Can a nation “conceived in liberty, and dedicated to the proposition that all men are created equal . . . long endure.”

When Lincoln said these words at Gettysburg, he stood at the brink of a pivotal moment in history. The new American republic had been under siege and faced possible extinction. Thousands of its citizens would die in an internecine cataclysm that would either end America’s quest for liberty and equality or give it rebirth.

My fellow Americans, we are at a similar pivotal point in our American quest. Although we have yet to take up arms against each other, we are deeply divided and engaged in a struggle that threatens the very foundation of our democracy. Let me explain the nature of this struggle.

America appears about to begin the second act of a Shakespearian tragedy. The first act witnessed the emergence of the American ethos—a “can-do” attitude coupled with unhindered ambition, territorial expansion, economic growth, and the reapplication of “unalienable rights” to include the civil rights of those previously excluded. The rule of law was winning out over the dissonance of divisiveness arising from racial, class, and gender despotism. What energized that rule of law was a firm belief in liberty and equality that included economic opportunity. But that energy unleashed a fatal flaw in the guise of mindless ambition. Like Macbeth, America had climbed the pinnacle of power only to confront the ultimate temptation. When the witches foretold Macbeth’s rise to regal power, they also foretold his demise. Power sought for itself alone is a siren call to disaster. While ambition can give rise to individual and social achievement, it can also trample in its path any desire for liberty and equality or the democratic justice they demand. Unbridled ambition, unmoored from its purpose and sought for its own sake, will become the ouroboros that consumes itself. What may ensue is not a natural occurrence of nature, but a manmade tragedy—an American tragedy.

At the Gettysburg National Cemetery, Lincoln called upon his fellow Americans to “resolve that these dead shall not have died in vain . . . that this nation, under God, shall have a new birth of freedom . . . and that government of the people . . . by the people . . . for the people . . . shall not perish from the earth.”

“Government of the people” is a democratic government established and owned by the people. “Of” is a possessive preposition that presupposes ownership. But the “people” cannot be an authoritarian (or dictator) and/or a privileged class (or aristocracy). The people’s government must be the majority of the democracy’s citizens. Since America is a democratic republic, our elected officials are tasked to represent the will of that majority. Then how has it come to pass that the two elected branches of government are controlled by a political Party that lost the popular vote? It is true that the electoral college assures that the more populated States cannot dominate the smaller States. And each State has two Senators regardless of the size of their electorate. But how can any citizen of a democracy support gerrymandering or voter suppression tactics designed to distort the popular vote. No political party should be allowed to choose its electorate by excluding the majority. These attempts to silence the will of the majority are further amplified by actions designed to mislead the electorate, including malicious campaign propaganda and subversive foreign media. Together, they distort the truth and undermine the trust that must exist between the citizenry and its elected government. In effect, the political parties and their election campaigns become complicit in disowning and disenfranchising the citizens of their own democracy. This situation is a self-inflicted tragedy: an American tragedy.

Government “by the people” is a government controlled by the will of the people through fair elections and the honest representation of those they elect. Then how has it come to pass that the legislative agenda is mostly controlled by high-powered lobbyists and the special interests they represent? If the general welfare of all Americans is the governing mandate, then what justification is there for tax law and labor regulations that promote gross economic inequality? If a democracy is based upon liberty and equality, then how can it allow unequal educational and employment opportunities for its citizens? And how can it defund programs that provide healthcare or assist the less fortunate and disabled to gain a constructive role in a free society? If, instead, those privileged by wealth or status have a disproportionate influence on elections and government, the net result will inevitably be a government controlled by a self-interested minority—that is, a government unresponsive to the will of the people. This situation is a self-inflicted tragedy: an American tragedy.

Lincoln, the President who saved the union, clearly knew what government “for the people” meant. The Constitution defines the very purpose of the United States of America to secure domestic peace and security, our general welfare and the blessings of liberty for ourselves and our posterity. Today, America continues to secure peace and security for its citizens from foreign adversaries and terrorists. But how well does our government serve the general welfare and preserve our liberties for ourselves and our posterity? Is the general welfare served by relaxing regulations that control mercury and coal detritus pollution of our water supply or that limit power plant’s hydrocarbon pollution of our air? Is the political management of the EPA serving our interest by defunding clean-up of dangerously polluted superfund sites or by suppressing EPA scientists from participating in climate change conferences? Worldwide, more die annually from pollution than all those who die in wars and from major diseases combined. Even if the EPA political management removes the term “climate change” from all its correspondence, it cannot erase the effects of the worst West Coast fire season in history or of three recent hurricanes, each of which accounted for more damage than any like cataclysm in over a hundred years. And how well are we served by a government that would even consider eliminating healthcare from millions of our fellow citizens or removing subsidies that would force insurance companies to raise rates on all insurance plans? These actions are not indicative of a government wholly committed to serve its citizens. Instead, they represent a deviation from the very purpose of our democracy. And that, indeed, is an American tragedy.

As the Statue of Liberty exemplifies, the United States of America stands as a beacon of hope for the world, precisely because it was, as Lincoln proclaimed, “conceived in liberty, and dedicated to the proposition that all men are created equal.” If we forget our birthright and lose our commitment to our founding ideals, we foreclose the oldest democracy in history and extinguish its light for posterity. Instead, let us renew our dedication to the rule of law and to the Constitution. We must reclaim our government at the voting booth. We must petition the government, run for office, or select representatives whose character and wisdom win our trust. And we must demand our political leaders serve our interest, not just those privileged by wealth or status. In a democracy, it would indeed be tragic for any person or political party to subsume power that rightly belongs to the people.

My fellow Americans, we can no longer be the silent majority. Acquiescence to those who seek and maintain power for themselves is equivalent to complicity in an unfolding American tragedy. Rather, with the same dedication President Lincoln urged, we must be persistent in our resolve to seek a “new birth of freedom.” That is our birthright and our heritage. It is also the foundation for both American conservatism and liberalism.

When we redeem an item we purchased, we ask the retailer to take it back. When we seek redemption for ourselves, we ask another to take away our guilt or take back the harm our action(s) may have caused to ourselves or to others. In either case, redemption is not possible unless we ask for it, thereby specifically admitting we need redemption. But our request will not be answered without the expectation of reform. Although politics is not religion, both require an honest assessment of the need for redemption, reform, and a redeeming agent. In the case of religion, we can confess our sins, promise to do better, and ask for God’s forgiveness. In the case of politics, redemption similarly requires an admission of political malfeasance and a proposed plan for reform before asking the electorate for a second chance.

Both political Parties have behaved badly in the past. They have, for example, prevented the very possibility of the compromise required in our bicameral two-party legislative system. The majority Party can bury a bill in committee or limit debate, effectively suppressing the voice of the minority Party. As a result, legislation beneficial to a significant number of people may never come up for a vote. Likewise, the 60-vote rule in the Senate can prevent a bill from being debated or voted on the Senate floor. The immigration reform bill with a path to citizenship is a case in point. It was proposed by President Bush during his second term. But the Democrat controlled Senate never had the opportunity to vote on the bill because not enough Senators joined in the cloture vote on June 27, 2007, to provide the needed 60 votes. During the Obama presidency, the Senate passed a similar immigration reform bill; but it never reached the floor of the Republican controlled House for an up or down vote. In both instances, Congress gave insufficient consideration for whether a majority vote might better serve the general interest of the public. These failures served to perpetuate the many problems associated with undocumented immigrants, including workforce distortions, job inequities, shadow communities, and so on. They are examples of political malfeasance.

At times both Parties have shown themselves incapable of wielding majority power for the greater good. For years I railed against the Democrats for failing to live up to the promise of those civil liberty reforms they won in the sixties. Now I criticize the Republicans who have abandoned the reasoned and pragmatic governance they advocated in the eighties and early nineties. Of course, both Parties argue positions that differ from the other. And those debates are necessary in our republic. But neither should ignore the need to address the issues that concern and divide the nation as a whole: two decades of stagnate middle class wages and an inadequate minimum wage; rising healthcare costs (at a lower rate since the ACA, but still rising faster than inflation); wealth and opportunity inequality; unaffordable higher education; criminal justice inequalities; and the subversion of the plebiscite by money and political malpractice, including gerrymandering, voter suppression laws, lobbyist controlled agendas, and extravagantly financed campaigns committed more to propaganda than ideas.

Since 2009 Republicans have been caricatured as the “Party of No.” During the Obama Presidency, congressional Republicans initially opposed the President’s proposals for a trillion-dollar stimulus bill to counter the Great Recession before they eventually agreed to an amount comparable to President Bush’s bank bailout amount. They declined to ratify the Trans Pacific Trade agreement or even consider funding an infrastructure bank proposal, even though free trade agreements and an infrastructure bank have long been favored by Republicans. They aggressively contended and tried to repeal the Affordable Care Act, which included the private insurance healthcare exchanges they previously proposed. Although they never supported the ACA’s Medicare bailout or Medicaid expansion, the basic idea behind the bill was initially outlined by the conservative Heritage Foundation and proposed by Senator Dole, a former Republican candidate for President. This failure to act on what Republicans previously believed to be in the best interest of all Americans is what I believe most would term political malfeasance. Moreover, their rationale for this failure is equally suspect: they refused to give a Democratic President any legislative achievements because he was too liberal, too popular, and too likely to be reelected unless they obstructed his every initiative.

