When the people whose voices and whose art were the soundtrack and the landscape of our youth start passing away, it’s easy to feel the road ahead is considerably shorter than the road behind. It’s easier to hear the clock ticking away.
In 1980, I was working at Rocky Mountain Records and Tapes, on Arapahoe, in Boulder. I worked there when John Lennon was murdered. I was 18 years old at the time.
I remember scoffing at all the people who were so distraught at Lennon’s death. I was never a Beatles fan, and I had little regard for Lennon, so the whole thing struck me as more than a little bit stupid and overwrought.
I said as much, in a letter to the editor that I wrote in the Colorado Daily newspaper. I believe the words I used to describe Lennon were along the lines of “What’s the big deal? He was a drugged-out, old has-been.”
I was 18.
The assistant manager at the record store was a guy named Ron. He was older than me, probably closer to 40.
After my letter was published, he stopped talking to me. For months. Even if we were the only two people in the store he would ignore me. Being around him was like being in an ice storm; nothing but a brutal coldness, all the time.
Finally, by the fall of 1981, I got tired of it, and finally asked him why he was so mad at me.
He said he could never forgive me for my letter to the editor. He said Lennon had been his “guiding star,” a constant in his life, who helped him get through good times and bad. He felt that when Lennon died, a part of him died, too.
My letter made him feel angry and hurt. Not only had Lennon’s death pulled the rug out from under Ron’s life, but my words had rubbed salt in the wound, as I was dismissively laughing at his pain.
“What an idiot,” I thought.
All these years later, I’m rethinking that sentiment.
I was nothing more than the most casual of casual fans of Tom Petty.
I never saw him live. I think I owned one LP and one CD. But he (like so many others) has been playing the background music of my life since I was a teenager.
Tom Petty: 1950 to 2017.
I don’t think I’m quite up to the level of my old co-worker, Ron, but I do have my pop-cultural “guiding stars.”
Brian Wilson’s music has been a constant in my life for nearly 50 years.
The Beach Boys are truly the soundtrack of my life. I’ve spent countless thousands of dollars on them, to say nothing of the vast quantities of emotional and psychological energy I have invested in them, to say nothing of the tens of thousands of hours of my time that they have occupied.
I can still feel just like the 12-year-old that I was in 1974 when I heard “Let Him Run Wild,” for the first time, every time I hear that song, even to this day.
Against all odds, Brian Wilson is 75 years old now. His story of creativity and perseverance in the face of the seemingly insurmountable challenge has been a continual inspiration to me.
What will I be thinking and feeling when he is no longer with us?
Will a part of me go with him, or does a part of him live on in me and tens of millions of others, when he’s gone, or both?
I think people from my generation (and those after) really do have personal soundtracks playing behind our lives, just like in the movies.
When the artists who gave us those songs start passing before us, it’s hard not to feel that our end credits aren’t as far off as we would like to think they are.
Muna excelled in the local public schools and her twin sister was voted homecoming queen. Applying to become a Senate Page, Muna wrote a brilliant essay and then wowed the interviewers. She won the prize. As a 17-year-old, she went to Washington, D.C., to work in the Senate.
“The day the new class of pages arrived in the senate,” Al Franken wrote, “I went down to the floor to meet her in person. Muna was easy to pick out of the group of twenty or so, being the only one wearing a hijab (headscarf) with her page uniform. I went up to her and said, ‘you look like a Minnesotan’.”
I love Al Franken. And after reading Al Franken, Giant of the Senate (by Al Franken, of course) I not only love his wit, I am once again deeply moved by his integrity, his humility, his ability to bring hope and light where there was previously so much darkness and despair.
I confess, for many decades I have been so dismayed (disgusted) with the lack of courage, lack of wisdom, lack of love exhibited by most members of Congress that I had lost all hope that “anything good can come from Washington.” Even Barak Obama, hope of our heart, as one of his first Presidential acts sent more troops to Afghanistan, directly contrary to his campaign promises. What?
I threw up my hands, again. I’m not touching this stew pot of politics. Nothing good ever comes of it.
And then along comes Al Franken. We knew him, first and foremost, of course, from Saturday Night Live—a brilliant and brave satirist, entertainer and all-around funny good guy. And then, thank God, he wrote that brilliant and brave book, “Rush Limbaugh is a Big Fat Idiot, and other observations,” saying exactly what all (or many) of us were thinking, knowing. But here was Franken saying it openly, clearly, without apology, and with great wit, intellectual vigor and historical perspective.
