November 8, 2016: What I know. What I don’t know. What I need to find out.

I am still a bit stunned by the election.  Did we really do that?  Is this really the country I thought I had been living in?  How do I make sense of this?  What do I do now?

So, I have been listening and reading, talking to friends, family and colleagues, trying to take stock.  It seems my thoughts fall into three categories: What I know, What I don’t know, and What I need to find out.  (I am still working on “What do I do next?”)

What I know

1.  This was complicated.  There was no one thing that accounts for this election result.  Trump had to be good at what he does.  Clinton had to be sub-par.  The media had to play its role in gracing Trump and treating Clinton with undeserved moral equivalence.  Bernie’s folks (and I am one) had to feel disaffected and unmotivated.  Trump voters had to show up.  I would like to come to some quick understanding of what happened and why, but I suspect this will take some time to sort out.

2.  Enthusiasm beats professionalism.  Trump had a clear “enthusiasm gap” over Clinton.  One of the commentators on PBS said that this was an election between Trump’s ability to generate enthusiasm and Clinton’s ability to manage an expensive, highly professional, data-based, modern political campaign.  Ask any political professional which they would rather have, he said, a great “ground game” or terrific enthusiasm.  Enthusiasm beats professionalism.

There was a clear enthusiasm for Trump.  He pulled together the Republican coalition, getting almost as many votes as did Romney in 2012 and McCain in 2008, and that energy was missed by the pollsters and pundits.  Oddly, he did his job.

Clinton suffered from less enthusiasm.  She got 7,000,000 votes less than Obama did in 2012 and 10,000,000 votes less than Obama in 2008.  Depending on where those votes were, that was probably the difference in this election.  And 42 percent of women voters did not vote for the first serious female candidate for the presidency.  And they voted for a serial practitioner of sexual assault!  She underperformed, and it cost her (and us) the election.

3.  Republicans came home.  I think the winning coalition that Trump put together was the traditional Republican base (minus the surprisingly small number of people who usually vote Republican but couldn’t stomach voting for him), plus a whole lot of very enthusiastic, working class white people suffering economic and cultural distress and anxiety, plus a smaller but highly visible“basketload of deplorables,” assorted xenophobes, islamophobes, homophobes, racists, anti-Semites and just plain ignoramuses.  Were there enough anxious white folks and racists to win?  I don’t think so.  The fact that the Republican party “normalized” Trump (with help from the unbelievable combination of Putin’s trolls and hackers and Comey and his FBI colleagues) allowed Republicans to “come home,” and vote for “our candidate.”

4.  We are all living in bubbles.  I am.  You are.  All those Trump voters are.  Look at the map of who won which counties around the country.  Rural people voted overwhelmingly for Trump.  In every state, not just in the “red states.”  Most “blue states” are largely red, when looked at county by county.  These people don’t know many minorities or Jews.  They disproportionately listen to Fox News, if they listen to the news at all.  They are more likely to doubt that global warming really exists.  They are much more likely to be mourning the loss of a lifestyle that centered around a good job at the factory and a Christian church.  They are less likely to be college educated.

Or at least I think that is who they are, because I am inside my bubble – college educated urbanites, heavily Jewish, lots of minority friends and colleagues, worried about climate change, listening to NPR and MSNBC, wondering whether to eat Thai or Vietnamese tonight.  We live in the tiny, but heavily populated blue islands in the sea of red on that map.  I don’t know anybody who voted for Trump, but half the people in the country did.  All of them live outside my bubble. 
The people in those red counties have absolutely no idea what my life is like and what my concerns are.  Nor do I understand their life and troubles.  Mutually exclusive bubbles.

5.  We are all desperate for leadership.  People who stand for something.  Who know their own values and share them well.  Who are willing to make tough choices and withstand the consequences.  We are kind of done with triangulation and nuance. 

While I continue to doubt whether Trump actually believes much of what he said, he sounded like he was sure of his positions.  And he didn’t seem uncomfortable that they might draw criticism; in fact, I think he fed off the criticism.

Clinton was careful.  Lawyer-like.  Guarded.  Precise.  She came across to me as insincere, not frank.  She talked a good game about taxing the rich, but she wouldn’t let us hear what she said to the rich in those highly paid speeches.  How hard is it to say “Boy, I really screwed up when I decided to put those emails on a private server.  I wanted to protect myself and my communications, but look at the mess I created.  My bad.”   I think distaste for her lack of sincerity was magnified in the rural bubbles.

I have said in earlier blogs how important leadership is to change public policy when you are up against the rich and powerful.  See my original argument in favor of Sanders, here:

http://danswartzman.blogspot.com/2016/02/my-heart-says-sanders-but-so-does-my.html

And here is my critique of Clinton and Jeb Bush on their lack of real leadership and my admiration for Sanders’ and Trump’s skills:

http://danswartzman.blogspot.com/2015/08/what-do-trump-and-sanders-have-in-common.html

Real leaders take strong positions on tough choices.  This is what we want, and Trump offered it.  Half of us were unmoved by his brand of leadership; the other half elected him.

6.  We all share some anger.  I am angry that millions of people lost their homes, and tens of millions of people were “under water” because of the economic disaster of 2008, while the people whose greed and arrogance caused it were bailed out and given bonuses and not one of them served time in jail. 

I am angry that the Obama administration missed the opportunity to argue for universal health care back in 2009, which might have made the Affordable Care Act something that lots of people could love.  I am angry that his chief of staff, Rahm Emanuel, yelled at people like me who didn’t get on board with the compromise they were making with the health insurers, the pharmaceuticals, the hospitals and the doctors, calling us “fucking retards.”  That compromise was the much unloved ACA. 

I am angry with the Republicans who decided to obstruct everything that Obama tried to do, and then had the chutzpah to criticize him because he couldn’t get anything done. 

Out in the rural bubble, they are angry and fearful, too.  White men, in their middle years, are the only demographic in the US whose rate of death is increasing.  Everyone else’s death rate (the poor and minorities included) is going down.  And the cause of these extra deaths are suicide, drug overdoses and alcoholism.  Something is very, very wrong with that population.  And Trump gave voice to their anger and their fear, and promised to make things right, to make things great again.

We are an angry population, angry about different things, all inside our bubbles.

What I don’t know

1.  Who ARE these people?  I mean the 59,000,000 Americans who voted for Trump.  Are they uneducated, ignorant red-necks with guns?  Are they hurting and anxious?  White men, stewed in the subtle or not so subtle racism and sexism of the last 100 years?  

President Johnson, after he signed the Civil Rights Act in 1964 famously told his press secretary, Bill Moyers, "I think we just handed the south to the Republicans for the rest of my life and yours."  So true.  In the next presidential election, Nixon’s Southern Strategy began the change from the Democrats’ “Solid South” to the red-tinged map we see today.  In the early part of the 20th Century, it was racist Democrats who ran things in the South, while the Republicans were the “party of Lincoln.”  After 1968 and into the new century, the bigots found a home in the Republican party.

