It’s The Sun Wot Won It… the topsy-turvy world of American media – and why it’s dangerous

By Mince Pie

In this week of dramatic developments on both sides of the Atlantic, I write from 35,000 feet above the Indian Ocean, having made a last minute trip home to London. A week surrounded by tea, queueing and the British media offered up much food for thought.

The UK is in the grips of election fever (or rather election malaise). After 3 major votes (Scottish Independence, General Election, Brexit) in two years, the British people will head to the polls again on June 8th after Prime Minster Theresa May called a surprise “snap” election.

In that context, in a supposed world of 24 hour news, fake news and social media hysteria one would expect wall-to-wall election coverage with vehement opinions flying all over the place. And yet, the British seem oddly calm and level headed about all this and the invective of American politics seems strangely absent. So I started to wonder why that might be.

One could chalk this up to natural British diffidence and refusal to get too excited about anything in case it “starts to rain later.” I don’t think that’s it though. I have been a resident of Australia for the last three years and have seen the same thing there.

I think the comparative equanimity of British and Australian voters comes not from the absence of political invective in media but from who is supplying that invective. In the USA, the TV channels are fundamentally biased towards either left or right. The TV companies that soak up the majority of news viewing were founded with agendas in mind: MSNBC, Fox etc. Sure if you want unbiased news coverage on TV you can find it (on CBS for example) but the big audiences are with the commercial behemoths. In general, my experience of the US is that if you want a level headed approach to news reporting and news commentary you have to pick up a newspaper.

In Europe and in Australasia, this situation is completely reversed. Small countries (in either geography or population) that have national broadcasters (the BBC, the ABC, TF1, ZDF etc) have embedded the concept of the neutral TV news report. In the UK, the BBC is duty bound by its governance to report both sides of an argument (in fact it often gets in trouble with conservatives for “sympathizing with the bad guys” because of it). Even the majority of the commercial channels get their news coverage from one source – Independent Television News (ITN) – which has a long history of outstanding independent news reporting and investigation. Monopoly rules prohibit agenda setting moguls like Rupert Murdoch from owning 100% of the news coverage of their own channels. Sky News (part owned by Murdoch’s right wing News International) has a rightward, populist tilt but he can’t push it too far. Certainly not as far as he’s pushed Fox in the USA.

The print media on the other hand is entirely different. From the holier-than-thou lefty liberalism of the Guardian to the right wing invective of the Daily Mail, the British press is a whole smorgasbord of vibrant political opinions of all stripes. The press are famous for claiming responsibility for shifting elections, particularly close ones. The support of the key tabloids is still, even in the declining age of print, seen as crucial to any would-be-leader’s chance of success.

So, why does having an even handed TV news underpinned by biased newsprint produce a more stable political culture than the other way around? Why do the Brits and Aussies manage to keep a lid on the invective when Americans do not?

The obvious answer is that print is much smaller. 5m people will watch the BBC TV news in an evening. Another 2m will be watching an ITN production on another channel. At the height of its powers the Daily Mail will sell only a third as many copies as that. The quality press (the right wing Telegraph, the centrist but establishment Times and the lefty Guardian) will come up with around a million readers a day between them. This creates a natural foundation of people who get either all or at least part of their news coverage from more even handed sources. That doesn’t happen in the US. The only people getting unskewed news coverage are the readers of certain print publications (The New York Times for example) or viewers of venerable TV channels like CBS.

Print also encourages thought through its format. Long form content that uses only one of the senses (sight) is a relative rarity in the digital age. Whilst sensationalist headlines sell newspapers, they don’t get far without the content underneath them. TV news isn’t like that. A big headline, a few talking points and on to the next story with no pause for thought provocation or analysis is the staple of lots of commercial TV news operations.

A vibrant mix of news is good – it showcases new thinking, new ideas and ensures minority opinion is heard. Bias is good as long as it is balanced by a healthy source of objectivity. The British, French and Australians have a news culture where TV is even handed and print is politically skewed. The USA is the other way around – and its news culture is all the more divisive and dangerous for it.

Advertisements

Trump Fires Comey: It’s About The Subpoenas, Stupid

May 9 started as an ordinarily confusing and disorganized day at the Trump White House. When asked whether the White House has confidence in Comey, Sean Spicer hedged and said he needed to ask the President. A few hours later, James Comey learned that he had been fired as FBI Director when the news media reported it. At some point in the day, he received a certifiably bizarre letter from Donald Trump, sayingI greatly appreciate you informing me, on three separate occasions, that I am not under investigation” and then firing him.  Earlier this hour, CNN reported that grand jury subpoenas had been issued to associates of former National Security Adviser Michael Flynn, saying it had learned of the subpoenas hours before Comey was fired. I think the chaotic, characteristically ill-executed firing of James Comey was a consequence of the progress of the Flynn prosecution, and the media’s awareness of it.

This is NOT about Hillary’s e-mails

I’m not one for excessive conjecture, but it doesn’t take an avid conspiracy theorist to conclude that Trump’s excuse for firing Comey is a pretext. Trump’s ostensible reason, as outlined in a very competent analysis by Deputy Attorney General Rod Rosenstein, is that Comey deserved to be fired because he mishandled the conduct of his investigation into Hillary Clinton’s e-mails, largely by discussing the investigation publicly and opining on whether she was prosecutable, which is not the FBI’s job (all true). However, given that the President and the Attorney General were fully supportive of this action until this morning reveals this justification as only the thinnest of pretexts.

