I Can’t Wrap My Head Around This….

As if the ongoing disaster that is the Republican presidential clown car wasn’t doing enough damage to the image and prospects of the once-Grand Old Party (not to mention the country), I recently came across two articles about the party’s lawmakers that made me ask not “what were they thinking?” but “was anyone thinking?”

Last week, Congressional Republicans passed a measure that would have blocked EPA enforcement of the Clean Water Act. The President vetoed it, but I remain absolutely stunned that—in the midst of the disaster in Flint, Michigan, and the national outcry over that massive failure of government oversight—such a bill would even be introduced, let alone passed.

Unsurprisingly, the effort unleashed headlines like “As Flint, Michigan Suffers from Contaminated Water, Republicans Attack Clean Water Act.”

Thanks to an ill-conceived effort to save an estimated $100 per day (followed by 18 months during which the Governor’s office responded to complaints from citizens by telling them the water was just fine although they knew it wasn’t), Flint’s children now face impaired cognitive development, behavioral problems, and nervous system damage. Meanwhile, estimates of the costs to correct the entirely man-made problem run into the billions.

And yet.

In the midst of this crisis, and just days before the state of emergency was declared, Republican House Speaker Paul Ryan wrote an op-ed attacking the EPA’s Clean Water Rule. In the op-ed, Ryan declares that the stricter rules (finalized by the EPA this past summer which gives the agency authority to regulate smaller bodies of water to limit pollution) are a prime example of government overreach and that the only goal of the agency is to micromanage how citizens use water.

There is a yiddish word for this behavior: chutzpah. (Look it up.)

You might think that nothing could top this particular display of tone-deaf arrogance, but you’d be wrong.

Whenever another mass shooting brings calls for better background checks or other modest gun-safety measures, the NRA and its enablers always respond by insisting that the problem is a lack of mental health screening and treatment. So Senator Al Franken has sponsored a bill to improve those services.

The Franken Bill would provide much needed mental health services and tools for police and the courts to address deficiencies in the nation’s mental health system. The legislation should be uncontroversial, but Mike Lee and Tom Coburn adhere dogmatically to an anti-government ideology that would even deny combat veterans and others suffering from mental illness, access to critical services.

So Coburn and Lee have blocked the bill.

Franken’s bill does have support from several less-crazy Republicans, but increasingly, GOP policy is in thrall to people like Lee, Coburn and the Governor of Texas, who recently vetoed a mental health bill in that state because—wait for it—he doesn’t believe mental illness is real. (Can I offer you a mirror, Governor?)

Speaking of cognitive impairment…Just how many Americans have been drinking Flint’s water, and for how long?

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The Tragedy—and Promise—of the Commons

The “tragedy of the commons” is a term often used by economists and ecologists;  it’s shorthand for situations where individuals who are acting independently and rationally in their own self-interest undermine the common good.

Indiana Law professor and activist Fran Quigley thinks the tragedy of the commons explains a lot about the state of American health care. As he explains in an intriguing new article he shared with me (not in print yet, so no link available)

Between the 15th to 19th centuries, the rich and the powerful fenced off commonly-held land and transformed it into private property. Land switched from a source of subsistence to a source of profit, and small farmers were relegated to wage laborers….

 More recently, a similar enclosure movement has taken place. This time, the fenced-off commodity is life-saving medicines. Playing the role of modern-day lords of the manor are pharmaceutical corporations, which have taken a good that was once considered off-limits for private profiteering and turned it into an expensive commodity. Instead of displacing small landholders, this enclosure movement causes suffering and death: billions of people across the globe go without essential medicines and 10 million die each year as a result.

Quigley points out that producing medicine for profit is a relatively modern phenomenon–and says it is time to reclaim this commons, and he spends several pages showing how medicines fit the definition of a public good.

The public health implications of access to medicines generate another core quality of public goods: positive externalities. One person’s consumption of an essential medicine provides clear benefits beyond the direct consumer. Vaccines, for example, prevent both the recipient from getting ill and also from spreading the disease to others. If a society vaccinates widely enough, the chain of disease transmission is broken, leading to the quintessential public good of herd immunity. Global distribution of the smallpox vaccine has led to the eradication of a disease that once infected 50 million people a year.

I hadn’t known that “Until well past the middle of the 20th century, few countries allowed individuals or companies to hold exclusive rights to produce medicines.” ( I was aware that pharmaceuticals are and always have been, as Quigley points out “the very opposite of a laissez faire market.”)  And I did know that the U.S. government is a major funder of medicine research.