Some amount of support for Trump was based upon bigotry, racism, anti-Semitism.  How dare a black man be President of the United States and tell us what to do?  And now you want us to vote for a woman?  How much of his support was based upon this?  If a lot, then it is easier to discount his constituents.  If not as much, then we need to find out why else they thought to support such a man.

2.  Was this what Wallace and Perot were trying to tell us?  George Wallace was the last third party candidate to capture electors when he won five states in 1968.  His message was heavily clothed in racism, but it was also a screed against the “pointy headed bureaucrats in Washington” who didn’t listen, who didn’t know much, who had too much control over our lives.  Ross Perot, in 1992, captured 19% of the popular vote with a message that the Republicans and the Democrats were equally incompetent and unwilling to address the real problems the country was facing, such as the deficit and the movement of jobs to other countries.  He warned of the “giant sucking sound” of jobs being pulled into Mexico.

Don’t those sound like familiar themes?  I’d like to understand the history of these ideas, some of which were faintly echoed by Sanders.

3.  Where were the Millennials?  The Millenials are now the largest generation, passing by us Post-War Baby Boomers this last year.  Yet only a fraction of them came out to vote in this critical election.  (We won’t know the percentage for a while.)  This is their future we were fighting over; among adults, they will spend more years in this future than anyone else.  I can not imagine an adequate excuse for their not taking the time to vote, when the choice was so stark.

Maybe some will say “We couldn’t see voting for Hillary.”  Well, how did that work out for you?

I didn’t care for Bill Clinton in ‘92 (his “Third Way” was responsible for accelerating the rightward, neoliberal drift of the Democrats), but I voted for him.  John Kerry was a terrible idea (wooden, out of touch with ordinary people, a centrist at a time we needed a leftist critique of W), but I voted for him.  Clinton was not my first choice this year.  And I can think of a lot of reasons to not want to vote for her, but there is one good reason to have done so, and he is now the President-Elect.

Millenials, your parents have been doing everything they could to guard your future, to try to assure your safety and prosperity.  One way they did those things is by voting.  But you are the largest group of adults now.  It is your turn.  Where the hell were you?

What I need to find out

1.  How is it that facts don’t matter?  Yes, we are in different bubbles, but why is it that facts don’t matter over in their bubbles?  I am a religious person, but evolution is science.  I am skeptical of technical expertise with a financial interest, but climate change is really happening.  (If you are 31 years old or younger, you have never lived in a month that was below average in global temperature.)  The economy is, at the national level, doing very well, with steady if slow growth and almost “full employment.”  Yes, there are pockets of anxiety and despair over lost manufacturing jobs, and there are still many, many poor people, but Trump’s assessment of the state of the economy was completely counter-factual.  How does that not matter?

2.  Could we find enough things that we are all angry about to forge new coalitions?  The only way that the average person (which we mostly are) can win against the rich and powerful is through social movements.  And social movements usually require coalitions.  Since the people in my bubble are angry and the people in those other bubbles are angry, might there be sufficient overlap to support some joint efforts? 

3.  How do we bridge the gap between the rural and the urban?  Joint efforts would require us to burst our bubbles and find common ground.  How would we do that?  Is that even possible?

4.  Did Putin and the FBI have pro-Trump agendas?  Russians were in contact with the Trump campaign.  They hacked Democratic emails and released the results with a mind towards affecting the election.  Russian hackers and trolls issued fake news and fake comments on online forums.  Before we do this again, we need to figure out a way to identify similar efforts and either stop them or call full attention to them. 

The FBI has to be investigated to see if what appears on the surface to be true, that they had a secret desire to tip the scale for Trump, is actually the case.  If so, people have to be fired, and better rules have to be put in place and enforced.  (I know – what are the chances either of these are going to be examined during a Trump Presidency, but we still need to know.  Hey, mainstream media, these might be good subjects for the kind of hard-hitting investigative reporting that only a paltry few of you did during the campaign.)

5.  Is it time to do away with the Electoral College?  Al Gore and Hillary Clinton were both supported by a majority of voters (actually a plurality if you include votes for other parties).  Yet they lost.  This is because of the Electoral College.  This is in the US Constitution, put in by the elites of the time to guard against their loss of power to the hoi polloi to whom they were giving voting privileges.  It was also a way to keep support for the new Constitution among the less populated states in the south by giving them a disproportionate share of the vote.

Quick primer – Each state is given “electoral votes” equal to the number of members of Congress they have, plus two for their two Senators.  So, since the least number of members of Congress a state can have is one (like Wyoming, Alaska, Delaware), then the least number of electoral votes that a state can have is three.  (The District of Columbia also gets three electoral votes.)   When the citizens of a state vote for President, they are actually voting for a slate of “electors” who are more or less committed to vote for the winner of the popular vote in that state.  These electors meet (figuratively referred to as the “Electoral College”) in December, where the 538 votes for President are cast, and the President is actually elected.

Of course, this is patently against “one person, one vote.”  California has 38,000,000 residents, and 55 electoral votes (53 members of the House of Representatives and 2 Senators).  That means each elector represents 691,000 people.  In Wyoming, there are only 583,000 people, and they have three electors.  Each of those electors represents only 194,000 people.  That isn’t fair, but that is what the Constitution calls for.  Without it, the smaller of the original thirteen states wouldn’t have ratified the Constitution, and we wouldn’t have a Constitution.

Trump lost the popular vote, but since more of his vote came from smaller states with disproportionately higher numbers of electors, he won the presidency.  That is why this is coming up again.  (It wasn’t a big part of the conversation back in 2000, because we were all expressing our outrage over the Supreme Court’s coup in favor of Bush.)

Most of the time this doesn’t matter.  The winner of the Electoral College vote is almost always the winner of the popular vote.  Only 4 times has it been otherwise.  Trump, Bush 43, Benjamin Harrison in 1888 and Rutherford Hayes in 1876. 

But this might start happening more often, particularly given the realities of the red/blue division in our country.  Should we change this?

It is an easy question to pose, and a quick response might very well be “Well, of course!  It is fundamentally undemocratic.”  But a slower analysis yields different insights.  There are many parts of our democracy that don’t operate on a “one person, one vote” rule, and for good reasons.  Like the Senate, where every state, regardless of size, gets two Senators.  And the Senate filibuster, where 41 Senators can stop the majority in advancing legislation.  (We are going to be very happy for that undemocratic procedure in the next four years.) 

The Supreme Court isn’t representative in any way, and yet it has enormous power over us and our government.  I remember being made to write an essay back in 11th grade about “majority rule and minority rights.”  That is a critical balance within our democracy.  We let such things go only after very, very careful thought.

And a popular vote would change, drastically, how we elect Presidents.  Small states would be largely ignored, and the big population centers would get all of the attention.  Sounds good to me, in my “big population center bubble,” but it would cut out lots of people in those red counties from the process.  Are they likely to agree to this?

