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Leveraging big ideas
October 21, 2021
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Molineaux is president/CEO of the Bridge Alliance Education Fund, and Nevins is its co-founder and board chairman. They are co-publishers of The Fulcrum.
As Americans we are on a path to discard and diminish the concerns of our fellow citizens. This is a destruction of our democratic values as most people sit on the sidelines, picking whom we hate more.
As publishers of The Fulcrum we are dedicated to supporting the democracy ecosystem and the individuals and organizations striving to repair and reform our democracy so that it works more effectively in our everyday lives. A healthy democracy ecosystem allows all citizens and community members the opportunity to participate fully in society.
Unfortunately, today's toxic polarization has reached the highest levels of animosity since pre-Civil War. No longer are citizens just partisan for the candidate or the party that they support. Instead, a growing "negative partisanship" is driving our political process and poisoning our commitment to democratic values.
Not only do liberals and conservatives disagree, they actually hate each other and thus rather than supporting the positions of the party they like, they oppose positions of the other party no matter how reasonable their policies might be, merely because it comes from the party they dislike. We seem to hate each other more than we love our nation.
As a result, according to Emory University professor Alan Abramowitz and student Steven Webster, "the parties hang together mainly out of sheer hatred of the other team, rather than a shared sense of purpose." When negative partisanship dominates, a political coalition is united far more by animosity than policy. The policy priorities are malleable and flexible, so long as the politician rhetorically punches the right people.
Social scientist Lee Drutman and others postulate that "negative partisanship" has reached levels that are not just bad for democracy, but are potentially destructive. And extreme partisan animosity is a prelude to democratic collapse.
As Drutman points out, it hasn't always been this bad. "Forty years ago, when asked to rate how 'favorable and warm' their opinion of each party was, the average Democrat and Republican said they felt OK-ish about the opposite party. But for four decades now, partisans have increasingly turned against each other in an escalating cycle of dislike and distrust — views of the other party are currently at an all-time low."
The solution to this destructive mindset amongst politicians and citizens alike will not be easy. We must re-frame our thinking as a people. We must create a new narrative of cooperation, collaboration that is solutions focused. We must embrace the diversity that is America and find the best from the left, the right and the middle. We must decide to like each other and respect our common humanity. Maybe even acknowledge some reasonableness in each other's perspective. We must start loving our country and democratic values enough to stop hating our political opponents. The Rev. Martin Luther King Jr. spoke poignantly to the problem facing America in the 1960s that still resonates today:
"Darkness cannot drive out darkness; only light can do that. Hate cannot drive out hate; only love can do that."
And his decision about his response to hate:
"As my sufferings mounted I soon realized that there were two ways in which I could respond to my situation — either to react with bitterness or seek to transform the suffering into a creative force. I decided to follow the latter course."
To do so we must support and engage a new cohort of diverse community leaders (across ideological, racial/ethnicity, generational and gender lines) who embrace a crosspartisan problem-solving approach to governance.
We must come together as a constituency of millions demanding a new approach to governance from our leaders. How might we, the citizens of the United States, demand our elected officials do the work of governance instead of endless campaigning?
A "Crosspartisan Creed" that embodies principles based on finding commonalities that transcend the divides that separate us is already engaging hundreds of thousands of Americans. A democracy ecosystem of Democrats, Republicans and independents is growing and elevating the voice and capacity of diverse community leaders via strategic investments with community/regional foundations.
Within a democracy ecosystem, we can work together to clean up the toxicity and remove invasive species like foreign influence, disinformation and propaganda. We must examine our own thinking to root out the toxicity we have. We need to create a habitat in which our democratic values will thrive, so we humans can thrive, too.
Our failure to do so is to remain on the path to authoritarian rule.
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October 21, 2021
October 21, 2021
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Michelson is the dean of arts and sciences and a political science professor at Menlo College. Liñero-Lopez is the Ask Every Student program manager at the Students Learn Students Vote Coalition.
In the average lifetime there are a handful of major transitions during which an individual can reinvent themselves and their place in society. These are moments that stay with us forever, like moving to a new city, starting a new job, or joining the military. Or voting for the first time.
Reams of social science have demonstrated humans' powerful commitments to our identities. In any given situation, we ask ourselves, "What does someone like me do?" and then decide accordingly how we act, dress and, increasingly, how we engage with our democracy.
That's why the long-term health of our country depends on our ability to foster democratic participation as a core tenet of our population's identity. To do that, we need to create successful "civic transitions" for every American. Once someone has voted for the first time, they tend to adopt an identity as a voter, and then vote again in subsequent elections. Getting young people to adopt voter identities by inviting them to participate in our democratic processes can create a lifetime of civic engagement.
