How Do We Fix Healthcare?

 

The current system of health care financing is hopelessly complex.

 

“I’m going to stay here until there’s really not a hope of getting it anymore,” said Jesus Neave.

Jesus is referring to the kidney dialysis treatments he has been receiving three times a week at Grady Memorial Hospital. The hospital had just decided to close its outpatient dialysis unit. Grady Memorial is an Atlanta public hospital. Like many public hospitals that serve the poor, it was in dire financial straits, with a multi-million dollar deficit.1

Jesus crossed illegally into this country from his native Mexico in 1992. Four years later doctors told him he had kidney disease.

With the closing of the hospital’s dialysis unit, Jesus was left with few options. Grady encouraged him to return home to Mexico for treatment. But, as Jesus explained to a reporter, “Mexico is my country, but over there if you don’t have money, the doctors won’t treat you.” As a maintenance worker, Jesus does not earn enough money to pay for his own treatment.

Another patient at Grady’s dialysis clinic, Cruz Constancia, said much the same about her home country of El Salvador, “People die very fast. The way it works down there is that if you do not have money, they don’t put medicine in your machine.”

DialysisCenter

Grady’s outpatient dialysis unit treated about 50 patients in the same situation as Jesus and Cruz. These patients are poor and almost all undocumented, so they are not eligible for government programs like Medicaid. The typical thrice-weekly treatment costs the hospital $50,000 a year for each patient.

Few of Grady’s dialysis patients made any effort to return to their home countries. They believed it would be futile. Besides, many said their families and friends all lived in this country. In the end, Grady Memorial agreed to pay for services for these patients at a private dialysis clinic….at least for one year. The hospital managers know that if these patients present themselves at Grady’s emergency room, the hospital will be required by federal law to treat them there, and dialysis in the emergency room is more expensive than in a specialized dialysis clinic.

It is not clear how Grady can afford to continue paying for dialysis treatments, given its poor financial state and its mandate to serve other indigent patients as well.

What happened at Grady Memorial Hospital illustrates the essential dilemma of our nation’s health care system. In an ideal system, everyone who needs care gets it. In practice, we come up against staggering costs that stymie that goal. Along the way, we face agonizing moral choices.

 

There was a time not long ago when no one thought it was government’s job to pay for  health care. If there were health care bills to pay, family or friends would step up, or the patient would do without, often with dire consequences. It wouldn’t have seemed right for the government to tax strangers—-to take part of their hard-earned wages—-to pay for another family’s medical bills. Today most people expect just that.

 

What Is The Problem?

How should we finance our American health care system? No other public policy issue has been a greater source of controversy among policy makers, politicians and the public. I am not an expert, but in this post I will lay out some of my ideas on the matter.

It is important to correctly identify the problem. The problem does not lie in the quality of medical services. American physicians and hospitals provide a sophisticated level of care that is the envy of the world. People who can afford it come to the U.S. for treatments that are substandard or unavailable in their home countries. The problem, in a word, is cost.

Studies have shown that medical services in the U.S. are far costlier than comparable services in other countries, even though measures of our national health (such as life expectancy and infant mortality) are below those of countries that spend far less on health care.2 Today we in the U.S. spend almost 18% of our Gross Domestic Product on health care and that is expected to rise to nearly 20% by 2025.3 If healthcare costs continue to rise, eventually we will need to spend the majority of GDP on health care. That is impossible because we have other essential priorities—-debt obligations, defense, and education, to name just three.

HealthCostAsPercentageGDP

The core dilemma in health care financing is that public expectations about the kind and scope of health care that can be provided by society are wholly unrealistic. How did this come to be? Politicians figured out long ago that a sure-fire way to remain in office is to promise their constituents that the government will subsidize their medical costs. Elected leaders make promises that can’t be kept…at least not for long.

We can see this in the way Medicare, the government insurance program for older people and the disabled, has changed over the years. It would be political suicide for politicians to “cut Medicare.” But Medicare costs are such that the system is unsustainable. For a while, introducing measures to increase efficiency worked, for example, by changing the way hospitals are reimbursed for care (payment based on patient diagnosis rather than service rendered). But as the Center for Medicare and Medicaid Services (CMMS) wrings inefficiencies out of the system, there is less and less room to save additional costs.

The result has been a stealth campaign to limit Medicare services or to cut benefits, although the changes are never described in this way. For example, CMMS has placed limits and restrictions on the amount of money they will pay for physical therapy. They have engaged in “utilization review” of hospitalizations, ruling in some cases that patients’ hospital stays were not “medically necessary,” thereby shifting costs to patients. They have limited or cancelled coverage for some drugs. I expect this trend to continue. The key to keeping the system going is to bleed the system slowly so that the public will not grow angry enough to vote against the politicians. But at some point, this stealth campaign will become apparent to the public. It is anyone’s guess what will happen then.

Another part of the healthcare puzzle concerns the cost of providing care to people who are in the U.S. illegally. Estimates vary, but there are probably 11 to 13 million such persons today.  They are not eligible for government program like Medicaid, but they do use emergency rooms and free clinics. In 1986 Congress passed the Emergency Medical Treatment and Labor Act (EMTALA). This legislation created a legal obligation for hospitals to provide emergency care to all persons who come to emergency rooms regardless of their ability to pay. Hospitals must provide care to these patients or arrange transfer to a facility that can provide needed care. As a result, hospitals have absorbed large unreimbursed costs for care of undocumented patients.4

A 2010 report found that Texas hospitals incurred an estimated $717 million in costs of uncompensated medical care given to undocumented immigrants in the state’s public hospitals. The report also showed that the state of Texas spent $118 million for pre-natal care for children of undocumented immigrants. Once these children are born on U.S. soil, they are citizens and qualify for public benefits such as Medicaid.

Although these costs are substantial, there is reason to believe that undocumented persons use fewer healthcare services than those who are in the U.S. legally. For example, although the undocumented were 12 per cent of the non-elderly population of Los Angeles County in 2000, they accounted for only 6 per cent of healthcare spending.  Compared to others, undocumented persons used fewer healthcare services and contributed less to healthcare costs in relation to their proportion of the population. This is probably due to their relatively better health and lack of health insurance.6

Are healthcare expenditures for undocumented persons justified? It depends on a person’s perspective. Some people believe that because undocumented persons are here illegally, they should receive no public benefits. Others point to the fact that undocumented persons perform essential labor and so are deserving of the same care given to others. In any case, our moral values require that we provide some level of care to people in need, no matter their circumstances.

 

Why Are Health Care Costs Rising So Much?

It will help to understand why health care costs are rising more rapidly than the nation’s ability to keep up. As President Trump admitted recently in the face of Congress’ inability to pass a reform of his predecessor’s Affordable Care Act, “It is complicated.” I’m not a health care economist, so all I can offer is a layman’s perspective about rising costs.

 

Patient Incentives

HealthInsuranceCertificateMost of health care is paid for by government or by private insurers. That has meant in practice that patients do not feel the full impact of their health care spending. This has encouraged patients to spend more than they would have otherwise. Most financing mechanisms try to avoid this by requiring patients to pay deductibles (the initial amount to be paid before benefits kick in) and coinsurance (a portion of costs, often 20 per cent). But deductibles and coinsurance have had only partial success. For the price of a secondary insurance policy, millions of Medicare patients effectively avoid deductibles and coinsurance. Because of this, patients have little incentive to economize as consumers of health services.

A part of health care inflation really isn’t inflation at all, because increased costs often represent additional and improved services. Researchers develop new drugs and new technologies that enhance health care outcomes. But these innovations are expensive—often very expensive. For example, patients with metastasized prostate cancer have a new drug —-Provenge—-that will prolong their lives for a few months. But the cost is staggering. On average, the drug will extend life for four months and cost $93,000.7 There are new costly innovations in every area of medicine: scanning technologies and other diagnostic techniques, surgical technology, and so on. Consider for example, that a Magnetic Resonance Image scan, which is now routinely used for minor and major medical problems, is many times more costly than the old standard X-ray. And the recently popular robotic surgery is a great medical advance, but requires the purchase of expensive machinery and extensive physician training.

MRI_On_Cocaine

 

Legal Issues

“Defensive medicine” practices also fuel health care inflation. Providers, sensitive to dangers of malpractice lawsuits, often choose to perform an excessive number of tests or treatment procedures as a way to defend themselves against charges of negligence.