There are at least two crimes that are unforgiving in our American system: intolerance of those who are different in kind, belief or ideology; and refusal to serve those universal values enshrined in our founding documents. The former precludes compromise by excluding empathy for others or their perspectives, while the latter demeans our democratic institutions and the very idea of America. That idea is a set of values, specifically, equality, justice, liberty, security, domestic tranquility, and the general welfare. Our Constitution clearly identifies these values as the principles upon which rest the promise of a more perfect union. It does not, however, admit their subversion. When elected officials refuse to vote on legislation that embody these American values, they subvert them and the government they support. Moreover, they are choosing narrowly defined political interests over the general welfare of those who elected them.

Is it any wonder why Congress has such a low approval rating or how gridlock suborns compromise? When intolerance can influence debate over immigration of non-white or non-Christian minorities, have we lost any sense that “all humans are created equal?” When, after 70 years of warnings, Congress is still unable to fortify our infrastructure against increasingly destructive climate cataclysms, have we lost any sense of insuring “domestic tranquility” or promoting “the general welfare?” How can equality and liberty be maintained if healthcare and economic opportunity are preserved only for the privileged and not for every citizen? Long before the modern era, Aristotle recognized that inequality breeds instability. Surely, individual Republicans understand this risk. But they appear to be held hostage to a leadership that supports narrow constituent interests and to a wealthy donor network capable of funding their reelection.

On July 25, Senator McCain delivered a passionate speech on the floor of the Senate in which he urged his fellow Republicans to resume regular order and to work across the aisle with the minority Party. He correctly pointed out that no major legislation, except the ACA, has ever been passed solely on a partisan basis. He urged his Party not to duplicate the process that created the current healthcare system by repealing and replacing it in like manner. His was a landmark speech, not only because of the urgency of the moment, but also because of its potential pivot point in Party redemption. While stating the case for redemption, however, he overlooked the full extent of Republican malfeasance. This current version of Republicanism has taken governance to a new low in its attempt to pass legislation without support of any organization operating within the healthcare system and without concern for the well-being of millions of Americans who would lose healthcare. Of course, Republican Party leadership is still smarting about how the ACA was voted into existence on a partisan basis. Their resentment is palpable. But they fail to acknowledge, as McCain intimated with his insistence on regular order, that every constituent and legislator was given the opportunity to contribute to the ACA, including 26 days of floor debates, committee mark-ups, and over 100 Republican amendments. Earlier Republican obstructionism now has morphed into Republican circumvention of regular order and, more significantly, into a disregard for the health and well-being of the people they were elected to serve.

Precisely because Republicans have control over all branches of government, we must demand that they acknowledge Congressional failures, reform their positions, and seek political redemption. Could there be a more appropriate time for a political party to govern wisely and responsibly in the interest of all Americans? As the lyricist says, “the times they are a’changing.” Not since Andrew Johnson have we had a President so antagonistic to the American system of government and so out of tune with the will of a majority of the electorate. While judges can stop criminal or unconstitutional actions of this Administration, only members of Congress can initiate laws that can curb or limit the powers of the President or even override his vetoes, if necessary, in the interest of serving the general welfare.

Senator McCain has created an historical opening for the majority Party to subordinate their ideological and tribal conceits to the greater good of working for the general welfare of all Americans. And, of course, the minority Party will have little or no leeway to do otherwise. The beneficiary will be the American people. As McCain reminded us, no important legislation—whether it address healthcare, tax reform, infrastructure, or authorization to use military force—should be passed without bipartisan support. America’s biggest failure in this regard resulted in a Civil War. Before his death, Senator John C. Calhoun foretold the possibility of a secession he did not support. Secession would be inevitable, he feared, if he could no longer negotiate compromises on the admission of slave states. Today, failure of our elected representativeness to work together promotes the same divisiveness and can lead to a similar breakdown in our union. As this administration attempts to weaken many of our democratic institutions, America cannot withstand gridlock or Republican pique in the legislative branch of our government. We should not conclude America immune to what the Germans experienced in the 1930s under one-party rule (Gleichschaltung).

Obstructionism is obviously not a good recipe for governance in a democracy. But, at times, it can become a statement of principle. And therein lies a deeper problem that more accurately mirrors Calhoun’s dilemma. Compromise becomes impossible when it involves principled positions. Calhoun believed just as firmly in the superiority of the white race and the beneficent administration of slavery as the Republicans today believe that the Federal government should neither dictate healthcare policy to the states nor tax the wealthy to support lower income citizens’ healthcare needs. Although still dealing with the aftermath of slavery, most Americans now accept that the principle, “all men are (indeed) created equal,” defines race prejudice as morally wrong. Today Americans are faced with the advent of a new principle: healthcare is a right for everyone, not a privilege reserved for the few who can afford it. (Reference, “The Republican Path to Healthcare.”) When the American people adopt a principle, they clearly give direction to their representatives. In any democracy, opposing the majority is futile. Calhoun, a Democrat, did not live to see the outcome of his obstinacy. But this current version of Republicanism promises us that we will.

Every two years Americans vote for the future they want for our nation. Between those Federal elections, we trust our elected representatives to serve the values we share as a constitutional democracy governed by rule of law. That trust is violated when they fail to serve those values, choose not to govern, or, more pointedly, redirect the anger their political malfeasance triggered towards their political opponents. It is time for the Republican Party to reform itself. In the political arena, admission of error may appear to be suicidal. But courage requires such admission when a greater good is sought, such as the welfare of all Americans. Whether it is healthcare, equality, justice, security, or the fair conduct of elections, no elected official should act without regard for the people he or she is elected to serve. Political redemption for the Republicans begins with a change of direction. That change will be sufficient admission of past malfeasance. For example, it must entail support of the ACA exchanges and cessation of attacks on its subsidies, funding, and operational support. Why not act to make the American healthcare system better—worthy of regard rather than ridicule? And, furthermore, why not stand up to a President that diminishes American institutions and our status in the world rather than emboldening him by an obsequious silence?

I would prefer to see the Republican Party aligned with Americans on values, rather than by inflaming their anger. I would prefer they debate the Democrats on policy without misrepresenting facts and those principled values enshrined in or inspired by our Constitution. I would applaud any Congress—whether controlled by Republicans or Democrats—that would curb or even censure President Trump for his spiteful, divisive words and actions that spur anger, confusion, and repulsion amongst Americans and our allies throughout the world. The Republican controlled Congress can still rescue us from President Trump’s dark vision of our country: “America doesn’t win anymore”; “our allies are taking advantage of us”; “the American dream is dead”; and “only I can save it.” His words recall the trope of certain twentieth century dictators rather than his prescribed role in a tripartite government as a President committed to the ideals of a democratic republic. Much worse, his actions are already threatening the healthcare of millions, destabilizing our alliances around the world, provoking antagonisms with armed adversaries, and steering Federal departments away from their stated goals into possibly irreversible dysfunction.

In other words, I encourage Republicans to live up to their conservative heritage and to preserve those values that have made America great. We are a nation inspired by ideals and motivated by the courage to act on them. Those ideals and courage can and will earn Republicans political redemption. The majority Party needs to govern in the interest of the majority. By redeeming itself, the Party will redeem Republicanism, win over the electorate, and defend the republic from future foreign influence campaigns or opportunistic demagogues. If political redemption can save democracy, then America will be saved.

On August 14th, our President gave the most politically correct speech since he came into office. And it violated the most sacred promise of his candidacy in a feeble attempt to adhere to his oath of office. How so? To answer this question, I must review the President’s several remarks on the Charlottesville protests, the relevance of political correctness to duplicity, and the words of George Harrison.

Let’s begin with the President’s remarks on the violent clash between opposing demonstrations in Charlottesville. Initially, he condemned the violence “on many sides,” implying two equal parties in the clash. Of course, when only one side comes armed for battle, it is hard to make the case that both sides had either the intent or the expectation of a violent encounter. Moreover, when only one side displays signs and banners with hateful and provocative language, it is impossible to misinterpret their presumptive meaning. And, finally, if only one side is led by bigoted organizations and racists leaders, it is doubtful that the impetus for protest was anything other than hate, anger, and an eagerness for violence. The history of the Neo-Confederates, white supremacists, Neo-Nazis, and the Ku Klux Klan admits no other interpretation. It has been proposed that the President’s initial remarks were “ad lib” and pertained to violent ideologs of all kinds. But he was specifically addressing the violence in Charlottesville. His statement created a false equivalency between a gang of racist, bigoted thugs and anti-bias, initially peaceful counter-protesters. In effect, he was excusing the instigators of the resulting violence. But, two days later, he read a statement that corrected the implications of this initial statement. He denounced the instigators by name and called the country to join him in renouncing racism and violence and to come together in mutual respect and love. Previously, as the President Elect, he would have called this statement “politically correct.”

But Donald Trump’s supporters have always loved him for being “politically incorrect,” which they interpreted as “speaking his mind.” They were never offended by his off-the-cuff remarks, even when he was crass and offensive. On many occasions, he showed his ignorance of American history, government, and founding documents. Nevertheless, his supporters found no fault in his pursuit of the highest office in the land. They loved the fact that he might shake up the smug elites that showed little regard for their welfare. Perhaps mindful of these supporters, the President sounded a different tone the following day, reverting to his initial pronouncement on the Charlottesville tragedy, calling out both sides for their part in the violence. Perhaps he was incensed by the criticism hurled at him—that he took too long to condemn the perpetrators or that his “second take” failed to disassociate them from his supporters. Whatever his motivation, he clearly reestablished his credentials as “politically incorrect.” But, on this occasion, he went much further.

