Birth Control And Health Care

If the pandemic has taught Americans anything, it is just how inadequate–and let’s be honest, discriminatory and stupid–our healthcare system is. (Actually, every time I write “healthcare system” I am reminded of the student who was studying to be a hospital administrator, who told me the phrase was inaccurate–“We don’t have a healthcare system. We have a healthcare industry.”)

A few days ago, the Supreme Court handed down an indefensible decision that denied women healthcare if they are unlucky enough to have an employer who has “religious qualms” about allowing their health insurance to include birth control.  Gail Collins provided a perfect analogy:

Let’s pretend there was an order of nuns with a particular devotion to the Sacred Heart of Jesus. So much so that the order had, over the years, decided that any human heart was a holy symbol, and it was immoral to mess with it, even if you were a physician doing cardiac surgery.

Following their consciences, these nuns banned heart-related care from their employees’ health policies. That affected thousands of workers, many of whom did not share their religious convictions. Still, the nuns noted, their insurance coverage was generous. Except for that one thing.

The Court affirmed the right of employers to omit birth control coverage from their group health policies. But that “right” is misleading.  The Obama administration had arranged for the federal government to intervene when religious employers had ethical objections. All the employer had to do was file a form, and they’d be off the hook; the government and the health insurance companies would provide the coverage. The employer wouldn’t need to spend a penny on a sinful women’s health measure.

But that wasn’t good enough. Filing a form would make them complicit. Trump, of course, pandered to the “religious” employers who placed their purported moral purity above the actual health and well-being of their female employees, and the Court acquiesced.

An  estimated 70,000 to 126,000 women will lose their current free contraceptive coverage–and contraception isn’t cheap. As the Times Editorial Board wrote, 

It bears reminding that the cost of birth control can be significant, and that many women rely on it not just to prevent pregnancy but to treat medical issues. Sometimes, the contraceptive method that works best — or the only one a person can tolerate — costs many hundreds of dollars without insurance coverage.

As the Editorial Board also noted,

It’s hard to imagine the conservative justices of this court, especially, allowing employers to claim a moral exemption and require their employees to pay out of pocket for, say, a treatment for Covid-19. That sounds absurd. And yet, when it comes to birth control, such state interference with personal health decisions is considered a legitimate matter for public debate.

The health care industry in this country is the real “American Exceptionalism.”

America could solve conflicts like this one–not to mention racial and economic inequities in access to health care–by emulating other advanced, civilized nations and moving to a single-payer system of health insurance. Not only would such a move eliminate the ability of some Americans to impose their religious convictions on others, not only would it ameliorate a number of racial and economic inequities, not only would it vastly reduce personal stress and the country’s high rate of personal bankruptcies, it would introduce cost-controls to a system that costs far more and delivers far poorer results than others.

How much of our stubborn refusal to provide universal health insurance is due to inertia, to misunderstanding of how markets work or don’t, or a false belief in American superiority–and how much of it is due to a shameful reluctance to extend the social safety net to “others”–minorities and women?

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One Of These Things Is Not Like The Other

There’s a children’s jingle/question that keeps popping into my head: “one of these things is not like the other.” It is a common lead-in to exercises encouraging children to distinguish between shapes, colors, etc.

If the Coronavirus has demonstrated anything, it is that Republicans can’t tell one thing from another.

Trump’s inability to tell the difference between science and superstition (let alone fact and fiction) is a given, but when it comes to science, the entire GOP has demonstrated cognitive dissonance and an astonishing capacity for incoherence.

Anyone who has followed what passes for Republican policy these days can give numerous examples of ways the party has rejected science. A May column in the New York Times by Michelle Goldberg was titled “We’re All Casualties of Trump’s War on Coronavirus Science.” She enumerated the multiple attacks on medical science and scientists by Trump and the dimmer bulbs in the GOP’s Congressional delegation.

The column began by referring to a 60 minutes investigation into the abrupt termination of an NIH grant to the EcoHealth Alliance, a nonprofit research organization focused on emerging pandemics.

The reason, as “60 Minutes” reported on Sunday evening, was a conspiracy theory spread by Representative Matt Gaetz, the Florida Republican who in March wore a gas mask on the House floor to mock concern about the new coronavirus. On April 14, Gaetz appeared on Tucker Carlson’s Fox News show and claimed that the N.I.H. grant went to the Wuhan Institute, which Gaetz intimated might have been the source of the virus — the institute may have “birthed a monster,” in his words.

