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        <title><![CDATA[Stories by Larry DeLuca on Medium]]></title>
        <description><![CDATA[Stories by Larry DeLuca on Medium]]></description>
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            <title>Stories by Larry DeLuca on Medium</title>
            <link>https://medium.com/@larrydeluca?source=rss-f8856be11f28------2</link>
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            <title><![CDATA[Riffing on “conservative oppression” … by someone who actually belonged to a group who was…]]></title>
            <link>https://medium.com/@larrydeluca/riffing-on-conservative-oppression-by-someone-who-actually-belonged-to-a-group-who-was-de38a96742e1?source=rss-f8856be11f28------2</link>
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            <category><![CDATA[donald-trump]]></category>
            <category><![CDATA[lgbtq]]></category>
            <category><![CDATA[lgbt-rights]]></category>
            <category><![CDATA[conservatives]]></category>
            <category><![CDATA[politics]]></category>
            <dc:creator><![CDATA[Larry DeLuca]]></dc:creator>
            <pubDate>Thu, 12 Apr 2018 19:18:54 GMT</pubDate>
            <atom:updated>2018-04-12T19:18:54.347Z</atom:updated>
            <content:encoded><![CDATA[<h3>Riffing on “conservative oppression” … by someone who actually belonged to a group who was oppressed …</h3><p>The LGBT community was (and in many ways still is) oppressed, though things are dramatically better than when I was a child. While there were a few voices crying out “we are oppressed!” from the beginning, the hard work of changing hearts and minds went on simultaneously, and while pointing to oppression might have been a rallying cry to organize, it certainly did little to advance equality beyond that point.</p><p>So take it from the oppressed. The conservative movements needs to do a lot of things:</p><p>1. Generate better data. Many of the most damaging stereotypes (and those that provoked the most extreme and violent reactions against LGBT individuals) were simply not true. However, when I was a child, my family believed all of the following:</p><p>- All gay people are child molesters</p><p>- All gay people want to “convert” people (otherwise how could they reproduce?)</p><p>- Gay people couldn’t sustain long-term relationships (despite a divorce rate of 67%)</p><p>- Gay people were all promiscuous</p><p>- Gay people were mentally ill</p><p>- Gay people were depressed because of their sexual orientation</p><p>Each of these myths has been disproven by data. I remember back when I was a closeted kid in my orthodontist’s office furtively reading a copy of TIME magazine that had a little blip about a study that showed that not all gay people were constitutionally depressed. I couldn’t talk to anyone about it (for obvious reasons) but man, oh, man, that was reassuring.</p><p>Since there wasn’t same-sex marriage until recently, it’s been much harder to gather statistics on same-sex couples in the same convenient way we can on opposite-sex couples (why Conservatives are fighting to get same-sex couples off the census).</p><p>The problem of “mentally ill” was a circular definition, that again needed better science. More finely-grained analyses and testing different hypotheses led to the discovery that many of the problems of the LGBT community were not inherent to being LGBT, but were situational and geographical due to the hostility of the outside community. That was a BIG change. It was part of what led to the declassification of homosexuality as a mental illness in 1973. However, that was done not by a diagnostic test, but by a vote of APA members — 5854 to 3810. Attitudes change slowly, and not uniformly.</p><p>2. Better PR. Tomi Lahren whining incessantly about conservatives being oppressed or Dana Loesch telling all of us without an AR-15 “Time’s Up” or any of the truculent stances recently displayed by movement extremists don’t win anyone over, and they spill over the to more moderate members of the aisle as collateral damage. It’s ironic that Conservatives are offended by #BlackLivesMatter because they fear its perceived militarism, yet they have no problem with Alex Jones or Roger Stone calling for Civil War if Trump is found to have committed impeachable offenses.</p><p>Frequently Liberals complain that Conservatives are simply not very nice. The problem for Conservatives is bullying is wearing off as an effective tactic, because in elevating Trump they’ve so badly overplayed their hand. There are a lot of us Liberals who have a lot of Conservative friends, and though our policy views might be extremely progressive that does not mean that we don’t have empathy, nor that we don’t understand that democracy requires compromise. Be nice, and we’d probably be both relieved and willing to work with you.</p><p>3. Re-establish trust. The current plan of deception and projection as a primary political tactic must come to an end. It got its most recent start in the 90’s, when the National Right to Life Committee realized they could never overturn Roe explicitly, so they set about a campaign of chipping away incrementally, and making the ruling moot. This is not new, as it’s the same sort of tactic used in the Jim Crow era. It’s also “love the sinner, hate the sin.” This gives Conservatives a problem when they try to sincerely be nice. No one trusts them, because Liberals have been deceived too many times.