Etiquette



DP Etiquette

First rule: Don't be a jackass. Most people are good.

Other rules: Do not attack or insult people you disagree with. Engage with facts, logic and beliefs. Out of respect for others, please provide some sources for the facts and truths you rely on if you are asked for that. If emotion is getting out of hand, get it back in hand. To limit dehumanizing people, don't call people or whole groups of people disrespectful names, e.g., stupid, dumb or liar. Insulting people is counterproductive to rational discussion. Insult makes people angry and defensive. All points of view are welcome, right, center, left and elsewhere. Just disagree, but don't be belligerent or reject inconvenient facts, truths or defensible reasoning.

Saturday, December 11, 2021

Fear in the Republican Party

In public comments the Washington Post has collected and printed, some Republican politicians say they keep quiet or vote to protect the ex-president out of fear for themselves or their families. The WaPo writes in an article entitled, The role of violent threats in Trump’s GOP reign, according to Republicans:
It’s a must-read, but a tough read. That’s because it describes an exceedingly ugly situation: one in which lawmakers are disregarding private principle in their votes and often doing so out of literal fear. [Rep. Peter Meijer (R-MI):]

On the House floor [on Jan. 6], moments before the vote, Meijer approached a member who appeared on the verge of a breakdown. He asked his new colleague if he was okay. The member responded that he was not; that no matter his belief in the legitimacy of the election, he could no longer vote to certify the results, because he feared for his family’s safety. “Remember, this wasn’t a hypothetical. You were casting that vote after seeing with your own two eyes what some of these people are capable of,” Meijer says. “If they’re willing to come after you inside the U.S. Capitol, what will they do when you’re at home with your kids?”

At one point, Meijer described to me the psychological forces at work in his party, the reasons so many Republicans have refused to confront the tragedy of January 6 and the nature of the ongoing threat. Some people are motivated by raw power, he said. Others have acted out of partisan spite, or ignorance, or warped perceptions of truth and lies. But the chief explanation, he said, is fear. People are afraid for their safety. They are afraid for their careers. Above all, they are afraid of fighting a losing battle in an empty foxhole.

[Rep. Anthony Gonzalez (R-Ohio)]: 

[Gonzalez] made clear that the strain had only grown worse since his impeachment vote, after which he was deluged with threats and feared for the safety of his wife and children.

Mr. Gonzalez said that quality-of-life issues had been paramount in his decision. He recounted an “eye-opening” moment this year: when he and his family were greeted at the Cleveland airport by two uniformed police officers, part of extra security precautions taken after the impeachment vote.

“That’s one of those moments where you say, ‘Is this really what I want for my family when they travel, to have my wife and kids escorted through the airport?’” he said.


[Rep. Liz Cheney (R-Wyo.):]

“If you look at the vote to impeach, for example, there were members who told me that they were afraid for their own security — afraid, in some instances, for their lives,” she told CNN in May. “And that tells you something about where we are as a country, that members of Congress aren’t able to cast votes, or feel that they can’t, because of their own security.”

Republican majority leader of the Pennsylvania state Senate, Kim Ward, was perhaps the bluntest of all:

Asked if she would have signed it [a letter urging the state’s congressional delegation to reject President Biden’s win], she indicated that the Republican base expected party leaders to back up Mr. Trump’s claims — or to face its wrath.

“If I would say to you, ‘I don’t want to do it,’” she said about signing the letter, “I’d get my house bombed tonight.”

Anonymous GOP members

A week after the Capitol riot, anonymous GOP lawmakers pointed to the threat of violence impacting both impeachment votes and decisions about whether to remain in Congress at all, according to The Hill’s Juliegrace Brufke:

“Yea — I think a lot of people are making political decisions here,” one member said when asked if threats of violence affected how members of the conference will vote. 
 
A second GOP lawmaker said they believe the threats could lead to an influx in retirement announcements, with some weighing whether remaining in Congress is worth the risk.

