Pages

Wednesday, August 12, 2020

Health Care Reform Articles - August 12, 2020

Editor's Note -

 This blog posting has some unusually long, but unusually good articles. There is some extraordinarily good journalism going on these days.

 -SPC

College-Educated Professionals Are Capitalism’s Useful Idiots

How I got co-opted into helping the rich prevail at the expense of everybody else

Author of Evil Geniuses: The Unmaking of America: 
 

From my parents’ teenage years in the 1930s and ’40s through my teenage years in the 1970s, American economic life became a lot more fair and democratic and secure than it had been when my grandparents were teenagers. But then all of a sudden, around 1980, that progress slowed, stopped, and in many ways reversed.

I didn’t really start understanding the nature and enormity of the change until the turn of this century, after the country had been fully transformed. One very cold morning just after Thanksgiving in 2006, I was on the way to Eppley Airfield in Omaha after my first visit to my hometown since both my parents had died, sharing a minivan jitney from a hotel with a couple of Central Casting airline pilots—tall, fit white men around my age, one wearing a leather jacket. We chatted. To my surprise, even shock, both of them spent the entire trip sputtering and whining—about being bait-and-switched when their employee-ownership shares of United Airlines had been evaporated by its recent bankruptcy, about the default of their pension plan, about their CEO’s recent 40 percent pay raise, about the company to which they’d devoted their entire careers but no longer trusted at all. In effect, about changing overnight from successful all-American middle-class professionals who’d worked hard and played by the rules into disrespected, cheated, sputtering, whining chumps.

When we got to the airport, I bought a newspaper at the little bookstore there that contains a kind of shrine to the local god Warren Buffett and his company Berkshire Hathaway. In it I read an article about that year’s record-setting bonuses on Wall Street. The annual revenues of Goldman Sachs were greater than the annual economic output of two-thirds of the countries on Earth—a treasure chest from which the firm was disbursing the equivalent of $69 million to its CEO and an average of $800,000 each to everybody else at the place.

This was before the financial crash, before the Great Recession. The amazing real-estate bubble had not yet popped, and the economy was still apparently rocking. But it was becoming clear that an egregiously revised American social contract had been put in place, without much real debate. “This is not the America in which we grew up,” I wrote in a magazine column at the time, by which I meant America of the several very prosperous decades after World War II, when the income share of the super-rich was not yet insanely high. Since the 1980s, the portion of income taken each year by the rich had become as hugely disproportionate as it had been in the 1920s, with CEOs paid several hundred times more than the average worker, whose average income had barely budged for decades. “We’ve not only let economic uncertainty and unfairness grow to grotesque extremes,” I wrote, but “also inured ourselves to the spectacle.”

I also thought: Mea culpa. For those past two decades, I’d prospered and thrived in the new political economy. And unharmed by automation or globalization or the new social contract, I’d effectively ignored the fact that the majority of my fellow Americans weren’t prospering or thriving.

In 40 years, the share of wealth owned by our richest 1 percent has doubled, the collective net worth of the bottom half has dropped to almost zero, the median weekly pay for a full-time worker has increased by just 0.1 percent a year, only the incomes of the top 10 percent have grown in sync with the economy, and so on. Americans’ boats stopped rising together; most of our boats stopped rising at all. Economic inequality has reverted to the levels of a century ago and earlier, and so has economic insecurity, while economic immobility is almost certainly worse than it’s ever been.

What’s happened since the 1970s and ’80s didn’t just happen. It looks more like arson than a purely accidental fire, more like poisoning than a completely natural illness, more like a cheating of the many by the few—and although I’ve always been predisposed to disbelieve conspiracy theories, this amounts to a long-standing and well-executed conspiracy, not especially secret, by the leaders of the capitalist class, at the expense of everyone else. A Raw Deal replaced the New Deal. And I and my cohort of hippie-to-yuppie liberal Baby Boomers were complicit in that.

The Yuppies Versus the Proles

At a dinner during my first visit to Washington, D.C., in June 1972—on the very evening of the Watergate break-in, as it happened—a mod young Department of Education bureaucrat informed me that the liberal political era in America was ending. To a 17-year-old fresh from Nebraska looking forward to wearing my McGovern for President button to a White House reception with Vice President Spiro Agnew the next day, this was a shocking revelation.

The guy turned out to be right, of course. And that fall, when I started college, I saw firsthand that the youthquake and student movement and greening of America, everything I’d spent the past few years getting stoked about, was palpably, rapidly ending. The Vietnam War was winding down and nobody was getting drafted, so fighting the Man started to seem like a pose. My senior thesis argued that more and more white-collar jobs, thanks in part to technology, were apt to become more and more proletarian, and it discussed whether workers in such professions might follow the lead of federal air traffic controllers, who had recently unionized.

But I wasn’t romantic or quite as enthusiastic about unions as liberals and Democrats used to be. In fact, the basic college-educated-liberal attitude toward unions was evolving from solidarity to indifference to suspicion, the result of a crack-up at that very moment of the old New Deal political coalition. The antiwar movement and counterculture, coming right after the successful civil-rights movement, had generated intense mutual contempt between the two main kinds of white Democrats, members of the working class and the expanding so-called New Class. The televised beatings by Chicago police of protesters outside the Democratic convention in 1968—beatings encouraged by Mayor Richard Daley, the principal national white-working-class Democratic power broker—was the most spectacular early episode in the crack-up, though there were others, most notably an organized attack in New York City by union construction workers on young antiwar protesters, in May 1970, that became known as the Hard Hat Riot. Plastic hard hats became a nationalist antiliberal symbol.

Beginning right then, the suspicion and contempt between less-educated white people and the liberal white bourgeoisie became what the American class struggle was most visibly and consciously about. And it would define our politics as the economy was reshaped to do better than ever for yuppies and worse and worse for the proles.

Demonstrators and police at the 1968 Democratic National Convention. (Getty)

During the 1960s, liberals had also started falling out of love with unions for reasons more directly related to political economics. It was a side effect of the long triumphalist liberal complacency, how Americans in general were taking for granted the progress and prosperity that the New Deal had helped make possible. Sure, an emerging liberal consensus had it, back in the day unions had been an essential countervailing force to the capitalists, but now—having won 40-hour workweeks, good health care, good pensions, autoworker salaries of $75,000 (in 2020 dollars), the Occupational Safety and Health Administration, and the Equal Employment Opportunity Commission—organized labor was victorious, powerful, the establishment. As a result, as the former machinist Irving Kristol wrote at the beginning of 1970, just before publicly moving full right, “trade unionism has become that most dangerous of social phenomena: a boring topic,” and “none of the younger reporters is interested in spending so much time in the company of trade union officials.”

Another reason people like me found unions kind of boring was that a unionized job was almost by definition a boring job. When I started work as a writer at Time in 1981, I joined the union, the Newspaper Guild, but I understood that everything I cared about in that job—good assignments, decent salary increases, titular honorifics—would be entirely at my editors’ discretion, not a function of collectively bargained rules. A union? Sure, fine. But I was talent. I was creative. I was an individual. College graduates tend to think of themselves that way, younger ones all the more, younger Baby Boomers at the time probably the most ever. And the intensified, all-encompassing individualism that blew up during the 1960s—I do my thing, and you do your thing—was not a mindset or temperament that necessarily reinforced feelings of solidarity with fellow workers or romantic feelings about unions.

How the Media Helped Kill the Labor Movement

What happened with organized labor in journalism during the 1970s is an excellent illustration of those early days of the deepening fracture between upper-middle-class and lower-middle-class (white) Americans. It encompasses both the cultural split (yuppies versus yahoos) and the introduction of transformative technology in the workplace.

Between the publication of the Pentagon Papers in 1971 through the end of Watergate in 1974, The Washington Post became a celebrated national institution, sexy liberalism incarnate. Following immediately on those two heroic achievements was another milestone episode, not very celebrated or heroic but likewise emblematic of the moment. In the spring of 1974, the journalists of the Post went out on strike—bumblingly. They didn’t even ask the paper’s blue-collar unions to join them, they refused their own Newspaper Guild leaders’ request to walk a picket line, the paper continued publishing, and after two weeks they gave up and accepted management’s offer.

It was a generation before websites and browsers, universal PCs and cell phones, 30 years before print dailies entered their death spiral, but technology was already changing newspapers in a big way, in the manufacturing part of the operation. Owners were eliminating typographers, who operated obsolete, elephantine Brazil-meets–Willy Wonka linotype machines that turned molten lead into blocks of type, and they also wanted to pay fewer people to operate the printing presses. A large majority of the Post’s 2,000 employees were those blue-collar workers, a large majority of whom were suddenly redundant. In 1975 the 200 pressmen wouldn’t come to terms and went on strike, and the other blue-collar unions at the Post went on strike in solidarity, as unions are supposed to do.

Absolutely key to how it played out was the behavior of the Post’s journalists. Just as the recent exposure of the secret Pentagon report on Vietnam and Nixon’s crimes had been game-changing work by journalists with the essential support of management, the crushing of the strike and pressmen’s union, also a game changer, was the work of management with the essential support of journalists.

Two-thirds of the Post’s unionized editorial employees didn’t stop working at all, and a majority voted again and again against striking in solidarity with the pressmen. “What I find ominous is that a number of Guild people don’t think they have common cause with craftsmen,” a Post journalist told a reporter at the time. “They feel professionally superior to guys with dirt under their fingernails.” At a guild meeting, a Post reporter referred to the striking pressmen as “slack-jawed cretins.” Four weeks into the five-month strike, a Times article reported that “if a Post Guild member is asked why he or she is not supporting the strike,” many “say they do not see themselves as ordinary working people. One said, ‘We go to the same parties as management. We know Kissinger, too.’” And while probably none of the pressmen knew the secretary of state, their average pay was the equivalent of $111,000, about as much as reporters, which is the excuse one of the paper’s reporters gave for crossing the picket line from day one. “If they got slave wages, I’d be out on the line myself,” said the 32-year-old Bob Woodward, co-author of the second-best-selling nonfiction book of the previous year.

The strike ended just before the release of the film adaptation of All the President’s Men, a fictionalization that only intensified the love of American liberals for The Washington Post, even though the Post pressroom was about to become nonunion. As a Post columnist wrote back then in The New Republic, “The pressmen’s strike was crushed with methods and with a severity that the press in general or the Post in particular would not be likely to regard as acceptable from the owners of steel mills. Yet because it was a newspaper management that broke the strike, no other newspaper has touched it properly, or even whimpered a protest.”

When I arrived at Time as a writer five years later, I went out of my way to produce copy the modern way—abandoning my office Selectric to use one of the special computer terminals crammed into a special little room, holed up with a few of the other young writers. That technology presently enabled the company to eliminate the jobs of the people downstairs who were employed to retype our stories. At the time I probably shrugged, like the newspaper reporters who hadn’t cared much about the redundant linotype operators and pressmen.

I think that if I had been one of those unionized craft workers who were abandoned by my unionized journalist colleagues 45 years ago, I would have watched journalists getting washed away and drowned by the latest wave of technology-induced creative destruction over the past 15 years with some schadenfreude.

What happened at newspapers (and magazines) back then also had disproportionate impact on this history of the right’s hijacking of America’s political economy, because once journalists were actively ambivalent about organized labor, that disenchantment spread more contagiously than if it had just been random young professionals bad-mouthing unions. News stories about labor now tended to be framed this way rather than that way or were not covered at all. Thus like most Democratic politicians at the same time, media people became enablers of the national change in perspective from left to right concerning economics.

During the 1930s and ’40s and ’50s, the right had derided liberal writers and editors as Communists’ “useful idiots,” unwittingly doing the Communists’ propaganda work; it looks in retrospect as if, starting in the 1970s, a lot of them—of us—became capitalists’ useful idiots. A huge new cohort of college-educated liberal professionals got co-opted.

From New Deal to New Democrats

My political coming of age coincided neatly with this process of assimilation.

One afternoon in the summer of 1971, at age 16, I was among 100 or 150 people in Omaha’s big central park watching Senator George McGovern deliver a speech. He was the most liberal, most antiwar candidate for the Democratic nomination. I remember nothing of what he said, because I was furtively inching toward and trying to overhear the two men standing near me: the 34-year-old actor Warren Beatty and McGovern’s 34-year-old campaign director, Gary Hart, whom I also recognized because I was a politics geek and a McGovern volunteer.

McGovern had led the Democratic Party commission that had just democratized the process of nominating presidential candidates, making it a matter of winning citizens’ votes in primaries rather than delegates’ votes at closed state party conventions. Which meant that from then on it was much harder for labor unions to influence the Democrats’ choice of nominee—which in turn enabled Hart to help win the 1972 nomination for the hippie-loving, antiwar, women’s-lib, “acid, amnesty, abortion” candidate despised by so many of the blue-collar union members.

Immediately after the 1972 wipeout, Hart launched his own political candidacy, for a U.S. Senate seat in Colorado. The Vietnam War and its cultural effects had made leaders and members of unions dislike McGovern, but as a child of the Depression and a former history professor, he had totally been on their side concerning the whole point of unions—maximizing worker power versus corporate power. Hart, on the other hand, was a cool young Yalie whose 1974 Senate campaign stump speech was actually called “The End of the New Deal.” He disparaged liberals who thought that “if there is a problem, [you] create an agency and throw money at the problem,” who “clung to the Roosevelt model long after it ceased to relate to reality.” In that first post-Watergate election, Hart beat the Republican incumbent by a landslide and became the very model of a modern major Democrat.

I felt some affinity for this new, youthy, college-educated political wing—as I felt at the time for postmodern architecture and New Wave music. I was in my 20s, so partly it was the sheer hubris of the young, rejecting the older generation because it was old. The slogan for Hart’s Senate campaign, even though he was a decade older than the oldest Baby Boomer, was “They had their turn. Now it’s our turn.”

But more than that, I actually, earnestly considered myself, as Hart put it, “a new breed of thinker questioning old premises and disregarding old alliances.” I wanted to be counterintuitive, contrarian, evidence based, ready to look at everything afresh. Like so many in my generation, I learned from the war in Vietnam and the war on drugs to mistrust the government, so maybe in other ways it had gotten bloated and inefficient, maybe nitpicky regulations were making it too hard to do business, maybe the antitrust approach invented in my great-grandparents’ day was outmoded. And weren’t labor unions retrograde and lumbering in lots of ways?

And thus the new buzzword that spread like mad during the 1970s and ’80s through art and culture, postmodernism, acquired a younger sibling in American politics—neoliberalism. Back then, at least in the United States, neoliberalism wasn’t yet what it is in the 21st century, certain leftists’ all-encompassing derogatory term for anything to the right of state-owned-everything socialism. Rather, it was a term proudly self-applied by a certain kind of U.S. political wonk. The notion, certainly among many writers and thinkers, if not necessarily the politicians, wasn’t to pursue centrism or moderation for their own sakes, or political triangulation between left and right, but intellectual rigor and honesty.

The new approach propagated rapidly. Soon almost every up-and-coming national Democratic politician was a New Democrat: Hart, Paul Tsongas, Jerry Brown, Bill Bradley, Al Gore, Bob Kerrey, Bill Clinton—all first elected senator or governor between 1974 and 1984 when they were in their 30s, all about to become serious presidential candidates.

For two generations, liberals had been in control of the government and the news media and the culture, so it seemed as if that hegemony afforded them the luxury of true liberalism—admitting mistakes, cutting some slack for the other side, trying new approaches. For 44 of the previous 48 years, Democrats had controlled both houses of Congress, and they had also held the presidency for most of that half century. All through the 1970s, when the GOP had only about a third of Senate seats, a third of that small Republican minority were bona fide liberals. Of course good-faith compromise and consensus between left and right were possible.

