6 October 2017

Dear Interested Readers,

What’s Inside: The Aftermath of Graham-Cassidy Plus Two Chronic “Distractions”

It is a measure of our current state of continuous confusion that it seems like a much longer time than 11 days ago that we heard that the Graham-Cassidy bill was dead. That onerous bill died because of the strange convergence of 48 Democratic senators that found the entire bill to be an anathema, plus Rand Paul who thought that it did not go far enough, John McCain who thought that the process that created it was at variance with the methods and traditions of the Senate, and Susan Collins who recognized it for what it was, an awful piece of legislation.

Perhaps the reason that the death of Graham-Cassidy feels as if it is quickly becoming ancient history is the distractions generated by the apparent schism between the president and the secretary of state over how to manage concerns about North Korea. Maybe it’s the uncertainty and drama of the plight of Puerto Rico, the bizarre startling horror of the Las Vegas shootings and the mysteries that surround its perpetrator. Maybe the ignominious departure of Tom Price from his position as the Secretary of Harassing Beneficiaries of the ACA pushes the defeat of Graham-Cassidy into the shadows of our recent memory. All of these events and issues are intertwined in ways that are further complicated by the next item on the legislative checklist of the Republican majority, tax reform.

Dr. Michael Wolchonok, a faithful interested reader, friend and worthy opponent in “Words With Friends” sent me two excellent articles written by another friend of his that advise us how to understand and contend with the confusion that occurs during any typical week off the Trump Presidency. The author, Abby Hafer, is a professor at Curry College and the essays are published in the American Rationalist. The first essay entitled “Trump and the Gish Gallop” points out that the president is a master of using a strategy for debate that was pioneered by Duane Gish, a defender of “creationism.” Gish would win the day with audiences and defeat his fact oriented opponents by talking non stop with run on sentences that contained so many misrepresentations, false claims and absurdities that his opponents didn’t know where to begin in their efforts to refute his numerous lies. He won the audience with his style, tenacity and showmanship. Thinking back to any of the presidential debates or any of the amazing pronouncements of the president in person or on Twitter, does this sound familiar? Hafer contends that Trump is better at the “Gish Gallop” than Gish because his sentences do not follow rules of syntax and are filled with innuendo making them even harder to refute. Refuting him becomes for the listener a “boring and thankless task.” Professor Hafer suggests that this tactic is best defeated by restraint. Rather than debating every falsehood, select just a few and address them with humor, pointing out how ridiculous they are.

Hafer’s second essay is from the July/August 2017 edition of the The American Rationalist. It’s title “This Is Your Brain on Trump” reminds us of the ad campaign that featured eggs in a frying pan with the notation that “this is your brain on drugs.” The similarities flow easily from that observation. Much of what Trump has said during the campaign and since to his base, as well as to those inclined to listen, is “addictive.” It is hard to look away. She contends that overstimulation diminishes attention. Trump has deftly used this tactic to undermine the discussion of complex issues. Fatigued and confused listeners are “over stimulated” and attracted to simplistic explanations and solutions that align with their emotional preferences. To quote Hafer:

Here’s why I’m bringing this up now. The frenetic pace of the events that have taken place since Trump took office has already begun to take its toll. In the coming months and years, the Trump administration is going to throw so much dangerous nonsense, propaganda, false accusations, invented stories, and dangerous actions at us that we may find ourselves overstimulated and, therefore, overwhelmed and unable to respond.

This is what they’re aiming for. This is how Trump the candidate bamboozled voters and his opponents. Most people were overstimulated by Trump. He could say more stupid and outrageous things in one day than the writers of Dumb and Dumber could come up with in a lifetime. He said things that would have killed any other political campaign and indeed any other politician’s entire career. He did this on a routine basis. We heard them on the radio, heard them on TV, read them in the newspapers, and saw them on social media. People commented on how all this weird stuff shut out substantive debate on most issues, but perhaps even more importantly, it also blitzed our ability to respond in an effective way.

Further along she offers more analysis and advice that makes more sense with each passing day and its associated tweets and tantrums:

Thinking about public policy is complex. Likewise, thinking about political strategy is complex. By constantly bombarding us with outrageous nonsense, Donald Trump managed to subvert the campaigns of others and, more importantly, managed to subvert our ability to respond to him. Even as we knew that we had to respond in ways that were intelligent, strategic, and timely, we found ourselves unable to do so. The bottom line is that this is how Trump succeeded. He threw so much overstimulation at people that they didn’t know how to respond...

Staring at the ugly mayhem of this administration will create additional dangers for ourselves and others, just as staring at the ugly mayhem of a highway accident does. You must save your brain’s ability to respond by looking away and noticing other things. By saving your brain, you can save the nation, too.