The first of Gaetz’s claims was flatly false, and the second unlikely; the C.I.A. has reportedly found no evidence of a link between the virus and the Wuhan lab.

True, Trump’s ignorance of and contempt for science has consistently undermined the country’s coronavirus response. But as Goldberg points out, his is just an extreme example of a longstanding anti-science bias on the part of conservatives. Republicans have tried to keep science classes from teaching evolution; they’ve objected to NIH or other government funding for stem cell research; and their dismissal of climate change has been a national embarrassment since well before Trump took the party down crazy lane. Goldberg attributes this hostility to a combination of factors, including populist distrust of experts, religious rejection of information inconsistent with biblical literalism, and efforts by corporations to protect their bottom lines.

Until recently, it seemed as if Trump’s sabotage of efforts to combat climate change would be the most destructive legacy of his disregard for science. But the coronavirus has presented the country with an emergency that only sound science can solve. That means that the Trump administration’s disdain for expertise, its elevation of slavish loyalty over technical competence, has become a more immediate threat.

Since Goldberg’s column, the administration’s response to the pandemic has only gotten worse. But that, ironically, is where the cognitive dissonance comes in.

The President whose Magical Thinking veers from promises that the virus will “just disappear” to suggestions that drinking bleach might protect you (in all fairness, it might; dead people don’t get sick), is counting on real scientists to produce a vaccine. Quickly. There are predictions that announcement of such a breakthrough will be the election’s “October surprise.”

Given the collective brainpower of a GOP base that equates refusal to wear a mask with patriotism, it will be interesting to see the response of those “patriots” to a genuine eventual vaccine. Will the know-nothings of a political party that pooh-poohs climate change and conducts a vendetta against “smarty-pants elitists” (i.e., scientists who actually know what they are talking about) nevertheless line up to take advantage of a product of medical science?

The Neanderthals rejecting science and expertise all seem willing to drive cars and use IPhones and computers and other products of science and technology. When it comes to medical science, most apparently do have doctors–and if TV advertising is any indication, they’re part of a robust market for all sorts of medications.

One of these things is not like the other……

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Did Trump Hand Us A Mirror?

Mirrors can be vicious–and educational.

I know I’m not the only one who finds it easy to indulge in forbidden food and drink, and to ignore the consequences–until I take a good look at myself in the mirror and decide it’s past time to begin that long-postponed diet and exercise regimen.

In a recent column for The Washington Post, Dana Milbank suggested a political analogy to that common phenomenon.

Four years ago, Christopher Parker, an African American political scientist at the University of Washington, made the provocative argument that Donald Trump’s candidacy could “do more to advance racial understanding than the election of Barack Obama.”

“Trump’s clear bigotry,” Parker wrote in the American Prospect, a liberal journal, “makes it impossible for whites to deny the existence of racism in America. . . . His success clashes with many white Americans’ vision of the United States as a fair and just place.”

Milbank lists several examples of Trump’s increasingly brazen embrace of racism; interestingly, the column appeared before the most recent example: his incendiary speech at Mount Rushmore, in which he barely stopped short of donning a white sheet.

It’s not just Trump. it is getting more and more difficult to ignore the evidence that the GOP has become the party of white supremacy. As Milbank reports,

Trump has accelerated a decades-old trend toward parties redefining themselves by race and racial attitudes. Racial resentment is now the single most important factor driving Republicans and Republican-leaning movers, according to extensive research, most recently by Nicholas Valentino and Kirill Zhirkov at the University of Michigan — more than religion, culture, class or ideology. An ongoing study by University of North Carolina researchers finds that racial resentment even drives hostility toward mask-wearing and social distancing. Conversely, racial liberalism now drives Democrats of all colors more than any other factor.

Milbank reviewed the changing responses of Americans to a question that has been used by several pollsters over a number of years to determine racial animus: the question asks people to agree or disagree with the statement “It’s really a matter of some people not trying hard enough; if blacks would only try harder they could be just as well off as whites.

In 2012, 56 percent of white Republicans agreed with that statement, according to the American National Election Studies. The number grew in 2016 with Trump’s rise, to 59 percent. Last month, an astonishing 71 percent of white Republicans agreed, according to a YouGov poll written by Parker and conducted by GQR (where my wife is a partner).