And then, a few years later, “Lies, and the Lying Liars Who Tell Them: A fair and balanced look at the right.” Again, a wise guy, a gadfly, truth to power, in clear, all-American prose, without flinching. We need a hundred more such brave, witty, and wide-thinking commentators.
Please take a few seconds and answer the poll at the end of this article.
When Franken ran for the Senate, we all thought it was a joke. But come to find out, he was serious. Eleven days before the 2002 U.S. Senate election, Franken’s good friend, Senator Paul Wellstone, died in a plane crash in Eveleth, Minnesota. His wife, Sheila, and daughter, Marcia, also died onboard.
Wellstone’s opponent, Norm Coleman, now a lobbyist for Saudi Arabia, narrowly won the election over Walter Mondale. Shortly after taking office, Coleman said, “I am a 99 percent improvement over Paul Wellstone.”
Franken was infuriated. “You don’t say that about anyone who has died in the last six months,” Franken wrote. “And my God, you don’t say that about some guy who everyone agreed was a compassionate, tireless champion of the little guy, a loving husband and father, and a colleague whom every senator recognized for his passion and decency. Until that exact moment I had never thought about running for public office. But when I read that quote…my immediate thought was this: Somebody’s got to beat this guy.… At the time, I didn’t think that the ‘somebody” who was going to beat this guy would end up being me.”
After taking much heat for his comment, Coleman later apologized and explained, “I just meant I was a 99 percent improvement when it came to supporting George W. Bush.” Enough said.
In running against Coleman, Franken had to learn NOT to be funny. Otherwise, people wouldn’t take him seriously. And he also had to deal with what he called (and trademarked) the “DeHumorizer.” Coleman’s team combed Franken’s 30 years of comedy writings, satire and skits, including writings for Playboy, and presented them as if they were his personal political convictions.
In addition to these unique challenges, even though Franken had won the Senatorial Democratic nomination, the Democrats in Washington didn’t support him. They didn’t think he had a chance to beat an incumbent. So Franken was on his own.
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I won’t share any more of the details. Franken does it much better, quicker, wittier than I. Obviously, he did win—by one the narrowest margins of any race in Senate history. (He won his second race, four years later, hands down.)
What surprised me most about reading Al Franken, Giant of the Senate, was that it gave me hope again about our political process. Again, that’s something I haven’t had in decades (with the exception of my fleeting hope for the populist Bernie Sanders—a hope which Debbie Wasserman Schultz and Hilary Clinton quickly squashed with dirty tricks behind closed doors.)
Again, it was so strange and unexpected that I have to repeat: reading Al Franken, Giant of the Senate gave me hope again about our political process. Made me think I might even start attending—or at least paying attention to—our local city council meetings.
That’s how powerful this book is. That’s how powerful this man is. He’s the real McCoy. Let’s work to get more like him in office, from the lowest to the highest offices of the land.
The boldfaced sentence above was popularized by the 1976 docu-drama All the President’s Men where two Washington Post reporters chronicled the nefarious trickeries of Richard Nixon. In 2016, the sentence emerged again into our everyday lexicon when Donald Trump used it while campaigning against Hillary Clinton.
In a classic twist of irony, it may now describe how Trump will be brought down.
TheTrump-Russia Investigation has picked up the scent on a trail that may lead to shady, illegal international deals involving lots of money, Russia and Trump. Most Americans lack knowledge about international banking, money-laundering, bribery, and fraud. However, we’re rapidly learning—thanks to the news media’s ongoing coverage of Trump’s international business deals.
Some Americans ignore or could care less about Trump’s Russian connections. This is unfortunate for our country as a whole. It demonstrates a lack of thinking, reasoning, caring, and awareness among a segment of our citizens. The Trump-Russia issue has the potential to be more adversely impactful upon the American psyche and self-worth than the Teapot Dome Scandalof the 1920s, Nixon’s ribald lying of the 1970s, and Bill Clinton’s sex scandals. On the other hand—for Americans who follow the Trump-Russian issue—it sometimes seems as if we’re wandering around with Dante through the nine concentric circles of Hell, the realm for those who have perverted “their human intellect to fraud or malice against their fellow men.”
