Healthcare – Unspoken Politics

On “the culture war”

Throughout 2022, but in particular in the aftermath of the midterm election, I’ve been circulating thoughts in my head about the term the culture war and how I would approach it from a sociological lens.

There are a couple of considerations that I want to address, in particular when the term has arisen in various forms of media. The culture war is not a catch-all for non-economic political issues, they often involve fundamental rights and also connect to a material base- basic Marxism here. It is also an asymmetrical term, so I want to avoid false equivalence. The culture war is a political process often for very cynical, self-serving reasons by right-wing political elites, but those affected by it are not “another side” of it.

So I want to define the culture war as best as I can using what has been circulating in my mind:

The “cultural war” is a political process wherein issues are pressed:

By conservative elites, a nexus of wealthy political donors, the conservative media, and politicians and their operatives.
Are aimed at activating white evangelicals in particular
Are tied to elections, with a limited number of culture war issues in the spotlight at any one time, and they are often dropped by elites for use later
However, they are framed as existential threats to America that are undermining some abstract values

We see some issues wax and wane for decades- the concern today about “smut” in libraries and classrooms goes back in its modern form to about 1974, when a frenzy was whipped up in West Virginia. For my lifetime, from Tango Makes Three to Gender Queer, the thrust has gone from certain language and depictions of heterosexual intimacy to anything regarding queer themes. This is a linkage in social movement literature, which lead to bloc recruitment (when a whole group comes as a single entity). People who didn’t really care about “banned books” for the most part, when a media frenzy and money being funneled into the issue led to dramatically increased attendance and hostility at school and library board meetings. So it went from a niche movement to a central point of cultural warfare.

As you remember, 2004 was the peak of anti-marriage equality as an election strategy. So many states had ballot measures attempting to bring out more apathetic voters (again, the centrality of almost every culture war topic is activating white evangelicals). As with 2022, it’s difficult to find convincing evidence that this ultimately mattered (https://www.cambridge.org/core/journals/ps-political-science-and-politics/article/abs/samesex-marriage-and-the-2004-presidential-election/1EF13FD3DEC005457783AF1DF79928D6). I would hypothesize that voters are, in many states, more apathetic than the media-political class. Even very red states in 2022 failed to advance abortion from the Dobbs decision to ballot measures, with a lot of vote splitting. The culture war is most felt acutely at the local level, where highly committed but numerically small ardent right-wing groups have the most leverage.

Transphobia and homophobia were an issue ushered in significantly in general and especially in regards to education, but even in reddest Utah, it doesn’t register (“other” is 13% so at most we’re talking one in ten people, probably much lower) (https://www.deseret.com/2022/7/25/23272939/heres-the-top-issue-on-voters-minds-ahead-of-federal-elections-inflation-economy-congress-president). With school policy as a whole, besides recurring concerns like class sizes and assistance to students who lag behind in expectations. Also the Uvalde shooting showed a much more existential threat to schools than any concerns about culture war issues.

I would say that the culture war is most pushed by red state politicians today, while nationally independents and liberals are often on the same page with progressive topics. Also, Democrats fell into a trap on a major issue in 2022, with Eric Adams and others raising fears of crime that the media was pushing- leading to a huge under-performance in New York. However, liberals, though often not vociferous about things, rejected the framing of gender identity and sexuality by the right and avoided it becoming the non-stop coverage by media of all types that promoted inaccurate narratives on crime.

It has been 42 years since the Christian right was fully politically activated in the election of Ronald Reagan. For a long time, before the radicalization of conservatives in the 1994, 2010, and 2016 electoral cycles, political elites generally used culture war appeals to win elections but did not have them as a serious priority. In my lifetime, more of the political right elites have gone from opportunists to true believers, bringing cultural warfare to the center of policy. Also, the media-political connection has changed with the deregulation of media in the late 1980s and the gradual move of much more extreme talk radio to television and political talking points.

To win liberation for oppressed groups, and to counter activated voters who become activists, a much more vibrant liberal-left political culture must emerge to counter the activists themselves but also the many wealthy elites who pour money into concern trolling on Critical Race Theory and who can say what in schools. Also direct action must play more of a role- the Supreme Court now has hard-right majority and is willing to rule decisively on things like abortion and discrimination that earlier courts tended to punt on. Though there is no political horizon thus far to actually counter the court through elections, SCOTUS is self-destructing its credibility and causing cracks in some parts of the Republican coalition, especially right-leaning independents. There is a time to seize the moment. The time is now.