Putting the advice of the two articles together is probably a strategy that can be coupled with advice from David Brooks who calls for a return to foundational principles by upgrading and making contemporary a compelling alternative view to “Trumpism.” The bulk of his column entitled “The Philosophical Assault on Trumpism” in Wednesday’s New York Times is a review of Republican efforts to manage Trump.

Establishment Republicans have tried five ways to defeat or control Donald Trump, and they have all failed. Jeb Bush tried to outlast Trump, and let him destroy himself. That failed. Marco Rubio and others tried to denounce Trump by attacking his character. That failed. Reince Priebus tried to co-opt Trump to make him a more normal Republican. That failed.

This failure has consequences of which a failing healthcare policy is only one dimension. The observations that Brooks registers are not dissimilar to the previous points made by Professor Amy Hafer:

Trumpist populist nationalism is still a rising force within the G.O.P., not a falling one. The Bob Corkers of the party are leaving while the Roy Moores are ascending. Trump himself is unhindered while everyone else is frozen and scared.

As a result, the Republican Party is becoming a party permanently associated with bigotry. It is becoming the party that can’t govern.

Brooks offers us the strategy of creating an alternative narrative by resuscitating the positive, inclusive aspects of the “American Dream” to right the ship of state and get it back on its course toward being an asset to its citizens and to the world that fits nicely with the survival tactics that Professor Hafer advises.

It may be dormant, but this striving American dream is still lurking in every heart. It’s waiting for somebody who has the guts to say no to tribe, yes to universal nation, no to fences, yes to the frontier, no to closed, and yes to the open future, no to the fear-driven homogeneity of the old continent and yes to the diverse hopefulness of the new one.

Brooks is a conservative Republican of a type that is endangered. His books and columns always support our traditional values of self reliance coupled with empathy for the less fortunate. He does believe in the benefit of bipartisan debate and has soundly denounced the sham bills that have been offered by the Republican leadership to repeal and replace the ACA. As I scan back over Brooks’ recent complaints about the way in which congressional Republicans have failed to serve the nation and the Republican inability to pass a bill, it occurs to me that we have a government that is suffering from a unique form of Republican ADHD.

There is a self administered test for those who are concerned that they might have adult attention deficit disorder. As I read the list of questions from the perspective of the Republican leadership in Congress, the idea of a collective disorder seems like a plausible explanation for the confusion and lack of results that we have witnessed over the last ten months. That opinion seems more charitable than the explanation of New York Times columnist and Nobel Prize winning economist Paul Krugman who prefers to think, as he wrote this week, that the Republican leadership is trapped by their own “flimflam,” or as he said in the column published the day before the end of Graham-Cassidy, trapped by their own lies.

One need not pause and think for long to realize that the first step toward something better after we are able to turn our eyes and attention away from Donald Trump is for all of us to demand a genuine attempt at bipartisanship. If there is any lesson that we should extract from the saga of the ACA it is that social policy that emanates from a single party springs from a rocky and arid soil and is destined to wither as soon as the other party regains power, or it can become the reason that the out party regains power. For a while we had some hope for a bipartisan process after the defeat of the “skinny repeal” even though the “smart money” was suggesting that the outcome would be a continued administrative attack on the ACA by the Trump administration.

The major section of this letter is an opinion piece from me that begins with the Second Amendment and feelings that I must express after the shootings in Las Vegas last Sunday night. What would have stood alone as the main piece of this week’s letter is a deeper dive into bipartisanship. We need bipartisanship on every controversial issues that faces us from the right to bear arms to how we will protect the health of every individual. When hundreds of people are sent and the hospital and fifty nine die in one preventable event we have a major health problem. We need to have a new conversation about how to make progress on the chronic problems that divide us. In the discussion I draw on insights gained from the recent reading of a book that you may have read a few years ago when it first came out in early 2015, Sapiens: A Brief History of Humankind by Yuval Noah Harari. The book created some controversy, as has his most recent book, Homo Deus: A Brief History of Tomorrow. A central theme of Harari is to emphasize just how we have made social progress at light speed compared with the slow process of biological evolution. I believe that progress toward bipartisan solutions to our complex problems is possible. Despite our sense of immediate vulnerability to the loss of the recently gained access to healthcare that millions have gained through the ACA, we will eventually have universal access. I believe we will even eventually reduce our vulnerability to mass shootings through bipartisan work by reasonable people who are willing to renegotiate the antiquities of the Second Amendment. It might be fun to speculate about how it will occur.


