Health Care

More Americans Now Die at Home Than in Hospitals

Good news on the hospice front. For the first time since the early 20th century, more Americans now die at home than in hospitals. From a report in the New England Journal of Medicine:

In 2003, a total of 905,874 deaths occurred in hospitals (39.7%), which decreased to 764,424 (29.8%) in 2017, whereas the number of deaths at nursing facilities decreased from 538,817 (23.6%) to 534,714 (20.8%). The number of deaths at home increased from 543,874 (23.8%) in 2003 to 788,757 (30.7%) in 2017, whereas the number of deaths at hospice facilities increased from 5395 (0.2%) to 212,652 (8.3%). These trends were seen across all disease groups.

This trend is beneficial. But more needs to be done.

A few years ago, the bioethicist Art Caplan and I — we usually disagree about bioethical issues — coauthored a piece in USA Today urging repeal of the “cruel choice” requiring hospice patients to forgo curative or life-extending treatment in order to qualify for hospice services. Dame Cecily Saunders — who almost single handedly created the modern hospice movement — once told me that is like telling people, “abandon hope, all ye who enter here.” Boy, was she right, and it explains not only why too few people access hospice care, but why so many are in the program for such a short time that they and their families don’t receive its full benefit.

Back to the study. The authors agree with Caplan and I and make a few other suggestions in The Statesman. Among their suggestions:

Only about half of Americans die while receiving hospice services, and home-based non-hospice palliative care is still in its infancy. We need a new movement, one that embraces the best of what hospice pioneers envisioned but that also adapts to the reality of modern health care and society.

Upgrade hospice…Eligibility criteria for hospice should be based on a patient’s needs, not inaccurate estimations of prognosis or the treatments she or he is willing to forgo.

Change the one-sized fits all approach. Current policies present barriers to wider hospice use for people with non-malignant condition, who may benefit from disease-directed therapies late in their disease course and whose prognosis is less predictable. Racial minorities have lower rates of hospice use, likely due to greater mistrust of the health care system, cultural beliefs and preferences, and greater desire for life-sustaining care regardless of prognosis…

Make quality end-of-life care available in all settings. When asked, most people say they would prefer to die at home, and hospice use increases the likelihood of this occurring. Yet a home death is neither preferable nor possible for everyone. It is good when preferences can be honored and people are able die in the place of their choosing. Yet the reality of serious illness and the capability for caregiving are complicated.

The authors conclude with a story of the kind I saw many times in my volunteer work for hospice and which my own parents experienced:

Hospice allows many people to experience what some refer to as a “good death” in their homes. The goal of our health system should be to ensure that all Americans have the ability to choose such an opportunity.

One such person was Mary who, in her late 90s, realized she was dying. Her daughter-in-law Nancy described her final moments. “She died on April 24, peacefully and painlessly, about an hour after her hospice aide, Marie, had given her a loving bed bath and shampoo, changed her sheets, and massaged her feet and hands with oil,” Mary wrote to us in an email. “Mary held out her hand to Marie and said ‘Thank you,’ snuggled down into her bed, and about an hour later was gone.”

Another way to boost the provision of hospice and expand palliative care opportunities for terminally ill and non-dying Americans alike would be for Congress to pass the Palliative Care and Hospice Education and Training Act. We shouldn’t let fear-mongering and inertia to maintain the failings of the current still-inadequate system.

Law & the Courts

Obamacare Insurers Might Get Bailouts Congress Refused to Fund

A sign on an insurance store advertises Obamacare in San Ysidro, San Diego, Calif., October 26, 2017. (Mike Blake/Reuters)

Indeed, judging from the oral argument at the Supreme Court earlier this week, that seems more likely than not.

Here’s the backstory. When the Democrats drafted Obamacare, they knew they were asking insurers to take a big risk in the first few years of the program — no one knew how unhealthy the new enrollees would be, and the law prohibited insurers from charging sick people more. Many insurers would be reticent to take such a gamble without high premiums. So the law created “risk corridors” to contain the problem.

Specifically, Obamacare promised that the government would reimburse insurers for a set percentage of their losses during the early years of the exchanges. Insurers that made money, meanwhile, would chip in to fund these bailouts.

The law made its promises in stark language: The government “shall pay” the insurers who lose money, just as the insurers who make money “shall pay” into the system. But there was no guarantee that the payments from profitable insurers would be enough to cover the government’s obligations to the money-losing ones, and the statute didn’t provide any extra money for this purpose. A future Congress would have to appropriate these funds if they became necessary.

