Tag Archives: U.S. politics

U.S. still isn’t screening international arrivals!

In looking for that explanation of why some countries have largely dodged the coronavirus bullet while the U.S. is melting down, many people are focused on masks. I wonder if the almost total failure to screen airport arrivals could be the single most important factor. Thousands of plane loads of infected people from Italy landed in the U.S. northeast airports in February and March. The CDC’s screening and tracking protocols completely broke down, and it got out of control before there was any chance to contain it. Fast-forward to June, and they still aren’t effectively screening airport passengers!

Then we arrived in the US. No one at Dulles International Airport checked passengers’ temperatures. SAA had given each passenger health forms to fill in for the US authorities. No one asked for them. No sanitisers were on offer. No social distancing was practised in the immigration queues. People literally breathed down my neck. In Joburg the 2m apart rule was strictly observed.

At the immigration counter my passport was stamped and the very nice border policeman said: “Welcome to America.”

I waltzed over to baggage reclaim, got my luggage and left. I could have walked into the US coughing, sweaty and feverish and not a single authority would have known — they hadn’t bothered to do a basic check that I wasn’t indeed feverish.

JUSTICE MALALA: What three American airports taught me about Covid-19 and political leadership

Before it gets to the U.S. arrival, the article recounts the strict measures in place in South Africa (“one of the nations Trump included in the class of “shithole countries” – direct quote from the article). I’m not familiar with this person or publication, by the way, but it matches my experience traveling in Southeast Asia (Singapore and Thailand specifically) during the 2009 swine flu epidemic. Temperature screening and screening questionnaires were everywhere, beginning the moment I arrived at an airport, and continuing in shopping centers, on public transportation, etc. It was all polite and professional, but I knew that if I developed symptoms I would be taken to a government-run quarantine center for 14 days. (And as long as they had three meals a day and a decent internet connection, that didn’t sound like the end of the day!) Thailand and Singapore have both handled this pandemic very well. Thailand in particular is a middle income country with (until recently) a lot of back and forth travel to Wuhan, China.

You can argue that the “second wave” or “second peak” horror show now unfolding in the U.S. can be pinned on poor state and local leadership, but the early failures of airport screening, tracking, and testing were squarely on the federal government’s shoulders, and they not only failed spectacularly compared to most other countries, they haven’t learned anything!

some numbers on police violence

U.S. police violence disproportionately affects black citizens, but U.S. police violence affects the population as a whole at much higher rates than other wealthy industrialized countries. The U.S. has a violence problem, and the police violence problem is one part of that.

American police forces killed three people per day in 2019, for a total of nearly 1,100 killings.

Those numbers are far higher than in other wealthy western countries.

In comparison, The Guardian newspaper reported in 2015 that there was a total of 55 fatal police shootings in England and Wales between 1990 and 2014. Only 15 people were shot fatally by German police in 2010 and 2011 combined, the newspaper reported. The U.S. population is about six times that of England and Wales, and four times that of Germany.

CNBC

It would be nice for the reporter above to do the math for the reader, but here it is. If England and Wales were the size of the United States, they would have around 25 fatal police shootings per year, and if Germany were the size of the United States, they would have around 30 per year. Compare these numbers to 1,000 in the United States!

Look at statistics for other types of violence (which I don’t have handy, but have looked at in the past) like assault, homicides, suicides, traffic/cyclist/pedestrian fatalities, and the picture is similar.

The U.S. has a violence problem. Why? I don’t know – I can list factors that almost certainly contribute to it, but I can’t tell you which ones are the pivotal ones. Racism is certainly one factor, although I would speculate that removing racism alone would not come close to solving the problem. Ubiquity of guns is certainly a factor, because it turns what could be minor altercations and mental health episodes and accidents into fatal ones. Related to the ubiquity of guns is a lot of hidden advertising created by the gun industry and the larger military-industrial complex (free guns, even actors and settings for movie and TV producers, so that stories with guns are cheaper to tell than stories without guns, and sometimes guns are a substitute for bothering to tell stories at all). Economic inequality, and the underlying inequality of opportunity, is almost certainly a root cause. Lack of a functioning mental health care system for most Americans (especially those who lack economic opportunity) is a root cause. Criminalization of some common types of substance use (especially among those who lack economic opportunity) is certainly a root cause.