</p><p>It’s also bad for policy. Consider the fight over whether gynecologists performing abortions in Texas needed hospital privileges at a nearby hospital. The discussion very quickly shifted away from patient safety and devolved into accusations that Conservatives were working to limit abortion access without science that demonstrated a need for something that would be expensive and intrusive. Same thing for making the patient watch ultrasounds, etc. It might generate more resistance upfront if you are honest about your motives — we want to reduce the number of abortions — but it might also generate better ways of doing so, because while there is disagreement about the means, there is broad agreement among Conservatives and Liberals that reducing the number of abortions performed is a desirable goal.</p><p>4. Fix your platform so it’s not in conflict with itself. This is hard, because there’s always a big plurality of thought. The LGBT community was not immune to this. But we’ve seen the virtual disappearance of lesbian feminist separatists, not because they’ve separated so much as because the idea of apartheid doesn’t look any better on the oppressed than on the oppressor, and the LGBT community has made equality and tolerance of diversity its central issue against which pretty much all others are measured. Promoting separatism of any sort is inconsisent with that shared value.</p><p>Conservatives are easily mocked when they argue for small government and that there should be no intrusion of government into private life, and then they support recriminalization of same-sex relationships, for example. So we hear Liberal snark like “government small enough to fit in your uterus,” but deep down one of the largest problems for Conservatives right now is there is so much disharmony in their various platforms, unless you consider the unifying principle to be the desire to live in a Christian Authoritarian State (which might explain why people like George Will and Jennifer Rubin are increasingly shut out of the debate).</p><p>The bigotry of a segment of the Conservative movement is toxic. It always has been. It was toxic when the Conservatives of the 1950’s (segregationists) were in the Democratic Party, and when we jettisoned them they brought their toxicity to the Republican Party. There are many good ideas that are worthy of preservation, and slow progress is important on many fronts. But in the US we have used Conservatism and fears for social stability as a smokescreen for bigotry for centuries. It needs to end.</p><p>Right now, Conservatives are advocating for small government that doesn’t interfere in private lives with respect to handguns. However, their platform also includes planks like “Overturn Roe V. Wade” and “Pass a Constitutional Amendment Banning Same-Sex Marriage.” Unless you are a Christian Authoritarian Bigot (or dumb as a rock) these are in conflict, and when you press Conservatives to resolve it they scream about the second amendment and then get very angry. The anger is a sign that the argument is likely not defensible, and needs to be reconsidered.</p><p>5. Start studying science and history seriously again. The Conservative movement has spawned an entire array of substandard academic institutions. One needs merely look at the pass rate for the bar from Liberty University compared to other law schools to understand that while this education may be theoretically based in “Christian Principles,” it is clearly substandard and not adequate for the majority of their graduates to function in the legal profession. But rather than recognize the need to raise educational standards, Conservatives have asserted “liberal bias” and are working hard to replace judges “with a Conservative viewpoint.” The cure to bias is not more bias. The cure to bias is better education and more intelligent arguments.</p><p>Conservatives likewise are damaged by their insistence on refuting science with theological arguments. The way to refute science you don’t agree with is with more science and hypotheses that test questions better, and more rigorous methods. Consider again the issue of the stability of same-sex relationships — or even Kinsey’s pioneering work on sexuality. The sexual revolution didn’t happen because Kinsey willed it. It was his academic rigor that brought two larger ideas out into the open — that there was much more variety in human sexual expression than previously thought; and that the denial of this variety was having a profound and damaging effect on individuals, families, and communities. But it was not a faith-based initiative — it was a data-driven revolution.</p><p>6. Accept that you may not personally have oppressed anyone, but you may have some history to answer for. You don’t have to be a bad person to acknowledge that wealth or skin color or ethnicity might have played a role in your success. But you should not be so insecure that you cannot face these realities, either. If we are to bring an end to systemic racism and discrimination we need to treat it in a systemic fashion. That means carefully examining gender, racial and ethnic disparities in interactions with law enforcement and the criminal justice system, disparity in educational opportunities and job advancement, and a host of other areas.