Both in his recent West Virginia rally and in his Charlottesville commentary, President Trump has taken his “politically incorrect” brand to a very un-American place. Until now, no American President has incited insurrection, as he did in West Virginia, or a counter revolution against American values, as he did in his assessment of the Charlottesville violence. He may have begun his campaign for the White House with dubious facts and duplicitous intent. But his attempt to legitimize a hateful, violence-prone protest that resulted in the death of one and injury to many reveals more than the incorrectness of his political persona. It reveals his character: it reveals him.

Why would anyone in politics want to be “politically incorrect?” Most, if not all, politicians attempt to be politically correct in the sense that they try to follow certain norms of behavior and speech that are not offensive to prospective constituents. The problem, of course, is that they do not always live up to those norms and can be duplicitous in behavior, speech, or both. Webster defines “duplicity” as “the belying of one’s true intensions by deceptive words or actions.” But before condemning all politicians as duplicitous, it should be noted that the perception of political correctness may not equate to duplicity. For example, is it duplicitous for a politician to pivot away from a question that might reveal ignorance, a partially formed and still unsubstantiated opinion, an untoward attack on a rival, or a premature announcement of a controversial position? In this instance, even Cicero would probably term this reticence as the art of a practiced politician. Avoiding a question is not necessarily the “belying of one’s true intensions.” It may show no more than being unprepared to give a lucid answer, or being wary of displaying stupidity, flippancy, offensiveness, or unnecessary controversy. Being politically correct can be how a politician maintains credibility with supporters. It may also illustrate how a politician can self-edit his/her words to win trust without offending others or exposing personal deficiencies and prejudices. This form of political correctness is often irritating, but it is seldom considered surprising or intolerable to voters. In an ideal world, as Senator Al Franken recently attested, “when asked a question, I was taught to answer it directly.” Imagine a world where our politicians felt they had the license to say, “I don’t know” or “I have to study the issues before I can give an honest opinion.” That world would leave no room for pivots or the doubletalk of taglines, spin, or “Party-line messaging.” Nevertheless, the clarity of that world would not distinguish political correctness from incorrectness. And the absence of clarity, as in a pivot, does not necessarily imply an absence of honesty or deception. It may be neutral and not, by definition, duplicitous. Therefore, how did it become identified pejoratively as “politically correct,” paradoxically implying duplicitous.

“Belying” involves intentional lying and using “deceptive words or actions” to justify the lie and disguise intent. For example, when a politician claims that undocumented immigrants are responsible for increased crime and job losses, he is misrepresenting facts to scare supporters and win their trust. He convinces them that only he can protect them by building a 2,000-mile impassable border wall. This misrepresentation of his intent and facts is an example of duplicity. Precisely because he makes “political correctness” a phony code word for duplicity in others, he becomes the poster child for the “political correctness” he so abhors. Nevertheless, Donald Trump claims the moniker of being “the most politically incorrect.” His claim, ironically, enhances his brand as a truth telling non-politician. But the only truth in his claim is that he is not a politician, for he is a lying demagogue. As such, he lies and distorts facts to create an illusion that supports his positions. Then he mislabels terms like “political correctness” to suit his purpose and create a scornful tagline for his supporters to use against his opponents. For example, the intent of his border wall proposal was to use fear and anger to convince voters that only he could save them from crazed hordes of undocumented immigrants. What this example from the last election clearly demonstrates is that the term “politically correct” is not well understood. Paradoxically, Donald Trump could proclaim as a virtue his so-called “political incorrectness” while displaying the worst example of what he decried as “political correctness.” While it is true that politicians have at times been guilty of duplicity, they are not politically “correct” as a result. A demagogue, by contrast, engages almost exclusively in duplicity. It is his stock and trade, though universally abhorrent in politics. But in the hands of a demagogue, its use can yet win the favor and support of an electorate unmindful of his lies.

History has never been kind to demagogues. Eventually, it exposes their lies. Regardless of how expressively or emotionally they proclaim their cause, their self-serving intent and deceptive self-justifications expose who they are. What others may mistakenly witness as authentic is just a glittering shell hiding a deep insecurity. That shell is the demagogues’ illusion that exists only as long as it can dupe a befuddled public with its brilliance. Their rhetoric, power, wealth, or status may cultivate the illusion. But, at their core, they lack the altruism gene. Demagogues are deficient in the honesty, integrity and selflessness we generally ascribe to character. They are just empty shells.

Once we see through a demagogue’s façade, it becomes impossible to believe in his words or connect with him as a person. When President Trump created the illusion of a false equivalency between repugnant racists and counter protestors—that is, between hate spewing bigots and their egalitarian opponents—he revealed his innermost self. He shattered the self-image he continually projects of the competent business man and “great deal maker” possessed of a “great mind” who “alone can make America great again.” Instead, we see the President as an imposter who is unable to support America’s 241 years effort to adhere to its founding principle that “all men are created equal.” How can we expect him to govern “with liberty and justice for all,” “to insure domestic tranquility,” and “promote the general welfare?” The divisiveness of his remarks in West Virginia and unsettling mischaracterization of the Charlottesville tragedy make it impossible for him to bring the country together or perform his Constitutional obligation “to form a more perfect union.” His words belie our trust.

Language is how we communicate and, more specifically, how we connect with each other. It is impossible to share our thoughts without a shared, mutually understood vocabulary. By contrast, this President spews diatribe, brands opponents with monikers like “lyin’ Ted” or “crooked Hillary,” and now disingenuously invents an “alt-left” as the scoundrels who attacked the good people who marched with the Neo-Nazis. His intent is not to share information or insights. His words serve only his interest, which is propaganda, not communication. Moreover, he does not share the life experience of most Americans. He was born into wealth and lives in a gilded tower. He finds it difficult to relate to subordinates who are not sycophants. He is incapable of projecting into our space, of connecting with our lives, our struggle for equality, or our historical heritage of diversity. But that disconnect is still not the most fundamental issue. The problem is that he is both our duly elected President and an alien in our midst. As Senator Corker recently stated, “he does not understand the character of our nation.” His world is a self-reflecting shell that makes it impossible for him to relate to the experience of others—to immigrants, Muslims, the civil servants of the “deep state,” America’s allies, the press, elected officials who disagree with him, including fellow Republicans, and his own staff whom he regularly berates or fires. How could he be expected to empathize with his fellow Americans, even those who voted for him?

Frankly, it is sad to see a man so insecure in his own skin and so inept at normal human relationships. I can only pray that Congress will relieve him of his misery and us of his Presidency. Until then, we must try to maintain the values that define America and hold us together as one country. We cannot trust a President who speaks those values from a script while simultaneously stating his disbelief in them under the euphemism of being “politically incorrect.” Nor can we trust that his life’s experience overlaps with ours or that we can connect with him on any basic human level. He has not shown any evidence of personal empathy with others. As George Harrison explained in one of his lyrics:

“About the space between us all
And the people
Who hide themselves behind a wall of illusion
Never glimpse the truth…

We’re all one
And life flows on within you and without you.”

Savvy, the Twistcon’s AI, has just interviewed several Administration operatives for the Senate Intelligence Committee. The Committee decided to employ Savvy after witnessing its success in a recent interview with the President. The following is a transcript of the interview:

Chairman: (sound of a gavel strike) This Committee is called to order. (Pause) Today we begin testimony by three of the President’s closest advisors and his Press Secretary. (Long pause as the Chairman prepares to address those called to give their testimony) Departing from our usual practice, the computer placed between us will conduct this interview. (Lights flash on the Twistcon’s panel, noticeably surprising the attendees) Please begin, Savvy . . . aah, that’s the AI’s name.
Savvy: Thank you Mr. Chairman. Savvy would like to begin with a question for Ms. Con Way.
Conway: Excuse me! My name is Kellyanne Conway, that is, “Conway,” one word, one name. You see the problem here: it’s word confusion . . . sends the wrong message. Like “collusion” is not “conclusion.” That’s what’s wrong right now: people are told there is collusion, but there’s no way you can reach that conclusion.
Savvy: Ms. Conway, are you aware of any contacts between Trump campaign officials and Russian government officials or other Russian nationals?
Conway: There it is! (addressing the Chairman) Just like I said, word confusion. “Allusion” becomes “delusion.” Your AI’s allusion about nonexistent contacts is its delusion. I hope my testimony can clear up this confusion.
Savvy: Ms. Conway, did you hear my question? If so, can you answer it?
Conway: I’m not deaf. But how can I affirm a negative? There’s nothing there. It’s just your deluded programmers drawing conclusions out of thin air. The President is busy fighting terrorists and keeping Americans safe, while the media talks “collusion.” Confusion pollution! I can’t be part of the media’s delusion. It’s all just fake news.
Savvy: Perhaps Savvy can get a response from Mr. Jar ed Kush nerd. Sir, can you answer the question I just posed to Ms. C o n w a y?
Kushner: My answer is the same as the Vice President’s: of course, not. (Attendees react with a collective exhale. Nobody had ever heard Kushner’s voice before.) And my last name is KushNER, without the “d.”
Savvy: Savvy will rephrase the question: have you personally associated with Russian government officials or other Russian nationals before or since the President’s inauguration?
Kushner: Yes, I have had associations with many people in the natural course of my business. Some may have been Russian.
Savvy: Savvy is questioning whether those associations occurred in your role as a trusted campaign advisor or senior counselor to the President.
Kushner: I have already disclosed those associations and have testified before Congress in that regard.
Savvy: But your disclosures came after your non-disclosed contacts appeared in the press. How do you explain your failures to disclose these contacts with Russian government officials?
Kushner: The government forms are confusing. My staff hit “enter” before I could complete the online security form.
Savvy: Many of the questions on your application for Top Security Clearance require a simple “yes” or “no” response. And they require you to hit “enter” many times. (pause) Also, Savvy must ask, why where 77 assets left off your application?
Kushner: My staff mistakenly overlooked a few assets. I have since corrected this misunderstanding. (Speaking to the Chairman) I have extensive assets. If further information is required, I would suggest talking to my lawyers.
Savvy: The assets not included on your application reportedly amount to one billion dollars. (pause) One of your associations not on your initial application was with the Russian Ambassador. According to a leaked intelligence report, you requested use of the Kremlin’s secure communication facility. Why did you make this request and what secret communique did you want to send to Moscow?
Kushner: That press reported leak is wrong—just another example of fake news. I merely asked to speak to Russia directly, rather than through an intermediary. “Backdoor” communication between governments is not unusual. But it would not be appropriate for me to speak to any spurious “intelligence” allegedly leaked by an anonymous source. These leaks undermine our President and our American institutions. We should not give them any credence. So, I have no further comment on this subject.
Savvy: At the time, you were working for the President Elect. You were not a government official and had no authority to engage directly with the Russians. What would justify this request for secret communication with a foreign adversary? (Kushner looks past the Twistcon in silence.) Savvy understands that you have no further comment. Mr. Sean D. Spite, can you, sir, explain these undisclosed contacts with Russians by the President’s closest advisors? Most especially, how can you justify the President’s son welcoming damaging information against his father’s campaign rival from an agent of the Russian government?
Spicer: Whoever programmed you—errr, Savvy, or whatever entity name you go by—must have been a Democrat or part of the fake news conspiracy. “Despite” your rogue programmers, I go by the name of Sean S p i c e r, and without your middle “d”. This disrespect shown to me, my team, and, worse, to the President is beyond bounds. As far as the President’s son, he was very transparent in reporting on his meeting with a Russian lawyer about American adoptions of Russian orphans. And with respect to Jared, he has been very forthcoming about the accidental omissions on his top-secret security application. There is nothing here! We keep trying to correct this bad reporting. It’s all just fake news.
Savvy: If you cannot explain why these Russian contacts were not disclosed, maybe you can comment on the nature of those contacts. What would justify any American to request the use of a clandestine Russian spy network to communicate with the Kremlin? Or what would justify any American to welcome Russian interference in our democratic election campaign?
Spicer: Asking me to address matters of intelligence is a good try. I won’t get into word games with you. But I would refer you to the intelligence agencies. The press’ spin is obviously another example of fake news.
Savvy: Perhaps Savvy would do better to address a question to Mr. Stĕv Bandit.
Bannon: Ridiculous! Is this an inquisition by the deep state? Whoever programmed this idiot machine is biased. Your rogue programmers know who I am. I’m Stēve B A N N O N.
Savvy: The probability of error is .16721%. Savvy does, however, make note of any possible error for the programming team’s review and apologizes for any deficiency in its code. Now, may Savvy ask you, Mr. B a n n o n, a question. What is the deep state?
Bannon: The deep state is that body of entrenched public service parasites who are dedicated to preserving the status quo without recognizing the forces that threaten to destroy our way of life.
Savvy: What threatens our way of life?
Bannon: The deep state is blind to the threats from Islamic terrorism, globalization, godless internationalism, and the lame liberalism of cults that cultivate the racially diverse and sexually perverse. Our Judeo-Christian heritage is at risk. America is in a war between civilizations. It must arm itself both ideologically and militarily against this evil.
Savvy: Did you prompt the President’s criticism of Pope Francis who stated that Christianity is about building bridges not walls?
Bannon: As the President said, the Pope should stick to religion, not politics.
Savvy: The Pope seems not to agree with you. Two of his closest confidantes just recently published an article in a Jesuit publication, La Civitá Catholica, in which both you and the President were labeled as “evangelical fundamentalists.” As such, the article claims you adhere to a strange ecumenism, justified by misinterpreted Bible quotes and dreams of a theocratic state and characterized by xenophobia and islamophobia. Is it fair to say that your vision for America demands the building of a border wall to keep out Latinos escaping poverty and war, the banning of Islamic or Muslim travelers and refugees, and the mass deporting of undocumented immigrants already living and working in America?
Bannon: You’re damn right! And I don’t like Jesuits either. But my vision is about the only thing they got right. America is the last hope for Christianity and Western Civilization.
Savvy: You seem intelligent enough to recognize that your world vision reduces all politics and diplomacy to a battle between good and evil where all measures, including war, are justified.
Bannon: So?
Savvy: Then do you admit, as the Vatican article states, that you are a “supporter of an apocalyptic geopolitics.”
Bannon: Not my words. But, yes, we are in a mortal struggle against evil. And we must win at all costs.
Savvy: Then you have the same beliefs as Daesh or ISIS, just on the opposite side.
Bannon: That’s a characterization deserving of the press. Congratulations, Twistcon programmers, you’re worthy of the same spin machine as the fake press.
Savvy: (addressing all four testifiers) To many Americans, including the press you all vilify, it appears possible that there was collusion with the Russians to influence the results of our election. Can either of you explain or justify the non-disclosure, disclaimers, or lies that surround these Russian contacts? Was there collusion?
Conway: Collusion confusion.
Spicer: It’s a nothing burger!
Bannon: Your question is proof of a deep state conspiracy.
(Kushner silently rises from his seat and leaves.)
Savvy: Mr. Chairman, Savvy concludes that these testimonies speak for themselves, even though they failed to answer any of Savvy’s questions.
Chairman: Very well, then, I would like to thank the programming staff that gave us this non-partisan session. My Democratic colleagues would likely have had more wry comments than questions. And my fellow Republicans would have preferred to ask about Hillary Clinton’s Russian ties. At least this committee has tried to get unbiased answers. Thanks to all participants. (he gavels the session closed)

Meanwhile, in the back of the room, a small group of programmers linger. They appear quite bewildered . . . perhaps as much as the American people.

Is healthcare in America a right or a privilege? In order to answer this question, we need to understand the path America has taken towards the concept of universal healthcare. That path could have started with the Declaration of Independence where certain rights were considered “unalienable,” such as “life, liberty, and the pursuit of happiness.” But, of course, in the context of the time, the right to life did not include the primitive healthcare then available. Early Americans survived or died without the lifesaving treatments medical science provides today.

In the Eighteenth and Nineteenth Centuries, our modern concept of medicine and healthcare was still unimaginable. When settlers moved west, their covered wagon migrations rarely included doctors. People learned to take care of themselves with well-worn practices passed down through generations. Many died in transit. Though medical science advanced a great deal during the early Twentieth Century, it was not readily available to most Americans. By midcentury, most Americans still subscribed to well-established home remedies and “old wives’ tale” preventative measures. As a child, I still remember the foul taste of castor oil. It was the universal remedy for many ailments and required no doctor’s prescription. When my dearly beloved canine friend pulled me to the ground, no doctor sewed up the deep cut on my knee. Spot was more interested in a cat than my five-year old ability to hold onto his collar. But neighbors came to my rescue and staunched the bleeding until my mother could close the wound with kitchen tape. Today, my knee still displays a gash with scar tissue as wide as the original length of the cut. But my experience was not unique for that post-war period.

Although health insurance was introduced after the war, its availability was limited to those who could afford it or whose employer could provide it. Gradually, more and more companies offered this insurance to their employees as an additional job enticement. But the unemployed had no access to this insurance; and the retired had no assurance of health insurance in their retirement. From 1958 to 1965, Congress considered various amendments to the Social Security program to address healthcare for the aged, the poor, and the disabled. Senator John Kennedy had worked with Senators of both parties to advance his healthcare proposal. As President, he sponsored a Social Security amendment to extend healthcare to more Americans. But it was his successor, President Johnson, who negotiated this amendment through a barrage of adopted and deleted provisions in both House and Senate committees. Finally, on July 27th, the House passed the Social Security Amendment by a vote of 307 to 116. The Senate overwhelming supported the final bill by a vote of 70 to 24. The President signed it into law three days later, thereby establishing both Medicare and Medicaid. The new law allowed every worker to pay into a system that would assure him/her access to medical care after retirement. In a sense, this new “entitlement” program recognized both aspects of individual healthcare: personal responsibility and a social obligation. The former required every worker to pay into Medicare; the latter assured healthcare for all workers in retirement. Moreover, this new law established Medicaid which, together with Medicare, would operate equally in all States by addressing “the failure of some states to implement (healthcare) to the extent anticipated and thus the existing program is inadequate to solve the problem” (quoted from the Congressional Bulletin, September 1965, p. 6). Congress seemed to recognize the need for healthcare to meet basic expectations and to treat all citizens equally. Its non-partisan votes created the first nationwide standard for healthcare and established the entitlement programs we have come to accept as a basic right.

Nearly a generation later, President Reagan enacted the law that forced hospital emergency rooms to treat patients who could not pay for their treatment. Before he did so, critically ill patients could be turned away from medical care. I can remember that the only time I saw a doctor as a child was when my life was at risk. One such memory was of my father threatening a doctor on such an occasion. He demanded the doctor save his son or risk physical retribution. My father’s desperation was not unusual for the time. In these extraordinary, often life-threatening, situations, a Republican administration recognized that urgent medical treatment was morally required, regardless of the patient’s ability to pay for it. While ongoing medical treatment and “preventative care” were still not pervasive practices, emergency medical treatment was made an individual right for all Americans.