 

Practices of Big Pharma

I’ve already mentioned the cancer drug Provenge. Many other drugs are likely more expensive than they could be. For one thing, large pharmaceutical companies have the financial resources to lobby Congress for laws that protect their profits. The Affordable Care Act (ACA) was the result, in part, of a devil’s pact between Big Pharma and the Obama Administration: In exchange for Big Pharma’s support for the ACA, Congress agreed to pass a law making it illegal for U.S. consumers to buy drugs outside the country. This keeps drug prices high. There is another perspective on this issue: Many foreign countries enforce price controls on drugs. To make up for these restricted prices in other countries, pharmaceutical companies keep their U.S. drug prices high.

The government allows pharmaceutical companies a period of several years of high prices for new drugs (called brand name drugs), ostensibly to incentivize companies to innovate and to recoup their considerable research and development costs. But pharmaceutical companies often artificially extend this period by unnecessarily tweaking their drug formulas or combining old drugs into a new form, and then claiming these drugs are “new” and thus eligible for higher brand name pricing. Older drugs, whose initial period has expired, are cheaper. They are called generic drugs. (I myself use an old generic drug that has been tweaked into a very expensive new brand PrescriptionDrugsname drug: an eye medication called Restasis. Restasis is nothing more than an old generic drug called cyclosporine. However, the FDA considers it a “new drug” because, in the form of Restasis, it is delivered as an eye drop rather than a pill. This way the manufacturer gets to charge a high price even though it did not incur development costs for creation of the drug—–although it did incur costs to test the safety and efficacy of the new formulation.)

The U.S. is one of only two countries to allow Direct to Consumer advertising of pharmaceutical drugs that includes health claims.8 This raises costs because patients see advertisements for these drugs and then demand prescriptions for them from their doctors. Patients then consume expensive brand name drugs when cheaper and effective generic alternatives are available.

 

Complexity and Administrative Overhead

The current system of health care financing is hopelessly complex. There are many hundreds, perhaps thousands, of “third-party payers” such as various federal and state government agencies, the military, Blue Cross and Blue Shield (there are many of these PatientEmergencyacross the country), health maintenance organizations, and a host of private insurance companies. Any one of these payers may administer several plans with different reimbursement rules and rates. Often, as in the case of many Medicare patients, part of the payment is assigned to Medicare and another part to a secondary insurer. Payment rules and rates are so complex that an entire profession has grown up around processing health claims: “medical billing specialists”. Of course, all of this costs money.

A proposed solution is the single-payer health plan. In this plan, the federal government pays all healthcare bills. A single payer system would rationalize and standardize reimbursement and reduce administrative overhead. However, I am skeptical that it would reduce total costs. I believe a single payer government program would result in higher use of services and less efficiency, which would overwhelm any savings in administrative overhead. It is a given that when a large flow of government money is directed at any segment of the economy, that segment experiences greater-than normal inflation. One example of this is the precipitous increase in the cost of medical care that accompanied the introduction of Medicare and Medicaid in 1965. There are additional examples of this phenomenon in other sectors of the economy.

“Coordination of care” is another hot-button issue in health care. Because our health care system is fragmented, many patients receive care from multiple providers in multiple settings. Although the situation has improved since passage of the ACA, with its requirements for electronic record keeping, patients may receive duplicate medical tests or treatments from providers who are not familiar with the patient’s medical history. This is especially true for patients with multiple, chronic conditions, who have several providers.

 

What Really Determines Our Health?

The “health care debate” has consumed a great deal of media attention, and has focused almost exclusively on health care financing. It is not surprising then, that most people believe the medical care we receive determines how healthy we are. But other factors are far more important. Here is my wish list for a healthy populace: good air and water quality; availability of healthful foods; balanced diet; safe workplaces; vehicle safety; responsible alcohol consumption and avoidance of street drugs; maintenance of a healthy weight; and low levels of violence in schools, workplaces and neighborhoods.

FoodCornSyrup

 

Over the most recent Fourth of July weekend, 100 people in Chicago sustained gunshot wounds. I don’t know of anyone who has tallied the cost to our health care system. But most of these gunshot victims survived and required medical care. The cost must have run into many millions of dollars…and this in just one American city on one weekend. Another example that has received media attention: Babies of crack cocaine-addicted mothers are born with multiple health problems and are themselves addicted to cocaine. Treating these babies costs the U.S. health care system millions of dollars a year.9 This cost is borne by the state and federal governments, that is, by working taxpayers.

 

Is Government the Answer?

Many people believe that a government run health care system would be a panacea. But government has a history of working at cross purposes. For example, until 2014 the federal government subsidized the growing of tobacco. At the same time, through Medicare and Medicaid, it paid millions of dollars for treatment of tobacco-related diseases. The federal government continues to subsidize the cultivation of corn, which is then used to raise beef and to add corn syrup to countless foods that consumers eat every day. But eating corn-raised beef is linked to cardiovascular disease and corn syrup to diabetes—two health conditions that consume a great portion of our national health care bill.

While liberals advocate for government-run health care, conservatives promote a free-market for health care services. For example, while liberals want Medicare for everyone (a single payer system), conservatives support Health Savings Accounts which provide tax incentives for patients to set aside their own dollars that they then use to buy health care on the private market. I’ve already discussed the drawbacks of a government-run single payer system. But would a free market approach be better? Perhaps. But the nature of health care spending does not fit well into a free market model.

A free market model works when the parties to a financial transaction have complete information about the good or service to be exchanged, including price. A free market also requires that the parties be free to make the exchange or not. Based on their knowledge and needs, the parties to the transaction may believe they can get a better deal elsewhere. This competition leads to more fair and efficient outcomes.

But the purchase of medical services does not work this way. Health care services require specialized medical knowledge that few patients have. In addition, in the current system, patients often find it difficult or impossible to determine the price of services. Providers charge wildly varying prices for the same service, depending on who the purchaser is. Finally, much of health care is delivered when the patient is in distress or does not have an easy option to “shop around” for the best deal. All of these factors generally work to the advantage of the provider and the disadvantage of the patient or payer.

 

A Few of My Ideas

In this post I have reviewed what I believe are some of the critical issues that must be considered in the design of any system of health care financing and delivery. Although I have studied and thought about this issue for decades, I don’t know what a fair, effective and efficient solution would be. But I can offer a few of my ideas.

  1. Discard the idea that health care is a right. Neither society nor its representative, the government, is morally obligated to provide health care. The notion that people are “owed” a service—-no matter how essential—- is inconsistent with American values of personal responsibility and freedom from government interference.
  2. Patients who can afford better care should get it. Allow providers to offer better care to those who can afford it. It is not immoral to allow a person who has guarded his health, worked hard and saved, to purchase better care than a person who has done none of those things. My proposal, of course, necessitates a two-tiered system of privileged and underprivileged patients. So what. Every other sector of the economy works this way. And if we are honest, we will admit that we have always had a two-tiered system of health care, with affluent patients paying for health care through private insurance and poor patients through government programs (although Medicare has changed this somewhat for the elderly and disabled).
  3. Ensure that, for adults, there is a link between personal behavior and personal responsibility. People who ruin their health through irresponsible behavior should not expect others to pay to remediate the damage they have caused to themselves. Is it fair for taxpayers to pay for dentures for a long-term methamphetamine addict when that addict knew full well that his drug habit would ruin his teeth? Should CrackCocainetaxpayers foot the bill for knee replacements for adults who are obese? Should a hospital cover the cost of a lung transplant for a life-long smoker? Every choice we make about who and what is covered has an impact on the costs incurred by others. I am not suggesting that the government should interfere in the choices people make about drug use, diet or smoking. People should be free to do with their bodies what they like. But they have no moral grounds to force the rest of us to pay for the consequences of their negative health behaviors.

This idea may sound far-fetched today. But as the population ages and health care inflation continues to put more and more care out of reach, tough choices will have to be made about who will be covered by social programs and who will not. Or, as one health economist posed the essential question of health care financing, “Who shall live?”10 We already see a hint of this approach in the health insurance policies of large businesses, some of which now charge higher premiums to employees who are obese, smoke, or refuse to participate in health programs. Coercive? Yes, but these sorts of choices are inevitable in an economy of limited resources.Government should mandate policies that promote good public health, thereby reducing health care costs. The Clean Air Act and the Clean Water Act are examples of such policies, as are all policies that promote a healthy environment and safe food supply. Government should avoid all subsidies for growing corn and tobacco. It should promote workplace and transportation safety.