</p><p>A lot of my own family’s arc followed this pattern. When you’re the first open LGBT member of your family, you lay a lot of ground for those that come after you. And we as a family wrestled with a lot of stuff. My family learned a lot about how to be an ally. And now with at least 3 other LGBT members in my family tree it’s made their lives immensely better. And part of “family values” to us has always meant loving the people in your family and finding ways to support them.</p><p>7. Acknowledge that your complacency with discriminatory policies furthers them, and figure out what you’re going to do about that.</p><p>The irony is that the people who say “I’m a Republican but I’m not a homophobe at all” are far more empowered to change damaging and discriminatory planks in their party’s platform than Liberals are.</p><p>If you think those policies are wrong-headed, and you know people who are hurt by them, why are you not actively working to change them? Even if you try and fail, your Liberal friends will think the world of you for your support.</p><p>8. Ditch Donald Trump. Not because Clinton should have won. Not because Conservative ideas are bad. But simply because he’s a bad person and a terrible role model. The Conservative movement has taken so much damage by continuing to prop up Trump. Imagine how different the world might be now if Clinton had won and Conservatives could still enjoy the security of knowing they had not compromised their morals. Past history suggests that a judge as qualified and intelligent as Neil Gorsuch, while a Conservative pick, is hardly the extreme idealogue Conservatives paid their thirty pieces of silver for. The number of lower-court judges that were poor candidates pushed through by this administration is staggering, and they will likely produce many erroneous and ill-informed rulings over the next couple of decades …. that will be overturned by the Supreme Court. Extremists know this, and it’s why they want the Supreme Court compromised. But that is very, very hard to do, because the competition is so intense, and the position requires so much scrutiny. Remember Harriet Miers? No one wants to go back to that. It should be a lesson that appointing someone who is completely unqualified will result in humiliation and withdrawal of the nomination at that level. And try as they might to stack the lower courts with idealogues, as long as the Supreme Court is the appellate court of last resort in the end those judges and all their bad rulings won’t matter. They’ll cause a lot of pain, and add to the costs of litigation, but they won’t prevail.</p><p>Conservatives, in elevating Trump, fail to acknowledge the degree to which the President is the moral leader of not only the Republican Party, but in this current climate also the spiritual leader of Evangelical Christianity. Trump has not only lived the life that Conservatives (and especially Evangelicals) rail against, his ascension reinforces the notion that there is no penalty for adultery, divorce, lying, and sexual assault. And unlike the host of defrocked evangelical leaders before him, voters had no illusion about what they were getting in Donald Trump — and voted for him anyway. THAT is the problem.</p><p>But Trump is a time bomb. He won’t fully detonate until the children of parents who voted for him now are teens or young adults. When their parents are wondering, “how could my child have ended up with a rape conviction?” Consider who you voted for, and the values you taught them when you said, “vote for the president, but act differently.” What kid doesn’t want to be president? And besides, look at what the President gets away with. Morals are for little people.</p><p>9. Reclaim the mantle of moral authority, but be willing to share. AKA, it’s time for the culture wars to end. The first step for Conservatives is to harken back to their fundamental principles. Sort out the discord. After that, it’s time to start living those principles, and choosing (qualified) candidates that embody those principles. Trump aside, in the last year we saw Roy Moore on the ballot in AL (who has thumbed his nose at the Supreme Court multiple times, his objectionable behaviors toward women aside), the current front runner for Paul Ryan’s district is a known and avowed white nationalist, and there is a LITERAL NAZI running for a seat in Illinois. Claiming you are the party of “moral values” is inconsisent with running candidates of this ilk.</p><p>It’s also time to acknowledge that part of the first amendment’s “Religious Freedom” is an acknowledgement that there are multiple different spiritual and moral paths that are accepted in our world as valid. While we have common, secular laws in the US, inherent in the belief that multiple religions can co-exist is the understanding that competing moral frameworks can be recognized as equally valid. This doesn’t mean you have to like your neighbor’s morality — but it does mean you have to respect it as valid, and that you have to find a way to treat them decently, even if you raise your kid differently.</p><p>10. You’ve got to clean up your house. Ditching Trump is only the start. It doesn’t matter that the Illinois Nazi will probably lose — it matters that Republicans can’t run a better candidate in the district — and it also matters that there were 20,000 people willing to vote for the Nazi in the primary. Whether these people are true Nazis or just extreme tribalists, it’s a problem. Nazis should get ZERO votes. Period. That’s not suppressing their viewpiont — it’s rejecting it. And rejecting Nazism shouldn’t really be a conflicting consideration in the USA.