Solutions: I am probably a broken record, if you have read my other posts. But end the war on drugs now, provide universal health care (including mental health care) now, and continue the long-term project of providing education and job skills to all citizens. Stop tolerating violent death as a result of outdated transportation and urban design choices, when better designs are out there free to copy.

Police reforms are a good idea too – I am just suggesting that police reforms alone are not the leverage point that will bring our violence rates in line with the world’s leading countries. Notice I’m not even saying “other leading countries”. The U.S. is a great and powerful country that has run out of gas and is coasting on its past success. We slipped from a leadership position to the middle of the pack, and now we are slipping behind the middle of the pack. Solutions are out there, if we choose to acknowledge our problems and accept that we might be able to learn from others.

perspectives on police violence

People, from activists to the police themselves, have differing perspectives on police violence. Trying to see things from someone else’s perspective, even someone you strongly disagree with, is the first step toward tolerance, and the first step toward maybe possibly changing someone’s mind.

Barack Obama made this statement on Twitter in response to George Floyd’s death:

…it falls on all of us, regardless of our race or station – including the majority of men and women in law enforcement who take pride in doing their tough job the right way, every day – to work together to create a ‘new normal’ in which the legacy of bigotry and unequal treatment no longer infects our institutions or our hearts.

Barack Obama

FiveThirtyEight discusses a poll (by the Pew Research Center) of police officers which indicates that most of them do in fact believe that they do their jobs in a fair and unbiased way, and that they are largely misunderstood. Black and female officers are somewhat more likely to dissent from this majority view.

In that survey, 67 percent of officers said they thought the deaths of black people in encounters with the police were isolated incidents, compared with 31 percent who said those deaths were part of a broader pattern. The public,3 by comparison, had almost exactly the opposite reaction — only 39 percent of Americans said the police killings of black Americans were isolated incidents, while 60 percent said they were part of a broader pattern. (More recent surveys of the public also indicate that around 60 percent of Americans think that these incidents are part of a broader pattern.)

FiveThirtyEight

Activists feel differently. Here is an article in the Intercept from Chenjerai Kumanyika, an activist based in my home city of Philadelphia.

A more historically informed and honest engagement with policing will have to confront a painful but urgent reality: The job of the modern police in America has been to reinforce a racist social order since its beginnings in the 19th century. Regardless of the good intentions of any individual police officer, the history, economic incentives, and culture of the police in every era, in every city in the United States, make this clear. 

Intercept

These viewpoints are all valid in the sense that they are based on some combination of evidence, personal experience, and sincere belief.

I still think a lot of issues between the police and African-American communities come down to the war on drugs, at least in the modern post-Jim Crow, post-redlining era. Think of Prohibition – outlawing something with an enormous demand raises its price so that the people providing it, newly criminalized, are willing to take up arms and engage in violence to realize the profits involved. In that situation, the government will either be too weak to enforce the law, or it will respond by arming and engaging in overwhelming force itself to stay in control. That is the story of Prohibition, of the drug cartels in Mexico and Central America, and of the War on Drugs. I believe the culture of the organizations charged with enforcing the law evolves to enable and rationalize the actions that are necessary to maintain control by force, and unfortunately bias against the people on the other side becomes part of that.

The way out is to end the War on Drugs once and for all. Then all the funding and weapons and violence will no longer have a purpose. The police-court-prison-industrial complex is a powerful organism and it will fight to preserve itself.

Philadelphia

As the protests, clashes between police and citizens, looting and arson continue in Philadelphia, I find myself thinking back to On the Run: Fugitive Life in an American City. A lot of the book is about the relationship between the police and citizens in Philadelphia neighborhoods, and specifically (although place names are thinly disguised in the book) one of the neighborhoods where the tear gas and rubber bullets were flying yesterday.

The story the book tells is one where young men grow up without much prospect of finding a job in the formal economy, and get involved in the informal drug economy as a way to earn an income. In the informal drug economy, there is no recourse to the authorities when someone is robbed or otherwise taken advantage of. There are robberies, assaults, and cycles of escalating revenge that wind up with the vast majority of men in some neighborhoods in jail, probation or parole. Once young men are in jail, they tend to come out harder than they went in, and they are even less likely to break out of the cycle.