Some say this termination has something to do with Comey’s mischaracterization of Huma Abedin’s use of e-mail on her home computer, and his subsequent “correction” of his misstatement. That explanation makes little to no sense. Comey’s initial statement supported Trump’s narrative. His need to walk it back, or at least to soften it, has been a constant theme in the Trump Administration. I think the explanation is a whole lot simpler than that.

It’s a pathetically transparent attempt to CYA

Donald Trump and his associates have been acting as if they are hiding something since the day they took office. Michael Flynn, Jeff Sessions, and Jared Kushner have all been caught in significant lies about ties to foreign powers, particularly Russia. It cannot be a coincidence that, on the day we discover a grand jury has been convened to consider the alleged criminal activities of Michael Flynn, Trump uses a very public termination letter to the man investigating Flynn to assert that Trump himself has never been under investigation. I don’t think we’ll know the full story anytime soon, but I don’t think we need to look far to figure out why an impulsive, reactionary, ignorant President decided to fire the nation’s Top Cop the day the country found out one of the architects of his campaign is in the early stages of a criminal prosecution.

The Day France Refused To Surrender

It is a great day for France, Europe, and western democracy; it is a terrible day for Anglo-American surrender jokes. Today Emmanuel Macron, a capitalist, pro-EU, pro-UN liberal, won the French Presidential election in what appears to be a landslide victory. The French people rejected Marine Le Pen’s nativist campaign in favor of the post-war values and institutions that have given us peace in the West for over 70 years. This is partially a testament to the virtue and reasoned choices of French voters, but it is also the result of Macron’s active defense against the Russian interference that helped convince Britons to leave the EU and Americans to elect Donald Trump. In our era, tyrannical regimes are not using tanks to threaten us; they are using cyber warfare and disinformation campaigns. Tyrants finally have a means to exploit the biggest weakness of democracies – that government leadership is determined by ordinary people who can make extraordinarily bad decisions if you scare them enough. In this war all democracies are equally vulnerable, and it was Britons and Americans, unprotected by the English Channel and Atlantic Ocean, who surrendered without much of a fight and, in America’s case, elected a collaborator. In a volte-face from 1940, it was the French (and the Dutch) who fought back.

The French rejected anti-refugee fearmongering and Russian interference

The French electorate resisted two of the driving forces that brought us Brexit and Donald Trump: fear of Islamic immigration and Russian propaganda. Marine Le Pen’s campaign included anti-Muslim and anti-refugee rhetoric similar to the Trump and Brexit campaigns, but her loss indicates that these narratives were not determinative for a majority of the electorate. France’s successful rejection of anti-refugee rhetoric is notable in light of the fact that it was France, not Britain or the US, who has suffered multiple significant terrorist attacks directed by the Islamic State. While the Pulse nightclub shooting in Orlando was a significant event, it was one of many “lone wolf” operations undertaken by a disturbed young man. While terrible, it was not an attack by an organized terror network. It is particularly impressive that France elected a pro-EU candidate, given the fodder the nativist right had at its disposal.

It is also promising that the Macron campaign seems to have resisted the cyberattacks from Russian hackers. Macron has taken a bullish position against Russian propaganda; in late April he revoked RT’s press credentials in retaliation for Russian hacks, and in recognition of the fact that it constituted an organ of Vladimir Putin’s propaganda machine. In the final hours of his campaign, hackers dumped a load of documents they had obtained from a “massive” hack. It turns out that the Macron campaign had prepared for this eventuality.  As the Daily Beast reported yesterday, the campaign deliberately planted fake passwords and documents to bamboozle hackers, and ensure that when any document dump came along, it could respond with certainty that some documents were fake. The French government also asked French media outlets to stay away from the document dump for the one day preceding the election. These are calculated controls designed to promote reasoned decisions by French voters and prevent hackers from acquiring an outsized influence. Ultimately, both French voters and French political structures found ways to resist the forces that compromised the British and American electoral systems.

Give the French their due – we’re the cheeseburger eating surrender monkeys

Yes, my friends, after 77 years it is time to surrender our jokes about the surrender of 1940. I don’t know what we’re going to do with all those dropped rifles, never used, but we no longer have the right to taunt anyone for cowardice. This time, at a moment when democracy was threatened, it was Britain and America who, demoralized and rudderless, fell victim to the fearmongering of antidemocratic forces from within and without. This time, France stood up and stemmed the tide of hate in defense of our common values. And we shouldn’t be surprised, despite the many, many digs we have thrown their way since 1940. As Winston Churchill once said, “all my life I have been grateful for the contribution France has made to the culture and glory of Europe, and above all for the sense of personal liberty and the rights of man which has radiated from the soul of France….Show me a moment when I swerved from this conception, and you will show me a moment when I have been wrong.” Contre nous de la tyrannie, L’étendard sanglant est levé. From the center of the new Résistance we will be looking to France for inspiration and leadership. Well done, my friends, and Vive La France!

