CHANGE Illinois is a nonpartisan, nonprofit leading systemic government and election reforms. CHANGE (the Coalition for Honest and New Government Ethics) champions ethical and efficient government and democracy and includes a diverse group of civic, philanthropic, business, labor, professional, and nonprofit organizations representing millions of Illinoisans. CHANGE Illinois works in collaboration with like-minded reform organizations, playing a leadership role in convening and facilitating efforts around shared policy agendas. The coalition works to improve challenges that undermine our democracy, including gerrymandering, restricted ballot access, voter suppression, uncompetitive elections, corruption, lack of government transparency and unethical lobbying, all of which have led to disillusionment and a decrease in civic participation.
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Andrew Heaton
'Election Countdown,' with guest Andrew Heaton
Oct 21, 2024
After a 14-year career as an Emmy-winning reporter, Scott Klug upset a 32-year Democratic members of Congress from Wisconsin. Despite winning his four elections by an average of 63 percent. he stayed true to his term limit pledge and retired.
During his time in Congress, Klug had the third most independent voting record of any Wisconsin lawmaker in the last 50 years. In September 2023, he launched a podcast, “Lost in the Middle,” to shine a spotlight on the oft ignored political center.
The Fulcrum has covered several of Klug’s podcasts about America’s “political orphans,” highlighting what he describes as 71 million bewildered, frustrated voters.
“The podcast was born,” Klug told Madison Magazine, “out of the sentiment that a wide swath of the American public, myself included, can’t figure out how in the hell we got to this place. And more importantly, is there a way for us out of it.”
And now with the election only a few weeks away, Klug and The Fulcrum present a series of podcasts titled “Election Countdown.”
Today we offer the first episode as political podcaster and comedian Andrew Heaton files his observations from a phone booth in Edinburgh. He’s the host of “The Orphanage” podcast, where some of Klug’s political orphans happily live.
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The mission of “Lost in the Middle” is serious — finding a way to something resembling common ground as a country — but it’s not solemn.
“I’m having fun,” Klug said. “I spent 14 years on TV. It’s telling stories. Getting out there and talking to people. Aside from my personal commitment to the issue, it’s just a lot of fun. I enjoy listening to people and telling stories.”
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Retired generals who served in the Trump administration, like John Kelly, need to speak out about the threat Donald Trump poses to American democracy.
Cheriss May/NurPhoto via Getty Images
By using military against ‘enemy within,’ Trump would end democracy
Oct 18, 2024
Sarat is the William Nelson Cromwell professor of jurisprudence and political science at Amherst College.
As the 2024 presidential election enters its final phase, Donald Trump has gone full bore in following the frightening playbook of wannabe dictators. He also plans to dust off old laws that will allow him to carry out his anti-immigrant crusade and use the American military against people he calls the “enemy within.”
At a rally in Aurora, Colo., on Oct. 11, the former president promised to be America’s protector. He said that “upon taking office we will have an Operation Aurora at the federal level” and undertake a mass removal of illegal immigrants.
Even as he has ramped up his chilling threats, his poll numbers have been rising. Parts of his message seem to be resonating with voters.
To take one example, polls now show that “More than half of all Americans, including a quarter of Democrats, support the mass deportation of immigrants who are living in the country illegally.” Public support for such a draconian policy has increased by 11 percent since 2021.
Last May, Trump made clear that he would “have no problem using the military, per se,” to deport millions of people. He now openly acknowledges that mass deportations would be “a bloody story.”
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The former president contends that laws meant to prevent the use of the military against civilians inside the United States would not be applicable if he ordered the military to round up migrants. “These aren’t civilians,” Trump argues. “These are people that aren’t legally in our country. This is an invasion of our country.”
With three weeks left in the presidential campaign, and as Trump reiterates his plan to use the military against civilians and his political opponents, retired generals who served in the Trump administration need to step out of the shadows. People like James Mattis (Trump’s first secretary of defense), John Kelly (who served as chief of staff) and Mark Milley (chairman of the Joint Chiefs of Staff) must come forward and remind voters about what they have said about the threat Trump poses to American democracy and the freedom that Americans now enjoy.
In the meantime, what Trump said in Aurora cannot be dismissed as an off-the-cuff remark. Reading from his teleprompter, Trump promised that as soon as he got back to the Oval Office he would invoke “the Alien Enemies Act of 1798 … to target every migrant criminal network operating on American soil” and expedite their removal.