Quigley is particularly critical of the notion that drugs can be patented, and points out that many countries limit the duration or scope of such patents:

Among governments and the public alike, medicines continue to be treated as a good quite distinct from consumer items like cell phones or flat-screen TV’s….Jonas Salk declined to pursue a patent for the polio vaccine, saying the patent belonged to the people. The creator of the first synthetic malaria vaccine donated the patent to the World Health Organization. As Salk said in 1952, “Would you patent the sun?”

Today, of course, major drug companies depend upon those patents for their profitability.

Economists call this process the transformation of a public good into a “club good,” like taking a public park and turning it into a gated dues-required golf course.

Quigley’s article is a fascinating history of how intellectual property protection overcame the previous widespread belief that medicines should be considered public goods, not consumer products. And he argues that

The history of pharmaceutical innovations, especially vaccine developments and life-saving treatments for infectious and chronic diseases, shows that the critical research behind these developments was created outside the patent system…The U.S. National Institutes of Health alone provides $30 billion annually for medical research, governments provide tax credits to support corporate research, and government health programs are bulk purchasers of patented medicines priced far above the costs of production. When it comes to medicines,  taxpayers of the U.S. and other research-supporting countries are the very opposite of free-riders: they pay to build the bus, fill it with fuel, and hire the driver, but still are asked to pay a prohibitive fare if they wish to take a seat.

In fact, a decade ago, U.S. economist Dean Baker crunched the numbers and estimated the savings to the U.S. government if its health systems could provide medicines without the artificial mark-up imposed by monopoly patents. The resulting savings could fund the replacement of all private industry research and development several times over, while still leaving billions of dollars in remaining public benefit. A significant source of those savings derives from eliminating the for-profit pharmaceutical companies’ expenses on marketing, a cost that exceeds their investment in research and development. As it happens, there are more efficient use of resources than funding television ads for erectile dysfunction drugs.

When the article is in print, I will share a link, because this abbreviated review doesn’t do it justice. But the question is, given the extent to which current practices are embedded in our economic system, can it be changed? Quigley admits the magnitude of the barriers, but he provides a surprisingly long list of reform efforts currently underway.

What struck me most while reading the article was how easy it is to assume that “the way things are” is the way they’ve always been, and the only way they can be—and how difficult it is to identify and protect a steadily shrinking commons in an America that has lost sight of citizens’ essential interdependence.

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A Useful Metaphor

You’d have to be living in a cave to escape all the hype about the new Star Wars movie. I rarely go to movies, but even I felt the need to see this one—if only to hold my own with my grandchildren.

For the record, I thought it was a pretty mediocre movie. I have always thought that Star Wars was space opera with great special effects, rather than inventive science fiction, but I think I understand the appeal of the franchise.

It’s the good guys against The Dark Side.

In real life, the lines are not so simple. Most people are neither saintly or unremittingly evil. (As a friend of mine likes to say, incompetence explains so much more than conspiracy.) In  many situations, determining right and wrong can be complicated. But—probably for that very reason— we humans tend to pine for bright lines, for simple demarcations between “us” and “them”—with “us” being the good guys and “them” the bad guys.

Of course, there really are “bad guys.” Sometimes, those we label “bad” are simply misguided, or mentally incapacitated  (or really, really stupid), but there is no denying that there really are a lot of malevolent people in the world—not to mention the assholes, the self-aggrandizing, self-centered power-seekers who aren’t affirmatively evil, but who don’t care about the harmful consequences of their actions.

These days, in various arenas and more often than we like to admit, the “bad guys” seem to be winning, and winners are attractive. Political psychologists tell us that people like to identify with winners, to climb onto the bandwagon of popular opinion.

In real life, we are challenged to reject the affirming mindlessness of the mob— to refuse to go over to The Dark Side, no matter what the temptations or inducements—and to do so without becoming “bad guys” ourselves.

Draw your own political analogies….

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The More Things Change

The battle at the Indiana Statehouse over adding “four words and a comma” to the state civil rights law has brought back some interesting memories.

I first began writing a column for the Word, a newspaper serving Indiana’s gay community, some 25 years ago. I stopped when the Word changed ownership, but the new editor (an old friend) asked me to come back, and I agreed.

Then I did something else.

I went into my files and reviewed some of my earliest Word columns. That review left me with two contradictory impressions: how dramatically things have changed—and how little.

Here, for example, are excerpts from a column from the year 2000. Just 16 years ago.

My youngest son recently attended the wedding of two co-workers. It was a lovely affair—formal, at an expensive Chicago hotel, conducted with meticulous attention to detail.

The program book included a message from the bride and groom, reciting how enthusiastic they were to enter into wedded life together, how sure they were that matrimony was the right choice for them. In fact, they said, there was only one hesitation, one fact that gave rise to a certain reluctance to marry: the fact that others were legally prevented from doing likewise. It seemed unfair that the status of matrimony was available to them, a man and a woman, and not available to others merely because they were of the same gender. The message concluded with a request that those present, who had shared the happy day with this particular couple, work toward a time “when everyone can enter into the institution of marriage and have their union recognized by society and the state.”