Where Do We Go From Here?: Facts and Fiction

“Keep Your Eyes on the Prize” evolved from a Southern gospel song to become an anthem of the Civil Rights movement of the fifties and sixties. It’s a phrase that frequently pops into my head when I am frustrated with my progress against a goal. It comes to mind now with the frustrations associated with both the slow progress of healthcare reform and the sickening realization that as a society we are unable to come to consensus around any strategy that offers us collective protection against a madman with a gun. Last week I referenced Atul Gawande’s article in The New Yorker about whether healthcare is a right. He was clear about the fact that at this moment it may be the opinion of a majority of Americans that it should be, but a law to make healthcare a right has never been passed. One reason is made manifest in a YouTube clip of Senator Ron Johnson from Wisconsin answering the question from a high school girl about whether healthcare is a right or a privilege. The link is from an article in the Daily Beast by Michael Tomasky contrasting GOP opinions about gun rights and healthcare. Click here for a serious discussion by fellow Americans that outline their logic behind the concept that healthcare is not a right although gun ownership is.

You probably know that when the founding fathers completed their imperfect (for example a black slave counted as 60% of a person for census purposes and only men could vote) negotiations on the issues and structure of our government covered in the Constitution, they suddenly realized that they had failed to make a list of “rights” for citizens. The correction of the oversight was produced as the first “Ten Amendments” to the Constitution which collectively are also known as the Bill of Rights. It is the rare election in recent times that has failed to touch on issues related to the Second Amendment. Just so you will have the whole list here it is. Click on any “right” to learn more.

Amendment 10 - Undelegated Powers Kept by the States and the People

Clicking on Amendment 2 we read:

A well-regulated militia being necessary to the security of a free state, the right of the people to keep and bear arms shall not be infringed.

That’s it. The second amendment does not even grant the privilege of recreational gun ownership. We are learning more than we would otherwise care to know about Stephen Paddock. So far nothing suggests that he purchased any of his dozens of guns in preparation to participation in the militia. Following a revolution by armed citizens against a foreign power it would make sense that people would be reluctant to give up their weapons, because the next government be equally oppressive. Gun ownership on the frontier was such a necessity it did not need to be listed as a rationale for the amendment. In late 1791 when the Bill of Rights was passed we did not have semiautomatic rifles that could be modified to function as an automatic weapon capable of firing hundreds of rounds a minute.

The National Firearms Act of 1934 actually outlawed “machine guns” and silencers following such horrific gangland activities as the St. Valentine’s Day Massacre and an attempt on the life of President Roosevelt. That act was gutted by the Supreme Court in 1968. Congress repaired some of those losses in subsequent statutes like the Omnibus Crime Control and Safe Streets Act of 1968. We had legislation that outlawed semiautomatic rifles until the law expired on September 13, 2004. The Federal Assault Weapons Ban was passed by a close vote, 52-48, in 1994 against great resistance and it is interesting to speculate whether or not the tragedies of October 1, 2017 could have occurred if the law had still been in place. This incomplete and brief history of gun control legislation is meant to provide perspective on the reality that we have been struggling with the issue of gun control for about as long as we have been struggling with the issue of whether or not healthcare is right or a privilege.

Early in his book Sapiens: A Brief History of Humankind Yuval Noah Harari divides human history into several sections. The interesting distinction that defined us as different from the other members of the genus Homo emerged between 70,000 and 30,000 years ago. He labels the development that occurred during that period as the “Cognitive Revolution.” For reasons that are unknown during that 40,000 year period we developed new ways of thinking and communicating that resulted, for better or for worse, in the elimination of all other members of the genus Homo and our ability to push almost any animal or plant, and perhaps our planet to extinction.

The shocker that Harari introduces is that the specific ability that enables our dominance is our ability to create and dispose of “fictions.” We can believe in ideas and concepts that are about things that really do not exist as hard realities in the real world. An example is money which enables trade. Another is a concept of laws or religious constructs that “order” our lives and allow us to function in groups of millions rather than in bands of dozens. One example of such a fiction that he uses is an old one that has long been discarded which is “the divine right of kings.” That fiction did not survive the guillotine of the French Revolution. It took a while but monarchies gave way to democracies much faster than the pace of biological evolution.

I would postulate that we are currently in the process of disposing of fictions from the nineteenth and twentieth centuries at an amazing pace although none of the transitions are yet complete or the resistance to the ultimate change completely quieted. In my lifetime we have made great progress in the transformation of our fictions about race, gender, marriage, family, our responsibilities to the environment, and even to the appropriate use of bathrooms. All of the issues remain active, but in every case the old “fictions” or mental configurations have given way to new ideas and ways of viewing the world that are less violent, more inclusive, and more empathetic than it was when it was totally controlled by the idea that is quickly becoming part of “the way it was.”