 “Without a doubt [it’s a factor]. Watch for a large number of members to resign early or not run again after this term,” the member said.


‘Trump’s made them think this is the Alamo’

One anonymous GOP member of Congress told Politico that those who voted against rejecting the election results in Congress were soon confronted by reality — and the threat of violence that accompanied it.

“Both parties have extremists,” the lawmaker said. “There’s a difference in our crazy people and their crazy people. Our crazy people have an excessive amount of arms. They have gun safes. They have grenades. They believe in the Second Amendment. They come here and Trump’s made them think this is the Alamo.”

The Trump allies’ own version of this

While these lawmakers have described specific instances in which lawmakers might well have voted or acted out of fear of violence, some Republican allies of Trump have also pointed in this general direction, albeit more gently. They’ve effectively argued that voting to impeach Trump would lead to more violence — suggesting it was a reason not to impeach.

During the impeachment debate, Rep. Debbie Lesko (R-Ariz.) said: “I really do believe that you pushing this is going to further divide our country, further the unrest, and possibly incite more violence.”

Sen. Lindsey Graham (R-S.C.) echoed the point, saying, that supporting Trump’s impeachment “under these circumstances will do great damage to the institutions of government and could invite further violence at a time the president is calling for calm.”

Questions:
1. Did republicans who voted to protect the ex-president out of fear just delusional or misinformed because there is no reason to fear because rank and file Republicans, who are merely peaceful, respectful law-abiding citizens that would never resort to violence against sitting politicians?

2. Are the ex-president’s allies, who routinely spew vicious, intentionally divisive dark free speech, right to argue that no one should vote to impeach him because it would lead to further division, unrest and/or violence? If so, should Democratic politicians, leaders and propagandists do the same to keep their party and politicians towing the line?

Book banning and teaching revisionist history: Another front in the march of radical right authoritarianism against democracy

Burnt books in modern times


Dictators, fascists and other kinds of authoritarians like to control and suppress inconvenient information. The Republican Party is adopting this hallmark of authoritarianism that looks very much like fascism in the American context. The New York Times writes:
Texas State Representative Matt Krause, a Republican, emailed a list of 850 books to superintendents, a mix of half-century-old novels — “The Confessions of Nat Turner” by William Styron — and works by Ta-Nehisi Coates and Margaret Atwood, as well as edgy young adult books touching on sexual identity. Are these works, he asked, on your library shelves?

Mr. Krause’s motive was unclear, but the next night, at a school board meeting in San Antonio, parents accused a librarian of poisoning young minds.

Texas is afire with fierce battles over education, race and gender. What began as a debate over social studies curriculum and critical race studies — an academic theory about how systemic racism enters the pores of society — has become something broader and more profound, not least an effort to curtail and even ban books, including classics of American literature.

In June, and again in recent weeks, Texas legislators passed a law shaping how teachers approach instruction touching on race and gender. And Gov. Greg Abbott, a Republican with presidential ambitions, took aim at school library shelves, directing education officials to investigate “criminal activity in our public schools involving the availability of pornography.”

“Parents are rightfully angry,” he wrote in a separate letter. They “have the right to shield their children from obscene content.”

“Education is not above the fray; it is the fray,” said Robert Pondiscio, a former teacher and senior fellow at the American Enterprise Institute, a public policy group. “It’s naïve to think otherwise.”

In Texas, such battles recur. In 2018, an education committee proposed striking a reference to “heroic” defenders of the Alamo, describing it as a “value-laden word.” A roar of resistance arose and the board of education rejected the proposal. The Republican lieutenant governor this year pressured a museum to cancel a panel to discuss a revisionist book — “Forget the Alamo” — examining its slaveholding combatants.

“One minute they’re talking critical race theory,” Ms. Damon, the librarian, said. “Suddenly I’m hearing librarians are indoctrinating students.”

