Just How Broken is Our Healthcare System?

A young woman dies in childbirth for lack of proper perinatal care. An elderly man can’t afford meds to control his chronic conditions, so he rations them. A child is misdiagnosed in the emergency room. A patient waits months to see her doctor about a troublesome symptom.

Stories like these abound. They are shared by patients, parents, partners, good healthcare providers and others who’ve had enough of medical runarounds, cost issues, access problems, diagnostic and treatment errors, insufficient time with providers, and more, to contend with. Reports of major issues in healthcare by medical professionals as well as patients and politicians with a conscience are increasingly sounding alarms.

In a recent Instagram post, for example, Senator Tammy Baldwin (D-WI) was outraged to learn that drug companies charge as little as $7.00 for an inhaler outside the U.S. while here the price gouging rises to as much as $380 depending on what type of inhaler is needed. Senator Bernie Sanders (I-VT) is among several Democratic senators, and The Senate Health, Education, Labor and Pensions Committee, that have demanded information about asthma inhaler patents and prices from four major manufacturers accused of “manipulating the patent system.”

One of the four companies was cited for charging $645 for an inhaler it sells in the UK for $49. Another company was called out for charging $286 on the U.S. market for an inhaler that costs $9.00 in Germany. According to another Instagram post in February, “Pharmaceutical giant Eli Lilly reported over two billion dollars in profit in the last three months of last year alone. This massive number comes from hiking prices of vital drugs for American seniors and other patients”.

Dr. Ashish Jha, Dean of the School of Public Health at Brown University wrote in a Washington Post editorial in January expressing his concern that some doctors are selling their practices to private equity firms because running a medical practice has become a management nightmare. “The number of private equity firms in health care has exploded in recent years,” Dr Jha lamented. “It’s a trend that should have everyone’s attention, from politicians to patients, because it can significantly increase costs, reduce access, and threaten patient safety.”

In an article published in the New York Times in November last year, Dr. Amol Navathe, co-director of the Healthcare Transformation Institute at the University of Pennsylvania, worried that non-profit hospitals were focusing more on dollars than patients.  He wrote that nonprofit hospitals are “hounding poor patients for money, cutting nursing staffing too aggressively, and giving preferential treatment to the rich.” It’s gotten so bad, he says, that nurses and other healthcare workers are resorting to strikes to improve workplace safety at several hospitals during an “acquisition spree” that is making healthcare less affordable.

Nursing homes and assisted living facilities are taking a hit too. According to the New York Times these profitable facilities charge $5,000 per month or more topped up by fees for such things as a blood pressure check, $50 for an injection (more for insulin), almost $100 a month for medication orders from external pharmacies, and over $300 a month for daily help with an overpriced inhaler. There can be extra charges for help in toileting, dining room fees, or a daily check in by staff.

There are currently 31,000 assisted living facilities nationwide. Four out of five of them are for profit businesses. Most of them cater to affluent white elders, although minority groups are a quarter of the population older than 65 in the U.S. According to the New York Times piece, assisted living is “part of a broader affordability crisis in long term-care for the swelling population of older Americans.” Aside from cost issues, there are reports of serious care problems reported by watch groups, ranging from staffing shortages, growing infection rates, and lower vaccination rates in assisted living facilities.

Another area of healthcare feeling a looming crisis is mental health, including addiction.  Daniel Bergner, author of the book My Brother’s Story, the Science of Our Brains, and the Search for Our Psyches, points out that while housing, additional psych wards, and community-based treatment facilities are traditionally identified remedies, budgetary and logistical problems are ignored. “These fundamental changes often involve the involuntary nature of care,  and the flawed antipsychotic medications that are the mainstay of treatment for people dealing with the symptoms of  psychosis,” he says.

Bergner reveals that existing laws in almost all states allow for mandatory care that can rely on court-ordered treatment, including the use of antipsychotic drugs. “Imagine,” he asks us, “being hauled off to an emergency room, forcibly injected with a powerful drug…and held in a locked ward until being dispatched into a compulsory outpatient program.” He points out that is likely to add to a patient’s trauma, isolation, and lack of agency, rather than their recovery. “Compulsory care is deeply problematic…made more so by the medications at its core. … Drugs shouldn’t be the required linchpin of treatment.”

This is just a sampling of the issues confronting our failing healthcare systems. Our disgraceful maternal and infant mortality rates are often linked to racial discrimination. Shrinking Medicaid payments to clinics for the poor dramatically affects healthcare for the poor. And reproductive healthcare is on a rapid road to crises that smack of sexism -- all among the reasons our voices and votes need to be heard this year.

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Communal Living Makes a Comeback

Some years ago, when I turned fifty, I gathered with my BFFs (Best Female Friends) to celebrate the milestone that each of us would reach that year.  It was a joyous and somewhat raucous Croning Celebration at a beach house that led to many more such times over the years. At one of our meetups, we got the idea that when we were old, we should have a Crone cottage together, staffed by a cook, a housekeeper, and a gardener (who some suggested could double as a toy boy). We would each have our own room but share communal space and camaraderie. It was a great idea, and we thought it was an original one, but that proved not to be true.

We’d forgotten that convents had preceded us. In the Middle Ages life was tough for females and convent living was a way out. There was a kind of freedom there, intellectually, educationally, and even politically, at least within the church, and sometimes the wider community. According to the National Museum in Zurich, Medieval nuns were not all living a simple ascetic life. Catherine of Sienna (1347 – 1380) is an example of women who evaded marriage (and childbearing). She chose to enter a convent and became an important voice in matters of church policy.

Later I learned about Beguines. They were part of lay religious groups for women in northern Europe during the Middle Ages. They led spiritual lives but didn’t join religious orders. The first group, comprised of upper-class women, started living communally in the late 12th century. They engaged in social and economic problems and supported themselves by nursing, sewing, and lace-making.While promising chastity while living with other similarly dedicated women they were free to return to the wider community and to marry, which would end their affiliation. Some claim, perhaps glibly, that these women were “the world’s oldest women’s movement.” Several of these women’s groups still exist in Europe, some of which are UNESCO World Heritage sites.

More recently, given housing costs and the cost of elder care, along with the challenges of finding one-floor living and the growing problem of homelessness, isolation and the need for support and friendship, the idea of group housing is becoming attractive again, especially for women.

In the UK, co-housing communities exclusively for women are becoming popular. An article in The Guardian last year revealed that a group of women in their fifties to nineties had set up such a community near a theatre, a patisserie, and other amenities in a suburb of London. As one of the women told the reporter, brothers, sons and lovers were welcome as visitors, “but they can’t live here!”

Many of these women, who live in individual apartments, work, volunteer, or remain active in the larger community in various ways. As the reporter noted upon visiting the women, “No one here bears any resemblance to the stereotypes of senior citizens.” Added a resident, “You can’t define us as old!”

These women fiercely reject the notion that they are a commune. They simple refer to their living arrangement as co-housing among a group of women who are “fiercely opposed to ageism and paternalism.”

A friend of mine lived happily with seven other professional women in two large houses for several years. Their ages varied but they could all relate to the various reasons for co-housing.  Last year they’d had enough of American life given the political situation, so they moved to France, where they now live in two houses again. Each is well-traveled, unafraid of new adventures, and clever about reinventing themselves. The have found or developed ways to work there – one is fluent in French and the others get by -- and they enjoy exploring their new country and making new friends. This model is unusual because it means adjusting to a different culture, and not everyone over fifty would find that inviting or viable, but it speaks to the array of ways to live in a shared-housing community.

My Crone group is now well past fifty and our Crone cottage hasn’t happened. It’s no longer likely to become a reality, but we still think about it so who knows?

One thing is certain: It’s an idea that is growing and it makes a lot of sense. As one woman who has managed co-housing settings told The Guardian, “People who are attracted to co-housing usually want purposeful closeness to their neighbors as a big part of their lives. It’s not just about alleviating loneliness – it allows people to become part of an ecosystem of families and individuals.”

Almost two years ago my husband and I moved from a rural setting to a smaller home closer to town and we really got lucky. The street we now live on feels like a co-housing community.  The individual little houses that we and others inhabit all make living on one floor possible, we are all in the same age group, and our neighbors are wonderful people who all look out for each other. I sometimes refer to it as a geriatric hippy commune (we’re all liberals), but really, it’s simply a great way to be in community as well as a participant in an ecosystem of families.

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It's Time to Confront Violence Against Women

“Do you know how it feels to get smacked around?”

“He abused me psychologically to the point that I wasn’t able to talk or think by myself.”

“I was told I was worthless. Abuse made me feel I’m nothing.”

“I asked my mom why indigenous women were being murdered. I wanted to be a boy. No one should be scared to be an Indigenous girl or woman. Please don’t let it happen to me.”

Those are some of the heart-wrenching testimonies on the walls of two collaborative museum exhibits that commemorate missing and murdered Native American women and victims of domestic violence. The exhibits, Portraits in Red by artist Nayana LaFond, and Voices by Cat Del Buono are powerful and important.

LaFond’s work is deeply personal. She is a citizen of the Metis Nation of Ontario and a descendant of the Anishinaabe and other indigenous groups and she is a survivor of domestic violence. “In indigenous cultures art is medicine,” she explains. “I see the work I do as sacred.”   

LaFond began painting the portraits when she painted an Indigenous woman from Saskatchewan who had survived violence. The woman appears strong and powerful, despite a red handprint over her mouth, which became iconic. “Red is believed to be the only color spirits can see in most indigenous cultures so I paint them the way a spirit would see them,” the artist explains.

 Subsequently she posted a call on the website of a Pow Wow held annually to commemorate the Day of Remembrance for Missing and Murdered Indigenous People. It changed her life and launched the Portraits in Red project. Offering to create similar portraits for other indigenous women at no cost, she had thousands of hits in no time from native women all over North America. Her portrait work grew exponentially with the women she paints having one thing in common; each of the women shares a symbolic red hand over their mouths, symbolizing violence and silencing. The women range in age; many wearing traditional dress. All of them offer a stunning wakeup call.

“When you’ve experienced something like these women have you want to claim yourself again,” LaFond says. “You want to speak up and be heard in a safe way. That’s why I do this work. I am claiming my own experience and turning it into something positive. I hope I’m creating change.”

“Voices,” an ongoing project by social change filmmaker Cat Del Buono, is a video collection based on more than a hundred interviews she has conducted with survivors of domestic abuse since 2013.  In the videos one sees only the mouths of women speaking and thus becomes part of an intimate, deeply sad conversation as women share their stories. Their voices serve to humanize and expose the travesty of domestic violence while encouraging others in need of help.