Birthin’ Babies On Single Payer: A British Mom On How Her Two Healthy Kids Arrived

A note from Pie Face: Pregnancy is a universal facet of any healthcare system, and so I have asked moms who gave birth in publicly funded systems to tell us about how they interacted with the systems, and whether they felt supported and prepared for the complicated and difficult medical process that is pregnancy and childbirth. Remember, this used to kill 1/3 of women, so it’s an important metric for the success of any healthcare system. Here’s one mom’s experience in Britain’s NHS.

By Rhubarb Pie

As a pregnant woman in the UK, my first point of contact with the NHS was an appointment with a midwife at my General Practitioner (GP) surgery. Considering I was only 6-8 weeks pregnant (think blue lines on a stick rather than cute scan picture), this was far more thorough that I expected. It covered birth options, weight and blood pressure checks, nutritional advice and any concerns or previous complications. I came away with a big folder of acronym-heavy maternity notes to keep with me in case of emergencies and take to subsequent appointments. Pregnancy is confirmed and dated based on an ultrasound scan at around 8-12 weeks, which I had at a local hospital. I also remember blood tests around this stage. Personally, I felt no pressure from my midwife in relation to screening options or my choice of where to give birth.

My two pregnancies were both straightforward until the later stages; I went along for appointments with my midwife every few weeks and to hospital for a routine scan at around 20 weeks, at which the sonographer checks for abnormalities. Barring the odd appointment delay, the system ran smoothly. I had my midwife’s mobile number and contact details for the hospital maternity assessment unit in case of any concerns.

Despite regular contact with midwives, I didn’t see a doctor at all during my first pregnancy until the day I went into labour. Maybe this hands-off approach is one of the reasons National Childbirth Trust (NCT) courses are popular in the UK among those who can afford them. I agree with the general consensus that these courses are good for peer support, but can see why they are criticised as too middle-class and for glorifying low-intervention birth. There are free NHS antenatal (prenatal) courses, but provision seems patchy and our local sessions were run on a weekday morning, so not great for working parents.

After a complicated birth first time round, my second pregnancy included an appointment with a hospital consultant: a frank, unhurried, informative conversation. Later in my second pregnancy, I became ill and had appointments with my GP and midwife. Looking back, I think better communication between these two could have reduced or avoided complications.

When it comes to the actual births, my tendency is to wax lyrical about the amazing NHS hospital staff involved. Possibly this says more about the nature of my experiences than the quality of care, but the fact is that in another place or another time, the outcomes for me and my children would have been very different. My first child arrived via emergency c-section, my second was born prematurely and spent three weeks in a neonatal intensive care unit.

Among the many positives (aside from two healthy children), I gave birth in a clean, comfortable, private room with the support of thoroughly professional midwives and doctors. I was discharged at a reasonable time and felt informed about and involved in decisions relating to our premature baby’s care. I’m not saying our hospital experience was without fault; an accidental double-dose of antibiotics for our newborn baby, staying two nights on a crowded ward after surgery and conflicting advice about breastfeeding could all be perceived as symptomatic of a system under strain.

My experience of postnatal care was mixed. The community midwife visited a few days after birth and I went to a local clinic for a postnatal check-up: all fine. However, subsequent home visits are made by a health visitor (a qualified nurse or midwife specialising in public health). These checks are intended to support parents and ensure the baby’s development is on track, but I’m not the only parent to find them a bit intrusive. Something I did find helpful was a free six-week postnatal course run by health visitors at my local NHS clinic, but this has since been scrapped (presumably due to funding cuts).

Contact with health services has been a regular feature of early parenthood – from getting prescriptions for antibiotics to treat mastitis to accessing support for mental health issues, infant vaccinations, getting coughs and colds checked out and minor surgery for trapped fingers. It’s not always easy to judge the seriousness of children’s health conditions – especially before they can talk – and I feel fortunate to have access to decent healthcare without having to worry about the costs.

 

Single Payer In The Era Of Austerity: An NHS Doctor Tells Us Why It’s Still Great

By Steak and Ale Pie

I work as doctor in one of the most monolithic healthcare systems there is.  The UK NHS is centrally funded from general taxation and is the third largest employer in the world.  Hospitals are mostly owned by the government and doctors and other healthcare workers in hospitals are effectively civil servants.  Family doctors on the other hand are effectively private contractors for the state.

The aim is to provide “cradle to grave” healthcare for all UK citizens and legal residents, free at the point of need.  The only charges are flat rate prescription charges which are waived if you are on a low income, under 18, or have a chronic condition like diabetes which means you will need a lot of repeat medications.  And of course the legalised extortion racket that is hospital parking charges.

That’s right, you can walk into an ER with a broken leg, get a kidney transplant or waste my time with your self-limiting viral illness and not pay a penny (or dime if you prefer).

Sometimes the quality of care provided is truly exceptional, and sometimes, well, less so. I’d like to talk about the good, the bad and the ugly.

The Good:

Particularly for acute problems, like heart attacks, the care you can get is truly world class.  If your coronary arteries give up on you after a lifetime of nicotine and saturated fat you can be on the slab getting angiography to unblock them in 20 minutes or less, with no questions about payment.  And this care is available to you whether or not you are a big shot banker in the City of London or something more socially useful like an alcoholic bum who sleeps in the park.

There is no co-pay (apart from – and I have no doubt you guys will find this hilarious – for dentistry), no lifetime limits, and you are not tied to your employer for healthcare.  You don’t have to save up in order to be able to pay to deliver a child, and you aren’t going to go bankrupt because you can’t pay for your chemo.