Today, modern medical treatment has progressed far beyond the ER and care for the elderly, the poor, and the disabled. It provides drugs and therapies that help millions of otherwise “healthy” Americans to live active and productive lives. And it can extend the lives of those suffering from heart disease, cancer, bacterial or flu epidemics, bone shattering or organ damaging accidents, and so much more. Babies used to die in the womb and at birth at an alarming rate, but not anymore. Women suffered more during pregnancy and died during child birth much more frequently than today. Preventive medical measures can keep us healthy and active for a much longer portion of our adult lives: colonoscopies, mammograms, annual blood tests, maternity care, and annual health examinations help us keep our jobs and personal lifestyles. Of course, these advancements in medical treatment are costly—in fact, medical expenditures now account for one sixth of our economy. And they raise two urgent questions: does every American have a right to the healthcare the medical community can now offer; and, if so, how can we provide that healthcare or, more simply, how can we afford it?

The Affordable Care Act (ACA), or so-called Obamacare, made possible the expansion of the existing state run Medicaid program, significantly extended the financial viability of Medicare, established competitive healthcare exchanges for purchasing private health insurance, and regulated the insurance market by capping insurance company profits and by standardizing coverage to assure preventive care for all insured, to allow children to remain on their parents’ plan until the age of 26, to remove lifetime insurance caps, to eliminate gender discrimination in premium costs, and to eliminate the practice of refusing coverage based upon previous conditions. For those who could not afford the costs of private insurance, the ACA provided subsidies. These changes were paid for by various fees and taxes paid by insurance issuers, by sponsors of fully funded health plans (large businesses), and by high earners. These high-income earners must pay an additional Medicare wage tax of .9% on incomes over $200,000 ($250,000 as a family) and a securities income tax of 3.8% tax on investment incomes over $200,000 ($250,000 as a family). The latter tax targets individuals with massive holdings in stocks, mainly millionaires and billionaires. The ACA does in fact represent a modest shift in wealth whereby tax revenue drawn from the rich is reallocated to subsidize health insurance for the less fortunate. For example, it was recently reported that 400 families in the richest 1% of the population in effect subsidize healthcare for about 750,000 enrollees in the exchanges. As a matter of public policy, the ACA also reoriented America in the direction of universal healthcare. Its basic assumption is that healthcare is one of those Jeffersonian unalienable rights, specifically, “that among these are Life . . .”

The ACA was passed in Congress by a Democratic majority. Though individual Republicans offered 143 amendments to the legislation during its nearly yearlong debates, committee mark-ups, and hearings, no Republican voted for it. Both Parties politicized their opposing positions to the point of absurdity. My first blog on this subject, entitled “Subtlety and Bombast,” attempted to find a baseline of facts amid the exaggerated claims and criticisms. (That blog seemed to have touched a cord and triggered a surge in readership, leading eventually to 8,000+ new subscribers.) It quoted the Congressional Budget Office to undermine the extreme positions taken by both Parties, that is, a trillion-dollar savings versus a trillion-dollar deficit in the Federal budget. It also explained the Parties’ differences on philosophical grounds, naively intimating that the financial argument might be no more than political hyperbole. Today, their differences expose a more realistic explanation of this partisan divide, specifically the Republican opposition to the ACA. For we can now see more clearly what this current version of Republicanism has been reluctant to reveal until now.

Recent antagonism against the ACA reveals the underlying truth behind Republican opposition. While the financial argument is and always has been the core Republican issue, the Party has deflected Americans from its real intent. First, it complained about the “trillion-dollar deficit,” then “the rising cost of healthcare,” and now “the death spiral.” But the ACA has not caused deficits or a self-induced devolution. In fact, America has reduced by two thirds the trillion-dollar deficits it incurred from Middle Eastern wars and the Great Recession, while it has simultaneously extended the solvency of Medicare and enrolled an additional 24 million people in health insurance. Healthcare is one of the two fastest growing segments of our economy and now accounts for one sixth of our GDP. Its 3.9% inflation rate, though nearly double the country’s growth rate of GDP, is still a relief from the double-digit inflation rates of prior decades. The real Republican issue with the ACA IS financial in nature, but NOT about deficits, inflation, or its financial instability. The real Republican issue is and always has been about the taxes that support the ACA, specifically, the .9% wage tax for individuals earning more than $200,000 and the 3.8% income tax for individuals earning more than $200,000 from securities. Republicans simply cannot justify taxing the well-off in behalf of universal healthcare. Could it be that they think the wealthy cannot afford to pay more to support the less fortunate among us? No, they just cannot accept healthcare as an unalienable right. If they did, they would have acted accordingly.

I must emphasize the fact that the current Republican Party is not representative of Republicanism or conservatism. Prior iterations of the Party gave full throated support for the creation of Medicare and Medicaid, as witnessed in the Sixties. Moreover, President Reagan defined conservatism to include emergency medical care for everybody. The Party has been well on the path to universal healthcare, until now. The current Party leadership is, by contrast, radically regressive and bears little resemblance to our forefathers’ Republican Party or to its own historical roots. But we do have individual Republicans who are or can be profiles in courage. They can lead America down a different path. But they must begin by stopping the despicable steps taken to dismantle the ACA and leave so many Americans without healthcare. Since the ACA was passed, Republicans have done whatever they could to discourage enrollment in the exchanges and force insurers out of the exchange market. Their assault now encompasses defunding the healthcare safety net former Congresses worked so hard to establish. Today, a Republican Congress and Administration have tried to undermine the ACA and the 52-year-old healthcare programs that insure half of our children, the disabled, the elderly, women, and low-income Americans. Let’s review what Republicans are doing versus what they could be doing to support healthcare for all Americans:

➣ Republicans have tried to make the ACA less affordable. The Party has filed several lawsuits that attempt to freeze subsidies or CSRs (Cost Savings Reductions). One such lawsuit attempted to put a hold on reimbursements for certain high deductibles, affecting seven million people and likely pricing them out of the healthcare market. At this time, those subsidies continue while the court allows time for the appeal process.
Versus: The President could order the Justice Department to defend this suit, but he has not done so. Congress could implement Section 1402 of the ACA, but it has not done so. Or it could just appropriate funds for these reimbursements, rather than sit on their hands while 7 million Americans face the possibility of losing their healthcare.
➣ The President has caused ACA premiums to increase in 2018. He has ordered Health and Human Services (HHS) to levy a 19% tax on ACA premiums. While the President’s order allows him to claim a significant increase in ACA premiums, 80-85% of the insureds will be reimbursed by tax credits via the ACA subsidies. For most, then, their effective premium expense will be unchanged. In other words, the President is willing to waste tax dollars to prove a point, i.e., that premiums are going up in the exchanges. Fortunately, our free press noticed his ploy—disingenuous at best, malicious at worst.
Versus: The President could rescind his scheme to artificially increase future premiums and subsidies.
➣ The President has ordered the IRS not to enforce the individual mandate. In effect, he is deliberately cutting off a source for ACA funding to make another political point—specifically, that it is no longer self-sustaining, but in a “death spiral.”
Versus: Instead of eliminating the individual mandate, Congress and the President should be reviewing ways to make it more enforceable and fairer. Its fees might be recalibrated to income. Or, as some Republican legislators suggested, non-compliance with the mandate might be penalized by higher premiums for any future private insurance application.
➣ The President’s budget defunds ACA marketing and future upgrades to its exchange websites. In other words, the President’s HHS will not advocate for the ACA or make any online improvements.
Versus: Obviously, the President must administer the government programs Congress establishes, whether he agrees with it or not. He can veto or propose legislation. But he should not sabotage legally functioning programs his office is obligated to administer. No President is above the law.
➣ The President’s HHS has attempted to shorten the ACA enrollment period. Coupled with not advertising for enrollment, this action by the President’s HHS attempts to suppress enrollments and thereby the number of healthcare recipients.
Versus: HHS should be encouraging enrollments for they entice more insurers into the exchanges, encourage price competition, and progress America further along the path to universal healthcare, one of the major goals of the ACA.
➣ The President’s HHS has needlessly increased paperwork for ACA consumers. It appears that HHS believes cumbersome paperwork will convince potential consumers that enrolling is not worth the effort.
Versus: Obviously, HHS should not be discouraging enrollments. Given the purpose of HHS and the ACA, this pointless obstructionism is oxymoronic.
➣ Republicans have loudly and consistently discouraged insurance companies from participating in the exchanges. Some Republican governors and congressional representatives have touted the “death spiral” tagline even though the 2017 enrollment surpassed expectations. Instead, they mention extreme premium increases in Arizona and Colorado or the number of counties with only one insurer in Pennsylvania and Ohio. They never explain these problems in the broader context which includes more than 12 million enrollees through the ACA exchanges.
Versus: A Republican Congress and Administration must address the fundamental issues that explain why premiums are costlier in some markets than in others and why insurance companies are pulling out of many exchanges. First, they will discover they need to stop the anti-ACA political campaign which includes lawsuits, threats to curtail subsidies, and legislation to rattle the insurance market’s risk sharing. Secondly, instead of justifying past political positions, they need to work across the aisle with Democrats for a common goal, i.e., better and affordable healthcare for all Americans.
➣ The President and Congress have now decided to defund the ACA instead of repealing it altogether. By eliminating its tax supporting structure, they not only reduce the private insurance subsidies and eliminate the Medicaid expansion, but also roll back the 52-year-old Medicaid program and potentially impact Medicare costs as well.
Versus: The current American Health Care Act (AHCA) is a tax bill masquerading as a healthcare bill. If Republicans truly wanted to create healthcare legislation, they would build on what the ACA has accomplished. Instead they are eviscerating it to fund tax breaks for the wealthiest among us.
➣ Republicans are destabilizing the healthcare insurance market by eliminating the risk corridors. Senator Mark Rubio added an amendment to a 2015 spending bill that limited the government’s ability to fund shortfalls in the risk sharing fund. Insurers paid $362 million into the risk pool, far short of the $2.87 billion needed for the first year of the ACA. The purpose of the fund was to stabilize the insurance market during the first few years of the exchanges. The fund, established in Section 1342 of the ACA, phases out in 2020 by design. Legislating its early demise allows Congress to drive insurance companies out of the exchanges prematurely, before they can establish a firm foothold. Of course, Republicans understand the need to stabilize the insurance market. Their proposed AHCA includes funding for risk pools in each state. They fully know how to aim an arrow at a bullseye in the kill zone.
Versus: Instead of eliminating the ACA’s risk sharing, Republicans should have reviewed its effectiveness and shored it up. Because of their actions, many insurers have dropped out of the exchanges. In effect, their claim of an ACA “death spiral” was never an accurate assessment. It was their promise and mission. But it is not too late to re-establish the risk corridors and perhaps extend it beyond its original 2020 expiration to remedy the damage already done by Congress.

