Mar 242017
 

A few thoughts on the demise of the American Health Care Act:

  • Paul Ryan is not a smart man. As others have noted, he is a dumb guy’s idea of a smart man. He actually thought he could pass a bill in a month without doing any of the hard work necessary to pass major legislation. He didn’t reach out to stakeholders. He didn’t hold public hearings. He barely allowed any debate on the bill. And I’m not even getting into the substance of the bill, which was breathtaking in its cruelty.
  • Trump is low-energy! Seriously, he couldn’t be bothered to focus on the task of realizing a major campaign promise for more than a few weeks. He claims to be more interested in tax reform, but that’s likely to be even more arduous than his failed attempt to repeal the ACA. He’ll need to be able sell tax reform on its merits, but he’s shown no capability for this.
  • The voices of constituents matter. If you called your representative or senator, if you showed up at a town hall meeting, if you wrote a letter to your newspaper, then you played a part in the demise of this terrible bill.
  • The fight is not over. Republicans will try to sabotage the ACA through regulatory actions, funding cuts, and other shenanigans. People of good conscience must be prepared to fight any efforts to diminish the effectiveness of the ACA. We must also offer practical solutions to fix the shortcomings of the ACA. And maybe we can even find bipartisan consensus on those fixes.
Mar 132017
 

I drafted the op-ed piece below in an effort to explain why the proposed cuts to Medicaid in the American Health Care Act would be so detrimental to me and millions of others. Alas, the Times was not interested, but perhaps this is a more fitting place for it.

Soon after I turned thirteen, I was hospitalized with pneumonia and my parents confronted an agonizing choice: should they surrender their parental rights to ensure that I received the health care needed to ensure my survival? I was born with spinal muscular atrophy, a rare neuromuscular disability that severely weakens muscles and compromises breathing. I had several bouts of pneumonia as a child and had always managed to recover, but this time was different. My lungs had weakened to the point where I would need a ventilator to help me breathe. Doctors advised my parents to place me in a facility that could care for children with intensive medical needs.

Fortunately for me, my parents refused this option and eventually I returned home with a boxy yet portable ventilator on the back of my wheelchair (this was 1987, when most technology was still in its boxy phase). Caring for me wasn’t always easy for my parents. I’m essentially a quadriplegic and I need help with everything from bathing and dressing to scratching my nose when I have an itch. But thanks to Medicaid, they didn’t have to care for me around the clock. Medicaid provided nurses to take me to school, which allowed my parents to keep working. It paid for modifications to my wheelchair so that I could leave the house more easily. Without the supports provided under Medicaid, I would not have been able to finish college and move to Minnesota for law school.

Today, I’m 43; I live independently and work as an attorney for the State of Minnesota. My life is ordinary in the best sense of the word. When I’m not at work, I go to the movies (Logan was great!), check out the occasional concert (you really must see CHVRCHES live), and generally indulge my pop culture obsessions (that new Star Trek series had better be worth the wait). None of this would be possible without the excellent, round-the-clock care that I receive under Medicaid.

Medicaid has made my life immeasurably better, along with the lives of countless others. However, that isn’t stopping congressional Republicans from embarking on an ideological mission to starve Medicaid of funds. Last week, House Republicans unveiled a bill to repeal and replace the Affordable Care Act. The entire bill is a travesty, but its proposed changes to Medicaid are particularly troubling. First, the bill would gradually repeal the expansion of Medicaid for low-income adults without children. This provision would rob eleven million people of the health coverage that they gained just a few years ago. Many of the people who benefited from the expansion have chronic conditions such as diabetes or mental illness that previously went untreated. Medicaid. Second, the bill makes radical changes to the funding of Medicaid. It would establish caps on the amount of federal funding for each Medicaid enrollee. While this may seem like a technical change, it would dramatically reduce Medicaid funding over time. Under such a scheme, states like Minnesota would soon face budget shortfalls totaling billions of dollars and they would be forced to find savings by cutting services, reducing payments to providers, or both.

For people with disabilities like me, such cuts could be catastrophic. States could eliminate services that we depend on in our daily lives, such as personal care attendants or specialized equipment like communication devices. Those of us who are employed could lose the option to buy into Medicaid, forcing us to quit our jobs in order to preserve our health coverage. In some cases, we may face the dreaded possibility of institutionalization and isolation from our communities.

Republicans claim that these changes are necessary to “save” Medicaid and protect it “for the most vulnerable.” These claims are absurd and deserve no credence. Like any program devised by humans, Medicaid has its flaws, but the Republican bill would do nothing to address those flaws. The true rationale for these cuts to Medicaid is to pay for the repeal of the taxes on businesses and the wealthy that fund the ACA. The vulnerable people whom Republicans claim to champion are those who will suffer the most if this bill becomes law.