Mr. Krause, who compiled the list of 850 books that might “make students feel discomfort, guilt, anguish” because of race or sex, did not respond to interview requests. Nor did his aides explain why he drew up the list, which includes a book on gay teenagers and book banning, “The Year They Burned the Books” by Nancy Garden; “Quinceañera,” a study of the Latina coming-of-age ritual by the Mexican Jewish academic Ilan Stavans; and a particularly puzzling choice, “Cynical Theories” by Helen Pluckrose and James Lindsay, which is deeply critical of leftist academic theorizing, including critical race theory.  
On the question of slavery, for instance, the Texas law prohibits teachers from portraying slavery and racism as “anything other than deviations from, betrayals of, or failures to live up to the authentic founding principles of the United States.” This conflicts with the views of many scholars who note that from America’s founding, slavery was woven into the structure of the nation and the Constitution.

The NYT goes on to point out that Texas law is ambiguous and vague, causing the list of bad books seems to send a chill through school boards. In the absence of clarity in state law, some librarians have been told to pre-emptively pull down books. A San Antonio school district took 400 books off the shelves for review.
 
It does seem naïve to think that the radical right will not target public education and inconvenient history and truth in Texas and everywhere else it can. Instead of critical race theory, something akin to White superiority theory will be taught. Texas law does not mention critical race theory, so there is ambiguity. The Texas radical right can play with that ambiguity as they socially re-engineer American society, government and law to fit the dominating neocapitalist and Christian nationalist ideologies that now dominate the radical right republican Party. A similarly vague law in Oklahoma has been challenged on grounds of vagueness

The Texas law states that teachers should “explore” contentious subjects such as slavery and treatment of American Indians “in a manner free from political bias.” However, it appears that the radical right has no real interest in anything other than indoctrinating students with their politically biased vision of reality and history. The right will self-righteously condemn any whiff of other points of view that do not accord with their sacred beliefs. That runs deep in Christian nationalist dogma.

Among other things, Christian nationalist ideology is rock solid in its dogmas that (i) heterosexual White men are God's chosen moral and political leaders, and (ii) America was Founded as a White Christian nation that God chose to rule over all other nations and racial groups. That literally is the history they teach in their religious schools. Christian nationalists want to force all public schools to teach the same thing as long as public schools exist.[1] 


Question: Is the radical right sincere about being unbiased in teaching, or is that just propaganda and lies? 


Footnote: 
1. Christian nationalists want all secular public schools replaced with private religious schools, and they want to force American taxpayers pay for all of it by law. That is core dogma among Christian nationalist elites and their legal strategy in the courts, not fringe crackpottery. This is no idle threat.

According to Pew research in 2020, half of Americans say the Bible should influence U.S. laws. 28% favor the Bible over the will of the people. Christian nationalists have made it clear that they do not care about majority public opposition to what they want to do. They are doing God's work and that trumps everything else including man's law, the US Constitution, public opposition, democracy and civil liberties. They are authoritarian.




Burning books about 80 years ago

Long haul COVID patients and their conditions

 The Washington Post looked at the situation for people who have long haul COVID-related symptoms such as brain fog and severe fatigue. About 750,000 to 1.3 million people are estimated to affected. Another  50 million have experienced some of these symptoms after a COVID infection to be able to return to work and a fairly normal life Research has begun to understand what causes the various symptoms and how to treat them. There is not much understanding at present about causes and treatments. One tragedy is that many of the people who are long haulers have lost their jobs first and then their health insurance, leaving them unable to afford whatever limited health care there is. Most of these people are hopelessly adrift in society. A few have fallen into poverty and homelessness.

At present, new cases of long haul are coming mostly from unvaccinated people, adding to the social and economic cost of a personal refusal to get vaccinated. The WaPo writes:
Long covid is testing not just the medical system, but also government safety nets that are not well suited to identifying and supporting people with a newly emerging chronic disease that has no established diagnostic or treatment plan. Insurers are denying coverage for some tests, the public disability system is hesitant to approve many claims, and even people with long-term disability insurance say they are struggling to get benefits.

