The post Traditionally Republican Cincinnati Enquirer endorses Clinton over Trump appeared first on Occasional Planet.
]]>In a break with its long tradition of endorsing Republicans, The Cincinnati Enquirer has endorsed Hillary Clinton for President.
The Enquirer published its endorsement on September 23, 2016. Acknowledging this year’s break from its staunchly Republican past, the editorial board said:
The Enquirer has supported Republicans for president for almost a century – a tradition this editorial board doesn’t take lightly. But this is not a traditional race, and these are not traditional times. Our country needs calm, thoughtful leadership to deal with the challenges we face at home and abroad. We need a leader who will bring out the best in all Americans, not the worst.
That’s why there is only one choice when we elect a president in November: Hillary Clinton.
Clinton’s track record of governing starkly contrasts with Trump’s total lack of experience in government, says the Enquirer.
As senator of New York, she earned respect in Congress by working across the aisle and crafting bills with conservative lawmakers. She helped 9/11 first responders get the care they needed after suffering health effects from their time at Ground Zero, and helped expand health care and family leave for military families. Clinton has spent more than 40 years fighting for women’s and children’s rights. As first lady, she unsuccessfully fought for universal health care but helped to create the Children’s Health Insurance Program that provides health care to more than 8 million kids today. She has been a proponent of closing the gender wage gap and has stood up for LGBT rights domestically and internationally, including advocating for marriage equality.
By contrast, the Enquirer calls Trump “a clear and present danger to our country:”
Trump has no foreign policy experience, and the fact that he doesn’t recognize it – instead insisting that, “I know more about ISIS than the generals do” – is even more troubling. His wild threats to blow Iranian ships out of the water if they make rude gestures at U.S. ships is just the type of reckless, cowboy diplomacy Americans should fear from a Trump presidency. Clinton has been criticized for being overly cautious when it comes to sending our troops into battle, but there is a measured way to react to the world’s problems. Do we really want someone in charge of our military and nuclear codes who has an impulse control problem? The fact that so many top military and national security officials are not supporting Trump speaks volumes.
And, while acknowledging its reservations about Clinton, the Enquirer adds, “our reservations about Clinton pale in comparison to our fears about Trump.”:
This editorial board has been consistent in its criticism of his policies and temperament beginning with the Republican primary. We’ve condemned his childish insults; offensive remarks to women, Hispanics and African-Americans; and the way he has played on many Americans’ fears and prejudices to further himself politically. Trump brands himself as an outsider untainted by special interests, but we see a man utterly corrupted by self-interest. His narcissistic bid for the presidency is more about making himself great than America. Trump tears our country and many of its people down with his words so that he can build himself up. What else are we left to believe about a man who tells the American public that he alone can fix what ails us?
While Clinton has been relentlessly challenged about her honesty, Trump was the primary propagator of arguably the biggest lie of the past eight years: that Obama wasn’t born in the United States. Trump has played fast and loose with the support of white supremacist groups. He has praised some of our country’s most dangerous enemies – see Vladimir Putin, Kim Jong Un and Saddam Hussein – while insulting a sitting president, our military generals, a Gold Star family and prisoners of war like Sen. John McCain. Of late, Trump has toned down his divisive rhetoric, sticking to carefully constructed scripts and teleprompters. But going two weeks without saying something misogynistic, racist or xenophobic is hardly a qualification for the most important job in the world. Why should anyone believe that a Trump presidency would look markedly different from his offensive, erratic, stance-shifting presidential campaign?
The editorial board specifically calls out Trump for being “the primary propagator of arguably the biggest lie of the past eight years: that Obama wasn’t born in the United States.” It concludes by saying this:
In these uncertain times, America needs a brave leader, not bravado. Real solutions, not paper-thin promises. A clear eye toward the future, not a cynical appeal to the good old days.
Hillary Clinton has her faults, certainly, but she has spent a lifetime working to improve the lives of Americans both inside and outside of Washington. It’s time to elect the first female U.S. president – not because she’s a woman, but because she’s hands-down the most qualified choice.
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]]>I’m not joking, I swear. It’s kind of disturbing how much of political discourse on social media is dominated by pictures with uncited, vague statistics on them. But this sort of thing isn’t new. Below, I explain how the grandiose oratory of the twentieth century evolved into the misleading images and videos we see today.
