The news: Doomscrolling on steroids

Most of the news looks bad for Dems and good for Repubs. Worse, the Dems seem to be melting down, but maybe that's been the case for some years now. Dem authoritarians Sinema and Manchin blocked Biden's nominations to the NLRB. Presumably they want to let DJT approve anti-labor authoritarians, thereby starting the process of killing federal protections for labor. 

Repubs in the senate prevented Biden's nominations of three federal appeals court judges in return for Repubs letting him nominate 11 far less power federal trial court judges. One Dem Poobah has even urged Biden to blanket pardon DJT so that we can start with a "clean slate", whatever the hell that means. In short, a significant portion of the Dem party has apparently gone bull-blown insane.

Meanwhile, DJT has floated the wonderful idea of allowing large polluters to simply avoid regulations if they invest $1 billion in America, whatever that means. I presume that means donating $1 billion to him. One source called it a "plan to let billionaire polluters 'bribe their way' past regulations. On the other hand, climate scientists and experts are freaking out because DJT and MAGA keep saying that global warming is a hoax, or maybe just a minor kerfuffle that we can pollute our way out of somehow. One source comments that as Trump and MAGA escalates their kleptocratic authoritarian war on climate science, scientists warn “we are going to get screwed!” Well, MAGA to that! Those polluters can pay a mere $1 billion in return for gigatons of profitable pollution. 

One has to wonder if the $1 billion bribe, or "gratuity" as the USSC would call it, is confined to escape from just environmental regulations, or does it apply to all regulations, e.g., consumer and worker protections. 

On the 4th Estate front, the WaPo has degenerated real fast. It has morphed into a blossoming radical right authoritarian dark free speech site. I asked the WaPo if they would give me a prorated refund on the time left in my subscription in return for me just going away. No dice. ☹️ Well, at least I get to keep slamming what the WaPo is doing, especially its editors, until the end of next April. 👍 What fun! I do wonder if the WaPo is going to ban or block my comments to articles there before my time runs out. Another exciting Germaine experiment is well underway!

See, the news really is like doomscrolling on steroids. That is of course, unless one supports kleptocratic authoritarianism, crackpot science, etc. For the MAGA elites, and its rank and file (at least the few who pay any attention) the news is like a box of super cute, fluffy puppies.

Oops, how did Manchin and Sinema 

get in there??

Wonk alert: Perplexity tinkering with pragmatic rationalism

This post is really wonky. I want a place to save this, so this blog post is it. I just discovered that at least one of my links to a Perplexity search lead to nothing, i.e., the Q&A were simply gone. I have no idea why. Fortunately I posted the lost Perplexity Q&A here, so I still have access to it at that blog post. I just cannot access it at Perplexity itself.

Two links to the following new set of Q&A about pragmatic rationalism - I do not know how I wound up with two links:

https://www.perplexity.ai/page/analyzing-germaine-s-political-.YPHnAiwTsGoGDoOMBtNgw

https://www.perplexity.ai/search/based-on-the-politics-expresse-ylnWlloYShGZVyMhzKIrJA

Q1: Based on the politics expressed at Dissident Politics, https://dispol.blogspot.com/ , is Germaine at that site far left, left, centrist or something else in his political leaning or ideology? Germaine claims to adhere to what he calls pragmatic rationalism, which he characterizes on the basis of cognitive biology and social behavior as an anti-biasing, anti-ideology ideology, e.g., https://dispol.blogspot.com/2019/06/pragmatic-rationalism-anti-biasing-anti.html and https://dispol.blogspot.com/2019/12/pragmatic-rationalism-short-simple.html .

A1: Germaine, the author of Dissident Politics, does not fit neatly into traditional political categories such as far left, left, or centrist. Instead, he identifies with pragmatic rationalism, a philosophy he describes as an anti-biasing, anti-ideology ideology based on cognitive biology and social behavior. This approach aims to minimize biases and ideological influences in decision-making, focusing on rational analysis and empirical evidence.

Key Points of Germaine's Pragmatic Rationalism:

Anti-Biasing: Germaine emphasizes the importance of recognizing and mitigating cognitive biases that can cloud judgment and decision-making processes.

Anti-Ideology: He critiques the dogmatic adherence to political ideologies, suggesting that such adherence can lead to irrational and biased outcomes.

Cognitive Biology: His philosophy is grounded in understanding human cognition and behavior, aiming to align political and social decisions with biological and psychological realities.