</p><p>There is also the obstructionism and duplicity of McConnell to deal with. Deep down you know you’d howl if a Liberal obstructed judicial appointments like that, and you would be right to do so. The idea that gumming up the wheels of government is good governance has to end. But it’s not just an obstruction problem — it’s a sincerity problem. McConnell let his mask drop when he said “my job is to make sure Barack Obama is a one-term president.” That’s not the role of Senate Majority Leader in anyone’s book. My guess is that his constituents voted for him to advocate for conservative ideas, not go to war with the White House.</p><p>In conclusion, I’d say go back to Reagan. As a Liberal I have no great love or worship of him, but he spoke to Conservatives in three broad ways that transcend policy: a) in the optimism of “morning in America”; b) as the “great communicator”; and c) as the ringmaster of “the big tent.” The LGBT movement in many ways successfully embraced aspects of all these strategies. While die-ins were an important part of ACT-UP’s activism, the joy of Pride parades and the color and fun were far more infectious, and got people to see that the LGBT community was colorful, yes, but also not so scary. The rainbow flag is really a visualization of the “big tent” analogy. And to finish where we started, it was finding a way to communicate and articulate that resonated with a broader community that allowed a lot of LGBT advances to happen. “Marriage equality” was more than a slogan — it’s a fundamental acknowledgement that there was something missing in civil unions and domestic partnerships. It reached out to one of America’s most fundamental values, and when Americans across the nation considered the idea, the majority by far agreed.</p><p>There are many good Conservative ideas. They need discussion. But they need it in a sincere and kind way, and they can’t get the breathing room they need while a small group of extremists pushes bigotry as public policy, misrepresents their intent, or simply wastes all their airtime talking about how they’re not being heard.</p><img src="https://medium.com/_/stat?event=post.clientViewed&referrerSource=full_rss&postId=de38a96742e1" width="1" height="1" alt="">]]></content:encoded>
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            <title><![CDATA[The Secular Humanist Argument for Bringing Religion Back Into Public Schools]]></title>
            <link>https://medium.com/@larrydeluca/the-secular-humanist-argument-for-bringing-religion-back-into-public-schools-8d76370beea2?source=rss-f8856be11f28------2</link>
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            <category><![CDATA[secular-humanism]]></category>
            <category><![CDATA[educational-reform]]></category>
            <category><![CDATA[education]]></category>
            <category><![CDATA[religion]]></category>
            <category><![CDATA[public-schools]]></category>
            <dc:creator><![CDATA[Larry DeLuca]]></dc:creator>
            <pubDate>Sat, 17 Mar 2018 22:04:39 GMT</pubDate>
            <atom:updated>2018-03-17T22:04:39.174Z</atom:updated>
            <content:encoded><![CDATA[<p>In my home state of Arizona, it seems the president of the state Senate has found a way to funnel hundreds of thousands of taxpayer dollars into his own pockets under the rubric of “school choice.” He runs the corporation, siphons 10% off the top for “overhead,” rents them a building, and outsources most of the data processing, etc., to subsidiary companies he own or in which he has a significant financial interest. All to the tune of nearly a million dollars a year (and that’s the parts we know about). It’s big money for a fairly rural state, but it sure smacks of small-town politics at its worst.</p><p>Maybe it’s not “big money” spent on influencing campaigns that’s as corrupting as “little money” — these small side-deals corrupt politicians like this cut with themselves.</p><p>The sadder side effect is places like the Arizona Christian School Tuition Organization (Acsto) funnel this money away from public schools and into schools that are theologically based in an end-run around laws prohibiting public financing of religious schools. I probably wouldn’t mind that so much if they didn’t get their materials from places like Bob Jones University — that if their science curriculum was evidence-based the religious bent might not be so deleterious to the future of society.</p><p>I wrote a paper in graduate school about this very subject. I can’t say it was a brilliant paper, but I can say after looking at the issue there are no easy answers, and that since 1997 when I wrote that paper I have (to use a tired trope) “evolved” on the subject. However, like any good scientist, I find that much of my “evolution” is based upon observation of how the concept of “school choice” has played out in the ensuing decades.</p><p>I long supported the secularization of the school system, and still for the most part do. Looking at the quality of education that is received by people in many fundamentalist Christian schools, it’s clearly substandard. Science is contorted to fit into a religious box that can scarcely contain it, and selectively cut and pasted in a way that causes it to make little sense. The perverse brew of religious and political influences on the curriculum of these schools leaves their pupils decades (or occasionally even centuries) behind in many of the areas of scientific enquiry that will affect their adult lives.