Chasing Those ‘Elitists” Away

Even policies that are adopted after extensive research and thoughtful debate often generate unanticipated consequences, so it shouldn’t be a surprise that a policy based on rejection of relevant evidence and refusal to engage in debate is rapidly degrading access to medical care in Red states.

I’m referring, obviously, to the abortion bans that were enacted (or triggered) immediately after the Dobbs decision overturned Roe v. Wade.

In November, Timothy Noah reported that warnings of an eventual “brain drain” caused by those bans had the timing wrong: it wasn’t “eventual”–it was already occurring. Red state culture wars aren’t only creating medical care “deserts,” they’re driving other college-educated workers— teachers, professors, and more—out as well.

Noah began his article by telling the story of a married same-sex couple, both Ob-Gyns practicing in Oklahoma. They now live in Washington, D.C.–a move that doubled their housing costs and reduced their pay. (It turns out that Red states, which have fewer Ob-Gyns, pay doctors significantly higher wages than states where there are ample practitioners.)

Kate Arnold and Caroline Flint are two bright, energetic, professionally trained, and public-spirited women whom Washington is happy to welcome—they both quickly found jobs—even though it doesn’t particularly need them. The places that need Kate and Caroline are Oklahoma and Mississippi and Idaho and various other conservative states where similar stories are playing out daily. These two fortyish doctors have joined an out-migration of young professionals—accelerated by the culture wars of recent years and pushed to warp speed by Dobbs—that’s known as the Red State Brain Drain.

Abortion restrictions have turbocharged that brain drain, but state laws restricting “everything from academic tenure to transgender health care to the teaching of ‘divisive concepts’ about race” are making these states uncongenial to other knowledge workers.

The number of applications for OB-GYN residencies is down more than 10 percent in states that have banned abortion since Dobbs. Forty-eight teachers in Hernando County, Florida, fed up with “Don’t Say Gay” and other new laws restricting what they can teach, resigned or retired at the end of the last school year. A North Carolina law confining transgender people to bathrooms in accordance with what it said on their birth certificate was projected, before it was repealed, to cost that state $3.76 billion in business investment, including the loss of a planned global operations center for PayPal in Charlotte. A survey of college faculty in four red states (Texas, Florida, Georgia, and North Carolina) about political interference in higher education found a falloff in the number of job candidates for faculty positions, and 67 percent of the respondents said they would not recommend their state to colleagues as a place to work. Indeed, nearly one-third said they were actively considering employment elsewhere.

Here in Indiana, school corporations are experiencing dramatically higher teacher vacancies, and like other Red states, Hoosier rural residents struggle to find medical care–and not just prenatal care. It seems it isn’t just Ob-Gyn practitioners who are abandoning Red states.

Family doctors are also “reassessing” their options–and training availability.

Researchers from the Person-Centered Reproductive Health Program at the University of California San Francisco have found there is reason to be concerned about training for family physicians in ban states as well.

A study published in the November-December issue of the Annals of Family Medicine found that 29% or 201 of 693 accredited family medicine residency programs in the U.S., are in states with abortion bans or significant restrictions on abortion access. The study used publicly available data from the American Medical Association to conduct the analysis, and found 3,930 residents out of 13,541 were in states where abortion is banned or heavily restricted.

For practitioners who remain in those states, the training they are now able to receive deprives them of the skills they need to deal with miscarriages and various problems in pregnancy. Residents in those states no longer have access to comprehensive reproductive health training because they’re not experiencing it within their state context. As the lead researcher explains, “they cannot see abortions, cannot perform them, cannot learn how to care for patients after abortions in the same way they would be able to if they were working in a state where abortion was unrestricted.” As she points out, early pregnancy loss is very common, and the skill set for caring for that and first trimester abortion are very similar.

It bears repeating that the exodus of educated citizens isn’t limited to medical professionals. (MAGA Republicans are actually applauding the exit of the teachers and professors they distrust.) Ironically, the rural folks these MAGA lawmakers disproportionately represent are the ones first experiencing the “unintended consequences” of their misogyny–the absence of teachers and doctors.

It will only get worse…..

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Is Shamelessness The Answer?

In these daily musings and rants, I’ve frequently noted my inability to understand why anyone would look at Donald Trump–as he parades his monumental ignorance, his bile and his obvious mental illness–and say, “Yep. That’s the guy I want to trust with the nuclear codes.” I simply haven’t been able to get my head around it.