“The immersive nature of the exhibit reveals the enormity and the pain of domestic violence,” Del Buono says. “It’s powerful. It helps viewers understand that domestic violence doesn’t discriminate, it affects all ages and social classes. It isn’t just ‘their’ problem. It’s a society problem that urgently needs to be addressed.”

These two collaborative exhibits break the silence that surrounds violence and abuse that women suffer in larger numbers than we think. To see them together is to witness the enormity of the domestic violence crisis that goes far beyond North America and is pervasive in all cultures, classes, and communities. The statistics are staggering.

 About 4 out of 5 Native women have experienced violence. They are twice as likely than most other women to experience violence and they face murder rates 11 times the national average. The murder rate for Native women is about three times more than that of most other women. 98% of Indigenous people experience violence in their lifetime.

 There is only a six percent prosecution rate. In 2016, there were 5,712 incidents of missing and murdered Native American and Alaskan Native women but only 116 cases were logged into the DOJ data base. Sixty percent of the number of cases between 2005 and 2009 involving sexual abuse in Native communities were never prosecute by U.S. attorneys. On some reservations 96 percent of sexual violence cases against Native women were committed by non-Natives. non-Natives.

 According to Cat Del Buono, the data on domestic violence is equally staggering. On average, nearly 20 people per minute are physically abused by an intimate partner in the U.S. One in four women will be a victim of severe domestic violence in her lifetime; every nine seconds a woman is assaulted or beaten. Chillingly, one in five women in the U.S. has been raped in her lifetime, almost half of them by an acquaintance.

 Myths about domestic violence are untrue and pervasive, according to a YWCA “End the Silence” campaign in Spokane, Washington.  For example, “Domestic violence only happens to women.”  “Drugs alcohol, stress and mental illness cause DV.”  “Abusers are just out to control and need anger management.” “DV is always physical abuse.”  “If a victim doesn’t leave, it must not be that bad or they are ok with how they are being treated.”

 The fact is that all kinds of violence, against women especially, surrounds us and not enough attention is being paid to stopping it. We urgently need policy changes at every level of governance, serious and effective gun legislation, long overdue changes in the judicial system, educational programs that raise awareness of the epidemic of violence and abuse in all their forms, and sufficient resources at the community (and reservation) level aimed at prevention, identifying perpetrators, and sufficient resources to stop the scourge.

 As Cat Del Buono and Nayana LaFond know, “this is a societal problem that urgently needs to be addressed.” Their deeply important artistic work is a monument to those women who are alive and still waiting for an end to violence, and to their missing and murdered sisters. Let International Women’s Day remind us of that.

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The Time for Change is Now

As Greek philosopher Heraclitus claimed around 500 BCE, “No man ever steps in the same river twice, for it's not the same river and he's not the same man. There is nothing permanent except change.” The noted philosopher meant that change is the only reality. Given our political processes in election years, institutional change is needed more than ever as we hover on the brink of disaster.

Four major changes need to occur, and none will be quick or easy, nor are they imminent, but maybe we can begin by ending the Electoral College, an antiquated system that means we are not a true democracy because our president and vice president aren’t elected by a majority of the popular vote, which is why five times candidates who won the popular vote didn’t get elected.   

The  Electoral College has its roots in racism and misogyny, as the Brennan Center points out. When it was established, it gave an electoral advantage to slave states in the South because they upheld the Constitution’s declaration that “any person who wasn’t free would be counted as three-fifths of a free individual for the purposes of determining congressional representation.” Racism still prevails through voter suppression. As for women, they didn’t get to vote until 1920, if they were white!

The 538 members of the Electoral College are chosen by state officials, a change from voter choice that resulted from the 2023 Electoral Count Reform Act designed to deal with prior problems regarding who became a member of the College. To win an election, a presidential candidate must have a majority of all the electoral votes cast to win. Nearly all U.S. states have a winner-take-all system in which all the electoral votes go to the candidate who won the popular vote in respective states.

To eliminate the College requires a constitutional amendment – difficult, but not impossible. The John R. Lewis Act passed in the House (but not Senate) in 2022 would have addressed many problems that arise as a result of the Electoral College. It’s a bill that desperately needs to be a priority in the next Congress.

Another pressing issue calling for change is lifetime appointments to the Supreme Court and the federal courts, an “outdated relic” as the Brennan Center calls the practice. Lifetime appointments to the courts gives enormous, long-term power to judges to decide laws that can affect generations. The consequences of that longevity can be dire, especially as the courts become more politically polarized. Abortion is a case in point. SCOTUS overruled the constitutional right to abortion that was established fifty years ago because far-right Trump appointees on the Supreme Court, who promised in their confirmation hearings to follow precedent, proceeded to overturn Roe v. Wade.

That’s why the call for 18-year terms and regular appointments on the Supreme Court is growing. Term limits would enable every president to shape the direction of the court and its decisions during the four years she or he served a four-year term.  There would be no constitutional crises because of unexpected vacancies late in that four-year term and scheduled appointments for Congressional oversight would be less contentious. Enforcing ethical rules would also be upheld and belief in the court’s integrity would be restored. Secret money would no longer be able to influence justices.

As the Brennan Center notes, “On average, justices today sit on the bench for more than a decade longer than their predecessors did. … Unbounded tenure allows a single justice to shape the direction of the law … without regard to the evolving views and composition of the electorate. It puts justices in an elite and unaccountable bubble.  … It is time to reform the Supreme Court.”

When it comes to reform and rebellion, Campaign Finance Reform is up there with the Electoral College and SCOTUS appointments.  Many organizations, like the ACLU, “support a comprehensive and meaningful system of public financing that would help create a level playing field for every qualified candidate.”

To make our playing field more equitable we can look to the UK for guidance. First, they have a “regulated period” prior to each election campaign. The length of time depends on the election and covers the period that someone is formally a candidate who must only spend a limited amount of money on campaigning. There is no political advertising on TV, radio, or social media, other than a short, free pre-election TV broadcast. There are no debates! Political donations to national parties over a certain amount, about US$8000, must be declared as well as donations to local parties worth more than US$2000. Donations to members' associations – groups whose members are primarily or entirely members of a single political party – also need to be declared above $8000. That’s it when it comes to financial.donations ( *[1])

In contrast, citing superPACs and dark money, the Brennan Center says that “A handful of wealthy donors dominate electoral giving and spending in the U.S. We need limits on campaign finance, transparency, and effective enforcement of these rules – along with public financing”.

 A fourth issue that calls for action is voting systems that keep people from the polls. Purged voter rolls, gerrymandering, and deceptive election practices, primarily meant to block voters of color, low-income communities, students and seniors, must be addressed so that everyone can participate in the democratic process of voting.

This is a time for constitutional change despite challenges. We must keep the pressure for reform up if we are not to become a banana republic.

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[1] Other source: https://researchbriefings.files.parliament.uk/documents/CDP-2021-0121/CDP-2021-0121.pdf

A Marriage Survives Culture, Religion, and Time

Not long ago, my husband and I celebrated our 50th anniversary. What’s more impressive in this time of division is that we are of different cultures – my husband is British – and religions: I’m Jewish and he was raised in the Church of England. That means we beat the odds that something would go awry, but we got lucky.

 As bi-relationships go, our situation might seem unremarkable. Neither of us is bisexual, nor is ours a biracial marriage. Even the bicultural aspect of our marriage is not as difficult as it might be if, say,  I were from Bosnia and my husband was from Bhutan. Still, our marriage has been more challenging than many people might suppose.

 The first signs of our cultural differences began appearing early in our relationship. My husband worked at the British Embassy in Washington, D.C. back then and we lived the diplomatic life that dominates that city. Our social scene was formal and obligatory, with dinner parties comprised of colleagues and their spouses, carefully balanced by gender so that seating arrangements alternated males and females.

 For a few years after we married, I was happy with that sort of thing. About twice a month we entertained, if not lavishly, at least with panache. Our candlelit table was set with flowers, fine china, and inherited silver, and salad followed the main course European style. In the early days I kept a guest book, though I shudder to confess it. But I drew the line at “hotting the plates” – a tradition in England so that hot food isn’t placed on cold dishes. Similarly, one heats the teapot before brewing tea, and “bring the pot to the kettle.”

 Eventually I drew the line at living in Washington. Once we escaped the diplomatic scene my husband began to accept American informality. We hosted picnics and barbeques, but there were still challenges, one of them being my cardinal sin; I used  paper plates and plastic utensils at picnics. “It’s tacky,” my beloved said. “It’s a picnic!” I responded. “You’re supposed to use disposables at a picnic. Otherwise, it’s a dinner party on grass!”

 Food rituals were not our only point of contention. There were honor codes and language issues, humor, and personal habits to be reconciled. My husband once nearly threatened divorce because he thought I had tried to cheat British Rail when the conductor neglected to collect my ticket on a trip back to London from Devon. “Look!” I said. “The conductor didn’t take my ticket. We can get the money back!” I felt like I’d  won at Ascot. His take was different. “Absolutely not,” he exclaimed. In his best British accent, he chastised me and said I was being dishonest. Filled with guilt I felt like a true miscreant.

 As for language, I can’t recount the number of times I had to translate for our children when they were young. The boot, the biscuit, and the bypass all had to be interpreted. Bangers and mash needed explaining. “Taking the mickey” and “a piss up in a brewery” begged for deconstruction. No wonder our offspring took pride in their linguistic capabilities, my daughter claiming to be bilingual at the age of five. “I speak two languages,” she boasted proudly. “English and American.”

 On the issue of humor (humour), suffice to say that my life partner still doubles over with mirth when he watches John Cleese reruns of Faulty Towers. He finds Mr. Bean and Monty Python hilarious, leaving me to marvel at how puerile he can be. In his defense, however, he can quote Shakespeare, Wordsworth and the War Poets. I don’t know one American who can do all that.

 Over the years, we have evolved nicely. He no longer worries when I ask guests to pour their own drinks and I’ve become used to the soiled handkerchief he tucks under his pillow every night. He finds potluck suppers fun now and when I cheat the system occasionally, he applauds so long as I’ve done it out of sense of justice. For the most part we now speak the same lingo and laugh at the same jokes. We celebrate Chanukah, Christmas and Passover with equal ecumenical and cultural enthusiasm.

 I seldom “get my knickers in a twist” over little things and I love being called “Darling.”  I wouldn’t dream of Sunday nights without Masterpiece Theatre. I adore scones and my hubby swoons over a good hamburger.