I find myself frequently turning to George Orwell’s essays these days. The piece most relevant to today’s public affairs is his 1946 essay “Politics and the English Language”. Orwell criticized the tendency of political writing to use jargon, passive voice, trite similes and metaphors, and other ways of obscuring meaning in order to justify atrocities. For example, he cites a communist pamphlet:
All the “best people” from the gentlemen’s clubs, and all the frantic fascist captains, united in common hatred of Socialism and bestial horror at the rising tide of the mass revolutionary movement, have turned to acts of provocation, to foul incendiarism, to medieval legends of poisoned wells, to legalize their own destruction of proletarian organizations, and rouse the agitated petty-bourgeoise to chauvinistic fervor on behalf of the fight against the revolutionary way out of the crisis.
It’s a prose poem, really. It makes use of Marxist jargon (“petty-bourgeoise”, “proletarian organizations”), as well as English or European common metaphors (“best people”, “gentlemen’s clubs” “medieval legends of poisoned wells”). For someone without prior knowledge of these concepts, the above paragraph is just about worthless. Not only does it make use of almost incomprehensible imagery, it contains no relevant information or policy prescription that a reader could advocate for. It’s merely meant to inspire hatred via pretty words.
This kind of ridiculous writing is still around, unfortunately. A glaring example from the present day: The Lion Guard, a tiny, pro-Trump, and pretty explicitly fascist group taking its name from a Mussolini quote, posted on its website:
The past week has revealed one singular conclusion, the politically correct mindset that dominates cultural, economic, social and political institutions must be disposed…Decision 2016 is a referendum on political correctness…While MAGA patriots were under attack in Arizona, another swarm of rootless barbarians sought to raise chaos in New York City, and shut down Manhattan from Columbus Circle to Trump Tower. While the horde ground mid-town Manhattan to a standstill, the organizers of the event, members of the NY Cosmos football club bragged the mainstream media advanced their cause by concealing the disorder caused by the “Cosmopolitan Anti-Fascist” march that quickly devolved into violent confrontations between police and neo-Spartacists, a group of militant communists that advocate a violent global revolution to establish their Trotskyite utopia.
Note the ancient terminology here: “rootless barbarians”, “horde”. The attempt to paint leftist demonstrators as Huns at the gates of Rome seems petty and few today would recognize the comparison. Also the far-right jargon: “MAGA” (Make America Great Again”), “neo-Spartacists” (not a real thing), and “Trotskyite” (technically the term is “Trostskyist”, but more to the point, no one cares about obscure communist sects). No theme is conveyed with the poetic and referential language beyond that of stirring up the emotions of those who already agree with its content.
But far-right groups like the Lion Guard aren’t really mainstream enough to make a difference. More importantly, various modern media outlets use quick videos and edited clips to make mainly emotional points. These short videos are the successors to the bad political writing of Orwell’s day. Call them memes if you want (I do, it’s funny), but political videos and images tend towards sensationalism and inaccuracy.
Watch this quick clip of Hillary Clinton “crushing” Donald Trump. It’s from AJ+, which on its Instagram page declares itself “news for the connected generation, sharing human stories and challenging the status quo”. Note how it uses a fun remix of early jazz (because we millennials love retro music), the way Clinton’s words visually appear to hammer home her points. Also note the quick gifs of Trump making silly faces, being attacked by an eagle, and finally, a short gif of Clinton at a separate event brushing off her shoulder, to indicate how cool her anti-Trump speech was.
Every single criticism Clinton makes of Trump in the clip is valid and accurate. That’s not my grievance with it. What I find troubling is the way the video uses music, imagery, and jokes to make a point as opposed to facts. This is the 21st-century equivalent of the bad communist pamphlet above.
AJ+ isn’t actually that bad. Frequently in their 90-second clips they include relevant statistics alongside the requisite cat gifs, and their longer-form documentaries are pretty cool (check out this disturbing one on anti-Muslim militias in Texas). But when I look on social media, the AJ+ posts I see tend to be sensationalist.
Obviously, biased, uncritical journalism is not the sole purview of the young left: Sites like Breitbart and The Blaze are equally obnoxious, with far worse ideals behind them. Breitbart even recently attempted to stir up hate because CNN used quotation marks in a way Breitbart didn’t like.