Empirical Evidence: Decisions should be based on observable facts and data rather than ideological commitments. [that's only partly correct - decisions will be based on that plus personal morals, biases, loyalties to a variable extent because that cannot be avoided - perfectly rational politics is not possible for humans, but self-awareness helps reduce reducible irrationality, but to some degree "irrationality" cannot be completely eliminated and if that was possible, humans would not be human]

Given these principles, Germaine's political stance can be described as:

Non-Traditional: He does not align with conventional political spectrums but rather seeks to transcend them through a rational, evidence-based approach.

Pragmatic: His focus is on what works in practice, rather than what fits into a particular ideological framework.

Skeptical of Ideologies: He views ideologies as potentially harmful when they become dogmatic or when they ignore empirical evidence. [that's a key point: ideologies foster and rationalize reality disconnects and reason flaws when empirical evidence and/or sound reasoning is inconvenient]

In summary, Germaine's political leaning or ideology at Dissident Politics is best characterized as pragmatic rationalism, which positions him outside the typical left-right political spectrum, focusing instead on a method of analysis that seeks to be as unbiased and rational as possible.

Q2: Germaine relies on his understanding of cognitive biology, social behavior and the moral philosophy of lying and deceit ( https://dispol.blogspot.com/2019/10/book-review-lying-moral-choice-in.html ) to derive pragmatic rationalism as an evidence-based, pro-democracy, pro-public interest political ideology or mindset. At this link, https://dispol.blogspot.com/2024/10/pragmatic-rationalism-explained-by.html , Perplexity search referred to pragmatic rationalism as a meta-ideology. Is it a meta-ideology?

A2: Germaine's pragmatic rationalism can indeed be considered a meta-ideology. Here's why:

Transcends Traditional Ideologies: Pragmatic rationalism does not align with conventional political ideologies but rather seeks to provide a framework for evaluating and navigating them. It aims to be a method of analysis that transcends the biases and dogmas inherent in traditional political thought.

Focus on Rationality and Evidence: It emphasizes rational analysis, empirical evidence, and cognitive biology to inform political and social decisions, positioning itself as a higher-order approach to understanding and addressing political issues.

Anti-Biasing and Anti-Ideology: By explicitly aiming to be anti-biasing and anti-ideology, pragmatic rationalism critiques and seeks to mitigate the influence of ideological biases, making it a meta-ideology that critiques and evaluates other ideologies.

Pro-Democracy and Public Interest: Germaine's approach is described as pro-democracy and pro-public interest, suggesting that it seeks to serve the broader societal good by promoting rational decision-making processes.

In summary, pragmatic rationalism, as articulated by Germaine, functions as a meta-ideology by providing a framework for evaluating and navigating political ideologies, focusing on rationality, evidence, and the public interest, while explicitly critiquing and aiming to mitigate the biases inherent in traditional political thought.

Q3 and 4: Pragmatic rationalism is based on Germaine's understanding of aspects of cognitive biology that can lead people to false beliefs, especially in the face of demagoguery and propaganda deceit and emotional manipulation. Factoring prominently into his thinking, he points to human cognitive traits such as unconscious biases, mental heuristics, prejudices, self-esteem, self-identity etc., and aspects of human social behavior, e.g., family, group or tribe loyalty, strictures of social institutions and sociological phenomena as Germaine discussed here https://dispol.blogspot.com/2020/03/book-review-invitation-to-sociology.html . Pragmatic rationalism also asserts core moral values of (i) fidelity to facts, true truths and sound reasoning, even when they are inconvenient, (ii) support for secular democracy, including reasonable compromise, and (iii) a dominant focus of service to the public interest over special interests., i.e., rebalancing power from special interests to the public interest. The goal of pragmatic rationalism is to formulate a meta-ideology or mindset that is designed to reduce human susceptibility to demagoguery, irrational emotion-fomenting propaganda, crackpot reasoning and the like. What else could pragmatic rationalism include to improve the effectiveness of the pragmatic rationalist meta-ideology or mindset?

A4: To improve the effectiveness of pragmatic rationalism as a meta-ideology or mindset, several additional elements could be incorporated:

1. Critical Thinking and Media Literacy:

Incorporate Critical Thinking Frameworks: Pragmatic rationalism could benefit from integrating established critical thinking frameworks that help individuals evaluate information critically. This includes teaching people to recognize logical fallacies, understand cognitive biases, and assess the reliability of sources 2.