The cost of elections would go up, way up, because every large population center would be in play, as opposed to now, where places like New York City, Los Angeles and Chicago are not targeted because they are in states that are going to vote reliably for Democrats.  Without an Electoral College, candidates would have to advertise in every single large media market.  And since the entire country would be “in play,” candidates would have to advertise all over the country.  The importance of money in politics would increase, when most of us are wishing it would decrease.

And what would happen if we had a really, really close election?  What if less than a percentage point separated the candidates?  The chances of error are very high when elections get that close.  Would we need a nationwide recount?  In 2000, the difference between Gore and Bush was less than a half of a percent.  And this year, the difference was one fifth of one percent.  We don’t have any idea how to do a nationwide recount, putting aside the cost and uncertainty of such a thing.  Virtual ties are possible within the Electoral College, but it has never happened, and there are provisions for a swift and certain resolution.  (If you don’t know what they are, you didn’t watch the last season of “VEEP” on HBO.)

Doing away with the Electoral College would require a constitutional amendment.  Good luck with that.  But there are easier ideas to implement.  The electors are not bound to vote for the candidate that wins their state.  (That is how the elite in 1789 were going to be able to control the hoi polloi.)  So, every state could pass a law saying that their electors were bound to vote for the winner of the popular vote.  That might work. 

I don’t know where I stand on this issue.  Like the whole analysis of this election, it is complicated.  But we ought to look at this and make a decision to change or not.

6.  Is this moment in history we are beginning to face any worse than the Vietnam War era or Nixon and Watergate?  I am old enough to remember the terrible conflict caused by the Vietnam War, a long-running civil war that we stepped into out of misguided “anti-Communism” and the cowardice of our government in not wanting to be “the people who lost Southeast Asia.”  We marched on the freeways.  We hanged our elected leaders in effigy.  We talked seriously about revolution.  (At least we did in my little bubble.)  We lost faith in our government, who systematically lied to us for years and years.  The four innocent students shot dead in Ohio at Kent State University by National Guardsmen in May of 1970 was a turning point in my own moral and political development.

Nixon continued that war, in fact escalated it with horrific bombings, and yet lied and lied.  Re-electing him was a tragic mistake, but we did it in one of the great landslides of all time.  (This was my first presidential election.  Not an auspicious start.)  But Nixon’s extraordinary shortcomings, his extreme and vocal bigotry, his paranoia in the face of what he thought were his “enemies,” his almost complete disinterest in domestic policy as he tried to play what he thought was his monumental role on the world’s stage, and his fundamental dishonesty in covering up the aftermath of the Watergate burglary all brought him down, the only President to resign from office. 

We survived those times, although not without long-lingering doubts and aching scars.  Will a President Trump be any worse?  I fear yes, but maybe not.  Those were truly awful times.

And now?

I don’t agree with those who say that we should hold out an olive branch to the Trump administration and give him a chance to show that he can do some good in his new office.  Maybe he will grow into the job?

Poppycock.  I know who this man is.  Thanks to the ridiculous, ratings-fueled coverage of him by the media over the last 18 months, there is very little I don’t know about him.  He is a narcissist with a short attention span.  He is ignorant about the problems we face and about the workings of government.  As some one said to me, he has taken command of a 30 ship aircraft carrier fleet and thinks he is going to be driving a motorboat.  He is guilty of repeated sexual assaults, and of bragging about it.  Damn, I even know what he thinks of the size of his penis. 

I was wrong about the likely outcome of this election.  Maybe I will be proved equally wrong about the Trump Administration.  But I don’t need to give him a chance.  He had plenty of opportunity to demonstrate good will during the campaign and never came close.  The ball is in his court.  Prove to me that you deserve my support.  I’ll listen, but I won’t stop fighting you at every turn as a signal danger to our country and to what I believe in, until you convince me otherwise.

And now, for a time, I will continue to grieve.  For the tens of thousands of people who will be denied the right to vote because of Republican efforts to suppress their votes.  To the hundreds of thousand of immigrants who, like all of our parents and grandparents, want a chance to live and work in our terrific country.  For the millions of women who may be denied their reproductive rights.  For the many millions of middle class taxpayers who will continue to pay more than their share because the rich will get more tax cuts.  For the many millions of small investors and holders of bank accounts and credit cards who will be, again, at the mercy of Wall Street after Dodd-Frank is repealed.  For the 11 million undocumented aliens who will now live in desperate fear from every knock on the door.  For the more than 20 million beneficiaries of the Affordable Care Act who will, once again, be without health insurance.

For the many, many millions of people around the world who looked to America for leadership in the formation and the preservation of democracy, who looked to us as diplomats first, and as warriors only when necessary.  And for the hundreds of millions, maybe billions of people, who will pile up in the northern countries of South America and Africa, fleeing starvation and pestilence because their homes are uninhabitable and their land is arid and their animals have died due to climate change, begging us to be let into the richer Northern Hemisphere.

And to all of us, who will now spend the next two generations subject to the rulings of a Supreme Court stacked with knee-jerk conservatives who will continue the behavior of the last 30 years, advancing a political agenda, covered brazenly, shamelessly with the good names of “justice” and the “rule of law.”

But grieving ends.  And the fight continues.  More on that soon.

Revisiting the "urge to care for the other"

I am redoing one of the classes I teach at Loyola, on “Health Care in America.”  I have decided to start the class with a more rousing call to "moral imagination," suggesting to the students that, if they want to change things for the better, health care is a great place to do that, since we are going to be going through lots of changes in health care, no matter what.

I want to present the class with an argument about why they should care about changing health care for the better.  It boils down to responding to our “urge to care for the other.”  To provide them some background, I am going to have them read a number of blogs that I posted in February, March and April of 2015.  These postings offer an explanation of why we might care for “the other” and where that urge might come from. 

As it turns out, because these were some of the first blogs I posted here, they have not had much viewership.  So, I decided to send you all a message, encouraging you to dig back a bit, and see if those of you who have come lately to the blog might be interested in these earlier postings.  Here is the list.  (They are best if read in this order.)   I look forward to hearing what you think.

Caring for “the other,” Part 1 – Why do we care?
http://danswartzman.blogspot.com/2015/02/caring-for-other-part-1.html

Caring for “the other,” Part 2 – Real, abstract, related, unrelated
http://danswartzman.blogspot.com/2015/02/caring-for-other-part-two_16.html

Does the “urge to care” come from biology?
http://danswartzman.blogspot.com/2015/02/does-urge-to-care-come-from-biology.html

Does the “urge to care” come from culture?
http://danswartzman.blogspot.com/2015/02/does-urge-to-care-come-from-culture.html

Beyond nature and nurture
http://danswartzman.blogspot.com/2015/02/beyond-nature-and-nurture.html

Life is not perfectible
http://danswartzman.blogspot.com/2015/02/life-is-not-perfectible.html

“Giving in” to perfectibility and the path to fundamentalism
http://danswartzman.blogspot.com/2015/03/giving-in-to-perfectibility-and-path-to.html

The inevitability of uncertainty
http://danswartzman.blogspot.com/2015/03/the-inevitability-of-uncertainty.html

“Only in our limits do we find our freedom”
http://danswartzman.blogspot.com/2015/03/only-in-our-limits-do-we-find-our.html

Thinking INSIDE the box
http://danswartzman.blogspot.com/2015/03/thinking-inside-box.html

Giving up
http://danswartzman.blogspot.com/2015/03/giving-up.html

Why secular idealism is insufficient
http://danswartzman.blogspot.com/2015/04/why-secular-idealism-is-insufficient.html

Faith
http://danswartzman.blogspot.com/2015/04/faith.html

What the hell is going on? Globalization plus austerity.

