Is It All Palin’s Fault?

My brother-in-law, a life-long and pretty conservative Republican, recently commented that Trump’s primary victory reminded him of an old saying. Paraphrasing, it went something like this: the man who knows, and knows he knows, can be trusted; the man who doesn’t know, and knows he doesn’t know, can be trusted; but the man who doesn’t know and doesn’t know he doesn’t know is dangerous, and cannot be trusted.

The Donald, of course, doesn’t know what he doesn’t know. If anyone had any doubts, his suggestion that he would “negotiate” the nation’s debt with creditors, and “do a deal” in which they would take less than they’re owed, should put those doubts to rest. (Among the multiple things he clearly “doesn’t know” that he “doesn’t know” are the importance of America’s creditworthiness to global fiscal stability, and the inconvenient fact that the majority of the nation’s creditors are its own citizens–including, importantly, those depending on Social Security.)

In the wake of the Indiana primary and Trump’s emergence as the GOP nominee-apparent,  the internet has been inundated with “analysis” and theories about how this happened, who’s to blame, and of course, “what the hell happens now.”

So far, one of my favorite (albeit dubious) theories lays the blame with Sarah Palin–or more accurately, with John McCain, who elevated the Wasilla Wacko to national prominence.

In this view, the damage Palin wreaked was in getting Republicans to lower their standards for what a vice-president or a president ought to be. Suddenly, what one writer called a “meaningful and valuable norm” no longer controlled public opinion.  Palin was embarrassingly unqualified for the job, but she was endorsed by McCain and establishment Republicans–and the result was that the bar was lowered so far that for a number of Republican voters, Donald Trump was no longer unthinkable.

I’m sure there are as many theories as there are pundits. Americans who are appalled at the prospect of electing someone so manifestly unprepared and unsuited for the Presidency are trying to make sense of it all (and in most cases, looking for someone–anyone–to blame).

There’s lots of blame to go around, of course. But while we are trying to make sense of the crazy situation in which we find ourselves, we’d better spend the time between now and November doing whatever it takes to ensure that voters understand the difference between voting for the winner of American Idol and the person who will be occupying the Oval Office.

We may or may not be enthusiastic about our other choices–but there are degrees of unthinkable, distasteful and very, very dangerous.

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What We Lost When We Lost Newspapers

I recently read an article on Resilience–an aggregator website–that struck a chord.

The author was bemoaning, as so many of us do, the disappearance of what I’ve referred to previously as the “journalism of verification.” These are the paragraphs that really resonated with me:

Our modern culture tells us that we have more information today than anyone in history, because of the internet – but that assumes that data that could theoretically appear on a screen has the same value as words read from paper. In truth, few web sites will cover the library board meeting or the public works department, and if they do they are likely to be a blog by a single unpaid individual. Yet these ordinary entities shape our children’s minds and our present health, and as such are infinitely more important than any celebrity gossip — possibly more important then presidential campaigns.

Even if a blogger were to cover the library board or water board, no editors would exist to review the material for quality or readability, and the writer would be under no social, financial or legal pressure to be accurate or professional, or to publish consistently, or to pass on their duties to another once they resign.

Recently, former programmers at Facebook accused the site of manipulating the identity of “trending” stories. I have no idea whether this is true (actually, I sort of doubt it, for a number of reasons not relevant to this post), but in a culture permeated by suspicion, I’m sure the accusation will get traction–and add to our already high levels of paranoia.

One of the most daunting challenges of contemporary governance–really, of contemporary life–is the pervasiveness of distrust. Americans no longer know who or what to believe, are no longer able to separate fact from opinion, and no longer feel confident that they can know the agendas and evaluate the performance of their social and political institutions.

We live in an era when spin has become propaganda, and reputable sources of information must compete with “click bait” designed to appeal to pre-existing prejudices. Partisans of all sorts play on well-known human frailties like confirmation bias. 

The result, of course, is that Americans increasingly occupy different realities, making communication–let alone rational problem-solving, negotiation and compromise–virtually impossible.

Just one recent example, among too many to count: Sean Hannity of Fox “News” recently cited an “authoritative report” to the effect that the Kremlin had hacked Hillary Clinton’s emails, and was debating whether to release them. And where did this “authoritative report” originate? On WhatDoesItMean.com.

Currently, WhatDoesItMean.com boasts front page headlines such as “Northern England Stunned After British Fighter Jets Battle UFO,” “Russia Warned Of ‘Wrath Of God’ Event As West Prepares To Honor New Planet With Satanic Ritual,” “Music Icon Prince Dies After Obama Regime Fails To Heed Russian Warning,” and “Mysterious Planet Ejected From Black Hole At Center Of Galaxy Warned Could Soon Impact Earth.”

Look, I don’t think anyone wants to return to the era of the “gate-keeper,” where reporters and editors got to decide what news was–what merited coverage and what could safely be ignored. But we desperately need to identify methods that will allow consumers of media to recognize what’s wheat and what’s chaff– to distinguish spin, propaganda and opinion from factual information.