In 2020, multiple student-serving organizations came together to help young people incorporate civic participation into their lives during a time of profound identity transition: enrolling in college. Through an initiative called Ask Every Student, they set out to increase college student voter registration by attempting to reach each individual student on nearly 200 participating campuses. An open-source framework enabled leaders to incorporate voter education and outreach into universal programs like student orientations and core curriculum courses. Campuses included private and public institutions, community colleges and minority-serving institutions such as historically Black colleges and universities.
An extensive study into the initiative's efficacy points to one clear conclusion: Just a few minutes of direct interaction has the power to profoundly impact a person's civic identity — especially when that person is new to the democratic process.
A survey of 2,267 students from 14 campuses that participated in the AES initiative (and approximately the demographics of the AES initiative as a whole) found that students who recalled hearing about an AES program on their campus said they were 8.3 percent more likely to register to vote, and 5.6 percent more likely to vote, than those who hadn't. Among first-year students — the group most likely to be experiencing profound life transitions at the time — those who recalled being encouraged to vote by an AES program on their campus were 14.2 percent more likely to register to vote.
In all, approximately 76.1 percent of students surveyed reported hearing about an AES program on their campus. Assuming a similar percentage holds true for the nearly 3 million total students enrolled in colleges that participated in AES, we estimate that millions of students were reached through this initiative and that tens of thousands of them registered to vote in part because of it.
Of course, registering to vote and voting are not the only acts of democratic engagement that matter. Community service, activism, dialogue across differences, and many other facets make up the full spectrum of a vibrant civic life. But by introducing college students to the bedrock functions of the democratic process we open the door for them to positively impact their communities in multiple ways.
One of the study's most exciting takeaways was the degree to which students shared information they learned from an AES program on their campus with their families. In our conversations with students at these campuses -- we held 24 focus groups across the 14 study campuses — students noted how they shared AES program information with their families, spreading the initiative's impact.
Most Americans will experience some kind of major life transition in the next decade. These times of transition, especially for young people, are an opportunity to shape their civic identity for the better — but only if we commit to reaching them where they are.
American democracy is experiencing its own transition moment, challenged by increasing partisan polarization, decreased confidence in public institutions, and increased incidents of anti-democratic attitudes and behaviors. Against this backdrop, applying the lessons of Ask Every Student at scale will foster participation and positive identities as voters, as well as strengthen our democracy.
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Coyle is a retired minister who writes about the intersections of faith, culture and politics. She is the author of "Living in The Story: A Year to Read the Bible and Ponder God's Story of Love and Grace."
Pittsburgh is the home of 446 bridges, more than any other city in the world. The City of Bridges is also home to a small group of Muslims, only about 0.5% of the population. Maybe this minority status contributed to the 2018 attack on a high school Muslim woman wearing a hijab. This violence is one reason Ebtehal Badawi began her "Pittsburg Builds Bridges" art project.
Even though she herself is a Muslim, Badawi's bridge paintings depict symbols of nine religions and cultures demonstrating a wide range of worldviews. She believes, as I do, that differences need not divide us. Our diversity can make us stronger, kinder and wiser if we will ground ourselves in the basic truth of our common humanity.
"The reason these things happen, incidents of racism and bullying, is because people are afraid of people who are different," said Badawi. "We need to accept those who are different, people who don't look the same or share the same belief. We need to be open, to see the people in front of us."
We need to see the people in front of us.
This is where bridges come in handy. Bridges bring us nearer to one another, connecting those who may have been separated by distance or terrain, by experience or opinions. When we make the effort to find ways to move closer, then we are able to see, hear and understand more clearly.
Some years ago, I attended an event called Dallas Dinner Table, a conversation of strangers around a shared meal on Martin Luther King Jr.'s birthday. The bridges of understanding we built during that evening made us all stronger, kinder and wiser.
When I served as a local pastor in several different congregations, we would create occasional opportunities for church friends with diverse (and sometimes clashing) opinions to sit down together and tell their stories. Strengthening relationships, cultivating mutual respect, and appreciating the context of our various lives often allowed us to find a path through our disagreements.
Living Room Conversations broadens the opportunity to build bridges of community across cyberspace. Even when we are separated by multiple miles and numerous time zones, we get to "see the people in front of us," hear their stories and understand viewpoints that are different from our own.