It does feel like events in Europe, with the decision to Leave and the rise of nationalist, right-wing movements, are similar to what is happening in the US with the almost inconceivable rise of Trump.  What is happening?

Lots of media response to that question.  Here is something I think we need to consider.

Globalization is a “net” benefit

Globalization may be a net benefit for modern industrialized societies.  We are usually told that open markets around the globe add one or two percent to the net wealth of people in America.  That is a good thing.

But note that that is “net” wealth.  Some of us benefit a lot, and many of us bear the burden of those benefits.  To see more on this argument, check out my posting on “Thinking carefully about free trade.”  If many people make scads of money, that might outweigh the widespread problems that globalization causes, when everything gets added up.  But just because there is a positive sum doesn’t mean that there isn’t a lot of pain happening.  Here is that discussion:

http://danswartzman.blogspot.com/2015/07/thinking-carefully-about-free-trade.html

The elusive “good living”

So, the last three or four decades of globalization have made fortunes for the wealthy and a good return for the upper-middle class.  But middle and working class people in the US whose jobs were imported are suffering from their losses.  The “good living” that could be had with skills, hard work and a high school diploma is not remotely as available as it was 50 years ago.

No wonder that people paying this price for other folks’ increase in wealth are angry, frustrated, scared, susceptible to demagoguery, following a huckster with no credibility, but who offers them promise and hope.  Less educated white men are demonstrating their despair in the most flagrant way possible, by killing themselves, by drinking themselves to death, by succumbing to drug overdoses. 

A “rising tide” does not appear to lift all boats; it seems to be swamping too many of our neighbors.  If the country is going to continue to promote globalization because it makes us, as a whole, more wealthy, we have to share that wealth with those who know only the pain.

But, I have heard pundits say, what can we do about this?  Retraining?  Maybe, but not the easiest prescription for 50-something laborers with little education.  Increasing programs like the Earned Income Credit, paying for it with taxes on those who benefit from more trade?  Might work, but difficult to pass in today’s political climate.

The obvious answer, to me, is government works programs.  Fifty years of Republican efforts to “starve the beast” have resulted in a crumbling infrastructure in need of trillions of dollars of maintenance, repair and rebuilding.  Just the sort of thing that skilled laborers and craftspeople could do to earn a living, doing something useful for their communities.

Folie de beaucoup

Ah, but we can’t do that because the entire community of industrialized countries is suffering from a “folie de beaucoup” called Austerity.  We have to limit government spending, we are told by “serious people,” because we have to keep down the national debt.  This is a largely unchallenged shibboleth held sacredly among the right, the center-right, the center-left, and the mainstream media. 

Pick at random any column by Paul Krugman, our most consistent and erudite spokesperson for modern Keynesianism, and you are likely to read a thorough refutation of this position.  At a time when the US government can sell bonds at virtually no interest, this must be the moment to start a program to rebuild our infrastructure and to promise work to those who are paying the price of globalization. 

Hillary has proposed a $275 billion program, but that is too timid and insufficient.  Sanders proposed $1 trillion over the next five years.  Still not thinking big enough.

The American Society of Civil Engineers, in their 2013 report card on American infrastructure, estimated the need at $3.6 trillion by 2020.  No wonder they rated the US infrastructure gap at a D+. 

How much and how soon?

OK, I don’t know how much we can afford and over what time period.  But I believe that as long as we ignore the real pain and hopelessness caused by globalization, and as long as we continue to pay homage to the gods of Austerity, we are not going to address the growing anger and disaffection of tens of millions of Americans and hundreds of millions of Europeans. 

If we want the millions of people who voted for Leave and who are promising to vote for Trump to rejoin the rest of us in working towards common and reasonable goals, if we want to keep them alive, we have to promise them hope, a way forward, a job and a way to make a respectable contribution to the good of the whole. 

Globalization, but no more Austerity.  Let’s make global plans, but let’s also make sure that everyone benefits by making big plans that stir faith and trust.   And let’s keep our bridges from falling down on our heads. 

Vouching for healthcare, Part 5

Vouching for healthcare, Part 5

Many years ago, when Calabresi and Bobbitt wrote Tragic Choices, they said that whether you allocate resources in a market or through political means, you run into “fundamental flaws.”  This blog thread on vouchers for healthcare benefits is based somewhat upon this notion.

Markets have flaws

As we demonstrated earlier, ideally markets have two benefits, liberty and efficiency.  They allow everyone to decide which trades to make, and they create more happiness without having to increase inputs. 

Markets also have three fundamental flaws:

1.  They overweight the prevailing distribution of resources.  If you are poor to begin with, you won’t be able to bargain your way to prosperity.

2.  They overweight individual preferences over preferences of the community.  There is no “we” in the marketplace, so what we want is subordinated to what “I” want.

3.  They overweight the instrumental over the intrinsic.  Since markets are based on voluntary exchange, they give weight to that which is exchangeable, like instrumentalities, rather than what is valuable in and of itself, like intrinsic values.

Political allocation systems may avoid the market’s flaws

Turns out, we can avoid some of these problems by using political means to distribute resources, but we run into another set of fundamental problems.

But first, what do we mean by political allocations?  Any allocation system that uses power is a political allocation system.  So, back to our “hats” example, if you get a particular hat because that is what the king decrees, or if you get a hat because that is what you were able to take and hold through force, these are political distributions.  As are distributions through the actions of committees or a hat commissar.  The same if we had a direct democracy, and allocated hats through a town meeting. 

The political allocation system we discuss most in the US is our representative (at least on paper) democracy.  If a legislature or a regulatory agency determines who gets which hats, this is a political allocation.

Note that political allocations can change the prevailing distribution of resources.  The decision maker can simply choose to overcome an inequitable distribution, and give the poor more.  Simply?  Well, apparently not so much.

And politics can overcome the will of the individual.  Politics enables the community, which can tell the individual what the community desires him or her to do.

And if the community is set on a particular intrinsic value, like equity or impartiality, it can superordinate that value above any transactional benefits.

But political allocations have their own flaws

The one benefit of political allocation is that it is directable.  Politics includes the potential to choose.  (We will see in subsequent blogs that our current governmental actors are systematically avoiding the making of choices, but that is for a future discussion.)

However, political allocation systems, such as government decisions, have three fundamental flaws:

1.  They overweight the community over the individual.

2.  They are inherently inefficient.

3.  They carry the “Burden of Explicitness.”

Danger to individual liberty

Let’s look at the first of these.  The community, through its agent, the government, can coerce the behavior of individuals.  What “we” want becomes enforceable against “me.”  We know this because we are all forced to pay taxes, we are all forced to hire people without using our prejudices, we are all forced to bend our property rights to the will of the zoning board.  Governments can, of course, make me do things and prohibit me from doing others.