I believe that our government was constructed to preserve the rights of the minority and smooth the transitions that are inevitable. We have seen it with issues of gender. In the same week that we see a mass shooting we see an NFL star castigated and loose endorsements worth millions of dollars over a comment that relates to the previous fiction about the appropriate status of women. The pace of change can be faster than we sometimes realize. A day after Cam Newton’s verbal indiscretion, a powerful movie mogul is finally outed for decades of sexual harassment. We create new “fictions” or social agreements that enable progress and we eventually dispose of the ones that do not promote the greatest good of social change at a speed that seems like a rocket launch compared to the creep of biological evolution.

Bipartisan discussions are negotiations. They are an attempt at finding “non zero” solutions to complex social problems. Sometimes, as with the passage of the 1957 Civil Rights Act, it seems like very little was accomplished, but it is unlikely that the more transformative Civil Rights Act of 1964 could have passed without the lessons learned from the inferior act of 1957. The time between 1957 and 1964 probably seemed like an eternity for many, and we all know that the struggle has continued for more than 50 years as incremental change erodes centuries of oppression.

The Second Amendment is not a law of the natural universe. Other advanced societies do just fine without it and enjoy the recreational use of firearms without coexisting with hundreds of millions of privately owned assault rifles. We will get there. Likewise, every other advanced economy sees the health of its population as a critical issue to be protected as a competitive advantage, if not a moral obligation. We will get there. We just need to keep our eyes on the prize and stay active at the ballot box and in the venues of public discussion until our elected leaders get the message. I believe that bipartisanship needs the assistance of external pressure as a catalyst. The right to speak your mind is the first amendment. It may be a “fiction” also, but it is one that has not yet lost its punch. We can use our voices to demote gun ownership from a right to a privilege and elevate healthcare from a privilege to a right.


We All Have Good Reasons To Keep Our Eyes On The Prize

I hope it is not a sacrilege to apply “Keep Your Eyes on The Prize” to advice for the Red Sox. Maybe I did not ask for enough. I bargained for an interesting September when what I really wanted was a successful October. Yesterday afternoon was very painful for a believer in the fiction of “Red Sox Nation.”

In world that really means something to me, last Friday was a Red Letter Day. Not long before this letter hit your inbox, my third grandchild made his much anticipated arrival in the delivery room at the Kaiser Hospital in Santa Clara, California. It’s been a great week of phone calls and hundreds (literally) of pictures and videos as we have followed young “Charlie’s” (Charles Thomas Lindsey) introduction to life in the wild. He was a little early, his predicted date of arrival had been around October 10, but at over twenty inches and seven pounds things seem just fine, and he and his mother were out of the hospital in less than twenty four hours.

It has been fascinating to watch his older brother begin to adjust to this new intruder into his world. Sharing is one thing for a three year old when it’s about a toy at daycare, but it’s a challenge with deeper meaning and more far ranging realities when it is about a permanent unalterable sharing of your facetime with Mom and Dad. Will gaining the status of big brother be worth the as yet not completely understood costs? Master Harold has now encountered uncertainty.

One thing is certain and that is that Nancy and I are headed West in the very near future to have our own initial hands-on experience with new Charlie and with old Harold who is on the learning curve of his new and expanded role as big brother. The efficiency of Charlie’s delivery, as well as the patient and family centered nature of the care that all of the members of the West Coast branch of the Lindseys experienced at Kaiser, reminds me of the work yet to be done. We must continue to work toward the day when the efficiency, safety and quality of the care they received is the expectation of every individual and every family. It is possible and should happen soon. We must “keep our eyes on the prize” of the Triple Aim.

Charlie does not need CHIP, but there are many children where he lives who do. Harold and Charlie and their parents have coverage that is not vulnerable to legislative whim, but there are others who live near them and you who are not so lucky. What Charlie and Harold do need is for our efficiencies in healthcare to spill over to the benefit of all of their contemporaries and their families. The savings gleaned from the elimination of waste in healthcare can be used to expand the many other collective endeavors that will improve the quality of the future lives of all of our children like Harold and Charlie and their Cousin Cami in Florida who was 15 this week.

It seems like Charlie also brought gorgeous weather with him. The sunsets this week have been outstanding. The picture used for the header on today’s letter was taken at the other end of Little Lake Sunapee at Bucklin Beach by a friend and multitalented woman, Cindy Benson. You do not see sights like this unless you are out and about. The forecast is that the warm weather will last yet a little longer in my neighborhood. I hope it will be true where you are also, and that you will enjoy it with others.