To break this cycle, we should follow the evidence of what has been tried and worked, of course. But just using logic and system thinking, the most obvious and quick way to break this cycle would be to legalize drugs. Then there would be no driver for the violence. Legalize, tax, and use the proceeds to fuel substance abuse and mental health programs that have been proven to work. Or just set up a universal health care system that provides these things to all citizens.

Then there is the harder long-term project of providing cradle-to-grave (at least cradle-to-retirement) childcare, education, and job training to people so they have the ability to earn a living, and providing generous unemployment and disability benefits to all citizens if they can’t earn a living through no fault of their own. Childcare, education, health care, unemployment, disability, retirement. The process of building a stable, fair, and democratic society for the long haul would be a hard and long-term project, but other countries have figured out most of it and the United States could learn.

CDC in the ICU?

I’m not the only one disappointed in the CDC. The Lancet has a scathing editorial.

The US Centers for Disease Control and Prevention (CDC), the flagship agency for the nation’s public health, has seen its role minimised and become an ineffective and nominal adviser in the response to contain the spread of the virus. The strained relationship between the CDC and the federal government was further laid bare when, according to The Washington Post, Deborah Birx, the head of the US COVID-19 Task Force and a former director of the CDC’s Global HIV/AIDS Division, cast doubt on the CDC’s COVID-19 mortality and case data by reportedly saying: “There is nothing from the CDC that I can trust”. This is an unhelpful statement, but also a shocking indictment of an agency that was once regarded as the gold standard for global disease detection and control. How did an agency that was the first point of contact for many national health authorities facing a public health threat become so ill-prepared to protect the public’s health?

The Lancet

Well, you can read the rest for yourself, but the answer to the question is defunding and political interference.

the “Playbook for Early Response to High-Consequence Emerging Infectious Disease Threats and Biological Incidents”

Obama left INSTRUCTIONS for dealing with this exact situation. There almost have to be competent people in the federal government who were familiar with these instructions and did their best to implement them, but were stymied by incompetent managers or political cronies. There’s an alphabet soup of acronyms that is a little hard to decipher for the uninitiated, but a couple things stand out to me:

  • Early on in a significant outbreak outside the United States, the plan is to provide significant financial support, material support, expertise, and manpower support to both the World Health Organization and directly to the foreign country. This is a nice humanitarian thing to do, but is also the best defense against the outbreak reaching the U.S. and wreaking havoc.
  • Domestically, the federal government is responsible for figuring out how to screen, and quarantine if necessary, travelers arriving from foreign locations, whether those travelers are U.S. citizens or not (reminder: we are all the same species of semi-hairless virus-prone monkey).
  • The federal stockpile plays a key role, as does research and development on potential diagnostics, treatments and vaccines. These things are supposed to kick into high gear at the first sign of trouble. Again, sending materials and equipment abroad is supposed to be considered early on because that may be the best way to keep the outbreak from getting out of control.
  • The federal government is just generally supposed to provide crystal clear guidelines, communications, funding, materials and equipment and coordination to state and local governments and to the public throughout a crisis like this.

There was a plan, and at least some of these steps must already have been in motion and been shut down.

As you know, I try to avoid political statements on this blog, sticking closely to facts and consideration of potential implications of various policies and lessons learned for the future.

FAIL FAIL FAIL Trump you stupid asshole, you have the blood of 85,000 Americans on your hands as I write this and of course it’s not over. Obama for King 2020!

Joint Task Force – National Capital Region

The Joint Task Force – National Capital Region is the unified military command responsible for Washington, D.C. and surrounding regions if they become a “battlefield”. In other words, if there is an armed attack, or if all hell breaks loose for whatever reason, and civilian government functions break down. According to Newsweek, it has been activated.

JTF-NCR is responsible for what the military calls “homeland defense”: what to do in the face of an armed attack on the United States, everything from guarding Washington’s skies to preparing for the civil unrest that could occur if a nuclear weapon were detonated in the capital. But most immediate, JTF-NCR is charged with facilitating continuity of government, particularly moving civil and military leaders to secret locations were the order given to evacuate the city.