What we are seeing here, overall, is selective exposure at work: People seek out news that reinforces their preconceived notions of the world. Then, elements like poetic word choice, music, imagery, and video can be used to further cement the viewer’s feelings. Think back to the communist pamphlet Orwell cited: Whose mind was changed from reading that? What worker decided to become a communist after reading that trash? The same question needs to be applied to contemporary media: If it preaches to the choir, if it’s factual reporting does not have the capacity to educate, it’s not good journalism. Keep that in mind the next time you read an editorial or think piece. Even this one.
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]]>The post America needs a new vision of foreign policy appeared first on Occasional Planet.
]]>The 2016 election cycle continues on its baffling way, but foreign policy issues have largely been neglected, with a few exceptions like ISIS. Each of the three remaining major candidates falls short in certain ways.
Allow me to summarize each candidate’s position, what I believe each lacks, and to describe the appearance and objectives of a new vision for American foreign policy.
I reviewed some key passages from each candidate’s website and came up with a short summary of their ideas:
This strategy might best be compared with what international relations scholars call “realism”, though that school has far from a monopoly on realistic proposals. Realism posits that since the world order is essentially anarchic, meaning that it has no central authority to enforce peace, states must engage in “self-help” by following national interest above all else. Because no supranational force will come and save us, we must maintain a strong military as a cornerstone of our foreign policy. Trump demonstrates this thinking:
Clinton’s platform more closely resembles international relations liberalism, which in this context means a foreign policy centered around international political and economic cooperation towards greater prosperity and freedom for all, theoretically. This is evident in her website’s national security section, which includes some interesting points:
Sanders’ policy is a little difficult to fit into the one of the schools of international relations, which are frequently descriptive rather than prescriptive. One might point to constructivism, which argues that international society is built by evolving norms of behavior, which Sanders’ caution probably seeks to build. Economic structuralism, a Marxist school of international thought, doesn’t accurate describe Sanders’ platform either: But Sanders’ “socialism” isn’t particularly Marxist or revolutionary: it stands for measured critiques of the corporate elite, the reform of capitalism, and opposition to international free trade deals and not the overthrow of the capitalist world-system. Liberalism may best serve to describe Sanders’ overall vision, which is that of peace, cooperation, and economic progress:
It is my opinion that the United States should focus in the long run on the improvement of the international system itself. Each of the candidates has not fundamentally addressed the root causes of the problems identified, namely, the lack of a system of global governance to solve problems individual states are unable to. It should be relatively obvious that Trump does not care about the world-system. His idea of a good world is one in which America is strong. In an increasingly interdependent world in which the borders between nation-states are dissolving, this nationalist position is as impractical as it is immoral. As for Clinton and Sanders, they seem to be focused on individual solutions to individual problems, holding out the promise of “international cooperation” as an antidote to climate change, terrorism, and trade. Though I am more sympathetic to their arguments, Sanders in particular, without a fundamentally just international system, none of these problems are solvable. Below I explain a little about our current international system, and posit some ways in which it must be reformed.
After World War II, the United States set up multiple interwoven systems to guarantee its global dominance. They include Bretton Woods, the system that regulated monetary relations globally, the IMF, the World Bank, and the United Nations. When I say “global dominance”, I do not mean to indicate that U.S. hegemony was totally negative in nature. It did allow a degree of prosperity globally, especially in U.S.-aligned states in Western Europe and Asia. However, it was a system that guaranteed the supremacy of the United States and, to a lesser extent, the other four permanent members of the UN Security Council: Britain, France, Russia, and China.
Conventional wisdom says the United States is a hegemon in decline. Regardless of the accuracy of this statement, we are certainly seeing what Fareed Zakaria describes as the “rise of the rest”, specifically the BRIC (Brazil, Russia, India, and China) as well as many states in Africa. We are facing a century in which the United States will not have overwhelming authority it possessed in the past. And despite the horrible human rights abuses of the United States and its allies since 1945, I am hesitant to declare that China, the probable next hegemon, would be somehow more peaceful or responsible. A responsible world wouldn’t be bound by American or Chinese dominance. What then must we do?
The international system is changing, and the United States foreign policy apparatus should use its clout to move towards a more inclusive, just, democratic, and peaceful world order. How do we do this? A strong commitment to human rights, for one. It is difficult to speak as a moral authority when the nation is engaged in unjust wars, and the intelligence apparatus supports kleptocrats in the developing world. In the long run, we should strengthen, reform, and reshape multilateral institutions like the UN. The international system should be just and more permanent than whoever is in power.