But over the holidays, I read a review in the Guardian of a book offering a plausible explanation. Let me share a (relatively lengthy) quote that describes the author’s theory:

Imagine a white, working-class American, most likely a man, from Louisiana or Alabama, perhaps, standing in a long line that represents his life’s journey. The man has been sold the American “bootstrap myth”, which states that his great country is a place where anyone can rise from the humblest of origins to become a billionaire or a president, and at the end of the line he expects to find a little part of that dividend for himself. But things aren’t panning out as he had hoped. For a start, the line stretches to the horizon, and even as he stands in it, he suffers: his pay packet is shrinking, the industry he works in is moving overseas, and the cost of everything from food to gas to healthcare is through the roof. Worse still, he can see people cutting into the line ahead, beneficiaries of “affirmative action” – black people, women, immigrants. He doesn’t think he’s racist or misogynist, but that’s what they call him when he objects. He is doubly shamed: privately, by his failure to live up to the myth; publicly, by liberal society.

This is the so-called deep story of the American right. We don’t have to accept the man’s worldview, just believe that this might be how he perceives it.

 Now a new figure enters the scenario, an orange-haired tycoon: we’ll call him Donald. Donald seems instinctively to understand the man’s shame. In fact, he’s a shame expert. He has a long history of transgression, and people have been trying to shame him for much of his life. But Donald has found a way around it: he has become shame-less. He demonstrates his shamelessness almost daily by producing a stream of shameful remarks – about Mexicans, say, or Muslims, or the sitting president, who happens to be black. Although people shout “Shame!” at him, each condemnation inflates Donald a little more in the eyes of his tribe, including the man in the line, who holds him up as a sort of shame messiah. By refusing his own shame, Donald absolves them, too.

The author of the book being reviewed, one David Keen, observes that the words “shame” and “shameless” are currently in greater use than at any time since the mid-19th century.

I have often theorized that the far Right is populated by people who are deeply unhappy with their lives–people who are looking for someone or some group to blame for their failure to achieve their goals. Keen’s analysis is consistent with that thesis, but adds another layer to it–the fact that failure to meet one’s own expectations (or those of the culture into which one has been socialized) will inevitably involve some measure of self-incrimination, or shame.

When you think about it, when people feel they’ve screwed up–when they fail at something they wanted or expected to accomplish–that failure is typically accompanied by feelings of unworthiness/shame, prompting a pretty human desire to find a scapegoat to whom they can “hand off” responsibility for the failure. Well-balanced adults can resist that urge, recognizing it for what it is, but a lot of people cannot–hence racism, misogyny, antisemitism.

The review made me wonder whether different cultural expectations might not ease those feelings of shame. What if we Americans didn’t “monetize” the concept of success? What if our expectations of other adults focused more on behaviors like loving-kindness or generosity or other markers of commendable adult behavior and less on career or money or fame?

What if we didn’t tell American children they could “grow up to be President”–didn’t burden them with expectations of professional or financial success, however we define that–but instead just told little boys and girls “when you grow up, I want you to be a good person–a mensch.”

What if we raised people who could be trusted with the nuclear codes?

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How To Save The Country–My New Year’s Resolution

Of course I don’t really know how to save the country–but I do know that an effort to change the direction of our politics requires not just a “what,” but a “how.”

(Forgive the digression, but when I listen to Mike Braun’s interminable TV ads, the utter   lack of that “how” drives me crazy. Granted, he’s a fairly unattractive person anyway, but when he pontificates that he has the “answer” to America’s problems, and advocates things like “sending illegal immigrants home,” he doesn’t bother to say how that might be accomplished. He talks about “stopping China,” but not what “stopping” would entail or how he proposes to do it.) (Of course, if these were issues he actually cared about, he’d remain in the Senate, since the federal government has exclusive  jurisdiction over them. He wouldn’t be running for Indiana Governor…)

As Trump, Braun and so many other candidates have figured out, it’s much easier to identify a desired destination than it is to map out a practical and/or constitutional journey to get there.

Yesterday, I concluded my post by identifying my New Year’s Resolution –working as hard as I can to defeat the racist cult that has replaced the Republican party. That statement raises a legitimate, and increasingly difficult, question, not just for me but for every American who is terrified by the prospect of a Trump or Trumpist victory in November: how?

What can an individual do to help ensure the continuation of the American experiment? Depending upon our particular skills, available time, energy, location…where can we each best deploy our efforts?

Probably the most important activity involves registering non-voters who are likely to vote Democratic. If you are like me, you have few–if any– unregistered friends and acquaintances, but there are organizations working on voter registration that can use volunteers. This is particularly important in rural areas, where Democratic-leaning citizens are convinced that they’re the only ones so there’s no point to voting.

Speaking of volunteering: volunteer with a political campaign being waged by someone you admire. This can involve phone banking, canvassing, organizing events, or providing support in other ways. If you have the means, contribute financially. Again, this is especially important in states like Indiana, where the biggest problem Democrats face is a  belief that no Democrat can win.

