Public Policy and Governance – Page 85

Urban Symbolism

There are a number of elements that tend to reinforce America’s increasing urban/rural divide–the sorts of differences that emerge among people who live in areas that are more or less densely populated. But we shouldn’t overlook the influence of symbolism–longtime images of dubious accuracy that have cemented our mental images of the country’s cities and countrysides.

Probably the strongest image that comes to mind when we hear the word “countryside” is bucolic–something between “Green Acres” and “Little House on the Prairie.” Mention “small town America” and we think “Mayberry.” Urban imagery is very different and much darker–as Paul Krugman pointed out in a column back in July, we tend to call up the various hellholes portrayed on television and in works of fiction.

But why do so many Americans still believe that our major cities are hellholes of crime and depravity? Why do so many politicians still believe that they can run on the supposed contrast between urban evil and small-town virtue when many social indicators look worse in the heartland than in the big coastal metropolitan areas?

To be sure, there was a national surge in homicides — although not in overall crime — during the pandemic, for reasons that remain unclear. But New York is still safer than it was a decade ago, vastly safer than it was 30 years ago, and, for what it’s worth, considerably safer than, say, Columbus, Ohio.

These stereotypes persist, despite the fact that, if anything, the roles have been reversed. While cities continue to have the challenges that occur when large numbers of people live together, emerging data locates more serious problems in the much-storied “heartland,” where–as Krugman noted– large numbers of men in their prime working years don’t have jobs and where “deaths of despair” have been steadily increasing.

If the waning accuracy of our urban/rural mythology was simply a product of imagery lagging reality, that would be one thing. But as Krugman and others have pointed out, the Republican insistence on the accuracy of that imagery is having destructive, even deadly effects on policy.

Some reporting suggests that one of the reasons the Trump administration downplayed the Covid-19 pandemic in its early stages was the belief that it was solely a large-city, blue-state problem; there were definitely many assertions that the risk was severe only in places with dense populations. And there were many pronouncements — some of them with an unmistakable tone of glee — to the effect that the pandemic would kill big cities and the states that contain them.

Of course, the harm done goes well beyond Trump’s fatally-flawed pandemic response. Support for the GOP is disproportionately rural, and the party responds to that reality by insisting to its rapidly radicalizing base that the inhabitants of rural America (overwhelmingly White and Christian) are the “real” Americans–and that their tax dollars are being siphoned off to support urban neer-do-wells.

Besides helping to cripple our pandemic response, the myth of rural virtue and urban vice means that many Republican voters seem unaware that they are among the major beneficiaries of the “big government” their party says it wants to eliminate. That is, they still imagine that the government spends money on urban welfare recipients, not on people like them.

For example, do red-state voters know that federal spending in their states — much of it taking the form of benefits from Social Security and Medicare — greatly exceeds the taxes they pay to Washington? In Kentucky, the most extreme example, the annual inflow of federal money per capita is $14,000 greater than the outflow.

Meanwhile, those of us who live in those urban hellholes of Republican imagination enjoy the benefits that only density can provide–not just the inviting coffee shops, restaurants and bars, multiple entertainment and education options, bike paths, parks and museums that are the stuff of tourism advertisements, but the salutary lessons to be learned through interaction with people who are, to varying degrees, unlike ourselves.

There are plenty of downsides to both urban and rural life, and good policy should address them. We need to figure out how to provide healthcare and stimulate economic development in rural areas. We need to improve police training and provide more affordable housing in our cities. Etcetera. But–as with so many of the truly serious challenges we face–we can’t solve problems we adamantly refuse to see.

Substituting mental images for complicated realities obscures our vision of both urban and rural America.

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Voter Turnout

A good friend and former colleague of mine moved back to Canada a few years ago, to accept a prestigious position. (I say “back” because he was originally from Canada. He’d married a U.S.Citizen, obtained joint citizenship, and for many years was a highly respected bioethicist at U.S. institutions of higher education.) We continue to correspond, and in the wake of Canada’s recent election, he sent me a column from a Canadian newspaper, bemoaning that election’s low turnout.

He also sent the results of a Google search for turnout percentages in both the U.S. and Canada. (You know what’s coming, don’t you??) Here’s a portion of his message:

I did find it charming that the article bemoaning low Canadian turnout (which this year was a historical low at ~58%) is still significantly higher than in the US.

Apart from the Trump v Hilary election in 2016 when it was 50%, the last time US voter turnout was above 50% was in 1912 if I am reading the charts correctly.

Worth pondering, eh?

