Category Archives: Public Policy and Governance

Meanwhile…

On the Late Show, Stephen Colbert has a recurring comedy bit he calls “Meanwhile.” Not part of the opening monologue, it’s a collection of brief–usually weird or ironic– items culled from the news of the day.

But “meanwhile” also has application to those of us who are fixated on contemporary threats to America’s Constitution and democratic norms. While we worry about the increasingly bizarre behavior of our fellow-Americans who live in a fact-free reality of their own devising, we ignore or just miss the daily challenges posed by technology–everything from the way social media is altering attention spans, to the mounting inability of the nation’s utilities to cope with the damage being done by climate change, to the rush to turn our highways over to self-driving vehicles.

That last item–the (debated) imminence of self-driving cars– is just one element of another under-appreciated threat: the loss of millions of jobs, and the issue of how we will handle the transition to a world where most labor (not just manual labor) is performed by machines. An enormous amount of research suggests that, sooner or later, AI–artificial intelligence–will replace a significant percentage of tasks that now require human performance.

It is easy to “pooh-pooh” those predictions, and to dismiss the likelihood of significant social disruption, by pointing out that someone will have to produce and program those machines, and noting that past technological progress has created as well as destroyed jobs. The cheery optimists insist that nothing is certain, so why worry? (Tell that to the estimated five million people who make their livings driving…)

The Brookings Institution has weighted in. In a paper aptly  titled “Preparing for the (non-existent) future of work,” the researchers write,

We analyze how to set up institutions that future-proof our society for a scenario of ever-more-intelligent autonomous machines that substitute for human labor and drive down wages. We lay out three concerns arising from such a scenario, culminating in the economic redundancy of labor, and evaluate recent predictions and objections to these concerns. Then we analyze how to allocate work and income if these concerns start to materialize. As the income produced by autonomous machines rises and the value of labor declines, we find that it is optimal to phase out work, beginning with workers who have low labor productivity and job satisfaction, since they have comparative advantage in enjoying leisure. This is in stark contrast to welfare systems that force individuals with low labor productivity to work. If there are significant wage declines, avoiding mass misery will require other ways of distributing income than labor markets, whether via sufficiently well-distributed capital ownership or via benefits. Recipients could still engage in work for its own sake if they enjoy work amenities such as structure, purpose, and meaning. If work gives rise to positive externalities such as social connections or political stability, or if individuals undervalue the benefits of work because of internalities, then there is a role for public policy to encourage work. However, we conjecture that in the long run, it would be more desirable for society to develop alternative ways of providing these benefits.

You can download the entire paper at the link.

The likelihood that much of world’s work will eventually be done by machines that don’t get sick, don’t need benefits, and can work 24/7 is part of what leads me to support a Universal Basic Income– an “alternative way” of providing a social infrastructure.

Analyzing America’s current polarization provides another argument for a UBI.   As political rhetoric makes clear, policies intended to help less fortunate citizens can be delivered in ways that stoke resentments, or in ways that encourage national cohesion.  Currently, we’re stoking resentments. (Consider public attitudes toward welfare programs aimed at impoverished communities, and contrast those attitudes with the overwhelming majorities that approve of Social Security and Medicare–universal programs to which virtually everyone contributes and from which virtually everyone who lives long enough  benefits.)

I’ve previously observed that we don’t hear angry accusations that “those people” are driving on roads paid for by my taxes.  Beneficiaries of programs that include everyone (or almost everyone) are much more likely to escape stigma. If work disappears for a significant percentage of our population, an approach that doesn’t require lawmakers to pick and choose who deserves help would be far less likely to tear the country further apart.

Of course, the armed and dangerous Americans who currently live in crazy-town may make attention to these “meanwhile” matters irrelevant. They involve questions of governance that they disdain, because they involve how best to achieve the common good, and they have absolutely no interest in helping anyone but themselves.

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Affording To Live…

GOP lawmakers–including, of course, Indiana’s two Senators–recently blocked a Biden Administration effort to cap the price of insulin for Americans with private health insurance. (Americans on Medicare will see their out-of-pocket costs decline, thanks to other provisions of the Inflation Reduction Act.)