  1. Insurance companies will likely have a role to play in health care financing for a long time to come. If the government guarantees a profit for insurance companies it is fair to insist that those profits be reasonable and that company executives are not paid exorbitant compensation at the expense of policy holders. We already use this model for the regulation of essential public utilities such as gas and electricity.
  2. Congress and state legislatures should pass meaningful campaign finance reform. Today powerful players such as pharmaceutical companies, medical device manufacturers, doctors’ groups, long-term care providers and hospital associationsCapitolHill can influence the legislative process in ways that serve the profits of these special interests, but work against the public interest. It is wrong that a phone call from a powerful senator to the Food and Drug Administration can quash the FDA’s efforts to regulate a pharmaceutical company. Or that politicians can effectively be bribed to prohibit American patients from buying pharmaceuticals from foreign countries, as I mentioned above. Meaningful campaign finance reform would make these sorts of influences illegal and restore the role of government in protecting the interests of its citizens.
  3. Some pundits have suggested that the government’s role in health care should be limited. That is, government should guarantee only a basic level of service—-perhaps emergency, preventative, and catastrophic care. Patients would be responsible for all other costs, which they could cover out-of-pocket or through private insurance and employer plans.
  4. Government’s goal should be to empower people to pay for their own health care to the extent possible. A case can be made for government funding of care for children and the mentally incapacitated, who cannot be held responsible for the choices of their parents or caretakers. For adults, government should promote private mechanisms that can reduce costs to patients. These mechanisms might include Health Maintenance Organizations in which patients pay a set fee for all services (capitation), or patient cooperatives, modeled after farmers’ cooperatives, which can negotiate bulk pricing for its members. Government subsidies could be used to increase the supply of providers, especially physicians, which would enhance competition and thus lower costs to patients.

 

There is no ideal way to finance health care. Nor will it be possible for any government or group to provide every health care benefit that everyone wants. But if we think carefully about how to improve our current hodge-podge system of financing we might just come up with a sustainable health care system that meets the needs of most people most of the time.

 

Footnotes

 

  1. Sack, K. Reprieve Eases Medical Crisis for Illegal Immigrants. New York Times. January 5, 2010. Retrieved August 8, 2017 from: http://www.nytimes.com/2010/01/06/us/06grady.html?action=click&contentCollection=Money%20%26%20Policy&module=RelatedCoverage&region=EndOfArticle&pgtype=article

 

  1. Khazan, O. U.S. Healthcare: Most Expensive and Worst Performing. The Atlantic. June 16, 2014. Retrieved August 7, 2017 from:

https://www.theatlantic.com/health/archive/2014/06/us-healthcare-most-expensive-and-worst-performing/372828/

 

  1. National Health Expenditure Data. Centers for Medicare and Medicaid Services. December 6, 2016. Retrieved August 7, 2017 from:

https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsHistorical.html

 

  1. What Illegal Immigrants Cost Our Healthcare System. Association of Mature American Citizens. November 4, 2016. Retrieved August 8, 2017 from: https://amac.us/illegal-immigrants-cost-health-car

 

  1. Ibid.

 

6. Goldman, D.P., Smith, J.P., & Sood, N. Immigrants and the Cost of Medical Care. Health Affairs. Retrieved August 8, 2017 from:

http://content.healthaffairs.org/content/25/6/1700.full

 

  1. Hutchison, C. Provenge Cancer Vaccine: Can You Put a Price on Delaying Death? ABC News, July 29, 2010. Retrieved August 7, 2017 from:

http://abcnews.go.com/Health/ProstateCancerNews/provenge-cancer-vaccine-months-life-worth-100k/story?id=11269159

 

  1. Ventola, C.L. Direct-to-Consumer Pharmaceutical Advertising: Therapeutic or Toxic? Pharmacy and Therapeutics, 36(10), October 2011, 669-674, 681-684. Retrieved August 7, 2017 from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3278148/

 

  1. The Economic Costs of Alcohol and Drug Abuse in the United States-1992. National Institute of Drug Abuse. National Institutes of Health. Retrieved August 7, 2017 from:

https://archives.drugabuse.gov/EconomicCosts/Chapter4b.html

 

  1. Fuchs, V. Who Shall Live?: Health, Economics and Social Choice (Second Expanded Edition). World Scientific Publishing: Singapore, 2011.

 

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Are Liberals Preventing Us From Speaking Out?

I wonder why it is that conservatives and liberals act

differently in the face of opposing views.

 

Political discourse and political opinion-sharing in our country have become tortured for liberals and conservatives alike.

But there is an asymmetry between the right and left ends of the political spectrum. Conservatives and liberals respond to opinions they disagree with in different ways. Of course there are intolerant people on both sides of the political divide. And liberal or conservative, each of us is firmly wedded to our view of the world. But challenging a conservative is rarely dangerous, nor is it likely to trigger a dramatic or violent reaction. That used to be the case for liberals too. But it is no longer. This divide is most clearly in evidence when it comes to Jewish students and to the Israeli-Palestinian conflict.

Just look at what happens on college campuses across the nation. Has your campus invited a speaker who is liberal? Or whose views do not offend liberals? You are not likely to encounter a problem. Example: A radical Muslim recently gave a fiery speech at the University of California, Irvine—a speech laced with the most extreme anti-Semitism you can imagine: Jews are responsible for every war that has ever occurred; they control the government; behind every social problem you will find ‘a Jew.’1 This sort of discourse does not get challenged on many campuses. This fellow gave his lengthy speech without any interference.

 

UCBerkeley
University of California, Berkeley

 

But Israeli speakers, and conservative speakers in general, are routinely harassed and often “shut down” by angry mobs. These mobs are increasingly violent: witness the riots that erupted recently at the University of California, Berkeley in response to a planned appearance by conservative Milo Yiannopoulos.2 Or the students at Middlebury College who “shut down” controversial speaker Charles Murray and went on to attack and injure a faculty member.3

At UC Irvine again, a group of Jewish students held a viewing of a documentary film that followed the lives of new recruits to the Israeli Defense Forces. A mob of anti-Israel students rioted outside the venue and the Jewish students required a police escort to leave the building.4 (It is galling that university administrators “evacuate” Jewish students in these types of incidents, rather than remove the rioting protestors.  And rarely do they discipline the protestors.) This sort of thing has happened on other campuses as well, here in the US and in Europe.

In many cases an Israeli or conservative speaker never makes it to campus to begin with. I have been told that at my town’s university, pro-Israel speakers are rare because almost no one will invite them. Yes, they may be invited by the single pro-Israel student association, but there is no department or other group on campus that will sponsor such a speaker.

In other cases, conservatives are unable to speak on campus due to protests of liberal students and faculty. This happened to Condoleezza Rice at Rutgers University5 and to Ayaan Hirsi Ali at Brandeis University.6 Brandeis went so far as to withdraw a previously-offered honorary degree to Hirsi Ali.

 

CondoleezzaRice
Condoleezza Rice

 

University professors are indoctrinating a generation of students to believe that anything or anyone who offends them should be shut down. Many of these professors require “trigger warnings” for any material that a student may find disturbing. Presumably, disturbing content includes the expression of political views contrary to the views of the students. This was dramatically illustrated in a video by conservative provocateur James O’Keefe.9 In the video, a young woman, posing as a student, complains to a student services advisor that she was upset when she encountered a group of students distributing copies of the U.S. constitution on campus. Revealingly, the advisor offers to soothe the student by shredding a copy of the constitution that the student had brought in. Lesson learned: if an idea offends you, destroy it or shut it down, rather than study, consider or debate it.

There is a parallel here with what happens beyond the universities. In Paris in January, 2015, terrorists murdered several cartoonists at the satirical paper Charlie Hebdo for violating an Islamic prohibition by drawing cartoons depicting Mohammed.7 This had a chilling effect on newspaper editors and publishers all over the world, who refrained from criticizing Islam out of fear of violent reprisals from offended radical Muslims. There is no such suppression against those who satirize or criticize Christian, Jewish, Hindu or Buddhist figures. When Pamela Geller, an outspoken critic of radical Islam, sponsored a Mohammed-cartoon contest to reinforce freedom of expression, two armed PamelaGellerjihadists showed up and attempted to carry out a massacre.8 Fortunately for the cartoonists, security officers managed to kill the attackers before they could enter the hall where the contest took place. Pamela Geller is deliberately provocative. And it is not nice to ridicule another’s religion. At the same time, we need people like Geller who are willing to stand up for freedom of expression lest we lose that freedom.  Liberals condemn Geller but don’t speak out about the defamation in Muslim countries against Jews and Christians—-not to mention the ethnic cleansing of these groups from the Middle East. (I acknowledge Muslims’ right to ridicule and defame my religion, which they do every day in mass media, government communications, and religious and civil society institutions. That is what free speech is about. It is sometimes an unpleasant affair, but one that is necessary in a free society.)