Well, they became necessary — but Republicans in Congress refused to appropriate the money, costing insurers who’d trusted the government’s promises billions of dollars. Some insurers are now seeking recompense from the Judgment Fund, an account Congress set up to pay judgments against the government.

The many legal issues here are technical and boring, and I won’t try to fully do them justice. But the basic arguments from the two sides illustrate what a frustrating situation Obamacare’s drafters and the later Republican Congress have managed to put us in.

First, the Constitution gives Congress the power of the purse: The federal government can’t pay out money unless Congress has authorized it to. When Congress refused to fund the payments, it arguably, by implication, repealed the government’s obligation to make them, even though it left the “shall pay” language in the law.

The counterargument is that no, the government can’t seduce companies into risking lots 0f money with the promise that any losses will be partially covered, and then simply refuse to cover the losses after they’ve happened. As Justice Stephen Breyer noted repeatedly, this kind of promise looks a lot like a contract — you do X, we’ll pay you $Y; they did X, they’re owed $Y. The Judgment Fund exists to take care of this kind of situation, and without it the government could run afoul of the takings clause by suckering companies this way.

Having read the oral-argument transcript, I agree with most others in thinking the insurers probably have at least five votes. They’ll likely get their bailouts, if a few years late.

World

To Be Zelensky, Etc.

President Volodymyr Zelensky of Ukraine and U.S. energy secretary Rick Perry following Zelensky’s inauguration ceremony in Kyiv, May 20, 2019 (Mykola Lazarenko / Ukrainian Presidential Press Service / Reuters)

Today on the homepage, we publish Part III of my Ukraine journal. I spend a little time on the new president, Volodymyr Zelensky, elected last April. He is an extraordinary figure, a populist par excellence. He had had no political experience whatsoever. He was a television entertainer — known by people throughout the country. In a series, he played an ordinary Joe who happened to get elected president. In real life, Zelensky won the presidency with nearly 75 percent of the vote.

Vitaly Portnikov, one of Ukraine’s leading journalists, says that his country has a “low political culture.” I will address this matter in Part IV tomorrow.

As I explain in today’s installment, I’ve talked with many people in Ukraine: pro-Zelensky and anti-Zelensky. All of them, however, have a degree of sympathy for the president: because he is in a daunting position. It’s hard enough to be president of Ukraine, given the war with Russia, etc. — but he has also been thrust into America’s current political drama.

A Ukrainian president cannot afford to be at odds with Republicans or Democrats. He needs the support of the United States, period. This support is vital to Ukraine.

Two days ago, President Trump had a meeting with Sergei Lavrov, the Russian foreign minister, in the Oval Office. As Kremlin spokesman Dmitry Peskov said the next day, “This is an important moment. The very fact that the Russian minister was received by the U.S. president is an important point, of course.” Indeed. It is very rare for a foreign minister to gain an Oval Office meeting with the president. A foreign minister is not a head of state or government, after all.

So far, Ukraine’s president has been denied a White House meeting. This is painful and bewildering to many Ukrainians. Ukraine is our democratic ally.

I would like to publish two letters from readers — the first relating to Viktor Yushchenko, whom I wrote about in Part II of my journal. I was discussing the Orange Revolution, in 2004. One of the presidential candidates that year, I said, had been poisoned. That was Viktor Yushchenko. I continued,

The poisoning did not kill him, quite — but it disfigured his face beyond recognition.

Yushchenko had a lot to endure. He had been known as an exceptionally handsome figure — he still is. And, yes, he survived the poisoning. But it sought to take away his sense of identity, his well-being, his security. He gave a tremendous example of physical courage and mental courage.

I saw him at Davos in January 2005, at the height of his disfigurement. (Over the years — with steady medical attention — Yushchenko’s looks returned to almost normal.) He was hard to look at. But he carried himself with tremendous dignity, and, honestly, you never saw a more noble face.

Yushchenko was president of Ukraine from 2005 to 2010. In the first two years of his presidency, he underwent 26 surgeries under anesthesia. A doctor was amazed that he could even sit. Yushchenko had to change his shirt several times a day, because of bleeding.

Opinions vary as to the quality of his presidency. But no one can gainsay the man’s courage. The Orange Revolution was bloodless, or nonviolent — except for Yushchenko.