“They are suffering in dramatic ways, and in ways that have altered their lives and placed them in financial peril,” said Harlan Krumholz, a cardiologist and scientist at Yale University and Yale New Haven Hospital.

Depression and anxiety that are part of the brutal mix of long covid symptoms are exacerbated by despair over vanishing income. 

Often referred to as “long haulers,” they experience mild symptoms to begin with, then get stuck with months of chronic fatigue, shortness of breath, confusion and memory loss, erratic and racing heartbeats, radical spikes in blood pressure, painful rashes, shooting pains and gastrointestinal problems.

The government calls it post-acute sequelae of SARS-CoV-2, or PASC. The National Institutes of Health is spending $1.15 billion to study the syndrome. The symptoms sometimes subside, lulling long haulers into a false sense of relief, only to come roaring back after performing simple chores like vacuuming a living room or raking leaves.

Even for those who do have insurance, treating long covid can be unusually complicated and costly, since it’s a new disease without an established diagnostic or treatment plan and coverage for certain tests may be denied.

Health insurance companies, citing the blizzard of tests being ordered, say they are waiting for data-driven protocols to emerge so they can match insurance coverage with the best testing and treatment strategies for long covid.

The cognitive and emotional impacts also make it difficult for patients to navigate the bureaucratic tangles required to keep health insurance and file disability claims after a job loss.

John Buccellato, 64, an emergency medicine doctor at an urgent care clinic on Manhattan’s Upper East Side, was hospitalized with the virus in March 2020, in the same hospital where his mother died of covid.

In a matter of days, he went from treating patients at a busy clinic to being engulfed in a health crisis as covid attacked his lungs and vascular system. Severe cognitive and emotional strain left him unable to manage his day-to-day affairs.

Overwhelmed by brain fog and the sense of loss over his career, he frequently sobbed on the phone as he described his struggles in an interview, including the loss of his employer-sponsored insurance.

Buccellato said he has tens of thousands of dollars in unpaid medical bills that accumulated when he first lost his health insurance. He has some property and savings, but no weekly cash flow, he said. He signed up for COBRA, which provides a continuation of health insurance after a job loss, but after congressionally approved waivers that made it free expired in September, it now costs $922 a month, he said.

Buccellato said he recognizes his career is prematurely over, but he can’t figure out how to dig himself out of his worsening financial predicament. A lawyer helped him file a disability claim with the Social Security Administration, which a member of his support team said was recently successful. Because he left work for medical reasons, he was not eligible for unemployment insurance.  
Patients, advocates and lawyers said private disability insurers, which offer long-term disability coverage through employee benefit plans, have also been denying many claims.

The WaPo goes on to point out that patients who apply for disability insurance benefits are initially denied and require lengthy appeals, partly because the medical community is still unable to diagnose the symptoms. The Social Security Administration has received 16,000 covid-related disability claims since December 2020, but it refuses to disclose how many of those were approved. Once again, secrecy shrouds government operations for unknown reasons.

And once again, the moral compass of America's for-profit health care system is on display. Profit is the sole moral value. Human life comes in a distant 2nd or 3rd, or maybe 4th behind whatever other factor(s) drives our grossly expensive, needlessly blindingly complex, opaque health care system. As time passes and the influence of radical right conservatism clamps down harder and harder on average Americans, the situation for most people will probably continue to deteriorate. 

It will be interesting to see how this aspect of the pandemic plays out and what the social and economic cost will amount to, assuming the COVID pandemic ever ends.


Questions: 
1. Given the cost, is America's health care system (i) probably more concerned with profit than human life and/or (ii) too complex and opaque?  

2. Should COVID long haulers who had the opportunity to get vaccinated but refused always be treated just like all other patients, i.e., first come, first served? Or do they not deserve priority when it crowds out similar care to other kinds of patients because the local health care system is overloaded? 