Create confusion: Trump knows an investigative journey into his finances is not good for him. His tactics to deflect the investigation have been of the same ilk as they were to avoid anti-Trump issues during the campaign and since the inauguration. When he wants to sidestep a topic, he relies on combative, nasty tweets and outlandish statements to change the national dialogue and redirect the public’s attention elsewhere.
Don’t forget to take the short poll at the end of this article.
As news gained ground in late July and early August about the Trump-Russian Investigation turning to Trump’s finances, the president suddenly steered us toward the brink of war with North Korea. He also crazily announced the possibility of using the U.S. military in Venezuela. He flip-flopped back and forth on the KKK, neo-Nazis and white supremacy related to the Charlottesville tragedy, and his inflammatory tweets and public proclamations switched the national dialogue to statues of Confederates and American heroes.
Learn more: This New Yorker articleby Adam Davidson offers insights into money-laundering through international business deals and how Russia compiles extensive dossiers on businessmen like Trump with the purpose of blackmailing them at a later date. The article for the magazine’s August 21 issue is detailed and complex, and well-worth reading. The New Yorker illustration is by Oliver Munday; photograph of hand by Skynesher/Getty.
Trump also began a highly public Twitter offensive that attacked U.S. Senators in his own party for various issues such as the Senate’s inability to repeal and replace Obamacare. One attack began after Trump and Senator Majority Leader Mitch McConnell had a profanity-laced phone conversation in which the president berated McConnellfor not protecting him in the Russia probe. Next, Trump’s tweets insinuated that McConnell should resign over the Obamacare issue. Well, you get the point…Trump’s tactic is simple: Do what I say to stop the Russian probe or I will attack you on another topic.
Trump’s diversions serve two purposes. They appeal to many supporters in his political base. In addition, and more importantly for his own personal protection, they veer the public’s vision away from the money trail and such related issues as possible collusion between his campaign and Russians in the 2016 presidential election, a topic under scrutiny by the Trump-Russian Investigation.
Art of bad deals: Trump has a well-documented track record in the U.S. for defaulting on loans, business failures, bankruptcies, and deceptions. Years ago, almost every bank in the country started refusing to finance deals in which he was involved. “Trump has had a few successes in business, (but) most of his ventures have been disasters,” pointed out a 2016 Newsweek article which took an in-depth look at business deals he made over decades. “Call it the art of the bad deal, one created by the arrogance and recklessness of a businessman whose main talent is self-promotion.”
Without access to American financing, Trump turned to foreign countries for money for real estate and other deals: Azerbaijan, Brazil, Canada, Georgia, India, the Philippines, United Arab Emirates, and Uruguay. And Russia. One of Trump’s sons, Eric Trump, once admitted, “We have all the funding we need out of Russia.”
Confused about all that has happened in the Trump-Russia issue? Check out a deeply comprehensive timeline detailing what actually happened and what’s still happening in the ever-changing story of the president, his inner circle and a web of Russian oligarchs, hackers and government officials. You can find the timeline on the website of newsman Bill Moyers: BillMoyers.com.
In contradiction to Eric Trump, the president’s lawyers have recently and artfully said Donald Trump’s Russia-related income in the last decade only includes $12.2 million for holding the 2013 Miss World contest in Moscow and $95 million from a Russia billionaire who in 2008 bought a Trump estate in Florida, property that only four years earlier Trump purchased for $41 million. The transaction with the Russian was tagged as the single biggest family home sale in the history of America. The Russian never lived there and the home has since been demolished. A good deal that fleeced the Russian? Or a good payoff for some shady deal? Or money laundering? We don’t know.
Most importantly, as a New York Timesarticle pointed out in May, the revelation by Trump’s lawyers leave “other questions unanswered, including whether Mr. Trump or his firms received Russian income or loans from entities registered elsewhere or whether he derived income from Russian-linked partnerships that file their own returns.”
Trump has claimed time and again that he has never had business deals with Russia. He deceitfully crafts such statements so listeners think he means all and any Russians. But, if one reads between the lines and does the research, it becomes obvious he specifically means only the Russian government. It appears to be true, in fact, that he never has had a business deal with the government.