A reader of ours says that Yushchenko’s achievements in office are unsung, or certainly under-sung:

In his first two or three years, Yushchenko increased direct foreign investment by 425 percent, from $8.4 billion to $36.5 billion; doubled GDP to $140 billion; doubled exports from $32.7 billion to $67 billion; doubled wages; quadrupled pensions; created 3.7 million jobs; obtained EU recognition of Ukraine as a market economy; obtained U.S. recognition of the same; got Jackson-Vanik restrictions lifted; got the Ukrainian education system accepted into the Bologna Process; initiated anonymous university entrance exams; established freedom of the press and held free elections; got the Holodomor recognized; and so on.

He did all this with powers vastly reduced by the constitutional reform of 2004, which increased the powers of the prime minister — who was a populist strongly opposed to serious economic reforms. And he did it while undergoing character assassination from the oligarch-owned media.

The reader adds that it is in the Kremlin’s interest to discredit the “color revolutions,” including the Orange.

Finally, a note from a member of the U.S. armed forces:

Hello, sir,

. . . I am a third-generation American, half Italian, half Ukrainian. Even with the Italian half, I consider myself one of the many in the Ukrainian diaspora. I was raised on stories of the oppression that my Ukrainian ancestors and relatives faced. When I went to college, Ukraine became my area of focus. I graduated with a degree in history and wrote my senior thesis on the Holodomor and why it should be recognized as a genocide. . . .

The diaspora I have found is amazing. I once saw a woman at an airport wearing a tryzub around her neck. [This is the Ukrainian coat of arms.] I lifted my sleeve to show her my tattoo and we smiled, with a strange sense of understanding. . . .

Here in the military, a fellow officer I met was actually an immigrant from Ukraine. One night in the field, he saw my tattoo and we got to talking, for hours. He knew little about Ukrainian history, but he knew about modern day-to-day experiences that were foreign to me.

My point, sir, is that the Ukrainian diaspora is a small but proud community, and as Ukraine has found its way into the news [for better or worse], there is an opportunity to inform people about important matters. . . .

Again, Part III of my journal is here.

Culture

Miller on The Madness of Crowds

Shane Miller at The American Conservative wrote a helpful review of Douglas Murray’s The Madness of Crowds. Miller draws both from Murray’s book and Scottish journalist Charles McKay’s similarly titled essay as he reflects upon the abrasiveness of modern Western discourse — from the tribalism that has embroiled our politics to the hostility that mars our culture. Miller writes:

The most plausible diagnosis for this cultural decay is that it’s a consequence of the loss of grand narratives and meaning that were once provided by the West’s religious and intellectual heritage. Murray also describes the astonishing appeal of these ideologies as a post-recession phenomenon, with the impact of the 2008 economic downturn having left young people feeling precarious and looking for ways to make sense of it all. As a result, politics isn’t a necessary nuisance; it’s the source of one’s purpose and meaning in life.

As politics became more and more an end unto itself — coincident with the collapse of organized religion — factional identity movements like women’s liberation, prefix-studies, and gender theory became functionally and ontologically religious. They developed unfalsifiable statements of faith — “a man can become a woman just by saying so” — as well as their own liturgies, heresies, and purity rituals. It has all of religion’s rules and mores with none of the grace and reconciliation.

Miller continues:

Naturally, making one’s identity and politics inextricable leads one to approach every question as if one’s entire existence is at stake. This subjects people to an ideological litmus test, as their sexual orientation, gender, and race take on political obligations. As a result, it is common these days to see excommunications of conservative gays and blacks…[Christian forgiveness has] been replaced by total retribution, which manifests in shaming others into oblivion for some moral crime they unknowingly committed.

As the West struggles to communicate amidst a minefield of identitarian “trip-wires,” Murray’s book is a helpful guide; Miller’s review is clarifying.

Education

Buckley Legacy under Attack from Campus Free-Speech Haters at Colorado College

William F. Buckley Jr.

Kudos to The College Fix for its coverage of efforts to suppress the distribution of Athwart Magazine, the new conservative journal published by students at Colorado College, who pay homage in the premiere issue to our founder (and who name the publication after the famous editorial he penned in National Review’s premier issue). TCF reporter Jeremiah Poff filed his story today, reporting that CC student snowflakes were angered by the magazine bearing the image of William F. Buckley Jr. on its cover, and proceeded to steal copies to prevent them from being available to the general student population. From Poff’s report:

A new student magazine at Colorado College that aimed to diversify intellectual discourse on campus and promised to publish a wide-range of unorthodox political opinions instead had dozens of copies of its debut edition stolen by bandits on campus.