Friday, December 10, 2021

Neoliberalism coddles bad nursing homes in comforting secrecy

Neoliberalisma political approach that favors free-market capitalism, deregulation, and reduction in government spending; neoliberalism is a political development of capitalism and a political and economic ideology that seeks to (i) maximize the freedom of the market by removing barriers to the private accumulation of wealth, and (ii) become a power over and above the state directed to the ends of profit without government interference; neoliberalism opposes regulation over which it has no control; the controlling ethic of capitalism is prudence which leads to wealth, but the ethic of neoliberalism is the accumulation of wealth for its own sake which leads to political power; neoliberalism, as the de facto only available political and economic option has had catastrophic effects on society and the environment 


The effects of the neoliberal influence on the Democratic and Republican Parties is usually manifest as deregulation of commerce and wealth with a concomitant flow of power from government and its ability to protect and serve public interests. Power flows to special interests and owners of wealth who gain advantage and use it over the public and public interests to their own benefit. Secrecy is a necessary and major aid in the power shift. Special interests and neoliberal politicians deny that this power shift happens, but they are liars. As we all know, an ignorant public is more compliant and profitable than an informed public. --- Germaine, 2021


Politicians love opacity and secrecy. So do lobbyists. So do courts. Businesses too. Obviously, fine citizens like tax cheats, embezzlers and drug dealers really like lots of secrecy. Everyone with things to hide loves secrecy. That runs the gamut from hiding merely embarrassing boo-boos to hiding shockingly illegal, cruel and/or lethal activities. That is why non-disclosure agreements are the norm in many or most businesses. That is why many or most consumer products and services come with a demand that disputes be settled by arbitration in secret. That is why most major lawsuits that settle before a court decides a case in public are settlements that demand secrecy of the terms. Usually the defendant demands secrecy from the plaintiff.

And it's always the same game: Those with power demand secrecy. Those without power, like the public interest and consumers, are forced to accept secrecy to the advantage of those with power over them. That is how neoliberalism works for people and interests in power, usually (always?) to the detriment of the public and its interest.

All that wonderful neoliberal secrecy allows the crooks, liars, and thugs an opportunity to downplay and lie about what they did, how bad it was and exactly who was responsible. The stench of plausible deniability for the bad guys is overpowering. The public is left free to decide what, if anything it wants to believe. Facts just cannot get in the way of forming false beliefs based on lies because the public remains ignorant of the truth. 



A New York Times article, How Nursing Homes’ Worst Offenses Are Hidden From the Public, provides a wonderful example of of what neoliberal government often produces. The NYT writes:
In Arizona, a nursing home resident was sexually assaulted in the dining room.

In Minnesota, a woman caught Covid-19 after workers moved a coughing resident into her room.

And in Texas, a woman with dementia was found in her nursing home’s parking lot, lying in a pool of blood.

State inspectors determined that all three homes had endangered residents and violated federal regulations. Yet the federal government didn’t report the incidents to the public or factor them into its influential ratings system. The homes kept their glowing grades.

A New York Times investigation found that at least 2,700 similarly dangerous incidents were also not factored into the rating system run by the federal Centers for Medicare and Medicaid Services, or C.M.S., which is designed to give people reliable information to evaluate the safety and quality of thousands of nursing homes.

Many of the incidents were uncovered by state inspectors and verified by their supervisors, but quashed during a secretive appeals process, according to a review of thousands of pages of inspection reports and nursing home appeals, which The Times obtained via public-records requests. Others were omitted from the C.M.S. ratings website because of what regulators describe as a technical glitch.

The Times this year has documented a series of problems with Medicare’s ratings system. Much of the data that powers the system is wrong and often makes nursing homes seem cleaner and safer than they are. The rating system also obscures how many residents are receiving powerful antipsychotic drugs.

On the rare occasions when inspectors issue severe citations, nursing homes can fight them through an appeals process that operates almost entirely in secret. If nursing homes don’t get the desired outcome via the informal review, they can appeal to a special federal court inside the executive branch. That process, too, is hidden from the public.