The way that act has been used in the past is a stain on our history.
As the Brennan Center for Justice observes, “The Alien Enemies Act of 1798 is a wartime authority that allows the president to detain or deport the natives and citizens of an enemy nation.” The act refers specifically to “invasions,” which may explain why Trump regularly refers to the influx of illegal immigrants into this country in those terms.
The law “permits the president to target these immigrants without a hearing and based only on their country of birth or citizenship … it can be — and has been — wielded against immigrants who have done nothing wrong, have evinced no signs of disloyalty, and are lawfully present in the United States.”
No wonder Trump can’t wait to get his hands on it.
If he does, he will follow in the footsteps of President Woodrow Wilson, who invoked it during World War I to target people from Germany living in the United States. The act also provided the legal basis for the infamous internment of Japanese Americans during World War II.
Wilson continued to use the act after the war ended, a precedent followed by President Harry Truman, who relied on it for authority to continue the internment and deportations started under Franklin Delano Roosevelt. The Supreme Court upheld the Truman administration’s extended reliance on the Alien Enemies Act.
Can anyone imagine that the court’s current MAGA majority would do anything different?
Trump’s speech at Aurora didn’t stop with his remarks about the Alien Enemies Act. He went on to offer some thoughts about the role of the military if he is reelected.
“We have,” Trump told a cheering audience, “the greatest military in the world, but you have to know how to use them. It’s the enemy from within. All the scum that we have to deal with that hate our country. That’s a bigger enemy than China and Russia!”
On Sunday, he reprised the “enemy from within” line in a Fox News interview.
In response to a question about whether he was worried about violence on Election Day, the former president quickly pivoted to his usual anti-immigrant riff. “I think,” Trump insisted, “the bigger problem is the enemy from within, not even the people that have come in and destroying our country and by the way, totally destroying our country. … I think the bigger problem are the people from within.”
Leaving nothing to the imagination Trump went on to say, “We have some very bad people. We have some sick people, radical left lunatics. It should be very easily handled by, if necessary, by National Guard or, if really necessary, by the military.”
Though he did not say it to Fox, the former president plans, as the Brennan Center reports, “to invoke the Insurrection Act, which allows the president to use the military as a domestic police force, on his first day in office.“ Like the Alien Enemies Act, the Insurrection Act has a long history.
It was first enacted in 1792 and does not define what counts as “insurrection” and “rebellion.” The Insurrection Act was kept on the books a century later when Congress prohibited “the president from using federal troops to enforce civilian law under most circumstances.”
Stirring up fear of internal enemies and radical leftists also has a long history. That history offers a troubling warning about Trump’s musings about what he will do to people he considers “very bad.”
That prospect underlines the urgency of the present moment. If Trump wins on Nov. 5, we would be left with freedom for those who do not offend the powerful, and repression — enforced by the military — for everyone else.
Is that the future that people who spent their lives wearing the uniform of our country want for themselves or the branches of the armed forces that they led? If it is not, then Mattis, Kelly and Milley need to speak out loudly and repeatedly.
Recall that in 2020, Mattis denounced Trump’s plan to use the military against protesters after the murder of George Floyd. He warned that doing so would “erode … the moral ground that ensures a trusted bond between men and women in uniform and the society they are sworn to protect, and of which they themselves are a part.”
He said that Trump’s behavior in office made a “mockery of our Constitution.”
In 2023, Kelly went on the record to describe the former president as “A person that has no idea what America stands for and has no idea what America is all about. … A person who admires autocrats and murderous dictators. A person that has nothing but contempt for our democratic institutions, our Constitution and the rule of law.”
And just this year, Milley apparently told The Washington Post’s Bob Woodward that Trump is a “fascist to the core” and “the most dangerous person to this country.”
Those retired military leaders, all of whom have served their country so well, can do so again by going on television and using social media every day to remind moderates and undecided voters of their warnings about Trump. There is no time to waste.
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Spectators look at Tesla's Core Technology Optimus humanoid robot at a conference in Shanghai, China, in September.
CFOTO/Future Publishing via Getty Images
Rainy day fund would help people who lose their jobs thanks to AI
Oct 18, 2024
Frazier is an assistant professor at the Crump College of Law at St. Thomas University and a Tarbell fellow.