I can’t give you specifics as to what an ideal world-system would look like. But I do know that Trump’s nationalism, and to a lesser extent the immediacy of Clinton and Sanders’ ideas, are fundamentally incapable of moving toward such a system.
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]]>The post Sanders, Clinton, Nevada and squabbling liberals appeared first on Occasional Planet.
]]>What happened at the Nevada Democratic Convention is awful and inexcusable, and Sanders needs to apologize; demand that his supporters stop such terrible, hateful, stupid, counterproductive behavior; and then carry on campaigning and talking about issues until the convention, by the end of which he should strongly endorse Clinton.
All that being said, a lot of what Kevin Drum, Josh Marshall, Koz, and Paul Krugman are saying is overwrought, and I don’t pay much mind to them anyway, because they made it clear from the start they don’t like Sanders. All of them have been beating up on him for months.
I am going to engage in some you-tooism here. Not on the behavior of some of his supporters, which is despicable, but on “feeling sorry” [as Krugman said about some Sanders supporters]—for Clinton supporters. I am truly shocked and disappointed by people who call themselves strong left-wing liberals who have been reduced to defending Clinton’s positions and actions on a wide range of things on which they would never have defended anyone else.
I appreciate Clinton supporters who say, “I agree with Sanders on the issues but I don’t think he can win.” I understand that. But I have seen way too many Clinton supporters who defend her blatant changing of positions depending on who she is talking to (as we just saw last week with coal miners), her being buddies with people like Kissinger and Blankfein, her multi-million dollar contributions and speaking fees from Wall Street interests, her hawkishness on foreign policy, her actions in Honduras, her refusal to support Elizabeth Warren on major issues like breaking up banks and reinstating Glass-Stegall, her opposition to an immediate moratorium on fracking, her turning back decades of Democratic support for single-payer health care by saying “it will never, ever happen” and chastising people who support it, and several other items.
For those of us who care about issues, this has all been a very sorry sight. We will vote for Clinton in November because the alternative is too awful to contemplate. But don’t sugar-coat her poor position on issues.
None of which is to excuse Sanders for not forcefully condemning the actions of his supporters and demanding that those behaviors stop. It is extremely maddening and disappointing that he has not done that.
I do want to add one addendum here, lest I be accused of being a fraud and hypocrite this fall: I did not mean to imply that I will vote for Clinton only because Trump is worse. In spite of my many and major policy differences with her, I also admire her in some ways. I think she has good experience, I like her strength on other issues including guns and reproductive rights, and I admire her for standing up to all the phony scandals and other crap that the Republicans have thrown her way. And I am excited to vote for the first woman president!
Much like I feel about Obama– I strongly disagree with him on some issues and on some things he has done, but overall I greatly admire him and think he has been an excellent president. I am optimistic that Clinton can be the same.
And I also recognize that this mainly a fight between liberals, albeit moderate liberals and left liberals. It’s not like we’re all conservatives!
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]]>The post Make America great appeared first on Occasional Planet.
]]>Hillary Clinton, I hate to break it to you, but we do have to make America great (again).
Now, before Donald Trump makes me his new Brown Muslim friend and tries to seat me behind him at a rally within camera-frame, let me reiterate that I find him despicable and think his plans would make America worse.
But he’s marginally right in the idea that we do need to work America great, although I’m still questioning the “again” bit. I believe that America has a lot of potential to be great, but I think as a country we make a lot of poor decisions and that in order to be a great country, we need to make a whole lot fewer poor decisions. Like a whole lot fewer.
Number one on that list, of course, would be not electing Donald Trump. Or, actually, any of the other GOP presidential candidates who are, in essence, espousing the same thing as him in a slightly less abrasive manner.
In fact Donald Trump represents, in many ways, everything that is wrong with America. As many have pointed out, Trump is racist, sexist, xenophobic, ableist, homophobic, Islamophobic, and on and on. Trump’s America has no room for anyone, really, other than old, White, Christian, cis, straight, wealthy men. And to far too great an extent, the nation already looks like that.
Think institutionalized racism, discriminatory housing policies, racial profiling, police brutality.Think being banned from being married, fired from your job for who you love, killed for the way you identify. Think restrictive immigrant policies, mass deportations, labor trafficking, less than minimum wage jobs. Think being shamed and mocked for a disability, being physically denied access to buildings, being told to “just get over” mental illness. Think being banned from the country for the religion you practice, being spied on, suspected as terrorists on every street corner, stopped at every airport, killed for your (perceived) faith. Think slashing welfare that allows you to eat, homelessness, mass unemployment, being called a social loafer, crippling student debt. Think rape culture, catcalling, gender pay gap, victim-blaming, luxury taxes on tampons, rape test backlogs.