The BS economy II: BS-ish jobs and the coronavirus recession

Years ago, I wrote a post entitled “The BS economy“, reflecting on David Graeber’s superb essay “On the Phenomenon of BS Jobs” that ended up being a runaway success. By the time his full-length book Bullshit Jobs (2018) came out, a poll had already been conducted that a substantial portion of people in developed countries believed their work had no societal value at all. And though bullshit jobs have in media discourse focused on the bureaucracy and public sector, many people from the private sector reported useless levels of middle management, creation of reports nobody actually reads, and people who exist to duct-tape together something that doesn’t work but could probably be fixed if that was the actual goal, rather than maintaining the status quo.

The spread of COVID-19, which has now enveloped many developed countries, who, with huge amounts of international air travel and centralized urban societies and health systems, were always going to be the first to be slammed by a pandemic. Italy is the post child of how bad things are now, with Spain currently outpacing them in terms of the rate of increase in death rate. The United States is in waves reaching and going beyond the saturation point of its gutted hospitals. According to World Bank data, the US has, per 1,000 people, about a third the hospital beds it had in the 1960s:

Screen Shot 2020-03-25 at 1.46.26 AM — Source: Trading Economics

The de-development of the US, wherein infrastructure is either destroyed deliberately (see, the auto industry buying and dismantling extensive and cheap electric streetcar systems in many cities) or through general neglect in the neoliberal era. The decrease in hospital beds, however, is astonishing not only for how much it digs into American Exceptionalism narratives, but also how it falls consistently even prior to the usual starting point of American neoliberalism in the Reagan era.

It is abundantly clear that the US will have the highest total deaths of any country, by an order of magnitude or more. The President wants to already roll back very inconsistent containment methods by Easter, in order to “restart the economy”. My state has still not adopted shelter-in-place, despite Boston being a major city with a large amount of imported cases and community transmission. It seems clear they will never receive federal assistance in going beyond current containment measures, let alone the medical supplies they need through the use of the Defense Production Act. The government, as most neoliberal governments in American and Western history, is basing their crisis response on handshake deals with large companies and promises of no-strings-attached bailout money.

I will revisit the difference between “the economy” (the method by which people obtain goods and services, through work or a welfare state) and “the Economy” (a reified concept based on a few stock indexes and how well billionaires and their conglomerates are doing) at a later date. I will focus on this post in how much the economy has been stripped down. Finding out which jobs are “essential” (largely the supply chains for food and medical equipment, along with education, though they are full of administrative layers and do-nothing middlemen skimming money off the top) and which are not is instructive. This is a natural experiment to go beyond the Bullshit Jobs framework, which relied on above-mentioned polling, a few hundred people who emailed about the bullshit parts (or wholes) of their jobs, and Graeber’s mastery of theory creation from an anthropological lens.

Landlords? Pure parasites, who get others to pay their mortgages and expansion, avoiding providing services as much as possible, which could be done collectively by tenants anyways.

Office jobs? Bullshit-ish, at the very least, if not total bullshit. The mass movement to working from home and teleconferencing within a couple of weeks indicates what a useless, environmentally-destroying artifice the office is. The office is an instrument of social control, whereby the bosses use the magic of at-will employment to add unneeded stress on people who know how to do their jobs infinitely better than management. With a huge drop in commuting, Los Angeles has some of the cleanest air it has ever had in the automobile era. Millions of hours of commuting and busywork have been cut, and people are able to balance whatever workload they actually have with accomplishing creative pursuits or otherwise having more time in the day. Graeber perceptively points out that many jobs have huge amounts of busywork because some jobs (like system administrators) require people to be on-call for a certain number of hours, but may frequently have no urgent work to do. Management hates to pay people to do nothing of substance, so they use the artifice of the office as a social control mechanism to feel they are getting their money’s worth and justify their existence.

It is clear that many jobs have bullshit-ish aspects to them. Some aspects, like interminable face-to-face meetings that could be sorted out in a ten-minute Slack chat, still persist. The “essential”, who are generally treated like dirt when there isn’t a crisis, show how little match-up there is between pay and social usefulness. A grocery store truck driver has orders of magnitude more importance than his superiors, and they could collectively management the supply chain with their co-workers, having so many years of combined experience on how food goes from farms to shelves. Countries like Denmark are paying a majority of laid-off workers’ salaries, though it should be re-evaluated what these workers should be paid given the social value of their work. 75% of salary seems okay (not ideal, but better than the nothing coming from America), but 75% of what, exactly? Marx’s labor theory of value has come into acute relevance in the past month, as it becomes clear who actually creates value (workers), and who is expendable (administrators, corporate executives, and industries like cruises and shale oil that have no future in a decarbonized economy).