What’s more, Athwart Magazine is facing backlash for dedicating its new publication to the legacy of William F. Buckley Jr., as accusations of racism against the conservative icon fly.

The magazine’s debut edition included op-eds such as “The Progressive Conception of ‘Rights’ Is as Seductive as It Is Dangerous,” “Against the $15 Minimum Wage” and “Identity Politics and the Dulling of Political Discourse on Campus.”

Student Nate Hochman, editor-in-chief of Athwart, told The College Fix in a telephone interview Tuesday that campus activists are rejecting the magazine’s call for discourse and have vowed to continue to prevent it from being read.

In a tweet Sunday, Hochman also noted that “student activists are attempting to pressure our college administration into taking action against us for including a picture of William F. Buckley on the cover of our new @ISI magazine, citing Buckley’s early writing on civil rights as reason for our censure.”

Athwart editor Nate Hochman, described the publication’s mission as providing an alternative to the “college’s monolithic culture self-censor.” Here’s the entire statement:

Our mission is to offer forth a platform for dissent from Colorado College’s political orthodoxy. Understanding that many students who feel suffocated in our college’s monolithic culture self-censor due to legitimate fears of angering the tyrannical and ever-morally righteous mob, Athwart hopes to protect and nurture unpopular and socially risky opinions. Athwart welcomes contributions from anyone who, regardless of personal ideology or political affections, regards the perpetual chorus of agreement in the classroom — and genuine shock, horror and confusion expressed towards rare instances of dissent — as deeply troubling. In the words of William F. Buckley, to whom this magazine is humbly dedicated, “we have nothing to offer but the best that is in us.”

How very triggering.

Here’s the Athwart website. You’ll find @AthwartMagazine here. It’s been launched via the great folks at Intercollegiate Studies Institute’s Collegiate Network.

National Security & Defense

Ideas Have Consequences

U.S. Army paratroopers in Afghanistan, September 2017 (Corporal Matthew DeVirgilio/US Army)

In the process of correcting Senator Josh Hawley and others on the details, I think my colleague Ramesh Ponnuru is understating the importance of ideas and ideology over the last 20 years of American foreign policy. We didn’t go to Afghanistan for an idea, nor Iraq, he contends. Ponnuru cites Bush’s ideologically extravagant second inaugural — the one that talked about the United States lighting a “fire in the minds of men” in its crusade against tyrants-as an “after-the-fact” justification in the absence of weapons of mass destruction.

It’s true that the public was sufficiently moved by arguments for avenging the 9/11 attacks and preventing others, but it’s wrong to think policymakers weren’t moved by ideology or intoxicated by the atmosphere it produced.

Early after 9/11, George W. Bush announced that U.S. foreign policy would not make a distinction between the terrorists and those who harbored them. Namely: state actors. Very quickly, this policy began to generate a theory that pitted democracy on the side of moderation, modernity, and peace, and tyranny on the side of terrorism and instability. At the State Department, Paul Wolfowitz would predict that Iraq would be the first Arab democracy, and it would “cast a very large shadow, starting with Syria and Iran, across the whole Arab world.”

By August of 2002, Vice President Cheney was advancing an early version of the new democratic-domino theory. “Regime change in Iraq would bring about a number of benefits to the region. When the gravest of threats are eliminated, the freedom-loving peoples of the region will have a chance to promote the values that can bring lasting peace,” he said. So, I think it’s a misjudgment to say that Bush’s second inaugural was merely a post-hoc rationalization for a war that lost a casus belli.

There was a post–Cold War surge of optimism about globalization, and it produced a lot of burble about how countries with McDonaldses don’t go to war with each other. That optimism was initially nurtured with big rewards: peaceful transition for post-Soviet Republics, NATO expansion, expansion and prosperity for the EU, an end to the Troubles in Northern Ireland, and great hope for Chinese democracy. In some ways, it was less an idea than a mood. 9/11 was felt as a serious shock or violation of this optimism. And the ideas generated in response to it seem in retrospect like a militant attempt at recovering that optimism about the post-Soviet world. The sunny uplands of democracy and peace were still the future, but we would have to fight for it.