I wonder why it is that conservatives and liberals act differently in the face of opposing views. Are liberals so convinced of the truth of their positions that they won’t consider others’ opinions? Or are they so insecure in their views that they believe that allowing the expression of alternative views would shatter their fragile world? Are conservatives more open minded than liberals? Or are they simply better behaved? And if so, why? Are liberals more self-righteous than conservatives?

The eerie part of all this is that we have been here before. The campus mobs that threaten and riot when Milo Yiannopoulos speaks or when Jewish students invite a pro-Israel speaker, are reminiscent of a much darker era in Europe of the 1930s and of Mao’s Cultural Revolution. Let’s call these tactics what they are: fascism. Using violence and threats of violence is a fascist tactic and no amount of posturing about “social justice” on the part of campus mobs can pretty up this reality.

As for me, I will continue to share my views with anyone willing to listen.

I believe that radical Islam is a threat to the world and that everyone should speak out against its dehumanizing and repressive political ideology. Of course, at the same time I recognize that, although radical Islam is no small part of world-wide Islam, most Muslims oppose these ideas. They long for the precious freedoms we have in the West.

There is a challenge for those of us who speak out against the intolerance and violence of radical Islam: Some will wrongly use our words to demonize all Muslims. That can add fuel to a delicate situation in which Muslims already face hostility from their non-Muslim neighbors. As I have written in an earlier blog, the key is to distinguish between Islam as a religion, and Islam as a political ideology.

History affords us an example. During the Second World War almost all Americans understood the poisonous nature of German National Socialism. But most Americans also were able to distinguish between the political ideology of National Socialism and the German people. Thus, there was little hostility or violence, and no legal restrictions against German-Americans. Of course, the situation with Japanese Americans was different. In this case, U.S. media and government deliberately blurred the distinction between being Japanese and being a supporter of Japanese fascism and expansionism. The results were catastrophic for Japanese Americans. These included not only involuntary internment in military camps, but also loss of homes and businesses, widespread discrimination and general social hostility. In the end, we damaged not only the welfare of Japanese Americans but also the integrity of our democratic institutions. And we set a dangerous precedent for the future.

JapaneseWW2Poster

Why did the nation react in dramatically different fashion when it came to Germans versus Japanese? We identified and sympathized with Germans because they were white Christian Europeans. These feelings did not extend to the Japanese; we saw them as alien, because their race, culture and religion differed from our own.

The danger of course, is that in our just fight against radical Islam we will treat mainstream American Muslims as we treated Japanese Americans in the past. Still, this is a reason to tread carefully, not a reason to quiet our voices and ignore the darker side of Islam. Doing so would harm not just Western societies but also Muslims.

It is Muslims themselves who are the principal victims of radical Islam. While it is Muslims who should speak out for a reformation of Islam, many cannot, because doing so makes them and their families targets of violence. This makes it all the more important for those of us in the West to speak out because we can do so, for the most part, without fear of violence. And we must also support the few brave souls in the Muslim community—-people like Noni Darwish, Ayaan Hirsi Ali and Zuhdi Jasser—-who risk their own safety in order to reform Islam.

We must speak out, despite the risk of disagreement, challenge, ruined relationships and even violence. Silence is not an option.

 

Footnotes

 

  1. Gockowski, A. UCI Chancellor Downplays School’s History of Anti-Semitic Incidents. Campus Reform. May 27, 2016. Retrieved July 15, 2017 from:

https://www.campusreform.org/?ID=7632

 

 

 

  1. Park, M. & Lah, K. Berkeley Protests of Yiannopoulos Caused $100,000 in Damage. CNN On-Line. February 2, 2017. Retrieved July 15, 2017 from:

http://www.cnn.com/2017/02/01/us/milo-yiannopoulos-berkeley/index.html

 

In addition to causing extensive property damage, protestors physically attacked two Berkeley College Republican students. At least six people were injured in the riots.

 

 

  1. Krantz, L. ‘Bell Curve’ Author Attacked By Protestors at Middlebury College. Boston Globe. March 5, 2017. Retrieved July 15, 2017 from:

https://www.bostonglobe.com/metro/2017/03/04/middlebury/hAfpA1Hquh7DIS1doiKbhJ/story.html

 

 

  1. Chastain, M. Anti-Israel Students Ambush, Attack Jewish Movie Screening at UC-Irvine. Legal Insurrection. Retrieved July 15, 2017 from:

http://legalinsurrection.com/2016/05/anti-israel-students-ambush-attack-jewish-movie-screening-at-uc-irvine/

 

 

  1. Sguelglia, K. Condoleezza Rice Declines to Speak at Rutgers After Students Protests. CNN-On line, May 5, 2014. Retrieved July 15, 2017 from:

http://www.cnn.com/2014/05/04/us/condoleeza-rice-rutgers-protests/index.html

 

 

 

  1. Perez-Pena, R. & Vega, T. Brandeis Cancels Plan to Give Honorary Degree to Ayaan Hirsi Ali, a Critic of Islam. New York Times, April 8, 2014. Retrieved July 15, 2017 from:

https://www.nytimes.com/2014/04/09/us/brandeis-cancels-plan-to-give-honorary-degree-to-ayaan-hirsi-ali-a-critic-of-islam.html

 

 

 

  1. Charlie Hebdo Attack: Three Days of Terror. BBC News. January 14, 2015. Retrieved July 15, 2017 from:

http://www.bbc.com/news/world-europe-30708237

 

 

  1. Gorta, W.J. Garland Shooting: ‘Draw Muhammad’ Contest Host Pamela Geller Wants More Similar Events. NBC News, May 5, 2015. Retrieved July 15, 2017 from:

http://www.nbcnews.com/news/us-news/host-draw-muhammad-contest-says-must-be-more-similar-events-n353546

 

 

  1. Gordon, S. Hidden Camera Captures College Officials Disparaging and Shredding Constitution. Project Veritas Website. November 3, 2015. Retrieved July 15, 2017 from:

http://projectveritas.com/2015/11/03/hidden-camera-captures-college-officials-disparaging-and-shredding-constitution-2/

 

My Mother-in-Law’s Rap Sheet

 

Slowly, over time, I began to understand that Janice’s

“church lady” persona had another side to it.

 

A long rap sheet is the last thing I expected my elderly “church lady” mother-in-law to have. But there it was.

The first time I met my partner’s parents I was nervous. Would they accept me into their family? To my relief, they were warm and accepting from the first.

Janice grabbed my hand and told me how glad she was to meet me, after all the nice things her son had said about me. Pretty soon she asked me to call her Mom. She began to say, “You know Ray, you are just like a son to me.”

I have no doubt she was sincere. But after a while I learned to take much of what Janice said with the proverbial grain of salt. One day, as we all sat in my in-law’s living room the drapery lady arrived to help Janice select fabric for her new window treatments. With just as much sincerity as she had spoken to me, she took the drapery lady’s hand in hers and said, “You know, Mary, you are just like a daughter to me.”

Slowly, over time, I began to understand that Janice’s “church lady” persona had another side to it. Once she told us, in great detail, how she responded to the ladies from the church’s Relief Society when they criticized gay people. “I just looked them in the eye. I told them, if you had raised a gay child, as I have, you would know how hurtful those words are. God loves gay people, just like he loves everyone.”

 

ChurchBuilding

 

I am certain Janice fabricated this story.

She told the doctor about her husband’s symptoms—–symptoms he never had. She explained to everyone who would listen that she loved and respected her step-son as if he were her own. In the next breath she berated him for never being able to hold a job and not being bright enough to succeed in life. In order to lose weight, she explained that she always skipped dinner. She didn’t mention that in lieu of dinner she treated herself to two scoops of ice cream. She insisted that the sugar cookies she ate every day helped relieve her chronic diarrhea, despite her doctor’s orders to lay off sweets.

Janice did all of this without the slightest intent or malice. She simply described the world as she saw it.

She never hesitated to ask people to help her—whether it was her best friends down the block, or later, the aides at the assisted living home. But when others complained about her excessive demands she seemed not to notice.

She always had a dish of candy available for visitors to her small apartment in assisted living. When an aide came in she said, “Go ahead. Take some candy.” When the aide complied, Janice cautioned, “Don’t take more than one piece. If your friend wants a piece, she’ll have to come in and ask for herself.”

