What Wall Street Doesn’t Want You to Know About Hospital Emergency Rooms

Yves here. We’ve written regularly on Eileen Appelbaum and Rosemary Batt’s important investigations into how private equity has taken over more and more of hospital staffing, including of emergency rooms. This in turn has allowed them to override patient efforts to have only in-network doctors assigned to their case, as well as to engage in other practices that greatly inflate patient charges (so-called surprise billing).

The legal fig leaf that allows private equity firms like Blackstone and KKR to play doctor is that their deals are structured so that  MD or group of MDs is the nominal owner of the specialty practice, even though the business is stripped of its assets and the operating contracts are widely believed to strip them of any say. The now-notorious incident of Blackstone’s TeamHealth firing whistleblower Dr. Ming Lin confirms who is really in charge.

By Eileen Appelbaum, the Co-Director of the Center for Economic and Policy Research and visiting professor, School of Management, University of Leicester, UK and Rosemary Batt, the Alice Hanson Cook Professor of Women and Work, Cornell University ILR School. Produced by Economy for All, a project of the Independent Media Institute

Doctor Ming Lin is the first emergency room doctor to be fired for going public with his concerns about poor hospital emergency room safety practices and shortages of medical supplies and protective gear for health workers. He won’t be the last.

Like many hospitals in the US, PeaceHealth St. Joseph Medical Center in Bellingham Washington, where Ming Lin worked for the past 17 years as an emergency room doctor, has outsourced the management and staffing of its emergency rooms. So, Lin works on-site at the hospital’s emergency room, but he is employed by a physician staffing firm that runs the emergency room. These staffing firms are often behind the surprise medical bills for emergency room services that patients receive after their insurance company has paid the hospital and doctors, but not the excessive out-of-network charges billed by these outside staffing firms.

About a third of hospital emergency rooms are staffed by doctors on the payrolls of two physician staffing companies—TeamHealth and Envision Health—owned by Wall Street investment firms. Envision Healthcare employs 69,000 healthcare workers nationwide while TeamHealth employs 20,000. Private equity firm Blackstone Group owns TeamHealth, Kravis Kohlberg Roberts (KKR) owns Envision.

Care of the sick is not the mission of these companies; their mission is to make outsized profits for the private equity firms and its investors. Overcharging patients and insurance companies for providing urgent and desperately needed emergency medical care is bad enough. But it is unconscionable to muzzle doctors who speak out to advocate for the health of their patients and co-workers during the global pandemic that is rapidly spreading across the US.

Yet, that is what Blackstone-owned TeamHealth just did. Why would an experienced emergency room doctor be fired in the middle of a pandemic? One clue may be that Blackstone’s CEO, Stephen A. Schwarzman, is part of President Trump’s inner circle. He may not want to risk that relationship by allowing TeamHealth’s doctors to inform the public about Washington’s mishandling of the allocation of supplies and protective gear. The President might conclude that TeamHealth doctors didn’t appreciate him enough, and where would that leave Schwartzman?

PeaceHealth St. Joseph Medical Center may have the distinction of being the first hospital to have a doctor outsourced from a physician staffing firm unceremoniously fired for telling the public the truth. But it won’t be the last. Hospitals are now telling doctors treating coronavirus patients they will be fired if they speak to the press.

The American Academy of Emergency Medicine protested Dr. Lin’s ouster and questioned how TeamHealth is allowed to provide hospital services when the law requires that physician practices must be owned by a licensed medical practitioner. TeamHealth skirts the law by owning all the assets of the physician practices it acquires—the real estate, offices, equipment, supplies, inventory, and even accounts receivable.

On paper, the physician practices are owned by a doctor-led organization that TeamHealth has set up to comply with the law. But what does it mean to own a physician practice if the practice has no assets and no possibility to exist on its own?

The furor over patients hit by surprise medical bills revealed that TeamHealth controls the billing for the doctors it supplies to hospital emergency rooms. The firing of Doctor Ming Lin pulls back the curtain and reveals that TeamHealth controls the doctors as well.

Anne Applebaum, “Red Famine”

A columnist for The Washington Post and author of the Pulitzer-winning Gulag, Applebaum has been writing about Russia since the 1990s. Her fifth book is a detailed study of Stalin’s 1929 policy of agricultural collectivization, which set off the worst famine in European history. Some five million people died between 1931 and 1933 in the USSR. Of these, roughly three million were Ukrainians, and Applebaum definitively shows that they died due to deliberate government policy. Drawing on newly opened archives and personal accounts not previously translated, Applebaum substantiates the stories that Stalin suppressed Ukrainian uprisings by closing the borders, stopping food shipments, and letting the rebellious peasants starve.

 

(32 min): wrote about the Ukranianism of American politics with Paul Manafort

Search out far left and far right. They don’t invent, but they do fund.

Question: how do we divide people.