But why would any of us do this bridge-building work when it's so very comfortable to stay safely within our own familiar territory? Badawi reminds us that violence is the price societies will pay when we allow ourselves to be fragmented and cut off from each other. Fear of "the other" will foster violence in thought, word, or deed in small and large ways. On the other hand, drawing near to another allows us to see the other, to recognize our shared humanity and (hopefully) to find there insight instead of fear.
Like my Muslim sister, as a Christian, I too ground my peacemaking efforts in my own religious faith. We both acknowledge that there are too many ways in which our various faith traditions have been misused to divide people instead of bringing people together, to foster animosity instead of cultivating love. We reject these kinds of misappropriations, and we will do whatever we can wherever we are to encourage our neighbors to break down barriers and to build bridges in their place.
I am grateful for the ways the Bridge Alliance effort is always seeking creative partners in this bridge-building business. Maybe you too are making similar efforts where you live. Maybe you see others in your community reaching out across divides. Will you tell us what you see where you are? Where do you find hope, courage, and wisdom in the midst of the challenges of our day? Where are your bridges?
A version of this article was first published at CharlotteVaughanCoyle.com.
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October 20, 2021
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The massive elections reform bill known as the Freedom to Vote Act appears to be headed down the same path as its predecessor: blocked from Senate consideration by a Republican filibuster.
Senate Democrats plan to bring the compromise bill to the floor Wednesday for a procedural vote that would allow lawmakers to begin debating the legislation. However, that debate can only begin if 60 senators vote to stop a filibuster, and Republicans remain staunchly opposed to the bill.
Voting rights advocates expect the legislation to be stymied and have set their sites on eliminating the filibuster rule. They say Wednesday's vote will force Senate Democrats to choose between keeping an "archaic" procedural tool and enacting broad electoral reform.
"I, along with other coalition members, as well as Black and Brown voters across the United States, are disappointed. We are experiencing political theater at the expense of our lives, at the expense of justice for our communities and the work that we have done," said the Rev. Stephany Spaulding of Just Democracy, a coalition of more than 40 Black- and Brown-led social justice groups that support eliminating the Senate filibuster.
Democrats introduced the Freedom to Vote Act last month after the For the People Act was blocked by a GOP filibuster in June. The new, pared-down legislation includes many of the same provisions as the original bill, while making some concessions to appease moderate Democrat Joe Manchin of West Virginia. Manchin was the only Democratic holdout on the For the People Act, saying he believed any election reform legislation should have bipartisan support.
- Both bills would require states to allow no-excuse absentee voting and offer automatic voter registration. But the Freedom to Vote Act would also make Election Day a public holiday, a provision that was dropped from the For the People Act.
- The Freedom to Vote Act also includes new protections for election administrators, who have faced heightened threats following the 2020 election. The bill would also empower voters to challenge burdens on their right to vote in court.
- Under this legislation, states with voter identification laws would be required to follow certain standards, such as accepting a broad array of photo and non-photo ID documentation when verifying a voter's identity.
- While the newer bill drops a provision that demands states adopt independent redistricting commissions, the Freedom to Vote Act does add new requirements to curb partisan gerrymandering and ensure the redistricting process is more fair and transparent. The bill also includes some campaign finance provisions, although they are significantly scaled back from what the For the People Act proposed.
These changes were made in response to critiques from election administrators who desired a more streamlined process and in the hopes of swaying Republicans to support the bill. But GOP lawmakers have not budged from their opposition.
Voting rights advocates have expressed frustration that these compromises were made in a fruitless attempt at bipartisanship.
Following Wednesday's anticipated blocking of the Freedom to Vote Act, Senate Democrats will be facing a "make or break" moment for American democracy, advocates say.
"Senate Democrats face a choice clearer than ever before: protect our democracy or protect the outdated, abused Senate filibuster," said Eli Zupnick, spokesperson for the Fix Our Senate coalition. "Despite Sen. Manchin's good faith outreach, there simply aren't 10 Republicans going to work with Democrats on this. Senate Democrats can have the filibuster, or they can defend our democracy. There is no third option, and we're running out of time."
A June poll conducted by Morning Consult and Politico didn't find majority support among voters for keeping or eliminating the filibuster. When voters were asked if the current Senate rule should be kept, 48 percent indicated support. But when voters were given a choice between whether legislation should pass with 60 votes or a simple 51-vote majority, 45 percent said the latter.
Another poll, this one conducted last month by Data For Progress, found supermajority support across party lines for the Freedom to Vote Act. Seven in 10 Americans overall indicated support. Democrats were most enthusiastic with 85 percent backing the legislation, followed by two-thirds of independents and 54 percent of Republicans.