</p><p>I carve out a bit of a niche for Catholic schools in because their penchant for intellectual rigor in most areas predates the particular culture wars that would cause Fundamentalists to turn their backs on science. Of course, this is ironic in and of itself, as it was the Inquisition that labeled Galileo’s observations heresy, and the pre-Vatican “Index” that put a chokehold on what could even be read in a classroom. So the Catholic Church and Catholic schools don’t get a complete pass by any stretch. But it’s important to distinguish that the fight that brought them into being in the US was not one of secularization vs religiosity but one of Catholicism vs Protestantism in a time when complete secularization of the classroom had not even been considered. So while Catholic schools have their blind spots, they are still not as completely untethered from science as fundamentalist Christian schools.</p><p>But as a practical matter, I wonder now (as I did in that paper two decades ago) whether secularization — despite its positive influence on the teaching of science and its positive effects on the treatment of ethnic and sexual minorities in this country — was a mistake, in that it froze many debates in time, and moved them out of the public square. It is patently ridiculous in the 21st century that we are still fighting the evolution debate as the level of the Scopes’ monkey trials, for example, and yet the splinter groups are now so isolated from mainstream science that they never managed to come along with the rest of society. Their understanding of the science of evolutionary biology is easily a century behind the rest of the world. But worse, they are now threatening to reach critical mass, and try and bring their ignorant and benighted ideas about science into the mainstream not through scientific persuasion but by political means. And while I’m sure that despite their self-dealing many people like our senate president are well-intentioned, this approach compromises the greatest tool that we have for combating such willful ignorance — rigorous scientific inquiry and an academy firmly grounded in the sciences.</p><p>If you ever wondered where the phrase “logic is the tool of the devil” came from, this is probably it. I would like to think that the original meaning of this biblical phrase is that we should be wary of rationalizing bad deeds. But that’s quite different from condemning clear and coherent thought, or a framework that leads people occasionally to uncomfortable or inconvenient truths. Sadly, it is quite possible that the latter usage was the original, and it was the first great utterance to justify authoritarianism when the numbers didn’t add up.</p><p>For the paper that I wrote the topic was assigned specifically to me (for a doctoral program it was very junior high). I was to write about “religion in the classroom.” I rebelled at the time because given the way the class was structured I felt as though I was being asked to produce a propaganda piece. I may have been naive, and the instructors may have sensed this was a topic they could choose that would challenge me and sharpen my rhetorical skills. Or I may have been asked to write a propaganda piece. To this day I’m not sure. It was the era of ED Hirsch and “cultural literacy.” An idea I might have embraced had I not considered his book the Cliff Notes of culture, absent any clear justification for why we should reject popular culture in favor of the Classics. After a semester of Plato one also felt more than a little condescended to, especially after the analogy of the projections (at least the way it was presented). Not surprisingly, I was already in a lot of trouble over my rebellious attitude toward the class, my willingness to express my opinions, and at the time my relatively unvarnished debate style.</p><p>My paper’s conclusion at the time was that since we couldn’t pick a favorite, cacophony was our only option. This was dismissed in a telling way by a faculty member I was embattled by all semester as “a conclusion so thin and frail as to hardly be called a conclusion” followed by admonishment that I showed my unwillingness to learn by placing my periods outside of my quotation marks. But another faculty member, reviewing the same paper, saw it differently — “you consider many sides to the issues and treat them fairly.” In the fullness of time, I realize that in their own way, during that time period, each criticism was valid. But I have come two decades later to understand my conclusion better.</p><p>At the center of the debate I came down to — “do you ban all religious expression in the classroom?” or “do you allow all religious expression in the classroom?” as a dichotomous question. In contemporary writings of the time, thanks to Supreme Court rulings a few decades earlier, it was often viewed as such. I ended up concluding that of the two approaches, the latter might actually be better, as there wasn’t a means to decide which ideas had more merit. So both “so frail as to hardly seem a conclusion” and “tackling difficult issues…with no easy answers.”