 After 50 years I treasure the traditions we’ve built, inspired by the best that both sides of the Atlantic have to offer. As I look back over our time together I’m reminded of an epic poem called “The White Cliffs” by Alice Duer Miller, an American woman who married a Brit just before World War I. “I am American bred,” she wrote. “I have seen much to hate [in England], much to forgive. But in a world in which there is no England, I do not wish to live.”

 Nor would I have wanted to live my life in a world without a certain Englishman, because marriage is hard enough. At least I’ve had my share of life with someone who “has the good manners of educated Englishmen,” as American writer Margaret Halsey wrote. “It’s all so heroic,” she said. It’s also, despite the challenges of any long term relationship, warm and wonderful, and with very few exceptions, jolly good fun.

Outrageous Acts and Necessary Rebellions

 In 1983 Gloria Steinem published a book called Outrageous Acts and Everyday Rebellions. Her essay collection reflected troubling issues that called for action at the time. The title of the book rings in my ears now as I contemplate outrageous acts that require rebellion again. The troubling issues before us are varied and wide-ranging. They must be addressed as we look to the future, which grows ever more worrisome. Here are some of those issues.

 Let’s start with abortion. What happened to Kate Cox in Texas is the canary in the coalmine when it comes to women’s lives, reproductive health, and personal autonomy. Cox, a young mother sought an emergency abortion when she learned that her much wanted third pregnancy would not conclude with a viable child because of a serious anomaly that would cause the baby’s death and would risk Cox’s health, fertility, and life.  A Texas court granted Cox’s request for an emergency abortion. Days later the state Supreme Court held up the lower court’s decision, extending the anxiety that Cox and her husband were enduring. Incredibly, the Republican Court ruled that the prior decision “lacked merit” while the state’s Attorney General warned several hospitals they would face legal consequences if they allowed the abortion. Cox fled her home state for the procedure.

 At the same time, an anonymous woman in Kentucky pleaded for an abortion when her fetus had no heartbeat at eight weeks. (KY has a six-week window for abortion care). She too was denied and had to seek care in another state. Stories like these abound since the end of Roe v. Wade. They literally condemn women to serious health risks and possible death – from a party that calls itself pro-life.

 Other states have attempted to restrict use of the FDA’s long approved drug Mifepristone, proven safe and effective as an abortifacient. The case will be heard in the U.S. Supreme Court. It’s Handmaid’s Tale and 1984, putting hundreds if not thousands of women in harm’s way for lack of necessary reproductive healthcare.

 Meanwhile, the slaughter of civilians in Gaza continues, with continuing support from the U.S. as the death toll reaches 20,000, nearly half of them children. The humanitarian crisis is inconceivable, with starvation, disease, homelessness, and imprisonment now weapons of war. Over 100 Israeli hostages remain in custody, possibly in tunnels that could be bombed or flooded. How does it end when a likely new generation of Hamas fighters takes over because of failed or absent diplomacy to negotiate a viable, peaceful solution in which Israeli and Palestinian peoples can live side by side with dignity, purpose, security, and hope.  How does the carnage end when politicians remain entrenched while the death and degradation of people and nations continue and antisemitism and Islamophobia flourish?

Along with all that, the world faces an immigration crisis such as we’ve never seen. Migration patterns and mass exodus to escape violence, crushing poverty, and now climate-driven hunger. can’t be stopped by walls, guns, indefinite detention or throwing small children back in the water. Nor can immigration end because families are torn apart and bused to already overflowing cities. Current policies and practices are not only inhumane; they are unstainable.

 In the face of political crises and a climate crisis that continues to be ignored or minimized by political talking heads, the situation grows ever more dire. As the Secretary General of the United Nations has said, “Climate change is the defining crisis of our time, and it is happening even more quickly than we feared. But we are far from powerless in the face of this global threat.”  According to a recent UN Report, “No corner of the globe is immune from the devastating consequences of climate change. Rising temperatures are fueling environmental degradation, natural disasters, weather extremes, food and water insecurity, economic disruption, conflict, and terrorism.  … The Arctic is melting, coral reefs are dying, oceans are acidifying, and forests are burning. It’s clear that business as usual is not good enough. As the cost of climate change reaches irreversible highs, bold collective action is clearly called for.” The continuing failure to act adequately and urgently to save our planet cries out for  rebellion.

These few issues are the tip of the iceberg.  Add to that the real and imminent threat of encroaching autocracy.  Everyday Donald Trump reveals his plans to be a full-blown dictator, and it won’t be for just a day.  He relishes the idea of an autocracy run amok in which he is in complete control with the support of obedient henchmen. Free speech will be a thing of the past, and protesters will be hauled off to jail. Schools will abide by state sanctioned curricula and books will be banned if not burned. There will be detention camps, state run media, massive deportation, political arrests and imprisonment, forced childbearing, and more – the kind of things dictators love and never let go of. If that doesn’t call for rebellious acts, I don’t know what does.

We can hope voters embrace acts of rebellion at the polls in November, but we can’t bank on it, nor is it enough. Other political actions and policies, and the absence of good governance, (e.g., gun legislation, accessible housing, healthcare, voting rights) call for non-violent rebellion now through to election day. As Bette Davis said in All About Eve, “Fasten your seatbelt. It’s going to be a bumpy night.”  In our case, it’s going to be a bumpy – and frightening – year. We clearly need to “make good trouble.”

Why I Write, with Thanks to George Orwell

Most years when we’re on the threshold of a new year, I don’t think about resolutions I probably can’t keep. But I do contemplate my life as a writer as I put aside prior works and enter a new ever changing writing landscape. I ask myself what I will write about and worry that I will not honor my annual resolution to return to revising my novel. I consider the fact that occasionally people are offended when I am being political in my commentaries, and I will likely continuing doing so.

This year I was inspired by George Orwell, author of Animal Farm and 1984, to ask myself the question the renowned writer asked himself: Why do I write? Where does the compulsion I have to put words on paper originate? Do my words, thoughts, and ideas matter? I found some answers in Orwell’s notable personal essay, “Why I Write,” written at the end of his life.

Like Orwell, I knew from an early age that I loved writing, reading, and rolling words around in my mouth but I didn’t know until I was ten that I wanted to be a writer. At that tender age I went to the “Five and Dime” store to buy the biggest pad of lined writing paper I could find. When the saleswoman asked why I wanted it I said, “Please don’t laugh at me. I want to write a book.” She smiled so I told her I already had the plot in my mind. At thirteen I submitted a Christmas poem to The Saturday Evening Post magazine. It was rejected but I still think it was a good poem.

As I grew older my fantasy life involved story ideas including pot-boiler romances, poems of people and place, and serious thoughts about life as I observed and lived it. In high school I loved writing essays, and I loved words, thanks to some fine, challenging teachers. Words were music to my ear, and I took profound pleasure in picking the right ones to express myself.

I was a bit of a truth teller by then and I had a growing propensity for standing up to authority when I thought those in power were wrong. I built a case in my head, choosing my words carefully, delivering them verbally or in writing with visible effect. Then I described the events with meticulous accuracy and a dose of drama to my friends. Just as Orwell wrote in his essay, “I wanted to write detailed descriptions and arresting similes …in which words were used partly for the sake of their sound.” I also wanted my words to make a difference in how I, and others, were treated by authority figures.

Orwell believed that there were four main motives for writing: Egotism, Aesthetic enthusiasm (“the desire to share an experience one feels is valuable in words and their right arrangement”), Historical impulse (“the desire to see things as they are”), and political purpose (“the desire to push the world in a certain direction, to alter other people’s ideas of the kind of society that they should strive for.”)

These four motives resonate mightily for me. I saw myself in all of them, including ego. Most writers want to be noticed, praised, and remembered posthumously. But it is Orwell’s other three motives that helped me know why I write. It’s because I believe I have something worthy to say, in my own voice, not only in commentaries and personal essays, but also via fiction, poetry, and memoir, all of which expose and grapple with human experience. The feedback readers share with me when they aren’t offended by my political perspective is a form of validation, and a gift that keeps me doing it, Also, I can’t not do it. It’s a way of being part of the human family, and it’s in my DNA. Like Orwell, my starting point is almost always “a sense of justice.” And like him, I “suffer the struggles of being a writer, driven by some demon which one can never resist.”

The writer Joan Didion also wrote about why she writes after reading Orwell’s essay. She famously said, “I write entirely to find out what I’m thinking, what I’m looking at, what I see and what it means.” In short, she is saying “How do I know what I think until I see what I’ve written.” Like her, writing gives me clarity as well as enormous relief when I am struggling with daily reality or existential challenges.

Didion asked, “What do we do with knowledge that we cannot bear to live with? What do we do with the things we don’t want to know?” Photographers like Diane Arbus and Dorthea Lange answered that question visually. Like other writers who view the world through lenses of human frailty, foibles and promise, I write my way through the challenges they present, not only for myself, but for others too. I’m sure I will be compelled to do it to my dying day.

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Democracy vs. Fascism: America's Choice in the 2024 Election

Let’s get real about the most vital issue Americans face as we slowly march toward our dubious future as a nation.

It’s not about President Biden’s age which is annoyingly centerstage. After all, Donald Trump is only three years younger than the president, morbidly obese, and an obvious psychopath.  It’s about one issue and one issue only and that is whether we survive as a democracy and what will happen if not.

So far in this threatening time President Biden is the only viable candidate if we value our freedom in this contentious time. Given his commitment to the principles of democracy and the protection of the Constitution and his years of experience and achievement domestically and internationally, there is no other choice. That story needs to be told often and powerfully. The fact is you don’t have to like him or always agree with him, but you do need to realize that our future depends on his re-election, because once democracy disappears you never get it back, at least not for decades if you’re lucky. Every other issue from the economy, taxes, gun control, reproductive healthcare, First Amendment rights, education, a free press, and our stature in the world depends on saving our democracy. It’s that simple – and that urgent.

Americans are lucky. We haven’t lived under an autocracy or a dictatorship. We have no idea what that’s like in real terms, but it’s never pretty. There are many examples of how bad it is. To be clear, autocratic governments and dictatorships are similar but there is a distinction between them as the Carnegie Foundation has noted. As they point out, there are two important differences: An autocracy focuses power on a single person, while single-party dictatorships can share power through a small group of people who are appointed by the dictator. Dictatorships always include inherent abuse of power, while some autocrats relying on centralized power can sometimes effect positive change for their citizens. Both autocrats and dictators, however, exercise total control.