"Americans overwhelmingly support the Freedom to Vote Act because they believe that every one of us should have the freedom to vote so that we all have an equal say in the future for our family and community, regardless of our age, our political party, our background or our zip code," said Common Cause president Karen Hobert Flynn.
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October 20, 2021
Discussions on gerrymandering often call for the creation of independent redistricting commissions to draw electoral maps. But in this episode of the Democracy Works podcast from the McCourtney Institute for Democracy, Christopher Fowler explains that plan is just part of a bigger solution to gerrymandering.
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Rubin is an alumnus of the Bridge Alliance Leaders Mastermind Cohort. He is founder and principal of Bstory, an initiative that uses the power of collective story to breathe new life into our civic and moral imaginations.
Earlier this year, I joined in the work of Urban Rural Action, founded by Joe Bubman. URA's primary mission is to bring together Americans across geographic, political, racial, and generational divides to build relationships, strengthen collaboration skills, explore different perspectives and tackle issues that impact all communities.
Being fully transparent, I am often suspicious of bridge-building efforts and I initially was reluctant to fully embrace the work. This is not because I do not believe in the premise, but because the end goal is often simply civility. Put another way, if we all just agree to not critique or debate then we can all just get along. Joe and I have had this discussion and he admitted in his own reflection that "We bridge-builders too often view the problem through a narrow lens."
For many of us this is hard to admit, but even our well-intentioned initiatives privilege some voices over others and in subtle ways uphold the status quo. As a result, consensus is formed and we spend more time, in the words of Anand Giridharadas, marketing "the idea of generosity as a substitute for the idea of justice." Ghiridharas related this to what he called the Aspen Consensus, which says, "Do more good" — not "Do less harm." (The Aspen Institute from which this consensus is derived, is in a loose network of many of these bridge-building organizations.) Rarely is consensus a road to justice.
This may be problematic to some of you, but our beloved President Abraham Lincoln stated, "If I could save the Union without freeing any slaves I would do it; and if I could save it by freeing all the slaves I would do it." Our calls for unity cannot come at the expense of those on the underside and while we are on the issue of slavery, we have to stop treating it as a footnote to American history and truly wrestle with how it has and continues to shape our nation.
Wrestling with our collective past has the potential to free us from guilt and move us toward reclaiming our shared humanity. As James Baldwin stated, "Guilt is a very peculiar emotion. As long as you are guilty about something, no matter what it is, you are not compelled to change it."
Wallowing in guilt is not the way forward, but neither is pretending that it never happened. Going along just to get along may be the easiest way to navigate this system, but it is also a sure way to maintain more of the same. Some of us need to become more comfortable in being uncomfortable. And perhaps even more challenging, some of us need to become comfortable in making others feel uncomfortable. It will be crucial to individual and shared growth. Too often we want to silence disruptors who insist on remembering, but every critic is not an enemy.
This past fall, I had the privilege of being chosen to participate in the Civic Saturday Fellowship, a program of Civic University. Civic Saturday is a civic analog to a faith gathering. Civic Saturdays are arranged in this format because the founders understood that organized religion has figured out a few things about how to bring people together, about how to create a language of common purpose and about how to use story and narrative to spark people's reckoning with their own shortcomings, weaknesses and aspirations.
Civic Saturdays serve to remind all of us that we are in this together, shaping the future of our communities and country. While we all approach it differently, we are working to realize the promise of our democracy. Many think democracy is already established, but democracy is an idea that is still being perfected and until we break our routines, democracy will remain static.
In one of my civic sermons I stated, "we have to embrace the discomfort that true patriotism requires and be willing to contend with difficult questions. An example of this would be to ask, how do African Americans hold in tension the legacy of systemic racism and have pride in this Country?" We are too quick to move past the fact that Black people arrived on these shores as legal property and even after their citizenship was achieved Black Americans' relationship with democracy has remained complicated.
This an issue that for many creates discord, but it must be acknowledged. So when we gather together to embrace democracy, we must hold on to that tension and refuse to flatten the texture and grain of our varied lived experiences. Many of us want to find ways that our voices can flourish together, but we must anticipate that it might take what sounds like struggle along the way. Perhaps through this grappling, we will save our civic souls.
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October 19, 2021
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The GOP-majority Texas Legislature approved new maps for Congress and the state Legislature this week, and the first lawsuit has already been filed — before any maps have been finalized.
Latino voting rights advocates filed the first federal lawsuit on Monday, claiming the districts drawn and approved by Texas lawmakers discriminate against Latinos by diluting their voting power and therefore violating the Voting Rights Act. Republican Gov. Greg Abbott is expected to sign the new maps into law in the coming days.