The newspaper article quoted Canadian political observers on the possible reasons for what the Canadians considered “depressed” turnout. The pandemic was one possibility, and attitudes about the need for this particular election were also mentioned. But the observation that really struck me was this one:

“We’ve historically had really high trust in our democratic institutions, in our election process … and I think that the challenges that they faced in this election are going to take some time to rebuild confidence in our elections.”

That prompted me to consider just where we are in today’s U.S. If turnout depends upon trust in the integrity of the electoral system, what can we expect in the wake of the GOP’s Trumpian assault on that integrity?

If a decision to vote requires trust– trust that one’s vote will count, trust that the election is being honestly run, trust that there is a meaningful difference between the candidates for office, trust that the people who’ve earned your vote will do their best to follow through on their promised agendas–what happens when a significant portion of the GOP believes, in the face of all evidence to the contrary, that voter fraud is rampant and the 2020 election was rigged?

It isn’t just trust in the administration of elections–trust in government has been steadily ebbing in the US. The evidence goes well beyond our pathetic voter turnout figures. If that meant that we could count on a direct correspondence between low turnout and the distrust that has led to virulently anti-government sentiment, we might expect a lot of Republicans to stay home in 2022 and 2024 (and from my perspective, that would be a very good thing).

But of course, it’s never that simple.

One of the regular readers of this blog sent me a You Tube interview between a scholar with the Humphrey School of the University of Minnesota and Stan Greenberg, the former Yale professor who’s been a Democratic pollster pretty much forever. Greenberg explained Trump’s 2016 win by pointing out that his racist appeal had generated turnout from people who’d never before voted—and according to his research, those previous non-voters remain engaged.

Evidently, they do have trust–trust that the current iteration of the GOP will protect White Christian dominance.

One of the oldest and truest rules of politics is that turnout is everything. It doesn’t matter how many Americans agree with party A or party B–as the saying goes, the only poll that matters is the one on Election Day.

The only way to ensure robust turnout of voters for what is currently the only sane party is for the Democrats to pass their agenda–especially the expansive infrastructure bill and the voting rights bill–and demonstrate that government can work, that Democrats can be trusted, that the right to participate in democratic deliberation via the ballot box can be protected.

To be clear, I’m not saying the Democrats are right about everything, only that they are currently the only sane option. We are truly at an inflection point, and constitutional government is in the cross-hairs.

Meanwhile, the Earth keeps warming, the GOP is now entirely the party of the batshit crazies, and I am very afraid that the Democrats will be unable to control their circular firing squad.

The world my grandchildren will inherit looks very scary….

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Preparing For Climate Change

A week or so ago, I suggested that it was time–past time, actually–to rethink federalism. Not to dispense with it, but to reconsider which governance tasks should be left to state and local governments and which must be tackled at the federal (or even global) level.

The problem with nationalizing too many issues is that sending authority to Washington effectively demoralizes local activists working on those issues. If the only people who have authority to do X or Y are far removed, the result is likely to be those feelings of powerlessness I’ve been writing about.

The problems with keeping too much local control over issues more properly addressed at the federal level include lack of impact and incentives for all sorts of mischief–see vote suppression..

There are also an increasing number of issues where we need all hands on deck. When it comes to overwhelming problems like climate change, even enlightened national/global efforts will require equally enlightened local measures. And individuals really can affect local decision-making.

A recent report from Inverse highlighted the resilience efforts of five cities, providing an “instruction manual” of sorts–a delineation of local measures that can make a positive difference. As the article noted, despite the grim evidence of impending climate catastrophe,

there are a few cities whose leaders have taken proactive measures to adapt their cities and protect their residents from the climate crisis. These cities serve as models for how we can modify and strengthen our built environments, reduce human suffering, and protect urban centers from the effects of a warming planet.

Fukuoka, Japan has been adding green spaces, including parks, community gardens and green roofs. It decides where to site those spaces based on surveys of windflow through the city and other measurements to determine the most effective places to plant trees and maintain parks. These green spaces reduce extreme heat and help absorb water runoff during periods of intense rainfall.

Rotterdam, in the Netherlands, is growing plants along railways to absorb flooding and reduce heat, and developing ‘water squares’ that can absorb rainfall and ease the stress on sewage systems.

Ahmedabad, India (a city of 7.2 million that I’d never heard of) was included for its “cool roofs” initiative.

This entails using eco-friendly building materials — such as coconut husk and paper waste — and cheap lime-white paint to deflect sunlight away from buildings. This keeps residents cool. According to Madan, cool roofs reduce indoor temperatures lower by 3.6 – 9° F.

Copenhagen, Denmark has pledged to become the first city to go fully carbon neutral by 2025. It has made substantial progress toward that goal: 49 percent of all trips in the city are by bike, and 98 percent of the city’s heating comes from waste heat from electricity production. Seawater cooling measures have removed an estimated 80,000 tons of carbon dioxide from the city’s atmosphere.

