Up in the Air

The New Yorker ran an especially good cartoon recently: a man standing up in coach on a plane–and others evidently cheering him on–saying something like “Who else is fed up with the smug attitudes of the so-called pilots who fly this plane? Who else would prefer that I fly it?”

The parallels to our Presidential election are too obvious to require added discussion.

I thought about that cartoon when I read another airplane analogy, this time in connection with the Republicans’ hell-bent-for-leather determination to repeal the Affordable Care Act–aka “Obamacare”–without having the slightest idea what they will replace it with, without any evident concern for the more than twenty million people who will lose coverage, and without any concern for the financial chaos that even their allies have warned will ensue.

As Josh Marshall at Talking Points Memo put it:

“The AMA, which has been rather comically pro-Trump to date, came out today and told Republicans that they shouldn’t repeal Obamacare without a clear replacement. Notably, even two of the most conservative health care economists at AEI, came out yesterday and said that ‘repeal and delay’ would be a disaster. The truth is that ‘repeal and delay’ is the policy equivalent of taking off from JFK to Heathrow with 2,000 miles worth of gas and saying you’re going to figure it out en route. No one who knows anything about health care economics, even people who are staunch free marketeers and hate Obamacare, think that makes any sense.”

From time to time on this blog I have referred to my cousin, an eminent cardiologist (and former Republican). I consult him when addressing issues that require medical expertise that I lack. He has shared with me the following statements on the proposed repeal from both the AMA and the American College of Physicians:

Chicago, IL, January 3, 2017––The American Medical Association (AMA) released the following letter today to congressional leadership from Chief Executive Officer and Executive Vice President James L. Madara, MD, concerning legislative efforts to reform the health care system.

Dear Majority Leader McConnell, Leader Schumer, Speaker Ryan and Leader Pelosi:

On behalf of the physician and medical student members of the American Medical Association (AMA), I am writing regarding our ongoing commitment to reform of the health care system and potential legislative actions during the first months of the 115th Congress.

The AMA has long advocated for health insurance coverage for all Americans, as well as pluralism, freedom of choice, freedom of practice, and universal access for patients. These policy positions are guided by the actions of the AMA House of Delegates, composed of representatives of more than 190 state and national specialty medical associations, and they form the basis for AMA consideration of reforms to our health care system.

Health system reform is an ongoing quest for improvement. The AMA supported passage of the Affordable Care Act (ACA) because it was a significant improvement on the status quo at that time. We continue to embrace the primary goal of that law—to make high quality, affordable health care coverage accessible to all Americans. We also recognize that the ACA is imperfect and there a number of issues that need to be addressed. As such, we welcome proposals, consistent with the policies of our House of Delegates, to make coverage more affordable, provide greater choice, and increase the number of those insured.

In considering opportunities to make coverage more affordable and accessible to all Americans, it is essential that gains in the number of Americans with health insurance coverage be maintained.

Consistent with this core principle, we believe that before any action is taken through reconciliation or other means that would potentially alter coverage, policymakers should lay out for the American people, in reasonable detail, what will replace current policies. Patients and other stakeholders should be able to clearly compare current policy to new proposals so they can make informed decisions about whether it represents a step forward in the ongoing process of health reform.

We stand ready to work with you to continue the process of improving our health care system and ensuring that all Americans have access to high quality, affordable health care coverage.

Sincerely, James L. Madara, MD

Washington, DC, January 3, 2017––In a letter sent today to leaders in the Senate, the American College of Physicians (ACP) implored them to vote no on a budget resolution that would start the process of repealing the Affordable Care Act (ACA). The College cautioned that this process could destabilize coverage, resulting in tens of millions of Americans losing coverage, benefits and protections established by current law.

The letter expressed concern that the pathway established by the resolution, which will lead to a subsequent vote on a budget reconciliation bill to repeal major elements of the ACA, with the effective date of such repeal being delayed while Congress attempts to develop an acceptable replacement plan, is unworkable and disruptive.