The lawsuit was filed by five registered Texas voters and nine Latino advocacy groups, including LULAC, Mi Familia Vota and Texas Hispanics Organized for Political Education. They are being represented by the Mexican American Legal Defense and Educational Fund, which successfully challenged the state's maps during the previous redistricting cycle.
Over the last decade, Texas has gained 4 million new residents, earning the state two new congressional seats. Half of the newcomers are Hispanic and 95 percent of them are people of color, according to the Census Bureau.
However, the recently approved maps do not reflect this growing Hispanic voting bloc in Texas. The number of state House districts in which Latinos make up a majority of the eligible voters dropped from 33 to 30. The number of congressional districts in which Hispanics were in the majority was also reduced from eight to seven.
Instead, Republicans, who control the state's redistricting process, drew the maps so the two new congressional districts would be majority white. The lawsuit claims legislators used gerrymandering tactics like packing and cracking to diminish Latino voting power.
"Fair maps" advocates have also flagged Texas' redistricting plans as examples of partisan gerrymandering. The Princeton Gerrymandering Project and RepresentUs gave the state's maps for Congress and the state legislature failing grades for ensuring "significant Republican advantage." The groups also noted that the maps have non-compact districts, meaning there were more county splits than usual.
This the latest, and perhaps most high profile, redistricting lawsuit to be filed since the process kicked off following the 2020 census.
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I was recently talking to an 86-year-old friend of mine, Michael Stapler, about The Fulcrum and our new Pop Culture section.
The Fulcrum believes there is a deep connection between democracy and American culture, and this new coverage area is designed to deepen the understanding of our differences and similarities, and discover our shared interests and common destinies.
Whether it is music of all types, poetry, dance, literature, painting and drawing, comedy, or drama, we will appeal to the human spirit — a spirit that expresses the joys, sorrows and harmonies of the heart and soul.
Michael, whose hobby is painting, took my words seriously and I was taken aback when he presented me with a beautiful painting he did that was inspired by our conversation about the connection between art and democracy.
His painting, "LIBERTY - Celebrating Freedom in America," is his expression of what celebrating freedom in America means to him.
His painting was accompanied by these words expressing how art is connected to democracy, and perhaps they were his inspiration for the painting:
- Art represents one of the key components of Democracy, the freedom of expression.
- Art examines and expresses culture, human rights, and diversity.
- Art can view ways of life that differ from one's own.
- Art is a universal language.
- Art often promotes citizen participation.
- Art engages one's emotions.
- The Statue of Liberty represents freedom, democracy and justice.
Many artists are drawn to the Statue of Liberty. Iconic pop artist Peter Max has been enamored with the statue, completing his first portrait of it 45 years ago. He has done many more over the years.
Standing at 305 feet tall, the Statue of Liberty for many is a symbol of freedom, optimism and friendship among nations. A gift from France in 1886, her base has these words inscribed:
Give me your tired, your poor,
Your huddled masses yearning to breathe free,
The wretched refuse of your teeming shore.
Each one of us as we look upon Michael's painting and read these words will feel different emotions and have different perceptions as to what the Statue of Liberty means to them. And that is America: a diversity of thought, a melting pot of ideas.As you look at this painting and read the words inscribed on Lady Liberty, what emotions do you feel? Email us at email@example.com to share your thoughts.
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Ballotpedia is keeping a close eye on elections across the country as we head towards November 2nd. Watch this briefing to learn about some of 2021's most interesting political races across the country as policing, public safety, affordable housing, and homelessness are at the forefront of voters' minds and candidates' policy debates.
October 19, 2021
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Thomas and Addams are co-executive directors of Mormon Women for Ethical Government.
As faith-based advocates for ethical governance, our work is motivated by a core belief: Every individual is a person of great worth. Our love of democratic governance is a natural outgrowth of this, as is our passionate desire to protect it. Good government upholds our rights, reminds us of our responsibilities to each other and protects our civil liberties equally. Democratic government trusts the people with the power to preserve those rights and privileges through the mechanism of the vote.
We believe that we are at a critical juncture in our nation's history — not unlike those we have faced in the past — where the few seek to impose their will upon the many. The freedom to vote is under aggressive threat, and a corruption of this foundational freedom threatens other freedoms that flow from it. Protecting the vote should be our primary national priority, superseding all others, and our senators — elected by the people — have a civic obligation to provide that protection.