The emergence of Donald Trump as the nominee of a once-respectable political party should be all the evidence we need that the extent of media coverage and the value, accuracy and relevance of that coverage are very different things.

What we lost when we lost the journalism of verification is our ability to engage in responsible self-government.

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Tupperware Trump

Oh, Donald. Tacky, tacky, tacky…..

We’ve all become familiar with the various kinds of pyramid schemes operating in the U.S. Most aren’t as monumental as the Bernie Madoff ponzi-scheme variety, and some even sell arguably useful products, but they all share certain characteristics: they’re based on recruiting an increasing number of “investors,” and typically, those new recruits pay a sum of money to join the “program” and become a distributor of a product or service. They’re told they’ll make money based on the number of new recruits they bring in. The basic idea is that the higher up on the pyramid you are, the more money you’ll make.

In reality, what happens is that only the originators of the pyramid scheme make money and the rest lose theirs when the pyramid scheme collapses.

Evidently, in-between bankruptcies, bottled water and steaks, Donald Trump engaged in a pyramid scheme to sell a “diet product” to the desperate/credulous:

The company’s flagship product was called the PrivaTest, which supposedly relies upon a mail-in urine test to determine one’s individual nutritional needs and create a custom vitamin formula (about $140 for the test; $70 per month for the vitamins; $100 to retest every 6 months).

From a scientific viewpoint, urine tests do not provide a legitimate basis for recommending that people take dietary supplements. Moreover, even if they could, the nutrients in the so-called customized formulas can be obtained far more inexpensively in retail stores. The Trump Network also acquired a weight loss program called The Silhouette Solution, which consisted of a book promising to lose the weight you want and have the silhouette you choose, which was included in the starter weight loss kit, all for a whopping $1,325. The package was marketed as “a complete eight-week program that contains everything you need to achieve your short and long term weight loss goals.” In it, they send you eight weeks worth of low-calorie food….

But it gets better….you could also purchase the $400 “business kit” and market the product to your friends and family, ala Tupperware. Trump sold Privatest and the Silhouette Solution in 2012 to a company called Bioceutica, LLC., apparently due to concerns about liability. Earlier this year, the Washington Post reported on Trump’s claim that his involvement with Ideal Health merely allowed them to use his name for marketing purposes and that he was not involved in the company’s operations.

But statements by him and other company representatives — as well as a plethora of marketing materials circulating online — often gave the impression of a partnership that was certain to lift thousands of people into prosperity. In fact, within a few years, the company fell on hard times, leaving some salespeople in tough financial straits. It ultimately was acquired by another firm.

But when Trump joined forces with Ideal Health, he was enthusiastic about its future.

“When I did ‘The Apprentice,’ it was a long shot. This is not a long shot,” Trump told a Trump Network convention of at least 5,000 people in Miami in 2009, his face projected onto a giant screen. “This is going to be something that’s really amazing.”

Yep. Amazing. You’ll be thin and rich.

And this is the charlatan who’s going to “Make America Great.”

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I Told You So

There’s nothing more annoying than people who say “I told you so”–especially when they told you so.

But, dammit, I told you so. Not that I was the only naysayer–not even close–but I posted several arguments against the privatization of Indianapolis’ parking meters.

So I’m going to be obnoxious, and share the lede of a recent report from the Indianapolis Star

In the five years since Indianapolis leased its parking meter operations to a private company, rates have skyrocketed, hours have expanded and the number of paid spaces has increased.

But the city is reaping only about a quarter of the dollars ParkIndy projected when it paid $20 million to the city to operate the meters until 2061.

Those of us who opposed this “deal” (a word that is beginning to take on Trumpian implications for me) raised several issues:

The fifty-year length of the contract. Even if the deal had been less one-sided fiscally, decisions about where to place meters, how to price them, what lengths of time to allow and so on have an enormous impact on local businesses and residential neighborhoods. They are decisions requiring flexibility in the face of changing circumstances; they are most definitely not decisions that should be held hostage to contracting provisions aimed at protecting a vendor’s profits.

Added costs to downtown development and civic events. More often than not, new  construction interrupts adjacent parking. If the city is managing its own meters, it can choose to ignore that loss of parking revenue, or decide to charge the developer, based upon the City’s best interests. Street festivals and other civic celebrations also require  that meters be bagged, and usually there are good reasons not to charge the not-for-profit or civic organization running the event. The ParkIndy contract requires the City to pay ACS whenever such interruptions disrupt its projected revenue from those meters.

Why privatize at all? This isn’t rocket science. There was never a satisfactory response to the obvious question “why can’t we do this ourselves, and keep all the money?” Why couldn’t Indianapolis retain control of its infrastructure, and issue revenue bonds to cover the costs of the necessary improvements? Interest rates were at a historic low at the time, making it even more advantageous to do so. If the Ballard administration was too inept to manage parking, it could have created a Municipal Parking Authority, as Councilor Jackie Nytes  suggested at the time.

There really was no compelling reason to enrich private contractors and reduce (desperately needed) City revenues.