“Independent and non–partisan analyses show that enactment of such a ‘repeal, delay and replace’ bill, especially without an alternative being offered now that could be thoroughly evaluated based on its impact on quality, access, and coverage, would create chaos in insurance markets, causing plans to pull out of the markets with more than 7 million losing coverage in 2017 alone,” said Nitin S. Damle, MD, MS, MACP, president of ACP in the letter. “Full repeal could result in nearly 60 million people becoming uninsured.”

ACP noted that the College welcomed the opportunity to make improvements in the law. Specifically ACP welcomes discussion of ways to stabilize insurance markets by bringing more young people into them without disadvantaging older and sicker patients; to expand consumer choice of insurance products and of physician and hospitals; to ensure network adequacy; to support state innovation including in Medicaid provided that current eligibility, benefits, and protections for current and future enrollees are not undermined, to reduce administrative burdens on physicians and their patients, and to support the critical role played by primary care physicians in providing accessible, high quality and cost–effective care to all types of patients.

“While we acknowledge that the ACA is not perfect (and no law is) and improvements to it can and should be made, our continued support for the ACA is grounded in the fact that it has reduced the uninsured rate to the lowest ever, a major stride toward providing affordable coverage to all Americans,” said Dr. Damle. “We encourage Congress to first put forward ideas for improvements rather than committing to a process that would repeal the ACA’s coverage and protections for many millions of people.”

But what do pilots know about flying planes…?

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The Little (Activism) Engine that Could?

Thursday morning, I blogged about a new tool for activism being developed by one of my sons, a web designer and developer living in Manhattan. I explained the underlying premise of the  site and how it will work; I also noted that its utility is dependent upon the currency and accuracy of the information it will convey–information that will have to be provided by organizations working to protect Americans’ rights (ACLU, Planned Parenthood, etc.) and by volunteers in each state.

After describing various features of the site–including ease of use–I made the following pitch for volunteers.

My son plans to roll out a beta test in Indiana later this month. BUT—and this is a big BUT—the usefulness of the tool he has worked so hard to create absolutely depends upon the information it will contain. In Indiana, that means that people who are knowledgeable about bills filed in the General Assembly need to insure that information is included and current; people aware of upcoming “direct actions” need to convey that information via the site.

This tool is free to use. The site will never have advertising, it is not an “organization” that will fundraise. It will never share private information about its users. It is meant to be an added “outreach” mechanism for organizations like Hoosier Environmental Council, Planned Parenthood and the ACLU—among many others. We hope–and expect–that those organizations will share information through the Activism Engine as well as their own websites.

As I mentioned, the plan is to “beta test” the site in Indiana, to see how it works, solicit feedback, and to fix any bugs before taking it national.

If this “one-stop-shop” for activism is to work, however, it needs dedicated volunteers who will post the necessary information. If you are interested in being one of those volunteers, or at least finding out what is involved, Please go to this url and fill out the form: https://ae.stephensuess.com/

At last count, 157 people have signed up, and the volunteers keep coming. To say that this level of response–after one post to one small blog– is gratifying would be an understatement. It’s particularly significant, in my opinion, because it suggests that people aren’t just expressing negative opinions of Trump et al and then going back to their normal routines; it’s a sign that many of them really are willing to put time and effort into resisting the GOP’s incredibly destructive agenda.

My son is currently sorting the responses by what volunteers have signed up for, and everyone who has filled out one of the forms will receive an email from him shortly.

I just want to thank everyone who signed up, forwarded the information, or otherwise participated in the effort to prepare for the launch. Once the beta test “rolls out,” which should be very soon, I’ll let everyone know.

We can do this.

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Oh Wisconsin….

And the hits keep coming…

It’s bad enough that every day brings a new outrage from those a reader of this blog aptly dubbed “the four horsemen of the apocalypse” –Trump, Pence, McConnell and Ryan. What is even more depressing at a time when our hopes for sanity lie with local resistance to the anti-intellectualism, self-dealing and demagoguery in Washington is news of similarly destructive behavior by state-level fools and toadies.