In the months leading up to the November 2020 election, a record number of Americans made significant sacrifices to vote and in doing so were able to accomplish what our institutions, including the U.S. Senate, had failed to do: place boundaries around an increasingly reckless administration. Citizens recognized the existential threat our nation faced, and utilized an orderly and peaceful mechanism to remove that threat. They voted.
That their collective votes were an exercise of significant power is clear, because almost immediately the people's authority came under direct attack. Unfounded claims about election fraud, pressure on election officials, race-based propaganda, unjustified lawsuits, demagoguery, attempts to manipulate long-standing electoral processes, and ultimately a violent insurrection — all are visible manifestations of a concerted effort to change the results of a peaceful and legal election.
Following those tragic events, a handful of principled Republican senators joined Democratic colleagues and made efforts to preserve the integrity of our elections and the peaceful transfer of power. But in the last 10 months, the attack on democracy has shifted. Having failed to overturn a past election, politicians at all levels of government now seek to exert undue control over future ones. There is still time to protect democracy, and Congress has the power under the Constitution to protect our future by placing federal protections around our right to vote.
Over the last eight months Mormon Women for Ethical Government has joined an ideologically diverse group of organizations and individuals in making repeated and good-faith efforts to engage with senators about voter rights. In a destructive departure from what was (as recently as 2006) seen as a shared value with bipartisan support, very few Republicans have shown any willingness to even dialogue about voter protection. They have not committed to the work of legislative compromise or co-sponsorship of bills protecting elections or voter rights. Most surprisingly, those who courageously spoke out against the unlawful efforts of the past administration have sought to justify their inaction around voting by claiming superseding allegiances. But nothing should take precedence over the freedom to vote.
As co-leaders of a nonpartisan organization who personally don't always share opinions about policy, we are deeply committed to ethical governance based on collaboration, compromise and cooperation. We have learned how differences can become strengths. Our collaboration is possible because we recognize the profound difference between core values and the social and political structures that have developed to — ideally — implement those values. Nationally these include concepts like bipartisanship, the protection of states' rights and legislative mechanisms like the filibuster. But these only have value if they are invoked as a means to protect and promote our nation's values.
Because these structures have been time-tested, moderating voices don't advocate discarding them in the pursuit of raw power. But at the same time they must not be used — as they were to protect slaveholders or deny basic civil rights — to aggregate power in the hands of the few or to trample on the rights of the underrepresented.
Extending voter rights will achieve the opposite; this extension serves to disperse power and to make leaders and parties more accountable, not less. The right to vote empowers our citizens to protect what is most precious: the Constitution, the rule of law, responsive government and individual rights. There is no justification for affording states the right to oppress their own citizens or privileging procedural means like the filibuster if what is at stake is a foundational national commitment to voter rights.
This week, the Freedom to Vote Act will come up for a vote before the Senate and the John Lewis Voting Rights Advancement Act will follow. These bills offer real and significant protections for voters. We plead with senators of both parties to prioritize the people and do what is necessary to ensure that future elections are safe and citizens have the freedom to vote. In November millions of citizens took our responsibilities seriously and we acted to defend your authority and our democracy. Now, almost one year later, we ask that you act to defend us. Protect the freedom to vote.
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October 19, 2021
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Pearl is a clinical professor of plastic surgery at the Stanford University School of Medicine and is on the faculty of the Stanford Graduate School of Business. He is a former CEO of The Permanente Medical Group.
Another year, another damning report for American medicine. In August, the Commonwealth Fund ranked U.S. health care dead last among 11 of the world's wealthiest nations (for the seventh time in seven reports since 2004).
Compared to its global peers, the United States is home to the lowest life expectancy, highest infant- and maternal-mortality rates, and most preventable deaths per capita. Worse, Americans spend twice as much on medical care as their international counterparts in exchange for these rock-bottom clinical outcomes.
Lawmakers are unlikely to solve the problem given the dysfunction that plagues Congress and partisanship that characterizes any possible government solution to our health care problems. However, the good news is that Americans can have greater access to excellent health care, along with effective social programs to tackle homelessness, food insecurity, obesity and other leading causes of illness.
Cue U.S. employers, which currently provide health insurance to 155 million Americans, nearly half the country. Businesses are growing sick and tired of seeing their coverage rates increase 5 percent to 6 percent each year. Absent a legislative solution, the only recourse for U.S. employers is to completely rewire the health care reimbursement model.
Today, approximately 90 percent to 95 percent of U.S. health care providers (doctors and hospitals) are reimbursed on a "fee for service" basis, getting paid for each new test, procedure and treatment — regardless of whether any of it helps patients.