One of the problems with empowering the community is that it can too easily overcome the will of the individual.  If you go down this route too far, you can enter a Stalinist nightmare, where the will of the community (as expressed by the elite in power, of course) justifies extreme, even deadly sanctions against the individual.  Think Mao’s Cultural Revolution of the 60's. 

This is the essential fear of Libertarians.  “We must have as little government as possible, because too much government is a danger to our liberty.” 

When I heard Calabresi discuss these ideas forty years ago, he argued that this concern about the danger of unbridled governmental power was what tipped him towards market-based solutions to as many problems as possible.  I imagine that such concerns are at the base of much “Neo-liberalism.”

If we allocate bicycles through government, we need to set up a bicycle commissariat, and which bicycle I get will be a function of that bureaucracy’s decisions.  I don’t get to choose which I want.  I buy the bicycle that is made available by the government. 

That loss of liberty is regrettable, but under certain circumstances, probably acceptable.  Many of us would support a government ban on the sale and ownership of assault weapons.  That is a threat to the liberty of those who want them.  But so is a ban on tanks and missiles.  So, too, are speed limits, and requirements to immunize, and the need for nutrition labeling, and zoning ordinances.  All of these are restrictions on the will of the individual that we, as a community, are relatively comfortable with.  (Well, not all of us.  Strict libertarians would consider many of these restrictions odious.  OK, maybe not a prohibition on tanks.)

What “I” want versus what “we” want

So, we want to empower the community and its values, and we know that doing so is a potential threat to the values of each individual.  If the threat to the individual is too great, as with reproductive rights or a universal right to be married, we choose to let the individual decide.

Sometimes, “we” win.  And sometimes “I” win.  That is one of the most difficult tasks of democracy, making exactly these choices between the public will and the private will.  If we let markets decide on healthcare, things that the group wants (prevention, equitable distribution of healthcare resources) may be subordinated to what the individual is willing to pay for with his or her voucher.  If we use government, we run the risk of infringing on liberties (like choosing my own doctor or deciding what medicine I am willing to pay for) that are important to some people.

We are starting to see that there is no such thing as a perfect allocation system.  Markets have their problems.  And governmental allocations have their problems.  We will have to choose which set of problems we prefer.

But political resource allocations are inherently inefficient.  Is that acceptable?  We will discuss that next.

If healthcare is a right, where does it come from? And what should we do about it?

I believe in a right to health care.  I think this is one of a number of birthrights that attach to all children.  And everyone I have ever met is somebody’s child. 

This makes a huge difference in the policy arena.  If healthcare is a commodity, a service that is purchased, a privilege to be earned or afforded, then it is completely possible to decide that some people get none, that some people get a lot, and that everyone else will fall in between, mainly a function of their financial situation, but probably also due to matters of race, class and gender.  Limits are easy to find when it is something you purchase.

What if it is a right?

If it is a right, then it is a “call” upon the larger society:  “You must care for me when I am sick.”  But no society can ever provide 100% of the care desired by 100% of the population.  There simply isn’t enough time, energy and money.  Therefore, each society has to make tough choices about how much care they are willing to give and to whom and under what circumstances. 

I think most wealthy enough societies will meet almost all of the healthcare demands of their children, and then start to make tough choices at the other end of life.  Along the way, there will be some limits, like with cosmetic surgery (not after trauma or disease, but strictly for appearances).  And some communities will decide that certain treatments are so unlikely to help that they won’t pay for them, while other societies might make a different evaluation.

But what is clear is that if healthcare is a right, then it is up to the government to provide it, since the call is upon the community, and the government is the agent of the community.  That is what TR Reid, the author of The Healing of America, found in the countries he visited, that they started with the notion that healthcare is a right, and that led them to universal coverage.

Lots of politicians have said the words – healthcare is a right – but they have not worked towards policies that are consistent with those words.  Obama has said that he thinks healthcare is a right, but the ACA is not based upon such a principal at all.  Sanders is the main person making the connection between the idea and the policy that follows from the idea.

Where do rights come from?

That is an easy question for me to answer, but I have found it so tough for others to answer it that they don’t even want to be asked the question.

As a public health ethicist, I have found that almost all of my colleagues in the field think that health care is a right.  In fact, a famous public health leader (Jonathan Mann) won quite a bit of acclaim for his argument that the basis of public health ethics was “human rights.”  But I have found almost no one amongst my colleagues who wants to discuss where such rights come from.  Either they hem and haw, or they mention something about the Universal Declaration of Human Rights, from 1948.  But were there no rights before that?

In the Declaration of Independence, we say that:

    "We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain inalienable rights – that among these are life, liberty and the pursuit of happiness.  That to secure these rights, governments are instituted among men, deriving their just powers from the consent of the governed."

The existence of these rights are “self-evident.”  You don’t need to conduct research on this.  These rights exist and we know that their existence is obvious.  Such rights are often referred to as “natural rights,” those rights that arise from the nature of what it means to be human.  They are inalienable (inseparable) from any human being, by virtue of his or her humanity.

And we get these rights from our Creator.  Some of you, who believe in a personal God, accept this as a direct statement. 

For people like me, who have a strong concept of Transcendent Meaning, but do not believe in a purposive entity named “God,” then this is really a metaphor.  For me, this means that there is a transcendent reality from which we draw meaning, and that the experience of this transcendent reality and the understanding of that meaning is what I label as “the holy.” 

A religious gesture

But whatever we call that which exists within Transcendence, we are making a religious gesture.  It is a spiritual commitment to the existence of Transcendent Meaning.  Our lives have meaning, and one of the things we know about that meaning is that every society owes its members certain rights, and that the government is assigned the duty of providing for those rights.  (That part of the Declaration is usually not included when this section is quoted.  More neoliberalism, I think.)

And among these rights are the right to life, liberty and stuff.  (The Founders really were referring to property rights, but thought that wasn’t gentile enough, so they used the euphemism of “pursuit of happiness.”  It is intended to mean a right to own stuff.)  Among these rights, but not only those rights mentioned. 

So, if there are such rights beyond these three, we as a community have an obligation to figure out what they are; we need to make exactly those choices.  And the basis for those choices ends up having to be our belief in Transcendent Meaning.

My assumption is that my colleagues don’t want to talk about where rights come from because they don’t want to have a conversation about religion, most (but not all) of them being atheists or agnostics, as are so many intellectuals today.

What if rights aren’t transcendent

If rights aren’t transcendent, if they are only material, then they are only the result of our agreements to uphold certain of them.  And agreements made can be unmade.  Non-transcendent rights are, therefore, dangerously ephemeral. 

Plus, if you want to condemn the practices of horrible people around the world, you need something I have referred to as “Transitive Morality.”  (From an earlier blog post.)  We have to be able to say that the third of the world that denies the dignity of women is morally wrong in doing so, and that they must change.  And that “must” must be based upon something other than a handshake.  It has to be based upon the moral ground that comes from the community agreeing to recognize the transcendent source of such moral values. 

