What Language Might Heal Our Family Feud?

By Bear Gebhardt

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?

Bear Gebhardt is a writer who lives in Fort Collins, Colo. Learn more about him…

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 language is 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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The Obamacare Nobody Knows – Part 2

By David Adamson

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.

David Adamson worked in high technology and health care. He’s the author of Walking the High Tech High Wire and The Wellness Club. He’s written hundreds of blogs on politics and fitness. Learn more about David…

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.

But another main function is to generate data to verify you are receiving high-quality care. This data shows up in various places such as the Healthcare Effectiveness and Data Information Set (HEDIS).

Prevention

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 healthcare circles). 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.

Your provider’s organization might be a National Center for Quality Assurance (NCQA) Patient-Centered Medical Home , which has very stringent performance requirements, and uses a team approach to your primary care, as well as coordinates your care with specialists and hospitals.

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.)

 

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Pop quiz: The Twitter-in-Chief’s tweets – Nasty or Meaningful?

By John Gascoyne

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?

John Gascoyne is a writer and lawyer living in Fort Collins, Colo. Learn more about him…

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.

There isn’t.

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.

 

Read a previous Writers With No Borders article about Trump’s tweets: Why Trump’s bait-and-switch tweets confuse Americans by Gary Kimsey.

 

Take the following pop quiz, please. We will report the results in the right narrow column of the next article posted by Writers With No Borders. 

The Obamacare Nobody Knows – Part 1

By David Adamson

(This is the first of a series.)

I was a foot soldier in the crusade to pass Obamacare.

David Adamson worked in high technology and health care. He’s the author of Walking the High Tech High Wire and The Wellness Club. He’s written hundreds of blogs on politics and fitness. Learn more about David…

Initially, it wasn’t by choice. I was the executive of a federally qualified community health center (FQHC) with outpatient clinics in rural mountain towns in Colorado. FQHCs, the linchpin of the national healthcare safety net, would play a frontline role in its implementation. Part of my job was to learn what was going to happen, when, and why.

I read books and articles, attended conferences and workshops, joined conference calls, and talked to high and low government officials. Most importantly, I read all 906 pages of House Resolution 3590, the Patient Protection and Affordable Care Act (ACA), which became known as Obamacare. Hidden within the legalese was the thinking of our best clinical and health economics and finance experts translated into policy.

Among the healthcare communities with whom I worked, word got out that I knew a little about the ACA, so I was invited to summarize it to county commissions, hospital boards, and public health departments who didn’t yet. I’d show graphs like this:

 

Then I would explain that our healthcare system had become a financial black hole, sucking in every free dollar, and closing in on 18% of GDP (it’s now 20%). Insurance premiums and deductibles were soaring out of control, as they had pre-Obamacare (and still are — in 2016 it was $25,826 for a family of four). They were squeezing out wage increases and other purchases, like vacations and college. Private sector American companies complained the cost of employee health insurance was making them uncompetitive in global markets. And uncompensated care delivered to the uninsured flooding emergency rooms was hurting hospitals. I’d finally present how the ACA would change this.

My time in the ACA crusade was an eye-opening adventure. Had I been more astute, I would have seen the anti-Obama, ultra-conservative onslaught coming that now plagues our body politic, starting with this troubling scene at a pro-Obamacare rally in Grand Junction, Colo., on Aug. 1, 2009.

Troubling scene: Protest at a pro-Obamacare rally in 2009 in Grand Junction, Colo. Photo by David Adamson.

Or two years later when I was requesting the support of a Republican county commissioner who dressed like a Wild Bill Hickok, right down to boots, duster, shoulder-length hair and handlebar mustache. We were planning a new clinic, to be partly supported by federal funds, in a town that was overrun by uninsured natural gas fracking workers with their attendant health problems, e.g., respiratory ailments, VD, alcoholism, and meth. He took me in his computer to show the National Debt Clock (it’s really cool), and, with sincerity, said that as a patriotic American concerned about our future, he would not support any project using federal funds because that would increase the debt. He added warmly that he supported what we were going to do (and did).