Which helps explain why almost nobody foresaw fully the enormity of the sharp turn America was about to take. Nobody knew that we’d continue heading in that direction for half a lifetime, that in the late 1970s big business and the well-to-do were at the start of a 40-year-plus political winning streak, economically, at the expense of everyone else.

Liberals were ill-prepared to appreciate or cope with what was about to happen. The suddenly energized economic right was led by a confederacy of corporations and the rich as well as zealots who’d been shut out of real power for decades. Modern liberals prided ourselves on entertaining all sorts of disparate policy ideas for improving the world, whereas the economic right really has one big, simple idea: Do everything possible and anything necessary to let the rich stay rich and get richer, and big business to stay big and powerful and get more so.

Most liberals, like most Americans, preferred not to regard capitalists as categorically rapacious and amoral, or to imagine the U.S. political economy as a never-ending struggle in which everyone must ultimately choose between two sides. That seemed crude. They didn’t vote for Reagan, but most didn’t hate him, certainly not at first, because in their way they shared his dreamy faith in the 1940s Frank Capra movie vision of America. And to some degree, most liberals succumbed, like most Americans, to a new form of economic nostalgia that was being revived and popularized—the notion that market forces are practically natural forces with which we dare not tinker or tamper too much. Finally, affluent liberals didn’t want to think badly of all their nice friends and neighbors and classmates who happened to work at banks or in real-estate development or in the vicinity of C-suites.

Starting in the 1970s, the Milton Friedman Doctrine, the righteous pursuit of maximum profit to the exclusion of absolutely everything else, freed and encouraged businesspeople and the rich to be rapacious and amoral without shame. Indeed, the new economic right even encouraged them to wage a class war—explicitly against (traitorous white) liberal professionals and the (black) “underclass,” more discreetly against the (white) working class they were enlisting as political allies. Such a colossal irony: After Socialists and Communists in the 1930s and then the New Left in the 1960s had tried and failed to achieve a radical class-based reordering of the American political economy, the economic right took its shot at doing that in the 1970s and ’80s and succeeded beyond anyone’s wildest hope or fear.

Joseph Schumpeter was a brilliant economist at Harvard in the first half of the 20th century who celebrated entrepreneurs but also thought that capitalism as it existed would collapse and be replaced by some new social-democratic system—not through workers’ uprisings but by means of a subtle, nonviolent process. The “perennial gale of creative destruction” would drive this evolution of advanced economic systems, he wrote (without italics) in 1942, right after the Great Depression. “This process of Creative Destruction is the essential fact about capitalism.”

I feel sorry for Schumpeter, who died in 1950, because three decades after his death, with the rise of newfangled old-fashioned free-market mania, he got famous when that phrase was revived and reduced to a meme, repeated endlessly to explain and justify the sudden obsolescence of blue-collar production workers (and then the lesser white-collar workers). Creative destruction was popularized in a way Schumpeter hadn’t meant it, as a celebratory sorry-suckers catchphrase for rootin’-tootin’ Wild West American capitalism as a permanent condition, where the rich and tough and lucky win and the losers lose hard. In the 1980s the term and its distorted meaning were enthusiastically embraced by the right and accepted with a shrug by college-educated liberals whose livelihoods didn’t look likely to be creatively destroyed anytime soon by competition from computers or foreigners.

We liberals had heard of Schumpeter, and we knew a bit about the industrial revolutions at the turns of the previous two centuries, and had learned in college to take it as a truism that painful transitions like these were just how history and economic progress inevitably unfolded, and that after a difficult patch—for the actual, you know, workers, in what we started calling the Rust Belt—things would sort themselves out.

That long view, however, tended to omit the history that had made the previous industrial revolutions come out okay in America—the countervailing forces that took a century to build, all the laws and rules and unions and other organizations created to protect citizens and workers and keep the system reasonably fair and balanced. And it was exactly this web of countervailing forces that, at exactly that moment, were being systematically dismantled by the right.

The Discreet Solidarity of the Bourgeoisie

By the 1980s, unions had been reduced to desperate parochial struggles to save jobs in declining heavy industries and, as mistrust of government grew, to unionizing more government employees. Moreover, the mainstream left offered no distinct, inspiring, politically plausible, national economic vision of a fairer future, as it had back in the 1930s and ’40s. In response to economic Reaganism, liberals were committed to preserving the social-welfare status quo for old people and the (deserving) poor, and to convincing America that Democrats were now modern and pragmatic, not wasteful bleeding-heart suckers or childish protesters or comsymp fools. Very few believed anymore that a term FDR used in his 1944 Economic Bill of Rights, unreasonable profits, could even be a thing.

The faction that was now dominant in the Democratic Party had been pushing for a more centrist economic and social-welfare policy since the 1970s, but the Republican Party after 1980 had no comparable moderating faction—which in a two-party system meant that Democrats kept moving toward a center that kept moving to the right.

Like most people in my milieu, I always voted for Democrats, and I wasn’t anti-union or anti-welfare or anti-government. The probability that elected Democrats would tend to increase my taxes wasn’t a reason I voted for them, but my indifference to the financial hit felt virtuous, low-end noblesse oblige. However, even after the right got its way on the political economy around 1980, many people like me weren’t viscerally skeptical of business or Wall Street either. Big businesses—various media and entertainment companies—paid me well and treated me fine, which probably didn’t sharpen my skepticism toward a political economy that was being reordered to help big business (and people like me). When it came to the millions of losers, I felt grateful that my work couldn’t be automated or offshored or outsourced, and I thought, Creative destruction, invisible hand, yada yada, and voted for politicians who said we should retrain steelworkers to become computer programmers.

Although very few people I knew voted for Reagan, affluent college-educated people, liberals and otherwise, tended not to disagree ferociously about politics in the 1980s and ’90s, and certainly not about economics. In retrospect, the rough consensus about economics looks like the beginning of an unspoken decades-long class solidarity among the bourgeoisie. Affluent college-educated people, Democrats as well as Republicans, began using the phrase socially liberal but fiscally conservative to describe their politics, which meant low taxes for higher-net-worth individuals (another new term) in return for tolerance of . . . whatever, as long as it didn’t involve big new social programs that affluent people would have to pay for. It was a libertarianism lite that kept everything nice and clubbable and it did at least have the virtue of ideological consistency.

When Gary Hart ran a second time for president, in 1988, one of his tax-policy advisers was Arthur Laffer, Reagan’s inventor of supply-side economics. When Jerry Brown ran for the 1992 Democratic nomination, he too sought Laffer’s help, to devise some kind of tax scheme “that was clear and easy to articulate,” and Laffer himself says he voted for Bill Clinton. (He’s now a Trump adviser.) The Democratic Leadership Council, co-founded by Clinton in 1985, became a think-tankish anchor for Democrats who didn’t disagree with Republicans that pretty much the only acceptable new solutions to any social problem were market based.*

For the remainder of the century, no candidate from the Democratic left became a plausible finalist for the nomination. In 1992, when Clinton won the nomination, his only serious competitors were two fellow New Democrats, Brown and Tsongas. Democrats had settled into their role as America’s economically centrist party. There was no organized, viable national economic left in the vicinity of serious power. The collapse of the Soviet Union and Communism at the beginning of the 1990s was very good news, but it had the unfortunate effect of making almost any left critique of America’s new hypercapitalism seem not just quixotic but also kind of corny and quaint.

Not everybody in the 1990s was sanguine about the emerging future, or as oblivious as I still was to the multi-faceted unfairness that had been built into the economy, or as complacent as I was about the millions of Americans losing out in the go-go globalizing digitizing frenzy. Around this time, a middle-aged law-school professor and bankruptcy expert, until recently a registered Republican who’d been affiliated in the late 1970s with the conservatives’ hugely influential new Law and Economics movement, began to see the light. Elizabeth Warren has said that she realized only in the ’90s that “starting in the ’80s, the cops were taken off the beat” in financial services. “I was with the GOP for a while,” she has said, “because I really thought that it was a party that was principled in its conservative approach to economics and to markets. I feel like the GOP just left that. They moved to a party that said, No, it’s not about a level playing field. And they really stood up for the big financial institutions when the big financial institutions are just hammering middle-class American families.”

I’m betting that at the end of 1999, Warren didn’t feel complete solidarity with all the thousands of demonstrators in Seattle outside the biannual World Trade Organization meeting. Their grievances were various—from AFL-CIO folks pissed off about U.S. companies manufacturing more and more things overseas to anarchists smashing store windows and otherwise acting out their hatred for the System. I know I rolled my eyes at the Gen-X kids in Seattle chaining themselves together and getting off on tear gas; at their lack of a feasible agenda or nuance or even coherence; and at the belief of so many of them in a shadowy, multi-tentacled conspiracy of the omnipotent elite to tyrannize the little people and subvert democracy. It took me a few more years to realize that their caricature of the new economic paradigm was closer to right than wrong. What that new paradigm ultimately brought us, of course, is Donald Trump.

How the Rational Right Begat the Madness of Trump

Back in the early ’70s, when the band of intellectuals and CEOs and politicians and the rich began pursuing their dream of hijacking the U.S. political economy and dragging it back in time to the days before the New Deal, surely none of them imagined they’d wind up here. Neither with the scale and durability of their victory, nor with such a front man—so brazenly racist and xenophobic and misogynistic and proto-fascist, a businessman so completely incompetent as an executive. Over the decades, however, as they decided again and again that their ends (money, supremacy) always justified any and all means (stoking hatred, spreading falsehoods, rousing their rabble while also rigging the system against them), it was bound to end somewhere in this horrid vicinity. In 2016, as the current generation of Fausts made their darkest bargain yet, surely some of them smelled a whiff of sulfur or heard a demonic cackle as they signed away whatever remained of their souls.

The obeisance of the rich right and their consiglieri to Trump for the past four years has exposed more nakedly than ever their compact—everything about money, anything for money—and the events of 2020 pushed that along to an even more hideous crescendo. In early spring, when COVID-19 had killed only dozens of Americans, Stuart Stevens, a strategist for the four previous Republican presidential nominees, wrote that “those of us in the Republican Party built this moment,” because “the failures of the government’s response to the coronavirus crisis can be traced directly to some of the toxic fantasies now dear to the Republican Party … Government is bad. Establishment experts are overrated or just plain wrong. Science is suspect.”

Entirely apart from this administration’s unique incompetence and Orwellian denial of facts, while its handling of the pandemic may wind up as a political failure for them, every piece of the crises’ exacerbation came directly out of the right’s playbook of the past four decades. Stevens could have also listed Believe in our perfect mythical yesteryear, Short-term profits are everything, Inequality’s not so bad, Liberty equals selfishness, and Entitled to our own facts.

Government is bad. A Republican administration uniquely unsuited and unready and unwilling to deal promptly and effectively with such a national crisis? Decades before this latest show-business president defamed his entire executive branch as a subversive “deep state,” the co-creator of late Republicanism announced in 1981, a few minutes after becoming the first show-business president, that “in this present crisis, government is not the solution to our problem, government is the problem,” and then made a shtick out of warning Americans to consider any offers of help from the government “terrifying.”  

Believe in our perfect mythical yesteryear. The right twisted and exploited nostalgia in the 1970s and ’80s to get its way, selling people on a restoration of old-time America with storybook depictions that omitted all the terrible parts of the past—including the epidemics before we had a U.S. public-health system and before government-funded vaccines that governments required citizens to get, the economic panics and collapses before governments intervened to help unemployed workers, the phony miracle cures marketed by huckster showmen before government put a stop to that.

Establishment experts are wrong, science is suspect. Since the 1980s, the oil and gas and coal industries have conspired with the right to encourage Americans to disbelieve the climate-science consensus, because that science created pressure to mitigate a global crisis with government interventions that could reduce those businesses’ profits. From the start in 2020, the reckless right, the president in the lead, encouraged Americans to disbelieve virologists and epidemiologists and other experts in order to achieve their overriding goals of keeping stock prices and corporate profits up.

Entitled to our own facts. That systematic spread of coronavirus misinformation by Trump and the right couldn’t have happened without the creation in the 1980s (Rush Limbaugh) and ’90s (Fox News) of big-time right-wing mass media. Their continuous erasure for two generations of distinctions between fact and opinion and truth and fiction have always served the propaganda purposes of the political party most devoted to serving the interests of big corporations, and during the COVID crises—Reopen Now—tried to serve those business interests directly.

Short-term profits are everything. Years of reckless greed by Wall Street and financial operators dragging healthy companies into leveraged buyouts, and piling on so much debt they become weak, rendered them barely able to survive in normal times. Excessive corporate debt turns out to be a main underlying condition comorbid with the economic effects of the pandemic.

Liberty equals selfishness. After the right spent decades forging a tantrum-based politics focused on sensible rules that reduce unnecessary deaths and sickness—No gun control! No mandatory vaccinations! No universal health insurance!—of course mobs of childish adults in the spring and summer of 2020 were excited to throw self-righteous tantrums on TV about the mean grown-ups grounding them and telling them to wear stupid masks. While also playing soldier by carrying semiautomatic rifles in public.

Inequality’s not so bad. The glaring new light of the pandemic showed what we’ve become—the health risks and the economic burdens borne disproportionately by people already near the financial edge, Black people, and people with low-paying jobs that can’t be done from home.

Countries with better social contracts and more effective national governments promptly put strict pandemic protocols in place and have COVID death rates running at a third, a quarter, or just 2 percent of America’s. They also straightforwardly and immediately addressed the massive economic consequences, without much political rancor, because providing good social-safety nets to try to protect everyone from economic disaster is simply what governments do.

A New World Again

Before this fresh hell, our political economy and society were already at an inflection point, Americans stuck uncomfortably and often dysfunctionally on the cusp between searching for lost times and imagining a better future. We have now arrived at a scarier place. But it’s not exactly unprecedented. We’ve been here before.

We were in a place like this when my grandparents were young, in the 1910s.

There was the global influenza epidemic, of course, which killed one in 150 people in the United States, the equivalent of 2 million Americans now. But in many other ways, those early 1900s look remarkably like the early 2000s.

Corporate mergers and consolidation had accelerated and political corruption by the rich and powerful had become extreme at the end of the 19th century. A Wall Street crash occurred in 1907. Americans experienced an extraordinary period of technological change—electrification, telephones, movies, airplanes, and cars, all at once. The foreign-born population of the United States reached 15 percent, up from 5 percent just a half century earlier. The influx of non-Protestant foreigners and the mass migration into U.S. cities of Black people, accompanied by skillful racist fictions in a riveting new medium (The Birth of a Nation), prompted a revival of the Ku Klux Klan. Political engagement was high: The big turnout in the midterm elections of 1914 wasn’t exceeded until … 2018.

Back then as now, anarchism was bubbling up on the right as well as the left in America, along with a general “sense of conspiracy and secret scheming,” as the young political journalist Walter Lippmann put it in 1914. Lippmann noted the rise of nostalgic anti-modern anger and its political embodiment by the populist Christian fundamentalist William Jennings Bryan, who’d just been a presidential nominee for the third time.

Twenty years after that, in the 1930s, when my parents were young, we were also in a place not unlike the one we’re in today. The Depression revealed the precariousness and unnecessary unfairness of our economy, then prompted a great political paradigm shift and the creation of fundamental changes that redeemed American capitalism by making it new and improved and more sustainable.