Otherwise, who are we to judge these misogynists?  After all, it is only their culture. 

But, of course, the oppression of half the race is not a matter of mere culture.  It is a call to the rest of us to act on behalf of the oppressed.  It is a call to us, because those women have rights that are being denied.  And we may act because those rights have a basis in Transcendent Meaning.

I do think healthcare is a right, and I am comfortable with the religious origins of my views.  And I feel the call to act.  Anyone else feel the same?

Giving up would be a historical mistake

My friend and colleague, Marc Rosen, commented on one of my earlier posts that finding optimism is difficult, amid today’s depressing displays of political appeals to public stupidity.  This is true.

Marc suggests the negative case for not giving up.  One way to bolster optimism is to ask people to consider the alternative – doing nothing?  Moving to Canada?  Giving up, in this view, is impractical, in spite of how much allure it has for me on my worst days.

I would, however, like to state the positive case for optimism.  Giving up would be a historical mistake.  Here is what I mean.

What abolitionism started

If you go back to the middle of the 19th Century in America, you find a relatively small group of people fighting against extraordinary odds to battle against slavery, America’s “original sin.”  To the abolitionists, it must have seemed a daunting task.  All of the big money was on keeping slavery, the only pressing question being where it would be allowed to be practiced.  Yet, as the archetype social movement, abolitionism fought for decades and, ultimately, succeeded, albeit at the cost of a civil war. 

This began an unprecedented century of American political progressivism, where one social movement after another battled the rich and the powerful and numeric majorities, in order to establish policies that promoted justice.  Here is a partial list of those movements:

The antitrust laws in the latter part of the 19th Century were a direct affront to the power of the richest class to control the economy as they saw fit. 

In the early part of the 20th Century, Progressives past the pure food and drugs laws that have been the basis of the last 100 years of food and pharmaceutical safety.  As with many of these social movements, that work is not over, but we shouldn’t forget the fight that began that effort.

It is well to remember that it was the leaders of the Republican party that championed conservationism at the turn of the last century.  Our system of national parks and forests, and our wildlife refuges on land and in the sea, are the magnificent evidence of the wisdom of that movement.

We passed child labor laws when the richest and most powerful fought to preserve the profits from the work of tiny fingers. 

We recognized the rights of women to vote at a time when all of the country’s wealth and power was concentrated in the hands of men.

After decades of fighting, politically and literally, with the deaths of many protesters, the labor movement in the early part of the 20th Century led to passage of national labor law reform.  While there is much still to be done, and while recent anti-union efforts have been scornfully successful, the basic legal statement that workers have rights to bargain collectively is the outstanding result of that progressive fight eighty years ago.

The New Deal brought us Social Security and the minimum wage.  That both of these successes are under attack doesn’t take away the accomplishment of the movements that achieved them, but calls to us to continue that fight anew.

In the middle of the 20th Century, a small minority of citizens started to make the case that the laws of the country did not provide equal treatment to all Americans.  Where did the Freedom Riders in 1961 get their optimism as they faced down Bull Connors’ dogs?  I imagine that, sitting in that jail in Birmingham in 1963, finding optimism might have been difficult for Dr. King.  Yet, the civil rights movement resulted in Brown v. Board of Education, the Civil Rights Act of 1964, the Voting Rights Act of 1965 and the Fair Housing Law of 1968. 

In spite of Ronald Reagan’s 1961 phonograph oratory against socialized medicine and the potential end of freedom as we know it, healthcare for the elderly and the poor was guaranteed in the passage of Medicare and Medicaid.  The social movement that continues to strive for true universal healthcare, based upon an acknowledgment of the right of all people to treatment when they are sick, is not done, the Affordable Care Act notwithstanding. 

In the 1960's and into the 1970's, social movements for women’s rights and environmentalism and occupational safety and health saw significant victories.

An end or a hiatus?

But this all came to a stop in 1980, as the right wing backlash, started in the 50's and 60's, finally out-organized us, and, I am afraid, out-thought us, and came to power.

From 1865 to 1980, this century of progressive public policy was the result of social movements that were numerical and political minorities fighting daunting odds and, yet, succeeding.  This era came, not to an end, but to a temporary hiatus in 1980 (see my earlier blogs on Decades, parts 1 and 2).

That is the real key – did this period “end” or are we waiting through a backlash?  Do we see the end of the ability of concerned and organized people to make a difference, or do we need to find the way to make such concerted efforts successful again?  That is the crux of the question posed to us by our current dismay over the ridiculousness of our current public policy making.  Are we seeing the final end of that progressive era?  Or might this, too, pass?

Frankly, I see no contemporary or historic argument that says that that century of Good works, from 1865 to 1980, was an anomaly.  If social movements can do something as unlikely as electing a black man to the Presidency, the approach must still hold some validity. 

Social movements need seven things.  They need intensity, focus, cohesion, structure, a bit of luck, a supportive reaction from the media and leadership.  Want to see what that looks like?  Check out any presentation by Bernie Sanders.

But he can’t really win, right?  Back to the basic question – are you a pessimist or an optimist?  I think pessimism, while absolutely delicious in its appeal, is a historic mistake. As it always has been, it is still time to get to work!
 

Vouching for healthcare, Part 4

A quick recap

I believe that conservative healthcare proposals are going to involve some type of  “vouchers.”  For instance, we might end Medicare as a direct payment from the government to your doctor.  Instead, we give everyone 65 and older a voucher to purchase health insurance.  The theory is that when ordinary people, acting as healthcare “consumers,” buy health insurance, they will negotiate the best deal possible, which will reduce the costs of healthcare and increase its quality.  In order to argue against this approach, you have to first understand why it might work.

So, in Part 1, we looked at a market for hats, and we found that each individual trade results in more net happiness, because the win/win trades that happen in markets make each trader happier, without increasing the goods needed to trade, the hats.  Our measure of success comes from adding up the individual happiness for each individual.  When the change in the sum of individual utility is positive, then you have a morally good thing.  Your people, at the level of the individual, are happier.

In Part 2, we looked at the dark side of this result.  Poor Ed, with his head condition, is going to die because no one will trade with him for a protective hat, no matter how much we want this to happen.  That is because there is no “we” in the marketplace.

And when someone gets dealt an untradeable hat, of solid lead, there is nothing they can do to trade their way out of their poverty.  That is because markets overweight the prevailing distribution of resources.

In Part 3, we identified the third fundamental flaw of markets – they turn the intrinsic into the instrumental.  There is a difference between driving a friend to the airport or being a taxi driver and doing the same thing.  In other words, motive counts.  For instance, in healthcare, there is a difference between taking care of people in order to make money, as do for profit hospitals, or making money in order to take care of people, as do mission driven not for profit hospitals.

We are getting closer to our conclusions, but we still need to understand something important about how markets work.  For that, we propose a market for bicycles.