Even when the citations are upheld by this federal court, some never make their way onto the Medicare website, known as Care Compare. In November, for example, the court sustained a major punishment against Life Care Center of Kirkland, Wash. — the nursing home that faced the first coronavirus outbreak in the United States — yet the citation is absent from the Medicare site. The facility has a five-star rating.

The pattern gives nursing homes a powerful incentive to pursue every available appeal. Even if they lose, the process eats up time and reduces the odds of damaging information ever becoming public.

“There is every advantage to the facility not to have an opinion issued for as long as they could possibly delay, and there’s no advantage to the public for that to occur,” said Richard Routman, a lawyer who represented the federal government in nursing home appeals until 2014.

“Once I realized that people wouldn’t see cases that are on appeal, I thought, why would anybody ever look at this again?”  
Representatives of the nursing home industry say it is only fair that they be allowed to appeal citations before they are made public, especially since many end up getting overturned or downgraded. But The Times found that the appeals process can be one-sided, excluding patients and their families.  
There’s big money at stake. Because of the weight that people place on the star ratings, researchers have found a connection between better inspection results and greater profits. The Times analyzed nursing homes’ financial statements from 2019 and found that four- and five-star facilities were much more profitable than lower-rated facilities. (For-profit companies own about 70 percent of all U.S. nursing homes.) 
For decades, federal watchdog agencies have criticized state inspectors for taking a light touch with the nursing homes they oversee.  
Inspectors rarely deem problems to be serious enough to harm homes’ star ratings. From 2017 to 2019, The Times found, inspectors wrote up more than 2,000 five-star facilities at least once for not following basic infection-control precautions, like having employees regularly wash their hands.

At 40 other five-star homes, inspectors determined that sexual abuse did not constitute actual harm or put residents in immediate jeopardy.  
“I feel sometimes the things I cite don’t mean anything because it gets tossed out at the state level or they determine it not to be as severe,” an unnamed inspector said in a 2013 survey conducted by the Center for Medicare Advocacy, a consumer rights group. “Sometimes it makes you wonder why we spin our wheels on a problem.”

One can clearly see the influence and power of economic incentives to do bad things when they are shrouded in secrecy. If the public never hears about bad things and no significant penalties attach, the bad stuff effectively did not happen. There is every reason to keep doing bad things that help make money, even if people are harmed or killed in the process. Power and wealth are the only moral values inherent in neoliberalism. Human and environmental destruction and death are not major factors in the profit equation unless government steps in and gives those those things major weight.


Ranking existential threats
Unwarranted secrecy and neoliberalism arguably are existential threats to liberal democracy, the rule of law, modern civilization via wealth inequality and maybe even the existence of the human species on Earth. Unwarranted secrecy is necessary for subversion of democracy and the rule of law. 

A ranking of threats to global democracy and the rule of law should help at least some to put this in context.
1. Nuclear war
2. Corruption and subversion of government by special interests
3. Unwarranted secrecy
4. Dark free speech and social media disinformation
5. Political polarization
6. Authoritarianism, neoliberalism and Christian theocracy
7. Wealth inequality (an aspect of American authoritarianism, neoliberalism and Christian theocracy)
8. Environmental damage (also an aspect)
9. Weak public education
10. Overpopulation
 
There is overlap among at least some of these things. Note that unwarranted secrecy is usually a major component of corruption and subversion of government by special interests, dark free speech and political polarization. This ranking just intended to give a general idea of how secrecy might fit into an existential threat assessment. Opinions on this will vary. For example, some or most conservatives might put the BML movement, critical race theory, the Democratic party and/or socialism/communism on the top 10 list of threats.


Questions: 
1. Why does the government allow secrecy to protect nursing homes, neoliberalism, fairness to nursing homes, and/or something else, or is secrecy not a significant factor here?

2. Is it more likely than not that unwarranted secrecy is a significant existential threat to democracy and the rule of law?