And we were in a place a little bit like this when I was young, in the 1970s. Crazy inflation and various disconcerting large events—the oil-price crisis, Watergate, the defeat in Vietnam, the collapse of iconic U.S. manufacturing—combined to create high anxiety of which the economic right took brilliant political advantage.

Today’s economic right was instantly determined to exploit the pandemic crises to maintain and increase their political and economic power, and thus the share of American wealth that flows to big business and the rich. So, too, must the economic left try to use the crisis to increase its political power and thereby begin to restore the democratic sharing of economic power and wealth we had as recently as the 1970s, and improve on it. And Americans at large need to rediscover the defining but atrophied national knack for taking up the challenges of the new in new ways.

We can already see how the pandemic will change the economy, the culture, and daily life temporarily. We will continue adapting and adjusting. But the permanent changes? For one thing, I’m betting that a jobless super-automated future will arrive even sooner than experts have been predicting. In just the past few months many of us have become habituated to working only from home by communicating only with little talking pictures of human colleagues. That’s why this week, when the overall Dow Jones stock-market average was back up 43 percent from its early-pandemic low, the Big Tech stocks were doing fantastically well—Netflix up 68 percent, Facebook up 75 percent, Amazon up 87 percent, Apple up 95 percent. Websites and AI and robots don’t get sick or sicken people or worry about getting sick.

But we really don’t know where the national experience of the pandemic will lead us—the overnight upending, the long trauma, judging how individuals and institutions and systems worked or failed. People in 1918 and 1929 and 1970 (and 1347, as the Black Plague began) had no clue what was coming next, either. Will my hypothetical grandchildren grow up as ignorant of the current events as I was of the global viral pandemic my grandparents survived? For Americans now, will surviving a year (or more) of radical uncertainty help persuade a majority to make the necessary radical changes in our political economy to reduce Americans’ unnecessary chronic uncertainty and insecurity? Like Europe after the plague 600 years ago, will we see some fantastic flowering of new creative works and the emergence of a new economic system? Or will Americans remain hunkered forever—as confused and anxious and paralyzed as we were before 2020—descend into digital feudalism, and retreat back into our cocoons of nostalgia and cultural stasis, providing the illusion that nothing much is changing or ever can change?

The United States used to be called the New World. It’s a new world again, maybe the way it was becoming new in the 1910s. Lippmann was pragmatic, in many ways conservative, in no way a utopian, but back at that chaotic, pivotal moment he quoted Oscar Wilde’s line that “a map of the world that does not include Utopia is not worth even glancing at,” because social progress only comes by navigating toward hopeful visions of perfection. “Our business is not to lay aside the dream,” Lippman explained, “but to make it plausible. Drag dreams out into the light of day, show their sources, compare them with fact, transform them to possibilities … a dream … with a sense of the possible.” He also wrote that the urgent national inflection-point struggle a century ago was “between those who are willing to enter upon an effort for which there is no precedent, and those who aren’t. In a real sense it is an adventure.”

So let’s go already.

https://www.theatlantic.com/ideas/archive/2020/08/i-was-useful-idiot-capitalism/615031/ 

The Hive Interview: Can We Undo the GOP’s Decimation of America?

Evil Geniuses author Kurt Andersen unravels how the right helped create a wildly inequitable society—and how Americans could hold the government accountable for overlooking their economic interests.

 by Joe Hagen - Vanity Fair - August 10, 2020

In his new book, Evil Geniuses: The Unmaking of America: A Recent History, writer and public intellectual Kurt Andersen describes a kind of secret history that happened in broad daylight: Starting in the early ’70s, he writes, a band of conservative economists and pro-business groups, terrified of the progressive movements of the 1960s, drew up plans and blueprints for a version of America in which big corporations and Wall Street would be liberated from regulation and labor unions and antitrust laws, allowing the free market to sort out the winners from the losers. Their ideas powered the Reagan Revolution of the ’80s and over the next three decades reengineered the American economy to favor Wall Street and fatten the wealthy, resulting in a wildly inequitable society and the violent convulsions of the Trump presidency.

“My ‘evil geniuses,’ the economic right, who really kept their eye on the ball and always keep their eye on the ball, let the rich get richer,” he says. “Lower taxes are everything. The power of big business to do what it wants is key and paramount and overrides everything else. But to get what we want and to be politically successful, we’re going to have to have as our allies this rabble. These white working-class people, these racists. That started in the 1960s and hasn’t stopped, and here we are with Donald Trump. That Faustian bargain maybe has come due, and maybe the evil geniuses will now, at least some of them, go to hell.”

This week Andersen joins special correspondent Joe Hagan for an in-depth conversation on Andersen’s virtual autopsy of recent history, including the role of toothless Democrats and the “liberal useful idiots” who not only cooperated in the great bamboozlement, but benefited from it—including, Andersen admits, himself.

Vanity Fair: Your last book, Fantasyland: How America Went Haywire: A 500-Year History, posited that the 1960s revolutions, the liberation movements, the birth of the modern individual in American society, engendered this revolution that indulged more freely in woo-woo thinking and conspiracy thinking and fact-free beliefs about reality, [and that] led us to this moment where we have a lying reality-TV-show president. Now you have this new book, Evil Geniuses: The Unmaking of America: A Recent History, a perfect partner book to the last one. But it’s interesting to me that the theory of the book in itself posits possibly a conspiracy: that starting in the 1980s, and possibly a little bit before, the United States economy was totally reengineered to favor Wall Street and the big business and the 1 percent by this cabal of right-wing economic thinkers and big business interests. So here we are, indulging in a conspiracy, but this one’s…real?

Kurt Andersen: Well, I have had that thought myself. I realized halfway through this book exactly that. That although these are two volumes, as a friend of mine says, two volumes in the history of the “fuckening” of America, they are in conversation. One, they are companion volumes, and yes, as you say, a large part of Fantasyland is about the conspiracy-mindedness that has always been part of not only the American way of thinking, but of [the] human way of thinking. But [it] was one of the things that got out of control in and after the ’60s, and of course I still believe that most conspiracy theories are preposterous/ Let’s fast-forward to now and look at QAnon for instance.

But writing this book and doing the research and realizing how much of a coordinated, strategic long game was involved by these rich right-wing people and right-wing activists, zealots, and big business...We can talk about what is defined as a conspiracy, but this one certainly quacks, walks, and looks a lot like one. I mean, again, it was in plain sight—most of us didn’t pay very close attention, or put two and two and two and two together, to see the whole landscape of change that was being wrought in the ’70s and ’80s and beyond.

Well, that was the amazing thing about reading your book. It wasn’t a secret. There are a lot of things I didn’t know: that in the early ’70s, partly as a reaction to what was going on in the ’60s, the right-wing economic thinkers and big business minds began to think, Well, if “If it feels good, do it” is going to be their mantra, well, we’re going to do it too, except instead of rolling around in the mud at Woodstock, we’re going to roll around in cash. So it’s a whole different—but it’s a similar impulse perhaps, but going in [a] totally different direction. The thing that really struck me was, you describe it as “organized capital” contra “organized labor,” and it really was an idea about: Let’s get the business minds together and re-architect and campaign on our own behalves for the economy.

That’s exactly right. And by the way, that combination of “do your own thing,” “find your own bliss,” “seek your own truth,” and focusing on profit and capital and material, I think you wrote a biography of somebody who embodied both sides of that ‘60s thing. [Ed: That's Sticky Fingers: The Life and Times of Jann Wenner and Rolling Stone Magazine.] But yes, I’m sorry. Now that I made my joke about you, no wonder I lost track of what your question was.

Jann Wenner, always the conversation stopper. Well, the impulse that people think of as driving the antiestablishment, countercultural figures, these guys got together, let’s talk for instance about—

Organized capital.

That’s right. And “the Powell Memo.” These people that we didn’t know about. I didn’t, anyway. Lewis Powell, nominated to the Supreme Court [by Nixon]. Tell us about that.

Ronald Reagan campaigns for president in Los Angeles, 1980.By John T. Barr/Getty Images. 

Yeah, well, I heard about the Powell Memo some years ago, and among a certain category of journalists and academics and lefties, it has been well known for 20-odd years. It was a revelation to me because just whether or not it was the original scripture and playbook for this long game that the economic right played to take over and reengineer our system, in retrospect, given the success of that long game along exactly the lines described in 1971 in this 40-page memo, it’s an extraordinary forensic artifact. So this guy Lewis Powell, he was an establishment Democratic moderate, decorous lawyer of national repute in Virginia. Worked for the tobacco companies and all kinds of corporate clients on boards. Just a normal establishment figure. He, like so many people in that milieu and C-suites and the rest in 1970 and ’71, [was] freaking out about this antiestablishment, specifically antibusiness sentiment that Ralph Nader and the general public were buying into. It’s unfair. Corporations are not to be trusted. What had begun in the New Deal had suddenly become, to their eyes, kind of extreme in the late ’60s. What are we going to do to stop this? Maybe this talk of revolution is for real. Maybe the socialist revolution is nigh, they thought in 1970-71. So Lewis Powell in Virginia, age 60 or whatever he was, was talking to a neighbor about this and ranting over bourbon, no doubt, and the neighbor happened to be an official of the U.S. Chamber of Commerce and said, “Lewis, why don’t we at the Chamber of Commerce commission you to write a memo explaining this and explaining your plan to stop this socialist, left-wing, Ho Chi Minh-of-America takeover of the American way of life and the destruction of free enterprise.” “Why, I sure will.” And he did that and turned it in and, again, was a couple of months later nominated by Richard Nixon to be a Supreme Court justice. That is interesting and that’s why Lewis Powell is famous, of course. But I’m not postulating that, for instance, as part of any conspiracy.

So this moderate guy was suddenly immoderately hysterical about what was going on in the late ’60s. But because he was this skilled lawyer and strategist, and had been for 40 years, he laid [out] in this very skillful, lawyerly way: This is what we got to do. We’ve got to create these think tanks to take over the intellectual life as much as we can. We got to change the discourse in the media. We’ve got to organize business people and CEOs to be effective. Not just protecting their own company, but protecting and defending and asserting the importance of capitalism and profits. But he just lays it out, which was an extraordinary thing to do at that time, and certainly given that what happened bears a striking resemblance to what he laid out in the summer of 1971 is amazing…I don’t really consider myself a real historian in doing primary research, but I did discover this very, very little-known speech of his that preceded that memo, the Powell Memo, as it’s now called, that he had given a year ago, which is even more hysterical about: “Oh, my God, ‘the Greening of America.’ It’s crazy, they’re going to take us down.” He didn’t quite say we’re going to be put up against the wall and shot, but…

So there he had it, and almost it was secret for a year, and then it was leaked to a newspaper columnist who talked about it and it wasn’t a big deal. But like, Oh, look this thing that Powell wrote a year and a half ago. But immediately, as soon as it became to that degree public, it became this truly founding scriptural document for Charles Koch, for instance, and all of the Charles Kochs of the world. The libertarian and right-wing people and general CEOs were suddenly liberated by: Now we have a mission. We have a doctrine. We have a document. We have a plan, a battle plan. So that was the beginning. And then there was so much I didn’t know, as I did the research, about in so many different realms of how to think about, how we should think or shouldn’t think about antitrust enforcement, and are monopolies good or bad?

Just all across the board, the way the conventional wisdom was pretty radically changed in America about fairness, basically, and about what the government should or shouldn’t do in terms of making the economy fair for most Americans. And they did it and they changed it, quickly. I mean, another memo that I knew nothing about was this one that was commissioned by a different...by a right-wing billionaire, Richard Mellon Scaife, in 1979 and was completed in 1980, [which] laid out even more extraordinarily, really beat by beat, how the right, the same economic right, should try to have influence in and, to whatever degree possible, take over the understandings of the law and the judiciary and jurisprudence in America.

Well, and a year later the Federalist Society is established, and the rest is history. So again, I am not, as you know, a conspiracist or conspiracy-minded. But you look at the evidence and the history, and it’s hard not to see that there was this extraordinary, brilliant effort in many different places to bring about this change. Also this thing called the Business Roundtable was founded right then in the early ’70s as well. The U.S. Chamber of Commerce was always the national business organization, but it consisted of thousands and thousands of companies large and small, and therefore all kinds of businesses belonged to it, had that power. But it was ineffectual because what does GE have in common with Dave’s Widget Shop over here.

So the CEOs of the biggest companies got together and said, “No, we need just us, just the 200 CEOs of the biggest companies, and instead of just being some public face and saying we believe in business, we need to get in there and fight the fight in Washington and lobby and threaten and be organized

capital.” My phrase, not theirs.

And you’ve pointed out in the book the big crucial year, watershed year is 1980, around the time that Reagan is going to come into office. He’s going to be the affable face and the salesman, really, of this new concentration of business minds and fellow travelers, from Milton Friedman to the Kochs, to name the people you’ve heard of now because they’ve all came to fame and power since. But the thing that really struck me reading your book was how important it was for them to do away with and ultimately crush the labor unions. How this was really to take away the bargaining power of the worker ends up being the most important block in all of this. Once you’ve got that out of the way, off to the races.

And I certainly at the time didn’t realize it. Of course I write about the history of growing, well, mutual attempts between young people like me, new young liberals coming of age in the ’60s and ’70s and ’80s, and labor unions and union members and essentially the educated white-collar cohort versus the unionized blue-collar cohort. Starting not over economic issues, of course, but over the war and the counterculture and all those late-’60s issues. We saw it, of course, in 1968 at the Chicago Democratic convention of Mayor Daley and his police beating up protesters. But there were other incidents like that, and that was the beginning of a big political fissure that we are still living with and dealing with obviously politically. I wasn’t anti-union, and I belonged to the newspaper guild at my first big journalism job at Time magazine. But unions, whatever, they’re old. They’re racist. They’re sexist. They were pro-war. Eh, the unions.

So that I call myself one of the liberal useful idiots. Not this time to the communists, as that phrase was originally used, but to the capitalist. Sort of allowing or at least looking the other way or shrugging about the crushing of the unions that took place very quickly and very successfully. I mean, the ground was softened in the ’70s, but then as soon as Ronald Reagan became president, crushed, really, truly crushed overnight one of the few labor unions, the air traffic controllers union, who had endorsed him for the presidency. That really just gave the greenlight to big companies to crush unions, to replace strikers, and do the whole range of things, [so] that within that decade, of the 1980s I mean, the labor movement and the labor unions of the United States as a key player at the table of the economy was just undone. Right.

Well, at this juncture I’m thinking about when I came into the workforce. It’s the mid-’90s at the dawn of the internet boom. All my assumptions about economics, about the stock market, about money in general, were received at that moment, right? I hadn’t done a lot of deep thinking about it in any way. So I came into the world thinking, Stocks go up, good, shareholder value. It was getting frothy. Everything was going crazy, and capitalism was taking on this “cool,” right? We were all a part of that. You talk about useful idiots. We were all indulging in it because it seemed like it was the post–Cold War inheritance that we won the game, all boats are rising. How were we wrong?