 

CandyDish

 

The kitchen workers expected her phone calls and the demands that followed each time they delivered a meal to her room. Janice had explicit instructions for what she would eat and how it must be prepared. She never noticed that the kitchen workers chafed at her demands.

The staff grumbled about this. But Janice often commented, “I am well liked around here.”

A couple of years back, the director of the home arranged for an “intervention.” Like a troubled drug addict, Janice was the center of attention. The attendants described how her constant intrusions made it hard for them to take care of her husband Carl, who lived at the home with her. They advised her to leave his care to the professionals. After that, things settled down.

 

Once we asked the head nurse, “Do you have any other patients as difficult as our mother?” The nurse replied cautiously, “Well, no one exactly like your mother.” We knew what she meant.

Now Carl is gone. But Janice is facing the biggest crisis of her old age: She has run out of money. We’ll have to find a new, less expensive place for her to live.

But a problem has emerged. Before agreeing to admit Janice, the staff at the new home must evaluate her. Is she eligible for Medicaid? Can she manage her Activities of Daily Living? As part of the evaluation, the new staff reviews the records from her current home. To our dismay, her current records reflect an impressive rap sheet: “excessive demands of staff,” “constant calls to the kitchen about her meals,” “won’t take medication for her diarrhea,” “upsets the nurses.”

 

DocWithClipBoard

 

The lady from the last home that denied her admission was diplomatic. But when we pressed her, she admitted that they “were not the right facility for your Mom.” The rap sheet had put them off.

Sooner or later we’ll find a new home for Janice. But, like a released convict looking for work, there is the matter of the rap sheet.

 

Many years ago I visited my in-laws in their comfortable, well-appointed home. One wall of a bedroom displayed a gallery of old family photos. I remember one in particular. In it, Janice is a child of five or six, clutching a doll and staring into the camera. I have never seen a look of such concentrated willfulness in a child. Without a word this child was saying, “I know who I am and what I want. And I am going to get it.”

I wonder if it is true that people never change.

The Three Musketeers

What was I thinking in bringing Mom to such an awful place? I eyed the door and planned our escape.

My 85 year old Mom got into a mess of trouble at Gray Bears, the senior agency where she volunteered.

Mom was never the sort of person to get involved with a community group. She preferred to stay at home, tending to the garden and puttering in the kitchen. Her favorite pastime was curling up in a recliner with a romance novel in her hands.

But things changed. My father died, leaving her alone and isolated in her Florida home. One day she passed out. When she awoke in the hospital she was different. Before her hospital stay, she had enjoyed solitude and socialized only with a close circle of other Holocaust survivors. According to her sister, who watched over her at the hospital, “When your mother woke up, she opened her eyes. The person looking back at me was not my sister.”

From that moment on, mother was terrified of being left alone. For a while she stayed in a mental health facility with a roommate, which provided some reassurance for her. But once back home, she sat alone in the family room, terrified. She hired a nurse to help at home. She didn’t need help. She just needed to be with someone. When the nurse was around during the day, she fretted about her departure in the evening. Mom dreaded nighttime. She worried about how she would make it through the night until the nurse returned the next morning. It was slow torture. Things weren’t working out.

OldWoman

            Eventually I coaxed Mom into selling the house. She moved into the townhouse that I shared with my partner in California. The three of us became inseparable—the Three Musketeers. We had no choice. We could not leave Mom alone. Together we cooked dinner, cleaned the house, sat on the terrace, took walks together. Once a week we shopped at the grocery store—-together. We rented and watched videos together. When we made a mistake and chose a video that was too violent or X-rated for Mom, we popped out the video cassette and read our books instead.

Gray Bears was our savior. It was a senior citizen agency that collected and sorted recycled materials and prepared weekly bagged groceries for homebound seniors.

At first, I didn’t think Gray Bears was going to work out. I had spent the last few weeks dragging Mom from one senior agency to the next. I could not interest her in exercise classes, tutoring school kids or sitting around a table learning watercolor. I was at wit’s end. We needed an activity for Mom. She needed the company. Gray Bears was our last stop.

Our tour included a visit to the “workshop,” a filthy, ramshackle wood building where, seated around a long table, a group of seniors and younger street people sorted used newspapers to be sold to florist shops. As we adjusted our eyes to the dim light in the room, a bedraggled fellow at the table shouted, “I can’t take it anymore. I’m a lesbian trapped in a man’s body!” What was I thinking in bringing Mom to such an awful place? I eyed the door and planned our escape.

NewspaperRecycling

But before I could grab Mom’s hand to lead her out of this Fagan’s lair, something remarkable happened. A very old and wiry woman seated at the table opposite us, reached her arm toward Mom. Their eyes met. To my surprise, Mom extended her arm toward her greeter. A few words of conversation between the two revealed that the wiry stranger was Gert. Like my Mom, she was Jewish, a widow, and like my Mom, she had grown up in Europe.

Mom turned to me, “This is where I want to volunteer.”

Mom lived for another two and a half years. For the rest of her time with us, she worked side-by-side with Gert at the long table where they had met—-four hours a day, five days a week, rain or shine. Knowing Gert and having the volunteer work helped Mom get through the long and difficult days.

There were problems. Mom still had free time in the afternoons and we weren’t always there for her during those times. We hired a Filipino lady to “help” Mom in the afternoons. One day we arrived back home in time to relieve the Filipino lady, only to find Mom in the kitchen preparing food for her “caretaker.” The caretaker was comfortably asleep on the living room sofa.

Mom told us sheepishly,”Esmeralda was tired. So I made her some lunch and put her down for a nap.” Esmeralda was reluctant to leave. But we were paying her by the hour, after all, so we escorted her out the door with some cash and a ‘thank you.’

There were crises. Like the time the doctor told her he couldn’t do anything to improve her hearing and I tried, unsuccessfully, to console her to the reality that she was going to miss out on much of the hearing world—even with the use of her troublesome hearing aids. We couldn’t do anything. Then there was the time I had to take her to the dentist and watch them pull all her top teeth, only to come home to an angry phone call from her Florida sister, “What the hell are you doing to my sister!” I wanted to remind my aunt that just a year earlier she had begged me to take Mom off her hands. “I can’t handle her anymore. YOU take care of her.” I didn’t say a word.

There was the day Mom returned home from Gray Bears, shaken and upset. Every day after their volunteer work, the seniors lined up to receive a bag of free groceries. Mom had sneaked in front of the line to stand next to her friend Gert. In Florida, where people were less polite, this would have gone unnoticed. But here in California it provoked a stir and Mom got a dressing down from her fellow volunteers. I narrowly missed a call from the Director of Grey Bears—-like being called to the Principal’s office about a misbehaved child.

But this episode passed, like all the other little hurts of our unplanned lives together.

One day Mom became ill with a cold. It seemed a trivial thing. But the cold turned into pneumonia. In a week’s time, with shocking suddenness, she was gone.

But we will always have our memories of the Three Musketeers.

 

They Must Be Executed

Every society needs to have deviants, outcasts or enemies in order to remind its members what beliefs and behaviors are acceptable and unacceptable.

           On the morning of June 15, 2017, 66 year old James T. Hodgkinson approached a baseball diamond in a suburb of the nation’s capital.1 On the playing field Hodgkinson saw a group of congressmen and other government officials practicing for an upcoming charity baseball match. Hodgkinson asked a spectator if the players were Republicans or Democrats. When he learned they were Republicans he opened fire on the group. He wounded Congressman Steve Scalise, two Capitol police officers, a lobbyist and a legislative aid. As I write this, Congressman Scalise remains hospitalized in critical condition.

The assailant was shot dead by police. Subsequent media reports revealed he was a supporter of far-left presidential candidate Bernie Sanders. He was angered by the election of Republican Donald Trump and the policies of the new Republican government in Washington. He railed against the Republicans on his Facebook page: “Trump is a Traitor…Trump has destroyed our democracy…It’s Time to Destroy Trump and Company.”

 

BaseballGame

 

This event was the culmination of years of extreme and violent rhetoric in the public sphere. It set off a spate of commentary by the usual cast of media pundits. Where did we go wrong as a nation? Why did we become so polarized? How is it that people can no longer engage in civil debate about opposing political views? Why is Congress hobbled by rigid and extreme positions and lack of compromise? Why have so many people turned to threats and violence when others express opinions at odd with their own?

 

Today’s news media are polarized. Over time I see fewer balanced sources of information available to the public.

I recall Rush Limbaugh, conservative radio talk show host, condemn the liberal “main stream media.” I observed news organizations such as MSNBC and the New York

RushLimbaugh

Times present news stories with narratives clearly skewed to the left. Reading the very same news stories on conservative Fox News gave me the feeling that the reporter was writing about a different set of events.