The NHS has exceptionally strong primary care.  NHS general practitioners (GPs) are a bit like the family doctors in the US.  They provide excellent general healthcare and manage most conditions. If you need to see a specialist like me it is they who refer.  This triage is hugely efficient and cuts down on unnecessary activity in the secondary care sector.  The upshot of this, and perceived downside for many, is that patients cannot see a specialist directly (more on that later).

One of the less tangible benefits, and one that I personally find satisfying, is that I have no pecuniary interest in my patient’s care. Have the scan or not, get the expensive treatment or not, have me do the procedure or not – it makes no financial difference to me.  This disinterest, in the purest sense of the word, means that people trust me to make the right decisions and offer them treatments that are best for them, and not my bank balance.

It is free.  Did I mention that it is free? Of course, if you fancy going to a private hospital with lovely carpets and better food but much worse care then you can get private health insurance.

The Bad:

It is free.  While that means anyone can access it, it also means that anyone can access it. Some people don’t always value what they don’t pay for and think it is perfectly ok not to attend booked appointments, or turn up to the ER at 2am on a Friday night with the same back pain that they have had for 25 years (to anyone thinking of doing this – I don’t think I am going to have any better ideas than the succession of doctors and reiki masters you have seen over the years, and someone is probably doing their best to die on me not very far from where you are sitting.  Stay at home!).

If your problem is not life-threatening, you will wait to see a specialist – longer than you and perhaps they would like.  As real terms funding has been going down (despite what the politicians would have you believe), that wait will get longer.

For some, the fact that GPs are effectively the gatekeepers to specialist care is a problem, and certainly one that patients can find frustrating.  Personally, I think the person with the medical degree and decades of experience is better placed than you to decide whether or not you need to see a gastroenterologist for that abdominal pain, but, you know, whatever.

Continuing in the vein of cost, some very expensive treatments, particularly newer cancer drugs (which it has to be said are in the main expensive with dubious survival benefits at present), are simply not available to NHS patients.   As funding cuts bite this is becoming increasingly problematic and it is currently the case that some high-cost cancer treatments that are standard of care in other countries are not offered to NHS patients.  NICE is a body which aims to promote cost and clinical effectiveness in the NHS and it is this organisation that decides whether or not treatments should be offered (the ins and outs and rights and wrongs of all this are a whole article in itself).  This is obviously highly controversial and some treatments are simply being rationed due to their high costs, for example the newer treatments for Hepatitis C.

The Ugly:

It all comes down to money at the end of the day.  We spend less as a percentage of GDP than other developed nations, and the fact that the NHS can provide care that is sometimes as good, sometimes worse, and sometimes better, but is definitely in the mix, when compared to these countries is a testament to the staff working within it.  But as costs rise and funding falls, there will be a reckoning.

Cuts in social care mean that often there is nowhere safe for patients to be discharged to, particularly the frail elderly.  They linger in hospital unnecessarily, waiting for care to be arranged while we all hope they don’t catch pneumonia and die. This happens on a distressingly regular basis.

Raising taxes to pay for the resources needed is, as ever, politically toxic.  While perhaps insurance-based “top-ups” could relieve things somewhat, they remain iniquitous and it is difficult to see how they will integrate with the NHS as it currently exists.  More worrying perhaps is that our political masters look not across the English Channel to our European neighbours for models of care but across the Atlantic to the catastrophe that is the US healthcare system.

In Closing:

So where does that leave us?  The NHS remains a towering achievement whose future is uncertain, but I am deeply proud to work for an institution that still aims to provide free healthcare for all as a fundamental right, and puts these ideals into practice every day.  Health policy is often made by people working in think tanks in their 30’s or 40’s who often have no direct experience of being unwell. As Susan Sontag so memorably put it, we have no idea what it is like in the “Kingdom of the Sick” until we are there.  The patients I see with serious illnesses, both chronic and acute, hugely value and appreciate the universal healthcare that they are provided. It is such a precious and important gift to be able to give – to relieve suffering, to cure diseases and sometimes even to save a life.  To be able to do so freely considering only a patient’s clinical need and not their financial situation is a wonderful privilege, and I cannot imagine it any other way.

Who’s Afraid Of Universal Healthcare?

In light of the GOP’s fresh assault on our fragile first steps toward universal health coverage, it’s worth asking: what is it that scares Americans so deeply about a universal system? I’m not talking about Republican politicians – their objections are rooted in an unwillingness to allow government to administer any major sectors of the economy. I’m talking about ordinary voters, who often support the idea of universal healthcare in the abstract, but don’t like any of the ways politicians propose to provide it. I think the answer lies in the ubiquitous statements by older voters who want Congress to keep its government hands off their Medicare. Americans don’t understand that many of them are already receiving state-run healthcare, and therefore they are afraid of what the experience of healthcare would be like in systems that provide universal coverage. I think American opposition to universal healthcare proposals is largely based in a fear of the unknown. Therefore, I will be publishing a series of articles by and interviews with doctors and patients from countries with universal systems, including those found in Britain, France, Germany, and New Zealand. Hopefully they will be able to provide a personal window into how the healthcare experience feels when government funding is involved, as opposed to just a dry explanation of policy. Nevertheless, it’s still important to understand what we mean when we say “universal healthcare,” so let’s do a quick review of how the systems work.