I couldn’t help thinking about the implications of this simple, powerful statement….

What would happen to the pervasive bigotry against gays and lesbians if hundreds, then thousands, of heterosexuals added similar paragraphs to their wedding programs? What if every church and synagogue that believes in human dignity added such language to their bulletins? What if businesses catering to families advertised for business by interpreting “family” in an inclusive and affirming way?

That would change the world.

What a contrast I see between my son’s friends and the group of shrill and homophobic clerics who called a press conference in Washington last week to announce that God hates homosexuality…

I am confident that, if there is indeed a judgment day, a good and just God will offer a special place in heaven to the young couple whose love extended beyond each other to embrace the human community and all its members.

The real question is, how would that good and just God respond to those who used the name of the Lord to justify their hatreds and excuse their bigotries?

As we now know, what did “change the world” was the courage of thousands of LGBT people who refused to live dishonestly and who “came out”–often with the support of their families and allies, but sometimes in the face of enormous hostility.

Last year, marriage equality became the law of the land, and survey research tells us that solid majorities of Americans now endorse marriage equality and support the extension of full civil rights protections to the gay community.

What didn’t change, of course, is the fury of the religious extremists—including Indiana’s Governor—who continue to use their religions and their crabbed versions of Deity to justify homophobia and discrimination. They are out in force to keep the Indiana General Assembly from adding sexual orientation and gender identity to Indiana’s civil rights law. Their persistence is why the rest of us can’t rest.

Not yet.

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Secret Government

A few weeks ago, the Boston Globe ran an article that should be required reading for all of the activists–left and right–proposing deceptively simple”fixes” for what ails government.

The article began by noting candidate Obama’s promises to reign in the NSA, close Guantanamo, and roll back portions of the Patriot Act.

But six years into his administration, the Obama version of national security looks almost indistinguishable from the one he inherited. Guantanamo Bay remains open. The NSA has, if anything, become more aggressive in monitoring Americans. Drone strikes have escalated. Most recently it was reported that the same president who won a Nobel Prize in part for promoting nuclear disarmament is spending up to $1 trillion modernizing and revitalizing America’s nuclear weapons.

Why did the face in the Oval Office change but the policies remain the same? Critics tend to focus on Obama himself, a leader who perhaps has shifted with politics to take a harder line. But Tufts University political scientist Michael J. Glennon has a more pessimistic answer: Obama couldn’t have changed policies much even if he tried….

In a new book, “National Security and Double Government,” he catalogs the ways that the defense and national security apparatus is effectively self-governing, with virtually no accountability, transparency, or checks and balances of any kind. He uses the term “double government”: There’s the one we elect, and then there’s the one behind it, steering huge swaths of policy almost unchecked. Elected officials end up serving as mere cover for the real decisions made by the bureaucracy.

The article describes what Glennon came to recognize from a career that included stints as  legal counsel to the Senate Foreign Relations Committee, and consultant to various congressional committees and the State Department: in a number of policy areas, but especially national security, the people we elect have limited ability to effect policy change. Bureaucrats–and the systems within which they operate–call the shots far more than most of us realize. As he notes,

It hasn’t been a conscious decision….Members of Congress are generalists and need to defer to experts within the national security realm, as elsewhere. They are particularly concerned about being caught out on a limb having made a wrong judgment about national security and tend, therefore, to defer to experts, who tend to exaggerate threats. The courts similarly tend to defer to the expertise of the network that defines national security policy.

The national security apparatus is probably the most extreme example, but the phenomenon that Glennon describes operates, albeit to a lesser extent, in virtually all large bureaucracies, public or private. (There’s a reason business schools and schools of public affairs offer classes in organizational culture—systemic dynamics make change far more daunting than those on the outside realize.)

When you add policy complexity and specialized expertise to systemic inertia, the barriers faced by would-be “change agents” become even more daunting.

This phenomenon is why well-meaning calls for term limits aren’t just naive, but dangerous. When a newly elected Congressman or Senator takes office, he is utterly dependent upon (nameless, unelected) staff to show him the ropes. With term limits, by the time he  learns enough about how it all works to actually be effective, he’s gone. The result is to place even more power in the hands of staff members who have staying power and know how the system works—anonymous functionaries that voters cannot hold accountable.

It would be far better to use the original mechanism for limiting terms: the ballot box. Unfortunately, rampant gerrymandering has removed that option by ensuring that far too many districts are uncompetitive.

It’s a problem.

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