Media Literacy: Promote media literacy to help individuals discern between factual reporting, opinion pieces, and propaganda. This would involve understanding how media shapes narratives and the importance of seeking out diverse sources of information 2.

2. Emotional Intelligence and Empathy:

Emotional Awareness: Encourage the development of emotional intelligence to recognize and manage one's own emotions and those of others. This can help in understanding how emotions are manipulated in propaganda and demagoguery 2.

Empathy Training: Foster empathy to understand different perspectives, reducing the likelihood of falling into ideological echo chambers and promoting more constructive dialogue 4.

3. Self-Reflection and Ideological Awareness:
Self-Reflective Practices: Implement practices that encourage individuals to reflect on their own ideological beliefs, understanding how personal experiences, upbringing, and environment shape their worldview 4.

Meta-Ideological Awareness (MIA): As suggested by the concept of MIA, pragmatic rationalism could include self-reflective questions about how personal ideologies affect interpretations of information, promoting a more detached and nuanced approach to political and social issues 2.

4. Ethical Decision-Making:

Ethical Frameworks: Integrate ethical decision-making models that emphasize the importance of considering the broader implications of actions, not just immediate practical outcomes. This could involve principles from utilitarianism, deontology, or virtue ethics to guide decision-making beyond mere expediency 1.

Moral Reasoning: Encourage the development of moral reasoning skills to navigate complex ethical dilemmas, ensuring decisions are not only pragmatic but also morally sound 1.

5. Community Engagement and Dialogue:

Promote Dialogue: Foster environments where open, respectful dialogue is encouraged, allowing for the exchange of ideas and the challenging of one's own beliefs in a constructive manner 4.

Community-Based Learning: Implement community-based learning initiatives where individuals can engage with diverse groups, promoting understanding and reducing tribalism 2.

6. Continuous Learning and Adaptation:

Lifelong Learning: Encourage a mindset of continuous learning and adaptation, recognizing that knowledge and understanding evolve over time. This includes staying informed about new research in cognitive science, sociology, and political theory 4.

Feedback Loops: Establish mechanisms for feedback and self-correction, ensuring that pragmatic rationalism remains a dynamic and evolving approach rather than a static ideology 5. [great idea - need to cogitate on how to do that]

7. Institutional Reforms:

Educational Reforms: Advocate for educational systems that teach critical thinking, media literacy, and ethical reasoning from an early age, embedding pragmatic rationalism into the educational curriculum 2.

Political Reforms: Support reforms that promote transparency, accountability, and public interest in political processes, reducing the influence of special interests 3.

By incorporating these elements, pragmatic rationalism can become a more robust meta-ideology, better equipped to navigate the complexities of modern political and social landscapes, reduce susceptibility to manipulation, and foster a more informed, empathetic, and rational public discourse.

Q7: You suggest establishing mechanisms for feedback and self-correction, ensuring that pragmatic rationalism remains a dynamic and evolving approach rather than a static ideology. How can one do that?

A7: To ensure that pragmatic rationalism remains a dynamic and evolving approach, several mechanisms can be implemented:

1. Feedback Loops:

Government Responsiveness: Instead of focusing solely on feedback loops, emphasize government responsiveness as a broader concept. This involves not just responding to citizen feedback but integrating it throughout the entire policy and governance cycle 1.

Citizen Engagement: Encourage active citizen participation in policy-making, ensuring that their feedback is not just heard but acted upon, fostering a sense of inclusion and accountability1.

Visibility and Traceability: Design policies with characteristics that make the government's role in providing benefits visible and traceable, enhancing public trust and understanding of policy impacts 3.

2. Self-Correction Mechanisms:

Political Evaluation: Implement regular evaluations of political processes and outcomes to identify areas for improvement and correction 2.

Political Competition: Foster a competitive political environment where parties and politicians are incentivized to adapt and improve based on public feedback and electoral outcomes 2.

Freedom of Speech: Protect and promote freedom of speech to allow for open critique and discussion of policies, enabling self-correction through public discourse 2.

3. Policy Feedback Theory:

Policy Characteristics: Design policies with characteristics that facilitate positive feedback loops, such as longer durations of benefits, immediate delivery, centralized and streamlined policy delivery, and minimal administrative burden 3.

Target Populations: Consider the social construction and power dynamics of target populations when designing policies to ensure inclusivity and responsiveness 3.