What does the future hold? The idea that the economy can be “restarted” while every hospital is flooded with sick and dying people, and people on the frontlines in healthcare and essential goods production get sick, is insane. There will be a recession, as long as the current range of workable proposals in Congress are where the imagination stops. The stock indexes, which were swollen from deregulation that made once-illegal stock buybacks driving share prices far beyond what assets and earnings a company actually has in meatspace. Bailout money without regulation will go to buybacks, which is just another version of bonuses given out by AIG and Goldman Sachs after the 2008 bailouts. But real-world growth, unemployment, etc. will spiral upwards. A contraction of over 20% of GDP is now being predicted this coming quarter, with Great Depression-levels of unemployment.

A select few elites will benefit, although largely being old men, they will be vulnerable to COVID-19 just like everyone else. A New England Journal of Medicine article on the inevitability of rationing PPE and medical care notes that wealth should not be a factor in testing and treatment, though it inevitably will be to some point. But nothing prevents the wealthy from having severe cases and dying, even if medical care was available. This is not Ebola, it is not confined to the developing (or “developing” but really gutted) countries. And the frontline employees who prepare your food and serve you don’t have paid sick leave and will transmit COVID-19 to others no matter what your bank account balance is.

COVID-19 and the “Lib Ownership Economy”

Since the 2016 presidential primary campaign, Chapo Trap House has been one of the most influential podcasts in a growing network of often humorous, but strongly leftist media. Matt Christman, one of the five co-hosts and the host with the most interest in political history, posited in early 2019 that “owning the libs” had become an influential component of consumption patterns and the United States economy in general.

Though this obviously connects to the rise of Donald Trump and “Make American Great Again” from 2015 to the present, the origins of decisions made primarily to outrage political opponents goes back at least a couple of decades. The modification of diesel trucks to produce plumes of dark smoke, called “rolling coal”, is often done at least in part to anger environmentalists. With the rise of right-wing talk radio after media deregulation during the Reagan administration, a confrontational political culture emerged that not only blamed “liberals” for the failings of the American political and economic system, but sought actively to antagonize them. What also emerges from this is the polarization of everyday consumption and decisions on political lines- the anti-LGBTQ activity of the leaders of Chick-fil-A spawned both protests and support-by-consumption by conservatives. The strongly reactionary nature of Barack Obama-era right-wing politics, embodied by the Tea Party, was rooted in opposition to everything that “liberals” (often centrist neoliberals like Obama and Hillary Clinton, in reality) wanted, and that liberal support of an issue was reason in itself to rally resources and people against it.

Triggered — **A book that only would exist in a lib ownership economy.**

Now, in 2020, a pandemic with all the deadly potential of climate change with a much more compressed timeline has arisen. The Trump administration has been marked by a permanent mobilization of the electorate and an end to off-peak electioneering. The President’s decision to file for re-election on the day of his inauguration, and holding mass rallies years before the 2020 election, fits with this new reality. Much like with climate change, there is a desperate attempt for the scientific establishment to get the whole of the population to heed its warnings. But defiance of social distancing and flattening the curve has emerged as about spurning liberal politicians (or public health officials who are seen as being such) than anything else.

A Tampa megachurch continued to hold mass services, even as social distancing was becoming a universal recommendation (or order). The pastor was subsequently arrested and charged with unlawful assembly and violating a public health order. It’s easy to see this person becoming a martyr in the way Kim Davis was for refusing to issue same-sex marriage licenses. A California megachurch gathering is now associated with at least 70 COVID-19 cases. Tate Reeves, Republican governor of Mississippi, rejected a shelter-in-place order well after many other states had implemented them. Quoting from the linked piece in the Jackson Free Press, emphasis added:

One Mississippian asked the governor why the state was not emulating China, the first country to detect COVID-19 and the first to control the spread of the virus. “Mississippi’s never going to be China. Mississippi’s never going to be North Korea,” Reeves responded. He added that “when looking at the numbers China’s putting out, claiming that they have no new cases over a period of time—I’m not entirely sure we can trust that data.”
Reeves’ skepticism of China’s control of the COVID-19 pandemic is incorrect, however. In areas across China most heavily affected by the novel coronavirus, the extensive lockdown, testing and case isolation protocols have eliminated the spread of the virus to the degree that the imminent danger for these areas is not community spread, but reinfection from travelers returning from abroad. Dr. Bruce Aylward, World Health Organization senior advisor, explains the dedication of the Chinese model. “They’re mobilized, like in a war, and it’s fear of the virus that was driving them. They really saw themselves as on the front lines of protecting the rest of China. And the world,” he said.

Reeves ultimately did issue a shelter-in-place order over a week later, but ultimately wasted valuable time at a political level (and not admonishing individuals for risky behavior).

At least in some places (including Fox News) have been ratcheting down the refrain that the United States needs to “restart the economy” and lift public health restrictions. However, even as more recommendations come in, the President gives them a political dimension. Upon announcing today that everyone should wear a face covering in public, he immediately pointed out that he himself would not be doing it. For the 40% of the country in lockstep with the President, such public statements dramatically undermine the efficacy of public health measures that require near-universal adherence to work within the confines and limits of the health system.