If at all possible, you can connect with local or even national grassroots organizations that are mobilizing voters and working to get out the vote. Turnout will be the single most important element of the coming election cycle: when lots of people turn out to vote, Democrats win. Republicans have figured this out–and credit where credit is due, they have been brilliant in suppressing turnout. (Gerrymandering has been their biggest success in convincing voters not to bother coming to the polls, but it isn’t their only tactic.) We can all encourage friends, family, and acquaintances to vote; if time and energy permits, you can organize a voter registration drive and/or a get-out-the-vote effort.

Speaking of time and effort, consider running for office yourselves.

Finally–be an advocate. Challenge officeholders who support unAmerican measures; call out bigotry (especially in campaigns); fact-check dubious assertions and fake news and communicate the results; share accurate information.

I intend to use this blog to mount such challenges and to call out the Mike Brauns, Jim Banks and others who should not be trusted with public office, and in addition, I have already volunteered on Marc Carmichael’s Senate campaign, as well as Trish Whitcomb’s very welcome campaign in Southern Indiana against “permitless-carry”  gun nut Jim Lucas. If anyone reading this post has added ideas about help I can provide to the “good guys,” let me know.

What will each of you do to defeat the MAGA effort to turn America into a replica of Victor Orban’s Hungary?

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A New Year

I’ve long since abandoned the practice of partying on New Year’s Eve. For the past several years, my husband and I haven’t even made it to midnight to welcome the turnover to a new, as-yet-unspoiled year.

But that lack of a proper welcome doesn’t mean that the turn of the calendar page goes unnoticed or that it lacks significance. Actually, for us older folks with grandchildren in their early adulthoods, the portents are especially significant. What will the coming year tell us about the world those grandchildren will have to navigate?

For what it’s worth, I think the year 2024 is likely to be pivotal for the United States–and thus for the world order.

I know that we tend to see whatever it is we look for, and I’ll admit up front that I’m looking for good omens. Those omens are out there–offsetting, to some extent, the dark clouds of hate and fear that dominate the news cycle. The bad omens remain “front and center”–wars in Ukraine and the Middle East, the growth of populism worldwide and Christian Nationalism at home, the ability of a handful of Congressional buffoons to paralyze the federal government, and over it all, the persistent warming of the planet and the multiple threats to human civilization posed by climate change.

Then there’s the inconceivable (to me) persistence of support for a moronic, narcissistic madman–coupled with an equally mystifying lack of appreciation for a President who will go down in history (assuming we have a history) as a leader as consequential as FDR.

I’m not ignoring the storm clouds.

But history develops in cycles, and the transition from one cycle to another is typically chaotic and difficult. Various academic studies peg those social cycles at anything between 40 and 80 years. In the US, the last truly monumental social upheaval occurred in the tumultuous Sixties, triggering a reaction that elected Ronald Reagan and devotion to trickle-down economics, and winked at racism and other forms of bigotry and tribalism.

The Internet came along and connected all the malcontents–both those who found modernity, with its multiple ambiguities, unbearable, but also those of us who welcomed it. The Internet destroyed local newspapers, and provided us with the ability to choose the news we wanted to believe, adding to the chaos of social change.

Among the positive omens is the fact that local news is rebounding across the country.

The international effort to combat climate change is moving more slowly than we might like, but more substantively than we had any right to expect in an ever-quarreling world. There are fewer and fewer people who dispute the reality of climate change, and encouraging scientific and technological breakthroughs aimed at ameliorating it.

Medical science continues to advance. People are alive today who would never have made it to their current ages but for those advances, and efforts to stamp out historically devastating diseases in poorer countries are succeeding. (The refusal of ideologically-motivated, scientifically-ignorant individuals to be vaccinated against a pandemic was unfortunate for those individuals and their families, but has likely improved the health–and perhaps the genome– of the overall population.)

And there are multiple signs that a majority of Americans reject the racism and antisemitism and misogyny that still garner headlines. It’s true that the minority of haters is a lot larger than I would have guessed a few years ago, and they are certainly more active. But they are a minority.

Think about it: the demonstrations after the murder of George Floyd were multi-racial. The “Karen” memes on social media and the sharing and shaming of racist incidents captured by those ubiquitous phone cameras are evidence of widespread disapproval of bigotry. Increases in inter-racial and inter-religious marriages (and I would add, the rise of the “nones”) are signs of weakened barriers between members of the human family. Add too, majority approval of same-sex marriage, and the overwhelmingly negative reaction to the (unbelievably paternalistic) Dobbs decision.

The fact that calling a proposal “socialist” is no longer sufficient to defeat it, and the rise of new economic theories challenging free-market absolutism are signs of a growing recognition that–as I used to tell my students–issues are complicated and finding correct answers depends on facts and context.