It’s important to realize that dictators have absolute power (think Stalin, Mussolini, Hitler).   Human rights are suppressed, and any sign of opposition is quickly shut down with intimidation, imprisonment, physical violence, or assassination. Citizens have “shallow levels of freedom,” and “no personal autonomy or quality of life. Social organizations and democratic institutions cease to exist, and democratic countries see the end of their rights as enshrined in constitutions.” People can lose their religion, see sexual orientation and same-sex marriage outlawed while security police are ubiquitous, and surveillance is prevalent. Over time no one dares to trust anyone.

According to the Carnegie Foundation democracies flourished in the 20th century but by 2019 dictatorships outnumbered democracies, sharing features including repressed opposition, control of communications, punishment of critics, imposed ideology and frequent attacks on democratic ideals.  Cross-border travel is stopped, and fear prevails as information becomes propaganda.

In the course of my international work, I became aware of the reality of autocratic and dictatorial countries. Even knowing I could leave, if I behaved myself, I sensed the oppression.  A Kenyan woman advised me to be cautious about the kind of questions I asked. In 1960s Greece when the political future there was bleak, I naively remarked to a man sitting next to me on an airplane that I didn’t think much of his government.  He interrogated me for the rest of the journey about who I’d been speaking with. In Romania, where the deceased dictator Ceausescu had mandated monthly pelvic exams for female students and workers to ensure pregnancies were carried to term I saw scores of children in an orphanage as a result. The visit shook me to the core. In Burma someone whispered her oppression, and in China, at the 1995 UN women’s conference, as a journalist I was barred from opening ceremonies, and I suspected I was surveilled and tapped in my hotel room. My relief as the plane departed was palpable.

We need to think about what life was like in the Franco, Marcos or Pinochet regimes in Spain, the Philippines or Chile. Today we must think about what life is like in Hungary under the control of Viktor Orban. In power for years he has “chipped away at the foundations of democracy,” as Vox.com put it. There journalism requires permits, propaganda prevails, and refugees and Muslims are seen as an existential threat. Dissent is silenced or disappears if it occurs in public or on blogs. Books vanish from libraries and shops. It didn’t happen overnight. It was achieved gradually in subtle ways.

Nationalism, right wing religion, militarism, anti-liberalism, and the silencing of citizens are deeply destructive forces that result in devastation and despair.  We cannot, we must not, ignore the signs of autocracy and fascism that already exist, or the dangerous pledges of Donald Trump. Nor can we think it can’t happen here. Our challenge is to ensure that autocracy or dictatorship doesn’t surprise us because we ignored its signals or couldn’t envision such systems. To protect ourselves and our country we must exercise the strongest sign of resistance to oppression, and that is our vote. It is incumbent upon each of us to keep that focus as we head to local, state, and national polling stations.

We must be prepared to save our democracy.

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The Power of Hope and the Promise of the Parkland Generation

 Ever since David Hogg, Emma Gonzales, and other high school student leaders began organizing against gun violence when their Florida school experienced a massacre in 2018 that killed 17 people and injured 17 more, I’ve clung to the belief that if we could get to the Parkland generation as political leaders, we just might save our country. I believe that now more than ever.

David Hogg is 23 now and a student at Harvard. It should come as no surprise that he has reached a new level of political advocacy. Working with Kevin Lata, Rep. Maxwell Frost’s (D-FL) campaign manager in 2022, the two activists have launched a new organization that seeks to put more young people in elected office at the state level and in Congress.

Leaders We Deserve has a PAC to coordinate with selected campaigns and a super PAC to raise funds for those campaigns. The organization has a diverse advisory group that includes Reps. Root, Swalwell (D-Calif.), Justin Jones (D-TN) and Lauren Underwood (D-Ill.). It plans to hire staff going forward.

“A big part of this,” Lata told NBC’s Meet the Press, “is electing young people that have the values of our generation [which] understands the anxiety of not knowing if you’re going to be able to survive math class.”

Hogg, who cofounded March for Our Lives, put it this way to CBS: “There are so many charismatic, brilliant young people that have come from March for Our Lives, and have now started running for office, like Maxwell, and there’s so many more that I think can come. That’s why I’m doing this, it’s to help build that pathway.”

Both Hogg and Lata take a long view of the work they have begun.  They know it’s more than an ideology-driven effort. It requires organizational skills, political savvy, resources, an experienced staff and viable candidates. That’s why they are starting with a plan that includes raising money, connecting 15 to 30 candidates at the state level to media, and supporting them in the “mechanics of a campaign.” Their goal is to help young people gain and remain in elected office with a view to running for higher office when the time is right. They are starting in states like Texas, Florida, Georgia, and North Carolina. As Hogg told NBC, the aim is to “make inroads and start building the bench now.”

They have notable role models to look to as their work progresses. Maxwell Frost was the first Gen Z member of Congress and he’s made a name for himself as he serves on the Committee on Oversight and Accountability, asking astute questions while standing up to Republican extremists who work hard to politicize committee work in Congress. He also represents a progressive view unfamiliar to many in Congress who are out of touch with youth, Black, and Latino constituents.

It's worth noting that Frost, a former organizer, activist, and special needs teacher, was inspired to activism when he was 15 years old because of the mass shooting at Sandy Hook Elementary School. He also witnessed and survived gun violence himself in Orlando in 2016.

Rep. Alexandria Ocasio-Cortez (D-NY) is another example of effective leadership from younger members in Congress. She worked in the 2016 presidential election as a volunteer organizer for Sen. Bernie Sanders (D-VT.) Inspired by demonstrations led by indigenous communities in South Dakota who opposed a new pipeline, she joined them, resolving after that experience to commit to public service. Shortly afterwards, she launched her first campaign for Congress, and won against a long-time incumbent.

She became the youngest woman and youngest Latina to serve in Congress in 2019 and she quickly got to work. During her first term she introduced 23 pieces of legislation, one of which was the Green New Deal resolution, which envisioned a 10-year plan inspired by FDR’s New Deal. It was designed to open work opportunities in construction and restoring infrastructure, reduce air and water pollution, and fight economic, social, racial and climate crises. She was also recognized for her skill as a questioner in committee hearings, effectively standing up to Big Pharma, defense contractors, and other power players.

Leaders like Frost and Ocasio-Cortez reveal the possibilities inherent in the purpose of Leaders We Deserve. Along with Hogg et al. they offer an important and timely new vision of effective leadership at a time when we are worried about the aging of some current, long-time legislators and leaders, many of whom have no real connection to or understanding of their constituencies or other Americans.   

According to a Tufts University study an estimated 8.3 million newly eligible voters emerged in the 2022 midterm elections, including White, Latino, Asian, Native American, and Black youth. In the current Congress, 52 members of the House are Millennials, aged 27 to 42, up from 31 in the last Congress. They represent 10 percent of all current voting House members and are divided equally between Democrats and  Republicans. In next year’s election those numbers are likely to grow.

David Hogg sees this as “a second step for our generation and the people in power. We’re not just voting, we’re also running.”

Activist Ariana Jasmine.agrees. “Young people are the future. They are showing that they are fed up, and they are showing up even if they aren’t old enough to vote. They understand that the direction we’re going in is completely unsustainable.”

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Are We Facing the End of Free Speech?

CEOs from major businesses in the U.S. demand that Harvard University release the names of students from 30 student organizations who signed a letter casting blame on Israel for the attacks by Hamas. The business leaders further urged the university to provide names of the signatories with photographs so that students who signed the letter would not be hired once they leave Harvard. Students began immediately to take back their signatures, as Axios and The Guardian reported.

 A law firm withdraws its job offer to a New York York University law student, president of the Student Bar Association, who wrote in the Association’s bulletin, “This [Israeli] regime of state-sanctioned violence created the conditions that made resistance necessary,” claiming that she made “inflammatory comments” that “profoundly conflict with [our] values.

 edish climate activist Greta Thunberg and 26 others are charged by British police in London for joining a protest outside an oil and gas conference. The charge? “Failing to comply with a condition imposed under section 14 of the Public Order Act,” according to the London Metropolitan police.

 In England police have made dozens of arrests after protests across the UK arose in the aftermath of Hamas terrorist attacks and Israel’s response. Many protesters are unsure whether they can now carry placards or wear symbols, or join in chants after

Suella Braverman, a member of the Conservative Party who became the UK Home Secretary in 2022, wrote to chief constables in England and Wales saying that waving a Palestinian flag or singing to advocate for Arab freedom might be a criminal offence. “I would encourage police to consider whether chants such as ‘From the river to the sea, Palestine will be free’ should be understood as an expression of a violent desire to see Israel erased from the world, and whether its use … may amount to a racially aggravated … public order offence,” she said

An increasing number of countries are resorting to force and legislation to crush protests, treating them as a threat rather than a right, as Amnesty International points out. “Peaceful protest is a right, not a privilege, and one that states have a duty to respect, protect and  facilitate.”

 In Washington, DC 49 Jewish demonstrators in front of the White House, including rabbis, were arrested urging President Biden to call for a ceasefire on his recent trip to Israel. Their charge? Crossing safety barriers and blocking entrances. And a recent post on social media revealed that the U.S. State Department has instructed ambassadors and other government officials not to use words like “de-escalation, ceasefire, end to violence, restoring calm and bloodshed.” The post has since been taken down.

 These are troubling signs that in this country the Constitution’s First Amendment is being ignored or violated. As a reminder, here is what the Amendment says: “Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances.” (emphasis mine).

Arresting protestors making their voices heard in peaceful ways is a dangerous travesty wherever it happens, but it is particularly egregious in a country that prides itself on “the rule of law.” In this time of terror and rapidly escalating international conflict America’s leadership and example could not be more urgent. Calls for a cease fire and an end to killing fields where both sides have become tragic victims is not an act of violence. Nor is it a display of national allegiance. It’s much bigger and more urgent than that. It is a call for restraint, human rights, and shared humanity in the face of unleashed rage and hopelessness.

That collective rage, fear and hopelessness threatens the future we wish for our progeny, whether we are American, Israeli or Palestinian.  We cannot move forward in a world in which a slaughter of innocents, no matter where they live, continues. We can’t make progress in the name of peace without allowing all of us to inhabit land we love because our roots are there. We can’t make peace if we are continually oppressed, and myopic in our views. And we cannot move forward if we cling to limited views of right and wrong, framed by the concept of winners and losers, power and weakness.

The struggles we face are not a matter of politics, persuasion, or power.  They are about people; ordinary people who all matter. In this time of conflict of biblical proportion, a time when history could lead us to the table of resolution, let us not seek to silence those calling out for – indeed begging for - compassion, intelligent discourse and wise decisions free of partisanship.