Two bicycle producers

Assume we live in a marketplace that has exactly two bicycle producers, Afshan and Gabby.  Afshan produces a very good bicycle, and sells them for $800.  Gabby produces an absolutely wonderful bicycle for the same $800.  Afshan is a good producer, but Gabby is more efficient, because she produces a great bicycle for the same amount of money.

Which bicycle would you buy, the good one or the great one?  

Right, even Afshan would probably buy a bicycle from Gabby.  So, very quickly, Afshan is removed from the market, as everyone buys their bikes from Gabby.   Now, what does Gabby do?  Well, she has control over price, which is the technical definition of “monopoly.”  There is no price pressure on her anymore.  As would anyone, Gabby raises her prices.

In fact, since she is now making so much money from each bicycle, she decides to open up other factories, because it is worth her investment to double or triple her production. 

This is a good thing, because it increases production by the high efficiency, high quality bicycle producer.  Gabby hires lots of people to work in these new factories, and we all benefit from having better bicycles available.  Ii is a good thing for the society as a whole when efficiency and quality are rewarded.

If you follow the story so far, you now have gotten to the point of understanding the underlying theory of “trickle down” economics.  When we reward the productive people at the top, the benefits accrue to us all as they trickle down.

Of course, the story might have ended there if we were talking about America in the Fifties.  Rewarding the “job creators”of the 1950's with special deals and tax cuts made work in manufacturing for many, many people, and the middle class (thanks, in part, to unionizing) grew in size and wealth.  This is what Obama means when he says we grew the country outwards from the middle, rather than from the top down.

It’s not the Fifties anymore

But this isn’t the Fifties.  At some point, Gabby’s brother-in-law comes to her and says “Why are you doing your manufacturing in Chicago?  The union wages are killing you.  You should move to Tennessee.”  A couple of years later, the brother-in-law talks Gabby into moving again, this time oversees.  The wealth might be trickling down, but it is doing so in sweat shops in China or Viet Nam, not in Illinois or anywhere in America.  The people at the top continue to make millions, but the benefits are no longer “on shore.”

It doesn’t stop there.  A couple of years ago, Gabby’s brother-in-law tells her that she is a fool for trying to make money in manufacturing.  The big money, he tells her, is in derivatives.  He convinces her to sell her bicycle factories to a foreign entity and put her money into the financial market.

So, now the riches made from bicycles accrues to the foreign owners, and the jobs go to poor Chinese.  And Gabby is now making more and more money trading paper fantasies, which make her richer and richer, and provide no benefits for the rest of us.

Three concepts

This story illustrates three important concepts: “the invisible hand,” “consumer sovereignty,” and “voodoo economics.”
 
Note that we didn’t need a study or a committee or a bicycle commissar to decide who to reward with our bicycle purchasing.  The free market allowed everyone to make their own choices, and we rewarded the high efficiency, high quality bicycle producer, “as if by an invisible hand.” 

When people say that we should empower the marketplace in healthcare, this is what they intend.  If patients purchased their care from the high efficiency, high quality medical providers, healthcare costs would go down, and healthcare quality would go up.  No need for government intervention; the “invisible hand” takes care of this.

However, that only works if the patients are the ones paying for the care.  “Consumer sovereignty” is the notion that the quality, price and quantity of a good or service in a market is determined by the demand for those services.  In a well-functioning market, with consumer sovereignty, the consumer will purchase the goods they want from whom they want, and that will set the price for the goods, as well as the quality that the consumer demands.  And smart providers will manufacturer enough goods to meet demand, but no more than that.  In our bicycle market, we all exercised our consumer sovereignty, and we drove the low efficiency, low quality producer out of the market, and rewarded the high efficiency, high quality producer.

But who actually buys healthcare?  Do you or I?  Nope. 

About 60% of the people with insurance in the US get their insurance from their employer.  Almost all the rest get their coverage through government (e.g., Medicare, Medicaid, the VHA, or the Children’s Health Insurance Program).  Almost no patients actually buy their healthcare directly.  (Millions of people have purchased insurance on the ACA’s exchanges.  But they represent only two or three percent of the entire population.)  So, patients are not the “consumers” in the marketplace.  The healthcare “consumer” is actually our employers and the federal government, because they buy the healthcare.

And from whom do they buy healthcare?  Mostly from insurance companies (although some government programs, like Medicare not run through a Medicare Advantage program, make payments directly to the healthcare providers).  So, the healthcare “providers” are actually the insurance companies.  Then, they sub-contract out this demand by contracting with healthcare professionals and hospitals and the pharmaceuticals. 

You and me?  We are merely wards of this system.

And the promise of all of that “trickling down?”  Well, that is the “voodoo economics” that George H. W. Bush warned us about before he tossed his lot with Reagan in 1980.  Now that we are no longer in the Fifties, there is no evidence that cutting taxes and making sweetheart deals for the rich benefit us all.  It benefits the rich.  And it encourages them to play fantasy economics in the financial sector, which makes them richer, and then causes millions of us to lose our homes and jobs when the unintended but completely foreseeable consequences of their games are realized.

Markets work, but only for some things

Markets do work, and they work well. . . for some goods and services.  Would I want a government sponsored distribution of hamburgers?  No, that is perfect for the marketplace.  Probably bicycles as well.  But should we treat healthcare as a market commodity?

Well, 32 of the 33 industrialized countries have asked that very question.  And they answered “No, healthcare is a right, not a commodity or a privilege.  Therefore, we can’t use markets to allocate it.” 

Rights only exist at the level of “the community.”  We talk of “individual rights,” but these are a function of what rights are recognized by the community.  And they are only guaranteed by concerted action on the part of the community.  Therefore, they must be allocated by the community.  And the standard agent of the community is government. 

Therefore, healthcare, these 32 developed democracies decided, should be allocated by government.

But that turns out not to end the analysis.  Because there are problems with government systems, too.  In fact, just as there are three fundamental flaws of every market, there are three fundamental flaws for every government allocation system.  We need to look at those before we are able to finally examine the promise of healthcare vouchers.

That is our next topic.

My heart says Sanders. But so does my head.

We are being told that even though our hearts are attracted to Bernie Sanders’ message, we should vote with our head, and support Clinton.  Herewith is my head’s response for why thoughtful people should support Sanders.

It all comes down to what you think is necessary to address the public policy problems we face:

•    a policy debate that has shifted dramatically towards the right
•    a dysfunctional Congress dominated by right-wing rhetoric and moneyed interests not acting in the face of climate change, economic inequality, institutionalized racism, the need for real healthcare reform
•    campaign financing rules that give the rich way too much access to policy debates
•    an economic system that purports to build from the top down but merely lifts yachts
•    the making of district boundaries that assure conservative control over the House for the foreseeable future
•    a mindless national  press corps that parrots the talking points of the oligarchs
•    a Supreme Court dominated by manipulative ideologues
•    political discourse that presents no room for a positive role for government

My heart tells me that Sanders could lead us in addressing these problems. 

Will Clinton solve these problems?