There’s more, but here’s the thing: the upcoming year will be pivotal. It will tell us whether a determined minority, empowered by gerrymandering and unencumbered by intellect or ethics, will strip women of autonomy, put gays back in the closet, and return Blacks and Jews to second-class status.

My New Year’s Resolution is simple: I intend to work my butt off to defeat the White Nationalist cult that has taken over what used to be my political party.

I hope you’ll join me.

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How Hateful Can They Be?

Here’s a “what-if.” What if orphans with serious medical problems–say asthma or epilepsy–were intentionally placed with foster or adoptive parents who were devout Christian Scientists or Jehovah’s Witnesses? Parents who would “pray away” attacks rather than provide medical care? What if a federal law required those doing the placements to ignore such parental beliefs on the basis of “religious freedom”? What if refusal to place a seriously ill child with a family that rejected medical science was considered “discrimination”?

I think–I certainly hope–most rational people would be appalled. 

Of course, Indiana Congressman Jim Banks is a culture warrior, not a rational person.

A Republican congressman has proposed a bill to prevent child welfare agencies from turning away prospective foster and adoptive parents who refuse to recognize transgender and nonbinary children’s identities.

U.S. Rep. Jim Banks (R-Ind.) introduced the bill earlier this month in response to a proposed rule from the U.S. Department of Health and Human Services.

The rule would require child welfare agencies to place LGBTQ-identifying children in homes where they will not be mistreated or abused due to their sexual orientation or gender identity. 

Caregivers for LGBTQ children would be required to receive training on how to provide for any unique needs those youth may have because of their identity.

Banks calls the rule discriminatory. He says it’s unfair to the “loving prospective parents who do not support the idea of transgender identity or who oppose homosexuality based on their religious beliefs.”

Yes, I can just imagine how “loving” those families would be to a child already struggling with both an absence of birth parents and thorny identity issues. Why not place Jewish children with “loving” Neo-Nazi families, or Black children with “loving” racists?

What the hell is wrong with these people?

Banks has instead proposed the Sensible Adoption for Every Home Act (SAFE), which would ensure that families that are headed by parents who hold anti-LGBTQ views are not rejected as foster parents. It would enforce that by prohibiting placement agencies that refuse to place LGBTQ children with otherwise qualified couples from receiving federal funds.

Even though social transition does not necessarily involve medical interventions, Banks — like many Republicans pushing anti-transgender legislation — equates affirmation with pursuing surgical and hormonal treatments.

His bill also seeks to protect parents who oppose psychological treatments or counseling for trans-identifying children, or refuse to use gender-affirming pronouns, from being discriminated against by placement agencies. 

Banks has company. Eighteen Attorneys General (all Republicans, of course) have signed a letter opposing the rule. And of course, the GOP’s rank hypocrisy is once again front and center.

As much as Republicans claim it’s unfair to discriminate against non-affirming parents, 13 states currently have laws that allow placement agencies to reject same-sex couples, single or unmarried parents, older opposite-sex couples, interfaith couples, and other prospective parents based on their purported religious beliefs.

I guess it’s okay to discriminate against people if the”sincerely held religious beliefs” of Republican lawmakers require legislating disapproval of those people. 

I have previously described Jim Banks as a Christian Nationalist’s wet dream. The remainder of the linked article supports that (admittedly unkind but arguably accurate) description.

In Congress, Banks has amassed a record that is hostile to LGBTQ rights.

He previously co-introduced a bill to allow adults who experience “regret” after undergoing transition-related treatments as youth to sue their former doctors.

He introduced another bill earlier this year, in conjunction with Sen. Marco Rubio, seeking to ban transgender individuals from serving in the U.S. military.

Last year, Banks submitted a discharge petition to force a vote on a bill to bar transgender women and girls from participating in female-designated sports. 

Banks was also previously banned from Twitter, prior to Elon Musk’s takeover of the platform, for deliberately misgendering Adm. Rachel Levine, the country’s first transgender four-star admiral with the U.S. Public Health Service Commissioned Corps and the Assistant Secretary of Health at HHS.

This is the culture warrior who wants to be Indiana’s next U.S. Senator.

I recently became aware of a PAC established by several of Banks’ current constituents; it’s called the Hoosiers for Common Sense PAC and its “primary goal is to elect a common-sense Hoosier Democrat, Marc Carmichael, and prevent Jim Banks from advancing to the US Senate.” You can contribute here. 

Or you can contribute at Marc Carmichael’s website. Among his other eminently sensible positions, Carmichael wants to put an end to demonizing trans children for political advantage. It’s hard to disagree with his statement that harming innocent children in an effort to garner votes is simply beyond the pale.

Way beyond.

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