This arrangement drives up health care costs with little or no clinical improvement to show for it. Of course, when physicians and hospitals are rewarded for doing more (rather than doing better), that's exactly what they do. They buy and advertise multimillion-dollar surgical robots that barely move the needle on patient outcomes, and they recommend pricy treatments that often prove ineffective. In fact, a study found one in four health care dollars is wasted.
In contrast to fee-for-service, some of the nation's highest-ranking health care providers rely on an alternative reimbursement model called "capitation." From the Latin caput, meaning "head," capitation refers to a "per-head fee." In practical terms, it works like this: A payer (insurance company or self-funded business) gives a group of doctors and hospitals a fixed, annual, per-patient sum, paid upfront for all health care services rendered each year.
At Kaiser Permanente, a large health care system where I served as a CEO for 18 years, capitation helped our clinicians curb wasteful spending, lower medical costs and achieve the nation's No. 1 quality rating from both the National Committee for Quality Assurance and Medicare. When physicians have incentives to do better (rather than do more), that's what they do. They achieve higher rates of medical prevention, reduce complications from chronic disease and commit fewer medical errors.
As a result, patients who receive care through organizations like Kaiser Permanente are 30 percent to 50 percent less likely to die from heart attack, stroke and colon cancer than patients in the rest of the nation. If every health care provider in the United States matched even the low end of those results, we'd not only save billions of dollars annually, but we'd also save more than a quarter-million American lives each year.
The benefits of capitation don't end there. Prepaid health systems also have natural incentives to invest in "non-traditional" health care programs, aimed at addressing the social determinants of health, thus providing the kinds of public health benefits seen in nations like Norway and the Netherlands.
In Pennsylvania, Geisinger Health provides patients with free transportation to doctors' appointments to remove the barriers to obtaining medical care. Geisinger also runs a weekly food program for patients with diabetes, offering fresh fruits, vegetables, lean meats and whole grains to bolster healthy eating habits.
Mount Sinai's Urban Health Institute sends community health workers to the homes of asthma patients to help address environmental triggers of the disease, such as dust and second-hand smoke.
Finally, leaders at Kaiser Permanente recently partnered with leaders in the Oakland community to invest $25 million in housing for the homeless because they understand that reliable shelter is essential for better health.
Of course, no health care solution is perfect, and capitation has its drawbacks, too. Americans like choosing their doctors, for example, but capitated systems rely on a narrower network of doctors and hospitals to maximize the efficiency and effectiveness of medical care. Meanwhile, doctors worry they'll lose income if the medical needs of patients outpace the available, prepaid funds. This fear keeps many independent providers from joining a capitated group.
Therefore the shift from fee-for-service to capitation in the U.S. will happen only after a few cost-weary businesses begin to demand or provide it. Once other employers learn about the improvements in quality and lower costs, they will follow suit. And when enough companies join in, momentum will grow, and our nation's health care system will be on the path to becoming the best in the world.
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October 18, 2021
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The 117th Congress is the most racially and ethnically diverse collection of lawmakers in American history, and yet it is far from representative of the country's population. But for congressional aides, lack of diversity at the staff level is even more of a glaring issue.
The Congressional Black Associates, which represents staffers in the House of Representatives, and the Senate Black Legislative Staff Caucus published an open letter to America on Friday, calling for changes on Capitol Hill to improve the recruitment and retention of Black staffers.
Congressional staffers are integral to the day-to-day operations on Capitol Hill. They write legislation, conduct research, bring in witnesses for testimony on important issues, provide constituent services and help finalize major political deals, among many other duties. Having staffers who better reflect the American public informs the critical legislative decisions made by elected officials, and ultimately leads to a more representative government.
While people of color make up 40 percent of the U.S. population, they only account for 8 percent of Senate staff directors and 16 percent of other top roles, such as deputy staff director, chief counsel, general counsel and policy director, according to a July report by the Joint Center for Political and Economic Studies. The center also found that Black people make up 13 percent of the country's population, but just 3 percent of top Senate staff positions.
Last week, Democratic Sen. Sheldon Whitehouse of Rhode Island hired Monalisa Dugué as his chief of staff. Dugué joins Jennifer DeCasper, chief of staff for GOP Sen. Tim Scott of South Carolina, as the only Black people to currently hold that position. Scott is the sole Black Republican currently serving in the Senate.
Additionally, only 30 of the 435 House members have Black chiefs of staff. Most of those individuals are employed by one of the 57 Black lawmakers in the House, according to the staff associations.