Well, we were wrong because we ignored the fact that the system—in all kinds of ways, many and probably most of them too tedious or obscure and abstruse to have paid much attention to—the system was rigged, was reengineered through tax codes, through regulation, deregulation, lack of antitrust enforcement. Of companies deciding, “No, we’re not going to give fixed pensions anymore.“ What happened to the health care industry and the resulting unaffordability of health care. On and on and on and on. All of which, all of which happened from 19, let’s say 78 to 1998. But especially in the ’80s. We ignored that because we were doing fine, basically is the answer. I was doing fine, you were doing fine, and we were enjoying ourselves, and this just seemed like the new reality. I mean, and part of my reason for writing this book is because I’m old enough that I at least experienced, up to the time I was, what, 25, the old system. I saw, and now having done my research, I see that this was a different, fairer system, especially since the New Deal in the ’30s, under which Americans were living. That was not only much fairer, much more economically equal, much more economically secure, but had become more so. And in 1976 had reached its top. In 1976, by the numbers and metrics, the United States was more economically equal than it had ever been. And hey, let’s celebrate. No, let’s twist all the dials so that it ceases to be so and starts becoming as economically unequal and insecure as it was a century ago.

Right. Well, and you and I were a part of a New York media world which sort of sent up all these power brokers who were getting super rich and living like pigs in the Hamptons and elsewhere. We were both on the margin of it and making fun of it. But even at the time, we were like, Wow, where does it end? This is crazy. And suddenly you started to see also working-class people, too, driving giant SUVs, and all of a sudden credit was all over the place and there was just this crazy ripening of the economy that was going on that turned out to be unsustainable. And Democrats—and this is a really important thing you point out in the book—were playing on the ball field of the GOP every time they got into power, right? If they had Congress or if they were in the White House—Clinton was a triangulator who basically paid lip service to their business values.

And really accepted that social problems can only be solved by market-based solutions. That was key. I mean, basically yes, Democrats and liberals on economics decided that they really didn’t disagree with Republicans. They became essentially liberal Republicans after liberal Republicans ceased to exist on economics. There was no party of the left on economics. And then of course the other important things that Democrats were distinctly and consistently to the left on, more or less, of matters of race and culture, sexuality and the rest, feminism and women’s rights and civil rights. That became the way in which they were distinct from Republicans, which if you are a hypothetical white working-class person, you look at the parties and go, “They’re pretty much the same on economics. They don’t give a fuck about me or the fact that my manufacturing job has either been automated or shipped to China or whatever.” Choose your legitimate reason to be an angry person like that. And then you’re like, what else? How are they different? How they’re different is maybe the Republicans don’t care about me, really. But the Democrats really care about other people than me. So there you have, that’s where we are politically.

Meanwhile, my evil geniuses, the economic right, who really kept their eye on the ball and always keep their eye on the ball, let the rich get richer. Lower taxes are everything. The power of big business to do what it wants is key and paramount and overrides everything else. But to get what we want and to be politically successful, we’re going to have to have as our allies this rabble. These white working-class people, these racists. That started in the 1960s and hasn’t stopped, and here we are with Donald Trump. That Faustian bargain maybe has come due, and maybe the evil geniuses will now, at least some of them, go to hell.

Continuing my Faustian trope, but we’ll see. But that’s what happened, and then people like me—I won’t drag you into this, but you’re of a different generation. But we were doing okay and we did accept the idea of regulating business and breaking up business and all the rest, the whole New Deal menu and more of how the balance could be maintained between workers and citizens, and the power of big business was broken. And we allowed it to be broken, those of us who were doing okay financially. I don’t want to go into the hyperbole of “because the rich people were giving us their leftovers or some crumbs,” but effectively that is what happened.

And I don’t think that everybody was paying attention to how the middle was getting hollowed out as the efficiencies of big business began to work their magic with automation and outsourcing and the rest. But 2008, the economic collapse, I feel like we’re only now finally coming to the final chapter of the ramifications of 2008. I’ve always noticed that it superpowered the conspiracy thinking that we’ve talked about. I mean, I remember when Alex Jones was on CNN as a guy they would bring on to actually talk about things, and he’s obviously a total nutjob…There was this angry reaction and it bifurcated into [the] Tea Party over here, Occupy [Wall Street] over here, but it was always there simmering [under] the surface. That’s where Trump comes in to exploit that. It’s interesting that it was Trump [on one side] and Bernie Sanders on the other side talking about trade, right? So I guess my question is, he took advantage of that, and the irony being that he was the caricature of the go-go’ 80s when all of this big business stuff blew up. And now he’s coming in to say, “I’m going to fix, undo, or otherwise assuage all the problems that I represented.”

One of the things he successfully ran on in 2016 was “it takes a thief,” effectively. “I know that. I know how these people work. I own these politicians. I’ll get rid of them.” Which was, in the ways that he is brilliant, that was a brilliant thing to do. But of course he wasn’t part of big business. Never part of big business. He’s a small business man who got big business, that is to say banks and Wall Street, to fund his vanities and follies for many decades. To me, I mean, this is a bit of a digression, but Donald Trump’s business success—I’m making quote marks, air quotes—is a collateral damage of the hideous growth of Wall Street and the financial industry and its recklessness…and we’ll see the truth of that once...Gosh, I do sound like Alex Jones, don’t I? Once the [Deutsche Bank] situation is fully exposed. But the fact that these banks, all these reputable banks and institutions, were providing loans to this guy they had to know was an untrustworthy buffoon, is evidence for the degree of recklessness and self-dealing and all the rest that Wall Street had undergone in the ’70s and ’80s.

And one of his campaign ads in 2016 had Lloyd Blankfein, the CEO of Goldman, in it.

As an evil villain.

As an evil villain.

Correct. Yeah, that‘s the other thing. The Steve Bannon version of Donald Trump, which is to say, yeah, racist, xenophobe, bigot, all that. But yes, we’re going to keep your Medicare, keep your social security. It’s going to be better than it ever was. We’re going to spend trillions rebuilding the infrastructure. If he had governed like that, this unusual Republican who’s not going by the normal Republican tenets, I believe that a lot of people on the left and liberals would have held their nose and said, “Yeah, not bad.” And he’d have 65, 70% approval rating now. I really believe that.

Instead what he did, because he’s an idiot, and because he understood that Republicans are elected, Republicans are quislings, and that all they want—because the prime directive of the economic evil geniuses is keep taxes low, keep regulation off of business. So he gave them all that. Oh, that’s what you care about, fine. Whatever. That’s how it works.

Right. Well, another subplot to your book is the cultural effect of all this redistribution of wealth to the top and the politicization of it, the political economy of it, which was that—you call the ’60s and ’70s “Peak New,” right? This is when we had all gotten used to a level of just continual change, which is part of the American impulse to reinvent constantly. Well, that began to slow down, and you noticed it from looking at a photograph of some people from the ’80s recently, maybe in the last 10 years. Tell me about that.

Well, and in fact I noticed it and then wrote a piece about it for Vanity Fair magazine that appeared in 2011. I happened to see this picture in 2007, I think, in the New York Times. It was a profile of Steve Rubell and his partner, who started, of course, Studio 54 and had become big hotel impresarios. Anyway, it was a picture of them and their staff at Morgans, which was this first fancy, boutique hotel in 1986. Anyway, all these waiters and attendants and bellpeople, big crowd of attractive young people standing outside with their bosses on a Manhattan street. It was 20 years old, this picture. That’s an old picture. Almost nothing about any of them, the way they were dressed, looked, groomed, looked anything other than 2007. And I thought, That is weird, isn’t it? Because of course for my whole lifetime, and then before my lifetime, things changed every decade, pretty significantly. I mean, cars look different. The way people did their hair and groomed themselves and dressed looked different. And design looked different, and each decade had its own character. I thought, Well, that’s weird.

So I began trying to figuring out...I became obsessed with this and why did that happen, and when I wrote about it—I wrote an essay about it—I didn’t really connect it very much to what had happened economically, what was happening economically at the same time. Again, I’m not such a conspiracist that I think the evil geniuses are genius enough or powerful enough to have contrived to stop that kind of cultural change.

Reverse engineer culture or something.

No. However, I do think they were synergistic, and I do think…that things after the ’80s really stopped after we spent a decade or two just wallowing in nostalgia, which was, the degree of the wallow, new for America. This stasis has happened, and I really do think that it has served the interests of the people who don’t want big political and economic change to make people to think, without even thinking that they’re thinking, but just, Oh, no, things don’t really change. It’s the same. Listen to the same music. This new singer is not so different than the singer that was 20 years ago. What has happened so radically new since hip-hop, let’s say, as an example in pop culture of a truly new thing in the ’70s and ’80s. But what’s been as big as that? And you can go through the whole realm of culture and think, That’s weird. Again, I mean, so while I’m not a conspiracy theorist, I am a seeker of unified theories of existence.

A Zeitgeistian.

I do in Evil Geniuses connect nostalgia and this strange cultural stasis to the bigger economic and political changes that happen. It really is unprecedented. I mean, America was about the new; modern life is about this constant novelty in all realms. And instead the novelty of the last several decades has been in the digital realm, sure. But very little else in the culture.

Right, and it almost serves as a fun house mirror of everything that we already had, like a giant archive constantly coming at us. Well, I thought about that—you and I have talked about this in the past. But we talk about the 20th century being this anomaly of a monoculture in which you have a narrow band of media through which everything was coming. A lot of us experienced all these newnesses you’re talking about through that, through the distribution of sound and image and news and information and politics and the rest. But as the internet came along and fractured that—and I made this parallel reading your book. I was thinking that these right-wing forces, they tried to de-engineer the New Deal and take us back to before the Depression. In doing so, ended up exposing us to similar problems, by the way, but also back to a pre-media time when you have a fragmented media and it’s more like the pamphleteering late 19th century now than it was 20 years ago. We reversed that too.

That’s a good point, and I think intentionally I wrote about that media part of it, which is so true. I mean, often I talk about pathological nostalgia, which is we are in nostalgia for something. But America and certain kinds of Americans have become pathologically nostalgic, and that drives a lot of our politics. But we talk about that it’s often, “Oh, they want it to be the ’50s again.” No, the ’50s were pretty good except for the racist, sexist, misogynist part of it. I mean, economically, the ’50s were good. They, my economic evil geniuses, wanted to be, as you say, before there was a federal government. Before there was income taxes. Before there was a public health system and indeed before there was—

A mainstream media.

A mainstream media. Again, newspapers, big newspapers that dominated American media for a century, were the result of business constraints, which is to say to sell as many newspapers as you could in a given city. You couldn’t be left-wing or right-wing, you had to appeal and have a big tent and appeal to everybody. Yes, with cable television and talk radio and unregulated talk radio and certainly the internet, that business constraint was no longer there. And the idea of the good side of mainstreamness, which is that mostly just untrue craziness could be kept out of the mainstream—that started disappearing, and here we are. I mean, no question there are all kinds of bad things about the mainstream and dissident opinion being stigmatized and kept out of it, no question. But we didn’t have QAnon for instance. Back when there were only three networks and two newsmagazines and a couple of national newspapers.

Well, and I thought a lot about Ross Douthat’s recent book, which makes a case that we’ve reached a decadence from our success.

Yes, yes. In which he quotes Fantasyland at length.

Well, and that makes perfect sense to me because this is all of a piece, and one of the things I love about your writing and your books is that you articulate things that have been floating around in my mind as I look out and I’m like, Yeah, why is the culture seeming to be a little bit static? I’m a big music fan. Why is music not as impactful as it once seemed. It doesn’t have the centrality to the culture. Well, the culture is no longer central; it’s been fragmented and it’s reflected the economic thing as well and that everybody now has the option to go into their little silo and then QAnon being one of the wacky ones, right? The decadence is a thing that we’ve been. And Trump could not be a more glaring symptom of that decadence.

Yeah, and when you say decadence, I think of capitalism as it’s practiced in the United States, because give me a free market like the Nordic countries and I’m good. And by the way, they are free market systems. They’re not socialist countries, they’re free market countries.

Right, and you make that point in the book.

With great social democracies and the systems. But the term that so many people have been using the last couple of decades and more and more lately is “late capitalism,” which of course implies that it’s about to die. Which I think, there’s a wishful thing. But it is definitely a decadent capitalism in America. No question. I think that’s to me a more precise and true phrase and doesn’t suggest that it’s going to collapse in some miraculous way because it’s too late. I mean, I’ve been hearing the phrase late capitalism for a long time. It’s like waiting for the end of the world when some prophet says the world is about to end.

But it is absolutely decadent, and in the story of Evil Geniuses [I argue] that we have become this, not North American, but traditionally Latin American oligarchy where only the rich are getting richer and building real and figurative gates to keep all the peasants away.

Well, and I think during this pandemic when we saw David Geffen on his boat out in the Caribbean or wherever he was, people immediately were stuck by that as a sign or symptom of the separation of the haves and have-nots. So one other thing to point out—let’s just get into the slivers-of-hope section of our conversation here. You point out a really interesting thing in the book: that 25 years ago there was a poll taken. They asked people, “Do you want the government to do more for people or less?” Sixty-two percent at the time said no, we don’t. It’s like, we don’t want more government, we want less.

And the choice was government more, or let people and businesses take care of their own problem.

Exactly. And now it’s flipped, more or less. Fifty-eight percent would like to see the government do more, and you start to explore whether we’re at an inflection point. Certainly it looks like it. I mean, the Bernie Sanders and the Elizabeth Warrens of the world and the Andrew Yangs have been on national stages delivering messages that you would never have heard 10 years ago.

Correct.

That’s a radical thing and that’s what—Trump will exploit the fear of that, but it may be that our options are narrowing at this crossroads, between more of this autocratic demagoguery and actually solving the problem.

The hopeful possibilities coming out of the pandemic and its economic consequences is sane people, sensible, reasonable people, will look and say, “No, we really do need an effective government to deal with not only huge one-off challenges like this, but both economically and in the public health sense. But no, *we really do need government.* We’re not all on our own. Business can’t do it by itself.” To me it’s a case study that the reaction of the Trump administration and the right from the get-go [was], “No, no, no. Open up right away. Open up right away. Well, we’ll deal with it. Keep the stock market going.” Down the line they just played from their playbook of how they’ve been privileging and prioritizing stock prices and corporate profits above all else. I mean, these last six months have been just an extraordinary case study in that.

Now I hope [it] will be clear to more people than ever that, wait a minute, not only do they not, as the survey question often has it, care about people like me, [but] they really care only about their narrow economic interest, period, end of story. So the question is, can the various other social and culture fissures in America that all kinds of people, especially Donald Trump and the Republican Party, exploit politically, can those be put in abeyance enough to create a good working majority of people who can be activated politically in their own economic interests?

And the economic interests, by the way, of America, of the economy. Again, racism and misogyny and patriarchy aside, the ’50s and ’60s and ’70s are a model. If we had that economy now, the growth, the fair, equitable arrangements of how the wealth was shared, my God. Literally we were as equal back in the day as some of the Scandinavian countries are now. It would be great, and so it’s not really radical, and we had these enormously higher tax rates on the rich. Didn’t seem to hurt growth, did it?

No, it didn’t. Two things you point out in the book are, I would say, interesting tea leaves to read. One is that the Business Roundtable, which is one of these big business groups as part of the cabal, came out in 2019 advocating for more responsibility to the workers. Like, Uh-oh, maybe this isn’t going to go so hot for us if we keep going in this direction we haven’t corrected in any way. You point out that Financial Times this last spring said about the pandemic, “Virus Lays Bare the Frailty of the Social Contract.” Now, this is the first election I can remember in which “the social contract” came up. We’re rethinking the entire thing. You talk about, in the book, the Alaska model; it’s an interesting thing because it gets to a lot of other conversations.