GOP opposition to the measure, which I can’t help thinking of as a manifestation of the Republican “Let them eat cake” approach to policymaking, reminded me of a recent discussion with my sister. Her doctor had rordered some medical tests, and when she  was scheduling them, she was told that one of them–a test for cancer!–wasn’t covered either by Medicare or by her private insurance. The test was $300, and she told me that her first thought was “I can afford this, but what about all the people who can’t? What about  people who don’t have an extra $300 but do have cancer?”(Fortunately, she didn’t.)

This conversation, rather obviously, wouldn’t have occurred in most Western democracies, because in those countries, health care isn’t just for people who can afford it.

When it comes to capping the price of insulin, the influence of Big Pharma–particularly Indiana’s own Eli Lilly–was front and center with the GOP.

Lilly’s enormous profits owe a lot to the high price of insulin. That’s especially ironic, given the generosity of those who first held the patent.

Before the 1920’s, a diabetes diagnosis meant a death sentence for people all over the world. The main treatment was starvation diets to prolong the inevitable.

In 1920, a Canadian physician and scientist named Frederick Banting began working on an idea to isolate and extract insulin. He worked in the laboratories of J.R.R. McLeod, a professor of physiology at the University of Toronto. The medical student Charles Best aided him in his work to test out insulin on dogs. Chemist James Collip worked with Banting and Best to purify and refine insulin for clinical trials in humans.

On January 23rd, 1923 Banting, Best, and Collip were awarded the American patents for insulin. They sold the patent to the University of Toronto for $1 each. Banting notably said: “Insulin does not belong to me, it belongs to the world.” His desire was for everyone who needed access to it to have it.

In order to make insulin widely available, Eli Lilly, Sanofi and Novo Nordisk were given the right to produce it, and they’ve turned it into a massive profit generator. As the linked article reports, “by 1923, insulin was the highest-selling product in Eli Lilly’s history, and profits from it accounted for over half of the company’s revenue.”

And that brings us to the recent refusal of Indiana’s Senators and other GOP recipients of Lilly largesse to ensure insulin’s affordability.

As The Intercept reports, Lilly Endowment–ostensibly separate and independent from the company–is not neutral when it comes to funding entities opposed to controlling the price of medications. The Endowment,”led in part by former Eli Lilly executives and still financed by corporate stock options” funds think tanks that “work to shield corporations from taxation or government regulation,” and has given millions of dollars to libertarian groups that lobby against price controls on insulin, categorizing those recipients as “community development organizations.” (The Endowment is also the largest shareholder of Eli Lilly, Inc., holding 104,161,053 shares worth approximately $31 billion.)

The Federalist Society, for example, has received over $1.5 million from the charitable arm over the last decade and is listed under “community development” grantees of the Lilly Endowment. The Washington, D.C.-based group is a professional society for conservative attorneys, with an eye toward pro-business ideological positions.

The Federalist Society funds included a $150,000 grant last year, at the same time that the group was sharply criticizing a new Minnesota law that forces manufacturers to provide free or affordable insulin to low-income residents. The law “[inflicts] an injustice upon companies that are regularly demonized in the media,” an attorney for the Goldwater Institute writes on the Federalist Society’s website.

Last year, Eli Lilly collected over $2.4 billion in revenue from its insulin products, including the brand Humalog, with roughly $1.3 billion of that from U.S.-based sales.

“One vial of Humalog (insulin lispro), which used to cost $21 in 1999, cost $332 in 2019, reflecting a price increase of more than 1,000%. In contrast, insulin prices in other developed countries, including neighboring Canada, have stayed the same,” wrote S. Vincent Rajkumar in the journal of the Mayo Clinic in 2020.

There’s much more detail in the linked article, and I encourage you to click through and read it. That said, the real issue is the one my sister identified: if government is supposed to provide a physical and social infrastructure within which citizens can flourish, isn’t access to health care and lifesaving medication as essential a part of that infrastructure as police, firefighters, roads and bridges?