These are institutional injustices built into the fundamental systems of the United States because of the history of our country. They’re why I hesitate to say “great again” and why I absolutely can’t say that America is already perfectly great.
There are plenty of ways to make America great, but adding to that list is not any of them. We have to get rid of the flaws in the system that leave people out, that hurt them, that oppress them. Not exacerbate those flaws.
The first step to which means that we must recognize they exist. So, sorry Hillary Clinton, I can’t believe you when you say “America is already great.” You’re almost as wrong as Donald Trump.
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]]>The post Voting rights watch: Is the pendulum swinging back toward democracy? appeared first on Occasional Planet.
]]>It has been very disconcerting to watch voting rights erode in America over the past 30 years or so. For those of us naïve enough to think that the 14th Amendment to the U.S. Constitution, the 19th Amendment, and the 1965 Voting Rights Act settled the thorniest issues around voting rights—we have been forced to rethink our assumptions.
The term “erosion” is not really accurate, though. Eroding seems too passive a verb for what has been happening: the deliberate attempt, by politically motivated legislatures, to shrink voting rights for people whose votes they’d rather not count.
I seem to remember from my 8th grade Civics class that the history of voting rights in America has, traditionally, been one of expansion. The reversal of that trend, via radical, anti-democracy, anti-voting policies initiated primarily by right-wing Republicans, is a shameful blot on a country that claims to be a democracy [“the greatest democracy in the world!”]
So, I feel encouraged by some recent developments that may indicate the beginning of a pendulum swing back in the appropriate direction. Here are a few, in no particular order:
Automatic voter registration
On the campaign trail, Democrats Hillary Clinton and Bernie Sanders have both called for automatic voter registration for everyone at age 18. Voting rights advocates [wait, why is voting-rights advocacy even necessary?] note that these declarations represent a breakthrough, as voting reform has been absent as a front-and-center issue in presidential campaigns for at least 50 years.
Further along this spectrum is Oregon, whose state legislature passed a bill in March 2015 putting that idea into practice.
According to the Brennan Center,
…the new law automatically registers eligible citizens who have driver’s licenses (and do not ask to remain unregistered). While there had been strong and bipartisan efforts across a majority of states to modernize voter registration, Oregon’s law went a step further, giving government the primary responsibility for ensuring that every eligible citizen is registered.
Soon after Oregon’s bill was signed into law, legislators in 17 states plus the District of Columbia and the United States Congress introduced similar bills that would automatically register citizens who interact with motor vehicle offices and ensure that voter information is electronically and securely sent to the voter rolls.
The Brennan Center estimates that the new procedure in Oregon will immediately add 300,000 citizens to the voting rolls.
Making Election Day a national holiday
It has been clear for many years that the first-Tuesday-in-November Election Day schedule is out of sync with contemporary life. Many states have found ways to adapt, mostly by offering early voting days and extended voting hours [both of which have been under attack in the 21st century]. But, because most voting still takes place on a single day, during slightly extended business hours, it’s hard for people to get to the polls, let alone wait in long lines for their turn. It’s also hard to get people to work for election authorities—and the most qualified, such as government workers, people accustomed to checking numbers, workers comfortable with electronic equipment, etc., are otherwise occupied with their day jobs.
Recognizing this disconnect in the most essential activity of a democracy, Bernie Sanders recently introduced a bill into the U.S. Senate to declare presidential Election Day a national, public holiday, making it more convenient for more people to vote, as well as to do the vital work of ensuring fairness and accountability at the polls.
Sanders is realistic in his expectations: Making Election Day a national holiday won’t cure Americans of their embarrassing indifference to voting, but it would make an important statement about a fundamental element of the American democratic system.
In introducing the bill, Sanders said:
We should be doing everything possible to make it easier for people to participate in the political process. Election Day should be a national holiday so that everyone has the time and opportunity to vote. While this would not be a cure-all, it would indicate a national commitment to create a vibrant democracy.
Reversing punitive voter ID requirements
In a decision that gives hope to those of us who see voting as a right, rather than a privilege, the 5th Circuit Court recently struck down Texas’ highly restrictive voter ID law. According to the Brennan Center for Democracy, the Texas law discriminated against blacks and Hispanics and violated the Voting Rights Act of 1965.