Andrew Yang, during his perfectly great presidential run, was probably not ever going to be

nominated for the presidency, but to get the conversation going, not only about universal basic income, but about how A.I. and automation are going to continue eliminating jobs. They just are, and this is different than the other industrial revolutions, and there are not going to be enough jobs that it makes economic sense for people to do. Period, end of story. How are we going to deal with that? So the fact that that was not regarded as crazy and that people, Republicans as well as Democrats, in polling said, “Yeah, universal basic income sometime might be necessary.” Fantastic that that is now legitimately on the table.

So Alaska, 50 years ago they had this gigantic oil strike in the north slope of Alaska and all the oil

companies wanted to drill there, and Alaska said, “Okay, you can do that, but we’re going to charge you. We’re going to get a share of [the] billions of dollars of oil revenues you’re going to get.” And the then Republican governor, since Alaska has almost exclusively Republican governors and is a very Republican state, decided on the advice of this libertarian socialist economist that worked at the University of Alaska, “We’re going to give a large chunk of that money, guaranteed within the constitution of the state, to give a portion of that money to every individual in Alaska—man, woman, or child, no matter what, no strings attached.”

So Alaska has had a universal basic income. Now, it’s small; it can’t let you live. But it’s thousands of dollars, often several thousands of dollars, at least a thousand or two dollars a year to every man, woman, or child. So if you’ve got a family of five—10, 15, 20 grand every year. That obviously makes a huge difference in people’s lives. So we’ve had this incredibly successful experiment. Now, ironically and unfortunately, it’s based on fossil fuels—and that’s a whole other conversation. But the principle, the thing, is that there is social wealth. Alaskans decided, “Hey, this is our oil. We should all each benefit from this, rather than have it just vaguely go away to whoever.”

And you point out in there that there was an uptick in women entering the workforce because they could afford childcare.

Yes, and there are also studies about childhood health that got better and all kinds of things. And by the way, it’s unclear exactly to what degree the Alaska fund, Alaska Permanent Fund, is responsible, this thing that has given every Alaskan thousands of dollars a year, every year, no matter what, for the last several decades, is responsible. But back then when it started, Alaska was one of the most economically unequal states in the union. Today it is one of the top one or two least unequal states in the union. But really I think it’s important that here is this conservative, Western, ultra-entrepreneurial, individualistic state that has had and loves and would not ever give up this social welfare payment. And understands that there is such a thing as social wealth, in this case oil. But it could also be allowing polluters, charging polluters to pollute or charging internet companies for all the work that the government did inventing the internet. Or any number of things.

Well, those are really interesting observations to me. I hadn’t heard them before, and you, God bless you, you read Hillary Clinton’s memoir. There was a little thing in there where she said she considered what if we made the fossil fuel industry pay based on how much CO2 emissions they have and then give it away to people.

Yeah, she specifically said basically copying Alaska on a national scale in some way. She wasn’t entirely clear whether it would just be fossil fuel or where the funding would come, but yes. She and Bill and her campaign decided, “No, no, we couldn’t make the numbers work, and so maybe that’s too bad, maybe I would have won.”

It is beginning to think outside the box in these radical ways that in this case isn’t so radical because as Justice Brandeis said in “the laboratory of democracy,” we had one of our states prove that in this way and this has worked just fine.

Yeah, and just as an aside, the other thing you pointed out that was interesting is how much the government is involved in the invention of things like the internet and receives no return on that investment, and you liken it to: We build a highway, and then we let a bunch of young college kids put toll booths on it and collect all the money, and we don’t get any of it. So I’m thinking now we’re talking about this “inflection point” and the importance of this election. I just want to go on record saying your book is a great primer for thinking about what the meaning of this election is. Look at the big view. Let’s go to 20,000 feet. Let’s look at the last 50 to 75 years and think about where we want to go from here. We’re so caught up in the daily news cycle, and we’re boring into every little Twitter war and dumb thing that Trump says. But let’s back up a minute here and think about which direction we want to go. Apocalypse and demagoguery or reinvent the country and go somewhere optimistic and sunny, okay?

Yeah.

The thing that I hope that Joe Biden will bring us in this election is something you point out. You just mentioned it in passing, but I just know that it’s going to be a thing, which is that all these people are out of work right now, and when the corporations go back [to full operation] they’re going to use this as an excuse to reduce their workforce, not hire more people. They’re going to see how efficient everything was without all these workers, and there’s going to be even more unemployment and more people without jobs and without security. A floor has to come under these people. We’ve got to reinvent the floor, right? A new New Deal has to be created.

Absolutely right. I think this is an inflection point moment, and Andy Grove, the great founder of Intel who popularized the idea of “the inflection point” for businesses and groups and societies and organizations, made the point that inflection point can take you to the stars or down to the bottom. That’s where we are. I really do [believe that] because I’m not without hope. If we reengineer our badly reengineered economic system, the sky is the limit with A.I., with automation, with all of it. And to their credit, people like Mark Zuckerberg, who—not to defend him or Facebook, except he and other Silicon Valley people are at least honest enough to have made the leap and understand where technology is going in terms of work and the larger economy to say, “Yeah, something like universal basic income is going to be necessary. The old way of just give business whatever it wants and screw the people, the losers, that just isn’t going to work.“ So at least he and they in their engineer Spockian way understand where this is going, and a solution that will look radical is going to be necessary.

Right. So we have Joe Biden, who is like, you can put the radical juice into the old Coke bottle and—

He’s Captain Kirk.

He’s Captain Kirk, that’s right.

I don’t know. Yeah, well, let’s cross our fingers and hope (a) that he’s elected, and (b) I believe that he is enough of a...he wants to do right. He wants people to be happy. He does. I mean, he is, God knows, beset by nostalgia to an extreme about how better life was in Scranton when he was a kid and all that, but it was. So he also is obviously a consummate politician, and if people, and specifically Democrats, are pushing him to the left, he’s not going to resist. He is not. So I’m hopeful about what could happen in his administration and beyond.

But it really, to your point about short term—like what happened today? What did Trump say today? Or what’s going to happen in the election in November? We really have to think, we have to obviously toggle between thinking short term, winning this election, and long term: Well, for what purpose other than to prevent a fascist autocracy? Yes, that’s important, but truly if we think beyond that and beyond not getting [an] unapologetic racist out of the White House and all of the obvious things about Donald Trump, let’s not think, as I’m afraid Joe Biden has, that it’s just about Trump. That there hasn’t been a big problem of which he, I, anybody who calls themselves Democrat mostly, have been part of. Of not understanding how what happened to the economy and how things went bad didn’t just happen. It was part of a set of plans in a very long game.

The things I talked about in Fantasyland, of the magical thinking and conspiracy theories and delusions and all that which has been part of the American character forever, that’s gotten out of hand. It’s a big problem. In a way it can’t be fixed. It can be stopped. It doesn’t have to—we can fight and need to fight to say, “No more. No more.” Take QAnon off Twitter for instance. But this is fixable. It was this other way 40, 50 years ago and then was changed, and it can be changed back as long as we have a democracy. As long as we have politics. But this can be fixed.

So I’m hopeful in a way that I really wasn’t once I came to the conclusions I came to about Fantasyland. But in terms of the evil geniuses and what they have wrought, well, they rotted, and indeed as you know from reading the book, I think we who are not of that ilk can look at what they did and copy it to some degree and see what a long game they played, and how they kept their eye on the important ball and all these other things. Man, they did it. And if we want to turn the United States of America into a decent, fair social democracy, well, there’s a lot to learn from the history of how they did it the other way.

https://www.vanityfair.com/news/2020/08/the-hive-interview-can-we-undo-the-gops-decimation-of-america

The Unraveling of America  

Anthropologist Wade Davis on how COVID-19 signals the end of the American era

by Wade Davis - Rolling Stone - August 6, 2020 

Wade Davis holds the Leadership Chair in Cultures and Ecosystems at Risk at the University of British Columbia. His award-winning books include “Into the Silence” and “The Wayfinders.” His new book, “Magdalena: River of Dreams,” is published by Knopf.

Never in our lives have we experienced such a global phenomenon. For the first time in the history of the world, all of humanity, informed by the unprecedented reach of digital technology, has come together, focused on the same existential threat, consumed by the same fears and uncertainties, eagerly anticipating the same, as yet unrealized, promises of medical science.

In a single season, civilization has been brought low by a microscopic parasite 10,000 times smaller than a grain of salt. COVID-19 attacks our physical bodies, but also the cultural foundations of our lives, the toolbox of community and connectivity that is for the human what claws and teeth represent to the tiger.

Our interventions to date have largely focused on mitigating the rate of spread, flattening the curve of morbidity. There is no treatment at hand, and no certainty of a vaccine on the near horizon. The fastest vaccine ever developed was for mumps. It took four years. COVID-19 killed 100,000 Americans in four months. There is some evidence that natural infection may not imply immunity, leaving some to question how effective a vaccine will be, even assuming one can be found. And it must be safe. If the global population is to be immunized, lethal complications in just one person in a thousand would imply the death of millions.

Pandemics and plagues have a way of shifting the course of history, and not always in a manner immediately evident to the survivors. In the 14th Century, the Black Death killed close to half of Europe’s population. A scarcity of labor led to increased wages. Rising expectations culminated in the Peasants Revolt of 1381, an inflection point that marked the beginning of the end of the feudal order that had dominated medieval Europe for a thousand years.

The COVID pandemic will be remembered as such a moment in history, a seminal event whose significance will unfold only in the wake of the crisis. It will mark this era much as the 1914 assassination of Archduke Ferdinand, the stock market crash of 1929, and the 1933 ascent of Adolf Hitler became fundamental benchmarks of the last century, all harbingers of greater and more consequential outcomes.

COVID’s historic significance lies not in what it implies for our daily lives. Change, after all, is the one constant when it comes to culture. All peoples in all places at all times are always dancing with new possibilities for life. As companies eliminate or downsize central offices, employees work from home, restaurants close, shopping malls shutter, streaming brings entertainment and sporting events into the home, and airline travel becomes ever more problematic and miserable, people will adapt, as we’ve always done. Fluidity of memory and a capacity to forget is perhaps the most haunting trait of our species. As history confirms, it allows us to come to terms with any degree of social, moral, or environmental degradation.

To be sure, financial uncertainty will cast a long shadow. Hovering over the global economy for some time will be the sober realization that all the money in the hands of all the nations on Earth will never be enough to offset the losses sustained when an entire world ceases to function, with workers and businesses everywhere facing a choice between economic and biological survival.

Unsettling as these transitions and circumstances will be, short of a complete economic collapse, none stands out as a turning point in history. But what surely does is the absolutely devastating impact that the pandemic has had on the reputation and international standing of the United States of America.

In a dark season of pestilence, COVID has reduced to tatters the illusion of American exceptionalism. At the height of the crisis, with more than 2,000 dying each day, Americans found themselves members of a failed state, ruled by a dysfunctional and incompetent government largely responsible for death rates that added a tragic coda to America’s claim to supremacy in the world.

For the first time, the international community felt compelled to send disaster relief to Washington. For more than two centuries, reported the Irish Times, “the United States has stirred a very wide range of feelings in the rest of the world: love and hatred, fear and hope, envy and contempt, awe and anger. But there is one emotion that has never been directed towards the U.S. until now: pity.” As American doctors and nurses eagerly awaited emergency airlifts of basic supplies from China, the hinge of history opened to the Asian century.

No empire long endures, even if few anticipate their demise. Every kingdom is born to die. The 15th century belonged to the Portuguese, the 16th to Spain, 17th to the Dutch. France dominated the 18th and Britain the 19th. Bled white and left bankrupt by the Great War, the British maintained a pretense of domination as late as 1935, when the empire reached its greatest geographical extent. By then, of course, the torch had long passed into the hands of America.

In 1940, with Europe already ablaze, the United States had a smaller army than either Portugal or Bulgaria. Within four years, 18 million men and women would serve in uniform, with millions more working double shifts in mines and factories that made America, as President Roosevelt promised, the arsenal of democracy.

When the Japanese within six weeks of Pearl Harbor took control of 90 percent of the world’s rubber supply, the U.S. dropped the speed limit to 35 mph to protect tires, and then, in three years, invented from scratch a synthetic-rubber industry that allowed Allied armies to roll over the Nazis. At its peak, Henry Ford’s Willow Run Plant produced a B-24 Liberator every two hours, around the clock. Shipyards in Long Beach and Sausalito spat out Liberty ships at a rate of two a day for four years; the record was a ship built in four days, 15 hours and 29 minutes. A single American factory, Chrysler’s Detroit Arsenal, built more tanks than the whole of the Third Reich.

In the wake of the war, with Europe and Japan in ashes, the United States with but 6 percent of the world’s population accounted for half of the global economy, including the production of 93 percent of all automobiles. Such economic dominance birthed a vibrant middle class, a trade union movement that allowed a single breadwinner with limited education to own a home and a car, support a family, and send his kids to good schools. It was not by any means a perfect world but affluence allowed for a truce between capital and labor, a reciprocity of opportunity in a time of rapid growth and declining income inequality, marked by high tax rates for the wealthy, who were by no means the only beneficiaries of a golden age of American capitalism.

But freedom and affluence came with a price. The United States, virtually a demilitarized nation on the eve of the Second World War, never stood down in the wake of victory. To this day, American troops are deployed in 150 countries. Since the 1970s, China has not once gone to war; the U.S. has not spent a day at peace. President Jimmy Carter recently noted that in its 242-year history, America has enjoyed only 16 years of peace, making it, as he wrote, “the most warlike nation in the history of the world.” Since 2001, the U.S. has spent over $6 trillion on military operations and war, money that might have been invested in the infrastructure of home. China, meanwhile, built its nation, pouring more cement every three years than America did in the entire 20th century.

As America policed the world, the violence came home. On D-Day, June 6th, 1944, the Allied death toll was 4,414; in 2019, domestic gun violence had killed that many American men and women by the end of April. By June of that year, guns in the hands of ordinary Americans had caused more casualties than the Allies suffered in Normandy in the first month of a campaign that consumed the military strength of five nations.

More than any other country, the United States in the post-war era lionized the individual at the expense of community and family. It was the sociological equivalent of splitting the atom. What was gained in terms of mobility and personal freedom came at the expense of common purpose. In wide swaths of America, the family as an institution lost its grounding. By the 1960s, 40 percent of marriages were ending in divorce. Only six percent of American homes had grandparents living beneath the same roof as grandchildren; elders were abandoned to retirement homes.

With slogans like “24/7” celebrating complete dedication to the workplace, men and women exhausted themselves in jobs that only reinforced their isolation from their families. The average American father spends less than 20 minutes a day in direct communication with his child. By the time a youth reaches 18, he or she will have spent fully two years watching television or staring at a laptop screen, contributing to an obesity epidemic that the Joint Chiefs have called a national security crisis.

Only half of Americans report having meaningful, face-to-face social interactions on a daily basis. The nation consumes two-thirds of the world’s production of antidepressant drugs. The collapse of the working-class family has been responsible in part for an opioid crisis that has displaced car accidents as the leading cause of death for Americans under 50.

At the root of this transformation and decline lies an ever-widening chasm between Americans who have and those who have little or nothing. Economic disparities exist in all nations, creating a tension that can be as disruptive as the inequities are unjust. In any number of settings, however, the negative forces tearing apart a society are mitigated or even muted if there are other elements that reinforce social solidarity — religious faith, the strength and comfort of family, the pride of tradition, fidelity to the land, a spirit of place.

But when all the old certainties are shown to be lies, when the promise of a good life for a working family is shattered as factories close and corporate leaders, growing wealthier by the day, ship jobs abroad, the social contract is irrevocably broken. For two generations, America has celebrated globalization with iconic intensity, when, as any working man or woman can see, it’s nothing more than capital on the prowl in search of ever cheaper sources of labor.