These days when Republicans threaten to repeal Obamacare, it’s obvious that they don’t know what Obamacare actually is. They didn’t when it was passed in 2010, and they don’t now.

Same protest at a pro-Obamacare rally in 2009 in Grand Junction, Colo. Photo by David Adamson.

President Obama could have enjoyed a long tenure in the White House without ever getting tangled with healthcare. As the hapless Republicans are about to discover, healthcare is dangerous for politicians. Corporate healthcare is not heavily populated with leaders whose values are inspired by Mother Teresa. If you threaten their profits, they will try to stop you. Obamacare has been profitable! (Remember insurers sponsored the ads that first branded Hillary Clinton as a cold-blooded, elitist bureaucrat when she tried to help Bill reform healthcare in the early 1990s, and the poisonous label stuck with her right up to her defeat in 2016.)

However, President Obama, a faithful Christian, believed that all people should have access to healthcare. Suffering, disability, and death may be part of the human condition, but access to modern medicine can often eliminate, reduce or postpone them. In his view, it was flat-out immoral that almost 50 million Americans were blocked from it. The Bible commands believers to heal the sick.

Also, one of the most visionary presidents ever, President Obama realized that the healthcare system itself poses a long-term threat to the US economy. He needed to act. It would be dicey; he would be like the kid in the boat with a hungry tiger in “The Life of Pi,” only he would have to finesse multiple tigers — insurance, pharmaceuticals, hospitals, nursing homes, provider associations, equipment suppliers, laboratories.

This already dangerous task was made worse by the ignorance, hostility, and, let’s be honest, racism of Republicans in Congress.

On Feb. 25, 2010, I stayed home from work with a wicked head cold and happened to flip on C-Span, which was live broadcasting the Health Care Summit, hosted by the President, for the leaders of both parties to exchange views about the bill.

Aware he was on national television, Eric Cantor, then Minority Whip, walked into the room with a hang-dog look on his face, carrying a foot-high stack of loose paper that he plopped down on a table with a dramatic sigh.

President Obama patiently watched this, then observed, “The truth of the matter is—is that health care’s very complicated. And we can try to pretend that it’s not, but it is.” At every opportunity, Republicans had been exaggerating the gross volume of the healthcare bill to frighten the public that it was packed with god-awful provisions such as death panels and socialized medicine. (Read the transcript here. President Obama knew his stuff.).

Senate Minority (now Majority) Leader Mitch McConnell, then and now the personification of active aggression towards President Obama, was in the room that day, sulking like always. But to his credit, he was listening because just last week, after releasing the Republican’s 147 page tax cut for the rich posing as a healthcare plan, he conceded that healthcare is “a big complicated subject.” Republicans have no plan of their own to improve healthcare.

Many of us, me included, would have preferred a single payer system like those in the rest of the industrialized world. However, President Obama was a pragmatist. He inherited an economy in the worst recession since the Great Depression. Support was shaky because of turncoat, deficit hawk Blue Dog Democrats. A single payer system was not a politically realistic option.

Facing reality, President Obama smartly neutralized the fears of the healthcare establishment, especially the insurance companies, by ensuring they would not lose money. He combined taxes on the rich, as well as several more obscure ones, and deficit spending to create access quickly. As a result, Obamacare has provided healthcare access to over 20 million Americans. That’s an amazing achievement.

Today no contorted Republican free market math can accomplish the same for less. Under any imaginable scenario, no matter how you fund access for the poor and people with pre-existing conditions, it will never be profitable and will have to be subsidized forever.

Obamacare was never just an insurance program. That’s why it was 906 pages long. It is the framework for a long-term transformation of our healthcare system to make it better and less costly.

It has already irreversibly changed the delivery of health care. You can see it when you go to your primary care doctor or into the hospital, if you know what to look for. In the long run, all of us, including Republicans, will be healthier because of it.