Is there only one type of universal healthcare coverage?

Republicans aren’t the only Americans who unaware of all the routes we could take to achieve universal coverage. Politicians like Bernie Sanders, who favors a single payer system, often conveniently neglect to mention that countries like Germany and Austria provide excellent universal health coverage to their citizens without a single payer system.  Consequently, many on the left confidently argue that if we can’t enact a single payer system, we will never provide healthcare for all Americans. Well, that just isn’t true. There are two primary types of universal healthcare systems: single payer, which can be found in Britain, Canada, Denmark and Norway, and insurance mandate, which can be found in Germany, Austria, and Japan.

Sometimes the government picks up the whole tab

A single payer system operates on the principle that the government should be the sole or primary provider of healthcare for its citizens. Sometimes, as in the UK, this means hospitals and other health facilities are owned by the government and doctors and nurses are government employees. Other times, as in Canada, it takes the form as basic government-provided health insurance, which patients use at privately owned doctor’s offices. In many countries, including Britain and Canada, private supplemental insurance policies are available. In Britain, these reduce wait times and sometimes make serious care more comfortable. In Canada, they cover needs like dental and pharmaceutical care, which are not considered “basic.” The key idea is that the government provides basic care without any contribution from citizens.

And sometimes the government makes you buy insurance

The insurance mandate system evolved from Otto von Bismarck’s welfare state, which he instituted when the modern German nation-state was founded in the late 19th century (many will note that there was a Holy Roman Empire in Germany for about 900 years, but since they spent much of the time murdering one another and definitely did not have universal healthcare, let’s stick with the modern date.) Insurance mandate systems like Germany‘s require that all citizens be covered by insurance. Most of those citizens are covered by non-profit, government regulated insurance providers. In Germany, citizens who earn less money are enrolled in the nonprofit coverage; those who earn more can substitute private insurance options. All employed Germans contribute a portion of their wages toward the sickness funds, as do their employers. The key takeaways from insurance mandate systems are that citizens must pay some portion of their insurance, and most facilities are privately owned. Insurance mandate systems are more complex and have more moving parts, but they can also be more flexible and provide greater choice for consumers, because there are so many different participants in the insurance market. Obamacare tried to take us down this road, but lost a crucial component on the way: a publicly funded nonprofit insurance option.

Read about all systems and make your own decisions

There are a number of ways to achieve universal healthcare. If you’d like to read more about how other industrialized countries have implemented universal care, take a look at this excellent survey by the Commonwealth Fund. No country has gotten it 100% right, and the US has the opportunity to look at all of the countries that have created systems before us and take the best from each. So I encourage everyone to read as much as you can, make your own decisions, and keep an open mind about both types of universal coverage as you read the upcoming stories of how universal care works from the inside.

Let Obama Get Overpaid To Talk At A Healthcare Conference – He Deserves It

Yesterday we learned that President Obama has accepted a $400,000 fee for speaking to a healthcare conference sponsored by the Cantor Fitzgerald investment bank. The level of outrage that greeted the news is completely ridiculous. Many on both the right and the left have leapt up to accuse him of hypocrisy, or of being susceptible to bribery by Wall Street. Elizabeth Warren tells us she is “troubled” by this speaking fee, saying “one of the things I talk about in [my] book (“This Fight Is Our Fight: The Battle to Save America’s Middle Class”) is the influence of money. I describe it as a snake that slithers through Washington and that it shows up in so many different ways here in Washington.” Indeed it is a terrible indictment of Washington that a former politician who is not a lobbyist and lives in Chicago might accept overpayment for speaking about healthcare, which, as everyone knows, is a policy area in which he has dabbled from time to time. Either the politicians claiming this is related to bribery are being disingenuous, or they fundamentally misunderstand the nature of the speaking circuit in which so many retired politicians participate.

This isn’t bribery, it’s a status contest

Warren’s linking of Obama to money in Washington is hysterical nonsense. Barack Obama is a private citizen who will never again run for public office (Hillary Clinton’s speeches were only controversial because she went back to Washington). You can’t bribe someone who doesn’t have the power to make laws. The people paying him to speak are not doing so to influence policy; they are doing so to prove their status and attract people to their healthcare conference. Rich organizations regularly pay former politicians and central bankers to speak on a wide variety of topics in order to attract movers and shakers to their events. These politicians’ speaking fees are proportionate to the importance of their former jobs. So Nick Clegg, the former leader of the Liberal Democrat party in the UK, commands a mere $48,000 (in avg 2015 dollars), Tony Blair, a former 2 term Prime Minister, commands $600,000. Bill Clinton, Rudy Giuliani, both George Bushes, Dick Cheney, Jeb Bush, Al Gore, Howard Dean, Ben Bernanke, and Alan Greenspan are all on the speech circuit. Some of these speeches are at fundraisers, like the charity fundraiser for veterans that paid George W. Bush $100,000, some for conferences, and some for corporate retreats. These fundraisers and conferences are paying these guys to say “we have a former US President at our conference, but our competition only has the former Mayor of New York – give us your money.”