This maybe wasn’t the dominant theme for public consumption, but news reports from before the start of the Iraq War were attentive to the ideas and ideology underwriting it. And we shouldn’t totally downplay the humanitarian and democratizing motives of the public, either. President Bush established the America’s Fund for Afghan Children shortly after 9/11, and we made much of the purple fingers in post-war elections in Afghanistan. It was important not just to avenge our attackers but to be seen as doing good.

Obama’s team may have rejected Bush’s unilateral approach, but they too tended to be naive about what democracy would mean in certain countries of the Middle East.

National Security & Defense

Finally, a Space Force — Now Comes the Hard Part

Tropical Storm Bill in the Gulf of Mexico in a picture from the International Space Station by NASA astronaut Scott Kelly, June 15, 2015. (NASA/Handout via Reuters)

So now, barring a last minute hold up, we have the Space Force President Trump wanted, a new military service dedicated as one proposed concept puts it “The mission of the US Space Force will be to deter conflict in space, enable commerce, ensure the rule of law, and should deterrence fail, secure American and allied diplomatic, information, military and economic interests in space while supporting terrestrial forces seeking the earliest possible war termination on favorable terms.” The organization’s success will be judged by its ability accomplish these tasks. Unfortunately, the Space Force starts life at a disadvantage.

Congressman Mike Rogers (R., Ala.), who has been a driving force behind this effort, is quoted saying that “We have allowed China and Russia to become our peers, not our near peers and that is unacceptable.” Indeed, when it comes to space weaponry, one knowledgeable source explained that if the Defense Department followed its usual procedures it would take us as long as ten years to catch up with Beijing and Moscow. Fortunately for us, the Space Force will be able to focus on repairing the vulnerabilities of America’s space systems without being distracted by other institutional priorities.

General David Goldfein, the outgoing Air Force Chief of Staff, has publicly confirmed that China has a full set of anti-satellite weapons, including co-orbital ones that can creep up on their targets and destroy them. They also now have high powered jammers that may be able to degrade or eliminate the U.S. GPS system and even take out our array of communication satellites that link with our intelligence gathering spacecraft.

The creation of Space Force is more important than ever, but the greatest challenge for President Trump will be to find the right military and civilian personnel to lead the new service. What the Space Force desperately needs are leaders who combine real expertise with vision, and above all: have the moral courage to go against those individuals in the military space establishment and the arms control advocates who’ve allowed the U.S. to lose the military space supremacy it once had.

This means that the men and women who’re going to lead the United States Space Force are going to have to go to Secretary Esper and to the White House and make the case for an urgent program that will quickly develop systems to defend our national space assets and to hold at risk those of our potential adversaries. And most important of all, they will have to convince a divided Congress to fund this effort.

The old procurement rules and their associated bureaucracies cannot be allowed to slow down these programs. The Space Force procurement organizations, including the new Space Development Agency must be allowed to experiment as well as the freedom to fail. The new service must also be allowed to deploy systems before they are fully certified and tested. Getting these systems into operation, even if they are less than perfect, is now more important than following rules that were laid down in the 1980s and before, which were intended to satisfy politicians who feared being accused of spending money on weapons that ‘wouldn’t work’.

As they begin to build a new organization and a new institutional culture, the men and women of the Space Force deserve to be encouraged and allowed a high level of forbearance. Their job is not going to be easy, but the reward, a future of Pax Americana in space, are worth it. The alternative may be devastating.

Politics & Policy

The Schiff Memo Was a Disgrace

It’s worth remembering, in light of the Horowitz report, the media freak-out that accompanied the release of the Nunes memo on FISA abuse, which was considered debunked by subsequent Schiff memo. The Wall Street Journal has a good editorial on how the rival claims of the two memos look now:

Monday’s Justice Department Inspector General report on the FBI’s Trump -Russia probe is illuminating in many ways, not least the light it casts on the previous claims by politicians when they were telling the public about what they saw in classified documents. House Intelligence Chairman Adam Schiff in particular has been exposed for distortions and falsehoods.

Americans first learned about the FBI’s abuse of the FISA process in a February 2018 memo from then House Intelligence Chair Devin Nunes. The memo disclosed that the FBI had obtained surveillance warrants from the Foreign Intelligence Surveillance Court against former Trump aide Carter Page; that the dossier written by ex-British spook Christopher Steele and financed by the Clinton campaign had formed an “essential” part of that application; and that the FBI failed to tell the FISA court about Mr. Steele’s political and media ties.