Here in the United States, Chicago, believe it or not, was one of the five cities cited in the report. Chicago made the list because is was an early adopter of green stormwater infrastructure, and a developer of urban vertical farms.

In 2014, under then-Mayor Rahm Emanuel, the city developed a $50-million, five-year green stormwater infrastructure plan with the aim of reducing basement flooding and water pollution and improving environmental quality and climate resilience.

Some of the key features of Chicago’s plan included capturing, storing, and filtering water through green techniques rather than channeling it into storm drains; investing in permeable, or more water-absorbent, pavement to reduce flooding; compiling rainfall frequency data to better predict flooding; and offering resources on green design to maintain water runoff and reduce flooding through rain gardens and natural landscaping.

The city also plays host to one of the world’s largest urban vertical farms, which grows vegetables in a 90,000-square-foot facility. Chicago made this urban vertical farm possible by changing its zoning laws.

The linked article not only highlights these cities, but includes suggestions for how other urban centers might emulate them.

We are finally, if belatedly, recognizing the threat posed by climate change, and large numbers of citizens–especially but not exclusively young ones–are coming together to combat it. Working at the local level on measures targeted to the specific threats faced by those localities can not only help ameliorate the effects of an over-heating world, it can give citizens an opportunity to work together to effect important changes.

Ultimately, the ability to actually do something–something that clearly matters– to work with our neighbors to ameliorate a threat we all face (and that, increasingly, we all recognize) can help us overcome the extreme polarization that has paralyzed our government.

After all, there’s nothing like a common enemy to bring people together.

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For Goodness Sake, Indiana!

Remember that much-hyped slogan, developed by (undoubtedly overpaid) consultants–the one that was going to bring gobs of tourists to our state? “Honest to goodness, Indiana!” didn’t do much for me, and as best I can tell, it didn’t prompt many people to think “well, that’s a state I simply have to visit!”

I wonder if we’d do better with a teaser like, “come see one of the most gerrymandered states in the whole of the USA!”

The results of the 2020 census have been issued and the states–including Indiana–are in the midst of the redistricting that takes place every ten years. In Indiana, a coalition of citizens headed by the League of Women Voters, Common Cause and other nonpartisan, “good government” organizations has been strenuously lobbying for fair maps for at least the last five years; clearly, as the IBJ recently reported, the hundreds of Hoosiers who’ve called and written their legislators and descended on the Statehouse could have saved themselves the trouble.

Republicans will keep greater control of Indiana’s Legislature than merited by the number of votes they receive, according to a political analyst who on Thursday called the state’s proposed new election districts among the most skewed in the country.

The analysis came as a legislative committee held a second day of public hearings on the Republican-drawn maps, with several people criticizing the fact that the new election district maps were released less than 48 hours earlier.

The redistricting plan review conducted for the left-leaning political group Women4Change found Republicans would likely win 69 of the 100 Indiana House seats while typically receiving 56% of the vote. Republicans now hold a 71-29 majority in the Indiana House.

Christopher Warshaw, a political scientist at George Washington University who analyzes election data, said the proposed maps that will be used for the next 10 years boost Republicans by creating overwhelmingly Democratic districts to limit the impact of those voters.

“I think that while geography or other factors could explain part of these biases, these are so extreme that really nothing but politically intentional gerrymander could really explain the extent of the bias in these maps,” Warshaw said.

Calling Women4Change “left-leaning” is only possible in a state where opposing race and sex discrimination and favoring civic education and “one person, one vote” are considered extremely liberal positions. The organization includes a number of prominent Republicans (granted, of the sane variety) and bends over backward to be nonpartisan. But I digress.

A friend who shall remain nameless had a meeting a couple of months ago with the current Speaker of the House, and raised the issue of maps. Let’s just say the response was not along the lines of “oh, yeah, we’re working hard to make them fair…”

The only hopeful data I’ve come across was an observation from a friend who is a political science professor. He’d looked at the census numbers, and noted that this particular round of partisan redistricting was considerably more difficult than in the past, because rural areas of the state are less populated than they previously were. Those areas are continuing to empty out. Indiana Republicans are dependent upon those thinly populated parts of the state, so unless there is a significant change in Hoosiers’ population trends, the GOP’s carefully constructed advantage will disappear–probably not in 2022 or even 2024, but soon thereafter.

I sure hope his reading of the population tea leaves is correct….

Meanwhile, the voices in the heads of the far right Trumpers continue to harp on “voter fraud” and the Big Lie. Since there is exactly zero evidence supporting these attacks on the legitimacy of those who won election, I was initially puzzled. On what, exactly, do they base these hysterical, manufactured claims?