These politicians speak to their areas of expertise

There is no indication any of them are saying something different from what they have always thought. Nicolas Sarkozy, former President of France, famously told the United Israel Appeal fundraiser’s audience that the international community must pressure Israel to take down the “walls of Jericho” with which it has surrounded itself and create a Palestinian state. Sarkozy had made the Middle East peace process (to the extent one exists) a central focus of his Presidency, and so a private group paid him to talk about his views on the issue. Given Sarkozy’s commitment to a 2 state solution, they shouldn’t have been surprised about what he said. Nor has there been any indication that Bill Clinton has given speeches inconsistent with his philosophy or that of his foundation. Clinton pretty much says what he wants – conferences that hire hire him don’t even necessarily get speeches on topic. The speech circuit is basically just a pissing contest between rich organizations to get the most revered former politicians and government officials to talk about their experience in a private setting once those politicians and government officials don’t have to worry about what they say in the Press (or at least don’t have to worry as much). The organizers and sponsors are using the draw of being “in the know” and having more private access to famous politicians to promote their events. As long as Obama does not abandon all his principles to pander to his audience, there is no justification for accusing him of moral bankruptcy or hypocrisy, as some on the left have done.

The Presidency is the worst job on earth, be glad someone is paying Obama for the years it took off his life

Anyone ever notice how rapidly our last three two-term Presidents have aged? They have the worst and most difficult job in the world. These men spent 8 years never really having a moment to themselves, making the most difficult decisions on earth (always imperfectly) and being publicly shamed and lambasted for every misstep, great or small. I don’t think any of us can truly understand what that does to a human being. There is no comparable job on earth, and no one goes into it fully understanding what it will do to them. Indeed, Donald Trump has and complained incessantly about how difficult the job is, and proved his assertion by being too incompetent to even nominate sufficient staff to run the government. Obama in particular suffered more illegitimate, prejudiced personal attacks than anyone before him, and he withstood it with grace. I don’t think there is any amount of money we could have paid him to compensate for that honorable self-restraint. If a bunch of status-seeking fools want to overpay him to give his opinion about his signature healthcare law, I think we should tell him to have at it. There are much more important things to worry about.

The Arkansas Executions Prove Politicians, Not Courts, Must End The Death Penalty

This week, Arkansas is rushing to execute as many inmates as possible before the last of its death penalty drugs expire. The 8 men slated for execution were all duly convicted under Arkansas law, and all have had the chance to appeal their convictions. Nevertheless, death penalty opponents, civil rights attorneys, and media outlets expressed outrage that Arkansas would schedule executions based on an expiration date. These activists are focusing their outrage on the wrong target. The problem is not the unseemly speed with which Arkansas has scheduled executions; the problem is that the death penalty exists at all. Activists have been trying to use the courts to end it, and that isn’t going to work. To end the death penalty permanently, the Supreme Court would have to rule that all executions violate the 8th Amendment’s prohibition against cruel and unusual punishment. They are just not going to do that when 60% of the American public supports the practice. The only way to end the death penalty is to convince Americans it cannot be justly applied in a flawed, human criminal justice system.

The Court will only abolish the death penalty if Americans stop supporting it

Ever since the Supreme Court briefly struck down the death penalty in the 1970s, activists have primarily focused on the courts as a vehicle to end it permanently. However, the Court has only been been willing to restrict application of the death penalty, not prevent states from applying it at all. Although lawyers successfully stopped the death penalty in 1972 for being racially biased, the penalty was reinstated when the Court concluded colorblind standards had been imposed (though it has since become clear executions are not blind to race).  The prohibition on executing the legally insane (legal, not medical, terminology) is also just a limitation on how you execute a marginalized group, not on whether they can be subjected to the death penalty.  The Court’s jurisprudence says you can’t execute anyone while they are actively delusional, not that an individual with mental illness cannot be executed. This delightful piece of jurisprudence has led states to forcibly medicate inmates in order to put them to death. These piecemeal measures may prolong litigation, but they seldom prevent executions.

Only twice has the Court truly dealt a blow to the death penalty. In the first case, it struck down capital punishment for the “mentally retarded,” noting that public opinion polls consistently supported eliminating the practice (certain states, like Texas, keep trying to roll this one back). Two years later it eliminated the death penalty for juveniles. In both of these cases, the Court was following public opinion. All of the justices, including Justice Ginsburg, are very wary of making decisions that are too far ahead of the public. More importantly, the “cruel and unusual punishment” standard is linked to public opinion. The reason we cannot put misbehaving teenagers in the stocks is that the Court decided our society has evolving standards of what is cruel and unusual. As long as public polls show broad support for the death penalty (and they do – California, of all places, recently decided to keep it) the Court is not going to strike it down.

The courts follow the people, so someone else needs to lead them in the right direction

We have no other option but to make an argument to our fellow citizens that the death penalty cannot be justly administered under our system. To be persuasive, we have to pick one of the many valid arguments against the death penalty and promote it relentlessly (think of how successful the gay rights movement has been since they decided to focus all their efforts on the marriage narrative). Knowing that many Americans still believe in the “punishing” part of capital punishment, I don’t think arguing that the death penalty is an absolute moral wrong or that it has no deterrent effect will be a particularly promising strategy. Instead, we have to focus on the fate of an innocent man wrongly accused. We must explain why the execution of an innocent man is fundamentally inconsistent with the American conception of liberty and justice, and why such executions are inevitable in a flawed system.

How many innocent men will you kill to keep the death penalty?