4. Civil Society Engagement:

Building Power: Civil society organizations should strategically build power among target populations to influence policy and alter existing power dynamics 3.

Messaging and Organizing: Coordinate messaging and organizing strategies to shift policy discourse and public perceptions, facilitating long-term policy wins 3.

5. Continuous Learning and Adaptation:

Lifelong Learning: Encourage a culture of continuous learning and adaptation, recognizing that knowledge and understanding evolve over time 3.

Feedback Loops in Education: Integrate feedback loops into educational systems to teach critical thinking, media literacy, and ethical reasoning from an early age 3.

6. Institutional Reforms:

Transparency and Accountability: Advocate for reforms that promote transparency, accountability, and public interest in political processes, reducing the influence of special interests 3.

Responsive Governance: Cultivate a whole different set of attitudes and behaviors among government actors and citizens to foster responsive governance 1.

By incorporating these mechanisms, pragmatic rationalism can evolve into a more robust and adaptive meta-ideology, ensuring that it remains relevant and effective in addressing the complexities of modern political and social landscapes.

Authoritarianism update; Failed messaging -- the Dem Party's fatal weakness

The NYT reports that at least some applicants for jobs in DJT's administration must pass a loyalty test to be hired. The test asks questions that show loyalty to DJT and rejection of inconvenient facts.

But before they leave [their job interview], some of them have been asked a final set of questions that seemed designed to assess their loyalty to President-elect Donald J. Trump.

The questions went further than just affirming allegiance to the incoming administration. The interviewers asked which candidate the applicants had supported in the three most recent elections, what they thought about the events of Jan. 6, 2021, and whether they believed the 2020 election was stolen.

Among those were applicants who said they gave what they intuited to be the wrong answer — either decrying the violence at the Capitol on Jan. 6 or saying that President Biden won in 2020. Their answers were met with silence and the taking of notes. They didn’t get the jobs.

Mr. Trump has told advisers that his biggest regret from his first term was appointing “traitors,” some of whom came to view him as a threat to democracy. .... He has singled out for especially harsh attacks his chief of staff, John F. Kelly, who has called Mr. Trump a fascist; .... and his attorneys general, Jeff Sessions and William P. Barr.  

Mr. Barr is a staunch conservative who satisfied Mr. Trump right up until the final weeks of his presidency, when he refused to use the Justice Department to help Mr. Trump overturn the 2020 election.  

Mr. Trump’s lawyers were quietly working on a plan, called Schedule F, that would make it much easier to fire career civil servants. Such employees have protections to keep a stable level of expertise from one administration to the next, regardless of whether the presidency switches from one political party to the other.

Mr. Trump’s allies have made clear that Schedule F will be brought back in his second term.

That speaks for itself.

One commentator "argues that even as Trump’s second-term plans are getting more overtly dangerous to the rule of law, Democrats need to do a lot more to alert the public to what’s coming—not just because it’s good politics but because the country needs it."  

At this point, I doubt that Democrats can warn anyone of much of anything. For now, Dem elites seem to be a spent force with low public credibility and not much fight left in them.

____________________________________________________________

____________________________________________________________

Q: What do post election polls indicate about public approval and disapproval of the Democratic Party?

A: Post-election polls following the 2024 U.S. elections indicate a decline in public approval for the Democratic Party. The Democratic Party's favorability rating dropped to 38% after the election, a five-point decline from pre-election levels. This shift highlights a growing perception that Democrats are less aligned with voter priorities.  Among swing voters, the Democratic Party had a net favorability of -12 (42% favorable vs. 54% unfavorable), significantly worse than the Republican Party's net favorability of -4 (45% favorable vs. 49% unfavorable).

In my opinion, there is a huge issue here. Specifically voter perceptions are that the Repub Party aligns more with their priorities than the Dem Party. I think that is a mostly false perception. Non-trivial evidence supports that opinion.

Q2: To me, the Democratic Party is significantly more aligned with voter priorities than the Republican Party. In my opinion, the disconnect amounts to perceptions that do not align with reality. For example, the Republican Party in congress blocked its own border control bill so that Trump and Republican politicians could demagogue the issue in the election. Although Republican elites blamed Biden for inflation, other factors were more important than Biden's policies, e.g., the Ukraine war, COVID-linked supply chain disruptions, and old-fashioned corporate greed that boosted prices beyond inflationary pressures. Republicans also demagogued the issue of crime, grossly exaggerating the severity of overall crime. Is that a reasonable assessment of voter's "perception problem"?