Why ACS? ACS is the primary partner of ParkIndy. There was extensive publicity about ACS’ performance problems in Chicago; there was also troubling information about the company’s track record in Washington, D.C., where an audit documented mismanagement, overcharging, over-counting of meters, and the issuance of bogus tickets (ACS got all the revenue for tickets). Washington lost $8,823,447 in revenue and experienced a twenty-fold increase in complaints from the public.

As I noted at the time, one of the problems with privatization in general is that it leads to speculation about cronyism and political back-scratching. In this case, the Mayor’s “personal advisor” was a registered lobbyist for ACS through the same law firm that employed the then-President of the City-County Council (who did not recuse himself, and whose affirmative vote was what allowed the contract to be approved by a narrow 15-14 margin.)

All of these criticisms were brushed aside as mean-spirited and uninformed. We were told that ACS/ParkIndy’s “expertise” would generate more revenue than would be realized under city management.

So, according to the Star, how’s that working out?

ParkIndy has collected $40.5 million in parking fees and fines since converting the first meter March 3, 2011. Projected over 50 years that amounts to about $426 million. The city’s take in a profit-sharing agreement has been $15 million, which would total about $158 million in 50 years.

ParkIndy estimated the city would earn $620 million over the 50-year life of the contract. To achieve that, ParkIndy would need receipts of about $1.5 billion, or more than three times its current pace.

Told you so.

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Right to Die

Those of us who listen to public radio are familiar with Diane Rehm, the raspy-voiced hostess of a respected public affairs program. Recently–in the wake of her husband’s terminal illness–Rehm has become a spokesperson for an individual’s right to decide how and when he will die.

Rehm said she decided to write the book because she was frustrated by the way her husband died.

“People need to talk about this issue,” she said. “Doctors need to be taught about this issue. The whole idea of doctors being taught about helping to keep people alive, but not being taught how to listen to those who are ready to die — that seems to me sad and misguided.”

One doctor who has come to agree with Rehm is my cousin, Morton Tavel, a cardiologist whom I often quote on this blog. He recently analyzed the issue thusly:

As a physician, I originally supported the dictum that death should be prevented at all costs. But more recently, I have come to realize that perhaps we should also consider suffering as well as dying.

These thoughts have directed my attention to the so-called “aid in dying” laws that are in force in the U.S. states of Oregon, Washington, Montana, Vermont, and California. They are sometimes referred to as “Physician-Assisted Suicide”. These examples often require that a patient’s death be expected within six months, and they compassionately offer a voluntary, self administered end to suffering at an individual’s own preferred time. Since 2014, aid-in-dying bills have been introduced in Washington, D.C. and several states. Canada is also considering such a bill. Other countries, including Switzerland and Belgium, allow aid in dying for people who are not even terminally ill. All these laws provide freedom for a physician to prescribe a lethal drug to a patient for self administration. At present, such a practice is unlawful in 46 states, including Indiana..

In the example of Oregon, which has had such a law in effect since 1997, subsequent study has uncovered no abuses, and, interestingly, about a third of patients who receive medication to end their lives never actually use it, meaning that many are likely reassured by the simple knowledge that they will be able to end their lives at any time of their choosing.

What people want, often, is knowledge that they can control their own lives and deaths.

Tavel recognizes the potential for abuse, and the need to ensure that people do not terminate their lives because they are depressed, or in pain that could be alleviated with proper medical intervention, but he insists that such issues can be addressed.

Laws addressing such issues should be clearly defined. First, I believe a specific time for life expectancy need not be spelled out, for misery without hope doesn’t necessarily conform to a distinct number of days or months. For instance, someone suffering from a severe progressive neurologic disease such as Lou Gehrig’s disease (ALS) can continue suffering for many months prior to death. On a personal level, I witnessed the suffering and death of a patient/friend of mine from a similar neurologic disorder called progressive supranuclear palsy (PSP), a disease that claimed the life of actor Dudley Moore, which is an uncommon progressive fatal brain disorder that affects movement, control of walking (gait), balance, speech, and many others.Given the choice, and if it were legal, he would have gladly opted to end his life by assisted suicide. Even various terminal cancers can behave for variable durations, but also cause prolonged pain and suffering.

In Oregon, for example,the attending physician and a consulting physician have to confirm the patient’s diagnosis and prognosis and determine whether the patient is capable of making and communicating health care decisions for him/herself. If either physician believes the patient’s judgment is impaired by a psychiatric or psychological disorder (such as depression), the patient must be referred for a psychological examination.

If this and the other safeguards of the Oregon law are satisfied, the prescription may be written.

In most cases, the drug used for this purpose belongs to a group of so-called “barbiturates”, commonly used in lower doses for the induction of normal sleep. In large doses, however, death is painless, peaceful, and will occur within a matter of minutes to hours.

A death in this fashion is usually far better than other, less desirable, alternatives. Thus I might conclude with a simple question: Isn’t it more humane to deal with one’s own species in a manner at least as appropriate as the smooth and painless exit we provide to our beloved animal pets?

What is the justification for over-riding individual autonomy, and insisting that a terminally-ill person suffer?

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