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Taking Us Back…

I’ve been working with a friend –a former academic colleague–on a book about the causes and consequences of what Americans call the women’s movement. He’s a quantitative guy (I think he sleeps in a bed of data…) while I am rather clearly not, but we are both interested in the history of women’s emancipation–not just questions like “To what extent did the invention and widespread use of the birth control pill allow women to enter the workforce?” or “How did the change from jobs requiring brute strength to those requiring skill benefit women?” but also things like “what changes in social and cultural attitudes were triggered by women’s suffrage, political activity and workforce participation?”

We most definitely aren’t planning an academic/scholarly book. Instead, we hope to provide a journey of sorts, an accessible trip through the last hundred years or so, focusing on the causes and consequences of American women’s change of legal and social status.

The incredibly important question we will not be able to answer is “Is that progress–and we do see it as progress–reversible?”

There are movements in today’s America absolutely committed to that reversal, and the current “abortion wars” are only one aspect of their agenda, which involves a wholesale retreat from numerous aspects of contemporary American life, not just the emergence of us “uppity” women.

Common Dreams recently had an essay by Mike Lofgren, describing the merger of some of the most retrograde of those movements and reporting on the danger posed by the recent “teaming up” of religious extremists with far-right fascist groups.

Here’s his lede:

The Supreme Court’s disastrous rulings on prayer on public school property and abortion rights have finally focused proper attention on the role of religious extremism in undermining democratic self-rule. For decades, not only has it been underestimated, most of the media has misunderstood Christian fundamentalism’s goals.

Make no mistake: the well-funded, well-armed alliance of motivated extremists that I have described constitutes the greatest domestic danger this nation has faced since the Civil War.

Katherine Stewart, who has written on the religious right for many years, has redressed this misunderstanding in a New York Times piece. She straightforwardly says that Christian fundamentalism’s goal is “breaking American democracy,” and that this is not an unintended byproduct of fundamentalism’s political activity. No, it “is the point of the project.”

You might think that church-going Christians, no matter how fundamentalist, have little in common with organizations like the Proud Boys and Oath Keepers, or with neo-Nazi groups like Richard Spencer’s National Policy Institute, or the Aryan Nation. Yet Lofgren points out that there is substantial overlap in the membership of those groups. He says they “bury their extreme theological differences to ally against their common enemy: the Enlightenment, a tolerant society, and equal justice under law.”

Among their other motivating issues, these movements share a commitment to misogyny and to a cult of masculine toughness. (Paging Josh Hawley ...)

This is obvious among fundamentalists and white nationalists alike: Southern Baptists and other evangelical sects preach “submission” of women, and every nationalist movement of the past century has diminished women’s rights.

Lofgren notes that Peter Thiel, a billionaire funder of the movement, has expressed his belief that it is was a mistake to “give” women the vote…

Fundamentalists want a universally Christian America that

they insist existed at the time of the nation’s founding, objections from Thomas Jefferson, James Madison, Mark Twain, or Ambrose Bierce notwithstanding. White nationalists pine for a traditional white America, regardless of the presence from the beginning of racial differences and tensions.

Lofgren quotes Umberto Eco, who described what he termed “ur-fascist” tendencies: a faux-populism coupled with a railing against “elite” straw men; the habit of using a vocabulary similar to Newspeak in that it obscures rather than reveals meaning; contempt for the weak; and more. And he focuses upon the recent Supreme Court decisions undermining the right to personal autonomy and the separation of church and state.

Now that the Supreme Court has seen fit to read theocracy into the Constitution, Americans have begun to wake up to the political threat to their liberties and their way of life. But few have noticed how synergistic the rest of its rulings are with a religious-right campaign to wreck the constitutional order. Past campaign finance and congressional redistricting decisions have been a gift to a party that has given up on competitive electoral democracy in favor of Russian-style elections and public religion enforced by state diktat.

Obviously, women aren’t the only people threatened by this movement. Everyone whose fundamental right to self-determination has led them to live a life disapproved of by White Christian Nationalists is at risk.