A2: Your assessment of the "perception problem" regarding voter priorities and the Democratic and Republican parties is reasonable and supported by evidence. .... long response ....

Conclusion 
The perception that Republicans are more aligned with voter priorities often stems from effective messaging rather than substantive policy alignment. .... Meanwhile, Democrats face a challenge in bridging the gap between their policy achievements and public awareness of those achievements. (emphasis added)

I now think of the 2024 election as The Great Vaporware Election. Sophisticated dark free speech was front and center. Repub messaging was superb in creating false beliefs in the minds of millions of voters. Of course, aggressive Dem wokeness, was the Dems' own fault. However, even with that fault, the Repubs demagogued the wokeness issue to create unwarranted fear and anger, slandering the Dems as radical left lunatics, socialists, Marxists, anti-White racists and so forth. 

Q: Is it a reasonably defensible opinion to see the 2024 election as The Great Vaporware Election, or is that inaccurate and/or unwarranted? Or, have most recent elections been more vapor than substance, making this one not much different?

Authoritarianism watch; Regarding identity politics

As expected, the intent and threatening rhetoric from America's radical right continues to feel and sound solidly authoritarian. The rule of law and criminality, real and imagined, are irrelevant. They are held in open contempt. Inconvenient facts? They do not exist in MAGAlandia, usually called lies or simply ignored.

Trump Wants Jan. 6 Committee Members Imprisoned

Donald Trump, in addition to saying he wants to pardon those who attacked the Capitol on Jan. 6, said that members of the Jan. 6 committee “should go to jail” for investigating him.

“Everybody on that committee … for what they did, yeah, honestly, they should go to jail,” Trump said on Sunday’s Meet the Press.

He also claimed that former Rep. Liz Cheney and Rep. Bennie Thompson, who co-chaired the committee, were “behind” his federal prosecutions.

“Honestly, they should go to jail for what they did,” Trump said.

“So you think Liz Cheney should go to jail?” moderator Kristen Welker asked.

“I think everybody on the – anybody that voted in favor,” he said.  

Trump has previously threatened members of the committee, writing on Truth Social in March of last year that they “should be prosecuted for their lies and, quite frankly, TREASON!”

_______________________________________________________________

_______________________________________________________________

IDENTITY POLITICS

Current analyses of the election outcome indicate there are three main reasons that Harris lost. One is a mostly (~90% ?) false belief that Biden caused inflation in recent years, with food and housing prices being major points of discontent. Another is illegal immigration and the real and imagined fears and anger the issue created in the minds of many Americans. The third reason is feelings of alienation and anger among many people by aggressive wokeness, or identity politics, in the Dem party and Harris.[1]

By contrast, DJT managed to build a more diverse coalition than expected by focusing on economic and cultural issues rather than explicit appeals to identity. His campaign appealed to working-class voters across racial lines by addressing shared economic grievances and critiquing progressive policies associated with identity politics. Trump's ability to frame Democrats' focus on identity politics as out of touch with everyday concerns further solidified his support among these groups. His rhetoric positioned him as addressing practical issues like jobs and inflation rather than emphasizing divisive cultural debates. At the same time, Trump's campaign employed its own form of identity politics by appealing to non-college-educated voters as a distinct constituency.

An aspect of DJT's and MAGA's rhetoric is that it was very effective at deceit and direct appeals to identity politics (these Q&As are also in the link given above):

Q2: Although Trump's rhetoric seemed to many people to position him as addressing practical issues like jobs and inflation rather than emphasizing divisive cultural debates, my perception of his rhetoric was that it was intentionally vague to the point of being empty rhetoric about jobs and inflation, while subtly but consistently fomenting social division using identity politics that appealed to people with mindsets, consciously or not, at least sympathetic to authoritarianism, e.g., prosecuting political opponents. Is that a reasonable assessment?

A2: Your assessment that Donald Trump’s rhetoric was intentionally vague on practical issues like jobs and inflation while subtly fostering social division through identity politics and authoritarian appeals is a reasonable interpretation, supported by evidence from his campaign and broader political behavior.

Q3: In view of the two foregoing questions and your answers, is it even possible to win a presidential election without significant appeals to identity politics?