This was news, but Mr. Schiff and Democrats called the Nunes memo false and weeks later released a rival summary of the classified FISA evidence. Now the IG has settled the debate by confirming the details in the Nunes memo and exposing Mr. Schiff’s untruths.

Elections

What’s Got Trump Doing Better in the Swing States?

President Donald Trump in Pittsburgh, Pa., October 23, 2019 (Leah Millis/Reuters)

Maybe it’s impeachment, or maybe it’s just that we don’t get head-to-head swing state polling that often, but Trump is looking a little better when voters are asked if they’re leaning towards the incumbent or one of the Democratic challengers. OH Predictive Insights puts Trump ahead of all challengers in Arizona, although by only 2 points ahead of Joe Biden and Pete Buttigieg. Firehouse Strategies — a GOP firm, so take as many grains of salt as you deem necessary — finds Trump has the lead in Michigan, Pennsylvania, and Wisconsin in hypothetical match-ups against former vice president Joe Biden, Senator Elizabeth Warren, Senator Bernie Sanders, Mayor Pete Buttigieg, and former mayor Michael Bloomberg.

Emerson had Trump narrowly ahead of Elizabeth Warren in New Hampshire, and now Emerson sees movement in the head-to-head matchups in Iowa, a state Trump won by 10 points in 2016:

Trump leads all potential Democratic opponents in head to head matchups in Iowa. The President leads Buttigieg by a point 46 percent to 45 percent. Against Biden, he leads 49 percent to 45 percent, and against Sanders and Warren he leads 50 percent to 43 percent. This is a shift from the previous Emerson Iowa poll, in which Sanders lead Trump by a point, and Biden and Warren trailed Trump by two points.

You can put in all the appropriate caveats — there’s still a lot of race to run, these leads aren’t very big, and some aren’t outside the margin of error, and so on. But for much of the past year, Democrats looked at the big swing in the 2018 House races and Trump’s low approval ratings and figured they would have the wind at their back in 2020. Eh, maybe not.

National Security & Defense

The Ideas That Didn’t Drive Our Foreign Policy

A few weeks ago, Senator Josh Hawley (R., Mo.) offered his thoughts on how U.S. foreign policy had gone wrong.

When the Berlin Wall fell 30 years ago this month, more than a few experts predicted the end of history: Communism was dead and democracy triumphant. Now U.S. power would remake the world, which would come to look a lot like America. George H.W. Bush famously called for a “new world order” of “open borders, open trade and . . . open minds,” a new era of international peace and harmony, all to be achieved by American exertion.

But history refused to end. Russia and China conspicuously pursued their own agendas and, in other regions and other places, ancient rivalries flared. None of this stopped American policy makers from pursuing their new global order. All these years later, we are living with the results: the longest war in American history, in Afghanistan; trillions of American dollars expended on failed nation-building; exhaustion at home, aimlessness abroad; and a newly dangerous world.

In our latest issue, Elbridge Colby makes a more muted version of this case. And much of what he has to say, like much of what Senator Hawley had to say, strikes me as sensible. It seems to me, though, that both of them are overstating the role that an ideology of bringing market democracy to the world has played in U.S. foreign policy.

President George H. W. Bush did not, in fact, call for a new era of peace and harmony, “all to be achieved by American exertion.” We did not go into Afghanistan because of our dedication to opening minds abroad. We didn’t go into Iraq for that reason, either. President George W. Bush’s second inaugural address was an after-the-fact rationale for what we were doing in Iraq after it turned out the U.S. government (and many other governments) had been wrong about its nuclear weapons program.

Hawley and Colby are making a welcome call for realism in foreign policy. It ought to include some realism about our recent past.

Politics & Policy

The American Political System Does Not Include a Magic Wand

Rep. Alexandria Ocasio-Cortez (D., N.Y.) waves on Capitol Hill in Washington, D.C., May 15, 2019. (Joshua Roberts/Reuters)

In the past year, we’ve heard Alexandria Ocasio-Cortez propose retrofitting every building in America for energy efficiency, Beto O’Rourke propose a mandatory nationwide buyback of AR-15s, and four Democratic senators introduced a Constitutional amendment to eliminate the Electoral College.

On the Right, President Trump declared that he wanted to eliminate birthright citizenship through an executive order, and Sohrab Ahmari envisions a system of American government that eliminates “viewpoint neutrality in access to public spaces” — that is, American laws would deem certain taxpayers would not be entitled to equal access to the facilities they paid to create because of their beliefs and ideas they propose.