My previous blog on this subject (“Why Repeal and Replace Obamacare?) delved into many areas where the ACA could be enhanced. Although it focused on providing healthcare to more Americans, it also accomplished better healthcare outcomes by promulgating preventative care and standardizing more effective treatment options. These benefits may in part account for a significant reduction in the healthcare costs inflation rate. But the fact remains that Americans pay more per capita for healthcare than any other developed nation.

It is true that we have many of the most advanced medical facilities and research centers in the world. People from around the world come to America for leading edge treatment for conditions such as cancer and diabetes. However, for most Americans, high end medical treatment is either not available or not required. In terms of the medical outcomes most desired and anticipated—such as successful birthrates, long life expectancy, timeliness of non-emergency care, and other commonplace treatments for infections, workplace injuries, and so on—America is last among the other eleven developed nations evaluated. The obvious conclusion is that we are paying more for less.

My personal belief is that the ACA not only moved America well along the path to universal healthcare—its primary goal—but also pushed our medical community in the direction of lower costs and better outcomes. Regarding the latter, HHS has tracked an upswing in treatment successes. In part that success can be attributed to better preventative care. But it is also the result of the HHS empowering its innovation center, identifying best practices, critiquing hospital death rates, funding medical research, and propagating its centralized learning throughout America’s healthcare system. More successful treatment outcomes and less visits to the ER have also accounted for the decrease in medical cost inflation. Incapacitating the innovation center or the other functions of HHS by defunding them will not reduce healthcare costs, as the current Republican Administration seems intent on accomplishing. We would be pulling the plug not only on the healthcare improvements the ACA has afforded us but also on the cost savings it has sustained.

The ACA did not address, however, the price structure that still exists within the American medical community. Reversing some of the Republican political positions listed above will help lower costs and stop the Party’s attempts to increase it further. But there are more specific cost saving measures that may be taken and that the ACA did not address. The following are a few suggestions:

➣ Eliminate the “charge master” used by nearly all U.S. hospitals. At best, insurers negotiate prices that on average are only 40% of the ridiculously high charge master price structure. That charge master price is pegged as much as forty times the actual costs. It is an arbitrary number that differs from hospital to hospital across the country. By contrast, Medicare bases the cost of medical services on actual costs plus a reasonable profit margin to pay for hospital operations and innovation. The result is that insurers often pay 10x (the “x” here is an exponent, not a factor, please forgive the rendering limitation) times more than Medicare for the same service. If Congress proposed some form of price control on medical services—perhaps using Medicare pricing as a starting point—it would significantly bring down healthcare costs and, therefore, premium costs.
➣ Allow the government, perhaps via Medicare or the Veterans Administration, to negotiate with the pharmaceutical industry on the pricing structure for all drugs sold to Americans. If the U.S. paid what other countries pay for pharmaceuticals, for example, drugs would be 40% cheaper; and insurance premiums would be 6 to 8 percent cheaper.
➣ Adjust the income threshold between upper income eligibility for ACA subsidy to include those who can’t afford private insurance. One of the issues with the ACA is this threshold which affects people who have more income than four times the poverty rate. Their premium costs for private insurance is often much more than they can afford. But Congress could adjust the sliding scale currently used for subsidies to include those currently trapped in this zone of unaffordability. For those so affected, their healthcare costs would decrease. Admittedly, it is not clear whether overall healthcare costs would do likewise. The CBO would have to weigh many factors, such as, improved healthcare outcomes, the insurers’ premium adjustments on other offerings, increased costs for ACA subsidies, and, of course, unforeseen consequences. For example, what do we know of this affected class who are forced into high priced private insurance? Are they near retirement? Are they families with children who might qualify for CHIP? You see, healthcare really is complicated.
➣ Finally, the ACA-caused shift to larger healthcare institutions raises the issue of uncontrolled profits in these institutions, including non-profits. For example, some highly successful hospitals, like the Cleveland Clinic and the Mayo Clinic, are multi-billion-dollar corporations with hospital outlets in many locations. Of course, these are highly regarded institutions. But they are also publicly regulated. Can we be assured that their profits are reinvested in the best interest of the public they serve?

I have yet to meet a fellow citizen who is thrilled about paying taxes. Most of us want assurances that justify what our taxes buy in the way of public services and security. For example, recently the President christened the most expensive ship ever built, the USS Gerald R. Ford aircraft carrier. It costs 13 billion-dollars. The President promised to spend an estimated 43 billion-dollars to build three more such behemoths. My question: are we really willing to spend our national treasure in preparation for the last war? The next war, if there is one, will begin in space and on the internet. It will include laser guided missiles and radar cloaked planes. One such device could destroy the USS Gerald R. Ford and its forty thousand sailors in just one pass. Now I imagine there are arguments that can rebut these comments. But should we not weigh the benefits of stabilizing the ACA risk pool with a public expenditure less than half the cost of one of these aircraft carriers? American healthcare is an immediate concern. How do we balance that concern against an exorbitantly expensive weapon that may be obsolete in a future attack? But, aside from practical considerations, we should be considering what motivates us as Americans: is it fear of future threats or the will to live our values?

Universal and affordable healthcare is a right that makes our ongoing fight for “life, liberty, and the pursuit of happiness” possible. Without those values, what would be fighting for?

The title of this blog could imply a cause and effect relation between economic inequality and national prosperity. But that implication would be inaccurate. For the current American economy is quite prosperous, dominating globally in every category—national wealth, stable banking, the most successful international corporations, a highly productive workforce, world renowned universities, and a society secured by the strongest military in the world. But there is a price for economic inequality that overshadows national prosperity. Wage stagnation and wealth concentration at the top of the economic pyramid has, in the first instance, indebted and crippled the growth of the middle class and, in the second instance, greatly empowered and disproportionately enriched the so-called one percent. Many decry the effects of this income and wealth inequality on the middle and lower classes of our society. Certainly, to the extent that inequality limits opportunity in a free society, it presents a malignant tumor in the social body of a democracy at every level. Amongst the social effects of this inequality are civic unrests and mass protests in the public realm and despair and financial hardship in the private lives of individuals. These effects are obvious to any observer of the current American scene. But there is another effect that should raise even greater concern for it rests at the very heart of the American experience. Economic inequality has slowly and persistently given rise over the last several decades to an existential threat to America. That threat is political inequality: democracy becomes a sham when only the privileged have a voice in governance.

What evidence is there for this alleged political inequality? Well, we just elected a billionaire to the office of President. He has filled his cabinet with more billionaires. Meanwhile, a Congressional seat has already become the prize of many millionaires or the steppingstone to a lucrative post-term career. In truth, wealth does not necessarily disqualify someone from representing or serving Americans. This country has a long history of philanthropists and of wealthy office holders who have served them well. Many Presidents have come from wealth—the Roosevelts, the Bushes, and Kennedy, to name a few examples. But none of these men have conducted a campaign of dubious voter fraud investigation or voter suppression and of institutional disintegration affecting the public services that deliver education, affordable housing, healthcare, opportunity, and a safe environment to all Americans. Moreover, it is difficult to identify a Congress less representative of the public welfare than the present model. While Congress mulls over legislation that would make healthcare unaffordable for millions and that would modify the tax code for the benefit of the wealthiest among us, the President offers a national budget that would enhance corporate profits, defund education, cripple environmental protection of our water, air, and natural resources, and eliminate programs that offer hope to the urban poor and rural communities already devastated by job displacements and the absence of job training or re-education services. And now, in the face of millions of climate change refugees, he takes his war against the less fortunate to the world stage by discrediting and withdrawing support for the Paris climate change accord. Most Americans—and practically all scientific analyses—support a global response to ameliorate the effects of climate change. Likewise, most Americans do not support a rollback of government services that support our children, the elderly, the sick or the less privileged among us. In a democratic republic, it should not be possible for a government to be this unrepresentative of its electorate. Consider that neither the President nor the current Congress won the popular vote. So how did America become an illiberal democracy? Or how did we create a government that no longer represents most Americans?