The Texas ID law is one of the strictest of its kind in the country. It requires voters to bring a government-issued photo ID to the polls. Accepted forms of identification include a driver’s license, a United States passport, a concealed-handgun license and an election identification certificate issued by the State Department of Public Safety.
[Note that, under Texas law, you could use, as proof of identity, your concealed-carry handgun license, but not your state-issued student ID, your voter registration card, or your utility bill.]
According to Think Progress:
The plaintiffs, including individual voters, civil rights groups and the Department of Justice, said it was discriminatory because a far greater share of poor people and minorities do not have these forms of identification and lack easy access to birth certificates or other documents needed to obtain them.
In its ruling, the noted that “the lack of evidence that voter fraud was a threat and cited expert testimony that about 600,000 Texans, mainly poor, black and Hispanic, lacked the newly required IDs and often faced obstacles in obtaining them.”
Previously, a lower court had ruled that the law “creates an unconstitutional burden on the right to vote” and blocked its enforcement.
It’s also worth noting that the 5th Circuit Court of Appeals, which issued the ruling striking down the Texas voter ID requirements, is considered one of the most conservative appeals courts in the country. Apparently, Texas’s rules went too far even for a conservative court. That’s significant.
Gerrymandering
There’s also some good news on the gerrymandering front. The Florida Supreme Court [recently] ruled that the state legislature’s redistricting plans ahead of next year’s U.S. presidential election are tainted by “unconstitutional intent to favor the Republican Party and its incumbents” and ordered new congressional districts to be redrawn within 100 days.
In a 5-2 decision the court found the GOP’s redistricting process in 2012 violated the the state’s Fair District amendment, enacted two years earlier to safeguard against legislatures redrawing congressional boundaries to give favor to a political party—a process known as gerrymandering.
The judges affirmed a previous ruling by a trial court, which found that Republican “operatives” and political consultants “did in fact conspire to manipulate and influence the redistricting process.”
Eight out of Florida’s 27 congressional districts will be redrawn.
It’s a victory for voting rights, and a precedent-setting decision that could influence future gerrymandering fights.
Susan Goodman, who heads up the Florida League of Women Voters said:
This was the fox guarding the henhouse. In gerrymandered states, lawmakers end up choosing their voters, rather than voters choosing their legislators,” Goodman said, adding that the ruling “sets a precedent for many states across the country who are dealing with gerrymandered districts.”
The state court decision follows a similar anti-gerrymandering ruling from the U.S. Supreme Court last month, in which the justices voted 5-4 to uphold an Arizona ballot initiative that took redistricting power away from elected politicians and gave it to a nonpartisan commission.
We’re not there yet
All of these developments are encouraging. But they are only baby steps toward returning our country to the democratic system it could and should be. And they will undoubtedly be staunchly opposed by the cheaters and vote-riggers who think it’s just fine to win elections by denying the vote to their perceived opponents and people whose interests they don’t share or bother to represent.
And it’s cold comfort to know that, even though women there have recently gained the right to vote, at least we’re more advanced than Saudi Arabia.
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]]>The post A healthy dose of good government: Flu shots at the pharmacy appeared first on Occasional Planet.
]]>One afternoon last week, I walked into the pharmacy in my local supermarket. Twenty minutes later, I left after receiving a needle’s worth of this season’s influenza vaccine. The cost? $20. For those in line behind me (lucky enough to have better insurance than I have), the cost was nil or $5.
When I first walked in, I was asked to fill out the necessary forms. While completing them, I noticed that my fellow vaccinees seemed, like me, to be quite relaxed and even a bit jovial. And why wouldn’t we? No waiting on hold at home to make an appointment weeks in advance. No sitting in stuffy waiting rooms—breathing in germs spread by the coughing and sneezing of fellow patients—just to see the blur of an over-scheduled doctor for a few moments.
My pharmacy visit spared me all that. The experience revealed something that deserves our attention and should be celebrated: a health-care success story and an example of good government.
It took all of a minute for the pharmacist to swab my arm and administer the shot. When I left, I found myself wondering just how such an effective innovation—now generally taken for granted—had come about.
Expanding access to healthcare
If you ask whether I was surprised to discover that the initial push for offering an alternative to vaccination at a doctor’s office had its origins in a Democratic administration, my answer would be “of course not.” Since the days of FDR’s New Deal, Johnson’s Great Society, and now Obamacare, progressive Democrats have been at the heart of the fight to expand access—whether in the workplace, health care, or civil and legal rights.