We are less than a month into any kind of response to the coronavirus and COVID-19. Pre-print academic research on the UK indicates a need for periodic lockdowns (far stricter than shelter-in-place, which is a broad term that may or may not be sufficient) well into 2021. Lockdowns are the only measure that has a chance of reducing R0 (the rate of infection) below 1, which was critical in keeping the Wuhan crisis from continuing to spiral further out of control.

fig-lockdown — **In-progress research by Davies, Kucharski, Eggo, CMMID nCov working group & Edmunds (2020).**

Both right-wing elites and their base will become increasingly restive the longer this goes on, especially as the recession and unemployment deepens, and the calls for increased social spending increase. Asymptomatic or mildly symptomatic people continuing to move in public and not taking sanitary precautions due to the discourse of conservative media figures and politicians is a real concern. Also, the need for shelter-in-place or lockdown measures will straddle a presidential election. Joe Biden has been reluctant to criticize Trump’s coronavirus response (to me, this underlines what a political relic he is, basing his instincts on a pre-1994 vision of what Congress was like), but coronavirus is clearly going to be a major election issue. Debates about policy, like economic stimulus and bailouts, may merge into debates about public health practices, with political divisions emerging as some governors and mayors move unilaterally relative to the federal policy, for or against. While “owning the libs” acts with regard to climate change, like not recycling or “rolling coal” only have long-term, aggregate impact, even a small sliver of people who want to enrage whatever they think liberals look like could mean thousands more dead.

The bullshit economy II: Bullshit-ish jobs and the coronavirus recession

Years ago, I wrote a post entitled “The bullshit economy“, reflecting on David Graeber’s superb essay “On the Phenomenon of Bullshit Jobs” that ended up being a runaway success. By the time his full-length book Bullshit Jobs (2018) came out, a poll had already been conducted that a substantial portion of people in developed countries believed their work had no societal value at all. And though bullshit jobs have in media discourse focused on the bureaucracy and public sector, many people from the private sector reported useless levels of middle management, creation of reports nobody actually reads, and people who exist to duct-tape together something that doesn’t work but could probably be fixed if that was the actual goal, rather than maintaining the status quo.

Landlords? Pure parasites, who get others to pay their mortgages and expansion, avoiding providing services as much as possible, which could be done collectively by tenants anyways.

We, They, and Us: UU Tactics and Strategy for 2020

We stand today a month removed from the 2019 UUA General Assembly, under the theme “The Power of We.” The tagline, and the Assembly content itself, has helped promote a discussion on what “we” within Unitarian Universalism means. From that, the logical next step is to discuss the not-we, the “they”. And in a dialectical fashion, with “we” the thesis and “they” the antithesis, “us” is the inevitable synthesis.

Or is it?

I attended a summer gathering in New England last Sunday, in which the topic was on the we-they-us trifecta. From the description, I wasn’t exactly sure what direction the sermon was going to take. Additionally, because the summer gatherings often had discussion segments, I didn’t know how the random mix of people who showed up that Sunday would interpret the title and topic.

i voted sticker lot — Photo by Element5 Digital on Pexels.com

Ultimately I was disheartened by what I heard from the individual leading the service. While in a recent post I dismissed the “generation gap” hypothesis explaining the tension within the current UU church, the content of the sermon clashed strongly with my political socialization, and the realities of America as it exists in 2019.

The address focused in part of the term “political tribalism.” This is an old concept, but it was revived by author Amy Chua in a new book Political Tribes: Group Instinct and the Fate of Nations. Chua has a fairly lengthy, fairly controversial history- she authored Battle Hymn of the Tiger Mother, which ignited a national debate on high-expectation parenting and whether that had a negative effect on child development. More recently she was a leading voice arguing Brett Kavanaugh was a great leader of young women and carried water for him during the rape allegations that threatened his nomination to the US Supreme Court (her daughter was later rewarded with a Kavanaugh clerkship in a blatant and cynical quid pro quo). She authored a giant Atlantic feature to uncritically lay out her entire thesis of political partisanship tearing apart the constitutional system of American government.