The opposite movement among white Democrats is even more striking. In 2012, 38 percent agreed that African Americans didn’t try hard enough. In 2016, that dropped to 27 percent. And now? Just 13 percent.

What these statistics don’t reflect is the rapidly diminishing number of Americans who identify as Republican, and the growing numbers of Democrats, Independents and “Never Trump” Republicans who find the party’s racism abhorrent.  Milbank quotes other political scientists whose research confirms the extent of that revulsion; white women, especially, are offended by the GOP’s appeals to racism.

Vincent Hutchings is a political scientist at the University of Michigan who specializes in public opinion research. He has found that racist appeals disproportionately alienate white, college-educated women, and has opined that such appeals exacerbate the gender gap even more than negative references to gender.

I’ve previously noted that the voluminous visual evidence of bigotry, captured and disseminated by our  ubiquitous cellphone cameras, has made it very difficult for comfortable white folks to believe that America is the idealized, equal-opportunity country described in dusty government textbooks. Every day, Donald Trump adds to that growing, uncomfortable body of evidence by loudly and publicly reconfirming his own ignorance and racism.

The iPhone pictures and videos, amplified by the constant tweets and utterances of a repulsive President, are providing Americans an extended look in the full-length mirror, and most of us don’t like what we see.

We need to remind ourselves that we have the power to change it.

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Respect

Tom Friedman isn’t one of my favorite New York Times columnists; I usually find him either tendentious or self-congratulatory. But he’s growing on me.

I especially liked his column last Wednesday, in which he suggested a slogan/bumper sticker for the Biden campaign:“Respect science, respect nature, respect each other.”

If only!!

As Friedman writes, not only are these values held by most Americans, they are in dramatic  contrast to Trump. (I’m pretty sure Trump doesn’t have anything we would call “values”–and I have never seen him display anything remotely resembling respect for anyone or anything..Even self-respect would be an improvement.)

Disdain for science is seen in Trump’s antagonism to fact, evidence and reality. It’s bad enough when his contempt for facts involves lying about crowd sizes or windmills causing cancer, infuriating when it involves denial of climate change– but with the advent of Covid-19, it poses an even more immediate threat.

But his disdain for science has become fatal, as we’re seeing in this widening pandemic. Trump has gone from offering quack remedies, like disinfectant, ultraviolet light and hydroxychloroquine, to mocking people, including Biden, for adopting the easiest and most scientifically proven method for limiting the spread of the coronavirus: wearing a face mask.

Trump doesn’t simply reject science. He’s lost whatever grip  he ever had on elementary logic.  Friedman echoes the astonishment so many of us expressed when our Commander-in-Chief–the purported leader of the free world–opined that we have more cases of Coronavirus because we test for it.

Think about that: Stop testing. Then we’ll have no knowledge. Then we’ll have no numbers. Then we’ll have no virus. Why didn’t I think of that?

Stop testing people for drunken driving, and then we’ll have no more drunken drivers. Stop arresting people for shootings, and then the crime rate will go down.

And if we didn’t have pregnancy tests, voila! Population control…

Then there’s the little matter of respecting Mother Nature.

Trump’s lack of respect for nature may be a political asset for him with his base, but it’s been a disaster for the country. …

Respect for nature also means understanding that we live on a hard rock called planet Earth with a thin cover of oceans and topsoil, enveloped by a thin layer of atmosphere. Abuse that soil, junk up those oceans with plastics, distort that atmospheric blanket and we will likely (further) destroy the perfect Garden of Eden that has been the basis of all human civilization.

According to National Geographic, the Russian Arctic has been having an extended heat wave that drove temperatures north of the Arctic Circle to 100.4 degrees F on June 20–the official first day of summer. (I can’t imagine what that will do to all the structures that have been built on the Arctic’s permafrost…)

The Trump administration has rolled back close to 100 environmental regulations–and has failed or refused to enforce a number of others. The administration reserves its “respect” for the bottom lines of fossil fuel and chemical companies that are operating with impunity as the planet heats and widely-used chemicals are found to be lethal.

Respect for other people? Can we even remember the civility, decorum and good manners of the Obama-Biden administration?