Just think of us women as the canaries in the coal mine….

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Dangerous Insanity

Climate change denialism has become much more difficult lately, as evidence in the form of heat waves, increasingly strong hurricanes, wildfires and the like continue to grow. And in most countries, as a recent article from the New York Times notes in its opening paragraphs, political fights over efforts to combat global warming are focused on the “how”–not on the immediacy or existential nature of the threat.

But then there’s the good old USA, and the GOP.

The article’s headline is “Weaponizing Public Office Against Climate Action,” and it documents yet another drawback of American federalism–the ability of Republican officeholders in Red States to actually bolster fossil fuel companies at the expense of the climate. It isn’t just in Texas, where we’ve become used to the deranged antics of Gov. Greg Abbott. (Abbott has actually prohibited state agencies from investing in businesses that have cut ties with fossil fuel companies.)

The Times investigation revealed a “coordinated effort by state treasurers to use government muscle and public funds to punish companies trying to reduce greenhouse gases.

Nearly two dozen Republican state treasurers around the country are working to thwart climate action on state and federal levels, fighting regulations that would make clear the economic risks posed by a warming world, lobbying against climate-minded nominees to key federal posts and using the tax dollars they control to punish companies that want to reduce greenhouse gas emissions.

Over the past year, treasurers in nearly half the United States have been coordinating tactics and talking points, meeting in private and cheering each other in public as part of a well-funded campaign to protect the fossil fuel companies that bolster their local economies.

Last week, Riley Moore, the treasurer of West Virginia, announced that several major banks — including Goldman Sachs, JPMorgan and Wells Fargo — would be barred from government contracts with his state because they are reducing their investments in coal, the dirtiest fossil fuel.

This is–rather obviously– insane. It’s as if an immensely wealthy patient diagnosed with terminal cancer were to decree that none of his monies could ever be used for cancer research or for the production of cancer treatments–and should instead be invested in Roundup and other cancer-producing products.

Mr. Moore and the treasurers of Louisiana and Arkansas have pulled more than $700 million out of Ti, the world’s largest investment manager, over objections that the firm is too focused on environmental issues. At the same time, the treasurers of Utah and Idaho are pressuring the private sector to drop climate action and other causes they label as “woke.”

 And treasurers from Pennsylvania, Arizona and Oklahoma joined a larger campaign to thwart the nominations of federal regulators who wanted to require that banks, funds and companies disclose the financial risks posed by a warming planet.

Reporters traced these efforts to a little-known nonprofit organization based in Shawnee, Kansas, identifying the State Financial Officers Foundation, an organization that once focused on cybersecurity, as the “nexus” of these actions . Following the election of President Biden, who pledged to make addressing climate change a significant element of his agenda, the Foundation began pushing Republican state treasurers–elected officials responsible for managing their state’s finances–“to use their power to promote oil and gas interests and to stymie Mr. Biden’s climate agenda, records show.”

The Heritage Foundation, the Heartland Institute and the American Petroleum Institute are among the conservative groups with ties to the fossil fuel industry that have been working with the State Financial Officers Foundation and the treasurers to shape their national strategy.

The Times notes that Democratic treasurers in Blue states support efforts to combat climate change; they  encourage banks and investment firms to acknowledge the risks that climate change poses to returns for retirees and others. But they haven’t created anything like the national campaign being orchestrated by the State Financial Officers Foundation.

Rational people–a category that rather clearly excludes these Republican treasurers–understand that  global warming is already damaging agriculture and causing extreme weather events that devastate communities and cost taxpayers billions in recovery and rebuilding. Instead, they insist that efforts to reduce emissions threaten employment.

These GOP treasurers have turned climate science into yet another issue in the Republicans’ unrelenting and suicidal culture wars.

But here’s the thing: It’s one thing to recognize that the economic health and quality of life in Blue states is superior to that of Red States. Americans can shrug–or move. However, we can’t create environmental silos–the stupidity and/or cupidity of these GOP officeholders affects the future livability of the entire globe.

The GOP proudly asserts that it isn’t “woke.” (We’ve noticed.)