Being for or against the death penalty comes down to this: do you believe a just society should let 10 guilty men go free rather than execute an innocent one? What about a hundred? What about a thousand? Our legal system goes to great procedural lengths to prevent conviction of the innocent. It is stacked in favor of the defendant because it is based on the premise that the state has immense power and should have overwhelming proof that a citizen has broken a law before depriving him of his life, liberty, or property. That is why we have a presumption of innocence. That is why we have juries – so one man does not have the power to deprive the accused of his rights in a potentially arbitrary manner (juries are actually far more effective than people usually think). Executing innocent men is antithetical to a jurisprudence so determined to protect the accused from the state.

However, such executions are inevitable under our system as it stands. All of our institutions are human, and we have discovered over the past 30 years that many people were convicted of capital murder, sat on death row for years before being exonerated. We have also learned that the human memory, and therefore all eyewitness testimony, is unreliable, that forensic experts can be unreliable, and that we all drop DNA evidence all over the place, rendering it less useful in the majority of murders where the victims know one another. Despite advancements, all criminal sentencing is still essentially the best educated (or sometimes uneducated) guess of one or more flawed human beings. It is the human flaws in our system that make the use of capital punishment inhuman. I do not often say this about fellow citizens, but anyone who cannot see that the inevitable execution of the innocent is a betrayal of our values does not understand what it is to be an American.

Shutting Down The Government Isn’t Just Stupid, It’s Ineffective

Donald Trump has decided that now is the time to withhold funding for Obamacare subsidies for millions of low-income Americans if he doesn’t get funding for his border wall. This is a typically asinine and pointless move on his part; for once, Democrats and Republicans in Congress seem to have been on their way to achieving a mutually beneficial deal without creating widespread collateral damage. Democrats’ reaction to this news was to promise they will shut down the government if funding for Trump’s border wall is included in the budget. No matter which party you support, this political brinksmanship with the basic functions of government has got to stop. If we were talking about a gross, unconstitutional threat to democracy like internment camps, there might be an argument in favor of a shutdown, but we’re not. We are talking about Trump insisting on pettily defunding a duly enacted federal program without repealing it, and the Democrats insisting on withholding funding for a stupid, pointless, expensive border wall that millions of Americans explicitly voted for. The integrity of the core institutions of government is more important than any policy goal. Holding the government hostage over partisan policy preferences erodes the structure of our Republic. More importantly, from a politician’s perspective, none of the shutdowns in the past 25 years benefited the fanatics who were responsible.

Newt Gingrich is a despicable megalomaniac and his gambit failed

Now, there were government shutdowns before Newton Leroy Gingrich came along, but they were in the order of 1-3 days. Even the first shutdown in 1995 wasn’t inconsistent with this history.  It lasted about 5 days.  However, Gingrich’s shutdown of 1995-1996 was a precedent-setting piece of political warfare that totally failed to achieve its goals. Gingrich initiated a standoff with Bill Clinton over which numbers Clinton had used to create his budget (Gingrich wanted him to use the Congressional Budget Office). Clinton, having produced a plan designed, as requested, to balance the budget in 7 years, refused to go back to the drawing board. On this basis, Gingrich shut down the government for 21 days. The American people were not impressed. Afterward, Republicans simply caved, and accepted Clinton’s proposal. The fact that the shutdown came after Gingrich felt snubbed during a ride on Air Force One did not help his reputation or make the shutdown more effective. Nevertheless, 17 years later, Republicans thought they’d have another crack at the shutdown strategy.

The Tea Party fell on its face trying to defund Obamacare

In 2013, the most fanatical tea party advocates in the House of Representatives advocated defunding Obamacare, since they did not have the ability to repeal it.  Over the summer of that year, tea party activists sent a barrage of phone calls and letters to members of Congress, demanding a government shutdown if Obamacare was not defunded. Senator Ted Cruz spoke for 21 hours on the Senate floor about his beliefs regarding shutdown. These developments forced even relatively moderate Republicans into going along with the party’s ideologues. Accordingly, the Republican House of Representatives shutting down the government for 17 days because it refused to fund the President’s signature domestic policy achievement. The shutdown ended when the Republicans were forced, due to widespread voter disapproval, to fund Obamacare. To add insult to injury, they were also compelled to raise the debt ceiling, or amount of debt the US government is able to repay, a particular bugbear of theirs during the Obama years. The shutdown was a total failure.

A failed strategy that damages government institutions is no strategy at all

It’s time to stop the madness. These ideological shutdowns don’t work! In this case, Congress seems to be working together, and Trump needs to stay out of it. Perhaps Trump is laboring under the delusion that he will get a popularity bump like Bill Clinton and Barack Obama did when the opposing party shut down the government. The trouble is, both of those men were trying to compromise with fanatics in Congress, not trying to insert poison pills into the negotiation at the eleventh hour. The Democrats seem to think taking a page out of the fanatics’ playbook is a great idea. It isn’t. In the last 25 years, Congress has never gotten its way from a shutdown. In our current political environment, I am vehemently opposed to drawing false equivalencies between the Democratic Party and the GOP under Trump. That said, if Congress fails to fund the government and shuts it down, I wish a pox on both their houses.