 

But even knowing all this, I was taken aback by a recent opinion piece in the left-leaning Huntington Post. Authored by Jason Fuller, the piece was entitled: “Impeachment is No Longer Enough; Donald Trump Must Face Justice.” 2 The introductory blurb read: “Impeachment and removal from office are only the first steps; for America to be redeemed, Donald Trump must be prosecuted for treason and—if convicted in a court of law—-executed.”

In the body of the op-ed Fuller went further, suggesting that a trial is simply a formality in the face of obvious guilt:

 

Draining the swamp means not only ejecting Trump from the presidency, but also bringing himself [sic] and everyone assisting in his agenda up on charges of treason. They must be convicted (there is little room to doubt their guilt). And then — upon receiving guilty verdicts — they must all be executed under the law. Anything less than capital punishment — or at least life imprisonment without parole in a maximum security detention facility — would send yet another message to the world that America has lost its moral compass. [Bold in original]

 

Among the public officials who must be tried for treason, Fuller named Senate Majority Leader Mitch McConnell, Speaker of the House Paul Ryan, presidential advisor Steve Bannon, Trump spokesperson Kellyanne Conway, and Vice President Mike Pence. According to Fuller, all top-ranking White House and Republican aides should meet the same fate.

Ironically, the description after the author’s name read: “Working to bring about the best in America, both on-line and off.” Fuller presented this without a hint that he understood the irony of his prescriptions, which represent the worst in America. Are today’s partisans so insulated in their own bubbles of injustice-collecting that they have become incapable of self-reflection?

Trump
Donald Trump

I could dismiss these rantings if they appeared in a fringe publication. That the editors of the popular on-line newspaper the Huffington Post saw fit to publish this incitement to violence is a measure of how far we have come in normalizing the extremes of political discourse.

How did we get here? It is useful to reflect on the causes of this national polarization.

In the US we don’t think of ourselves as tribal. Yet many people have attached themselves to identities like “Republican”, “progressive,” or “conservative.” This tribalism is so persistent that I am tempted to conclude it is in our nature to be intolerant to ideas that are different than our own. This leads to a “them versus us” mentality.

In 1966 sociologist Kai T. Erikson published a study that showed that human communities have a need to draw moral boundaries around themselves so as to mark those who are in the mainstream and those who are deviant.3 His idea was that every society needs to have deviants, outcasts or enemies in order to remind its members what beliefs and behaviors are acceptable and unacceptable. He applied this theory to a study of historical records drawn from 17th century Puritan New England communities. He studied court records over a period of time to determine the nature and number of offenses that resulted in convictions.

Erikson’s findings were stunning. He found that, over decades, social definitions of what was criminal changed in such a way that a consistent percentage of the population was found guilty of various offenses. Over time, norms of behavior changed. But the total portion of villagers deemed to be deviant remained constant.

Erikson concluded that Puritan communities had a need to identify a consistently-sized pool of deviants. This was not a conscious process. But it did ensure there were enough individuals with “wrong behavior” to serve as an example of what “good” behavior ought to be. Deviance was needed in order to draw society’s moral boundaries. And it was defined in such a way as to provide a constant pool of deviants.

This phenomenon may apply to today’s polarized political climate. Conservatives need their deviants: the mainstream media, liberals, feminazis, gay “agenda” advocates and the like. Liberals need their deviants as well: heartless Republicans, supply-siders, evangelical Christians, the Alt-Right. Like yin and yang one cannot define itself without the other.

Erikson’s theory may help to explain today’s social polarization. But it is not adequate to explain the obvious deterioration in social cohesion that we have seen in recent times. So, what else is going on?

 

One social change has slipped beneath the radar. In the past, most of us received news from companies dedicated solely to gathering and reporting news. Somewhere in

 

the recent past, large entertainment corporations bought up news corporations. This led to the birth of “infotainment”: the merger of news information and entertainment. News content was longer determined solely by professional journalists following journalistic standards. Today’s news is just another part of the entertainment industry. As such it is driven by the number of readers or viewers—-it is driven by eyeballs.

 

And how do corporate planners achieve the maximum number of eyeballs for their news programing?: by turning news into entertainment. They have done this by transforming a formerly staid and relatively impartial news industry into a heated battle of talking heads and partisan attacks and counter-attacks.

 

SeanHannity
Sean Hannity

 

I first became aware of this when watching a heated debate among talking heads on Fox News. Something unanticipated and revealing emerged in this debate that unmasked the motives of the broadcaster. The debate became so heated that host Sean Hannity admonished one of the guests to “cool it.” The guest shot back, “But before the program you told us you wanted sparks!”

I understand why Hannity wanted his guests to spar. Like the promoters of cock-fights, Hannity wanted to generate verbal violence in order to give his viewers a good show for their money. The more sparks, the more eyeballs, the greater the profit. Today’s unfortunate reality is that much of what passes as news commentary is delivered as a shouting match or as personal attacks.

I think this phenomenon has had a profound influence on the tenor of political discourse. Today’s young people have never witnessed the measured presentation of newscasters like Edward R. Murrow, David Brinkley or Chet Huntley. Nor have they witnessed the honest and meaty debates of programs like Meet the Press. I wonder if today’s young people believe that shouting and talking over one’s opponent is the norm in political debate.

Another factor in the increasing polarization of our country is the proliferation of news sources enabled by the internet and digital media. Before the internet era we got our news from just a few sources—-newspapers and radio and television news broadcasts. By their very nature these outlets had to appeal to the mainstream in order to remain in businesses.

Today every news consumer can choose from among thousands of sources. There are the traditional newspapers and radio and television programs. But these are waning in the face of thousands of on-line newspapers and magazines, newsletters, blogs, You-Tube videos and the like. Unlike traditional news sources, these news outlets are unashamedly partisan. As a result, news consumers today turn to sources in-line with their already established views. For example, conservatives watch Fox News and liberals watch MSNBC. As we all crawl into our news cubby holes we become more convinced of the truth of “our” beliefs versus “theirs.” And we never hear opposing views that might temper our own.

BerkeleyRiot
Berkeley Riot

There is also something afoot at today’s universities that feeds public polarization. Many students have learned that their feelings are to be protected at any cost, that someone who hurts their feelings has committed an offense. Hence we see campus prohibitions of “microaggressions” and the imperative to avoid “hostile environments.” The result is that any speaker with a message that is not in agreement with the current politically correct set of beliefs has committed an offense. And in the face of such an offense, listeners are within their rights to shout down speakers, shut down events, threaten and harass.

There have been numerous examples of this phenomenon. Some are so absurd as to be comical. Recently one university prepared students for Halloween by advising them to avoid any costume that might offend others, such as a costume that reflected an ethnic identity.4 One professor released a statement advising students not to be excessively restrained but rather to use Halloween costuming to learn how to tolerate differences. The reaction from students was an outrage so intense that the professor was harassed and forced to resign. So much for free speech. So much for intellectual debate.

Even more disturbing, we have seen many instances in which speakers on controversial topics are attacked (sometime physically) and prevented from speaking. The situation has gotten so bad that on some campuses it is now impossible for students to hold pro-Israel events or even non-political events that involve Israel in any positive way.5 When conservative speaker Milo Yiannopoulos was scheduled for a talk at the University of California, not only was he prevented from speaking. Students and others rioted, set fires, and vandalized local businesses.6 Unfortunately, these are not isolated events.

The scary part of all this is that today’s students are tomorrow’s leaders and citizens. This does not bode well for the future.

The obvious antidote to this national illness of polarization is to teach and cultivate tolerance. That is easier said than done.

 

Footnotes

 

  1. Gunman Targets Republican Lawmakers, Wounds 5. World Israel News, June 15, 2017. Retrieved June 16, 2017 from:

https://worldisraelnews.com/gunman-targets-republican-lawmakers-wounds-5/

  1. Fuller, J. Impeachment Is No Longer Enough; Donald Trump Must Face Justice. Huntington Post, June 11, 2017. Retrieved June 16, 2017 from:

https://archive.fo/5VvI5#selection-1908.0-4200.0

 

  1. Erikson, K. T. Wayward Puritans: A Study in the Sociology of Deviance. Wiley, 1966. (Revised edition 2004, Boston: Allyn and Bacon).