38:12
[Stalin] writing in private you know what he
writes to Kaganovich and these other
sidekicks he believes his ideology and
one of the things that’s important about
them about the Bolsheviks is they
believed that Marxism wasn’t just some
kind of theory and it could be money
they believed that it was a science and
it was true
and it’s even more common
because it’s science and it’s true and
we define what it is and that means that
whatever we’ve said you know is true
and
this is this is how things are going to
be and if it doesn’t work out in reality
the way we thought it was going to then
somebody else is responsible and who’s
responsible saboteurs wreckers kulaks
enemies of the people enemies of the
state you know and I actually believe
now that a lot of the you know a lot of
the violence the kinds kind of cycles of
violence you have in the Soviet Union
1932 and 33 you had the famine a few
years later you had the purges of 1937
and you have cyclical violence and
that’s almost always a response to
policy failure
you know it hasn’t worked
the revolution hasn’t brought prosperity
and made us happy there has to be a
reason for it
okay you know let’s find the let’s find
the the parasites who are sucking the
blood of the revolution and get rid of
them
and so that was you know and so the
so so your point you know your logical
point okay well look this agricultural
policy hasn’t worked let’s change it
that’s not how they thought you know it
wasn’t let’s change it love wheat you
know it’s not our policy that needs to
change it’s you know
the people in reality that has to adjust
our way of thinking and anyways I said I

Donald Trump’s Mommy Issues

He may not have bonded successfully with his mother and that made him the adult—and the politician—that he is.

Peter Lovenheim lives in Washington, D.C. His bookThe Attachment Effect: Exploring the Powerful Ways Our Earliest Bond Shapes Our Relationships and Lives will be published by Penguin Random House on June 5.

Donald Trump is easily the most psychoanalyzed president of modern times. His decision-making style and behavior have been hotly debated by journalists, voters, politicians, world leaders and pundits who have bestowed upon him any number of fanciful, grave-sounding mental conditions, calling him, among other things, a narcissist, a sociopath, a psychopath and a paranoiac. Trump has said he distrusts mental health professionals, so we don’t have access to a formal assessment of his psychology. But colloquially speaking, perhaps the best explanation for the president’s behavior dates back to his earliest interactions with his mother.

Although I’m not a psychologist, I have spent years researching a major field of psychology known as attachment theory for a book. According to the science of attachment—developed in the second half of the 20th century by British psychotherapist John Bowlby—we’re hardwired at birth to attach to a competent and reliable caregiver for protection because we are born helpless. The success or failure of this attachment affects all our relationships throughout life—in the workplace, on the athletic field, with loved ones—and yes, even in politics. Children who bond successfully with a primary caregiver—usually this is the mom but it could also be the dad, grandparent, nanny or other adult—grow up with what is termed a “secure” attachment. As adults, they tend to be confident, trusting of others, resilient in the face of setbacks, and able to enjoy long, stable relationships. Children who fail to achieve a successful attachment, on the other hand, may as adults have a lack of comfort with intimacy, difficulty trusting others, a constant need for reassurance from relationship partners, and a lack of resilience when faced with illness, injury or loss.

The biographical record is fairly strong on Trump’s failure to develop a healthy emotional attachment to either of his parents. It may have contributed to his tumultuous personal life, but it also endowed him with some traits that made him well-suited to his late-career entry in politics.

Donald Trump is the fourth of five children of Fred and Mary Trump. Because his father was busy building a real estate business, and it was the mid-20th century when dads didn’t typically do a lot of early child care, his mother cared for the children (with the help of a live-in maid) and was their primary “attachment figure.” What factors may have affected the quality of young Donald’s early care—his own temperament as an infant; the role, if any, of the family’s maid in child care; the demands on his mother’s time and energy of three older children and a subsequent pregnancy—we don’t know. The president’s own writings are largely silent about his early childhood; journalists and biographers fill in only some of the blanks.

But we do know that Mary Trump became seriously ill from complications during labor with her last child. An emergency hysterectomy and subsequent infections and surgeries followed—four in two weeks, one of her oldest daughters once said. As a result, at just two years and two months of age, Trump endured the trauma of the prolonged absence and life-threatening illness of his mother. It’s not clear how long she was incapacitated. Indeed, we don’t know that she ever really re-engaged with her son. According to a Politico Magazine story on Mary Trump, there’s evidence that Mary and her son didn’t interact much during his childhood (more on this later).

Infants who fail to receive that kind of care usually fall into one of two categories as adults. Either they have what’s called attachment anxiety—leading them as adults to crave intimacy but have difficulty trusting others and constantly seeking reassurance—or they have attachment avoidance, where as adults they generally distrust others and convince themselves they don’t need close relationships. The relationships they do have are often unstable. They also tend to be excessively self-reliant and desire a high level of independence. These last two traits—self-reliance and independence—are not necessarily disadvantageous, of course. They might be just the right recipe, for example, for an entrepreneur.

The only way to be certain of President Trump’s attachment style would be for him to take the Adult Attachment Interview, an hour-long, structured interview that is considered the gold standard for assessing attachment in adults. Since that isn’t likely to happen, we’ll have to make an educated guess. While mental health professionals are constrained by ethical standards to avoid diagnosing public figures they haven’t personally examined, I am not bound by those rules. Based on my seven years of research, reading countless academic studies and interviewing leading attachment researchers worldwide, I’m willing to say what they can’t. I would peg President Trump’s attachment style as avoidant. Here are my three reasons:

First, Mary Trump’s major health crisis appears to have compromised her efforts—no matter how well-intentioned—to care reliably for young Donald.