Civil Disobedience – a Primer of Sorts

By John Gascoyne

Let’s start with a definitional reality check: Civil Disobedience (CD) is an intentional, non-violent criminal act, committed in support of a perceived worthy public need or ambition. Inherent in an act of CD is that it will be done in public and that the actor makes no effort to conceal her/his involvement.

John Gascoyne is a writer and lawyer living in Fort Collins, Colo. Learn more about him…

If you engage in civil disobedience and are arrested, be aware of some of the consequences to you and to those close to you:

  • Your freedom of movement will be immediately curtailed for an unknown, but usually fairly short, period of time – e.g. overnight or over the weekend. Yes, it could be for a longer time. This time frame contemplates your being able to make bail; it does not consider a possible jail sentence following a trial.
  • Your access to other people, to work, to school, etc. will be severely or completely limited for an indefinite period if you are serving time as a result of your involvement
  • If convicted for your action(s), you will carry some kind of criminal record – one that may very well stay with you. Consider having older activists perform the civil disobedience with younger folks being part of the support group – and thereby avoiding the stigma of a career-endangering rap sheet.

On the other hand:

  • Historically, acts of civil disobedience generally have been regarded as both noble and effective. Henry David Thoreau coined the term in 1849 and his writings influenced the thinking and actions of Mahatma Gandhi, Martin Luther King and thousands of other heroes. Thoreau said, “Let your life be a counter friction to the machine.”
  • If someone is convinced that the stakes are great enough, and that other redress isn’t going to work, civil disobedience can be a meaningful personal response.

Some do’s and don’ts if you plan to engage in CD:

  • Carry yourself and your objectives with dignity and reserve.
  • If arrest is imminent, you can submit to law enforcement peacefully. If you choose to not do so – e.g. by going limp – you may face additional charges such as resisting arrest. Try to chart your own course ahead of time. There is never good reason for you to physically engage with or be aggressive toward authorities.
  • Don’t insult or demean arresting authorities. On the other hand, the deputy sheriff or police officer is not your friend – during arrest, transportation, or incarceration. No digas nada – don’t offer anything beyond your name and address.
  • Historically, some political and social movements have been infiltrated by government agents. Be wary of the stranger who wants to run the show or who is encouraging excessive actions.
  • Don’t assume that the friendly stranger in your cell can be confided in. Jailhouse snitches earn points by ratting on you.
  • Plan ahead – let one or two non-participating friends know your intentions. Carry their contact information with you. Consider giving them access to your rainy day bail money.
  • If necessary, carry prescribed medications with you. You will be searched after arrest, so don’t carry anything that will embarrass you in front of Officer Friendly.
  • If you have attorneys who will likely represent you, keep their card with you if possible. Memorize their phone number or write it on your arm or leg. Be aware that advising your attorneys in advance of the particulars of an act of civil disobedience will put them in an awkward position as they cannot condone a criminal action of which they have prior knowledge.
  • If you do have an attorney, or intend to have one, the first thing you should say to the police is, “I want to contact to my lawyer.”
  • The Public Defenders are extremely busy and tend to handle mostly serious offenses. It may be difficult for them to engage on your behalf.
  • Try to record everything about the action, about your arrest, and about your post-arrest experience. If possible, keep a pen and paper with you after the initial search.
  • Have non-participating confederates witnessing from a secure position and recording the action on cell phones and video cameras. These witnesses should avoid impeding arresting officers; on the other hand, they cannot legally be ordered to stop recording. Not every authority will respect the law in this regard; you may have to verbally stand your ground.
  • Develop rapport with local and national media personnel. Advise them of when and where they should be on hand.
  • Some CD actions can result in the use of tear gas or other irritants. Your handkerchief, soaked in water and tied behind your head, can offer some protection for your breathing.