</p><p>I find myself now believing however inartfully or brashly or fuzzy-thinking-wise I expressed that idea at the time, that history has borne out that conclusion as the right one. Perhaps we need to reconsider our interpretation of the first amendment and its impact upon schools, if only to bring people back into a common fold. Let people have their prayers — but that includes menorahs and prayer rugs. It includes the Satanic Temple. It might have to include the Unification Church. And even the worshippers of Ralph, the head of lettuce. And the Flying Spaghetti monster people. And most certainly and equally seriously, the non-believers — humanists and secularists and skeptics of all stripes.</p><p>In doing so, the now-combined group will have to accept a common framework for interaction and for placing new knowledge in context. Science and religion have always had their differences, especially when one treads into the other’s sphere. But necessarily each informs the other (and I’m putting secular humanism and atheism in here on the religious side as well). I don’t need an external deity to conclude that what the Nazis did was abhorrent. I’m very much a post-conventional moralist in the Kohlbergian sense, and I claim my own right as a free thinker to develop and follow my own moral precepts. But that doesn’t mean that I don’t live in a society that has rules, including rules for how existing rules change. Indeed, secularists and humanists and agnostics and atheists may have far more powerful motivations than a fear of the everafter to treat their planet and their fellow humans kindly — if there’s no chance for a cosmic re-do you must get it right the first time. Similarly, if you destroy the planet there is no god who will replace it.</p><p>In the film “Jesus Camp,” a woman known as “Pastor Becky” explains to a group of elementary school aged children that they need not recycle because God knows their needs and that when we use up the resources of this planet God will give us an even better one. Such arguments, unchallenged, are actively shaping the minds of children who will grow up and become voters or businesspeople or policymakers. But imagine instead if Pastor Becky was in the same building as a science teacher who might also be a Christian but was able to say, “Becky, you’ve got the scripture wrong. The Lord does not teach us that if we are guests in a house and defile it that we will be rewarded with a bigger house.”</p><p>But in ways we’ve never intended, the peeling off of religious fundamentalists and other splinter groups has harmed the sort of free debate it was supposed to protect. In a way we couldn’t appreciate back in 1997 (because things like school voucher programs to sidestep federal rules against funding religious education were in their nascency), we didn’t know in the ensuing years how the separation of the religious into their own schools would reverberate and grow. The Catholic school model was extremely misleading in that regard. While the Catholics certainly had their blind spots, their schools were established in a far more rigorous academic tradition than the fundamentalist Christian schools that would follow. This may be due to their the zeitgeist when the schools were formed or the age of the Catholic schools compared to the newer fundamentalist schools.</p><p>The Catholic Church in the Medieval era sought to do what many fundamentalist Christian sects do today — build a bulwark against inconvenient science and bolster peoples’ feelings of “specialness” in the world. After all, what could make you feel less special than some upstart like Galileo telling you your world was not the center of the universe? And worse, to provide clear and convincing evidence he was right. “Logic is the tool of the devil.” Logic is also a means of escaping authoritarian control.</p><p>But as secularism re-emerged in the Enlightenment era, while there was an increased emphasis on empiricism, religion was hardly being abandoned wholesale. This is reflected in our contemporary debate about whether or not the founding fathers were Christians. Indeed, Jefferson was a Deist. Deists did not deny the existence of a creator, but their belief about the relationship of that creator to worldly events (in every sense from politics to faith healings) was radically different from what had come before. In this sense, separation of Church and state as a concept make tremendous sense — not as a refutation of the existence of a creator but as an acknowledgement of separate spheres of influence. In some sense, it was the logical response of scientifically minded men and women of the Enlightenment to resolve a seeming conflict between Galileo’s observations and religious teaching. For once the earth is removed as the center of the universe, and it’s understood that there are other heavenly bodies around which the earth itself rotates (or even that there are other heavenly bodies), even for an all-knowing, all-powerful god there is a management issue, and the importance of any one planet (or even any one individual) to the degree that every aspect of their lives necessitates supervision by the Almighty is called into question. In other words, we’re simply not that important (to the Almighty) at that level.