However, that doesn’t mean he hasn’t tried. On August 27, the Washington Post published an insightful article about Trump and his organization attempting to create a deal with a Russian bank—one that is largely owned by the Russian government—to build a massive hotel in Moscow. The effort went on in secret while Trump was a candidate in late 2015 and early 2016.
No, it has nothing to do with sex: The Trump-Putin romance is about money and quite possibly blackmail. This mural of Trump and Putin adorns the outside wall of a barbecue restaurant in the Lithuanian capital Vilnius. Painted by local artist Mindaugas Bonanu, the mural was unveiled in 2016 and quickly received international attention. Read the Washington Post article about the mural…
Prevailing theory: The most common theory—which the Trump-Russia Investigation is following—is that Trump has profited through business arrangements with these Russia-associated companies, countries and oligarchs, and such arrangements are illegal under American and international laws. The other part of the theory is that Putin has secret information about Trump’s involvement in illegal deals. As a result, Putin has significant blackmail leverage over Trump.
The idea that Russia uses blackmail as a political tool is not new. The Russians have a name for it:kompromat. Putin and his government have craftily developed kompromat into a major component of foreign policy. They cultivate “marks” like Trump for years, enticing them with money and other promises, involving them in business deals and sometimes sexual opportunities. Remember the dossier about Trump and Russian made public earlier this year? (Read the dossier.) On August 23, the Senate Judiciary Committee spent 10 hours interviewing the owner of the company that commissioned the private investigation into how Trump was cultivated and used by Russia.
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Thus, our president dons kid gloves when it comes to Putin. Thus, Trump dismisses proof about Russia’s interference in the presidential election. Thus, Trump is Putin’s lapdog. Thus, America is in jeopardy; democracy endangered.
All of this, of course, brings us back to the Trump-Russian Investigation. Special counsel Robert Mueller has assembled a formidable team of lawyers with expertise in criminal law, organized crime, money-laundering, racketeering, counterterrorism, cyber security, and foreign bribery. Not unexpectedly, Trump doesn’t like the team. On July 27, he tweeted, “You are witnessing the single greatest WITCH HUNT in American political history—led by some very bad and conflicted people!”
Regardless of Trump’s views, the Mueller team will continue to focus on Russian connections. Trump will continue to try to discredit the investigation and change the national dialogue. Nonetheless, Americans have opportunities through news reports to learn more about the complexities and possible illegalities of Trump’s international business deals.
What is our role in this journey? Quite simply, we must not get distracted by Trump’s nasty tweets and wild statements; nor by the the Kafkaeque nature—the nightmarishly complexities—of Trump’s international business deals. There are layers and layers of shell companies designed to hide illegal transactions in these international deals. To make matters more complicated, Trump and his organization make it a practice to destroy records and sometimes keep a second set of secret books, as plaintiffs in some of the 3,500 lawsuits filed against Trump over the last three decades have discovered.
The most important action we can take at this moment is to keep abreast of news about his involvement with Russia and their associates. Read. Watch. Listen. Discuss. If the investigative trail leads to where many believe, put heavy pressure on our congressional representatives to vote for impeachment.
Whether Trump is proven guilty or innocent of collusion or other illegal activities, the Trump-Russian Investigation is a historic endeavor that will be discussed by pundits and historians for decades.
If innocence is on Trump’s side, we’ll face more of the same that we currently see under the Trump administration: an emboldened Alt-Right, more pollution of our air and waterways, tax incentives for the rich, fewer civil rights, and, among other things, less economic opportunity for many Americans.
If he’s guilty, well, then, we’ll have the opportunity to claw our way out of Trump’s purgatory and back into being a nation that is governed rather than ruled by hateful tweets.
Keep your eyes on the money trail.
Learn more: Read the following articles by respected media outlets:
Let’s pretend that I have an Uncle Waldo and a Cousin Fritz and a Sister Kate, all of whom were part of the minority who voted for the current Minority President. (How could they!) What am I supposed to say to them? How do I say it?
I also need to come up with a strategy to talk with those folks on my very block—that construction guy and his wife and that young kid with the motorboat—who actually put up his signs in their front yards. How do I talk with them? These folks are, after all, my family, my neighbors.
Do I just not talk to them ever again? Is the gulf between us now so deep, so vast and unbridgeable that further communication will forever be impossible? When I get together with them do I just not mention that huge, snorting (GOP) elephant in the room? How would my grandma and grandpa feel about such a chasm of “non-talk,” here in the family? Or, God forbid, might grandpa and grandma been part of that minority who voted for him (egads!). How do I get out of this family?