One organization’s How-To Guide and Suggestions

In order to move from the abstract to the real, the following commentary depicts one successful group’s operating procedures:

Direct Action means the overall effort to achieve an important social or political objective at a particular location. We employ circles of Direct Action and Civil Disobedience – Green, Yellow and Red-zoned participation levels. These are designed as concentric levels of support at levels which participants feel they can comfortably contribute to the issues and actions.

Naturally, all factors must be discussed and thoroughly evaluated before an action is taken. Every part of every element for every person and action must be analyzed and projected in order to assure the advancement of the social objective. In The Art of War, Sun Tzu states: “Those who can see the outcome before they start will always win the battle.

Red: Imminent arrest. A situation where a known law(s) will be broken and where the participant faces almost assured arrest. The participant is well aware of the laws that may be broken at this time, the subsequent consequences, and their effect on the direct action as a whole. If arrest is not going to escalate, i.e. serve the purposes of the direct action issue, then arrest is generally avoided where possible.

Yellow: This is an immediate outer circle layer of support of the “arrestables”. The word “support” has many meanings, some of which can include, but not be limited to film, photography, equipment, and safety in support of the person in the red zone. Yellow participants assume a certain level of risk of arrest, but generally do not participate directly at the same level of involvement in the direct action as someone in the Red Zone.

Green: The green zone is generally the safest of all and arrest is unlikely. This zone generally provides legal observation, scouting, communications with a legal team, media agencies, social networks and other resources.

Have legal support

One of the most critical aspects of what we have done nationally or internationally has been to always have legal support. If someone is going into the red zone, they use a permanent marker and write, on the inside of the thigh or arm, the phone number of their personal legal counsel and any other phone numbers necessary to their release from custody. No phone numbers should give away extra information regarding the group or their tactics.

Volunteer legal observers – lay persons – are always on site and document every movement of persons in the red zone, any interactions with authorities, etc. These documents can be utilized in court actions to defend an arrested person. This is also true of any video or audio content that might be captured from the location and the direct action.

If a person who is engaging in civil disobedience “goes limp” when given lawful orders by police authorities, they may have to deal with an added charge of resisting arrest.

Location “lock downs” are usually considered among the most effective tactics. For example, where someone’s arms are handcuffed inside of a large iron pipe, it can take a great deal of time to arrest them, thus providing lots of time for media coverage – one of the main goals of civil disobedience.

Lastly, protection of all parties is paramount. The safety of participants, law enforcement agents, and observers must be maintained.

Welcome to World War III, My Friend

By Gary Kimsey 

Part I of a series for Writers With No Borders

I’m not a philosopher, a scientist, politician, or deep thinker. I’m a guy from middle America who likes beer, pretzels, Sunday football, and naps.

On one specific topic, I’m a fellow who has plenty in common with the observation Butch Cassidy made when he announced to the Sundance Kid: “Boy, I got vision, and the rest of the world wears bifocals.”

Gary Kimsey is a writer and editor who lives part of the year in his hometown of Independence, Mo., and the rest of the time in his family’s ancestral home along the Poudre River in the northern Colorado Rockies. Learn more about him...

My vision: We’re in World War III and most Americans don’t know or care. The few average Americans aware of the global conflict don’t know what to do. This isn’t a war where we enlist, donate blood, or manufacture tanks, cannons and ships.

This war is being fought with computers instead of guns. Combatants rely on the sophisticated technology of bytes, bots, worms, Trojans, malware, viruses, and 010101s, the coding upon which computer language is based. Most Americans don’t even begin to understand the crucial inner workings of such technology.

During the last few years, the Internet has been crammed with news articles and opinion columns focusing on “when” or “if” World War III ever comes about. The general consensus: the war will be cyber attacks on such infrastructures as power grids, banking and financial systems, communication networks, voting systems, airlines—you know, the stuff of the culture and lifestyles in America and the countries of our allies.

While issuing such predictions, almost every expert qualifies statements by couching their thoughts in the future tense, as if they believe a cyber war may or may not happen in the future. Bifocals they wear; the war is here.