Let us remember that our voices are not weapons. They are instead our monuments and our roadmap to a sane future for all of us.  No one should be punished for raising them.

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Elayne Clift writes from Brattleboro, VT. www.elayne-clift.com

Why is Holocaust Denial Growing?

This month Jews everywhere marked the High Holy Days of Rosh Hashana and Yom Kippur to welcome our New Year. They are solemn days and a time for renewal shared with family and friends every year, even by the most secular Jewish people.

As a child I was moved by those days when I stood with my parents and siblings in our small synagogue and listened to the Hebrew prayers being chanted. I loved hearing the Shofar blown on Rosh Hashana and the time for reflection and hope at Yom Kippur, a day of atonement when we forgive ourselves for the past year’s transgressions and promise to do better in the coming year. I crafted a poem about these annual rituals some years ago as I remembered years gone by.

In that poem called “Kol Nidre” – the mournful prayer that marks Yom Kippur - I wrote this (edited) verse: “Kol Nidre  and I am bound to every Jew, in every place, at every time…and in every corner of the globe [where] a Jew is standing, swaying, weeping, praying…I stand beside the Jews in the Warsaw Ghetto, and in the camps, and I am with the Jews of pogroms,… Kol Nidre, and I am everywhere and in every time there is a Jew to remember.”

Later I wrote another poem. It was inspired by my learning that I was born in the same month as the fall of the Krakow Ghetto. A month later the Warsaw Ghetto collapsed. “It happened over and over again, until the black saber of the Holocaust disemboweled European Jewry,” I wrote, imagining myself in Anne Frank’s attic, and wondered “if I would have had the courage, the cunning, the chutzpah to survive?” I imagined what it must have been like in Kracow and Waraw and Auschwitz “because I was born a Jew.” “I might have been among them, racing for a cellar, a closet, a bed cover. Anywhere where they could not, will not find me.”

I share those excerpts because both of my parents had fled pogroms in Ukraine with their families when they were children early in the 20th century, simply because they were Jewish. I share them because the pogroms and the Holocaust are part of my history and my heritage. I share them because I’ve read Elie Wiesel and Viktor Frankl and copious other writers who wrote true Holocaust stories. I share them because I’ve been to Yad Vashem and Holocaust museums and memorials here and in Europe, and I share them this year because for the first time I was afraid to attend High Holy Days services given the increase in anti-Semitism and the increasing denial of the Holocaust.

An April program on PBS’s News Hour reported that “antisemitism rose in the U.S. last year and shows little sign of abating worldwide,” according to researchers. Last year a similar study reported that “2021 set a new high for antisemitic incidents, and in some countries, most alarmingly the United States, it intensified.” Additionally, the Anti Defamation League (ADL) reported that the number of antisemitic incidents in the U.S. increased by more than 35 percent in the past year.

A survey reported in The Atlantic titled “The World Is Full of Holocaust Deniers,” almost ten years ago found that only 54 percent of the world’s population had heard of the Holocaust. Let that sink in: 54 percent, in 2014.  Only a third of the world’s world population at that time believed the genocide had been accurately described in historical counts and 30 percent of survey respondents thought that “Jews still talk too much about what happened to them in the Holocaust.”

Today the problem is exacerbated by social media and the Internet where misinformation, memes, and hate-filled posts that perpetuate antisemitism and Holocaust denial are proliferating.  Most sites have done little to end this travesty in the name of free speech and debate. For example, Facebook and Twitter enacted weak policies prohibiting Holocaust denials a few years ago but as of this year, they continue to allow dangerous content on their sites. And they are not the only ones.

In 2022 the United Nations approved a resolution stating that genocide “will be forever a warning to all people of the dangers of hatred, bigotry, racism and prejudice.”  Israel’s ambassador to the UN at the time went a bit further. A grandson of Holocaust victims, he said “the world lives in an era in which fiction is now becoming fact and the Holocaust is becoming a distant memory. Holocaust denial has spread like a cancer, and it has spread under our watch.”

The resolution and the rhetoric of politicians and diplomats seems to have had little impact. Holocaust denial and distortions are growing, and they are stunning, while antisemitism has risen in many countries. The Netherlands is one of them.

A government minister there made this statement at a cabinet meeting in July this year: “Denial of these kinds of heinous crimes against humanity is commonplace. …This … should not be left unaddressed, as the lesson of the Holocaust is not just a history lesson. It affects the here and now. … It is about good and evil.

He’s right of course. But we need more than words and resolutions to stop the scourge that has so many Jews frightened. We need to bear witness as the few remaining survivors of Auschwitz and other death camps give testimony. We need to read the books of Holocaust writers and to look at the photos and write poems. We need political action and responsible information platforms. And we need it all now so that we can feel safe - simply because we are Jewish.

A is For Absent: America's Teacher Shortage

 Her name was Shirley Myers, and she was a gift in my life when I needed one. I was in middle school and a loner, unlike most kids that age, because my mother suffered from depression that meant she was hospitalized for long stretches. Ms. Myers was a calm teacher and a gentle soul and somehow, I started going to her classroom after school to talk with her. It was quietly comforting to be with her, and we formed a bond that got me through those lonely times.

 She wasn’t my only good teacher. In high school, Desmond Jones, who scared everyone with his high standards and grim demeanor, taught me how to consider literature carefully and to write cogently about it in his English class. Vivienne Davenport gave me my love of language with her Word for the Day. They were delicious words like obsequious, sartorial, serendipity, and ubiquitous. We were required to learn their definition and to write a sentence using each day’s word. I think about her each time I use one of her many fine words. Doc Martin, slightly disheveled and occasionally distracted got me through Latin; later Spanish helped me become bi-lingual until I forgot how to conjugate.

 In college I had fine teachers who taught me about literature, art, religion, psychology, sociology, and other subjects that interested me.  And in graduate school I learned to do professional research, explore interdisciplinary methodologies in my chosen field, write for publication, and have confidence in my abilities. My advisor during that time is still a close friend.

 Later I became a teacher myself. I taught at high end colleges and universities and at community colleges, and I now teach in adult learning programs because I love teaching no matter where I do it. I know the joy of watching motivated students consider issues they’ve never contemplated before, the pleasure of seeing their thinking and writing skills grow, their openness to new ideas, their new sense of confidence.

 So I am deeply saddened, and worried by the loss of so many good teachers, at all levels, who are leaving their chosen, and often undervalued, profession. They are quitting for numerous reasons that are valid. They work under poor conditions, suffer high stress, heavy workloads and burnout, as well as insulting salaries and a lack of administrative support, and now more than 60 percent of them fear mass shootings at their schools according to a 2018 survey conducted by the National Education Association (NEA) and reported by CNN earlier this year. CNN also reported that “one in three teachers say they are likely to quit and find another job in the next two years, according to a recent survey by the EdWeek Research Center and Merrimack College.

 Briana Takhtani, a teacher who resigned and spoke to CNN, said she quit her “dream job” because of the pandemic and school shootings. “It just became too much for me to handle on a day-to-day basis and still feel sane,” she said. Her statement is reflective of those made by numerous other teachers.

 The loss of qualified teachers is alarming in many ways.  Some schools have had to cancel core classes, others are hiring people who lack professional teaching qualifications and, in some cases don’t even have a basic college degree. The impact is especially dramatic for children who need special education or bilingual teachers as well as those who live in rural areas.

 One superintendent told PBS at the start of the 2022 school year that “it really impacts the children because they’re not learning what they need to learn. “When you have these uncertified, emergency or inexperienced teachers, students are in classrooms where they’re not going to get the level of rigor and classroom experiences.” In other words, a generation of children are not being prepared adequately for what lies ahead for them, not only professionally but intellectually, culturally, and psycho-socially.

 As a story in The Atlantic revealed recently, “The education system is headed toward a cliff at a moment when it most needs to help students who fell behind during the pandemic. For nearly a decade, America’s students have been backsliding on the nation’s report card, which evaluates their command of math, science, U.S. history and reading.”

That’s a sobering reality. It makes me grieve for all the children who will never have a Shirley Myers, a Desmond Jones, or a Vivienne Davenport in their academic lives, and will never experience the difference they make. Teachers like those I was gifted with understood that as a Tibetan proverb says, “A child without education is like a bird without wings.”

I am ever grateful for having been educated in a time when they represented the finest members of the teaching profession and I fervently hope that children will fly again once the reasons for our educational crisis are adequately resolved.  

The Recovered Joy of Summer Travel

All my life I have disagreed with Henry David Henry: Unlike him, I think it is “worthwhile to go around the world to count the cats in Zanzibar.” That’s why inveterate travelers find the return to post-pandemic travel an exhilarating experience.

This spring my husband and I were excited to resurrect an aborted trip abroad that was planned almost four years ago. We were so excited you might have thought it was something we’d never done before.  The truth is travel is in our DNA so having to stay close to home for so long was hard.

The joy of travel began when I was a child,nd the high point of summer was a family trip to Toronto to visit my father’s relatives.  On the eve of the journey my sister and I laid out new shorts, T-shirts, and sandals to be ready when the alarm rang at 6:00 a.m. Teeth brushed and hair combed, we skipped to the back of the black Buick and didn’t argue with our brother for the window seat.  We were too busy savoring breakfast at Howard Johnson’s, part of the annual ritual that always began our trip to another country.

Every year we took a different route to enjoy the scenery. Pre-interstate and Holiday Inns, we drove through Pennsylvania Dutch country or New England or New York State, where we visited Ithaca’s gorges, the 1,000 islands, and of course, Niagara Falls. Every night, we looked for AAA-approved cabins in which to sleep, with their worn linoleum floors, chenille bedspreads, and inevitable spiders.  We thought it was pure heaven (except for the spiders.)

Crossing the border was like going to a forbidden country. We had to answer questions about where we were going, why, and for how long, and reassure customs officials that we had nothing illegal with us. Once cleared to proceed we headed to the Falls to ride in the Maid of the Mist boat that went behind the Falls spraying us with water.

In Toronto we checked into the Royal York Hotel where a little man in a maroon uniform roamed the lobby every day calling out, “Call for Mr. Smith!” “Call for Mr. Jones!”  The next morning, before heading to my grandfather’s cottage, we ate breakfast in The Honeydew Restaurant.  Only then were we ready for the obligatory visits that lay ahead.