I’m not going to devote this entire post to Chua, who I think is decent at historical analysis but pretty consistently wrong in her contemporary social commentary (for the record, I read her comparative historical book Day of Empire when I was a teenager and thought it was pretty good). The idea of “political tribalism” in the sermon was, from my perspective, a fundamentally misleading concept for a number of reasons. It’s also been taken pretty much at face value in the media. Let’s list three big problems:

The term has an imperialist mindset. “Tribalism” is used as a way to say our politics are more primitive, brutish, and violent than they were previously. Whether that is true or not isn’t the point in this case. Many communities exist as tribes today, they are not a historical stage of development. To suggest that tribes and “tribalism” (whatever that means) are primitive and inferior is both cultural erasure and pretty racist.
It’s a false equivalence. Dividing America into “left” and “right” tribes, or “red” and “blue”, or saying tribes fall under racial, ethnic, national, and gender lines is painting with a broad brush and saying all these “tribes” are short-sighted and destructive. Conflating the alt-right, who have murdered people in cold blood in places like Charlottesville and Christchurch, with the left, who in this period haven’t killed anyone, is misleading and indicates a politically useless centrism. It also treats ideological difference as little more than bickering, rather than a life-and-death struggle for universal health care, an end to the climate collapse, and justice for communities of color targeted by police violence.
Its logic is entirely backwards. The idea is that political partisanship is undermining the Constitution and the government that stems from it. This is both really obvious, but also misidentifies the problem. Partisanship is not what’s hurting society. It’s the Constitution. As I wrote in 2016, in “The pre-democratic American Constitution“, the Founder were fundamentally opposed to democracy and willfully ignorant that partisanship and political parties would arise around issues such as taxation, the extent of federal power, and most importantly, slavery. The Constitution has never been rewritten to establish America as a contemporary democracy, unlike every other modern country, developed or developing. Reducing partisanship is not only not going to happen, it’s not even going to solve the core problem.

The sermon then transitioned from political tribalism to reaching out to the “they”, creating dialogue with the other side. This means talking with “reasonable” Trump supporters, finding common ground, and using moral suasion to stop the racist Trump regime. The individual giving the sermon talked about regular discussions with a Trump-voting gym acquaintance, and how productive all their discussions have been.

Here’s a reality check: of all the potential options for 2020, this person is most likely voting for Trump again. 2020 will be a very high-mobilization election, this is very clear. Basically everyone who voted in 2016 is going to vote in 2020 as well- with the exception of those being disenfranchised by Republican state governments, the Trump-packed court system, and the Department of Justice. So, it’s not likely that this person abstains from voting for president. There’s a slight chance they vote third party instead of voting for Trump, but people who say they’re going to vote third party often end up voting for a major party candidate. So is this proud Trump voter really going to vote for a Democrat, even a centrist like Joe Biden? Let alone a progressive like Warren, or Sanders? To do that, they would have to like the Democrat more than they like Trump, and Trump has 90% approval among Republicans, which is as high if not higher than approval ratings by Republicans for previous GOP presidents.

Is it worth the time and effort to try to persuade one Trump voter to vote for the Democrat? Probably not.

Gene Sharp, in his influential pamphlet From Dictatorship to Democracy, talks about four ways for a nonviolent resistance campaign to win- conversion, accommodation, nonviolent coercion, and disintegration. Here is the section where he discusses the probability that opposing forces will convert to the resistance’s side:

Screen Shot 2019-07-22 at 10.31.46 PM — (Sharp, *From Dictatorship to Democracy*, p. 35) (full text)

Now this applies more to mass action at a very large scale, like what is currently happening in Puerto Rico. The mainland has not had mass action of this scale for any sustained period- not during the Women’s March(es) or the airport protests, or the recent Lights for Liberty vigils.

But it can be fairly applied to the one-on-one conversations we have with political opponents. Can Trump voters be converted? Maybe, a few? I was politically socialized starting around the beginning of the Iraq War, with the first phase ending with the election of Obama. The “bipartisan” period in American politics is dead, and has been for a long time. The parties are now, for the first time in a long while, if ever, ideologically coherent. There are no longer sectional differences, meaning liberal Northern Republicans and reactionary Southern Democrats. Trump has control of the Republican Party, and its voting base agrees with what he’s doing. They don’t want someone “moderate.” The party will not be taken back by Trump opponents, who are a tiny fraction of the party and politically irrelevant. People who think individual moral suasion is a viable political tactic want to go to a mythical past that, if it ever existed, hasn’t in my 29 years on this planet. The desperate need for “normalcy” is wanted, but there never was normalcy. Unless you were an upper-middle class professional white person, for whom the profound injustice and violence of the US political and legal systems do not reach you, except in documentaries and charity outreach.

Alternatives to Converting “Moderate” Trump Voters

Register a street to vote. Or a neighborhood. You have a lot of time to do it. Every hour you argue with an uncle or a tennis friend or whomever in your social lives voted for Trump, you could do something that a) affects more than one person, and b) uses energy to uplift marginalized communities
Fundraise and organize rides to the polls.
Phonebank for candidates and ballot issues.
Collect signature for popular ballot issues (like the minimum wage or legalized cannabis) which boost turnout.