 

  1. Friedersdorf, C. The New Intolerance of Student Activism: A fight over Halloween costumes at Yale has devolved into an effort to censor dissenting views. The Atlantic. November 9, 2015. Retrieved June 17, 2017 from:

https://www.theatlantic.com/politics/archive/2015/11/the-new-intolerance-of-student-activism-at-yale/414810/

 

5. AMCHA Initiative website: http://www.amchainitiative.org/

 

6. Park, M. & Lah, K. Berkeley Protests of Yiannopoulos Caused $100,000 In Damage. CNN Website, February 2, 2017. Retrieved June 17, 2017 from:

http://www.cnn.com/2017/02/01/us/milo-yiannopoulos-berkeley/index.html

 

 

 

 

 

The Misery of a Successful High School Career

I did learn a lesson: It isn’t always wise to follow rules; Also, life isn’t fair.

 

I wouldn’t say I had a happy high school career.

I was an exceptionally conscientious student. By regular attendance and hard work, I managed to learn a lot.  And I got good grades. I suppose I shouldn’t take that for granted. After all, I left high school with all the skills I needed to do well in college. In this way, I was ahead of many of today’s students who graduate high school without basic skills.

But the truth is that high school was miserable.

My day began and ended with a difficult experience on the bus to and from school. As a student, I rode the bus using a special “Student Pass.” This meant that the SchoolBusregular bus—-which had empty seats and well-behaved adults—-would almost always pass us by as soon as the bus approached the stop and the driver saw that we were kids. The bus that we students rode with our special pass was overcrowded. To get on the student bus at all I had to be aggressive and fight the hordes of other students trying to cut in. If I didn’t, I didn’t get to school on time.

I solved the bus problem by starting my journey an hour early. At that hour, there were no student busses, so the regular bus driver had to pick me up. The downside was that I had an hour to kill before my first class. That wasn’t really a problem. Because students at my high school had no lockers, I carried my books with me all the time. So, when I got to school first thing in the morning I headed straight for the cavernous assembly hall, took a seat and read my books or reviewed the homework I had done the night before. I coped.

One morning, as I headed into the assembly hall for my one hour wait, I noticed that the door to the Guidance Office was ajar. This was at about the time I was selecting AssemblyHallEmptymy future college choices, and I knew that the Guidance Office housed a shelf full of college catalogs. So I slipped a couple of college catalogs off the shelf, pulled up a chair, and began to read.

It was not long before a stern and visibly upset guidance counselor entered the office.

“You are not supposed to be here!” she barked. I guess she thought I might do some mischief with no one around. But such a thing never entered my mind. Nor would it.

She told me to leave. That was my only contact with the school’s Guidance Office. I don’t think I ever figured out how to get to talk to a school counselor. I just ordered the college catalogs I needed on my own.

I mention this incident because it was typical of the way the adults at that school utterly failed to connect with me.

Looking back on my school experience, I realize that I could have used direction from a helpful adult. It never came. Neither of my parents had finished high school. Neither parent ever stepped inside my high school building. They never thought to involve themselves in any way in my education. And, as working class refugees from Eastern Europe, they knew nothing about careers in the U.S.

I also remember the drudgery of high school.

Once the school day began, we students were prisoners. As soon as the first bell of the day rang, a group of women appeared from within the bowels of the building  to guard the exits so no student could leave. I don’t know who hired these matrons but they were made for the job—that is to say, they were sufficiently large to dissuade any student foolish enough to cross them. It was as if the powers that be had stationed a Rock of Gibraltar at each and every escape point. During the school day the only way you could get out of the building was if you had a pass from the principal or the nurse. There was no option to get a break or stretch one’s legs outdoors. Along with my fellow students, I was trapped. And I felt that way too.

 

SchoolBuildingOld

 

There were far too many students for the space available in the dreary turn-of-the century brick building that housed the school. So we had what the teachers called “split shifts.” Some students started at 8 am; others later in the day. That complicated the ability of students to fit their required classes into their schedules. One year the teachers gave me a schedule with two “study halls” wedged in between my real classes, making my school day absurdly long. It was bad enough that study hall was a noisy sojourn among students who could have cared less about their behavior or their studies. The worst part was during the winter season: My school days were so long that when I arrived at school in the morning it was dark outside; when I left for the day it was dark again. Because no student was allowed to leave the building until his school day was over, for five days of the week I never saw daylight.

Looking back on it, I wonder why I didn’t complain and demand a new class schedule. But my parents had taught me never to question authority. I sucked it up.

Then of course, there was the problem of bullying. I imagine that I did not suffer as much as some of the other students who were short or slight of build. What stands out in my memory was the feeling of being utterly alone. The teachers never did a thing to help. I got hit a few times and had a sweater smeared with glue, ruining it. In the winter, getting home from school meant having to dodge showers of snowballs. The meanest kids knew how to pack the balls into hard spheres of ice and aim them directly at their victim’s eyes. Until the snow melted in the spring, walking home from the bus stop every day was a scary experience.

Gym was no fun either. One year the students were required to play “dodgeball,” a needlessly vicious sport where the bullies shone. Of course, the teachers told us to aim the large volleyball at our opponent’s midsection. But one bully decided that he would go for my face. It might not have been so bad except that I wore braces on my teeth. Between the impact of the ball and the sharp edges of my braces, I had to flee the court with blood flowing ominously from my mouth. But the dodgeball games continued.

It was in high school gym class that I developed a life-long contempt for gym teachers. Among the pearls of wisdom I absorbed from my gym teachers: guys who sit down to pee are fags, and people who didn’t support the US War in Vietnam were also…..fags. Funny how that works.

Another gym teacher was assigned to teach our required “hygiene” class. Here the boys were separated from the girls, although we never approached anything resembling GymClasssex education. My none-too-bright hygiene teacher had the apt but unlikely name of Mr. Simian. (I am not making this up.) He was the consummate bulked-up football player and, to my mind, he was ape-like, as his name suggested. I remember once he read a passage from a book out loud to the class and “corrected” the author’s grammar, changing it from correct to incorrect. He seemed pleased with himself.

At the first class, Mr. Simian explained his straightforward grading scheme. Every hygiene student who was also a member of the football team started the year with an “A,” after which his hygiene class performance factored in. The opposite grading scheme applied to the rest of us: We all started with an F and had to work our way up. Mr. Simian left no doubt about his priorities.

To relieve himself of the intellectual burden of teaching, he assigned every student to give a class presentation. Students gave speeches about athlete’s foot, dental health and the ideal athlete’s diet. The topic of my speech was strategies for good study skills. Mine was not the sort of speech that one of his favored jocks would have given. I don’t think Mr. Simian liked my speech.

There were so many students packed into our ancient school building, that during change of class the halls filled wall-to-wall with students, making movement difficult. To resolve the problem, the teachers enforced a strict rule: in navigating to the next class, only counter-clockwise movement was permitted in the halls. Students had to hug the walls in single file. Crossing the hall to the other side was prohibited.

It was the first day of a new school year. To my chagrin, after home room, my first class was just one door down—-in the prohibited direction. The simple route would have been to cross to the other side of the hall, but crossing the hall was verboten. Trying my utmost to follow the rules, rather than cross to the other side of the hall, I instead went around the entire floor before circling back around to my class.

Having followed the rules, I now arrived late to the first class of the new school year. My new teacher promptly scolded me in front of the entire class. He assumed I was a reprobate. In those days I was too shy to defend myself, and in any case, the teacher was in no mood to allow my defense. Once again, I sucked it up.

I did however learn a lesson: It isn’t always wise to follow rules; Also, life isn’t fair.

 

One bright spot in all of this was Mrs. Jankowitz’ math class. Mrs. Jankowitz was the age my grandmother would have been. She wore unfashionable skirts that were left over from the previous decade, and she walked with a heavy limp, as if one leg was ClassroomOldshorter than the other.  She spoke with a slow Brooklyn accent and was never impatient or cross. I did not have a close relationship with Mrs. Jankowitz but I appreciated her because she was kind. She would never have scolded me for arriving to class late (although I never did).

Maybe the other students thought that math class was boring. But to me, Mrs. Jankowitz made math into magic. These were the old days of chalk boards. When we studied how to graph equations, she would unfurl a punctured shade that hung permanently at the top edge of the blackboard. Whop! Then it was a simple matter of tapping the felt blackboard eraser into the chalk dust at the bottom lip of the board, and swiping it up and down across the punctured paper. Mrs. Jankowitz then lifted the paper shade and—- voila!—-a perfect imitation of lined graph paper magically appeared on the blackboard.

Mrs. Jankowitz would then carefully plot the paired X and Y values and connect them with lines, explaining the resulting Y-intercept and the slope of the line. The numbers and letters that made up equations became a picture that followed a set of universal rules that anyone could master. Magic. More magic followed with trigonometry, interpolation of trigonometric values, and the mysterious imaginary numbers.