Later, in my early twenties, I took my first solo trip to Europe. I thought I’d died and gone to Heaven as I experienced Amsterdam, London, Paris, Rome, and the Swiss landscape, relying on travel books that promised you could do this kind of thing economically.  Relishing every moment and every conversation with fellow travelers from different cultures, I thought I’d go mad with the pleasure of it all.  I marveled at the sight of Michelangelo’s David, wept in San Marco Square, thrilled at the pageantry of the Changing of the Guard, sat in cafes on the Champs Elysee and smiled back at Mona Lisa.  I even fell in love twice.  More importantly I knew that my life had changed and that I would never stop traveling.

Luckily, I married a Brit who loves traveling as much as I do and with whom I was able to travel internationally because of his work, then mine. We even lived for a year in Thailand when I got a teaching gig there. We traveled like cockroaches then, scurrying around Southeast Asia, discovering new foods, new art and music, new friends, beautiful rituals, and other ways of living.

Travel also offers a diverse and sometimes dramatic education. History, art, literature, religious beliefs all come alive as we are exposed to other cultures, rituals, and norms. We become more curious, learn new ways of thinking or expressing ourselves, and grow in ways we never imagined.

Traveling also offers challenges. Before there was a single currency in Europe, I had to learn how to convert currencies, to communicate without a common language and to know the difference between the Alps and the Pyrenees. It was instructive and fun. I also had to develop bargaining skills and to know how to deal with dangerous situations. Luckily, in my experience, there is always someone to help.

Travel, if it’s possible, can be simply a pleasurable experience or a profound life-altering event. For me it was both, and I view it as a great blessing.

That’s why I continue to agree with Mark Twain who claimed that travel is enticing, not least because it is “fatal to prejudice, bigotry and narrow-mindedness.”   Like Twain, whose account of one trip gave us Innocents Abroad, I think “it would be well if such an excursion could be got up every year and the system regularly inaugurated.”

Traveling may have seemed a thing of the past during the pandemic. Now we may find ourselves changing venues because of the climate crisis or different opportunities. We may prefer more café crawls and fewer cathedral and museum visits along with more chatting with the locals. But I am among those travelers who are not ready to let a passport expire because I never know when I might have a fierce urge to weep again in Venice, to learn something new, to make new friends, or to count cats in Zanzibar.   

From Designer Babies to Devalued Children

A recent press release I received got me thinking about how much we really care about kids?  The press alert came from the Coalition to Stop Designer Babies, which is organizing internationally to oppose efforts by some scientists and would-be parents who want to overturn legal bans and prohibitions on Human Genetic Modification (HGM).

A so-called designer baby is defined as “an infant whose genes or other cellular components have been altered by practitioners at the embryo or pre-embryo stage, ostensibly for the purpose of avoiding passing on genetic diseases, or making babies that are smarter, taller, or stronger,” according to the Humane Biotech organization.

Coalition spokesperson Dr. Daniel Papillon, a French scientist, notes that” There is no unmet medical need for this technology, but the risks are immense. … It would increase ableism and entrench social inequality.” Like other opponents of this technology, he notes that “HGM is the latest high-tech version of Eugenics,” the belief that the human race could be improved if reproduction was controlled and only those who were deemed worthy of being born or of reproducing should live or bear children. The movement advocated selective breeding and the elimination of those considered to be imperfect. Advocates ranged from Margaret Sanger to Adolf Hitler. Even Vermont practiced Eugenics.  Between 1931 and 1941, about 200 people, mostly women, were sterilized in the state.

The idea of designer babies and perfect progeny smacks not just of social control but of affluence and exclusion. It illuminates the deep chasm between privilege and poverty, both of which speak to the deprivation of lives that might have been lived. Let’s not forget that eugenics was at the core of slavery and is still a threat in a world of growing fascism.

The idea of designer babies versus impoverished, marginalized children made me think of all the ways children throughout history, and children now in this country, have been damaged, degraded, and devalued, despite the rightwing devotion to fetuses. There are deeply disturbing examples of the abuse children of all ages experience, physically, emotionally, sexually and via neglect and exploitation.

Take, for example, the revelation revealed by the Houston Chronicle that Texas state troopers were told to push immigrant kids, even babies, back into the Rio Grande as they tried to survive crossing the river alone or with others. Or the fact that thousands of children are at risk of separation, abuse and neglect at the Mexico-US border, and that documented major abuse takes place in retention centers on the US side. Kids trapped in Mexico are sleeping in the streets where they are exposed to violence and abuse, as Save the Children and other organizations have pointed out. And those who make it to U.S. Customs and Border Protection report physical and psychological abuse, unsanitary and inhuman living conditions, isolation from family, extended periods of detention, and denial of access to legal and medical services, reported in a University of Chicago Law School report five years ago.

Sadly, the National Children’s Alliance reports that more than 600,000 children are abused in the United States each year, with children in the first year of their lives being 15 percent of all victims; more than a quarter of child maltreatment victims are under two years old. Nationally, neglect is the most common form of abuse. What does that say about who we are as a country?

What does this say?  According to the Equal Justice Initiative eleven states have no minimum age for trying children as adults; some states allow children between ten and thirteen to be tried as adults, while children as young as eight have also been prosecuted as adults. Shockingly, the U.S. is the only country in the world where kids as young as thirteen have been sentenced to life in prison without parole, and until 2005 children were executed in the U.S.

Law enforcement and police brutality contribute to the abuse and criminalization of children ranging from kindergarteners to teenagers. Stories abound. In one state, an off-duty policeman placed his knee on a middle school child’s neck, while in another state, four

Black girls were arrested for not stopping young boys from fighting.

The stories are immensely disturbing. A child in kindergarten was arrested for picking a tulip at a bus stop. A12-year old was arrested for doodling at his desk.  A nine-year-old was arrested, pepper sprayed and handcuffed for “acting like a child” when police were called to her school. These and other stories like them have been exposed by the Legal Defense Fund.

Now comes the exploitation of kids in the workplace, courtesy of Republican legislators who are happy to ignore labor laws. Lawmakers in several states want to let children work in hazardous workplaces, and to work longer hours on school nights, including serving alcohol in bars and restaurants as young as fourteen. The Economic Policy Institute revealed that ten states in the last two years have tried loosening child labor laws, while the Department of Labor reported this year that child labor violations have increased by nearly 70 percent. It’s Dickensian!

These tragic tales are the tip of the iceberg. They speak volumes to the level of child neglect that is rapidly being normalized in America. The big question is what are we going to do about it? That’s a good question to ask anyone running for office next year. As for designer babies, that’s a question for the wealthy who are wedded to privilege and perfection.

The Time for Bread and Roses is Now

When I think about labor movements and unions, two favorite stories come to mind, and both are true. The first one is about a group of girls and young women known as the Lowell Factory Girls. They worked in the mills and factories of Lowell, Massachusetts in the 19th century. Little more than children who labored for long days doing dangerous and exhausting work, they revolted in 1836 when their dismal wages were cut while their factory-owner mandated living expenses went up.

One day an 11-year-old worker named Harriet Hanson, decided enough was enough. She walked out “with childish bravado,” as she wrote in her 1898 memoir, declaring that she would go alone if she had to. That wasn’t necessary. A long line of girls followed her and thus began a strike that led to an organized labor movement launched by women, and the establishment of an early U.S. union.

The second story is less well known. It involves a labor leader and activist, Esther Peterson, who was born into a conservative family in Utah. Esther, who was much older than me, eventually came to New York where she taught wealthy girls by day and the daughters of their household maids at night.  Working at home, the young girls sewed pockets onto Hoover aprons if they were old enough, alongside their mothers. The pockets were squares until management decided heart-shaped pockets were nicer. The work was piecemeal, and hearts took longer than squares. Esther was outraged that they weren’t paid more.

“Why don’t you do something about it,” her husband asked. “Organize a strike!” Esther, who grew up thinking unions led to danger and violence, resisted. But she decided to advocate for the children, so she organized the “Heartbreaker Strike,” inviting her wealthy day students’ mothers to go on picket lines since the police would never brutalize them as they would the poor mothers. It worked, and Esther was on her way to becoming a beloved labor leader.   

I think of the Factory Girls and Esther now, when so many large-scale strikes loom large, and for good reason.  It’s no coincidence that workers at UPS and in Teamsters unions, Amazon warehouses across the country, Starbucks, and Hollywood writers and actors are striking or contemplating striking for better wages, benefits, and working conditions. American Airlines cabin crews may soon be joining them as I write this commentary.

That’s a wide, diverse swath of American workers and a huge number of jobs, goods, and services at stake. The implications are alarming. A short time ago the threat of a railroad strike was enough to make economists shudder and that’s only one sector that could have wrought havoc throughout the country.

Leaders of unions that represent large numbers of people working in companies trying to deny them their right to unionize act as though union organizing was something new and egregiously difficult. The fact is that huge, organized strikes are nothing new in this country. We’ve had labor unions forever, inspired originally by the 18th century Industrial Revolution in Europe. Shorter work days, livable minimum wages, and rational benefits have always been a bit part of union organizing. For example, poor pay and working conditions led to strikes by the Pullman Railroad Workers and the United Mine Workers in the late 19th century.

Over the years unions grew across many sectors and by 1979 there were 21 million union members in America. Today union membership is growing again after a slump, thanks in part to the pandemic and a rapidly changing labor market.  Young workers are unionizing across various sectors now because of tech-driven jobs. They are joining farmers, factory workers, food handlers, and others as they seek safe and equitable employment, just as factory girls and children sewing apron pockets did before them.  

For UPS drivers, Amazon workers, Starbucks baristas and others, companies that refuse to bargain are enraging. Labor leaders and workers have had enough. They are tired of corporate leaders who make phenomenal amounts of money a year, own mansions and yachts, and still continue reneging on workers’ rights.  Amazon, for example, has engaged in dozens of unfair labor practices, Including terminating the entire unit of newly organized workers.  Starbucks “has become the most aggressive union-busting company in America,” according to a staffer for Bernie Sanders (I-VT) and more than 200 workers have been fired for taking part in organizing activities.

I’m not trying to put a Pollyanna spin on unions. I know there is a troubling history of corruption and criminal intent in some organized labor movements and unions, and that is not something to be overlooked.  But I agree with John F. Kennedy that, “Labor unions are not narrow, self-seeking groups. They have raised wages, shortened hours, and provided supplemental benefits. … They have brought justice and democracy to the shop floor.”

More to the point perhaps in these troubling political times, labor leader Delores Huerta was right when she put the point this way: “If we don’t have workers organizing into labor unions, we’re in great danger of losing our democracy.”

My friend Esther would agree with her old boss, JFK , and with Delores Huerta, with whom  she worked on labor rights for women and children.