"These statistics are discouraging because they send the underlying message that the path forward for Black staffers to be hired or promoted to senior-level positions within their respective offices is limited," the two congressional staff associations wrote in their letter. "It is not enough to simply hire Black staff. Congress must also foster clear pathways for recruitment and career advancement."
The two staff associations would like to see four changes:
- A stronger college-to-Congress pipeline in which congressional offices develop better relationships with historically Black colleges and universities.
- More career opportunities and investments so that Black staffers can be promoted to senior-level positions by their own merit.
- Livable wages for all congressional staffers, especially given the heavy workload and high cost of living in the District of Columbia, Maryland and Virginia.
- Purposeful and fair hiring decisions by members of Congress that reflect the constituents they serve.
"We believe that if the United States Congress wants to hold steadfast to its representative form of government, then congressional staffers hired to construct and inform legislation should be reflective of the United States' population," the letter says. "Congress can be a powerful vehicle for change when we are all at the table and well-positioned and equipped to make those changes."
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October 18, 2021
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Weichlein is the CEO of FMC: The Former Members of Congress Association.
The 2020 election was the most secure in American history and there's no evidence that any voting system deleted, lost or changed any votes. There, I said it!
Actually, I didn't say it, but rather Chris Krebs, who served as director of the Cybersecurity and Infrastructure Security Agency during the Trump administration, said it and was fired shortly thereafter by the then president.
Since last November, there have been almost six dozen related lawsuits adjudicated by state and federal judges across the country, most of them dropped for lack of evidence. There have also been several recounts, including multiple in Georgia alone, all resulting in essentially the same number of votes for each candidate. Yet a Sept. 12 poll by CNN showed that six in 10 Republicans and Republican-leaning independents agree that "believing that Donald Trump won the 2020 election" was very or somewhat important to what being a Republican meant to them.
No matter where you are politically, that number should really concern you because it means that 60 percent of the supporters of one of our two parties have lost all faith in the integrity of our elections. They don't believe their often-Republican local elections officials, conservative judges in various jurisdictions across this country, or the results of any recount or audit. To this 60 percent of Republicans, Joe Biden is not a legitimately elected president.
To many Republican officeholders at the state level, where election processes are enshrined in state regulations and law, their base's doubt has become a rallying cry to change election law. Republican candidates for secretary of state or other election-focused offices highlight the perceived failures of 2020 as they campaign in their communities. These political actors are seizing upon their voters' or constituents' doubt rather than reinforcing the mountain of evidence from court findings, recounts and other credible sources. This is the definition of solutions in search of a problem.
Given this tenor across the country, especially in swing states like Pennsylvania, Georgia or Arizona, how will the electorate ever accept the outcome of an election again? Won't a Democratic win merely showcase the same "rampant irregularities" as in 2020? Won't a Republican win merely prove that "voter suppression measures" implemented by Republican state legislatures after 2020 were successful?
The No. 1 challenge our representative democracy faces right now is the erosion of trust when it comes to the integrity of our elections. And while the Constitution clearly recognizes the states' primary role in election administration, it also outlines specific powers and responsibilities for the federal government. Congress in the past has not been shy about inserting a federal response to shortcomings at the state level, such as the abolition of poll taxes or requiring that polling stations be accessible to the disabled. Congress could and should act again to reinject trust into the system.
Most of us envision Election Day as a singular and unifying event, with millions of Americans exercising their right to vote and engaging in essentially the same voting process across the country. Unfortunately, that vision is quite blurred; all voters are not on equal footing.
There are 51 different elections happening across the 50 states and the District of Columbia. They each come with different standards for who gets to vote. For example, in Washington, D.C., a convicted felon never loses his or her right to vote, while in Kentucky certain violent felonies may cause one to permanently lose their right to vote. This also applies to how and when one can register to vote, how and where one can cast their vote, and how that vote is tabulated and reported.
If the outcome affects us all equally, then why should it be easier for me to participate in the process than someone in another state – or even in the same state but in another county? We don't have 50 different standards for what makes an airplane safe, and because of that I trust that I'm flying safely, whether I board the plane in New York or Houston.
There already are a number of federal entities devoted to our electoral process, most prominently the Election Assistance Commission and the Federal Election Commission. But partisanship is rearing its ugly head when it comes to both of these agencies: One is woefully underfunded, while the other for years has lacked the requisite number of politically appointed commissioners to do its job. By empowering these existing organs, Congress could restore trust and integrity into our electoral process and enforce election laws so that your ZIP code no longer determines your ability to participate in the democratic process. If that isn't a bipartisan goal, then what is?
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