Respect each other? That’s not so easy in the midst of our other pandemic — a pandemic of incivility. You cannot exaggerate the impact on the whole civic culture of having a president who has elevated name-calling, denigration and lying to a central feature of his presidency, amplified by the White House.

Friedman acknowledges that there are multiple sources of disrespectful behavior–especially the algorithms of social media platforms–but he notes that restoring interpersonal respect will require  two things: a president who every day models respect rather than denigration, and citizens who actually listen to each other. Right now, we have neither.

Respect for science. Respect for nature. Respect for each other.

I like that.

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Good Religion, Bad Religion

There’s a yiddish word that describes today’s post: chutzpah. 

Chutzpah is gall of the “how dare she” variety. It’s sometimes illustrated by an anecdote about a person who kills his mother and father and then throws himself on the mercy of the court because he’s an orphan.

Today’s post is about Christianity, and the reason I acknowledge my own chutzpah is because I am neither a Christian nor a believer. I come from a tradition that emphasizes behavior over belief–works over piety–and has co-existed pretty comfortably with science and secularism. (Minorities tend to flourish in more open, secular societies.)

What prompted this post was an article I came across in–of all places–Marketwatch, asking  why approximately half of Catholics and a majority of Evangelicals continue to support Donald Trump. The basic answer to that question, according to the article, is continued resentment of the First Amendment’s separation of Church and State.

To this day, there are many people who would like to put religion back into the center of public and political life. This is presumably what U.S. Attorney General William Barr, a deeply conservative Catholic, meant when he denounced “secularists” for launching an “assault on religion and traditional values.”

Of course, a preference for putting “religion” back in the public sphere raises a question that becomes more and more relevant as the country diversifies: whose religion? 

The article also referenced the relationship between a certain kind of Christianity and racism. It noted that Protestants had been supportive of Separation of Church and State so long as they remained culturally and racially dominant.

This changed after the Civil Rights movements in the 1960s, which alarmed many white Christians, especially in the southern states. Today, evangelicals, like Catholic conservatives, are among President Donald Trump’s most ardent supporters. They, too, believe that family and faith are under siege from liberals and secularists…

The attempt by contemporary Catholic conservatives and Protestant evangelicals to infuse politics with their religious beliefs obviously runs counter to the ideas of the French Revolution, which sought to uphold freedom from religion, but also of the American Revolution, which instituted freedom of religion. Both groups are targeting the carefully erected barriers between church and state.

This is dangerous, not only because it fosters intolerance, but also because it challenges, in the spirit of de Maistre, the idea that political argument should be based on human reason.

Once political conflicts become clashes of faith, compromise becomes impossible. A believer cannot bargain over a sacred principle.

You can’t argue with God. (Or your version of God.)

The article reminded me of Robert Jones book The End of White Christian America, which probed the anxieties–and rage– of white Christian men, as the racial, religious, and cultural landscape continues to change in ways that erode their previously privileged position.

When I was researching my 2007 book God and Country, I came across the very useful categorization of the nation’s founders into “Planting Fathers” and “Founding Fathers.” The Puritans were Planters. They came to the New World for “religious liberty,” which they defined as freedom to worship the right God in the right church and establish a government that would require their neighbors to do likewise. One hundred and fifty years later, the Founders who drafted the Constitution and Bill of Rights defined liberty very differently–as the right to follow one’s own beliefs, free of government interference.

What had intervened was the Enlightenment.

Our legal framework may be based on Enlightenment understandings of liberty and the role of government,  but America is still home to lots of Puritans who reject that understanding– along with the Enlightenment’s emphasis on science, evidence and empiricism.

The continuing culture war between our contemporary Puritans, secularists, and adherents of  non-fundamentalist religions raises some important–and too often neglected–questions: what good is religion? do modern societies still need it? what separates “good” religions from harmful ones? what’s the difference between a religion and a cult?

My youngest son has suggested a useful distinction between good and bad theologies: If a religion makes you struggle with the hard questions–what does it mean to be honorable, to act humanely, to treat others as we would want to be treated, etc.–it’s probably good.

If, instead of helping you confront the questions, it provides you with the answers, it’s bad.

To which I will add: if your religion leads you to support a leader whose behavior is contrary to everything you profess to believe because he promises to erase the line between Church and State and restore White Christian male privilege, you are a flawed person embracing a deeply flawed theology.

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