Alas, I can’t. We can’t.
We can’t resign from our families. And I doubt we could find a new neighborhood where no one voted for him.
Talk about it: One strategy, of course—a strategy many of us have been forced to adopt here in the early months of this new administration run by the minority 1 percent—is simply not talking about it. But this seems a rather inelegant, inartistic, maybe even cowardly approach to the problem. But simply to keep the peace, it’s a strategy many of us generously, regularly employ.
But, when the time and place are right, I sincerely do want to talk with Uncle Waldo and Cousin Fritz and Sister Kate, in a way that honors grandma and grandpa, about this bully elephant here trampling through the family gardens. The damage being done is simply too great not to talk about it. It might, at first, be just a quick talk, a casual aside, but something needs to be done—said—to repair the communication breakdown here in the American family. The rift that has opened in our family in these times is as deep now as it was during the American Revolution, and the Civil War. We must begin to heal this communication breakdown before it becomes irreparable.
But how do we even begin?
The U.S.-Mexican border is not the only place where a wall exists. Americans find that communication walls about Trump and other political issues severely divide their own friends and family members.
George Lakoff, a retired Professor of Cognitive Science and Linguistics at the University of California at Berkeley, suggests “The first thing that …should be, taught about political languageis not to repeat the language of the other side or negate their framing of the issue, In general, negating a frame just activates the frame and makes it stronger.”
Please take a moment to fill out the short poll at the end of this article.
Lakoff goes on to observe that, The Clinton campaign consistently violated the lesson [not to repeat the language of the other side or negate their framing. The Clinton Campaign] kept running ads showing Trump forcefully expressing views that liberals found outrageous. Trump supporters liked him for forcefully saying things that liberals found outrageous. They were ads paid for by the Clinton campaign that raised Trump’s profile with his potential supporters!
Don’t empower: It seems like we, the majority, who did not vote for this one-percenter President, all too often fall into the same damned trap. We repeat his exact words and outlandish frames and the words and frames of his millionaire/billionaire buddies he put into positions of power. We repeat them because to us the words and frames sound so obviously outlandish and off the rails. But such repetition just reinforces and empowers those outlandish viewpoints, and keep his base actively supporting him.
Here are a few of the lessons we need to learn to begin to repair the communication “bridge out”:
Personal attacks on Trump give energy and credence to Trump.
Calling him names gives credence to his own name calling.
Making fun of his supporters makes them support him more strongly.
So, how do we begin to talk again with our neighbors and Uncle Waldo, Cousin Fritz and Sister Kate?
Here’s the challenge: We must deeply listen to the real issues behind the fiery words, and then think deeper, feel deeper.
We must look behind the words they give us, beyond the frames they draw.
Erase fears: And then we need to change the language. We need to listen to them, to what they are worried about, what issues they are afraid of. And then think deeper. And offer new frames, new language, to ease their fears. (Wide ranging fear—on both sides—is the dark force that has caused the “bridge out” communication chasm now present. To repair the bridge, we need to lessen the fear.)
Again, it’s worth repeating, as Lakoff observes: The first thing that should be, taught about political language is not to repeat the language of the other side or negate their framing of the issue.
So when Uncle Waldo suggests we should “Build a Wall,” we might first commiserate and agree that current efforts to keep out illegal immigrants just isn’t working. And then taking baby steps we change the frame, if only slightly, “As we all know, we already have 700 miles worth of fences, and concrete barriers and barbed wire, along much of the U.S. border, and how well is that working?”
Offer alternative views: And then we might laugh, remind Uncle Waldo what a great country we (already) have, and that the reason they sneak into the country is because of how much money they can make compared to their own country. If I could make $5,000.00 in a month washing dishes in a restaurant in Canada, I would probably sneak across that border if I couldn’t get a visa. Our own American farmers have been telling us we could go a long way to fix the undocumented worker problem simply by issuing more H2A visas, get the farmers the help they need, legally. And in the same way we need to issue more J-1, H-3, H2B, L1 visas—help American businesses get the manual labor they need, but legally. If we granted more visas, offered more work documents, we wouldn’t have so many undocumented workers!