All of these things are better uses of your time. It is not about reaching across and compromising with “they” to create “us.” Not everyone should be compromised with. The leader of the service suggested “not leading” with UU values like trans inclusion and marriage equality. To hide these issues in discussions is to treat them as, ultimately, political expendable. This election is about mobilizing and empowering the “we”, more than reconciling with “they.”

“They” need to be defeated politically. Their policies need to be repealed. The courts they packed need to be countered. The concentration camps need to be destroyed and their inhabitants freed. I don’t really care whether my uncle votes for Trump in 2020. Because I’m going to find people to cancel his vote out and then some. That’s the way forward.

The Democratic Party: No litmus test, no foundation, no point

House Minority Leader Nancy Pelosi’s rejection of single-payer as a litmus test for Democrats, which follows from a similar statement with similar language about abortion rights indicates what many of us have known for years- the Democratic Party has no ideological foundation, thus no political base, thus no hope of enacting meaningful change. How the leadership expects this to increase turnout and win political power remains a deep and profound mystery.

It should be obvious that the Democratic Party is not the party of working people. It is barely a party at all. In the absence of a clear purpose it simply reflects and enforces the status quo: neoliberalism, austerity, and whatever the rich people that fund the party want at any given time.

The Democrats and the death of SB 562

Over here in California, a considerable wave of excitement was building around SB 562, a bill that would can the current healthcare system in the state and replace it with a single-payer structure. For supporters, there was budding optimism. The current national framework created by the Affordable Care Act seems doomed, either through legislation or executive neglect. Polls indicated strong support, and though support dropped when the prospect of new taxes was raised, studies showed that implementation was probably not nearly as expensive as projected. The Democratic Party holds the governor’s office and has big majorities in both houses of the legislature. And single-payer had been passed twice during the Arnold Schwarzenegger administration.

But it died this week when Assembly Speaker Anthony Rendon shelved the bill. Activists I know are, as expected, absolutely livid. Part of the anger comes from how illogical SB 562’s death was. There was the means, motive, and opportunity to change things, but that didn’t happen. Political paralysis in a one-party state.

There are two ways to look at this. The first, pretty common among lifer Democrats, is that this was a bug in the system- SB 562 should have eventually become law, and there needs to be a couple small changes to make sure the next time (whenever that is) it succeeds.

The second is that this failure is a feature of the political system. A key piece of evidence is that single-payer has gotten through the obstacles that doomed it this time around, but in a different context:

Similar bills passed the legislature fairly easily in 2006 and 2008, only to be vetoed by then-Governor Arnold Schwarzenegger. At a time when premiums were rising and there were few other proposals out there, it was an easy vote for Democrats certain of the governor’s veto.

When legislators craft bills that are guaranteed to receive a veto, what they produce is more marketing than ideology. Republicans and their endless ACA repeals passed between 2010 and the end of the Obama administration were this- political theater. In the theater, the chains of pharmaceutical and insurance influence are invisible. It tells activists that the Democratic Party can be the vehicle of progressive action, even if that never happens when cards are on the table. The California Democrats haven’t lifted a finger on higher education affordability, the housing shortage, and healthcare. The main shift since Brown took office is from purely symbolic action to milquetoast half-measures, which are passed but don’t change the trajectory of any social problems.

The failure of SB 562 will make Rendon a convenient boogeyman. There will undoubtedly be a campaign to remove him from office, or his position of power in the Assembly. It will disguise the truth: that both major parties take cash from the only groups that lose out in single-payer.

The Democratic Party feeds on the dreams of its most active members- it is the fuel that makes everything else happen. SB 562 didn’t die immediately, preserving the idea that the future is within the Party, and that the important thing is the next election. More time, more money, and what was promised will be fulfilled.

The death of Alfred Olango, disability, and “failure to comply”

A black man, Alfred Olango, was killed by a police officer on Tuesday in El Cajon, CA. It’s the first major city to the east of San Diego, about 20-25 minutes by car from where I live.

screen-shot-2016-09-28-at-3-23-02-am — Site of shooting in downtown El Cajon, Sept 27 2016

Not much is known for sure, other than that the dead man was “acting erratic.” A woman identified as his sister said he had mental health issues. According to the NBC report, the police “did not release details on the specific threat he presented to officers.” There is also contention about whether the police confiscated cell phones of bystanders who may have had video of the incident. They likely did, given how often the police aim to suppress video that may run counter to police testimony. There’s also little reason to give police the benefit of the doubt. Look no further than the recent allegations of gun planting in Charlotte and a much clearer case of planting in 2011 in St. Louis.