We have yet to witness a cyber Pearl Harbor or a cyber event with the magnitude of the assassination of an archduke that set off World War I. This is a war we’ve slipped into mostly unnoticed by Americans. We continue on with our lives in a state of denial or the bliss of ignorance, save for the inconvenience of having to change passwords now and then.

Some leaders are playing politics at a critical time when wisdom and action are needed much more. The most recent example occurred June 13 when Attorney General Jeff Sessions told the Senate Select Committee on Intelligence about the extent of his knowledge of Russia’s intrusion into the 2016 presidential election: “I know nothing but what I’ve read in the paper.”

Does anyone really believe that ignorance constitutes a valid excuse from our nation’s top prosecutor? My opinion: Sessions pirouetted away from the issue because his boss is under investigation in the matter of Russian cyber warfare. Even Sessions himself is under suspicion.

Cyber attacks come almost daily: hacks that steal millions of IDs and supposedly protected information from banks, credit card companies, Yahoo, political parties, hospitals, and even the CIA and Department of Justice. The list is long, detailed and depressing.

The newest revelation came June 13 with the news that Russia’s incursion into the 2016 election was more widespread than previously believed. The attack targeted voter data bases in 39 states, twice as many and more viciously waged than initially identified. The attack upon Illinois, for instance, attempted to delete or alter voter data. These were attacks on the basic core of democracy, on our way of life. Not a single gunshot was fired or bomb exploded.

The cyber weapons reflect the evolution of warfare. World War I had its new technology: tanks and airplanes. World War II: jet propulsion; self-propelled missiles and nuclear bombs. The weapon now is intellect, the ability to arrange a mass of electrons so they go forth in an almost magical way to cause havoc and destruction.

Today’s combatants aren’t the 400-pound guys sitting on their beds, as Donald Trump proclaimed in trying to lay blame for the 2016 hack of the Democratic Party’s computer records. Rather, the combatants are Russia, North Korea, England, France, Iran, China, the Baltic countries, and other nations, including the U.S.

We must not forget ISIS. We frequently see TV news footage of bloodied ISIS battlegrounds. Yet, seldom do we hear that ISIS has a covert “hacking wing” which has the potential to be more dangerous than any other cyber warriors.

The basic purpose of World War III’s technology: espionage and sabotage. They—whoever they are—are trying to take us down. We—our computer geeks—are trying to stop and take them down. Sound familiar? Opponent against opponent. Warrior against warrior. It’s a war scenario.

At the risk of sounding like a hopeless doomsayer, I think what we witness now is tame compared to what we’ll see in the future. The current flexing of cyber warfare muscles is merely a toning and strengthening—like young athletes training for the Olympics. The gold medal represents a discernable shift in the order of the world.

Next in this series: Ted Koppel and the darkness.

Congress Forgets: Healthcare Impacts Real People, Real Lives

By Alan Vitello

My wife, Ann, is a pediatric physician assistant at a publicly funded community health center in Aurora, Colo.

She sees roughly 400 patients per month. That’s usually 20 to 25 patients a day. (Yes, you read that right.)

Alan Vitello is a writer and an award-winning cartoonist who lives in Colorado. Learn more about Alan…

Twenty to 25 children, poor children, immigrant children, refugee children, children with serious physical, psychological and emotional problems, foster children, homeless children, children from two-parent homes, children from single-parent homes, children who have been sexually abused, children who have been physically and mentally abused, children with fetal alcohol syndrome, autistic children, children whose mom or dad or mom and dad work three fast food jobs (each) to make ends meet, children who’ve gotten pregnant and don’t know why or how, children with sexually transmitted infections, newborns, toddlers, little boys, little girls, tweeners and teens, some children struggling with issues of gender and sexuality, sick kids, injured kids, children in for a well-baby visit and children in for a sports physical, children who speak English, children who speak only Spanish, children from Africa, and the Middle East, and Eastern Europe, and children from the good ol’ US of A…and on and on.