The opposite of wakefulness, of course, is sleep. In this case, it’s a coma…..

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Putting Their Money Where Their Mouths Are–NOT

Even in Kansas–a deep-red state--voters have seen through the pious lies of the forced birth movement.

Rabid anti-abortion activists insist that they care about “both”–the woman and the fetus that they insist upon calling a baby. The New York Times recently published some data that shows just how hollow that declaration really is.

Pro-choice advocates have long emphasized that hollowness: the fact that the forced-birth movement conveniently ignores the complexities of pregnancy and its impact on women’s health, and the fact that once those little fetuses become actual babies, interest in their welfare magically evaporates. As the saying goes, the Times article brings the receipts.

The headline and sub-head really tell the story: “States With Abortion Bans Are Among Least Supportive for Mothers and Children.” “They tend to have the weakest social services and the worst results in several categories of health and well-being.” Extensive charts confirm the message that the states that are most hostile to abortion score poorly on a wide variety of health and well-being outcomes, while states supportive of abortion rights  have more generous social safety nets.

You might conclude that–in states where legislators actually give a rat’s patootie about women and babies–they pass laws that both respect female autonomy and provide support for the children of women who choose to give birth. They put their money where their mouths are.

Let’s look at Mississippi–a state Indiana seems to be trying to emulate:

In Mississippi, which brought the abortion case that ended Roe v. Wade before the Supreme Court, Gov. Tate Reeves vowed that the state would now “take every step necessary to support mothers and children.”

Today, however, Mississippi fares poorly on just about any measure of that goal. Its infant and maternal mortality rates are among the worst in the nation.

State leaders have rejected the Affordable Care Act’s Medicaid expansion, leaving an estimated 43,000 women of reproductive age without health insurance. They have chosen not to extend Medicaid to women for a full year after giving birth. And they have a welfare program that gives some of the country’s least generous cash assistance — a maximum of $260 a month for a poor mother raising two children.

If it was only Mississippi, that would be bad enough, but the Times investigation found that in the 24 states that have banned abortion (or probably will) policies on a broad range of outcomes are substantially worse than in states where abortion will probably remain legal. The article cited policies on child and maternal mortality, teenage birthrates and the share of women and children who have no health insurance.

The majority of these states have turned down the yearlong Medicaid postpartum extension. Nine have declined the Affordable Care Act’s Medicaid expansion, which provides health care to the poor. None offer new parents paid leave from work to care for their newborns.

One of the charts accompanying the text lists the states that have banned or dramatically restricted abortion or are likely to, along with their ranks on lack of insurance, maternal and infant mortality, and child poverty. (They all appear to be Red states. Indiana, unsurprisingly, is toward the bottom of those categories, just as we are at the bottom of states in voter turnout–which may not be a data point as unconnected as it first appears…among other issues, gerrymandering is bad for women.)

Indiana ranks 30th in its percentage of insured women; 41st in maternal mortality; 39th in infant mortality, and 28th in child poverty.  Those rankings are likely to sink even further after our retrograde legislature’s attack on women’s autonomy.

The article also acknowledges the role of racism.

Studies have repeatedly found that states where the safety net is less generous and harder to access tend to be those with relatively more Black residents. That has further implications for Black women, who have a maternal mortality rate nationally that is nearly three times that of white women.

The article has other examples of “pro life” states’ lack of concern for those “precious babies” once they are actually born.

None of the states that have banned abortion (or are likely to) guarantee parents paid leave from work to care for and bond with their newborns. Just 11 states and the District of Columbia do. Paid leave has been shown to benefit infants’ health and mothers’ physical and mental health as well as their economic prospects.

In most states, there is no guaranteed child care for children until they enter kindergarten at age 5. Subsidies available to low-income families cover a small segment of eligible children, ranging from less than 4 percent in Arkansas (which now bans abortion) to more than 17 percent in Vermont (which passed abortion rights legislation).

I encourage you to click through. Read the statistics and peruse the charts. And the next time someone piously proclaims that they “love them both,” hand them a copy.

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