This latest expansion originated during the Clinton administration, when then–Secretary of Health and Human Services, Donna Shalala, proposed to the American Pharmacists’ Association (APha) that the organization develop a plan to train pharmacists across the country to deliver immunizations. At the time, Shalala and others in the administration were alarmed by low vaccination rates, particularly among the uninsured and rural populations underserved by the medical community.
Remember that 1993 was the year in which President Clinton focused his domestic agenda on health care and unleashed a task force (headed by First Lady Hillary Rodham Clinton) that tried nobly—and failed miserably—to take on the entrenched interests of a health-care industry that was (and is) costing the public and private sectors dearly and delivering poorly on services.
Shalala, one of the unsung crusaders of the Clinton administration’s focus on health care, hoped that convenience and lower cost might boost vaccination rates and provide a more broadly based entry point to the front lines of preventive health care—the vaccination.
Secretary Shalala’s efforts paid off when her proposal was embraced by APha. The organization responded by developing a rigorous program to train and certify an army of pharmacists who would be available to administer vaccinations. Although at the time a few states already had existing laws on the books allowing vaccination in pharmacies, implementation had been slow or nonexistent. Shalala was determined to change that.
Although the Clinton administration laid the groundwork, administering vaccinations in pharmacies really began to take off in the 2006–2007 influenza season. The number of vaccines delivered by pharmacists that year comprised seven percent of total vaccinations. By 2011 the rate had increased to eighteen percent.
Lest this seem like a success story unmarred by controversy, it’s important to remember that doctors were hardly on board. Their lobby pushed back and pushed back hard. Even today, state medical societies continue to fight against ceding vaccination delivery to pharmacists. Their objection holds that vaccination by pharmacists disrupts the doctor/patient relationship and complicates record keeping in doctors’ offices. Talked about less often is the loss of doctors’ fees from patients, insurance companies, and Medicare and Medicaid.
State-by-state
Which vaccines may be administered by pharmacists continues to be controversial as well. Each state determines its own regulations, and those regulations are all over the map.
It was not until 2009 that all fifty states allowed some or all of the CDC-recommended adult vaccinations to be delivered by pharmacists. (Maine being the last state to pass the necessary laws.) Only six states—Massachusetts, Washington, Connecticut, Colorado, Minnesota, and Kentucky—have passed regulations allowing all CDC-recommended adult vaccinations to be made available at pharmacies, supermarkets, and big-box stores.
In New York State, pharmacists are authorized to administer the adult influenza, pneumonia, and, just this year, shingles vaccinations but have not yet been authorized to administer the adult whooping-cough vaccination.
(In an unexpected move on January 12, 2013, Governor Cuomo, responding to an influenza rate of infection of epidemic proportions in the state, issued an executive order permitting pharmacists to temporarily administer seasonal influenza shots to children between the ages of six months and eighteen years.)
Pro-active, good government
There’s another important dimension to this story that goes beyond health benefits. And this brings me back to the concept of good government (an idea nearly extinguished by conservative Republicans but, thankfully, robustly revived by President Obama in his recent inaugural speech).
The success story of pharmacist-delivered vaccinations is an example of what can happen when a government agency pro-actively identifies a problem and then works aggressively, innovatively, and nimbly to craft a solution that yields results not for a single special-interest group but for the benefit of all.
And so I find myself asking: How many of the cheerful vaccinees that day in my local pharmacy realized that they should be thanking former President Clinton and Donna Shalala for sparing them time out of their busy days and saving them money by going to the pharmacy rather than a doctor’s office? In fact, every day in pharmacies, supermarkets, and big-box stores in cities, suburbs, and rural areas, individuals are unknowingly experiencing up close the intersection of their daily lives with the benefits of good government.
How altered our political discourse would be if only we all realized it.
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]]>As we approach the lame duck session of the 111th Congress, we can learn a lot from how previous Congresses dealt with this challenging task. In an earlier post we discussed lame duck history sessions from 1940 – 1970. It’s important to look at more recent ones, particularly with the challenges that face the current Congress. The biggest issue facing the 111th is the so-called “fiscal cliff” or “driveway slope” that challenges members of the present Congress to address a previous deal, in which they delayed addressing the national debt. If nothing new is done, the Bush tax cuts will be rescinded for all, including those for the middle class, and there will be another two trillion dollar cut from expenditures, including half from the military budget.