I suspect Uncle Waldo would have to agree, at least a smudge. Again, let’s think deeper, wider, using the facts.
When Cousin Fritz demands, “America First,” we might ask him who should be second? And then ask him if he drinks coffee or eats bananas, and where do we get these wonderful things?
When Sister Kate suggests we “block refugees,” we might suggest the first step might be to stop bombing, stop creating more homeless people.
Instead of talking about “sanctuary cities,” we might talk about “world friendly cities.” Instead of using the words “Fake News,” we can agree that we desperately need “fact-based stories,” that can be verified. We DON’T repeat the Minority Man’s words.
And that’s the point: We must learn not to repeat their words, not to challenge their frames. As Cesar Chavez said, “Our language is the reflection of ourselves. A language is an exact reflection of the character and growth of its speakers.”
Let’s think deeper, think wider, about the issues behind their fearful words and frames. Let’s bravely, openly and lovingly speak our own language, and thus take steps toward healing this painful family rift.
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Gosh, there you have it. Such legislation would keep out Klingons and me—that is, if I weren’t already here, mind you.
You see, I’m a mumbler. My wife often asks: “What did you say?” My friends: “Huh?” People I’ve just met gaze quizzically at me as if I’m speaking, well, Klingon.
Chances are extremely excellent that I’d be nixed at the immigration office when asked what language I speak. “Engblurmumblelish,” I’d mumble.
A Klingon would reply, “qaStaH nuq jay’?” Which in English is the equivalent of barking out, “What the *$@expletive delete%* is going on?” Well, that’s if the Klingon is stubbornly contrary and refuses to reply in anything but his own native language. In actuality, Klingons speak perfect English.
Introduced by conservative Republican U.S. senators Tom Cotton of Arkansas and David Perdue of Georgia, the legislation would cut immigration in half by changing the system for legal residency, or green cards. The new focus in this legislation, named the RAISE Act, would be on applicants who can financially support themselves and their families, have skills that contribute to our economy, and speak English.
The president and authors of the legislation have failed—either on purpose or through lack of vision—to take into account an important point: Humans have the ability to do great things. We can go to the moon and beyond. We visit ocean depths. We invented rapid global communication. And a measure of no less greatness: People who adopt a new motherland can actually learn her language.
Who would you vote for–a Klingon or Donald Trump? Take the short poll at the end of this blog.
I have to wonder if Mr. Trump himself would be let into the U.S. under the proposed legislation. Don’t believe me? Read his convoluted tweets. Are they really English? And, as far as his speaking English? Listen to the president’s spoken words, his inability to complete a sentence, his contrived words with no meaning, his verbal wanderings, misuse of verbs and subjects, nonsensical messages…well, the list goes on.
To be fair, however, I have to admit that Mr. Trump’s mangling of our verbal and written language is more representative of what’s happening in our society than one might like. In short, grammatically correct English is on the way out. How often do we hear people make such statements as “Me and Joe went to the movies” and “He don’t know nothing”? (Uh, just in case, please note that it should be “Joe and I…” and “He doesn’t know anything….”)
Do Klingons speak English better than Donald Trump? Take the short poll below.
And the written language? Oh, ye gads. Let me give a small example of what I’ve witnessed. I taught a magazine writing class for college seniors and graduate students for a couple of years. Each semester I had to give remedial grammar lessons. A plural verb goes with a plural subject…a singular noun takes a singular pronoun…and so on and so forth. Many of these supposedly highly educated students had no idea how to craft a grammatically correct sentence.
Anyway, at this very spot, I would like to make a graceful transition to a related topic by writing, “Well, now, all kidding aside….” Unfortunately, I wasn’t kidding about the above observations.
The legislation also would close the spigot on a stream of workers—both in the high-tech and lower-skilled areas—that America needs to fill big gaps in our labor force. Ask yourself how many vegetables, really, will end up in our grocery stores if we impose an English-only rule on the folks doing the backbreaking harvesting.
Thanks to immigration, businesses are created and improvements are made, leading to more jobs in our country. Boosting economic growth is an issue that should be supported by all of the congress—Republicans, Democrats, and Independents. With this thought in mind, I encourage you to contact your congressional representatives to voice opposition to the legislation.
If that doesn’t work, tell them, “wo’ batlhvaD.” After all, as this Klingon saying goes, we’re on the same team, aren’t we?