Medicaid has been instrumental in helping people with disabilities achieve lives of independence and dignity. Advocates have worked tirelessly to improve the program and its focus on providing services in the community. The Republican bill puts those hard-fought accomplishments in jeopardy and threatens real harm to those of us who depend on the program for our very survival. The only thing that Medicaid needs saving from is this vicious and mean-spirited legislation. 

Dec 152016
 

It’s only now that I feel like I can write about the election and its aftermath with any degree of perspective. I was wrong about so many things; things that maybe should have been more obvious at first blush. I thought Clinton’s experience and competence would compensate for her lack of charisma and aloofness. I thought that bragging about sexually assaulting women was far more disqualifying than e-mail mismanagement. I thought that the Obama coalition would turn out in droves to defeat a flim-flam man with no prior political experience and a penchant for manic tweeting.

In the weeks since the election, I’ve been watching a lot of Seinfeld and doing my best to avoid my Twitter feed. Reading the news has become a grim exercise in endurance. Ben Carson will be in the Cabinet? The guy who ran Breitbart will have an office in the White House? The president-elect is dismissing reports that Russia may have hacked our political process to give Trump an advantage? This would all be hilarious if it wasn’t, you know, actually fucking happening.

So now what? Perhaps Trump will turn out to be just a generic Republican, which is still pretty awful. Perhaps he’ll resign after a year or two because he’ll be unable to reconcile his authoritarian tendencies with his pathological need to be liked. Whatever happens, progressives will need to figure out how to mount an effective opposition to this administration. Republicans wrote the playbook on this and we shouldn’t hesitate to use their own tactics against them. Any efforts by Trump to shred the social safety net, undermine efforts to prevent climate change, or cut taxes on the wealthiest among us must be met with the staunchest resistance. We can try to work with Trump when he has some genuinely good ideas, but I’m guessing that will be a rare occurrence. Too much progress has been made in the last eight years and too much remains to be done.

This blog will be a very small part of that resistance. If nothing else, it will serve as the chronicle of a snarky middle-aged guy trying to navigate Trump’s America. So buckle up, Dear Reader. We’re both in for a bumpy ride.

Jun 262015
 

This week has reminded us that the United States is, at its heart, a progressive country. That progress does not always come quickly or easily and there can be long stretches of time when it seems like things will be ever as they are. But in fits and starts, we bend the long arc of history a little closer towards justice and equality.

In the wake of a horrific terrorist attack at a Charleston church, we came to the much-belated realization that the Confederate flag represents the worst of our country’s history and it is not a symbol that should be flying over state capitols. Meanwhile, the Supreme Court turned back a cynical challenge to the Affordable Care Act that, if successful, would have left millions of people without health insurance. And today, the Court affirmed that marriage equality is the law of the land.

Any of these events would have been momentous. Together, they represent a period of rapid and long-overdue change that will probably leave some people feeling confused, overwhelmed, or even angry. We may not recognize it now, but history will regard this time as a critical juncture in the country’s evolution and I feel so fortunate to be a witness to it. Here’s to the ongoing work for a better future and the countless anonymous people who will make it happen.

Jun 212015
 

The Supreme Court will rule on King v. Burwell in the coming days and the outcome could determine whether millions of people will continue to receive subsidies to purchase health insurance. But as Ezra Klein rightly points out, a ruling against the government won’t destroy the Affordable Care Act. In blue states that have set up their own exchanges (like Minnesota), the ACA will continue to function as if nothing had happened. It’s people living in red states who will suffer the  consequences of an adverse ruling. And some Republicans may rue the day that this suit was filed in the first place. They’ve had the luxury of taking potshots at the ACA without having to propose a serious alternative. If millions of their constituents suddenly learn that they are losing coverage, Republicans will be pressured to come up with some kind of solution. Whether they can pass anything is another matter entirely.

I’m still cautiously optimistic that the government will prevail, but a bad decision won’t realize conservative fantasies of a wholesale dismantling of health care reform. There will be turmoil and some people could suffer real harm if Republicans refuse to act. The law itself will remain and most states will eventually find a way to ensure their citizens enjoy its full benefits.