Then I figured it out. As Jamelle Bouie noted in the New York Times,

“Voter fraud” is not a factual claim subject to testing and objective analysis as much as it’s a statement of ideology, a belief about the way the world works. In practice, to accuse Democrats of voter fraud is to say that Democratic voters are not legitimate political actors, that their votes do not count the same as those of “the people” (that is, the Republican electorate) and that Democratic officials, elected with those illegitimate votes, have no rightful claim to power.

Yep. Members of the GOP’s super-majority in our legislature firmly believe that “those people”–city dwellers, Democrats, people of color–aren’t really entitled to cast ballots that count the same as the ballots cast by “real” Americans…so the gerrymandering that disenfranchises them is perfectly appropriate.

For goodness sake, Indiana!

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We’re Number Eleven…

The problem with living at a time when there are so many problems–and so many truly major ones, at that–is that our focus gets splintered. Climate change. Vote suppression. White Supremicists. Rightwing domestic terrorism. Guns. Government gridlock. The pandemic. Continual wars and the growth of the military-industrial complex …The list is endless.

But a recent report in the Washington Post reminded me of one of our most long-term and shameful problems–America’s perverse refusal to follow the lead of other wealthy (and plenty of non-wealthy) countries and provide universal access to health care. The negative consequences of our refusal to allow anyone to opt in to Medicare (Medicare for those who want it), or just to broaden the scope of the Affordable Care Act, have receded from prominence.

We may be distracted by other policy failures, but the problem remains–and it is as acute as ever, if not more so.

Researchers at the Commonwealth Fund compared the health-care systems of 11 high-income countries: Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom and the United States.

The United States has the worst health-care system overall among 11 high-income countries, even though it spends the highest proportion of its gross domestic product on health care, according to research by the Commonwealth Fund.

“We’ve set up a system where we spend quite a bit of money on health care but we have significant financial barriers, which tend to dissuade people from getting care,” said Eric Schneider, the lead author behind the findings and senior vice president for policy and research at the Commonwealth Fund, which conducts independent research on health-care issues.

The researchers identified five metrics of a well-functioning health care system: access to care, the care process itself, administrative efficiency, equity and overall health-care outcomes.Norway, the Netherlands and Australia were judged to be the top-performing countries overall.

The high performers stand apart from the United States in providing universal coverage and removing cost barriers, investing in primary care systems to reduce inequities, minimizing administrative burdens, and investing in social services among children and working-age adults, the Commonwealth Fund found.

The latter is particularly important for easing the burdens on health systems created by older populations, according to Schneider. “These sort of basic supports throughout younger age groups reduce, we think, the chronic disease burden that’s higher in the U.S.,” he said.

Since I have a son who lives in Amsterdam, I was particularly interested in the description of the Netherland’s high-performing system. The researchers found that it was a “well-organized system of locally placed primary care doctors and nurses who provide care on a 24/7 basis”–a system that keeps minor problems from turning into major ones.

The U.S. doesn’t come close. (As a former graduate student, a hospital administrator, told me years ago, we don’t have a healthcare system in the U.S.; we have a healthcare Industry.)

The United States was rated last overall, researchers found, ranking “well below” the average of the other countries overall and “far below” Switzerland and Canada, the two countries ranked above it. In particular, the United States fell at the end of the pack on access to care, administrative efficiency, equity and health-care outcomes.

The article noted that the inequities in America’s healthcare, together with our inadequate primary care, put the country in a much weaker position when it came to confronting the pandemic. That fact–together with the GOP’s advocacy of vaccine denial–may account for the fact that the U.S. has the second-highest COVID death rate among the eleven countries in the study.

America’s healthcare industry is costly in both lives and dollars.

Spending on health care as a share of GDP had grown in all of the countries the Commonwealth Fund surveyed, even before the pandemic. But the increase in the United States has “greatly exceeded” those of other nations. The United States spent 16.8 percent of its GDP on health care in 2019; the next highest country on the list was Switzerland, at 11.3 percent of GDP. The lowest was New Zealand, which spent roughly 9 percent of its GDP on health care in 2019.

Meanwhile, health care in the United States is the least affordable.

I hate sounding like a broken record, but this is what happens when racism drives decisions about the social safety net. Political scientists and sociologists confirm that–in addition to the profit motives/special interests of insurance companies and Big Pharma–the fact that White Americans don’t want “their” tax dollars spent on medical care or other social benefits for “those people” has prevented us from installing a less-costly and vastly more effective medical system.

We keep filling in that swimming pool…

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