The Twin Engines Driving Climate Disasters

 It’s been over 90 degrees where I live in Vermont for days on end. We can’t take evening walks, plant our gardens, or breath all that well since the Canadian wildfires first compromised our air so badly that some of us have experienced respiratory issues. We’re halfway through the summer and we have yet to spend time on the deck with friends. And all that happened before biblical floods started after record monsoon rains that just wouldn’t quit. 

 It's beginning to seem like we’ve been witnessing the final stages of our own well-crafted horror movie for a long time now and the credits are about to roll. Among them are extreme heat and massive fires, along with our prolonged denial of global warming and the urgency of acting to decelerate it.

 We’ve seen otherworldly orange skies, orange fires that resemble the surface of the sun, erupting volcanoes, cars, homes, and debris tossed around like toys in tornadoes, or floating away in immensely powerful rivers. On the news people are beginning to wander around looking like stunned zombies because they’ve lost everything and have no idea what to do next because things will never be normal again. We all know that there is more to come and our resources, financial and emotional, are running low.

 There are those who will say this is too doomsday a scenario to talk about, but we all know it’s going to happen again, and worse. We know that because climate change is rapidly driving unprecedented heatwaves that fuel wildfires -- the two engines hovering over us faster than we thought. We ignore it at our own peril.

 Here’s the reality. As the climate continues to warm, heatwaves will get worse – everywhere. It’s happening in Europe, China, India, the U.S. and pretty much everywhere. Temperatures are already soaring above 110 degrees Fahrenheit and towns in several countries are being forced to evacuate, including in Italy and Greece. Florida could be next. This is not hyperbole. Scientists have been warning us about a global pattern of rising temperatures largely due to human activity and too many of us chose to look away. Now even Pope Francis has called on world leaders to heed the Earth’s “chorus of cries of anguish.”

 “Every heatwave that we are experiencing today has been made hotter and more frequent because of climate change,” says climate scientist Friederike Otto, co-leader of a World Weather Attribution research collaboration.

 Scientists agree that manmade greenhouse gas emissions have rapidly heated the planet and further speculation and theories have led to hundreds of studies conducted for decades, especially   involving situations where heat, floods, and drought have occurred. The important thing is that the situation is getting worse and fast.  Heat events that happened once every ten years before are now three times more frequent, according to Zurich-based climate scientist Sonia Seneviratne.

 Hot, dry conditions help fires spread rapidly, burn longer, and rage more intensely. Heat also means less moisture is retained for vegetation so that it turns to dry fuel for fires. Kim Cobb, director of the Institute at Brown for Environment and Society, noted in June that treacherous heat and fire had burned a large area of the U.S. that month killing more than a dozen people. She said the events embodied the “multiple stressors linked to man-made climate change” that the United Nations has warned about through its scientific panel on global warming. “If ever there was a moment to stop and re-evaluate our fossil fuel emissions trajectory, that moment is now,” she said.

 In his recent book, The Heat Will Kill You First: Life and Death on a Scorched Planet, writer Jeff Goodell says “global warming” sound too soothing, like we can just turn up the AC and all will be well. But, he says, the planet is burning and we’re running out of time, citing dying fish, melted asphalt, and melting glaciers.”  “When it gets too hot, things die,” he says simply.

 Noted environmentalist Bill McKibben, co-founder of 350.org, is another truthteller. “We can’t stop global warming at this point,” he told Democracy Now during a June 7th interview. “All we can do is try to stop it short of the places where it cuts civilizations off at the knees.” He calls on politicians and ordinary people to cut into the status quo. “This is the last of these moments we’re going to have when the world is summoned to action by events and when there’s still time to make at least some difference.”

I’m with him. The time is now to turn off the horror movie we have produced and get to work on saving our planet, ourselves, and our kids’ future. Maybe then we can go back to the backyard deck with our friends, no longer complacent, and ready to do what it takes.

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Balfour's Big Blunder and Today's Israel

“What goes around, comes around” and “You reap what you sow” are truisms that come to mind when I learn what is happening in Israel. I wouldn’t know much about it if I relied on mainstream media or cable news because no editorial decisionmakers dare risk raising the issue of ethnic cleansing in a country that the U.S. supports in policy, rhetoric, and military support, despite the consequences. Nor do policymakers want to utter a word that might result in the alienation of Jewish organizations, funders, or voters. 

As a Jewish American, like many others, I am heartbroken by what is happening to Palestinians because of the excessively rightwing government now in power in Israel, a country that was founded because of atrocities committed against them. 

Understanding how Israel got here is helpful. A brief history is instructive. In 1917 a document, the Balfour Declaration, was issues by the British government calling for the establishment of a “national home” for the Jewish people in Palestine. It was the first time the term “Zionism” was used by Britain, a major political power.   No boundaries for what would constitute Palestine were specified in the document, but it was made clear, rhetorically, that the national home of Jews would not cover all of Palestine. The declaration also called for safeguarding the civil and religious rights for Palestinian Arabs, who made up a vast majority of the local population.  In 2017 the British recognized publicly that the Balfour Declaration should have assured political rights for Palestinians in the declaration.

So how did we get here? That question is largely answered in Ilan Pappe’s 2006 well documented book, The Ethnic Cleansing of Palestine. He explains that in 1948 over 700,000 Arabs, three fourths of the Palestinians living in territories that became Israel, fled or were expelled from their homes. Pappe identifies that exodus as the planned beginning of ethnic cleansing by Israel, designed by David Ben Gurion, a leader in the Zionist movement, and his advisors who had declared before 1948 that they were developing plans for ethnic cleansing of Palestinians in order to establish Israel. The exodus and expulsion of 500 Arab village residents along with terrorist attacks against civilians came from that plan known as Dalet.

The Palestinians called the ethnic cleansing occurring during Israel’s establishment Nakba (catastrophe) as they became “stateless refugees.” For Palestinians, Nakba continues, and no wonder. Many Israelis, including political and religious leaders think Plan Dalet didn’t go far enough. In March, for example, a Palestinian man was killed by an Israeli soldier or settler. Israeli settlers then set hundreds of Palestinian homes and cars on fire in the occupied West Bank and Netanyahu’s finance minister, Bezalel Smotrich, a senior member of the Knesset, said in an interview that he thought “the village needed to be wiped out.” Two years ago he told Palestinian members of the Knesset that “it’s a mistake that Ben Gurion didn’t finish the job and throw you out in 1948.” Smotrich was recently appointed governor over the occupied West Bank.

Another favorite ethnic cleanser advocate, National Security Minister, Itamar Ben Gvir, has been given an Israeli national guard, actually a militia. He’s the guy who went to Jerusalem’s Al-Aqsa Mosque in May and stood there in mock prayer as a Jew in an affront to Palestinians, thus mixing politics with religion. (The site of the mosque is called Temple Mount by Jews.)

Clearly tensions are mounting. No wonder. In February the Israeli military killed ten Palestinians, include two elderly men and a child, and injured numerous others in a raid on Nablus, then blocked Palestinian medical teams from treating them. More recently Israeli forces raided a refugee camp along with several Palestinian cities and villages where they fired live ammunition into crowds of people, injuring over 70 and killing two young Palestinians, one of whom had a disability. Again, they blocked Palestinian ambulances from providing medical care and used tear gas in a hospital.

Attacks are increasing and getting worse. In June a brutal assault was carried out, authorized by Smotrich, to hasten settlement expansion. F-16s and Apache helicopters fired on Palestinian ambulances, killing a teenager. Also in June, Israeli forces fired at a car, killing a two-year-old and critically injuring his father outside their home. Mohammad, the child, was the 27th Palestinian child killed by the Israeli military in the first half of this year. His death will not be the last of the child victims.

Palestinian journalists are also being targeted. In June six of them covering Israeli raids, were targeted. A cameraman was shot covering the Jenin killings, a journalist was killed in raids along with two youngsters, and another journalist was shot in the head. Let’s not forget that it’s been a year since the Palestinian-American journalist Shireen Abu Akleh was killed by Israeli forces – an anniversary that American media failed to mention.

I have written frequently about Israel’s increasing violence against Palestinians, so I know to expect blowback, some of it chilling. But I cannot remain silent, and neither should our government in light of what has just occurred in Jenin, and is likely to continue elsewhere. As Israel becomes a fascist dictatorship, it’s imperative that we call out the “intentional escalation of violence by an occupying military power” as Jewish Voice for Peace says.

We must not reap what we sow in silence.

Are We Ready for Another Pandemic?

Almost four decades ago, when I was deputy director of the first major global health communications program supported by the US Agency for International Development (USAID), my work involved child survival and family planning.  But our project, and its lessons learned about health promotion, went further than that, modeling a proven methodology related to behavior change for better health outcomes. 

It was during those years that the HIV/AIDS crisis erupted, which I learned about before most people took it seriously, through a journalist I knew who had written about what was coming at us around the world and here at home. When I alerted my boss to what would become a deadly epidemic, advising him that as a health communication organization we needed to be paying attention to the problem and thinking of ways to mount a strategic health communication response, was typical.  “If you’re not gay it’s not going to amount to much,” he said, which in itself was shocking in its prejudice. It was also irresponsible coming from someone working in public health. When HIV hit hard and several gay men in our organization began to die, the head of the organization publicly apologized to me in a staff meeting for not taking the crisis seriously.

 Later, when I worked in public health advocacy, promotion, and communication internationally, I followed news, challenges, and concerns shared with the public health community from the World Health Organization (WHO) and the Centers for Disease Prevention and Control (CDC). That’s how I knew that they were worried because, they said, we were long overdue for another huge epidemic, bigger than the early 20th century “Spanish flu,” and we weren’t prepared for it.

So when Covid-19 showed up, I wasn’t surprised that we still weren’t prepared, nor was I particularly shocked when the Trump administration was totally unprepared for an event that would take millions of lives here and globally. What was shocking was the disinformation, misinformation, and dangerous false information Republicans glibly spread in soundbites and press briefings as more and more people succumbed to the virus.

Those memories come back to me now because history seems to be repeating itself when it comes to public health preparedness related to epidemics and pandemics in light of myriad lessons learned by now.

It’s not for lack of scholarship on this issue. In researching this topic, I found no shortage of analysis about a rising concern about what’s going on as we recognize that we’re going to have to struggle all over again when another health crisis occurs.