The killing of a mentally ill man echoes last year’s killing of Fridoon Nehad, which involved a long fight to release surveillance footage of the incident. The details I covered in December 2015 here. A big similarity in these cases is the difference between being erratic and being dangerous. Erratic behavior has many sources- in Olango’s case it looks like a seizure is the reason. A variety of disorders like bipolar disorder, schizoaffective disorder, schizophrenia, and some types of depression can also make individuals confused and incapable of responding to police demands- which are often given loudly, on top of one another, and with a very small time window for compliance. At my low point in 2012 when my mental health was worst, I could have easily been described as erratic. And I now realize that can put my life at risk, in a way never before considered.

Police protocol in these cases is infested with ableism. It assumes a perfectly compliant, quick, enthusiastic response to police orders. If someone fails on any of these counts, their life can be in danger. Sometimes the cops will just open fire before any real attempt at less-lethal options- Fridoon Nehad was shot by an officer who spent about 25 seconds from parking his car to killing him. But consider the case of Charles Kinsey, a black man shot for trying to help a young autistic man in his care, Arnaldo Rios. Kinsey served a perfectly compliant surrogate for someone who was unable to do so, and yet police did open fire on Rios, missing and hitting Kinsey instead. The resulting trauma for Rios has been awful, with him not getting proper therapy. But many people with mental or development disorders don’t survive their encounters with police. Robert Ethan Saylor, who had Down’s Syndrome, was tackled and asphyxiated over a dispute about a movie ticket. Again, defensive behavior or tics was interpreted as a threat. People who are deaf or hard of hearing routinely suffer from violence, since a basic assumption is that all people can hear instructions. And of course, many people don’t speak English, so being yelled at in the foreign language is just confusing and may lead to so-called ‘erratic’ actions. Police always filter civilian behavior through a lens of perfect ability. That is, those who are not fully able and somehow lesser and more likely to be targets of violence. The most vulnerable sections of the population are threatened by the institutions that in theory should protect and serve them.

These issues would be much less prevalent if American police really committed to deescalation, and had proper understanding of the symptoms and nature of mental illness. I was even part of a county program in 2014 that helped explain mental illness and stigma to schools, crisis lines, and yes, police departments. But it’s not working- street-level cops still can’t process disability at any level. The existence of the ADA, and the sense that people with mental and physical disabilities have rights has no place among the police.

Screencap of ABC 10 report: https://www.youtube.com/watch?v=zi5Xa_ja_7I

The true answer, to help make sure there is never another Alfred Olango, is community policing. Community members and organizations band together to help keep things safe, using their pre-existing trust to make bonds that the police will never be able to. And a community effort means more local knowledge, including those who live with mental or developmental disabilities. Communities also don’t want gun homicides and violence- they have the most vested interest in deescalation. Restorative justice can change mindsets in a way mass incarceration and the school-to-prison pipeline cannot.

Alfred Olango is not the first, not in this country or this county. But he is a reminder that police departments have the most sinister and deadly ableism one can imagine.

San Diego will participate in 022, the October 22nd National Day of Protest to Stop Police Brutality, Repression and the Criminalization of a Generation. Event details are on Facebook here. The national event website is here.

Stein, vaccines, and the new, better Green Party

Jill Stein has gotten some negative media attention due to an answer in a Reddit AMA regarding vaccines.

Part of her statement:

“I think there’s no question that vaccines have been absolutely critical in ridding us of the scourge of many diseases — smallpox, polio, etc. So vaccines are an invaluable medication,” Stein said. “Like any medication, they also should be — what shall we say? — approved by a regulatory board that people can trust. And I think right now, that is the problem. That people do not trust a Food and Drug Administration, or even the CDC for that matter, where corporate influence and the pharmaceutical industry has a lot of influence.”

followed up later with this, mentioning controversies with the use of hormone replacement for menopause, and treatments for Alzheimer’s that backfired:

it’s really important that the American public have confidence in our regulatory boards so that all of our medical treatments and medications actually are approved by people who do not have a vested interest in their promotion.

and clarification on Twitter:

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Snopes also lists the claim that Stein is anti-vaccination as unproven.

My mother, a psychiatrist, was concerned about Stein’s take on vaccines, so I did some research to make sure I had all the needed context.

The Washington Post story, which is the norm among large, nonpartisan media outlets, takes a skeptical look at Stein’s claims, assuming that the formal independence of the FDA more or less as true.

The closest Stein gets to anti-vaxx arguments is here:

“There were concerns among physicians about what the vaccination schedule meant, the toxic substances like mercury which used to be rampant in vaccines. There were real questions that needed to be addressed. I think some of them at least have been addressed. I don’t know if all of them have been addressed.”