I am sorry I never got to know Mrs. Jankowitz better.

 

By the time the last two months of my senior year I was fed up. I stopped going to school and instead, took the train every day into Manhattan. To tell the truth I don’t remember how I filled those hours. My grades up to that point were solid, so that even without the last two months of school my teachers gave me high grades. I did make it back to school to take the state-wide graduation exams—-“The Regents”—and again, because I had been studying all along, I passed them all with flying colors.

I did not attend graduation. I saw no need to. My father was barely aware that I had completed high school and my mom seemed just as happy not to attend the ceremony. So on graduation day, instead of attending the ceremony, I worked at a job I had found in a mirror factory—just to earn a bit of money to help with upcoming college expenses.

Several days after graduation I returned to the principal’s office to pick up my PrincipalOfficeacademic awards. There were several certificates, pins and a fancy gold-hued medallion on a fabric strip. They are long since gone. But somehow I remember the medallion: the “Lester F. Zasully Award for Academic Excellence.”

I have no idea who Mr. Zasully was, what the award was for, nor why Mr. Zasully would bother to have an award named after him. In the unlikely event that Mr. Zasully, or his heirs, read this, please get in touch and explain this award to me.

More lasting than these ephemeral awards, were the words of the principal when she saw that I had picked up my little bag of awards without having attended the graduation ceremony.

As I received the little brown bag from the school secretary, the elderly principal, Miss Darymple, sneeringly commented to her secretary (as if I was not in the room): “Harumpf! Not attend graduation? Some people have no respect for themselves.” I kept silent.

I am sure the principal is long dead. But if I had a time machine and could return to that moment I would tell her, “Harumpf! I didn’t attend graduation because I have no respect for YOU, Miss DahhhhRYMPLE!”

I’m not saying I didn’t learn a lot in high school. But still, the best part of high school is that I’ll never have to go back.

 

A Terrible Accident and a Terrible Set of Beliefs

As Angie drove, she spoke to her father. She can’t remember what they talked about. It was their last conversation.

 

It has been three decades since my stint as a college professor and I am sure I have forgotten most of what I once knew about my students.

But I’ll never forget Angie.* And I’ll never forget the horrific events she recounted to me.

As part of a research study, I had been interviewing people who had survived severe trauma of one kind or another. One person had survived the murder of a grandchild. Several had experienced life-threatening and disabling illnesses. One lovely young woman had been kidnapped, held against her will and raped.

Angie had survived a vehicle accident…but not an ordinary one.

On a clear summer day, Angie was driving the family car with her father seated next to her in the passenger seat.  Angie navigated a road she had driven many times CarOnRoadbefore in the small town where she and her sisters had grown up and where her father served as minister of a small church.

As Angie spoke about her Dad, emotion bubbled up in her voice. Angie’s Dad was her guiding light and a constant in her life. When she became a teenager, her father approached her with a proposition.

“Angie,” he began slowly, “I know that you and your friends have been sneaking cigarettes behind the high school.”

Angie kept mum.

“Well, young lady. If you want to smoke, I give you my permission. I’ll even get you the cigarettes. But there is one condition. You have to smoke only in front of me. No more sneaking around.”

Angie acquiesced. She finished off one cigarette in front of her father. He offered her another. She only made it half way through before she started retching.

“Still wanna smoke, young lady?” her father asked without a hint of judgement.

It was the last time Angie touched a cigarette…or wanted to.

As Angie drove, she spoke to her father. She can’t remember what they talked about. It was their last conversation.

Angie does remember seeing a familiar pick-up truck in the distance, travelling in the opposite direction, and steadily approaching her car. The truck belonged to a neighbor, a young man in his twenties, known for his wild ways.

The next thing Angie remembers is struggling with all her might to crawl up a hillside that crested at the blacktopped road above. She did not see her car. Suddenly she realized she was on fire.

Later in the hospital she learned the details of the accident. The young man had filled a few tanks with propane gas, loaded them onto the flatbed of his truck, and headed out of town.  He had been drinking and he was in a hurry. When he came within sight of SpeedometerAngie’s car, the road opened onto a long flat stretch. The young man pushed the gas pedal to the floor of the cab. The two opposing cars hit head-on. There must have been a tremendous noise and a fireball as the propane tanks ignited from the collision. Angie doesn’t remember any of that.

The coroner’s report revealed that the young man’s blood alcohol level was over twice the legal limit. An ambulance took his lifeless body from the scene. Another ambulance took her father and Angie.

ExplosionIn an instant, Angie’s life changed. Her father, her guiding light, was gone. And she faced a long and excruciating recuperation from third degree burns over half her body. She faced an uncertain future.

I won’t recount Angie’s bravery and the dignity she showed in the hospital through months of painful treatments. Or her spunk in demanding that her doctors listen to her directions about how best to operate to help restore at least some of her mobility. Or her tireless insistence in returning to as much of a normal life as she could muster…including a return to school, where she was completing a masters’ degree.

I suppose that, as accidents go, this one wasn’t all that unusual. But one detail stuck in my mind. I have never been able to shake it.

“After that accident,” Angie told me without emotion, “We became the black sheep of our town.”

I struggled to understand what Angie was telling me. As we talked, the details became clear. In the days, weeks and months after the accident, Angie and her family had to suffer another loss: the loss of the emotional support of their friends and neighbors in town. Far from holding the young man accountable for the accident, the townspeople blamed Angie.

There was no objective reason for the town to blame Angie or her father for the accident. Angie and her family had been on good terms with just about everyone in town. Her father had been a popular minister, well-known to the townspeople. The police believed that Angie was without fault. And there was no question that the young man was far too drunk to drive safely.

What can explain the town’s blame toward Angie?

 

I’ll never know for sure. But over the years I have come to my own understandings about what happened. One understanding derives from religion, the other from human psychology.

 

To explain the religious understanding, I have to turn the clock back to the beginnings of small town America, all the way back to the seventeenth century Puritan settlements in

Puritans
New England Puritans

New England. I believe that the town’s unsympathetic reaction to Angie was rooted in a set of beliefs that have survived since the nation’s Puritan beginnings.

When the Puritans arrived on America’s shores in the 1600s, they brought with them a set of severe Calvinist beliefs. Perhaps the two most important of these were beliefs in predestination and in the supernatural.

According to predestination, the world was divided into two groups of people: those who are elected by God to be saved in the hereafter, and those who are damned. Any person can fall into one group or the other, independently of that person’s good works in life. There is no way for humans to know for certain if a person will be saved or damned. But the events that befall a person can be an indicator of God’s judgment in this matter.

The Puritans believed in the supernatural just as fervently as we today believe in science. To the Puritans, every human event is a sign of God’s mercy or of his judgement. If evil should befall a person—in the form of illness, accident or other misfortune—this is a sure sign that person has fallen from God’s grace. He is damned.

To the Puritan mind, and to the minds of her religious neighbors, Angie’s misfortune was a sign that she was not chosen by God to be a saved soul. God had found Angie and her father wanting. Punishment surely followed.

Without being aware of it, the people in Angie’s town were driven by a very old set of beliefs, deeply rooted in the Christian faith. Although the townspeople were not Calvinists, these beliefs have become ingrained in American culture. I am not suggesting that the local ministers taught the townspeople to be heartless, but rather that it is difficult for any of us to escape from the influence of beliefs passed down through the generations, even if we are not explicitly aware of them.

There is also a psychological explanation for the townspeople’s harsh reaction to Angie. When someone we know, especially a person who is similar to us, suffers a tragedy we are thrown into a state of anxiety. If this tragedy happened to Angie, it could very well happen to us. To insulate ourselves from that anxiety we rationalize that the victim was unlike us, or that at least we can choose to act differently and thereby avoid the tragedy. So, for example, a townsperson may believe that Angie drove carelessly, and that is what caused the accident. This belief, true or not, insulates the believer from the terror of random acts of God: “I am not like Angie. I am a careful driver, so this will not happen to me.” In this way, blaming Angie serves the observer’s emotional need to feel safe.

It doesn’t matter that these beliefs—-religious or psychological—are irrational. They persist.

I have not kept in touch with Angie over the years. I think of her from time to time. I think of the way she inspired me to overcome my own, much lesser life challenges. I hope she is doing well. I hope that she discards the negative judgments of others.

 I hope that she feels the warmth of God’s love smiling down on her.

*   Angie is a pseudonym.