Here’s what happened in some recent lame-duck sessions:
Post-impeachment, 1974
Going back thirty-eight years, the 1974 lame duck was unique because, over the previous two years, both the House and the Senate had been consumed with impeachment charges against President Richard M. Nixon. The most important measure was to confirm new President Gerald R. Ford’s nomination of Nelson Rockefeller to replace him as Vice-President. That went smoothly but only a few of the ten other proposals that Ford submitted were passed.
Filibuster, gridlock
It was eight years, 1982, until the next lame duck session. President Ronald Reagan expressed concern that only three of 13 appropriation bills had been cleared for his signature. Congress promised to pass nine of the ten, but in reality only four passed for FY 1983. With serious concern about a recession, five bills were delayed to be dealt with the second year of the Congress in 1984. The lame duck session was particularly acrimonious, because the Senate held many filibusters. We now call this tactic gridlock.
Impeachment, again
In the 104thCongress, impeachment once again consumed Congress. This time the target was President Bill Clinton. While there were no charges for his dalliance with Monica Lewinsky, it was Clinton’s unwillingness to tell the truth and his proclivity to obstruct justice that caused Congress to have another lame duck session. Two charges against President Clinton passed by margins of 228-206 and 228-190. This lead to a Senate trial on the impeachment charges in the second session of the 104th Congress. Clinton was acquitted.
Expanding the power of the executive branch
The issue of unfunded appropriations once again came to the fore in the 107th Congress, 2nd Session in 2002. President George W. Bush had an agenda that included establishing the Department of Homeland Security. This plan was quite controversial, because it involved a major consolidation of separate bureaus, including the F.B.I., C.I.A, National Security Council, and FEMA. Finally, both the House and the Senate agreed to the proposal on November 22. The result was that Bush expanded the power of the executive branch, in the wake of the terrorist attack on the United States on 9-11-2001.
Be careful what you wish for
Two years later the 108th Congress, 2nd Session, had a lame duck session because the uncertainty of the 2004 election resulted in many appropriation bills left unfunded. Once Bush had won reelection, Congress agreed to most of his proposals. Congress also followed up its approval of the Department of Homeland Security with the establishment of a September 11 Commission that had the power to thoroughly investigate the causes of and the follow up to the 9-11 attack. This became a commission that was quite critical of the Bush administration, but the administration was able to block most of the recommendations.
2010, not very lame at all
The most recent and memorable lame duck session was two years ago, in 2010. The battle royale between President Obama and the Congress, in which Republicans had the power to filibuster in the Senate, resulted in a strange set of fiscal and monetary policies.
President Obama wanted the Bush taxes for the wealthy (net income over $250,000) to expire, but Republicans argued that these cuts were essential to stimulating the economy. Previous tax cuts for the wealthy amounted to mere 10%, from 39.6% to 36%. If the cuts for the wealthy were to be rescinded, the result would have been billions of dollars for the federal government. To address the middle class, the payroll tax was reduced by 2%. This move provided more disposable money all workers who were paying the payroll tax, but it also reduced revenue for the underfunded Social Security and Medicare programs. Some felt that President Obama conceded on this issue too easily, without a strong push from Republicans to do so.Congress passed a repeal of the “Don’t Ask, Don’t Tell” measure that banned openly gay and lesbian soldiers in the military. Now there would be no discrimination against gays and lesbians in the armed forces.
Congress also passed a bill to provide medical treatment and compensation to first responders of the September 11 attack. However there was a major omission in the bill because it did not cover most forms of cancer, one of the primary maladies suffered by the first responders.
Congress also passed an extension of the START (Strategic Arms Limitation Treaty) with Russia. Several Republican Senators joined with all Democrats to make this possible.
Perpetual can-kicking
The second session of the 110th Congress will go down in history as refusing to finish appropriation bills submitted by President Obama and an unwillingness to reform the tax code, particularly with regard to the taxes levied on the wealthy.
Most of these issues have been delayed for two years until the upcoming lame duck session. House Speaker John Boehner has already indicated that he won’t compromise on restoring the income tax on the wealthy to their Clinton levels. It’s possible that, once again,even as the so-called “fiscal cliff” approaches, Congress will delay again. Whether it’s a lame duck or a regular session of Congress, this is a deplorable way for our primary legislative body to operate.
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