For many years, those on the conservative right in the United States have invoked a nostalgia for the 1950s, and an America that never was, but has to be presumed to have existed to rationalize their sense of loss and abandonment, their fear of change, their bitter resentments and lingering contempt for the social movements of the 1960s, a time of new aspirations for women, gays, and people of color. In truth, at least in economic terms, the country of the 1950s resembled Denmark as much as the America of today. Marginal tax rates for the wealthy were 90 percent. The salaries of CEOs were, on average, just 20 times that of their mid-management employees.

Today, the base pay of those at the top is commonly 400 times that of their salaried staff, with many earning orders of magnitude more in stock options and perks. The elite one percent of Americans control $30 trillion of assets, while the bottom half have more debt than assets. The three richest Americans have more money than the poorest 160 million of their countrymen. Fully a fifth of American households have zero or negative net worth, a figure that rises to 37 percent for black families. The median wealth of black households is a tenth that of whites. The vast majority of Americans — white, black, and brown — are two paychecks removed from bankruptcy. Though living in a nation that celebrates itself as the wealthiest in history, most Americans live on a high wire, with no safety net to brace a fall.

With the COVID crisis, 40 million Americans lost their jobs, and 3.3 million businesses shut down, including 41 percent of all black-owned enterprises. Black Americans, who significantly outnumber whites in federal prisons despite being but 13 percent of the population, are suffering shockingly high rates of morbidity and mortality, dying at nearly three times the rate of white Americans. The cardinal rule of American social policy — don’t let any ethnic group get below the blacks, or allow anyone to suffer more indignities — rang true even in a pandemic, as if the virus was taking its cues from American history.

COVID-19 didn’t lay America low; it simply revealed what had long been forsaken. As the crisis unfolded, with another American dying every minute of every day, a country that once turned out fighter planes by the hour could not manage to produce the paper masks or cotton swabs essential for tracking the disease. The nation that defeated smallpox and polio, and led the world for generations in medical innovation and discovery, was reduced to a laughing stock as a buffoon of a president advocated the use of household disinfectants as a treatment for a disease that intellectually he could not begin to understand.

As a number of countries moved expeditiously to contain the virus, the United States stumbled along in denial, as if willfully blind. With less than four percent of the global population, the U.S. soon accounted for more than a fifth of COVID deaths. The percentage of American victims of the disease who died was six times the global average. Achieving the world’s highest rate of morbidity and mortality provoked not shame, but only further lies, scapegoating, and boasts of miracle cures as dubious as the claims of a carnival barker, a grifter on the make.

As the United States responded to the crisis like a corrupt tin pot dictatorship, the actual tin pot dictators of the world took the opportunity to seize the high ground, relishing a rare sense of moral superiority, especially in the wake of the killing of George Floyd in Minneapolis. The autocratic leader of Chechnya, Ramzan Kadyrov, chastised America for “maliciously violating ordinary citizens’ rights.” North Korean newspapers objected to “police brutality” in America. Quoted in the Iranian press, Ayatollah Khamenei gloated, “America has begun the process of its own destruction.”

Trump’s performance and America’s crisis deflected attention from China’s own mishandling of the initial outbreak in Wuhan, not to mention its move to crush democracy in Hong Kong. When an American official raised the issue of human rights on Twitter, China’s Foreign Ministry spokesperson, invoking the killing of George Floyd, responded with one short phrase, “I can’t breathe.”

These politically motivated remarks may be easy to dismiss. But Americans have not done themselves any favors. Their political process made possible the ascendancy to the highest office in the land a national disgrace, a demagogue as morally and ethically compromised as a person can be. As a British writer quipped, “there have always been stupid people in the world, and plenty of nasty people too. But rarely has stupidity been so nasty, or nastiness so stupid”.

The American president lives to cultivate resentments, demonize his opponents, validate hatred. His main tool of governance is the lie; as of July 9th, 2020, the documented tally of his distortions and false statements numbered 20,055. If America’s first president, George Washington, famously could not tell a lie, the current one can’t recognize the truth. Inverting the words and sentiments of Abraham Lincoln, this dark troll of a man celebrates malice for all, and charity for none.

Odious as he may be, Trump is less the cause of America’s decline than a product of its descent. As they stare into the mirror and perceive only the myth of their exceptionalism, Americans remain almost bizarrely incapable of seeing what has actually become of their country. The republic that defined the free flow of information as the life blood of democracy, today ranks 45th among nations when it comes to press freedom. In a land that once welcomed the huddled masses of the world, more people today favor building a wall along the southern border than supporting health care and protection for the undocumented mothers and children arriving in desperation at its doors. In a complete abandonment of the collective good, U.S. laws define freedom as an individual’s inalienable right to own a personal arsenal of weaponry, a natural entitlement that trumps even the safety of children; in the past decade alone 346 American students and teachers have been shot on school grounds.

The American cult of the individual denies not just community but the very idea of society. No one owes anything to anyone. All must be prepared to fight for everything: education, shelter, food, medical care. What every prosperous and successful democracy deems to be fundamental rights — universal health care, equal access to quality public education, a social safety net for the weak, elderly, and infirmed — America dismisses as socialist indulgences, as if so many signs of weakness.

How can the rest of the world expect America to lead on global threats — climate change, the extinction crisis, pandemics — when the country no longer has a sense of benign purpose, or collective well-being, even within its own national community? Flag-wrapped patriotism is no substitute for compassion; anger and hostility no match for love. Those who flock to beaches, bars, and political rallies, putting their fellow citizens at risk, are not exercising freedom; they are displaying, as one commentator has noted, the weakness of a people who lack both the stoicism to endure the pandemic and the fortitude to defeat it. Leading their charge is Donald Trump, a bone spur warrior, a liar and a fraud, a grotesque caricature of a strong man, with the backbone of a bully.

Over the last months, a quip has circulated on the internet suggesting that to live in Canada today is like owning an apartment above a meth lab. Canada is no perfect place, but it has handled the COVID crisis well, notably in British Columbia, where I live. Vancouver is just three hours by road north of Seattle, where the U.S. outbreak began. Half of Vancouver’s population is Asian, and typically dozens of flights arrive each day from China and East Asia. Logically, it should have been hit very hard, but the health care system performed exceedingly well. Throughout the crisis, testing rates across Canada have been consistently five times that of the U.S. On a per capita basis, Canada has suffered half the morbidity and mortality. For every person who has died in British Columbia, 44 have perished in Massachusetts, a state with a comparable population that has reported more COVID cases than all of Canada. As of July 30th, even as rates of COVID infection and death soared across much of the United States, with 59,629 new cases reported on that day alone, hospitals in British Columbia registered a total of just five COVID patients.

When American friends ask for an explanation, I encourage them to reflect on the last time they bought groceries at their neighborhood Safeway. In the U.S. there is almost always a racial, economic, cultural, and educational chasm between the consumer and the check-out staff that is difficult if not impossible to bridge. In Canada, the experience is quite different. One interacts if not as peers, certainly as members of a wider community. The reason for this is very simple. The checkout person may not share your level of affluence, but they know that you know that they are getting a living wage because of the unions. And they know that you know that their kids and yours most probably go to the same neighborhood public school. Third, and most essential, they know that you know that if their children get sick, they will get exactly the same level of medical care not only of your children but of those of the prime minister. These three strands woven together become the fabric of Canadian social democracy.

Asked what he thought of Western civilization, Mahatma Gandhi famously replied, “I think that would be a good idea.” Such a remark may seem cruel, but it accurately reflects the view of America today as seen from the perspective of any modern social democracy. Canada performed well during the COVID crisis because of our social contract, the bonds of community, the trust for each other and our institutions, our health care system in particular, with hospitals that cater to the medical needs of the collective, not the individual, and certainly not the private investor who views every hospital bed as if a rental property. The measure of wealth in a civilized nation is not the currency accumulated by the lucky few, but rather the strength and resonance of social relations and the bonds of reciprocity that connect all people in common purpose.

This has nothing to do with political ideology, and everything to do with the quality of life. Finns live longer and are less likely to die in childhood or in giving birth than Americans. Danes earn roughly the same after-tax income as Americans, while working 20 percent less. They pay in taxes an extra 19 cents for every dollar earned. But in return they get free health care, free education from pre-school through university, and the opportunity to prosper in a thriving free-market economy with dramatically lower levels of poverty, homelessness, crime, and inequality. The average worker is paid better, treated more respectfully, and rewarded with life insurance, pension plans, maternity leave, and six weeks of paid vacation a year. All of these benefits only inspire Danes to work harder, with fully 80 percent of men and women aged 16 to 64 engaged in the labor force, a figure far higher than that of the United States.

American politicians dismiss the Scandinavian model as creeping socialism, communism lite, something that would never work in the United States. In truth, social democracies are successful precisely because they foment dynamic capitalist economies that just happen to benefit every tier of society. That social democracy will never take hold in the United States may well be true, but, if so, it is a stunning indictment, and just what Oscar Wilde had in mind when he quipped that the United States was the only country to go from barbarism to decadence without passing through civilization.

Evidence of such terminal decadence is the choice that so many Americans made in 2016 to prioritize their personal indignations, placing their own resentments above any concerns for the fate of the country and the world, as they rushed to elect a man whose only credential for the job was his willingness to give voice to their hatreds, validate their anger, and target their enemies, real or imagined. One shudders to think of what it will mean to the world if Americans in November, knowing all that they do, elect to keep such a man in political power. But even should Trump be resoundingly defeated, it’s not at all clear that such a profoundly polarized nation will be able to find a way forward. For better or for worse, America has had its time.

The end of the American era and the passing of the torch to Asia is no occasion for celebration, no time to gloat. In a moment of international peril, when humanity might well have entered a dark age beyond all conceivable horrors, the industrial might of the United States, together with the blood of ordinary Russian soldiers, literally saved the world. American ideals, as celebrated by Madison and Monroe, Lincoln, Roosevelt, and Kennedy, at one time inspired and gave hope to millions.

If and when the Chinese are ascendant, with their concentration camps for the Uighurs, the ruthless reach of their military, their 200 million surveillance cameras watching every move and gesture of their people, we will surely long for the best years of the American century. For the moment, we have only the kleptocracy of Donald Trump. Between praising the Chinese for their treatment of the Uighurs, describing their internment and torture as “exactly the right thing to do,” and his dispensing of medical advice concerning the therapeutic use of chemical disinfectants, Trump blithely remarked, “One day, it’s like a miracle, it will disappear.” He had in mind, of course, the coronavirus, but, as others have said, he might just as well have been referring to the American dream.

https://www.rollingstone.com/politics/political-commentary/covid-19-end-of-american-era-wade-davis-1038206/

It’s the healthcare system, stupid

‘Populist’ is now an insult in the US, especially when applied to anti-expertise reactions to the current pandemic. But the true history of US populism is of a long fight to place medical experts at the service of the wellbeing of ordinary people.

by Thomas Frank - Le Monde Diplomatique - August 6, 2020

The great underlying political crisis of this plague year, it is often said, is the stubborn refusal of Americans to respect expert authority. There’s an epidemic raging... and just look at those people frolicking in a swimming pool at the Lake of the Ozarks, repeating stupid conspiracy theories, spreading non-peer-reviewed medical advice on social media, running errands without a mask on, setting off roman candles in the street. And just look at their idiot of a president, dismissing the advice of his own medical experts, blaming everyone but himself for the disaster, suggesting we inject ourselves with Clorox because it’s effective on countertops and toilet bowls.

In truth, this grand conflict between the ignorant and the enlightened has been a motif of our politics for years (1). Liberals, we believe, are uniquely attuned to objective reality; they dutifully heed the words of Nobel laureates and Genius Grant winners. But Republicans are different: they live in a world of myth and fable where the truth does not apply.

Ordinarily our punditburo plays this conflict for simple partisan point-scoring. Us: smart! Them: stupid!

But the pandemic has given the conflict an urgency we have not seen before. These days, right-thinking Americans are tearfully declaring their eternal and unswerving faith in science. Democratic leaders are urging our disease-stricken country to heed the findings of medical experts as though they were the word of God.

Our ‘thought leaders’, meanwhile, have developed a theory for understanding the crazy behaviour we see around us: these misguided people are not merely stupid, they are in the grip of a full-blown philosophy of anti-expertise called ‘populism’. These populists are the unlettered who resent the educated and sneer at the learned (2). They believe in hunches instead of scholarship; they flout the advice of the medical profession; they extol the wisdom of the mob. Populism is science’s enemy; it is at war with sound thinking. It is an enabler of disease, if not a disease itself.

So sweetly flattering, so gorgeously attractive is this tidy little syllogism that members of our country’s thinking class return to it again and again. Medical science is so obviously right and populism so obviously wrong that celebrating the one and deploring the other has become for them one of the great literary set pieces of the era, the raw material for endless columns and articles.

Crushing national failure

Unfortunately, it’s all a mistake. Donald Trump’s prodigious stupidity is not the sole cause of our crushing national failure to beat the coronavirus. Plenty of blame must also go to our screwed-up healthcare system, which scorns the very idea of public health and treats access to medical care as a private luxury that is rightfully available only to some. It is the healthcare system, not Trump, that routinely denies people treatment if they lack insurance; that bankrupts people for ordinary therapies; that strips people of their coverage when they lose their jobs — and millions of people are losing their jobs in this pandemic. It is the healthcare system that, when a Covid treatment finally arrives, will almost certainly charge Americans a hefty price to receive it (3).

And that system is the way it is because organised medicine has for almost a century used the prestige of expertise to keep it that way.

Poor people get sick quicker, stay sick longer, need medical aid most, get it least. Some are poor because they are sick. Others are sick because they are poor Michael A Shadid

Populism, meanwhile, was the reform impulse that tried (and failed) to change the system so that it served ordinary people.

Which is to say that the pundits and the scholars and the thinktankers in their grave solemnity have got it entirely backward. Bowing down before expertise is precisely what has made public health an impossible dream. And the populism that our pundits so hate and fear is, in fact, the cure for what ails us.

Who was a populist?

Begin with the word. The term ‘Populist’ was coined in Kansas in 1891 to describe members of a brand-new American farmer-labour party who demanded a modern currency, a war on monopoly, and the nationalisation of the railroads. The movement caught fire, and the people who called themselves Populists seemed poised to succeed at first. Instead, their party fizzled out by the end of that decade. Still, Populism’s influence lived on for decades; its ideas can be traced through the American Socialist Party, the New Deal of the 1930s and 40s, and the Bernie Sanders campaigns of 2016 and 2020.

The rise and fall of the American Populists — again, the people who invented the word — has long been a favourite subject of romantically inclined historians. The Populist party’s principles and its leading figures are well known to scholars and are the subject of many books.

A curious fact that is repeated often in those books: the Populists were not opponents of science or learning. On the contrary: Populists produced homages to technology and scholarship and education that were so earnest and ornate that they are embarrassing to read today. They thought their own ideas about regulation and the welfare state were in full alignment with the scientific advances of the late 19th century.

At the same time, the Pops fought endlessly with the business and academic elites of their day — experts who regarded the established order as the work of God. Populists regarded all special privilege with suspicion, including the prestige that props up the professional class. A clear illustration of this theme can be seen in the famous Garden of Eden sculpture garden in Lucas, Kansas, which was built as a primer on Populist/socialist principles. One of its focal points is a rendering of ‘Labour crucified’ and the people who can be seen torturing the working man to death are society’s honoured professionals: banker, lawyer, doctor, preacher.