We have no shortage of political thinkers and Twitter revolutionaries who envision grand, sweeping overhauls of American society, including dramatic changes to the Constitution. Very few of those making these sweeping proposals have figured out a foolproof plan to win a House or Senate majority. Never mind crawling before they can walk, they want to jump straight to interplanetary travel from crawling.

Show me that candidates you endorse can win a few swing states or districts with that explicitly stated and detailed agenda, and then we’ll talk about how you’re going to completely change the daily life of every American — and immanentize the eschaton along the way.

World

Britain’s Election: Red Swan Approaching?

(Paul Hackett/Reuters)

The latest polling for tomorrow’s U.K. election makes uncomfortable reading.

The Spectator:

. . . YouGov forecasts that the Conservatives would win 339 seats with Labour on 231, the Lib Dems on 15 and the SNP on 41. The previous MRP poll had Labour losing 44 seats to the Conservatives – this has now been reduced to 29…

What will give the Conservatives pause for thought, however, is that although the MRP projects a majority – its range of possible outcomes stretch from 367 Tory seats to just 311, short of a majority. Based on the data, YouGov’s director of political research Anthony Wells said: ‘based on the model we cannot rule out a hung parliament.’

And this polling (I imagine) was taken before the incident described by Madeleine Kearns yesterday:

In a cringeworthy exchange with an ITV reporter, an exhausted-looking Johnson refused to look at a picture of a four-year-old boy with suspected pneumonia. Holding up his phone, with the photo of the boy, the reporter claimed that the child had been forced to sleep on a pile of coats at an NHS hospital. As the reporter continued asking him to look at the photo, Johnson took the reporter’s phone and temporarily put it in his own pocket while continuing to hammer home his scripted message about the NHS.

Even if we discount (as we should) some or most of the debunking that followed it, the story is a little more nuanced than was widely reported, as are its non-political implications, but its political consequences might be devastating. As Madeleine points out, the NHS (Britain’s National Health Service) weighs disproportionately heavily in British elections. And, however unfairly, it weighs in ways that rarely benefit the Tories.

Whatever the Conservatives might have hoped, to believe that this election ‘would’ just be about Brexit was naïve. One of the consequences of this naïveté has been a failure to focus enough on what Labour’s Britain would be like. Spoiler: Venezuela. Such an approach should also have incorporated a sustained — and far fiercer — attack on the highly disreputable pasts of both Labour leader Jeremy Corbyn and John McDonnell, his infinitely more accomplished, and infinitely more dangerous, lieutenant, not to speak of the anti-Semitism ingrained in a Labour Party that bears very little resemblance to what it once was.

Then there’s this:

The Guardian:

Is the “youthquake” of 2017 about to be upstaged? After just a glimpse at the voter registration figures for the upcoming election, it looks as if the next quake might chart even higher on the Richter scale. More than 3 million people registered to vote between the election being called and the deadline – 875,000 more than the same period in 2017 – and two-thirds of them were under 35.

The under-35s skew extraordinarily heavily towards Labour.

Tory hopes essentially rest on the party’s ability to win over Leave-voting blue-collar voters in such numbers that they will compensate for tactical voting in the affluent south by Conservative Remainers still hoping to stop Brexit by securing a ‘hung’ parliament.

While I think that the Tories will see a substantial increase in their vote among working class Leavers, I am unconvinced that such voters will switch sides in enough numbers for enough Labour seats to change hands.

As for any ‘hung’ parliament, it would effectively be dominated by Labour, which would now have political momentum behind it. Contrary what is now being claimed, a resurgent Labour could not be safely contained within the ‘progressive’ coalition of Remainer dreams. After another election within, inevitably, nine months or so, and, aided by the Scottish Nationalists, Labour would be calling the shots, and Britain’s road to ruin would be clear.

The best hope for the Tories now is that this latest poll may persuade Conservative Remainers and even a few Liberal Democrats that, however much they detest Brexit, “lending” 10 Downing Street to Corbyn (or a surrogate) is much more of a dangerous gamble.

At the end of October, I wrote this:

My predictions are, of course, famously flawed, but it looks to me as if the Tories are finally going to pay the price for an approach to Brexit characterized by wishful thinking, arrogance and an unwillingness to dive into the details that Brexit was always going to demand. And if I’m right about the consequences of this bungling (I hope I am not), the result will be a defeat for the Conservatives and their replacement by a “progressive” coalition that includes the Liberal Democrats, the Scottish National party and, of course, a Labour party that has swung far, far to the left.