Newsweek

You would assume that the commander in chief has command over the commander of this unit, which would be comforting in even remotely normal times. But the commander of this unit does have the authority to take whatever steps he or she (it’s a he) deems necessary if there is no civilian oversight available.

It seems unlikely there are any missiles inbound. It seems entirely likely that the Covid/election season could be the time a foreign enemy could try a cyberattack or attack critical infrastructure like the electric grid – kick your enemy while they are down. Hopefully we are ready for that.

Newsweek was the first “main stream media” source of news I paid attention to when I became aware of current events sometime in middle school. I don’t know if it is still the credible source of information I considered it back then (or if I was right back then.) One questionable claim did catch my eye – “Federal officials in the nation’s capital expect a New York-like epidemic in the District, Maryland and Virginia, one that could potentially cripple the government.” Taking a look at that claim on the University of Washington modeling site, it doesn’t hold up. The entire Boston-to-DC corridor is in fact hard hit, but the death rate and hospital utilization rates in DC are peaking right about now (I’m writing on Saturday April 18, the Newsweek article is from Thursday April 16) and both are projected to start falling. Hospitals in the DC, Maryland, and Virginia are busy but not expected to be overrun like they were in New York, New Jersey, and Connecticut. So it’s not clear what evidence the “federal officials” cited above would lead to a projected “New York-like epidemic…that could potentially cripple the government”. Perhaps some of these officials are used to working from home anyway, like in a white house for example.

private equity and surprise medical billing

This article from Center for Economic and Policy Research (I admit I don’t know much about this organization) claims that private equity firms have bought up medical practices and intentionally insert out-of-network doctors into teams treating you at your in-network hospital. Members of Congress have introduced legislation to curb this, but the financial lobby has been too powerful to beat.

Private equity-owned physician staffing firms grow by buying up many small specialty practices and “rolling them up” into umbrella organizations that serve health care systems across the United States. KKR-owned Envision Healthcare with 69,300 employees, and Blackstone-owned TeamHealth with 20,000 employees, dominate the market for outsourced doctors’ practices. A team of Yale University health economists examined what happened when private equity-owned companies EmCare (part of Envision Healthcare) and TeamHealth took over hospital emergency departments.5 They found that when EmCare took over the management of emergency departments, it nearly doubled its charges for caring for patients compared to the charges billed by previous physician groups. The researchers also found that TeamHealth took a somewhat different tack. It used the threat of sending high out-of-network surprise bills for ER doctors’ services to an insurance company’s covered patients in order to gain high fees from insurance companies as in-network doctors.6 This avoids the situation where a patient gets stuck with a large, surprise medical bill, but it raises premium costs for everyone. In both cases, healthcare costs increase when outsourced emergency rooms and other physician services are owned by private equity firms.

My take: Campaign finance reform and Medicare for All, baby!

what happens in Vegas doesn’t stay in Vegas

Axios has some interesting stats comparing the demographics of Nevada today to the projected future of the U.S. as a whole.

  • The U.S. is on track to become minority white by 2045. Nevada is one of just 4 states that are already there.
  • Hispanic people are expected to make up 25% of the American population by 2045. They’re 29% of Nevada’s population today.
  • Immigration will likely be the backbone of the U.S.’ future population growth, and will likely hit record levels by 2045. Today, immigrants’ share of the Nevada population is the 5th largest of any state.
  • The vast majority of Nevadans live in urban areas, just as 89% of Americans are projected to by 2050, according to UN data.
  • At 10% of the population, Nevada’s black voting bloc is also significant. The U.S. will be 13% black in 2045.

the stats on Bernie Sanders’s health risks

Slate has an interesting article on health risks for someone Bernie Sanders’s age with Bernie Sanders’s known health condition. The author points out that these estimates can be done for Bernie because he has released a fair amount of health information (although still not everything the author would like), while the other older candidates have not.

  • His 12-month risk of a heart attack, stroke, or death is about 6%.
  • His risk of being hospitalized for any reason between now and November is about 30-35%.
  • His odds of surviving a first presidential term are about 65%, and his odds of surviving a second about 40%.