So, my head wants to know — What do you think Hillary Clinton will do to solve these problems?  In spite of her protests to the contrary, she is, of course, utterly a creature of the establishment.  Made rich by courting the rich.  Playing the games of Washington.  Carefully triangulating every position.  Yes, she is the first woman to come this close, but she is not someone who will change the substance or the ground of political debate.  More of the same, but in a pants suit.

Hillary proposes to right the country’s wrongs by doing pretty much the same thing as has President Obama, only better.  We have no evidence that she will do things better than he, but more importantly, neither he nor she seems to understand that playing the game inside of Washington, only more exquisitely, is not the solution to any of the above problems.  These are battles that can only be won out among the public, building a social movement that will trump the establishment and its rich, conservative benefactors.  Obama never understood that; Clinton doesn’t either.

Maybe she will do less well

And I think there is evidence that Clinton would do less well than Obama.  It has to do with how good you are at chess.

Me, I am not a good chess player.  I have difficulty thinking that far ahead.  Move, counter-move, counter to that, and so on, ten or twenty moves down the road. 

Yet that is exactly the strategic capacity we need in a president.  To understand the nature of the real domestic political fight ahead of us.  And to represent America in foreign policy by thinking deep into the moves and counter-moves of international strategy.

So, there is Clinton, serving as Secretary of State, knowing full well that she is going to be running for President in a couple of years, and she decides to handle her email on her own personal account.  She must know that this is going to be just the sort of thing that will plague her during her coming campaign, yet she does it anyway.  Or worse, she hasn’t thought it through far enough ahead of time.  How could she do that?  I don’t think she needs to apologize for using her personal email.  The apology she owes us is for not thinking more strategically about the implications of doing so.

And there is Clinton, having left the Administration, now actively planning her race for president, but also ready to work with her husband in his successful efforts to cash in on their cache.  She takes $225,000 from Goldman Sachs for each of three talks.  And she doesn’t realize that this will be a problem when she is running?  She hasn’t thought that far ahead?  Or maybe she is so deeply acculturated to the corruption of Washington that she doesn’t even see the problem?  “Well,” she offers, “that is what they offered me.”

And she gets taken by surprise when a reporter asks to see the transcripts of these talks.  Come on now – didn’t she see that coming?  I mean, I didn’t see that coming, but I am not running for president, either.  We need better.

I want a president who is a whole lot better than I am at thinking through the deeper moves in strategic analyses.  I don’t think Clinton is that person.

But that is not the point

But actually, this is a digression.  Because the real reason she isn’t the right person is because we don’t need more of Obama.  We need to do what he wasn’t willing to do, which is create a movement that goes “over the head” of the corruption in Washington, that empowers politicians to reconstruct our institutions and actually address our problems.  Barack Obama made the mistake of not seeing this necessity.  Nor does Hillary Clinton.

What is wrong with America is not a new thing.  It has been forming for more than 50 years.  The conservative movement has been strategizing, planning, building for decades.  The fact that the center of gravity of our political discourse has moved so far to the right didn’t just happen.  It has been a concerted effort, executed over many years by thoughtful people on a mission.  A mission to delegitimize government, to play off of the anger of people frustrated by a changing economy, a changing culture, and a changing world.  And to exploit racism as a political tool, as Southern politicians became the leaders of the new Republican Party after Nixon’s successful “Southern strategy.”

Not sure that is what really happened?  Yet, this is the story told by Jane Mayer in A Dark Money: The Hidden History of the Billionaires Behind the Rise of the Radical Right and E. J. Dionne in Why the Right Went Wrong: Conservatism from Goldwater to the Tea Party and Beyond. 

And Hillary Clinton is part of the problem, not the solution.  She was an integral part of this history.  By working with her husband to pull the Democratic Party to the right in the 90's, allowing the rightward current to carry them along, rather than acting as a counter-balance to that trend.  And as a favorite dart board target for conservatives, distracting us and the public from facing our real problems, a dynamic which won’t stop if she is elected President.

A counter-revolution

Bernie Sanders is almost right when he asks us if we are ready for a political revolution.  But what he really is proposing to lead is a counter-revolution, an attempt to bring things back to an equilibrium where government is seen as a positive force in the lives of Americans, not by excluding the market, but by accompanying it.  Yes, some things are best left to the market to allocate, like hats and bicycles. But other things should not be  “marketed,” like healthcare and
protection of our common resources.

A respect for government.  That alone would be enough.  After all, some of our problems are problems that exist only at the level of “community,” like justice, racism and environmental decay.  These aren’t problems of the individual.  These are problems that will only be solved by the community acting upon them.  And the legitimate agent of the community is the government.

Yes, the Declaration of Independence emphasizes the right to life, liberty and the pursuit of happiness.  But the next phrase is too often ignored: “That to secure these rights, governments are instituted among [people], deriving their just powers from the consent of the governed.” 

What is needed is a social movement that moves us toward more justice, less prejudice, a respect for “waging peace.”  A respect for the legitimacy of collective action, made possible through government.

This counter-revolution is what will be necessary to go “over the heads” of Congress and the Washington press, to confront directly the oligarchs.  To succeed, this social movement needs leadership and intensity.  Leadership must be based on authenticity and intensity will come from rousing people’s frustrations with the corruption of the present and their spirited belief in a better future.

What Sanders is saying

And Sanders has been saying exactly what that would entail:

    Returning to a progressive income tax
   
    Recognizing the right to healthcare
   
    Reforming our campaign finance system
   
    Redistricting that is non-partisan
   
    Restructuring our energy production system

    Building prosperity by supporting the broad middle of the economy, not rewarding the rich and hoping it will “trickle down”
   
    Preparing to keep us safe in a violent world, but also becoming a voice of peace and justice in that world

    Electing progressive Senators, Congresspeople, Governors and State Representatives around the country

My heart and my head

My heart is lifted by this call.  But, in addition, my head is clear that Hillary Clinton will never achieve any of these things, not because she is a bad person, but because she is utterly a creature of the problematic present, not someone who can lead us into that future.  She has neither the authenticity nor the vision to rouse our spirits. 

Let me be clear about something.  If Hillary Clinton is the Democratic nominee, I will work for and pray for her success.  It would be far worse to have any of the current Republicans as president.  And I am not oblivious to the danger of supporting Sanders.

But my head tells me that Hillary is no more likely to win than Bernie.  Democrats have a substantial Electoral College advantage.  And Sanders has shown himself to be a powerful political force.  Will he be attacked as a Jewish, non-religious, socialist?  Of course.  But won’t Hillary suffer from the brutalizing that has marked her continuous battles with the right-wing?

If neither Sanders nor Clinton win, woe to us.  But if Clinton wins, we will not heal the gaping wounds of our body politic.  There are not enough bandaids to apply.

So, there it is.  My heart tells me that Sanders is speaking truths of great consequence.  And my head says that following those truths is the only way to promote justice and fight corruption, to reverse the rightward movement of our policy discourse, to relegitimize a balance between government and the market, to allow me to be proud again of our policy making. 

Bernie Sanders for President.  Sounds right.