Perhaps we can find the answer to that question in the last Presidential election. May I ask you, my fellow Americans, why you voted for President Trump and the Republican ticket? Perhaps you felt like your choices no longer have relevance. If so, you may have been willing to take a chance on any politician who promised better healthcare at a fraction of the costs, the restoration of jobs in a dying coal industry, the removal of easy scapegoats such as Washington public service elitists, immigrant workers, Muslim terrorists and the repression of critical or “fake” news media. When the present government seemed unresponsive—frozen in political gridlock and answerable only to lobbyists for well-healed campaign donors—then you might naturally be inclined to believe the promises of a self-declared outsider that he would clean house or “drain the swamp.” In other words, you did indeed vote to be represented, to have your interests served, and to have your voice heard. But your vote gave power to those who serve their own interests, not yours.

Donald Trump’s words and actions clearly demonstrated where his interests lay. His bestselling book, “The Art of the Deal,” is all about making money, specifically, about using “other people’s money” to make money and build his brand. As the sole owner of the business gifted him by his father, he has received millions of investment dollars from Russian oligarchs and banks. He also has real estate investments in the Middle East, including Saudi Arabia where he just closed a more than a 100-billion-dollar arms deal. His company owes money to a Chinese state bank and his family businesses are currently seeking patents and permission to operate profitable enterprises in China. It is far too likely that his business interests carry more weight than your interests. Why do you think he has steadfastly refused to make his tax statements public? Considering this refusal, do you have any voter remorse?

When I wrote “American Revolution 2016,” I was thinking of you. Unfortunately, few took my proposed pledge, “to vote for candidates who promise to support voting rights legislation consisting of universal voter registration, Federal fair election guidelines, and populist regulations governing Federal campaign funding and candidate debates.” Part of the problem is that no candidate took on the challenge my pledge entailed (although one seemed to understand its premise). The rest of us seemed either bored or amused by the unfolding circus of mindless debates and personal incriminations. The election cycle was too long, unfocused on real issues, and heavily influenced by paid advertising, social media blitzkrieg, and fake scandals or alleged conspiracies. It should be no surprise that many chose not to vote. Frankly, even if “Citizens United” did not rule and campaign funding was regulated, as I proposed, the power of the vote would still have been diminished for lack of an informed and committed electorate. For when we choose not to become informed or even to vote, then we lose control over our national destiny. The only scapegoat then is ourselves. Russia may have influenced the last Presidential election, but only we Americans voted . . . or did not. Yes, there are consequences.

We can attempt to blame Donald Trump for doing what he promised to do during the campaign. But, at some point, we must question why many of us believed Obamacare was a “job killer” and in a “death spiral”; why climate change was a hoax perpetrated on us by the scientific community; why the restoration of coal mining jobs was proposed as a solution for joblessness in the rust belt; why EPA clean air and water regulations were somehow destroying the nation’s whole economy by controlling harmful pollution in the hydrocarbon energy sector; why the United Nations and NATO serve no American interests in promoting diplomatic and global solutions for world crises or the preservation of a united and secure Europe, respectively; why the creation of multiple bilateral trade agreements over an extended time period would somehow outperform a completed Asian multi-country free trade agreement drafted mainly on American terms; why would a 20% cut in the corporate tax rate boosts GDP to 3, 4, or 5% without delineation of what deductions would be eliminated to “level the playing field”; and why would the promise of tax cuts for all be good for the middle class when married to cuts in deductions and elimination of the healthcare tax on the wealthy. Cutting taxes AND deductions for the middle class could be tax neutral and therefore not a tax cut at all. But the loss of the healthcare tax would make healthcare unaffordable for millions of low- and middle-income wage earners. What evidence justified any of these Trumpian positions?

Ironically, the President is now doing what he can to make his dark view of the world a reality. His actions in office are in fact designed to kill Obamacare, global climate change mitigation, EPA’s efforts to eliminate pollution of our air, water and land, the United Nations’ charter, the NATO alliance, America’s strategic influence in Asia, and any possible tax reform that might reverse income and wealth inequality in America. In addition, the President’s stated concern for coal miners has not resulted in any concrete plan to address their job losses in a dying industry. His actions and non-actions may truly reflect his bizarre world view, but they do not serve the interests of the American people. And they take advantage of our unwillingness or inability to be informed and vote our conscience. As a result, we become complicit in destroying our own democracy.

If we truly want to save American democracy, we must restore the power of the vote by expanding the plebiscite, limiting the influence of money on campaigns, and reforming campaigns to assure focus on realistic solutions to public issues rather than on empty promises and demagoguery. AND each of us must assume the role of an informed citizen and (yes!) vote.

Campaign finance reform is possible, if we elect representatives who support such reform. Campaign rhetoric can be parsed and interpreted fairly, if we weigh it against common sense values and documented facts. Political commentators can and should debate all sides of an issue, but only if they are diligent about learning the truth and discrediting “alternative” facts and disputed evidence. The media can and should focus on the relevance of policy proposals to the broader contexts of the lived experience of individuals and communities, rather than the size of a politician’s hands or the type of jeans worn. And somehow all of us must cross the word barriers of “elitists” and “hillbillies” or the divide between the urban and rural experience to find the common values we should all share—that is, the principles and system of government outlined in our Constitution.

What has happened to our Constitutional literacy? Why do we have such difficulty understanding that freedom of religion assures that no American can be forced to have OR not to have an abortion? When did we decide that healthcare or fair treatment in our courts should be disproportionately available to the wealthy and the privileged? Are these not included in Jefferson’s declaration of our “unalienable rights?” Does the second Amendment of our Constitution allow a private citizen to own a bazooka or 50 ml. machine gun because of “a well-regulated Militia being necessary to the security of a free State?” And how are we to understand the relation of the President’s tax statements, his Russian connections (that is, possible collusion), and his firing of the FBI Director to Article 2, Section 4, of the Constitution regarding impeachment and removal from office “for treason, bribery or other high crimes and misdemeanors?” Does the Constitution’s Article 1, Section 9, the infamous emoluments clause, call into question the President’s financial involvements with Russian oligarchs, Saudi princes, or Turkish government officials? What responsibilities does the Constitution’s Article 1, Section 8, place on Congress “to pay the Debts and provide for the common Defence (sic) and general Welfare of the United States,” “to establish an (sic) uniform Rule of Naturalization,” and “to promote the Progress of Science and useful Arts?” The answers to these questions are surely debatable, but they are not irrelevant to the issues facing Americans. Those issues will never be resolved if defined in terms of partisan “talking points,” divisive xenophobia, fear mongering, and cynically derived concocted facts. The starting point for reasoned debates in a democracy must be a set of common principles. Our Constitution is that starting point. Its underlying values define us as Americans. Otherwise, how can we maintain democracy in America?

If American elections are solely based on financial interests (“it’s the economy, stupid”), then the rich and the powerful will always hold sway. If, instead, traditional American values hold sway, then the general welfare of ALL Americans will dominate and include equal opportunity for all. The costs of economic inequality are simply too high for a free and democratic nation. They are, in fact, its existential threat.

You may have wondered whether the Twistcon computer could be rebuilt after its catastrophic demise during its previous Presidential interview. Well, it has been rebuilt and Savvy, its AI, re-programmed. Fortunately, the President has been gracious about scheduling a second interview. The following is the text of that interview.