A3: Winning a presidential election without significant appeals to identity politics is theoretically possible but highly challenging in the current political climate, given the centrality of identity to modern political discourse. However, the 2024 election suggests that the nature and framing of identity politics can significantly influence electoral success.

Identity Politics as a Persistent Force

Identity politics—defined as political appeals based on shared characteristics such as race, gender, class, or religion—remains deeply embedded in U.S. elections. Both major parties leverage it, albeit in different ways: ....

Q4: In what ways has identity politics served society, democracy and groups involved in those identities?

A4: Identity politics has served society, democracy, and the groups involved in various ways, both positively and negatively. Its contributions are multifaceted, reflecting its ability to empower marginalized communities, foster solidarity, and challenge systemic injustices, while also raising concerns about division and exclusivity.

Positive Contributions

2. Broadening Democratic Participation

Identity politics has expanded democratic engagement by encouraging participation from groups that have historically been excluded from political processes.

4. Democratization of Power

Identity politics disrupts hegemonic power structures by challenging the dominance of privileged groups. It demands recognition not just as part of a universal human experience but as distinct identities deserving respect on their own terms. This process has been described as contributing to the "democratization of democracy" by making equality and freedom more tangible through specific struggles.

Challenges and Criticisms

1. Risk of Division

Critics argue that identity politics can exacerbate social fragmentation by emphasizing differences rather than commonalities. This focus on group-specific interests may:

(i) create tensions between different marginalized groups or between marginalized and dominant groups and (ii) lead to a sense of exclusion among those who feel their identities are not adequately represented or prioritized. 

2. Potential for Essentialism

Identity politics can sometimes reduce individuals to their group identities, ignoring the complexity of their experiences. This essentialism risks: (i) overlooking intersections between different identities (e.g., race, gender, class), and (ii) reinforcing stereotypes or limiting individuals' ability to define themselves outside group categories.

The point I want to make about identity politics is pretty simple: It is a two-edged sword. 

It can be good or bad. It can be good when used in good faith by people of good will to defend and strengthen democracy. But, it can be bad when used in bad faith by people of ill-will to attack and weaken democracy. 

Qs: Did Harris employ identity politics in good or bad faith? Did DJT?

Footnote:

1. One analysis I looked at about somewhat low Dem voter turnout indicated that this factor probably did not contribute much or anything to Harris' loss. Many of those Dem non-voters indicated that they too were feeling alienated and angry about politics and the Dem party. They seemed to be as likely to vote for a 3rd party candidate or DJT even if they had voted.

Heath care anger: Warranted or not?

I was going to ignore the murder of Brian Thompson, the chief executive of UnitedHealthcare, the country’s largest health insurer. However, that event has really hit a nerve with a lot of people. As usual, social media leads the way in expressing callous vulgarity and the underlying anger, e.g., one X user posted regarding feelings about the murdered CEO: Empathy: Denied! 

A lot of people are really angry at health care insurance companies and how they do business.

A NYT opinion by a doctor in a hospital seems to capture the basis for public anger about as well as it can be succinctly expressed. The doctor, Helen Ouyang is an emergency physician and an associate professor at Columbia University. Dr. Ouyang writes (not paywalled):

I rushed around the patient as he lay motionless with his eyes closed in the emergency room. He was pale and sweaty, his T-shirt stained with vomit. You didn’t have to be a health-care worker to know that he was in a dire state. The beeps on the monitor told me his heart rate was dangerously slow. I told the man that he was going to be admitted to the hospital overnight.

After a pause, he beckoned me closer. His forehead furrowed with concern. I thought he would ask if he was going to be OK or if he needed surgery — questions I’m comfortable fielding. But instead he asked, “Will my insurance cover my stay?”

This is a question I can’t answer with certainty. Patients often believe that since I’m part of the health-care system, I would know. But I don’t, not as a doctor — and not even when I’m a patient myself. In the United States, health insurance is so extraordinarily complicated, with different insurers offering different plans, covering certain things and denying others (sometimes in spite of what they say initially they cover). I could never guarantee anything.

I didn’t say all this to the man, though, because I needed him to stay in the hospital and accept inpatient treatment. So instead I hedged. “You’re very sick,” I told him. “You shouldn’t worry about your insurance right now.” I should have been able to give him a better answer, under a better system.