Artificial intelligence will eliminate jobs.
Companies may not need as many workers as AI increases productivity. Others may simply be swapped out for automated systems. Call it what you want — displacement, replacement or elimination — but the outcome is the same: stagnant, struggling communities. The open question is whether we will learn from mistakes. Will we proactively take steps to support the communities most likely to bear the cost of “innovation.”
We’ve seen what happens when communities experience sustained loss of meaningful work. Globalization caused more than 70,000 factories to close and 5 million manufacturing workers to look for new jobs. Those forced to find work elsewhere rarely found a good substitute. The remaining jobs usually paid less, provided fewer benefits and afforded less security in comparison to a union job at a factory, for example.
Economists assumed that those workers would eventually move to more lucrative pastures and find the areas with more economic vibrancy. Workers stayed put. It’s hard to leave your pasture, when it’s the place you, your family and your community have long called home. This tendency to stay put, though, created a difficult reality. Suddenly, whole communities found their economic well-being on the decline. That’s a recipe for unrest.
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The same story played out in my home state, Oregon. New technology and policies rendered the timber industry a dying trade. Residents of towns like Mill City, a timber town through and through, didn’t jointly march to a new area but understandably stayed where their families had established deep roots.
It’s time to stop assuming that people will give up on their communities. Home is much more than just a job. So when AI eliminates jobs, what safeguards will be in place so that people can remain in their communities and find other ways to thrive?
I don’t have a full answer to that question, but there’s at least one safeguard that deserves consideration: a rainy day fund. We don’t know when, where and how rapidly AI will upend a community’s economic well-being. That’s why we need to create a support fund that can help folks who suddenly find themselves with no good options. This would mark an improvement on unemployment because it would be specifically targeted to assist those on the losing end of our AI gamble and should be available to both laborers and local governments.
The AI companies responsible for prioritizing their pursuit of artificial general intelligence — AI systems with human-level capabilities — over community stability should front the costs of that fund. Congress can and should tax the companies actively inducing a new wave of displacement.
The fund should be dispersed upon any sizable disruption to a specific industry or sector. Both cities and workers could apply for support to weather economic doldrums and find new ways to thrive. Such support helped us all get through Covid. A similar strategy might help mitigate the worst-case scenarios associated with AI.
The potential downsides of this fund are worth the certain benefits of more resilient communities. A tax or penalty on AI would hinder the ability of AI companies to develop and deploy AI as quickly as possible. The specific allocation of that revenue to a rainy day fund might also nudge companies to avoid creating models likely to disrupt various professions. That’s all fine by me. We have survived centuries without AI, there’s no need for the latest and greatest model to come as soon as possible, especially given the immense costs of that pace of innovation.
Now is the time for Congress to enact such a proposal. Following the election, we may find Congress to be even more gridlocked and fragmented than before. Elected officials should welcome the chance to tell their constituents about a policy to bolster their economic prospects.
The urgency to address the job displacement caused by AI cannot be overstated. By establishing a rainy day fund, taxing AI companies to support displaced workers and exploring additional policies to maintain community stability, we can mitigate the adverse effects of rapid technological advancement. Congress must prioritize the well-being of communities over the relentless pursuit of AI innovation. Doing so will not only knit a stronger social fabric but also ensure AI develops in line with the public interest.
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Akarapong Chairean/Getty Images
What's next for the consumer revolution in health care?
Oct 18, 2024
Pearl, the author of “ChatGPT, MD,” teaches at both the Stanford University School of Medicine and the Stanford Graduate School of Business. He is a former CEO of The Permanente Medical Group.
For years, patients have wondered why health care can’t be as seamless as other services in their lives. They can book flights or shop for groceries with a few clicks, yet they still need to take time off work and drive to the doctor’s office for routine care.
Two advances are now changing thisoutdated model and ushering in a new era of health care consumerism. With at-home diagnostics and generative artificial intelligence, patients are beginning to take charge of their health in wayspreviously unimaginable.
Patients can now bypass the doctor’s office and diagnose a range of medical conditions with home testing. Meanwhile,one in six Americans already use generative AI for medical advice. Together, these technologies are shifting health care away from the traditional, clinician-led model to one where empowered patients can make independent medical decisions.
But with this power comes responsibility. The shift to health care consumerism will require patients, doctors and government to assume new roles, ensuring people are protected and the medical profession remains sustainable into the future.