Apr 012015
 

Indiana lawmakers are really bad at understanding cause and effect. How else can we explain their stunned and bumbling reactions to the swift public condemnation of the “religious freedom” law that they recently passed? They should have been prepared to give a full-throated defense of their discriminatory law before the ink was even dry on the governor’s signature of the bill. They should have proudly declared that their fellow conservative Christian evangelicals deserve protection from the strains of living in an open, diverse society. They should have presented reams of testimonials from thousands of Christian businesses owners who lie awake at night, terrified at the prospect of selling a pizza to a gay couple or baking a cake for a same-sex wedding. Instead, they’re still staring slack-jawed into the high beams of censure from a modern world that is becoming ever more foreign to them.

I don’t have a problem with people opposing homosexuality and same-sex marriage. Their views are rooted in superstitious silliness, but they are free to hold them. But when those in power implicitly legalize discrimination as a reactionary response to changing social mores and then get called on it, they have no right to wave their hands and claim it’s all a big misunderstanding. Lawmakers in Indianapolis, who most likely regard themselves as “real” Americans, decided to pass legislation that spits in the face of American ideals of equality and fairness. They don’t get to claim victimhood after the fact.

Oct 092014
 

Americans are masters at freaking about things that really aren’t threats. Case in point: Ebola. 20% of Americans are afraid of catching Ebola; a ridiculously high number considering that exactly one case has been diagnosed in the country. As Jeffrey Young of HuffPo points out, the flu virus presents a much more significant danger to public health. Thousands of Americans will die from the flu in the coming months, yet I’m betting that most of the people in hysterics about Ebola won’t bother getting a flu shot.

If you are concerned about becoming sick in the next few months, get a flu shot. Tell your friends and family to get flu shots. A flu shot will provide actual protection against a real threat. Panicking about anything is rarely helpful and only makes us look incredibly silly to the eyes of the world.

Sep 022014
 

The ALS ice bucket challenge has dominated social media for the last few weeks and has raised tens of millions of dollars for ALS research. Countless more people have now at least heard of ALS and have a basic understanding of the disease’s effects on those who have it. This is all good news, right?

Maybe. Slate points out that the ALS Association is no closer to finding a treatment or cure after decades of research and it’s unlikely that a sudden influx of money will change that. And while ALS is a potentially fatal disease, it affects relatively few people. Does it make sense to throw $100 million (according to some estimates) at a single and rare medical condition? Would that $100 million have otherwise been spent on other charities that are more likely to achieve immediate results with the money (like feeding the hungry or developing new sources of clean water for poor communities)?

I won’t be giving money to the ALS Association. To be clear, I also don’t give money to charities related to spinal muscular atrophy (my disability). Medical research is a decades-long process that isn’t going to yield results any faster because of my $100 dollar contribution. I certainly don’t begrudge the ALS Association for its sudden windfall and I hope it puts the money to good use, but there must be a better way to fund and coordinate research in “orphan” genetic diseases that otherwise attract little attention from the private sector. It would be great if the ice bucket challenge kicked off a more thoughtful conversation about that very topic. Unfortunately, thoughtful debate isn’t a strength of social media. What’s more likely is that donations to the ALS Association will fall off a cliff before long and the long-term benefits of the ice bucket challenge will be ambiguous at best.

Aug 282014
 

Earlier this summer, my mom made some worried comments about the violence in Ukraine. I told her that things would calm down soon because Putin would realize that further intervention wasn’t worth the risk of tougher sanctions. Silly me. Putin has been far craftier with his Ukrainian strategy, engaging in a kind of slow-motion invasion that has has sown confusion and hesitancy among Western leaders. I still doubt that a shooting war will erupt between NATO and Russia, but tensions could easily escalate if either side misread’s the other’s intentions.

World affairs have been something of a horror show this summer and it would be nice if the human race could spend the rest of the year not bearing witness to a slowly unfolding global crisis.

Aug 152014
 

My family was in town this week for a low-key reunion, so posting has been particularly light. But here are a few stray thoughts for a Friday:

  • The news of Robin Williams’ death was a terrible shock. I loved his manic form of comedy that sometimes became a deluge of pop culture references. His humor channeled the Internet before the Internet was a thing. But I was also saddened by the harassment inflicted upon his daughter Zelda after she posted a tribute to her father on social media. I understand that even sociopaths have the right to express themselves, but it should be far easier to mute their toxic chatter on timelines and newsfeeds. The Internet is supposed to be a self-regulating platform, but that regulation seems to be lacking even as we become more dependent on the platform.
  • On a lighter note, I’m thoroughly enjoying Divinity: Original Sin. It’s a throwback to the isometric role-playing games of the 90’s such as Fallout and Baldur’s Gate, which are among my favorite titles. Divinity doesn’t offer much hand-holding, but I appreciate the opportunity to figure out things for myself. Between this and the forthcoming release of similar games like Pillars of Eternity, my gaming calendar should be booked through the winter.