re-read those periodic rants.) I wouldn’t test the patience of my regular readers by returning to the subject, but for the vivid and shocking example provided by lawmakers in Tennessee.

The bare-bone facts are these: Three members of the Tennessee legislature joined an estimated thousand protesters who had marched to the statehouse in the wake of that state’s school shooting, demanding gun reform. According to several reports, they had bullhorns, and disrupted the order of the assembly. The protest itself was described by the media as peaceful–giving the lie to the hysterical Republican lawmakers who compared it to the January 6th insurrection.

Tennessee has a Republican supermajority–courtesy of gerrymandering–and that supermajority responded by voting to eject two of the three–the Black ones.

The three lawmakers did violate House rules, and a reprimand of some sort would have been appropriate. They could have been censured, or removed from committee assignments. But as the Washington Post noted

Republicans charged them with breaking House rules of conduct, which they don’t deny. But the protests, while raucous, were peaceful, and according to the Tennessean, no lawmaker has ever been expelled for breaching decorum rules….

All of this mirrors a larger story. Red states are sinking deeper into virulent far-right culture-warring — banning books, limiting classroom discussion of race and gender and prohibiting gender-affirming care for transgender youth. GOP legislatures passing these things were of course legitimately elected by majorities, though in some cases gerrymanders increase their power.

I would amend that last sentence to read “in most cases, gerrymanders increase their power.”

Those legislatures are also finding onerous ways to use power to tamp down on the unexpectedly ferocious dissent their culture war has unleashed among numerical minorities, largely concentrated in cities and suburbs inside red states. As analyst Ron Brownstein argues, this often pits an overwhelmingly White, older, rural and small-town Republican coalition against an increasingly diverse, younger and more urban coalition.

“These Republican legislatures are stacking sandbags against a rising tide,” Brownstein told CNN. Call it the GOP retreat into Fortress MAGA.

As the article notes, Republican-dominated state legislatures are pushing “preemption” laws that restrict cities and counties from making their own policy choices. It listed examples from DeSantis’ Florida, and from Georgia (and could easily have found similar ones from Indiana)

Yet this retreat into Fortress MAGA faces a problem: Whenever state-level Republicans undertake another reactionary lurch, it often goes national in a big way. Attention has poured down on everything from insanely broad book bans to shockingly harsh proposed punishments for abortion to anti-transgender crackdowns with truly creepy implications.

The Tennessee super-majority expelled these lawmakers simply because they could–because their supermajority (courtesy of gerrymandering) allowed them to demonstrate their rejection of democratic norms and to display their animus toward colleagues who were young, Black and Democratic.

As the AP has reported

A growing chorus is pushing back against Tennessee Republicans seeking to oust three House Democrats for using a bullhorn to shout support for pro-gun control protesters in the House chamber, while the GOP has previously resisted removing its own members even when weighing criminal allegations.

Most recently, the Republican-controlled Statehouse declined to take action against a member accused of sexual misconduct, as well as those who have faced indictments or came under pressure for liking nearly nude social media posts.

Ah–but those members were White Republicans.

The Hill interviewed one of the two legislators, Justin Jones of Nashville, who said his race played a role in his expulsion from the state House on Thursday.

“I basically had a member call me an uppity Negro,” Jones, who is Black, told MSNBC’s Joy Reid after the 72-25 vote that expelled him….

“What we saw in Tennessee yesterday was an attack on democracy and very overt racism, as you can see that the two youngest Black lawmakers were kicked out, but our colleague, my dear sister, Gloria Johnson, a white woman, was not,” he said. “And we see clearly, the nation has seen clearly what is going on in Tennessee.”

What this incident very clearly underlines is the critical importance of systemic reform. It isn’t enough to elect better people–although that would certainly be helpful.

We need to reform the institutions that are not working properly. We can start with the Supreme Court, which has declined to notice that gerrymandering is incompatible with fair elections. The recent confirmation that Clarence Thomas’ corruption extends well beyond his refusal to recuse from cases implicating his wife’s political activities should provide a wake-up call.

Then we can move on to the Electoral College….

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