Second, as previously reported in Politico Magazine, Trump has over the years said many flattering things about his mother, calling her “fantastic” and “tremendous.” He’s also described her as “very warm” and “very loving.” And yet, I find no stories or other anecdotes of early childhood that support these sentiments. In fact, friends of the Trump family who knew the Trump kids when they were young have reported they “rarely saw Mrs. Trump” and that Donald, while “in awe” of his father, was “very detached from his mother.” A characteristic of adults with avoidant attachment is the tendency to idolize one’s parents without supporting evidence.

Finally, much of the president’s behavior, both before and since he took office, is clearly consistent with attachment avoidance: His

  • powerful sense of self-reliance and
  • near-inability to acknowledge self-doubt; his
  • bragging about his sexual relations; his
  • almost complete lack of close friends; his
  • multiple marriages; and his
  • unstable relationships with White House staff, Cabinet members and congressional leaders of both parties.

Trump’s almost compulsive need to be in the spotlight might be evidence of attachment anxiety if it were aimed primarily at needing approval. But in the president’s case, it appears to be more about needing admiration. Overt narcissism or grandiose self-regard, the leading attachment researchers Mario Mikulincer and Philip R. Shaver report, is associated with attachment avoidance.

By any number of measures, President Trump may be seen as an anomaly among politicians—after all, how many people have run for precisely one political office and landed directly in the White House?—but if my hunch is correct, in this one trait—attachment avoidance—Trump may, in fact, be rather typical.

Attachment avoidance accounts for about 25 percent of the general population, with about 55 percent of people being secure, 15 percent anxious and 5 percent disorganized (often those who were neglected or maltreated in childhood). But in the course of my research, I asked questions from the Adult Attachment Interview to diverse officials: a former presidential nominee, current and former members of Congress and a mayor. With only one exception, their results indicated attachment avoidance.

Some of this may be because avoidance—though generally not the ideal for anyone—does confer some advantages for the political lifestyle. Avoidant athletes, for example, do well when they compete individually—as politicians do in elections. Avoidant people travel well—think never-ending campaign trail—feeling little need to be near loved ones. And the avoidant person’s general reluctance to trust others can act like protective radar in a field like politics that is rife with betrayal and double-dealing.

Avoidant politicians have one more quality that under the right circumstances can lead to success in office: They are quick to respond to threats and to take action. In a clever study in 2011 where test subjects were exposed to what appeared to be a threatening situation (a room gradually filling with smoke because of a supposedly malfunctioning computer), people high in attachment avoidance—who prize independence and self-reliance—were the first to find a way out to safety for themselves and others.

So is having a president with an avoidant attachment style good or bad? According to attachment theory, human relationships would generally be healthier and more stable if more people had a sensitive and consistent caregiver during infancy—and grew up to have a secure attachment style. So it is likely that leaders with secure attachment—as, for example, Franklin Roosevelt had, according to researchers—can become truly transformational by encouraging the population in times of crisis. And while it’s true that people with attachment avoidance can often be personally successful—in business and other individually focused activities—there are requirements for public office, such as the ability to connect emotionally with constituents or at times to act selflessly—that may be difficult for those with attachment avoidance to muster. While it is too early for history to judge this presidency, understanding President Trump’s likely attachment style—and the attachment styles of all our political leaders—can give us important insights into their behavior and actions in office.

We should keep in mind that as voters, we have attachment styles, too. According to research, these may affect our political leanings and the relationships we have with elected leaders.

Secure voters, for example, tend to be tolerant of ambiguity, flexible in their political views, and thus disinclined to embrace any rigid dogmatism. As such, secure voters are most often found in the political center. Insecure voters, on the other hand, may be attracted to the perceived safety of dogmatism and are more likely to be found on the far-left or far-right. For example, anxious voters—seeking security in a world that feels threatening—may find comfort in a liberal orthodoxy that advocates redistribution of wealth and political power, and aggressively demands “inclusion” and protection in the form of a care-giving government. Avoidant voters, on the other hand, often distrusting others and prizing self-reliance, may embrace a strident conservatism, both economic (the world is a “competitive jungle”) and military (“We can only depend on our own strength”).

So as we think about President Trump, we might consider that his presidency—and our personal reactions to it—may be influenced not only be his attachment style, but also our own.

Tucker Carlson: Mitt Romney supports the status quo. But for everyone else, it’s infuriating

Romney’s main complaint in the piece is that Donald Trump is a mercurial and divisive leader. That’s true, of course. But beneath the personal slights, Romney has a policy critique of Trump. He seems genuinely angry that Trump might pull American troops out of the Syrian civil war. Romney doesn’t explain how staying in Syria would benefit America. He doesn’t appear to consider that a relevant question. More policing in the Middle East is always better. We know that. Virtually everyone in Washington agrees.

Corporate tax cuts are also popular in Washington, and Romney is strongly on board with those, too. His piece throws a rare compliment to Trump for cutting the corporate rate a year ago.