</p><p>Perhaps ironically this explains some of the appeal of Donald Trump. With his ridiculous baseball caps and his endorsement of ethnic slurs and his playing dumb (in a vein similar to George W Bush’s interchangeable accents depending on the audience he was addressing), he is better than any career politician in a generation in channeling the same fear that was exploited by Urban II and his successors to wage the Crusades. But more importantly, it’s the same fear-based motivation that enabled burning witches, gassing Jews, and beating up gay people over the centuries. Trump promises people what the Catholic Church did in the Middle Ages, and the Fundamentalists do now in their “personal relationship with Christ” — a way to feel important and that we are at the center of the universe when science tells us increasingly that isn’t the case. Consider the blows in succession: from a polytheistic society where demigods were sort of middle managers, and everyone could have one, to a singular god with a flat management structure (demigods demoted to saints and martyrs) where it was necessarily a “do or die” relationship. In that regard, Satan functions not only as the Anti-Christ, but as the “anti-every-other-religion.” The stakes are higher. You’re either in with the big guy, or you’re toast in the hereafter.</p><p>Then science (after centuries of slumber following the burning of the Library in Alexandria) comes forward and says, “hey, the earth is not at the center of the solar system” — advanced by Copernicus. It wasn’t till decades after Copernicus died that Galileo was born. And Galileo does what scientists do — builds upon the work of Copernicus. And all of a sudden now people are even less special. By the time of Galileo the heliocentric theory had gained some adherents, by the 1700’s (after the death of Galileo) heliocentric and geocentric theories were still being taught side by side in the schools (despite the fact that two centuries earlier even the heliocentric theory was observed by Galileo to be naive and incorrect). It wasn’t until 1822 that the Catholic Church finally accepted heliocentricism, and it wasn’t until the last few years that they finally “pardoned” Galileo for making observations and reporting on them.</p><p>As Esther Ingris-Arkell asks in her article “When did the church accept that the Earth moves around the sun?” — “sound familiar?” Which brings us forward to Darwin, and sadly to debates that rage to the present day. And, in part, to why so-called Christian Conservatives line up behind Donald Trump. In the end, it’s about feeling special. And science is often at best cold comfort in that regard. Over and over we discover that our universe is both bigger and smaller than we thought, that it’s much older than our recorded time, and in this new knowledge the feeling of our uniqueness recedes. What if we’re not descendants of God’s “chosen people?” What if we’re all just here trying to get by until we die? What if there is no payback for leading a life of denying yourself earthly pleasure? What if being poor just leads to a wretched life and an unnoticed death? What if the meek are not blessed but simply downtrodden by the powerful?</p><p>Trump speaks to all those fears. As Bob Jones or Roger Applewhite or the Catholic Church before him, he stands up there and says, “you matter” in a way that many people feel science says they do not.</p><p>In some sense it’s sad, because the reality is that the Deists never argued for or against a supreme being, or for whether or not people were important. They were more interested in issues of relevance. Moreover, their rejection of monarchy in their time (with its notion of Divine Right) is a clear analog to our modern struggle with a would-be authoritarian. I think they would, had they the opportunity to view the film, “The Powers of 10” — jumped up and down animatedly and screamed, “Yes! Yes!” Like a large corporation, the CEO may not know your name or even that you work there or have anything to do with the day-to-day aspects of your job. But that’s not to say you are not important. It’s a question of spheres of influence and relevance. It could also be argued that beyond making sure your company stays in business, that the CEO is not terribly important to YOU.</p><p>So what does this have to do with education? With religion in the schools? With the continuing battle between science and religions other than empiricism and the various branches of secular humanism?</p><p>The 20th and 21st centuries have seen a change in the way religion and science view each other. The mutual distrust hasn’t changed, but as religion has given up on straightforwardly snuffing out science (as the Popes tried unsuccessfully to do in Medieval times), or to control it and selectively use it to their advantage (as was tried during the Renaissance), the Enlightenment era was the beginning of an attempt to disentangle the two. While on the one hand it’s led to the unbridling of science and a tremendous explosion of knowledge, there are real risks to science untethered from any sort of ethical framework — as episodes like the Nazis, the Cold War experiments on private citizens, or using prisoners as research subjects without their consent make abundantly clear. Science cannot live without ethics any more than ethics can live without science.</p><p>And that brings us up to the toxicity of the late 20th and early 21st century compromise. The “separation of church and state” wasn’t meant to banish either, but to allow both to co-exist without either reigning supreme. And while I support this notion unreservedly, I most also wholeheartedly endorse the ideas of both a) each sphere informing the other; and b) the idea that just as multiple theories can exist in the scientific realm, so can we tolerate dissent and controversy in the ethical/philosphical/religious one. The difference is that science has a framework for resolving religious disputes that, due to its Enlightenment roots, is inherently democratic. It involves the free exchange of ideas, empiric measurement, congenial debate, and consensus. Many Fundamentalist Christian religions, on the other hand, are essentially an authoritarian model — and are led by increasingly less educated men than their Catholic or mainstream Protestant ancestors.