Remember Wisconsin’s Scott Walker? A perfect contemporary Republican–a corrupt lackey of big money, antagonistic to education, dismissive of science? Of course you do.

When I read a friend’s post to the effect that Wisconsin’s DNR webpage had been scrubbed clean of all uses of the word “climate”–and altered to imply a lack of scientific consensus about anthropogenic global warming–I checked with Snopes.

Turned out to be true.

In a 26 December 2016 op-ed published by the digital newspaper Urban Milwaukee, environmental writer James Rowen reported that a section of the Wisconsin Department of Natural Resources’ (DNR) web site, originally titled “Climate Change and Wisconsin’s Great Lake,” had been substantially altered:

Gone are references to known “human activities” contributing to a warming planet, warming’s contributions to changes in rainfall and snowfall patterns, extreme weather events, drought, species and economic losses are among other truths whitewashed off this official, taxpayer-financed website.

Snopes reproduced the former text, which had accurately reported the relevant science, and that which replaced it; the new language says that reasons for changing conditions “are being debated and researched by academic entities outside the Wisconsin Department of Natural Resources.”

Responding to our request for comment, Wisconsin DNR Communications Director James F Dick stated that their office’s official position is that the science is not settled and that the page was updated to reflect this view.

Of course, the science is settled. As Snopes concludes,

The overwhelming scientific consensus from the climatological community is that the climate is indeed warming and that human activity is contributing to that process.

Here’s what mystifies me: if the settled science is right, and we do not act, we will face massive planetary devastation. If the settled science is wrong, and we do act, the worst thing that will happen is we’ll get cleaner air and water, and cheaper and more renewable energy.

This doesn’t seem like a difficult choice.

Oh yes– fossil fuel companies will make less money. But I’m sure that has nothing to do with climate change denial….

When the history of this era is written–assuming there are survivors left to write that history–it will undoubtedly be called “the age of insanity.”

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Rubber, Meet Road

In the wake of the election, a number of commenters to this blog—here and on Facebook—have asked a simple question: what can we do? How can Americans of good will mount an effective resistance to Trump and the Congressional Republicans?

It’s a question that has been asked on a number of other venues as well.

There is a big difference between sharing concern and disapproval on social media with friends who are likely to agree with us, and actually engaging in productive activism. A decision to make a genuine difference, deciding how to do that and actually following through is where the rubber meets the road, as the old saying goes. So it will be interesting to see who steps up to engage with the forthcoming “Activism Engine.”

Regular readers of this blog know that one of my sons lives in Manhattan, where he is a free-lance web designer and developer. Since the election, he has spent countless hours creating a website geared to people who want to make a difference, but have no idea how to start—people who are not “web savvy,” who have not necessarily been politically involved before.

The site is very simple to use: you can choose your state (or entire country, and eventually, your city), choose what most concerns you from a relatively short list of issues (the environment, reproductive rights, elections and voting rights, etc.), and see what legislation is pending in Congress and/or your state and what direct actions—marches, petitions, protests– are being planned by organizations focused on those issues. There is a place to keep track of your involvement, and even share it on social media if you are so inclined.

Perhaps the most impressive—and useful—part of the site allows you to effortlessly contact your elected officials. Put in your address, and a list comes up of everyone who represents you from your City-County Councilor to the President, with contact information including telephone numbers. No need to go elsewhere to find out who your congressman or state legislator is, no need to look up address or phone number.

My son plans to roll out a beta test in Indiana later this month. BUT—and this is a big BUT—the usefulness of the tool he has worked so hard to create absolutely depends upon the information it will contain. In Indiana, that means that people who are knowledgeable about bills filed in the General Assembly need to insure that information is included and current; people aware of upcoming “direct actions” need to convey that information via the site.

This tool is free to use. The site will never have advertising, it is not an “organization” that will fundraise. It will never share private information about its users. It is meant to be an added “outreach” mechanism for organizations like Hoosier Environmental Council, Planned Parenthood and the ACLU—among many others. We hope–and expect–that those organizations will share information through the Activism Engine as well as their own websites.