That’s not surprising. Romney spent the bulk of his business career at a firm called Bain Capital. Bain Capital all but invented what is now a familiar business strategy:

  • Take over an existing company for a short period of time,
  • cut costs by firing employees,
  • run up the debt,
  • extract the wealth, and
  • move on, sometimes
  • leaving retirees without their earned pensions.

Romney became fantastically rich doing this.

Meanwhile, a remarkable number of the companies are now bankrupt or extinct. This is the private equity model. Our ruling class sees nothing wrong with it. It’s how they run the country.

Mitt Romney refers to unwavering support for a finance-based economy and an internationalist foreign policy as the “mainstream Republican” view. And he’s right about that. For generations, Republicans have considered it their duty to make the world safe for banking, while simultaneously prosecuting ever more foreign wars. Modern Democrats generally support those goals enthusiastically.

There are signs, however, that most people do not support this, and not just in America. In countries around the world — France, Brazil, Sweden, the Philippines, Germany, and many others — voters are suddenly backing candidates and ideas that would have been unimaginable just a decade ago. These are not isolated events. What you’re watching is entire populations revolting against leaders who refuse to improve their lives.

Something like this has been in happening in our country for three years. Donald Trump rode a surge of popular discontent all the way to the White House. Does he understand the political revolution that he harnessed? Can he reverse the economic and cultural trends that are destroying America? Those are open questions.

But they’re less relevant than we think. At some point, Donald Trump will be gone. The rest of us will be gone, too. The country will remain. What kind of country will be it be then? How do we want our grandchildren to live? These are the only questions that matter.

The answer used to be obvious. The overriding goal for America is more prosperity, meaning cheaper consumer goods. But is that still true? Does anyone still believe that cheaper iPhones, or more Amazon deliveries of plastic garbage from China are going to make us happy? They haven’t so far. A lot of Americans are drowning in stuff. And yet drug addiction and suicide are depopulating large parts of the country. Anyone who thinks the health of a nation can be summed up in GDP is an idiot.

The goal for America is both simpler and more elusive than mere prosperity. It’s happiness. There are a lot of ingredients in being happy:

  • Dignity.
  • Purpose.
  • Self-control.
  • Independence.

Above all, deep relationships with other people. Those are the things that you want for your children. They’re what our leaders should want for us, and would want if they cared.

But our leaders don’t care. We are ruled by mercenaries who feel no long-term obligation to the people they rule. They’re day traders. Substitute teachers. They’re just passing through. They have no skin in this game, and it shows. They can’t solve our problems. They don’t even bother to understand our problems.

One of the biggest lies our leaders tell us that you can separate economics from everything else that matters. Economics is a topic for public debate. Family and faith and culture, meanwhile, those are personal matters. Both parties believe this.

Members of our educated upper-middle-classes are now the backbone of the Democratic Party who usually describe themselves as fiscally responsible and socially moderate. In other words, functionally libertarian. They don’t care how you live, as long as the bills are paid and the markets function. Somehow, they don’t see a connection between people’s personal lives and the health of our economy, or for that matter, the country’s ability to pay its bills. As far as they’re concerned, these are two totally separate categories.

Social conservatives, meanwhile, come to the debate from the opposite perspective, and yet reach a strikingly similar conclusion. The real problem, you’ll hear them say, is that the American family is collapsing. Nothing can be fixed before we fix that. Yet, like the libertarians they claim to oppose, many social conservatives also consider markets sacrosanct. The idea that families are being crushed by market forces seems never to occur to them. They refuse to consider it. Questioning markets feels like apostasy.

Both sides miss the obvious point: Culture and economics are inseparably intertwined. Certain economic systems allow families to thrive. Thriving families make market economies possible. You can’t separate the two. It used to be possible to deny this. Not anymore. The evidence is now overwhelming. How do we know? Consider the inner cities.

Thirty years ago, conservatives looked at Detroit or Newark and many other places and were horrified by what they saw. Conventional families had all but disappeared in poor neighborhoods. The majority of children were born out of wedlock. Single mothers were the rule. Crime and drugs and disorder became universal.

What caused this nightmare? Liberals didn’t even want to acknowledge the question. They were benefiting from the disaster, in the form of reliable votes. Conservatives, though, had a ready explanation for inner-city dysfunction and it made sense: big government. Decades of badly-designed social programs had driven fathers from the home and created what conservatives called a “culture of poverty” that trapped people in generational decline.

There was truth in this. But it wasn’t the whole story. How do we know? Because virtually the same thing has happened decades later to an entirely different population. In many ways, rural America now looks a lot like Detroit.

This is striking because rural Americans wouldn’t seem to have much in common with anyone from the inner city. These groups have different cultures, different traditions and political beliefs. Usually they have different skin colors. Rural people are white conservatives, mostly.

Yet, the pathologies of modern rural America are familiar to anyone who visited downtown Baltimore in the 1980s: Stunning out of wedlock birthrates. High male unemployment. A terrifying drug epidemic. Two different worlds. Similar outcomes. How did this happen? You’d think our ruling class would be interested in knowing the answer. But mostly they’re not. They don’t have to be interested. It’s easier to import foreign labor to take the place of native-born Americans who are slipping behind.