The pressing issues include the need for more research as new and mutant viruses rise, scaling up production of newly developed and FDA approved vaccines, planning for broad and  rapid vaccine distribution, cost containment, and equal access to vaccines from various health facilities. It’s no longer only about Covid. Other infectious diseases are on the rise. According to WHO, “zoonosis”, infectious diseases that jump from animals to humans, now number over 200 identified bacterial, viral or parasitic agents. “They can be transmitted through direct contact, food, water, or the environment, constituting a major public health problem,” WHO says. “Many of these emerging infections have the potential to cause global  pandemics.”

The Covid pandemic revealed the challenges related to supply chains and their disruptions when it comes to vaccine distribution, in addition to vaccine shortages, which can occur when companies no long choose to make vaccines, often because of manufacturing and production problems. That leads to insufficient stock piles, and reduced competition so that prices for vaccines rise.

Another major failure in pandemic preparedness revealed itself during the Covid crisis. As health communication specialists like Kizzmekia Corbett, a researcher at the National Institutes of Health (NIH) point out, “Public health practitioners need to recognize that our research is only as strong as our communication. Even our strongest peer reviewed, evidence-driven findings won’t have full impact if we cannot clearly and effectively communicate them to the public.”

Practitioners also need to understand and respect the field of health communications as a multidisciplinary methodology aimed at behavior change for health promotion and disease prevention. Vicki Freimuth, former director of communications at the CDC, says that “the agency struggles to assure that experienced communication professionals are included in decision-making and developing scientifically sound public messages free of political influence.” (personal communication).  The exclusion of experts whose work has proven that behaviors can be changed (e.g., mask wearing) with research-based messaging is a troubling omission.

According to a poll taken in March and reported by  Politico, two-thirds of respondents believed the threat of future deadly pandemics is growing, while almost 90 percent wanted the federal government to be more prepared for another pandemic in its budget and planning. Still, the focus in Washington, DC seems to be on assessing what went wrong during Covd-19.

Mauricio Santillana, a professor at Northeastern University paints a daunting picture regarding future efforts. He says the influence of politics on government funding causes a “collective amnesia,” that leads to reactive responses to crises vs. proactive  prevention.

If the government prioritizes the prevention of deadly viruses, perhaps they will remember to include health communication strategies along with financing and other challenges that accompany pandemics that need to be stopped quickly. I’m not holding my breath.

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Elayne Clift has a master’s degree in health communications and has worked internationally with a focus on maternal and child health. 

Choosing Freedom: A Political Imperative

 When Franklin Delano Roosevelt uttered his famous phrase, “The only thing we have to fear is fear itself,” at his first inaugural address in 1933, he recognized that fear of the Great Depression could paralyze people and interfere with ways to address an unprecedented economic crisis. He realized that catastrophic thinking and overwhelming anxiety had the power to harm his plan for economic (and political) recovery.

 He recognized, as Auschwitz survivor Viktor Frankl did, that “between stimulus and response there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom.”

FDR and Frankl were both right, and in many ways, we find ourselves in that space where fear and insecurity reside, inhibiting our ability to respond appropriately and effectively to the political, economic, and emotional situation we find ourselves in as a nation as we approach the most crucial election of our time.

In his 1941 State of the Union address, FDR also said that there was “nothing mysterious about the foundations of a healthy and strong democracy.” He noted that he looked forward to “a world founded upon four essential human freedoms, as the New York Times pointed out in an op-ed. by Jamelle Bouie last month .Those were the freedom of speech and expression, the freedom of every person to worship God in his [sic] way, the freedom from want, and the freedom from fear. They were the guiding lights of his New Deal, and “they remained the guiding lights of his administration through the trials of World War II,” as Bouie reminds us.

In his essay, Bouie also enumerated four freedoms that today’s Republican party embraces. They are, he says, the freedom to control, the freedom to exploit, the freedom to censor, and the freedom to menace. “Roosevelt’s four freedoms,” he claims, “were the building blocks of a humane society – a social democratic aspiration for egalitarians then and now. These Republican freedoms are also building blocks not of a humane society but of a rigid and hierarchical one, in which you can either dominate or be dominated.” 

It’s a parallel vision of a future in which we do not have the basic freedoms and human rights that FDR espoused. Should the Republicans win the White House and the Congress next year, we will find ourselves living in a theocratic, oppressive country driven by oligarchs and dictators who embrace fear, violence, and autocracy with absolutely no regard for fundamental freedom, privacy or self-determination.

So let’s think about some of the freedoms that should drive us to the polls in droves next November. First and foremost are the freedom from fear and the menace of gun violence as we walk the streets, attend houses of worship, schools, entertainment or simply go to the market, the movies, and the mall.

Let us also think about the urgency of freedom to control our bodies and our futures as we remember the women and girls who have been denied bodily autonomy and privacy and who have suffered and died as a result of forced pregnancy because the State owns their wombs. Let us remember the women jailed for miscarriage, the health providers who live in fear of losing their licenses, or worse, and the mothers, sisters, friends, advocates who could well be imprisoned for driving someone to the airport or across a state line.

Let us remember the freedom to speak openly and honestly, and to gather, as guaranteed by the First Amendment, and the freedom from censorship so that we can read books we choose, and the freedom to worship in our own ways, and the freedom to keep our children free from want, whether it’s food or healthcare or the right to be who they are. Let our friends and families be free to live in the houses and neighborhoods they wish, be they Chinese, Syrian, Cuban, Muslim, Jewish, gay or straight, or otherwise. Let there be an end to Otherness, persecution, blinding stereotyping, and ungrounded assumptions that strike fear in the hearts of so many of us in this time.    

Let us be free from financial and physical exploitation in the workplace, especially when that exploitation involves children. And let us be free from willful prejudice, evil intentions, unenlightened faux leaders, and restrictive political actions that inhibit democracy, human rights, and social justice once and for all.  

And let us remember the wisdom of Nelson Mandela, who said “To be free is not merely to cast off one’s chains, but to live in a way that respects and enhances the freedom of others,” along with the wise words of Dag Hammarskjold, former General Secretary of the United Nations, who so wisely noted that “’Freedom from fear’ could be said to sum up the whole philosophy of human rights.”

It’s a philosophy we need to value, remember, and embrace. We are called upon it in this moment and in the days to come to do the right thing for future generations.

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 Elayne Clift writes about women, health, politics and social justice from Brattleboro, Vt. www,elayn-eclift.com

The Horror of Healthcare Financing

It’s no secret that America’s healthcare system is broken. Most of us can cite a litany of problems we’ve personally experienced. But few would include the travesty surrounding how healthcare costs are billed and covered.  I ventured into that morass recently and what I learned provided another compelling reason for universal healthcare and a single payer system.

 It began with a pneumonia vaccination that I received at my doctor’s office instead of a Walgreens pharmacy. I expected a charge but assumed it would be minimal. Then I got the “patient statement” from the hospital where my doctor practices. On the statement a “pharmacy” line item appeared in the staggering amount of nearly $700. Other charges were for “preventive care services” and “physician fees.” I saw these charges as redundant since I saw my doctor for a “wellness check” that constituted preventive care with a physician.

 Although I was billed a small amount for these services because “contractual allowance adjustments” covered the bulk of the bill, I began trying to learn what it all meant. I started with two simple questions: Who sets healthcare costs and fees, and who regulates those fees, which included overhead costs and $243 the hospital is charged for “medicine” (serum). 

 Thus began an exhaustive search for answers that led me down a frustrating rabbit hole. Among the Vermont state offices called for information were the Governor’s office, the Healthcare Administration Financial Regulations office, the Division of Licensing Protection, the Department of Health Division of Rate Setting, and more.  Fifteen calls later I still had no answers. Instead, each call resulted in a circular handoff, often to agencies I’d already called. No one in these agencies, it seemed, had any idea how costs were established, who regulated them, and who paid for them.

 This led to a discussion with my local hospital’s CEO and financial officer who walked me through a bureaucratic maze of rules and regulations emanating from federal and state mandates, organizational finance relationships and more. It was so complex that even though I worked in public health as an educator, policy analyst, and advocate for over forty years and hold a master’s degree in health communication and promotion I could not understand everything they shared with me.

One of the things I learned is that no one actually pays the gross charges, which are based on what will be reimbursed by insurance companies, and the costs of various services and procedures as identified by Medicaid and Medicare, with fixed rates periodically negotiated based on current reimbursements. This is known as “cost shifting.” In Vermont, organizational relationships regarding financing of healthcare also play a part in this cost sharing.

 Christopher Dougherty, CEO of Brattleboro Hospital, agrees that the current system of healthcare financing is an odd system that “puts us at risk.” He is troubled by the fact that the financing system is modeled on covering the costs of services rather than measurable outcomes of patient care. That viewpoint aligns with equitable, accessible, quality healthcare for all and it is grounded in the holistic and cost-saving idea of health promotion and wellness, and the fact that healthcare is a human right.  

To explain the convoluted, crazy financing of American healthcare, which is fundamentally a national disaster, requires a full investigative report if not an entire book. My purpose here is two-fold: First, it’s to expose the problems in healthcare financing and to encourage healthcare consumers to self-advocate when those, or other healthcare dilemmas, affect them personally. That means asking key questions of politicians and healthcare professionals along with other measures that lead to accountability and transparency. It also means voting for leaders who understand and care about healthcare issues.

My second objective is to underscore the urgency of a universal healthcare system that eliminates the outrageous bureaucratic enigma and the power brokers that now drives health care and costs. To paraphrase the late Princess Diana, “there are three [organizations] in this marriage,” and one of them is not the patient. It is Big Pharma, the insurance industry, and the fact that healthcare delivery systems like hospitals are increasingly dedicated to business models rather than putting people above profits. This powerful triumvirate must be called into question, revised and re-invented in ways that will be difficult to achieve. But they are not impossible.

In 2020, T.R. Reid wrote a book called The Healing of America.  Reid researched five developed countries in which some form of universal healthcare was practiced. Drawing upon what he learned, he developed a model of universal healthcare that would be viable in the U.S. His recommendations went nowhere because Americans are loathe to pay higher taxes for social services (a chunk of which would be financed by corporate America paying its fair share of taxes), and very few in Congress, who are loathe to lose an election, understand what a social democracy looks like.

 Ironically, when I was mired in trying to get to the bottom of healthcare costs, not just in my state, but nationally, I was facilitating a seminar for hospital personnel, called “Humanity at the Heart of Healthcare.”  As great physician writers and profoundly humanistic caregivers still out there know, we need to return to that foundational idea in the delivery of health care. With enough people standing up for the principle that caring and curing can go hand in hand, we can focus on the Hippocratic idea to “do no harm,” (including financially).

As poet Amanda Gorman wrote in her poem Hymn for Humanity, “May we not just ache, but act.”  Now is the time.

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