As I mentioned, the plan is to “beta test” the site in Indiana, to see how it works, solicit feedback, and to fix any bugs before taking it national.

If this “one-stop-shop” for activism is to work, however, it needs dedicated volunteers who will post the necessary information. If you are interested in being one of those volunteers, or at least finding out what is involved, Please go to this url and fill out the form: https://ae.stephensuess.com/

Be the rubber that meets the road.

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Less Trust, More Conspiracy

“People say” was the way our embarrassing President-elect introduced bizarre conspiracy theories about Hillary Clinton, Barack Obama or others who had offended him in some fashion.

No evidence. No factual basis. In most cases, no plausibility.

The question rational people asked–and still ask–is “why would anyone believe that?” Because clearly, many did. A recent report from Journalists’ Resource offered an answer, or at least the beginning of one.

President Barack Obama was not born in the United States, goes one common conspiracy theory. Another: George W. Bush knew in advance about the 9/11 attacks and let them happen. Conspiracy theories can spread quickly in this era of social media, especially as people sort themselves into information silos, only sharing information with the like-minded. During the 2016 presidential election one candidate frequently leveled charges against his opponent with little evidence, sometimes framing them with the noncommittal phrase “people say.” He won.

A 2009 paper defines conspiracy theories as “an effort to explain some event or practice by reference to the machinations of powerful people, who attempt to conceal their role.” Other researchers add that conspiracies often allege the illegal usurpation of political or economic power.

The authors of a 2014 paper found “over half of the American population consistently endorse some kind of conspiratorial narrative about a current political event or phenomenon.”

A number of studies have found that politically active people–especially conservatives with deeply ideological commitments–embrace conspiracy theories that confirm their beliefs and paint their political opponents in a bad light. A new study builds on that previous research, and adds an important element: the absence of trust.

“Conspiracy Endorsements as Motivated Reasoning: The Moderating Roles of Political Knowledge and Trust,” published in the American Journal of Political Science in October, investigated the hypothesis that people endorse conspiracy theories to serve “both ideological and psychological needs.” They anticipated that people who endorse such theories would be “both highly knowledgeable about politics and lacking in trust.”

Miller and her team explain that people with deeper political knowledge are better equipped to make connections between abstract political ideas, that they are more likely to seek to protect their positions, and thus more likely to endorse “ideologically congruent” conspiracy theories – that is, theories that are consistent with their political positions.

People with a reasonable amount of trust in social and governmental institutions were far less motivated to accept such theories. The study’s authors asked approximately 2,200 Americans who self-identified as either liberal or conservative to consider eight conspiracies. Four were designed to appeal to conservatives and four to appeal to liberals (for example, respectively, Obama was not born in the U.S. and the Bush Administration knew about 9/11 before it happened). The authors also created a “trust index” based on how much the individuals trusted the federal government, law enforcement, media and the public to do what is right.

Here were some of their conclusions:

  • Conservatives are more likely to endorse ideologically congruent conspiracies than liberals.
  • Individuals with a high level of trust in institutions are less likely to endorse conspiracy theories.
  • Conservatives knowledgeable about politics are more likely to endorse ideologically congruent conspiracy theories. There is no evidence of a similar correlation among liberals.
  • Conservatives knowledgeable about politics who also have little trust in institutions are most associated with endorsement of ideologically consistent conspiracy theories: “Highly knowledgeable conservatives are more likely to engage in ideologically motivated endorsement, especially if they believe that the world is an untrustworthy place.”
  • For liberals, greater knowledge about politics and greater trust in institutions both appear to decrease their tendency to endorse conspiracy theories.

As I have previously noted, labels like “conservative” and “liberal” can be inexact. (I’ve been called both–and my own definition of both terms is probably different from that of many other people.) Furthermore, there is a demonstrable difference between principled conservatism and the sort of Tea Party and “alt-right light” individuals who call themselves conservatives these days.

That said, the study is illuminating.

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