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From Lab To Living Room: The Rise Of Patient Empowerment
The early days of Covid-19 showcased a stark contrast between what patients and clinicians expect from health care.
While doctors and public health officials prioritized PCR testing — accurate but uncomfortable and slow —patients flocked to antigen tests that were easier, faster andnearly as reliable.
Today, the preference for at-home testing is more entrenched than ever. Americans already use FDA-approved home tests for a wide range of conditions, from diagnosing urinary tract infections to confirming pregnancy. Home tests forcervical cancer and syphilis are now available, making it clear that patients will continue favoring the privacy and convenience of at-home options over the discomfort of doctor visits.Dozens more tests are soon to follow.
Generative AI is also gaining traction as patients become more comfortable using the technology to make health care decisions and choose the best treatments. A recent study found thatchatbot responses to patient questions were rated four times higher in quality and nine times higher in empathy than those of doctors. As AI continues to improve — becoming32 times more powerful in the next five years — consumers will increasingly trust it as a source of medical expertise.
These advancements will require fundamental changes to health care. The question is: How should doctors, patients and government officials approach medical care going forward?
Doctors Bear New Burdens In Consumer-Driven Medicine
Whether clinicians embrace it or not, health care consumerism is here. Patients now rankconvenience in health care as more important thanquality and even cost. This means doctors will need to adapt or risk losing patients toretail clinics and telemedicine platforms.
To respond to these changes, doctors must see home testing and AI not as threats, but as valuable tools to build a more collaborative relationship with patients.
For example, when patients receive a positive result from an at-home test for syphilis or cervical cancer, they are likely to feel a sense of urgency — even if immediate intervention isn’t medically necessary. Doctors who reserve time for same-day or next-day appointments will help build trust, minimize treatment delays and reduce the risk of complications.
Similarly, as patients increasingly use generative AI, they will come to their doctors not just with symptoms but often with a presumed diagnosis or suggested treatment plan. Given AI’s growing ability tomatch human diagnostic accuracy, clinicians will need to approach these AI-generated insights with an open mind. Rather than dismissing them or restarting the diagnostic process from scratch, doctors should integrate this information into their decision-making. And, when clinically appropriate, offering a same-day telemedicine consultation will help address patient concerns quickly while strengthening the doctor-patient relationship.
To a busy doctor — unaccustomed to this level of service — these changes might seem overwhelming. But with AI having already provided the likely diagnosis, the time required for doctors to confirm and treat the issue will be much shorter, helping to reduce appointment backlogs and streamline care.
The Responsibility Of The ‘Consumer Patient’
With patient empowerment comes responsibility. Patients embracing health care consumerism must be prepared to take greater accountability for their health. Here are three key steps.
- Knowledge: Patients should educate themselves on which at-home diagnostic tests areavailable and appropriate for their symptoms or screening needs. Similarly, they should familiarize themselves with generative AI platforms and test them with past medical encounters to gauge their accuracy.
- Expertise: Patients should compare home testing options with traditional lab tests. How accurate are at-home tests? Areerrors likely to result in false positives or false negatives? Understanding these factors is essential to judging whether the convenience of at-home testing outweighs the risks.
- Planning: Don’t wait until a test result or AI diagnosis causes concern. Plan ahead. Who will you contact if a test raises red flags? Where will you go if AI suggests a serious issue? If you don’t have a personal physician, will you turn to telemedicine, urgent care or an online doctor?
A Shift In Government: From Regulator To Facilitator
Consumer-friendly health care tools allow patients to stay on top of preventive care, better manage chronic conditions and avoid unnecessary office visits. But for this shift to succeed, government agencies like the CDC and FDA must take on new roles, as well.
First, the government must support companies developing safe and secure consumer health tools, from at-home diagnostics to GenAI platforms. Second, it needs to ensure these tools are accessible to all Americans, regardless of their location or income. Finally, agencies must prioritize educating the public on how to use these technologiessafely and effectively.
When done in collaboration with doctors and supported by government efforts, these tools will make health care more efficient and effective. Just as Amazon revolutionized shopping with speed and convenience, home testing and GenAI will drive consumerism in medicine. The combination of engaged clinicians, empowered patients and advanced technology will be far more powerful than any of these alone.
The consumerism train has left the station. It’s time for doctors, patients and the government to get onboard.
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