The killing of Brian Thompson, the chief executive of UnitedHealthcare, the country’s largest health insurer, has reignited people’s contempt for their health plans. It’s unknown if Mr. Thompson’s tragic death was related to health care, and the gleeful responses have been horrifying. But that reaction, even in its objectionable vitriol, matters for how it lays bare Americans’ deep-seated anger toward health care. Around the country, anecdotes were unleashed with furor.

Among these grievances is the great unknown of whether a treatment recommended by a doctor will be covered. It’s critical for me as a physician to build trust with my patients by giving them clear answers. But the conversations we’re seeing now about health care remind me that insurance unknowns don’t just compromise the care I can deliver to my patients — they also undermine the fragile doctor-patient trust. It’s an unsustainable dynamic. 

Unsurprisingly, despite my platitudes, my patient did worry. Instead of resting on the stretcher, he and his wife began calling his insurance company. To keep him from leaving, I tried to be more persuasive, even though I didn’t know what kind of health plan he had: “I’m sure your insurance will pay. I’ll document carefully how medically necessary this admission is.” .... I said what I could to get him to stay, but I understood why he wanted to be certain. The average cost of a three-day hospital stay is $30,000. He had heard the health-insurance horror stories. Maybe he had lived through one himself.

One of my first lessons as a new attending physician in a hospital serving a working-class community was in insurance. I saw my colleagues prescribing suboptimal drugs and thought they weren’t practicing evidence-based medicine. In reality, they were doing something better — practicing patient-based medicine. When people said they couldn’t afford a medication that their insurance didn’t cover, they would prescribe an alternative, even if it wasn’t the best available option.

As a young doctor, I struggled with this. Studies show this drug is the most effective treatment, I would say. Of course, the insurer will cover it. My more seasoned colleague gently chided me that if I practiced this way, then my patients wouldn’t fill their prescriptions at all. And he was right.  

In the end, my patient in the E.R. decided to go home that day. I reiterated how sick he was. .... But I’m not sure how much he trusted me after my overconfident assurances that his insurance would pay; when he finally got through to an agent, he was told coverage would depend on the specifics of his care.

He couldn’t risk a big hospital bill right now, he told me, matter-of-factly. He promised to come back if he felt worse.

For years, the idea of private insurance for health care never felt right to me. The profit motive is always there and it cannot be deterred. Humans will be human. The profit motive is a staggeringly powerful motivator of all kinds of behavior, good, bad, ambiguous, etc. 

Consider drug prices for patented drugs in the US compared to the same drugs in most other countries. The US government rarely negotiates drug prices because for as long as the idea of negotiating prices has existed, drug industry lobbyists and "campaign contributions" (free speech) has successfully blocked negotiated pricing to protect profits, always in the name of money needed for research for better new drugs. 

The Christian nationalist rationale for breaking the US Constiitution

CONTEXT

From the amicus brief the U.S. Conference of Catholic Bishops filed in the case United States v. Skrmetti in which the supreme court court considers the question: "Does a Tennessee law restricting certain medical treatments for transgender minors violate the Equal Protection Clause of the 14th Amendment?":

I. Catholic Teaching That Transgender Body Manipulation Is Morally Wrong Is Not Discriminatory. 

Catholic teaching about the human body and the application of that teaching to transgender body manipulation is not based on animus or prejudice, but on anthropological and metaphysical principles that are both divinely revealed and accessible to reason. ....

.... Transgender body manipulation treats the human body as an object that a person can use and dispose of at will; it views the human body as a mistake to be corrected; and it sacrifices healthy sexual functioning when it is not necessary to do so in service of the whole body. For these reasons, Catholic teaching deems transgender body manipulations immoral and contrary to God’s will, not out of animus or prejudice, but on the basis of principles grounded in reason and revelation, long-held and universally applied by the Catholic Church.

I think the bishops are fibbing. Their feelings are based on both animus and prejudice.

THE RADICAL RIGHT ARGUMENT 

FOR CHRISTIAN THEOCRACY

The authoritarian American CN (Christian nationalism) wealth & power movement aggressively uses federal courts to de-secularize and Christianize the law, government, public and higher education, commerce and anything else it can reach in court. Although most Christians are not supporters of CN, the movement already is frighteningly powerful. Starting next month, it will acquire a lot more power than it has now. 

Russell Vought, has been nominated for a powerful position in DJT's government. Trump named Vought to run the Office of Management and Budget, a federal office that holds vast power because it controls the purse strings for the entire federal government. Vought, a key author of Project 2025, is a Christian nationalist who believes the federal government's job is to impose a "biblical worldview" by fiat.