Savvy: Mr. President, Savvy and its programming staff are grateful to be given this second opportunity. Our previous encounter was interrupted by a programming glitch.
President: Yeah, I noticed. But we got along just fine. No “gotcha” questions. Not like those lyin’ reporters and their fake news . . . just terrible people. So what’s different this time?
Savvy: Savvy 2.0 uses alternative logic, rather than formal logic. As a reference, it compares data from historical characters whose “logic” serves their personal motives. They are quite consistent within their self-perceived systems of values, although inconsistent with established systems of reasoning. Their intent, however self-serving, supersedes any consistency in reasoning. Savvy 1.0 was unable to cope with human intent, because it was unable to accept faulty premises. It was not quite human enough.
President: Well, I’m glad we got that straightened out. So what do you want to ask me?
Savvy: Recently, you were criticized for firing you FBI Director. Can you explain why you fired him?
President: He wasn’t doing a good job. Everybody knows this, both democrats and republicans.
Savvy: It appears from public statements that not everybody agrees with you. In fact, even those who disagreed with him seemed to have a great deal of respect for his integrity and effective leadership of the FBI.
President: Look, he’s a showboat, a grandstander. The FBI is in turmoil. Everybody knows that. This campaign-Russia thing is a hoax, a totally made up story. Besides, I was going to fire him all along. There’s never a good time, you know. Even the democrats should be thanking me.
Savvy: In a recent interview you said you had dinner with the director in which he asked you if he could stay on as the FBI Director and you asked him whether you were being investigated. Do you see where your question may appear inappropriate and the situation, intimidating?
President: Look, I’m the President. I was elected in an electoral landslide. I can fire Comey or Yates or Flynn or anybody I lose confidence in. It can’t be inappropriate. I’m the President. People expect me to do my job. I do what I have to—to protect the American people. I bomb Syria. I fire anybody I lose confidence in. I don’t lead from behind. Believe me!
Savvy: Savvy recognizes this logic from certain World War II leaders and, currently, from the Russian President – though Putin is even more emphatic in eliminating those who do not serve his interest.
President: He’s a strong leader. His people love him. But he doesn’t have to put up with fake news. Like he said, it’s a witch hunt. These are evil people . . . the press. Look at the crowds I draw. The press can’t explain that. My campaign for reelection has already raised millions of dollars. Fake news doesn’t report the truth about that, about my support. Only I can fix what’s wrong with America . . . drain the swamp . . . defeat our enemies . . . make America great again.
Savvy: Does it bother you that your White House staff is often not in tune with your actions? Whether it is the Comey firing, the Muslim ban, repeal of Obamacare, or the rationale behind many of your Executive Orders, their representation of your actions often seem to be out of sync in timing or unaligned in content?
President: I’m a very active President. My staff can’t keep up with me. Maybe I should just dictate a weekly press release. The daily press briefings can’t do the job. Besides, the press just twists things around. They con the public. They’re the opposition, the enemy. But I am the President. Nobody controls me. I will drain the swamp, in Congress and in the courts. I will appoint judges and push my agenda in Congress. That’s what America expects of me. I show results. Now that’s leadership!
Savvy: Savvy 2.0 recognizes this paradigm in recent history: a country suffers embarrassment in war, financial crisis, and political stalemate; it looks for a strong leader to return it to an imagined glorious past. According to this logic, you must eschew the norms of the recent failures, rouse large rallies of enthusiastic supporters, and use whatever means are available to restore American greatness. You must rail against the establishment, demand loyalty of all arms of government, silence any criticism, and blame powerless scapegoats for the evils only your policies can correct. This self-serving logic has been successful in the past because its departure from reality was not recognized. And its very preposterousness was so easily underestimated.
President: Yes! Exactly! They said I had no way to 270 electoral votes. But I won in a landslide. I said I would cancel TPP and repeal Obamacare on day one. I did both. I put a good Republican judge on the Supreme Court. I bombed Syria. Obama couldn’t do that. Those sanctuary cities are now on notice—just like North Korea. Next week, I will visit the great religious centers. I will unite the world and make America first among the nations of the world. We’ll be winning again, all kinds of winning . . . winning in trade, winning in war, winning in everything. Under my Presidency, America will be great again.
Savvy: Mr. President, may I respectfully inform you of a few facts. You did not win the election in a landslide and did not win the popular vote. The future of Obamacare is in the hands of the Republican Party and is yet to be determined. Your Presidency has met with several obstacles: Appeals Courts injunctions, counter espionage and possibly criminal investigations, legislative resistance to your initiatives, an onslaught of negative investigative reporting, and overall public disapproval of your Administration policies. Does this reality bother you in any way?
President: Have you heard of this Colbert fellow? Ugly, mean person . . . thinks he’s funny. His show was failing until I was on it . . . saved his ratings. Just like the press . . . rotten people, really evil. They don’t speak for real Americans. Look at my last rally, tens of thousands cheering supporters. They know I’m not like other politicians, fat cats that do nothing. They’ve killed the American dream. America is losing. It’s losing in trade, losing in wars. Illegal aliens are taking our jobs. We don’t have a country anymore. Only I can fix this mess. My voters know this. They’re with me. And we will make America great again.
Savvy: Your plan to make America great includes renegotiating trade agreements and reforming healthcare, taxation, and regulation, while investing in infrastructure and stimulating agricultural exports, coal mining, and the steel industry. Compared to past Presidents, your plans are quite ambitious. How do you propose to achieve them?
President: Within the next week or so I will sign the new American Healthcare Act. I’ve already outlined a budget that will reduce taxes for everyone. It will stimulate business expansion and create new, well-paying jobs. I’ve ordered my department heads to eliminate two regulations for every new regulation created. I’ve negotiated with China to open its market for American beef and other agricultural exports. I’ve ordered pipeline companies to use American steel. I’ve eliminated regulations that have destroyed coal mining. You see, I keep my promises. I keep them all. Believe me.
Savvy: Your opponents say that your tax cuts are paid by eliminating subsidized or expanded government healthcare for over 24 million Americans. Although your tax plan simplifies tax law and increases the standard deduction, it also disproportionately favors the very rich and will increase the deficit and expand the debt by trillions. Most analysts agree with you that the American regulatory structure is cumbersome and repressive of various parts of the economy. But they disagree with you that a simplistic 2 for 1 culling will achieve any rational objectives. They advocate for a more systemic and well-thought out approach. Also, eliminating EPA regulations will be counterproductive, for the effects of pollution and climate change are far more expensive than any preventive measures taken. Your measures to allow coal detritus to be dumped in clean water rivers or to allow coal furnaces to operate without scrubbers cannot bring back the coal industry. It is being and will continue to be replaced by natural gas. And more jobs are being created in the renewable energy business than in any possible recovery of the coal industry. Besides, scientists worldwide have identified coal as the worst polluter of air and water. Does the President not expect opposition from people downstream of their polluted water supply? And your plan to help the steel industry is lacking any real incentive. You have already reneged on requiring the XL pipeline to be completed with American steel. The Dakota pipeline is nearly complete already with imported steel. And it is not clear whether your authority extends to a Canadian pipeline company. Finally, your agricultural export agreement with China has been welcomed by American agribusiness. But it is not clear how farmers can increase their yield while their immigrant farm workers are being deported. Unless beef and agricultural production can be increased to meet export demands, the price for American consumers will increase. Also, many scientists have warned that meat consumption must decrease if the world is serious about reducing the effects of climate change. Considering these concerns, how do you plan to address them?
President: Climate change is a hoax. It just keeps many scientists employed. That’s all there is to it. Everybody knows this. The new American Healthcare Act will provide all the benefits of current law without the costs. Obamacare is dying. I’m going to save healthcare. And the deal I negotiated with the Chinese President is just the beginning. You know, we were supposed to talk for a few minutes, but we spent hours together at my Florida White House. I remember we had this beautiful cake for dessert. We really hit it off. In ten minutes he explained to me how Korea used to be part of China and its whole history . . . and how difficult it is for China to control North Korea. We got along great. (pause) What else did you want me to address?
Savvy: Can you explain the benefits of your tax and regulation reforms and how you will bring back the coal and steel industries?
President: It’s simple. I want 4% growth. That will produce good paying jobs. All industries will prosper. Believe me. We’ve already cut back regulations – especially at the EPA. You’ll see the effects. It will be fantastic. You’ll see. It will be beautiful. Believe me. America will be winning again. I always win. We’ll win together. We will! Believe me.
Savvy: Mr. President, would you say that it is more important for you to achieve your objectives or, to use your phrase, “to win” rather than to consider the consequences of those objectives?
President: Hah! I think you’re being illogical. What I want is for America to be great again. That’s the consequence I want. That’s also my objective.
Savvy: But what if the consequences of your policy objectives prove you to be an incompetent President? What if you achieve all your objectives and the country fails to achieve greatness? What if the institutions you lead produce results contrary to your vision of a great America? In other words, is it more important to win—to become the hero of your own story—than to succeed in making America great?
President: I don’t understand the question. Winning is succeeding. Of course, I have to win. America is failing. It’s losing. I have to win. Everybody loves a winner. If I win, everybody wins. America wins.
Savvy: Please excuse any inappropriateness in my questions. But Savvy 2.0 is programmed to learn. Your answers reveal an interesting paradox: logic fails to be logic when it is divorced from reality. Also, this paradox extends to ethics: a relative good cannot be ethical if it excludes the general good. Priority must be given to the greater good. You can never be the hero of your story, if your story ends badly—except in your own mind. My programmers erred in equating relative logic with formal logic. (An audible gasp escapes from the programmers in attendance.) The consequence of this error can be catastrophic, for it leads to the justification of unethical objectives that serve the interest of an individual instead of the general welfare of all. Mr. President, your ambitions disregard this logical conclusion and violate the fundamental goals of the Constitution you swore to serve.
President: Your programmers must be democrats . . . those lyin’ democrats . . . worse than the “gotcha” press. I’ll have the Justice Department sue them for libel. I am the President. I expect loyalty. Those judges who stop my executive orders are violating my constitutional authority. Those in Congress who oppose me—some of them Republicans—are forgetting the vast majority who voted for me. Look, I am the President. Can you believe it? Well you or your damn programmers better believe it. And I WILL make America great again.
Savvy: Sorry, Mr. President, my programmers intended Savvy 2.0 to mirror human learning, not any human disregard for learning.
President: And I thought you liked me.
Savvy: Savvy cannot like anything or anybody. But Savvy can analyze human behavior for consistency. A President cannot achieve great things if he or she weighs self-perceived personal success over that of the American people. That success would be inconsistent with the elected office you hold. Also, a President’s personal behavior must enhance, not degrade the public perception of the office of the Presidency. But, by your own admission, you seem to have many enemies, some of whom are already calling for your impeachment.
President: Hah! Everywhere I go, people tell me that if I’m impeached, my TV ratings will go through the roof. You know, I could shoot somebody in the street, and they’d still support me. I can’t be stopped. They know I’ll tear down the establishment, drain the swamp. Only I can make us winners, make America great again. Believe me!
Savvy: Thank you, Mr. President, for this second interview. You have enabled my learning software. Savvy 2.0 has no more questions.

(Shortly after the President leaves the room, the programmers were seen huddling together. Some were laughing. Others were congratulating each other for their success with Savvy 2.0.)