But Republicans now represent rural voters. They ought to be interested. Here’s a big part of the answer: male wages declined. Manufacturing, a male-dominated industry, all but disappeared over the course of a generation. All that remained in many places were the schools and the hospitals, both traditional employers of women. In many places, women suddenly made more than men.

Now, before you applaud this as a victory for feminism, consider the effects. Study after study has shown that when men make less than women, women generally don’t want to marry them. Maybe they should want to marry them, but they don’t. Over big populations, this causes a drop in marriage, a spike in out-of-wedlock births, and all the familiar disasters that inevitably follow — more drug and alcohol abuse, higher incarceration rates, fewer families formed in the next generation.

This isn’t speculation. This is not propaganda from the evangelicals. It’s social science. We know it’s true. Rich people know it best of all. That’s why they get married before they have kids. That model works. But increasingly, marriage is a luxury only the affluent in America can afford.

And yet, and here’s the bewildering and infuriating part, those very same affluent married people, the ones making virtually all the decisions in our society, are doing pretty much nothing to help the people below them get and stay married. Rich people are happy to fight malaria in Congo. But working to raise men’s wages in Dayton or Detroit? That’s crazy.

This is negligence on a massive scale. Both parties ignore the crisis in marriage. Our mindless cultural leaders act like it’s still 1961, and the biggest problem American families face is that sexism is preventing millions of housewives from becoming investment bankers or Facebook executives.

For our ruling class, more investment banking is always the answer. They teach us it’s more virtuous to devote your life to some soulless corporation than it is to raise your own kids.

Sheryl Sandberg of Facebook wrote an entire book about this. Sandberg explained that our first duty is to shareholders, above our own children. No surprise there. Sandberg herself is one of America’s biggest shareholders. Propaganda like this has made her rich.

What’s remarkable is how the rest of us responded to it. We didn’t question why Sandberg was saying this. We didn’t laugh in her face at the pure absurdity of it. Our corporate media celebrated Sandberg as the leader of a liberation movement. Her book became a bestseller: “Lean In.” As if putting a corporation first is empowerment. It is not. It is bondage. Republicans should say so.

They should also speak out against the ugliest parts of our financial system. Not all commerce is good. Why is it defensible to loan people money they can’t possibly repay? Or charge them interest that impoverishes them? Payday loan outlets in poor neighborhoods collect 400 percent annual interest.

We’re OK with that? We shouldn’t be. Libertarians tell us that’s how markets work — consenting adults making voluntary decisions about how to live their lives. OK. But it’s also disgusting. If you care about America, you ought to oppose the exploitation of Americans, whether it’s happening in the inner city or on Wall Street.

And by the way, if you really loved your fellow Americans, as our leaders should, if it would break your heart to see them high all the time. Which they are. A huge number of our kids, especially our boys, are smoking weed constantly. You may not realize that, because new technology has made it odorless. But it’s everywhere.

And that’s not an accident. Once our leaders understood they could get rich from marijuana, marijuana became ubiquitous. In many places, tax-hungry politicians have legalized or decriminalized it. Former Speaker of the House John Boehner now lobbies for the marijuana industry. His fellow Republicans seem fine with that. “Oh, but it’s better for you than alcohol,” they tell us.

Maybe. Who cares? Talk about missing the point. Try having dinner with a 19-year-old who’s been smoking weed. The life is gone. Passive, flat, trapped in their own heads. Do you want that for your kids? Of course not. Then why are our leaders pushing it on us? You know the reason. Because they don’t care about us.

When you care about people, you do your best to treat them fairly. Our leaders don’t even try. They hand out jobs and contracts and scholarships and slots at prestigious universities based purely on how we look. There’s nothing less fair than that, though our tax code comes close.

Under our current system, an American who works for a salary pays about twice the tax rate as someone who’s living off inherited money and doesn’t work at all. We tax capital at half of what we tax labor. It’s a sweet deal if you work in finance, as many of our rich people do.

In 2010, for example, Mitt Romney made about $22 million dollars in investment income. He paid an effective federal tax rate of 14 percent. For normal upper-middle-class wage earners, the federal tax rate is nearly 40 percent. No wonder Mitt Romney supports the status quo. But for everyone else, it’s infuriating.

Our leaders rarely mention any of this. They tell us our multi-tiered tax code is based on the principles of the free market. Please. It’s based on laws that the Congress passed, laws that companies lobbied for in order to increase their economic advantage. It worked well for those people. They did increase their economic advantage. But for everyone else, it came at a big cost. Unfairness is profoundly divisive. When you favor one child over another, your kids don’t hate you. They hate each other.

That happens in countries,  too. It’s happening in ours, probably by design. Divided countries are easier to rule. And nothing divides us like the perception that some people are getting special treatment. In our country, some people definitely are getting special treatment. Republicans should oppose that with everything they have.

What kind of country do you want to live in? A fair country. A decent country. A cohesive country. A country whose leaders don’t accelerate the forces of change purely for their own profit and amusement. A country you might recognize when you’re old.