The Populist way of looking at things was radically democratic: the people came first. The correct role of experts, the original Populists thought, was to serve and inform the people as they went about their lives as citizens of a democracy.

The original Populist movement didn’t have much to say about healthcare policy. In the 1890s, American medicine had not yet hardened into the supremely costly bureaucratic labyrinth we know today. But as the price of medicine grew out of reach in the decades that followed, farmers and unions and charities proposed all kinds of alternative, more democratic arrangements, and always with the same aim: to make healthcare an affordable part of life for ordinary, working-class people.

Elk City’s cooperative system

My favourite of these neopopulist efforts was launched in 1929 in the high-plains town of Elk City, Oklahoma, a state that once had a vivid Populist streak. The idea was a cooperative healthcare system in which farm families would pay a modest sum each year for guaranteed access to doctors, dentists and a modern regional hospital. Members of the cooperative — meaning ordinary people, farmers, mainly — would elect the board and run the business side of the enterprise. This system was the brainchild of one Dr Michael Shadid, who organised it with the help of the state Farmers’ Union.

The populism of the Elk City enterprise can be understood by a glance at its backer, the Farmers’ Union, a more or less direct descendent of the old Populist party. Doctor Shadid’s story is more interesting still. A Lebanese immigrant who spent his career practicing among dirt-poor American farmers, Shadid was once a member of the Socialist party. While the doctor had unusual political ideas, he was no quack; his medical standards were high. What set him apart from his peers was his criticism of the predatory way medicine was practiced in places like small-town Oklahoma. He understood himself as something different, a ‘Doctor for the People’ (4) who would solve the persistent American problem of costly healthcare and a sickly population — the same basic problem that afflicts us today.

‘In war times and peace times, panic and prosperity, fair weather and foul, these facts stand,’ Shadid once wrote. ‘Poor people get sick quicker, stay sick longer, need medical aid most, get it least. Some are poor because they are sick. Others are sick because they are poor’ (5).

Shadid wrote that he acted on behalf of ‘the American people’ in their struggle ‘to escape from the domination of special privilege, which is leading this country toward dictatorship and chaos.’ After quoting this passage in a 1939 book, the journalist James Rorty appended, ‘These are native slogans, populist rather than socialist, and they hit the Oklahoma farmers right where they live.’

By ‘special privilege’ Shadid was likely referring to the American Medical Association (AMA), the doctors’ professional group, which had essentially declared war on him for daring to open a cooperative hospital. They came after the neopopulist reformer in all sorts of diabolical ways. His enterprise was ‘unethical’, they said, because it placed laymen in charge of the business decisions. They tried to get Shadid’s medical license revoked, and then they reorganised the local AMA chapter without him in it, which had the effect of cancelling his malpractice insurance. Doctors he tried to recruit were warned not to sign up with his endeavour and they stayed away.

Science’s war on populism

Most of today’s pundits would no doubt cluck with grave concern over Dr Shadid’s populist war on science. But what happened to him could be more accurately described as science’s war on populism.

Science’s war raged on for many years, as the AMA fought and defeated proposal after proposal for democratising healthcare. Once, for example, its members organised a boycott of a dairy company in order to persuade a vaguely related charitable foundation to stop researching what was then called ‘medical economics’. On another occasion, according to historian Paul Starr, when a medical co-op was set up in Washington DC, on the Oklahoma model, the AMA ‘threatened reprisals against any doctors who worked for the plan, prevented them from obtaining consultations and referrals, and succeeded in persuading every hospital in the District of Columbia to deny them admitting privileges...’ (6).

For this outrage the AMA got hit with a Federal antitrust suit. But that didn’t even slow them down. These were, after all, the greatest medical experts of their day, and they demanded that society show them the deference to which they were entitled. Nearly every effort to reform healthcare, in the AMA’s view, was ‘unethical’. In 1938 the AMA’s president even denounced a federal inquiry on the issue as a perversion of the social hierarchy, with the laity demanding some quack remedy and bawling that the experts must prescribe it to him. ‘That is not scientific medicine and that is not scientific economics,’ he sneered.

It is amazing the things professional ethics forbid when professionals feel their status to be under threat. After winning the election of 1948 with a campaign far more populist than Donald Trump’s, President Harry Truman made universal healthcare his defining issue. He rolled out a plan for universal health insurance, acknowledging the achievements of modern medicine but pointing out that their price tag had put medicine out of reach. ‘It is no longer just the poor who are unable to pay for all the medical care they need,’ he said; ‘such care is now beyond the means of all but the upper income groups’ (7).

The forthrightly populist Senator Bernie Sanders is most closely identified with universal healthcare these days. And it is the forces of organised expertise and private power that have repeatedly torpedoed it

The AMA fired back, describing Truman’s plan as the ‘discredited system of decadent nations’, pointing out that it would put medical doctors — highly educated members of a highly honoured profession — beneath ‘a vast bureaucracy of political administrators, clerks, bookkeepers and lay committees’. To stop the unlettered Missourian, the group levied a special assessment on its (quite affluent) members, generated an enormous war chest, and hired the nation’s pioneering political consultancy — a California outfit called Campaigns Inc — to direct its forces in the field. This outfit rained down upon the country a veritable hailstorm of pamphlets and letters and mean-spirited cartoons denouncing ‘socialised medicine’ as the final extinction of human freedom (8).

By these notorious means the Truman plan was defeated, as has been every attempt to secure true universal healthcare in the United States. It was in Canada, however, that science’s war on populism came to a volcanic climax. In the country’s plains provinces, the historian Robert McMath has pointed out, the American Populist revolt of the 1890s continued on for decades (9). During the Great Depression the populist tradition culminated in a radical agrarian party called the Co-operative Commonwealth Federation (CCF); when this group finally swept the election in Saskatchewan in 1944, it famously formed the ‘first socialist government in North America’.

The CCF went on to win many elections, and for the 1960 Saskatchewan election this Canadian incarnation of the populist tradition declared that it intended to establish universal healthcare for the province. In that election, fought over that one big issue, the CCF prevailed again. By July of 1962 the CCF government in Regina was ready to launch what it called Medicare, its single-payer healthcare plan, the first in Canada.

In response, organised science dropped the big one. On the day single-payer healthcare began in Saskatchewan, the province’s doctors walked off the job. There were only roughly a thousand of them, but still, it was the ultimate Ayn Rand moment: a strike by the One Percent, with the brains and the money teaching an uppity peasantry to show respect.

A ‘democracy scare’

This particular showdown between science and populism — between a small but prestigious professional group and the working people of Saskatchewan — saw many of the AMA’s patented tricks rolled out before a new audience. The local doctors’ association assessed its members and built up a huge treasury for propaganda efforts. The province’s Chamber of Commerce backed the doctors’ walkout, as did other professional associations. The Saskatchewan press overwhelmingly took the doctors’ side, shrieking fear of communism and fear of disease. Far-right protesters made an appearance as well — the so-called Keep Our Doctors movement, which appeared out of nowhere to challenge the government’s single-payer scheme by means of public demonstrations, red-baiting, and racist innuendo — this last because the neopopulist government planned to replace striking doctors with medicos from other lands.

The real issue, of course, was the place of professionals in a democracy. In those days doctors held a monopoly on determining treatments and costs. They answered to no one but their peers. The CCF’s plan — like the Elk City plan, like Harry Truman’s plan — diluted this power, handing ordinary people a certain authority over society’s highest-ranking group. Doctors were ‘the “high priests” of our world’, an American journalist wrote of the Saskatchewan controversy. And ‘these “high priests” are not used to taking orders from government men.’

Stephen Taylor, the British peer brought in to mediate the Saskatchewan doctors’ strike put it in quasi-medical terms: the AMA, he wrote, was ‘hysterically opposed to Medicare; and it endeavoured, not without some success, to communicate its hysteria to the doctors and the public in Saskatchewan’ (10).

This is a precise diagnosis: a professional group deliberately spread hysteria across the Canadian prairie. The result was what I call a ‘democracy scare’, in which society’s high-status groups come to believe that their privileges have been placed in mortal danger by the actions of the vast, seething multitude. Symptoms of this recurring hysteria include depictions of democracy-as-tyranny; denunciations of the lower orders for meddling in matters they do not understand (economics, foreign policy, or in this case, medicine); and, of course, a near-airtight unanimity among the news media.

All these features were present, for example, in the great democracy scare of 1896, when the American ruling class, backed almost unanimously by the nation’s press, came to believe that it was threatened by a bloodthirsty proletariat, led by the seemingly radical Democratic presidential candidate William Jennings Bryan, who had been cross-endorsed by the Populists. From the towering heights of the East Coast press, the learned men of the 1890s denounced Populism as an insane uprising of the crazy and the stupid.

These features were also present in 1936, when ruling elites again came together with the press to inveigh against the seemingly radical Franklin D Roosevelt. And all of them are present again today, as scholars and journalists recycle the hysterical rhetoric of the past for a modern audience.

Sometimes democracy scares succeed in their purpose. In 1962 in Saskatchewan, however, the great strike of the One Percent was a resounding flop. After the first initial wave of fear, support for the doctors evaporated. The outrageous rhetoric of the allies of expertise — a radio priest called for blood in the streets — turned people off (11). Within a month the strike was over, and within five years every province in Canada had adopted a healthcare system like Saskatchewan’s; today, Medicare is one of Canada’s proudest civic achievements.

Privilege vs equality

None of the reformers I have described disputed the importance of research or any particular scientific findings. These neopopulists all admired modern medicine; they merely wanted it to be accessible to the lowliest members of society. Which is to say that these were battles of privilege versus equality.

‘The most important issue at stake in the battle between the Saskatchewan government and the doctors of that province is not medicare but democracy,’ declared the Toronto Globe and Mail a few weeks into the strike. ‘The professional, in whatever line, must always be subject, in the final analysis, to the laity, or democracy cannot function.’

This was exactly what was wrong with democracy, others screamed: it gave the unlettered ‘laity’ power over their betters. George Sokolsky, an American syndicated columnist, thundered his support for the striking doctors of Saskatchewan on the grounds that they were ‘fighting a battle for the professional men in this era of mobocracy’. Sokolsky, a ferocious anticommunist, saw the doctors struggling to keep their heads up as the rest of the world drowned beneath the waves of equality. ‘It used to be that human beings respected each other for their worth, but today the motto seems to be “I’m as good as you are”.’ This was a false and pernicious doctrine, the columnist raged. Everyone in a country like ours can speak their mind, but as the world grows more complicated, ‘only the expert can have an opinion on an increasing number of subjects.’

Sokolsky was an extreme right-winger, an enthusiastic McCarthyite. The Saskatchewan CCF, meanwhile, was a party of the farmer-labour left.

But now, here is the twist: today, everything is reversed. Harry Truman’s Democratic Party has become the bought-and-paid-for vehicle of affluent and highly educated professionals. It dutifully bails out the geniuses on Wall Street. It responsibly obeys the economists who tell us about the wonders of ‘free trade’. And when our modern Democrats propose healthcare reform, they do it from the top down, by convening experts from every affected field and asking them to redraw the system amongst themselves — and then are astonished when the public erupts in outrage.

‘Democracy is a problem’

The healthcare equation has changed as well. The AMA is no longer the mighty bulwark of medical professionalism that it once was; others have eclipsed both its power and its leadership in the fight against universal healthcare. Still, the hospital chains, pharmaceutical companies and insurance companies that now hold the fort against single-payer do so on the same grounds as before: respect for what is now called ‘innovation’ and the professionals who deliver it.

The biggest change of all has been in the thinking of the anti-Trump faction. As their abuse of the term ‘populism’ indicates, they have turned strongly against liberalism’s democratic heritage. Today they remind us about the bright side of censorship (12) and pine for the days when bosses chose our leaders for us. Democracy is a problem, they tell us, because democracy allows the common people to ignore the authority of expertise. Disobedient democracy is to blame for Trump. Disobedient democracy is why we can do nothing about global warming. Disobedient democracy is the reason we can’t beat the Covid pandemic. And all of it is the fault of We the People.

The politics have been inverted but the fight remains the same. Expertise, identified now with the icy moral purity of the left rather than the Neanderthal anticommunism of the right, continues to rage against the insolence of those who defy its authority. The privilege of the expert is the real contested matter.

Put aside the self-serving fantasies of our modern punditburo, however, and the old political equation can still be seen through the fog of liberal self-righteousness. Squint and you can see that it is the forthrightly populist Senator Bernie Sanders who is most closely identified with universal healthcare these days. And it is the forces of organised expertise and private power that have repeatedly torpedoed it. In our awful current situation, a dose of authentic populism would be a remarkable tonic.

https://mondediplo.com/2020/08/02populism-expertise

Conflicts running rampant in the Covid era

By Judith Garber - The Lown Institute -  August 10, 2020
 
 

As our country faces difficult decisions about how to mitigate the Covid-19 pandemic, pharmaceutical companies are wielding their influence through considerable contributions to policymakers, health care administrators, and journalists. These conflicts contribute to media hype of new treatments and propagation of the idea that lower prices threaten innovation.

Campaign contributions abound

Let’s start with the big picture. According to a recent analysis in StatNews, more than two-thirds of sitting members of Congress have received contributions from pharmaceutical companies in advance of the November 2020 election. This includes payments from Covid-19 vaccine developers AstraZeneca ($314,500 paid to politicians), Johnson & Johnson ($542,000), and GlaxoSmithKline ($195,000), as well as remdesivir drug developer Gilead ($174,000).

These contributions are partly for “greasing the skids on a particular issue for which a company has great concern or sees great opportunity,” like Covid-19, said Sheila Krumholz, the executive director of the Center for Responsive Politics.

Altogether, the 25 largest drug companies and trade groups spent $11 million on 2020 campaign contributions. Although the contributions favored Republican incumbents, Democrat politicians still received about 47% of these contributions from drug companies.

“The breadth of these contributions shows drug corporations have no intention of doing anything to lower their prices.”

Ben Wakana

“The breadth of these contributions shows drug corporations have no intention of doing anything to lower their prices — they are lavishing millions in campaign contributions to protect their power to dictate high prices for prescription drugs,” said Ben Wakana, the executive director of the advocacy group Patients for Affordable Drugs Now.

Hospital CEO’s conflicts go undisclosed

In early February, Betsy Nabel wrote in a syndicated op-ed that lowering drug prices would harm the “innovation ecosystem” and curtail drug development. We’ve seen this argument used many times before, but this was one of the few times a hospital CEO had made this point, giving the “innovation” claim more weight.

Nabel’s byline identified her as a “cardiologist, a professor or medicine at Harvard Medical School and the president of Brigham Health and its Brigham and Women’s Hospital.” But she did not disclose that she was a member of the board at the biotech company Moderna until very recently, the Boston Globe reported. As a member of the board, Nabel received $487,500 in stock options last year, and owned millions of dollars in company stock.

As a member of the board, Nabel received $487,500 in stock options last year, and owned millions of dollars in company stock.

In the op-ed, Nabel wrote that policies such as drug price controls “could eliminate the financial incentives that allow research scientists to explore new treatments.” Coming from an independent doctor and researcher with decades of experience, this claim holds some weight; from a Moderna board member with a fiduciary duty to the drug company, the argument is much less convincing. Writers at the Globe noted that Moderna plans to price their vaccine at a much higher level compared to other companies, casting further suspicion on Nabel’s insistence on higher prices for the sake of “innovation.”

https://lowninstitute.org/conflicts-running-rampant-in-the-covid-era/ 

How doctors and patients view statins for primary prevention?