For various reasons, I am mildly more optimistic than I was six weeks ago, but not by enough to give any grounds for comfort. Thursday evening will be . . . interesting.

Culture

The Person Who Most Influenced the News in 2019 Was . . .

Greta Thunberg speaks at the 2019 United Nations Climate Action Summit, September 23, 2019. (Carlo Allegri/Reuters)

Time magazine selecting juvenile climate-change activist Greta Thunberg as the publication’s “Person of the Year” is not surprising.

But it is surprising to see the Washington Post‘s Jen Rubin grumbling about the selection, contending it is “preposterous to assert that Thunberg had a unique, transformative impact on public opinion in a way no other person has.”

Rubin writes she would have preferred the Hong Kong protesters, the whistleblower who set the impeachment process in motion, or House speaker Nancy Pelosi.

If the criteria is simply which figure had the greatest impact on the news in the past year, every year the President of the United States qualifies, and other world leaders like North Korean leader Kim Jong-un and Russian president Vladimir Putin often shape world events, year in, year out.

Past selections like Hitler, Stalin, and the Ayatollah show the magazine’s newsmaker of the year may be a villain. By that criteria, surely Jeffrey Epstein qualifies as a monster who inadvertently revealed to the public a deep and far-reaching corruption among the wealthy and powerful. Perhaps no figure loomed larger in American politics in 2019 — or surprised us more — than special counsel Robert Mueller. The news around him disappointed Democrats, but that does not make it any less consequential.

But if you want to pick the figure who had the wildest and most unexpectedly consequential year, how about Volodymyr Zelensky? At this time last year he was just a comedian and television star, then he was elected president of a country fighting off an invasion by Russia, and now he is a central figure in the impeachment of an American president.

Or, if Time just wanted to sell a lot of copies, they could have just picked Baby Yoda.

Politics & Policy

Five Points on the IG Report

U.S. Justice Department Inspector General Michael Horowitz arrives to testify before a Senate Judiciary Committee hearing on Capitol Hill in Washington, U.S., December 11, 2019. (Erin Scott/Reuters)

Five things we haven’t discussed regarding the various IG reports.

1) Are FISA judges so naive that they would accept DOJ and FBI submissions of transparently weak evidence supported mostly by Steele’s amateurishly composed dossier? And if they were notified that the information was the work of oppositional research, why did they not simply ask who paid for it? Who were the judges who signed these fraudulently produced requests, and are they subject to judicial review?

2) What was the actual role of Deputy Attorney General Rod Rosenstein, who signed a FISA application and according to Andrew McCabe discussed ways of wearing a wire to record private conversations with the president in order to find support to invoke the 25th Amendment?

3) There appears to be no evidence for the FBI contention that its operatives did not warn candidate Trump of collusion investigations of his campaign, because of legitimate fears he might be involved. And this FBI alibi operated in a larger landscape in which James Comey in a private conversation with the president later misled him about ongoing investigations, then memorialized his version of that confidential conversation, and then leaked that information to the press (earning him a criminal referral from the IG), and a McCabe-Rosenstein conversation about potentially entrapping the president to reveal evidence on tape of alleged mental instability to fuel a 25th Amendment motion. In sum, the degree to which the FBI decided to brief the president seems entirely contingent on its ongoing efforts to entrap, mislead, or set him up.

3) If Hillary Clinton hired foreign national Christopher Steele, through three firewalls of the DNC, Perkins Coie, and Fusion GPS to find dirt on her political opponent, through his use of one or more Russian sources, why has she not been called before Congress to testify about what seems to be a clear violation of the law governing the use of foreign nationals in a U.S. campaign? Did she not use Russian sources to attempt to damage her opponent and thereby to warp the 2016 election?

4) Was there one major principal in the Horowitz report — Comey, McCabe, Steele, the Ohrs, Downer, Strzok, Page, Clinesmith, etc. — who either had not given some prior evidence — in texts, emails, statements — of anti-Trump bias, or did not have conflicts of interest involving receiving Clinton-related cash or donating to Clinton related entities?

5) Was there one cited example of wrongdoing in Appendix A of the Horowitz that could be remotely interpreted as evidence of pro-Trump bias? If not, why not?

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