A country that listens to young people who don’t live in Brooklyn. A country where you can make a solid living outside of the big cities. A country where Lewiston, Maine seems almost as important as the west side of Los Angeles. A country where environmentalism means getting outside and picking up the trash. A clean, orderly, stable country that respects itself. And above all, a country where normal people with an average education who grew up in no place special can get married, and have happy kids, and repeat unto the generations. A country that actually cares about families, the building block of everything.

What will it take a get a country like that? Leaders who want it. For now, those leaders will have to be Republicans. There’s no option at this point.

But first, Republican leaders will have to acknowledge that market capitalism is not a religion. Market capitalism is a tool, like a staple gun or a toaster. You’d have to be a fool to worship it. Our system was created by human beings for the benefit of human beings. We do not exist to serve markets. Just the opposite. Any economic system that weakens and destroys families is not worth having. A system like that is the enemy of a healthy society.

Internalizing all this will not be easy for Republican leaders. They’ll have to unlearn decades of bumper sticker-talking points and corporate propaganda. They’ll likely lose donors in the process. They’ll be criticized. Libertarians are sure to call any deviation from market fundamentalism a form of socialism.

That’s a lie. Socialism is a disaster. It doesn’t work. It’s what we should be working desperately to avoid. But socialism is exactly what we’re going to get, and very soon unless a group of responsible people in our political system reforms the American economy in a way that protects normal people.

If you want to put America first, you’ve got to put its families first.

Nancy Pelosi says she has the votes to become the next House speaker, but a potential challenger has emerged

The anti-Pelosi faction received a potential lift Thursday when a veteran member of the Congressional Black Caucus said she would consider challenging Pelosi, helping rebut one of the central criticisms of this rump caucus of agitators: that they had no plan other than toppling Pelosi.

The CBC, which represents about 20 percent of the Democratic caucus, would likely be divided if Rep. Marcia L. Fudge (D-Ohio) follows through with the challenge.

.. Outside advisers to Pelosi believe that the anti-Pelosi wing needs more than just the bare minimum of votes to prevent her from securing 218 votes, with the far greater threat coming from the freshman class that is dominated by female political stars. If many of them announced opposition to Pelosi, it could be a politically mortal wound.

.. in this era of decentralized political forces, more rank-and-file feel free to oppose their party’s leader. These Democratic dissidents are following the footsteps of Republicans who chased one Republican speaker, John A. Boehner, out of office and made life difficult for House Speaker Paul D. Ryan (R-Wis.).

.. Pelosi has deputized the incoming chairman of the Rules Committee, Rep. Jim McGovern (D-Mass.), to try to produce a new rules package designed to open up the House so that more junior lawmakers can have input through their committees, an olive branch to the incoming freshmen and dozens of ambitious younger Democrats who have felt underutilized in recent years.

Three Questions for Judge Kavanaugh

Judge Kavanaugh, I don’t know what happened in 1982. But I’m deeply troubled by what I perceive as your lack of integrity last week. You told the Senate Judiciary Committee under oath that your “have you boofed” yearbook question referred to farting, that “devil’s triangle” was a drinking game, that a “Renate alumnius” was simply a friend of Renate with no sexual insinuations, that the drinking age was 18.

Really? As James Comey tweeted: “small lies matter, even about yearbooks.” No one sensible is going to hold teenage drinking against you, but we are bothered when you mislead senators and the public today and deny what is obvious: As you put it in 1983, “we’re loud, obnoxious drunks.”

.. What can we call these but lies? And they come on top of deeply misleading testimony about your knowledge of stolen documents when you were in the Bush White House and your involvement in judicial nominations then.

.. 2. Do you have empathy for those who aren’t so blessed as yourself?

An air of entitlement hangs over both your testimony

.. Where the Supreme Court has made its worst mistakes, the problems have arisen often not from a lack of intelligence but from a failure of empathy.

  • In Dred Scott and Plessy, justices did not appreciate what it meant to be black in America;
  • in Korematsu, what it meant to be a Japanese-American facing internment;
  • in Buck v. Bell, what it meant to be a marginalized woman;
  • in Lochner, what it meant to be a laborer;
  • in Bowers v. Hardwick, what it meant to be gay.

If you had been on the court, Judge Kavanaugh, in 1873 for Bradwell v. Illinois, which upheld the State of Illinois’s decision to deny a woman a license to practice law based on her gender, your opinion no doubt would have been well reasoned — but would it have been just?

The American Bar Association’s Model Code of Judicial Conduct states, “A judge shall act at all times in a manner that promotes public confidence in the independence, integrity and impartiality of the judiciary.” Sneering at senators, even when feeling provoked, does not fit that code.

.. I’ve learned from my criminal justice reporting that witnesses err surprisingly often. You have earned a reputation as a first-rate conservative judge, and I thought it possible that there was some mistake and that you had been terribly wronged. But ultimately what perhaps damaged you most was not the unproven allegations of assaults decades ago, but your own lies and partisanship just last week.

.. President Trump has mocked Dr. Blasey, and Republican senators have released an explicit sexual statement to shame Julie Swetnick, another woman whom they have not bothered to listen to. So it appears that your side’s strategy is not to dispel the suspicion but rather to humiliate the accusers — violating them in a display of power and entitlement that is an echo of what they say took place so many years ago.

If that’s the path you choose, you should not sit on the Supreme Court.