Pretty different from what her remarks were being portrayed as. At its core, Stein doesn’t believe that vaccines have any of the purported negative effects that are common currency among anti-vaxxers. Nor does she see any existing issues as overriding the massive public health necessity of vaccination. In fact, she specifically says vaccination rates need to go up in light of Jenny McCarthy and others. As she said on Twitter, the issue is that government agencies have a credibility problem. Even if their statements are 100% true, the intensive lobbying by pharmaceutical companies, and a revolving door between the FDA and private industry, invites skepticism. And indeed that is part of why parents may choose to ignore warnings about things like vaccinations. Even if “the FDA is a tool of Big Pharma” is unrelated to “vaccines are essential for public health,” it can muddy the waters.

The pharmaceutical lobby is incredibly powerful. A 2005 piece by the Center for Public Integrity pointed out over $100 million annually in lobbying. To quote, emphasis mine:

The industry’s multi-faceted influence campaign has also led to a more industry-friendly regulatory policy at the Food and Drug Administration, the agency that approves its products for sale and most directly oversees drug makers.

Most of the industry’s political spending paid for federal lobbying. Medicine makers hired about 3,000 lobbyists, more than a third of them former federal officials, to advance their interests before the House, the Senate, the FDA, the Department of Health and Human Services, and other executive branch offices.

A 2015 story in TIME about the now-current head of the FDA, Robert Califf M.D pointed out that he was making six figures in consulting fees annually from pharmaceutical companies. Pharmaceutical companies were instrumental in the passage of Medicare Part D, which is a cash cow because it has no price controls unlike most government health programs. Pharma is also the only part of the health system that was not impacted by the Affordable Care Act, trading perks in exchange for not blocking the bill.

I’ve been a registered Green from mid-2009 until today, minus the time myself and many others registered independent to vote in the Democratic primary this year. In years past, Green ideology was a complete mess. It was sort of socialist, sort of capitalist, and alternatively enthusiastic about and skeptical of science. Going to a party conference, I was frustrated by the lack of coherence and a tendency towards conspiracy theories and quack medicine.

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This election cycle is different, because the primaries have manufactured a large disenchanted bloc of voters who see Stein as an answer. This has had the effect of making Green ideology more consistent, and pushing out its more kooky aspects. An amendment to the 2016 platform was passed by the National Committee to make the Green Party explicitly anti-capitalist and move towards eco-socialism. This would resolve the ambiguous take on economics in Green politics and give the party something to stand on. The party this year also voted to remove support for practices like homeopathy. I do believe that Jill Stein has been part of the solution rather than the problem- her status as a doctor makes outsiders more likely to listen, and since her run in 2012 there has been pressure to move beyond a niche party.

Your vote in November is yours alone. Don’t let people bully you into a decision. If you are in a swing state, it’s a tough decision and in some sense I’m glad I don’t have to make it. If you live in a safe state, a vote for the Greens would be huge. A large result would secure millions in public funding, improve ballot access. Minor parties spend more money on litigation to get on the ballot than anything else. And even if Clinton wins, a 5%+ for Stein shows that the Sanders movement against politics as usual has survived.

Enough is enough. Vote Stein.

Mental illness as disability in college

So I was reading a 2012 report by the National Alliance on Mental Illness (NAMI) recently. Over 750 college students were surveyed, with NAMI attempting to determine views of mental illness among young adults, and the quality of campus services. The report is located here (PDF).

Most interesting to me is the data on disability accommodations (pages 12-13). While there is a lot of current data on students and mental health, they usually focus on counseling services. In that area, the rate of students getting help has sharply increased, though college-age adults remain the group least likely to seek help. This isn’t a terribly good survey in terms of research design, but any information is good.

A couple key insights emerge, which I’m fairly confident would hold in a more rigorous study.

There is a substantial difference between how many people with mental health conditions who know about accommodations, and those that actually use them. About 20 points separate the two.
Disability resource centers are orientated to physical disabilities, and aren’t designed with psychological conditions in mind.
Among those that dropped out of college due to mental health issues, getting accomodations may have kept them in school.

The conceptualization of disability in the United States has created these conditions. This gap between physical and mental doesn’t emerge from modern disability law necessarily, where the definitions are broad and inclusive. Rather, society has yet to shift its perspective on mental illness. Some tendencies:

People discount any claimed disability that is not clearly visible to outsiders. When I served on a county disability commission a couple years ago, a long impromptu discussion broke out during a meeting about people being harassed for parking in the special spaces because they didn’t “look like they needed it.”
The stigma against mental illness and disability are different, and a sizable group of people accept their belonging in the former group but not the latter.
The type of assistance given to people with psychological conditions, including more time on exams, exams in a quiet room, and longer deadlines, may seem unearned by those who qualify. Accomodations otherize. If you take your exams in a different room, or have different deadlines than your classmates, there may be resentment.
Faculty treat psychological accomodations as less important than physical accomodations.

The disability office as an institution is caught in the crossfire. It can be a key part of students succeeding in college, but many people have no concept of mental illness as being connected.