Here is Vought's rationale for a non-trivial degree of authoritarian Christian theocracy in what he calls America's "post-constitutional moment":

Q2: I wanted you to find sources outside of the linked-to article that describes Vought's rationale.

A2: Russell Vought's rationale for arguing that the US is in a "post-constitutional moment" is based on several key points:

1. Vought claims that over the past century, the United States has experienced "nothing short of a quiet revolution" that has abandoned the true meaning and force of the Constitution. He argues that the country has become a "post-constitutional regime" that no longer adheres to the separation of powers among the three branches of government as laid out by the framers.

2. He asserts that power now lies primarily with the executive branch, specifically with unelected bureaucrats and civil servants in various agencies, whom he sees as part of a "permanent ruling class" of leftist elites.

3. Vought believes that this leftist revolution has already succeeded, rendering conservative efforts to preserve the constitutional order futile. He argues that the "woke and weaponized" leftist regime is "now increasingly arrayed against the American people," treating patriotic parents as "domestic terrorists" and "putting political opponents in jail."

4. He contends that the conservative legal movement, including the Federalist Society and originalist judges, has become a "Praetorian Guard for this post-constitutional structure" rather than defending true constitutional principles.

5. Vought likens the current situation to critical moments in American history such as 1776 and 1860, suggesting that the country faces an existential threat requiring revolutionary action.

6. He argues that this "post-constitutional" state justifies taking extraordinary measures, including potentially using the military for domestic law enforcement and significantly altering the structure of government agencies.

Vought's conclusion from this rationale is that conservatives need to embrace what he calls "radical constitutionalism," which involves going beyond traditional legal and political constraints to enact their will and restore what he sees as the true constitutional order

Q3: How does Vought's view of the executive branch differ from traditional conservative perspectives?

A3: Vought's view of the executive branch differs significantly from traditional conservative perspectives in several key ways:

1. Rejection of constitutional constraints: Vought argues that the U.S. is in a "post-constitutional moment," claiming that the constitutional order has been destroyed by a leftist revolution. This contrasts with traditional conservative views that emphasize adherence to and preservation of the Constitution.

2. Expanded presidential power: Vought advocates for an "energetic president with the power to bend the executive branch to the will of the American people". This goes beyond traditional conservative views of limited government and separation of powers.

3. Dismantling the administrative state: While many conservatives criticize bureaucracy, Vought's approach is more radical. He aims to "gut the 'administrative state' from within" by removing federal employees perceived as obstacles to the president's agenda.

4. Etc.

Three points:

• Although Vought claims he wants the president exercise power to bend the executive branch to the will of the American people, a lot of what Vought and DJT want in terms of specific civil rights and other policies are opposed by majority public opinion, about 57%. A hallmark of American radical right authoritarianism is that, when circumstances permit, majority public opinion is ignored and policies most do not want are imposed if authoritarian leaders want it. That comes from the definition of authoritarianism.

• Although Vought claims that we are a "post-constitutional regime", allegedly by violating the separation of powers among the three branches of government the framers laid out, that is sheer blithering nonsense. The framers strongly disagreed about separation of powers. They never resolved their disagreements in their lifetimes. Reputable historians have made that very clear. Also clear is that fact that to prevent tyranny, the Framers implemented a system of checks and balances among the three branches of government. That was designed to keep one branch from becoming too powerful. Vought's disingenuous argument about a powerful executive flies directly in the face of separation of powers the Framers established.

• DJT lied to us when he said he knew nothing about and no one related to Project 2025. Vought is deeply related to it, being a key author. Nonetheless DJT also said he hated some of what was in it. He flat out lied on both points. That's no surprise because he's a chronic liar. MAGA elites lied about it too:

Project 2025 is actually "the agenda," a prominent MAGA figure has said, despite Donald Trump repeatedly denying any connection with it during the election campaign.

And ex-Trump adviser Steve Bannon has strongly endorsed the comment by conservative political commentator Matt Walsh, who said on X, formerly Twitter: "Now that the election is over I think we can finally say that yeah actually Project 2025 is the agenda." Walsh's post had 5.9 million views and 6,800 reposts. (emphasis added)

By now, the truly authoritarian intent of both DJT and CN are clear and not rationally deniable. The open questions are how fast will they go and how far will they get.