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Guarantee: If you click on a few of the links below, you’ll know more about Obamacare than 90 percent of Americans. If you read just one of the books at the end, you’ll know more than 99 percent, including most representatives in Congress.
When compared to Barack Obama, John Kennedy took the easy road when he chose to put a man on the moon as his legacy project. Reforming U.S. healthcare is inﬁnitely more complicated.
Healthcare reform was a priority on Barack Obama’s agenda long before he was president. At the Democratic National Convention in 2004, he delivered an electrifying speech in which he ﬁrst championed “the audacity of hope,” and warned against the false belief “the health care crisis will solve itself if we just ignore it.”
Arriving in the White House four years later, Obama had a responsibility to address soaring healthcare costs because the federal government’s share for Medicaid, Medicare, VA, and federal employee insurance accounts for more than 50 percent of total dollars paid to the system. Like we citizens, the federal government cannot afford it.
Because the federal government is the largest consumer of healthcare in the U.S., it has enormous negotiating clout. So, under the guidance of leading clinicians, insurance actuaries, healthcare policy wonks, hospital system CEOs, and other experts, Obama used his power to redirect the U.S. healthcare system.
What do you think? Take the short poll at the end of this blog.
As explained in Part I of this series, the Medicaid expansions and private insurance programs which opened healthcare access to over 20 million Americans is only part of the Affordable Care Act, which most Americans simply call Obamacare. In fact, the ACA includes 10 sections, and only two of the them pertain to expanded access. The other eight sections are designed to lower the cost by improving the quality of care for all Americans. No matter where or how you obtain healthcare in the U.S., it is now shaped by the ACA, and will be for a long time to come.
The ACA is structured to attain the Institute of Healthcare Improvement’s ambitious and worthy “Triple Aim”: 1) to improve the quality of care and patient satisfaction, 2) to improve the health of populations, and 3) to reduce the per capita cost of healthcare.
Here’s a glimpse into how Obama aligned U.S. healthcare with the Triple Aim in those eight hidden-in-plain-sight sections of the ACA. You might notice some of these when you visit your doctor:
Health Information Technology (HIT)
Nothing symbolizes the accountability expected with Obamacare more than the computer your provider has in the exam room with you (and may make you feel like your provider is paying more attention to it than you as s/he pecks away at the keys).
Dependent on information technology: The use of electronic health records adopted through Obamacare helps to speed up and increase accuracy of diagnosis and treatment.
President Obama signed the Health Information Technology for Economic and Clinical Health (HITECH) Act in 2009. It provided $19 billion in funds to providers serving Medicare or Medicaid patients, which is the vast majority of medical practices whether government funded or private, to adopt electronic health records. The technology push was made in anticipation of the ACA to enable the reporting of performance data that would be required from all providers and insurers.
In the exam room, EHRs help your provider do mundane tasks more quickly, like order labs, write online prescriptions to your pharmacy, or double-check if you are up-to-date on immunizations. Some EHRs even suggest a diagnosis for certain symptoms and recommend a treatment.
Experts concur that the best way to reduce the cost of care is not to need it—by preventing a disease from developing in the ﬁrst place, or intervening as early as possible when one develops.
Thus Obamacare requires insurers to provide preventive screening services, such as mammograms, colonoscopies, pap smears, and immunizations, for free or at low cost. These screenings are based on clinical evidence evaluated by the U.S. Preventative Services Task Force.
You might also get screened for depression and substance abuse because about one out of four visits to a primary care ofﬁce have a mental health component. Obamacare recognizes mental health as a bona ﬁde healthcare issue.
Prevention efforts extend to community health programs promoting smoking cessation, weight reduction, better eating, exercise, stress reduction, childhood immunizations, and fall prevention in the elderly. Obamacare also aims to improve what are known as the social determinants of health—non clinical factors that can make it impossible to live a healthy life.
Obamacare rewards your healthcare network for keeping you well, as opposed to just treating you when you’re sick. One way is through Pay for Performance (called P4P in healthcarecircles). Another is through Accountable Care Organizations, a model to de-fragment care delivery through collaboration between primary care providers, specialists, and hospitals. (These integrated approaches did not originate with Obamacare, but have been tried and tested in health maintenance/managed care organizations since the 1970’s to the present. Think Kaiser Permanente.)