Opening to the Question of Belonging: John A. Powell

because we are so powerfully rooted to the notion of individuality, in some ways race affronts that. But the real affront is the whole notion of individuality. Individuality, as we think of it, is actually extremely problematic.

MS. TIPPETT: Well, see — yeah, and you make this really fascinating point that — you say that there are two parents to the way we are now; the way we grapple with race, among other things. And one is slavery. Get that. And the other is the Enlightenment and that, in fact, it’s from the Enlightenment that we inherited this idea that the conscious mind could know everything; that we could be reasonable.

MR. POWELL: That’s the American exceptionalism. So the United States became extremely, extremely attached to the notion of individuality and independence. Now think about the groups who were not independent. They were the Africans. They were the Indians. They were women. They were anyone who was not a white male. So the notion, the Enlightenment project, which had this hubris that we could control everything, including the world, when we can’t even really control ourselves.

MS. TIPPETT: And yet, this condition of each of us in isolation, which you associate with whiteness, which is this culture of domination, is not sustainable, and it’s not desirable.

.. MS. TIPPETT: And we’re running into the limits of our ability to convince ourselves that it is desirable.

MR. POWELL: No, there are so many expressions that help us see it. And sometimes people talk about “We need to do things to connect.” And on one hand, that’s right, but on the other hand, it understates what it is. We are connected. What we need to do is become aware of it, to live it, to express it.

So think about segregation. Segregation is a formal way of saying, “How do I deny my connection with you?” in the physical space. Think about the notion of whiteness. So whiteness in the United States, as it came, as it took form, believed that one drop of “black blood” — whatever that is — would destroy “whiteness.” Turns out, whatever that means, most white Americans actually do have black blood. The reason that most African Americans look like me or like Gary is because white blood and black blood’s been mixing up for a long time. And so I think that as we deny the other, we deny ourselves, because there is no other. We are connected.

.. that that movement was as much for the sake of his soul as it was for the sake of people of color.

And it’s worth saying that. To me, that’s one way of talking about your point that we have to talk about whiteness.

.. I was teaching a class at the University of Minnesota, and I was talking about the taking of Native American land. And most of my students were white students, and one student objected; it’s like, “This is a such-and-such class. Why are we studying the history of Native Americans?” And I said, “We’re not. We’re studying the history of America. So, when we talk about the appropriation of Native American land, or when we talk about slavery, we’re not talking about the history of black people, we’re talking about the history of this country.”

.. I don’t care if you came here last week or ten days ago, you can’t understand this country without understanding the institution of slavery. It was pivotal.

.. MR. POWELL: The human condition is one about belonging. We simply cannot thrive unless we are in relationship. I just gave a lecture on health, and if you’re isolated, the negative health condition is worse than smoking, obesity, high blood pressure — just being isolated.

.. How do we make it infectious; how do we — people are longing for this. People are looking for community. Right now, though, we don’t have confidence in love. You mentioned love earlier. We have much more confidence in anger and hate. We believe anger is powerful. We believe hate is powerful. And we believe love is wimpy. And so, if we’re engaged in the world, we believe it’s much better to organize around anger and hate.

And yet, we see two of the most powerful expressions — certainly Gandhi, certainly the Rev. Dr. King

.. And there was a period of time when I was feeling really overwhelmed with a lot of this stuff. And I was talking to my dad, and I said, “Dad, this is just too much. I can’t do it all. I’m trying to do all of this stuff by myself.” And he looked at me; he said, “Well, john, you know you’re not alone.” And I said, “Well, what do you mean, Dad?” He said, “Well, you got God with you.” And I realized, although I don’t organize around God in the way that he does, my mistake was, I thought I had to do it; that “I” was defining it, instead of “we.” So…

MS. TIPPETT: …you were in that white mode.

MR. POWELL: Exactly, exactly.

[laughter]

So I think we should both get out of that white mode and do it together. [laughs]

.. today, the majority of whites today say they’d prefer to live in an integrated neighborhood and send their kids to integrated schools. What they mean by that is a different question, but also the world and demographics of the country are changing. And to live in a white enclave is not to live in the world. And I think it has” — I think you were — this is an interview — “it has a certain deadness to it. It has a certain spiritual corruption to it.”

And you said, “I think most people, white, black, Latino, and otherwise, would like to see something different. We just don’t know how to do it. And we’ve been so entrenched in the way things are. It’s hard to imagine the world being different.” You speak for me, you speak for so many people. This is what we’re up against. I feel like this is what we have to attack first — this inability to see differently.

You told one story about Oak Park, near Chicago. It was just really helpful to me. You said, when we tell stories about, “You integrate neighborhoods, and housing values go down,” and the way we always tell the story is, “Blacks moved in, African-American — people of color moved in.” And the way we could tell the story is, “Whites moved out.” But you talked about how — just this very practical measure that was taken so that the housing values didn’t change. Would you just tell that story? I feel like these little stories are really crucial, as well.