All day. Every day.

Think you could hack it? I’m pretty sure I couldn’t.

…and that’s to say nothing of the 12-hour days, and the up-late every night, sitting with the laptop, finishing patient charts, just to go to bed at midnight, to get up to do it again, tomorrow.

Like I said, think you could hack it? I’d like to see you try.

And guess what? She’s not alone. She has five very dedicated co-workers: pediatricians, fellow PAs, nurse practitioners who do the exact same thing, every day.

And that’s only the pediatric side of the house. The other side of the clinic sees adults.

The providers who see adults don’t see as many patients per month as the pediatric side does, but the problems they see can be exponentially more complex.

Complex because of age. Complex because of cultural issues. Because of language issues. Because of lack of insurance or lack of money. Complex because the patient is a refugee who has been in the United States a week and doesn’t know anything, like how to fill out a form in English or how to ride a bus to reach the clinic. Complex because poor people—because they may not have any insurance, or enough insurance, or because they may not have enough money—wait until a health problem becomes a health crisis before seeking help at the clinic. Complex because of domestic violence or substance abuse. Complex because of homelessness or transience. Complex because of joblessness. Complex because life is more complex when you are on the bottom rung of the socio-economic ladder.

And this is only at Ann’s clinic.

The organization she works for runs or provides staff members to 20 clinics—from pediatrics and mental health to school-based clinics and family practice—all over the Denver metropolitan area. Twenty clinics providing basic healthcare to tens of thousands of people, every day, every week, every month, every year, year and year out.

That’s 126,700 individual patient medical visits in 2015 alone (to say nothing of mental health visits or pharmacy, wellness, substance abuse, or dental or school-based visits).

That’s 126,700 human beings depending on 535 people in Washington, D.C.—members of the U.S. Congress—to make a wise decision on health care that will have a profound and far-reaching impact on human lives, and the lives of their spouses and children and parents and…

My wife sees the REAL WORLD on her doorstep every, single day. Every day.

For Ann, and her incredibly dedicated and hard-working co-workers, “Healthcare” is not some wonky, abstract idea that people like Rep. Paul Ryan, speaker of the House, and Sen. Mitch McConnell, majority leader of the Senate, bat around to score political points.

It’s not about “winning.”

It’s not about “getting something done in the first 100 days,” just to say you did.

Nor about getting revenge on Barack Obama and his Democrat cohorts. Or about sticking it to Obama’s legacy.

It’s REAL. It’s living, breathing human beings. Real children. Real parents. Real circumstances. Real world. Reality.

When we stop talking about the “real” in healthcare we lose the thread. We lose the key that must drive the conversation.

Real people. That’s where it starts and stops.

Americans must demand members of congress answer these questions:

  • Which one, or ones, of Ann’s patients are you going to tell they can no longer afford care, or because of cuts to Medicaid, will have no prospect for care, at all?
  • Which ones are you going to decide are worthy enough, or lucky enough, to have the chance at life; their life, their real life?
  • Which ones would you tell that their chances have run out, because for you, “winning” is more important than “caring?”

With a straight face, I’d like to see members of congress tell them that “party” beats “compassion,” and “politics,” well, sorry, but that’s simply more important than common sense and common decency.
I mean really tell ’em, face-to-face. In person.

But, unfortunately, it’s likely not to happen until we make it happen. As we’ve seen in the last few weeks, many of our elected officials are avoiding meetings with concerned citizens; some have even ducked out of back doors when a town hall event got too tough with questions and comments.

Many of our elected officials have forgotten they have the power to impact real people’s real lives. Everyday in Ann’s exam rooms, and the dozens of other exam rooms, all over Denver, all over Colorado, all over the United States. Millions of real lives that don’t care about scoring political points.

Something to nosh on. Then contact your U.S. representative or senator to provide them your thoughts.