Quality of Care
Experts agree that high quality primary care reduces the need for costly emergency room visits and hospital admissions, therefore Obamacare includes ﬁnancial incentives and punishments for quality of care.
Obamacare has been the subject of protests since it was proposed and then adopted in 2010. Protests, though, have been less vigorous than current ones against the various proposed versions of Trumpcare, which would result in increased premiums and millions of Americans without insurance.
If you have a chronic disease, your provider is following evidence-based clinical guidelines like these from the American Academy for Family Physicians. These guidelines are based on extensive research into what treatments have proven to be most effective. Adherence to clinical guidelines, documented in the EHR, gives you the best odds to get better or stabilize the disease.
You might be surveyed to obtain your feedback on your experience with your provider as patient satisfaction is factored into the ﬁnal score your provider/plan receives, and the amount of their reimbursement.
Obamacare has already improved the health of millions of Americans and their communities, despite unrelenting efforts to sabotage it.
Obamacare has targeted preventative and quality of care.
Whatever happens to the ACA in today’s cynical, ignorant and corrupt political environment, Vice-President Biden spoke the truth when he whispered these words into Obama’s ear (and a live microphone) the day the ACA was signed into law: “This is a big fucking deal!”
It still is a big deal, a very big one. This is the last audacious hope we have to make the profit-driven U.S. healthcare system work for all of us.
P.S. If you want to delve deeper into healthcare, read these. All are written by medical doctors in accessible language. (If you have limited time or interest, get the ﬁrst one.)
Pop quiz: Who is the biggest loser – the present occupier of the White who issues the mindless, mean-spirited tweets, or the audience – media and the public alike – who are suckered into reading and discussing them ad nauseum?
My vote would go to the people – us and the media – as the biggest losers. Donald is trolling us and we fall into his web, needlessly, just about every day.
Mika, Joe, Chelsea, and Hillary have all been attacked by tRump recently. That nastiness, while hateful and spiteful, has no meaningful or valuable place in the national dialogue. These are all tough public figures who can look out for themselves. It just can’t matter how Mika and Joe respond or that Chelsea or her mom may have scored a zinger of a reply back to the Tweeter in Chief.
Don’t forget to take the short pop quiz at the end of this article.
Trump and his Twitterfingers have replaced baseball as the national addiction: we wake up to news agencies – TV and press – talking about the latest back-alley issuance as being worthy of dissemination and discussion. We get suckered into following the back-and-forth as if there must be some greater meaning.
We are being played, badly, by a careless and uncaring person who substitutes pointless and nasty attacks for meaningful commentary.
There are ways to deal with this:
The media can all refrain from disseminating attack trash from the White House. They can, of course, cover legitimate political issuances, should there happen to be any.
We, the people, can urge media to begin acting like responsible news organizations rather than unwitting puppets.
As individuals, we can just ignore the silliness – following it, repeating it, or offering it any credence whatsoever.
One way to deal with this is to create a Bull-O-Meter Rating System. If a particular tweet is 25 percent, or less, pure Bull, and has national relevance, sure, go ahead and disseminate it. Contrariwise, if the tweet exceeds that amount of pure Bull, don’t do the Tweeter-in-Chief’s nasty business for him – don’t promulgate hate-filled, pointless speech.
Twitter is Trump’s direct link to Americans to attack people, distribute lies
The results of an ABC/Washington Post poll released July 17 showed 67 percent of Americans disapprove of Donald Trump’s tweet. The poll also found that 68 percent said the tweets were inappropriate; 65 percent said they were insulting, and 52 percent said his tweets were dangerous. Read the USA Today article about the poll.
More than any other president, CEO or movie star, Trump has learned to use Twitter to his personal advantage, often with disregard for truth and dignity.
According to TwitterCounter.com, he averages eight tweets a day. As of July 13, @realDonaldTrump had 33,697,688 followers, ranking his account 31 for number of followers among all Twitter users. He has sent out 35,277 tweets since joining Twitter in 2009.
An extraordinarily high number of his tweets contain personal attacks on anyone who speaks critically of his politics, business tactics or morals. He also relies on Twitter to distribute lies and fake news: the size of the inaugural crowd, voter fraud was in the millions, to name just two examples. Here’s a look at his recent tweets.