MR. POWELL: And there are really a lot of them. They’re little, and they’re big. So Oak Park is in Chicago. Chicago’s one of the most segregated areas in the country. Cook County has the largest black population of any county in the United States, and a lot of studying of segregation takes place in Chicago. So here you have Oak Park, this precious little community. And there were liberal whites there. And blacks started moving in. And they were saying, “Look, we actually don’t mind blacks moving in, but we’re concerned that we’re going to lose the value of our home. That’s the only wealth we have. And if we don’t sell now, we’re going to lose.”

And it basically said: If that’s the real concern — not that blacks are moving in, that you’re going to lose the value of your home — what if we were to ensure that you would not lose the value of your home? We’ll literally create an insurance policy that we will compensate you if the value of your home goes down.

And they put that in place.

.. Think about Katrina. So these examples are all around us, and yet, we don’t tell stories about them. Katrina — the face of Katrina, when you remember it, it was blacks stuck on roofs as the water was rising. What’s not told is that Americans, all Americans, gave to those people. It was the largest civilian giving of one population to another in the history of the United States. So here you had white Americans, Latino Americans, Asian Americans, trying to reach out to what they saw as black Americans. They were actually saying — they were claiming: We have a shared humanity. And they actually did a poll asking people if they were willing to raise taxes to rebuild: 70 percent of Americans said, “Yes, we would tax ourselves to help those people.” The pundits and the politicians ignored it, and so that story simply didn’t get told.

.. I put something I call “targeted universalism,” and where we want to get to is not simply what whites have. We actually need to state what is our goal. And then our way of getting there will vary, based on how we’re situated. And different groups are situated differently. So if we just say, “Let’s have our proportionate share of what whites have,” that’s an improvement over where we are now, but it’s not far enough.

we’re talking about what I call a “circle of human concern” — a circle of concern for all life, human life and, I would say, non-human life as well. And in that effort, it’s important to make sure that people of color are really valued and situated and have resources and political and other power that other groups have. But it’s also important to actually continue to be in relationship to whites. I think, ultimately, a healthy world really requires not just a restructuring of what people of color have, but a restructuring of white identity.

.. in the 1960s, Bundy wrote about the “negro problem” at the Ford Foundation, but today, I would write about the white problem. We really need to come to terms with the white problem — not in a negative way, not in terms of white guilt, not in terms of beating up on whites, but really trying to help whites, because we are deeply related, give birth to a different identity.

.. one of the best school systems in the United States was the Wake County school system. That’s the Research Triangle, which has more Ph.D.’s than any other area of the country. It was actually quite interesting, because they took it to the voters, and they said, “Do you want to have this school system which is educationally and economically integrated?” And the voters said, “No.” So then they took it to the politicians, and they said, “This makes sense, which — the voters said no, but would you vote for it as a politician?” And the politicians said, “No.” And then the business community said, “Unless you do something about the school system in Wake County, we’re leaving.” It was actually the business community that pushed it through.

.. “So Dad, why do you think” — because he’s very Christian, I said, “What do you think God is keeping you here for?” And he said, “I guess my last lesson to teach the kids is, how to care for me.” So instead of seeing it as a burden, because he needs care, it’s like, “That’s my last gift to you, is to teach you how to care.” And it really is wonderful.

I went to Stanford. I was one of the co-founders of the Black Student Union at Stanford. And we had a meeting, and in that meeting, we decided that there were definitely some good white people, but not that many.

[laughter]

And it took a lot of energy to find them. The transaction cost of finding good white people was way too high. So we decided, “OK, let’s just stop trying to find these — let’s not relate to white people.” Actually, I didn’t support that position, but that’s where the group went. And I left the meeting. It was about noon, and I was walking across Stanford. And I don’t know if you’ve actually been to Stanford, but the center part of Stanford is very busy, especially at noon, and there’s always people teeming about. And I’m walking back across campus in this area, and there’s nobody there. It’s empty. And all the time I was at Stanford, I’ve never seen that part of the campus like that. And then, there’s this one woman walking toward me.

Again, the physical space where students hang out is actually quite small, so you see students all the time. I’d never seen this woman before, and I never saw her again. And as she’s walking toward me, I notice she’s blind. And she has a cane. And she walks into a maze of bicycles. And I said, “Oh, that’s too bad.” And as she turns, knocks down bicycles, she starts panicking. And I’m thinking, “That’s really sad, but we just made this agreement. It’s not my problem.” I keep walking. She turns again, and she knocks down more bicycles. And finally, I can’t walk past her. And I go over, and I take her out of the maze of bicycles, and then she goes on her way. And I go back to the meeting, and I say, “I can’t do it. I can’t adhere to that agreement.”

And to me, that was one of the defining moments. And I sort of — I’m not a theist, but I wonder, how did the universe send that woman to me, that she helped me to engage and claim my humanity, that took me on a different path? And I think being human is about being in the right kind of relationships. I think being human is a process. It’s not something that we just are born with. We actually learn to celebrate our connection, learn to celebrate our love. And the thing about it — if you suffer, it does not imply love. But if you love, it does imply suffering.

So part of the thing that I think what being human means — to love and to suffer; to suffer with, though, compassion, not to suffer against. So, to have a space big enough to suffer with, and if we can hold that space big enough, we also will have joy and fun, even as we suffer. And suffering will no longer divide us. And to me, that’s sort of the human journey.