Jeff Sessions Declares War On Blue America

Like many Americans, I was surprised to learn that the fiftieth American state is just an island in the Pacific with a seriously uppity judge. Earlier this week, Attorney General Jefferson Beauregard Sessions III went on the Mark Levin show, a conservative talk radio program, and expressed bewilderment that a federal judge in Hawaii can interfere with the President’s constitutional prerogatives. Many on social media have excoriated Sessions for insulting Hawaii, and delighted in explaining the functions of the third branch of government to him. I certainly also feel moved to remind him that Hawaii was the only American state to suffer attack by a foreign adversary in the 20th century; if it was American enough for Tojo, it should be American enough for him. His home state of Alabama, in contrast, hasn’t seen action since it picked up its toys and went home because it couldn’t put slaves in Oregon.

Jeff Sessions didn’t attack a Hawaiian judge because he doesn’t understand the Constitution or historical significance of the state. As a former US attorney and Senator, he doesn’t need reminders about the power of the judiciary, and he remembers Pearl Harbor just fine. In fact, this fresh attack against poor Hawaii is part of an insidious effort to undermine the credibility of judges and lawmakers in Democrat-dominated states and cities. This strategy started during Trump’s campaign and shows no sign of stopping. Sessions’s statements are just the latest salvo in what appears to be a full on assault by the Trump Administration and its Justice Department not just on the judiciary as an institution, but on judges, residents, and policymakers in blue states.

Somehow, only blue state judges are “fake” and biased

Trump’s attacks on judges began during his campaign, when he accused Indiana-born California Federal District Judge Gonzalo Curiel of bias against him due to Curiel’s Mexican heritage and Trump’s blatant anti-Mexican rhetoric. Trump attacked Washington Federal District Judge James Robart as a “so-called judge” when he stayed Trump’s first travel ban, inviting criticism even from Trump’s own Supreme Court nominee. Now Sessions has attacked Hawaii Federal District Judge Derrick Watson for staying his second travel ban. All of these judges hail from reliably blue states. Notably, the judge in purple (formerly red) Virginia did not receive the same criticism. Sessions and Trump have not criticized red state judges who ruled against their policy preferences. Yesterday, the 5th Circuit Court of Appeals, the most conservative in the country, ordered Texas to pay $600,000 to the couples who fought their marriage ban. Likewise a Federal District Judge in Texas threw out Texas’s congressional redistricting map under the Voting Rights Act, which Sessions does not support. Trump and Sessions are not only attacking the judiciary – they are attacking the legal and political perspectives and rights of states held by the political opposition.

Sessions’s announced policies would endanger many residents of blue states and cities

The Trump Administration, particularly Jeff Sessions, has not stopped at attacking Blue State judges. He is reviewing consent decrees with police departments in Baltimore and Chicago – which are widely supported by the communities – saying that it is not the Justice Department’s job to intervene in this way, and it would rather enact policies to “support” the police. Fourteen cities across the country are under Obama-era consent decrees and are designed to reverse abuses in overwhelmingly Democratic and minority-dominated communities where the police have been particularly abusive. The consent decrees don’t exist in every city; they are designed to intervene to protect the civil rights and bodily safety of citizens who are put at risk by state government. His announced policy of reversing them can only be described as punitive to the most vulnerable urban citizens, who also happen to be the most reliable Democratic constituency.

Sessions has threatened economic attacks on blue states

Sessions has threatened to revoke federal funding for sanctuary cities, which decline to allow the federal government to deputize local law enforcement to carry out federal mandates. These cities are almost universally run by Democrats and mostly found in Democrat-run states. These cities have the legal right to refrain from participating in Sessions’s immigration roundups.  It is a part of the separation of powers.  The federal judge hearing a challenge to this policy has already expressed skepticism. So in this case, a former Southern “state’s rights” Senator is cracking down on state prerogatives to economically punish the states and cities run by the political opposition. Sessions’s economic punishment doesn’t end there. The Trump Administration’s extremism on immigration and deportation has led them to attack H1-B visas, which Silicon Valley and many New York companies rely on to import the educationally qualified workers from India and East Asia they cannot find in the US. These visas are not a threat to US workers; there are not enough Americans to meet employers’ needs. There is no valid reason for Trump’s attack. Sessions has also attacked marijuana legalization – a Democratic initiative primarily found in blue states. Major marijuana industries have sprung up in California, Oregon, Washington, and Colorado, and they are likely to spread. By attacking legalized marijuana, Sessions is really attacking the economies of liberal states who have legalized it.

Attacking the safety of residents, rights of states, and state economies constitutes a new level of partisan warfare

These policies are not like the North Carolina bathroom law. The Obama Administration may have been criticized for interfering with states’ rights in that case, but it did not attack the North Carolina economy or safety of its citizens (even the advocates of that law could never produce evidence its citizens were being harmed). Trump and Sessions have produced and promised policies that will actively harm minority communities harassed by problematic police departments, states who elect to be sanctuaries, and businesses who rely on immigrant workers or engage in the legal sale of marijuana. They have also regularly attacked judges in those states responsible for policing executive overreach. These policies are not a normal result of a change in political parties.  They reflect a polarization so extreme that the representatives of red America are waging war on the residents and businesses in Blue America.  We can hope that, as it becomes clear to Trump voters that he is not providing the jobs he promised, they will begin to realize that by attacking the coasts, which are the engines of the American economy, they are also hurting themselves.