By Judith Garber - The Lown Institute - August 9, 2020
 

Statins, a class of cholesterol-lowering drugs, are among the most commonly taken medications worldwide. An estimated 28% of adults over 40 in the US were taking statins in 2013, up from 17% in 2002. But despite the prevalence of this drug, there is still debate among clinicians on whether the benefits of statins for some patients exceed the harms. Further, there is little known about the perceptions of clinicians and patients, who prescribe and take statins for primary prevention, respectively.

Which patients benefit from statins?

Statins are prescribed to prevent future cardiovascular events, for patients of both moderate and high risk. However, not all patients benefit equally from taking statins. People at a higher risk of cardiovascular events–particularly those who have previously experienced a heart attack or stroke–benefit more from taking statins than lower-risk patients.

The 2012 Cholesterol Treatment Trialists (CTT) meta-analysis, which included 22 trials with more than 130,000 patients, examined the effects of statins on people of varying risk levels. Together, these trials show that patients with heart disease at high risk of cardiovascular events taking statins reduced their absolute risk of heart attack or stroke by 2.24% and reduced their absolute risk of cardiovascular death by 0.46%. This means that 1 in 45 people in this risk group avoid a cardiovascular event by taking statins and 1 in 217 avoid death from heart attack or stroke.

But for people without existing heart disease in the CCT meta-analysis, the benefit was much lower: there was an absolute reduction of 0.4% in major cardiovascular events, and no statistically significant mortality benefit from statins. This means that 1 in 250 people in this risk group avoid a cardiovascular event by taking statins, and none avoid death.

Statins are not without side effects: muscle pain is a common side effect, affecting one in 21 people taking statins, and other studies have found an increased risk of diabetes associated with taking statins. The pill burden and financial cost (for branded statin drugs in particular) can also be taxing.

How do clinicians and low-risk patients perceive taking statins?

In a recent study, health services researcher at the National University of Ireland Galway Dr. Paula Byrne and colleagues conducted interviews with general practitioners and people taking statins for primary prevention, to better understand how they perceive the purpose of taking statins, and the potential benefits and harms.

A key takeaway from the interviews was that both clinicians and patients view “high cholesterol” itself as a disease in need of fixing, rather than a risk factor for heart disease. Statins are seen as the solution to high cholesterol, not a preventive measure taken to reduce the risk of heart attack and stroke. Patients generally perceived taking statins as a normal aspect of healthy living, and did not question the decision to take them as they might other types of drugs.

“The idea that ‘statins are necessary to treat high cholesterol’ regardless of other risk factors is deeply embedded in both patients and doctors.”

Dr. Paula Bryne

Yet there was ambivalence among the participants about taking statins. Some participants noted that they would rather not be taking them, but because their cholesterol was “too high” they had “no choice.” Clinicians too were not all sure about whether increasing the number of patients on statins was a good thing. Some clinicians trusted in the guidelines, while others “noted a creeping medicalization” of high cholesterol and said they would not necessarily take the drug themselves. Clinicians also struggled to balance their desire to empower patients to make their own decisions with the knowledge that they could be blamed for future heart attacks if they did not persuade patients to take statins.

Byrne et al. found that some patients overestimated the benefits of statins, and believed that once you started taking them, your risk of heart attack was eliminated, rather than just reduced. One woman said, “It is a bit scary when you think that maybe you could get heart disease, even if you were taking [statins]. That is a whole different ball game.” None of the patients in this study said that their doctor had used a risk calculator or decision aids to assess their overall risk of cardiovascular events before suggesting they take a statin, although most of the doctors in the study said that they used these tools.

The results of this study shed light onto some of the reasons why so many low-risk people take statins. The authors write:

Ambivalence and negotiation abounded throughout the reports of our interviewees indicating a complex ‘muddling through’ by doctors and members of the public in the face of uncertainty. Paradoxically, it is this very uncertainty that may give authority to doctors to propose statins in spite of their doubts, and drives patients to accept them as a way to try to live a healthy life. This may explain the high level of the use of statins in low-risk people.

https://lowninstitute.org/how-doctors-and-patients-view-statins-for-primary-prevention/ 


How Progressives Flipped the Script on Medicaid Expansion

Missouri is the latest state where ballot initiatives took the issue directly to voters, bypassing Republican leaders.

by Sarah Kliff - NYT - August 10, 2020 

It was the middle of 2016, and Obamacare supporters were stuck.

Nineteen states were refusing to participate in the health law’s Medicaid expansion, which provides health coverage to low-income Americans. States run by Democrats eagerly signed up for the program, lured in part by generous federal funding.

Most Republican governors and legislatures had little interest in expanding the reach of the Affordable Care Act, and declined the money.

“People were frustrated,” said Chris Jennings, a longtime health care strategist who served in the Clinton and Obama administrations. “We were left with either doing nothing or finding a new solution. And then these guys came up with this referendum strategy.”

“These guys” are the Fairness Project, a nonprofit created by a California health workers union. Their strategy: ask voters to expand Medicaid with state ballot initiatives.

In a few years, the Fairness Project’s ballot campaigns have gone from an untested tactic to the main approach for expanding the Affordable Care Act’s reach.

Missouri on Aug. 4 approved a Medicaid expansion ballot initiative, extending coverage to 217,000 low-income residents. It is the sixth state to do so since President Trump’s inauguration. A seventh, Virginia, expanded Medicaid after Democrats gained control of the state legislature.

These efforts have extended Medicaid eligibility to around one million low-income Americans living in states where governors or legislatures have opposed the program. “Some of us were a little skeptical at first,” said Mr. Jennings, who has since become an informal adviser to the Fairness Project. “We thought there would be extraordinary resources waged against them. But they’re taking on hard issues in hard states, and they’re a lot more successful than some of us can say.”

Missouri’s ballot initiative passed with 53 percent of the vote. Gov. Mike Parson, a Republican, had opposed the initiative, arguing that it would harm a state budget that was already under strain because of the pandemic.

The financial impact of Medicaid expansion is uncertain and could range from $200 million in extra costs to $1 billion in additional annual savings, according to an estimate prepared by the state’s auditor, Nicole Galloway, a Democrat who is running for governor this fall.

The Fairness Project grew out of a memo that a California union leader wrote in 2014, warning that steep declines in union membership could leave workers unprotected with fewer benefits.

“Unionism is in decline, and there is no end to that in sight,” Dave Regan, president of United Healthcare Workers West, said recently. His group represents 95,000 hospital workers in California. “But we still need to give regular people the opportunity to have positive change in their lives.”

In his memo, Mr. Regan proposed creating a nonprofit that would use the ballot initiative process to secure policies that would benefit workers, like increased access to health coverage and a higher minimum wage.

“Ballots are an opportunity to put a question, in its undiluted form, in front of millions of people,” he said. “As opposed to traditional legislative work, where things get watered down to get out of committee, you end up with what you actually want when you use the ballot.”

Not all of his union members were enthusiastic about the project. Some questioned why dues paid in California would be spent running campaigns in the Midwest. But the initiative had enough support that the United Healthcare Workers West executive board approved its funding, and has continued to do so each year since.

The Fairness Project began in 2016, starting with ballot initiative campaigns for increasing the minimum wage in California and Maine. The next year, it came back to Maine to support the country’s first Medicaid expansion referendum.

The Maine legislature had already passed bills to expand Medicaid five times, only to have each vetoed by Gov. Paul LePage.

“We kept falling a vote or two shy of overriding the governor’s veto,” said Robyn Merrill, executive director of Maine Equal Justice. “It felt like this was a huge problem that many wanted to fix, and that we had to find a way to make it happen.”

Ms. Merrill’s group quickly gathered enough signatures to secure a spot on the 2017 ballot. The Fairness Project joined the campaign shortly afterward, providing financial support for advertising and data about which voters to target and how to reach them.

“The way we ensure that we win is by running these campaigns like gubernatorial or Senate races,” said Jonathan Schleifer, a former congressional staffer who now leads the Fairness Project. “They have modeling, they have research, they have a diverse coalition; we have that, too.”

The Maine campaign succeeded, with 59 percent of voters supporting Medicaid expansion. That caught the attention of supporters in other states, who were similarly struggling to enact the program.

“I got in touch with the Fairness Project and basically asked: What would it take to have you come to Nebraska,” said State Senator Adam Morfeld, who had spent years introducing legislation to create the program. “They immediately did a poll in December 2017, and saw there was a path to victory.”

In 2018, the Fairness Project ran successful Medicaid expansion campaigns in Nebraska, Utah and Idaho. A fourth ballot campaign, to continue funding Montana’s already-existing Medicaid expansion, failed, but the state legislature ultimately stepped in to pay for the program.

The Fairness Project does not disclose a list of its donors, and declined to provide one to The New York Times (Mr. Schleifer did identify United Healthcare Workers West as the group’s “most significant” supporter). This lack of transparency has led to some criticism of the group because it makes it harder for voters to know who is supporting and organizing the ballot measures.

The ballot initiative method has its drawbacks. After the initiatives pass, governors often delay, alter or outright refuse implementation. Some have even sought to change the ballot initiative process, making it harder to secure spots, after seeing Medicaid ballots succeed elsewhere.

Governor LePage of Maine said he “would go to jail” before expanding Medicaid. The program did not start enrolling members until the state elected a new governor, Janet Mills, a Democrat, in 2018.

Utah’s government added a provision that Medicaid enrollees had to work, volunteer or search for work to secure coverage, a restriction not in the original ballot.

Nebraska began enrolling patients into its Medicaid expansion only this month, nearly two years after the ballot passed. It also added a work requirement, although both it and Utah have suspended those rules during the pandemic.

“Even after the people pass it, they still fight it,” Senator Morfeld said.

Such post-ballot resistance prompted the Fairness Project to revise its strategy for its 2020 Medicaid campaign in Oklahoma. The ballot asked voters to approve a constitutional amendment, which could be altered only by another statewide referendum. The referendum passed in June. The Fairness Project employed the same method in Missouri.

A constitutional ballot typically requires more work and stronger support. In Oklahoma, for example, ballot organizers can pursue statutory or constitutional initiatives. The constitutional initiatives have more staying power, but also require gathering twice as many signatures.

Not all states allow ballot initiatives. Of the 12 remaining states that have not decided to expand Medicaid, only four have referendum processes: Florida, Mississippi, South Dakota and Wyoming.

Florida, which has 2.7 million uninsured residents, is the Fairness Project’s next major focus.

“We’ve been working in Florida for about two years now,” Mr. Schleifer said. “It’s such a massive undertaking, but the number impacted would be the same as everywhere else combined, close to 800,000.”

He has targeted 2022 as the earliest date the Fairness Project could run a campaign there.

“One of the things we’ve learned is there is a huge benefit to building a long runway,” he said. “You need a substantial campaign entity, especially in Florida where every region is like its own state. We need the grass-roots infrastructure, and we need to disrupt the messaging and all that has been invested in attacking this policy.”

https://www.nytimes.com/2020/08/04/upshot/missouri-election-medicaid-expansion.html?action=click&module=News&pgtype=Homepage

 

Why I’m Obsessed With Patients’ Medical Bills

To report on the true cost of health care, it’s critical to see what a hospital charges patients. But since hospitals keep those prices a secret, I turn to the next best source: you.

by Sarah Kliff - NYT - August 8, 2020

My reporting obsession with medical bills started with a bandage. A very, very expensive bandage.

Four years ago, before I worked for The New York Times, a reader emailed me a surprising story. He had taken his 1-year-old daughter to the emergency room because after her nails were clipped a bit too short, her finger started spurting blood. The little girl was fine, and received a disposable bandage that fell off on the car ride home.

Then the bill came: $629 for the visit. How could such a simple visit cost so much? I discovered that the real cost lay in fees that every emergency room charges just for walking in the door. I also discovered something else important.

At the bottom of my article about the little girl’s case, I asked readers to reach out if they had similar bills to share. I expected a few dozen emails. I ended up with hundreds. Frustrated readers desperately wanted to share their billing experiences — and, I quickly learned, had access to some of the most valuable, most private information in the American health care system.

Now, I’m turning to the readers of The Times, where I work as an investigative journalist, to help me report on what people are being charged when they get tested or treated for the coronavirus. This week, The Times introduced a new form so patients may submit their bills, which contain insights that are nearly impossible to find elsewhere.

That’s because in the United States, hospitals and doctors’ offices typically keep their prices secret. Powerful lobbies want to keep things that way. But people in the Trump administration see transparency as a way to reduce medical costs. Last year, when they proposed a rule that would make public the prices that providers negotiate with insurers, the American Hospital Association sued to stop it. (The hospitals recently lost in federal court but plan to appeal the decision.)

The secrecy that surrounds health care prices is a huge hurdle for health care reporters like me. I know from academic studies that America’s health care prices are the highest in the world, and that fees can vary drastically from one hospital or doctor’s office to another.

But it’s still difficult, sometimes impossible, to write a story about which hospital or doctor is the most expensive or the least. That’s the information readers want. It’s the information I want, too. And it’s the hardest to get.

The emails readers sent me after I wrote about that $600 bandage gave me a solution. Many included medical bills with the price charged, what the insurer paid and what the patient was responsible for. The secrets were suddenly in plain sight.

Since then, readers’ medical bills have become a crucial source for my reporting. They are the documents that say exactly what medicine costs in the United States. Coupled with interviews with patients, who can explain the effects of those costs on their lives, they underpin powerful stories about living in a country where routine care can cost three or four times what it does abroad.

Coronavirus Schools Briefing: How is the pandemic reshaping education? Get the latest news and tips as students go back to school.

Last year, readers’ bills helped me figure out that the only trauma center in San Francisco was out of network with all private insurance companies, leaving patients with thousands of dollars in medical debt. I received those bills through a reporting project at my last job, where we crowdsourced a database of 2,000 emergency room bills.

Just last month, I got exceptionally lucky when four patients who received coronavirus tests in one Texas emergency room decided to send me their billing documents. Three patients sent them in totally unconnected to one another, each aghast at the prices. (The fourth came from one patient’s friend.) Together, they showed that the price of a test could range from $199 to $6,408 — all in the same facility.

That story made me eager to better understand what the price of testing and other coronavirus care looks like in the rest of the country, and, working with my Times colleagues, I decided that readers’ bills were the best way to tell the story. (When handling sensitive information, access is highly restricted and is never published without prior consent.)

Collecting medical bills is, admittedly, a slow, inefficient process that doesn’t lend itself to automation. The documents that come in are messy. Some are image files and others are PDFs. Each hospital and insurer uses its own formatting. A few medical bills — the ones I now swoon for — include detailed, itemized information that shows the price of every pill and scan. Others, frustratingly, lump everything together into one price.

Running a project like this is equal parts stressful and exciting because I don’t know in advance what stories I’ll tell. Instead, I’m waiting to see where the readers’ submissions will guide me.

Right now, I’m mostly excited: Since starting on Monday, we’ve already had nearly 200 submissions. The more I read, the more interesting patterns I start to notice.

Sarah Kliff is an investigative reporter for The New York Times. Her reporting focuses on the American health care system and how it works for patients.  

https://www.nytimes.com/2020/08/07/insider/coronavirus-medical-bills.html?action=click&module=Well&pgtype=Homepage&section=Reader%20Center 

 

 

Posted by at

No comments:

Post a Comment

Subscribe to: Post Comments (Atom)