</p><p>These new fundamentalist sects are also progressively more removed from the modern world. While apoloyptic groups have always existed, and htere is evidence of them in American life (such as the Shakers), what is new is that they are struggling to become the defining religious ethic of the nation.</p><p>Catholicism did not retreat from the world — it sought to define it. Fundamentalist Christianity may have similar grand designs. Divine Right gave the Popes such power over even Kings that Henry VIII was forced to create the Anglican Church. However, in the late 20th century the attempts at domination have become much more underhanded. The approach to abortion the 90’s and beyond is a classic example — if we can’t win on the merits, we’ll make the victory hollow by imposing so many restrictions that there will be no way to enjoy the freedom the courts have recognized. Fundamentally authoritarian, and not democratic.</p><p>So what is the cure? Ironically, it may be to bring religion BACK INTO THE PUBLIC SCHOOLS, but to do so in a way that not only welcomes all religions (including those Fundamentalist Christians may find objectionable). It will also be necessary to also acknowledge the worth and validity of each religious tradition, even if one does not worship that particular god. It is also high time to acknowledge that atheists, agnostics, and secular humanists of various stripes deserve equal stature at the religious/philosophical table. Government doesn’t have to be opposed to any and all religion, it just can’t play favorites.</p><p>But if religion is to come back into the secular sphere, that’s only the first step. If religion wants to advance ideas in the scientific one about how the world works, it is necessary for religion to meet science on its own terms. “My god says you’re sinful” doesn’t wash in this regard. It may be a belief that people embrace personally, but not favoring a particular religion (and favoring empiricism, as the founding fathers clearly did), also means that one god doesn’t get to make the rules. Democracy requires consensus, and by its nature rejects authoritarianism, whether it’s rooted in religion or any other belief system.</p><p>Bringing religion back into the schools is an idea that many liberals (myself included) feel is fraught with danger. But what is the alternative? We can engage in a risky debate eyes open and re-emerge as a single nation, or we can continue to divide ourselves, with the very real possibility that fear will win, and the Christian Fundamentalists with their “evolution is just a theory” and “the earth is 6,000 years old” talk will plunge us if not all at once then by stages into a new Dark Ages. I for one don’t want to wait for that eventuality to happen, nor do I have the lifespan left to wait for the second Renaissance. We must reach out and bring these people back into the fold before they wander out further into the desert. Our very survival depends upon it.</p><img src="https://medium.com/_/stat?event=post.clientViewed&referrerSource=full_rss&postId=8d76370beea2" width="1" height="1" alt="">]]></content:encoded>
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            <title><![CDATA[I read John Pavlovitz’s “Stop Tone Policing My Outrage At This President” this morning.]]></title>
            <link>https://medium.com/@larrydeluca/i-read-john-pavlovitzs-stop-tone-policing-my-outrage-at-this-president-this-morning-7b7512cf2bb7?source=rss-f8856be11f28------2</link>
            <guid isPermaLink="false">https://medium.com/p/7b7512cf2bb7</guid>
            <dc:creator><![CDATA[Larry DeLuca]]></dc:creator>
            <pubDate>Sat, 03 Feb 2018 15:17:45 GMT</pubDate>
            <atom:updated>2018-02-03T15:17:45.602Z</atom:updated>
            <content:encoded><![CDATA[<p>I read John Pavlovitz’s “Stop Tone Policing My Outrage At This President” this morning. A lot of times I reflexively shrink back from pieces like this. Not that I’m silent, per se, but that I do appreciate decorum.</p><p>But over and over I keep coming back to the quote: “In Nazi Germany one third of the population exterminated another third, while the remaining third sat by and watched.”</p><p>This piece is clearly written to speak to the remaining third.</p><p>I can’t imagine what I’d do if the Democrats went completely off the rails. I’d like to think that I’m not sufficiently tribal that I would feel bound to stay in the party if it reverted to its racist past (referring to pre-1964 here). I’m pretty sure I’d be one of the people to speak up — but how strong would the bonds be? There are things I get upset with about the party — their milquetoast approach to universal health care, for example — but I have also come to appreciate the value of incrementalism, and do have respect for passing compromises that may be imperfect but have true bipartisan support.</p><p>I think about this when I think about my Republican friends. So many have become mysterious to me. Part of it is my battles aren’t theirs. The urgency of civil rights positions isn’t apparent to those whose civil rights are never threatened. When both Democrats and Republicans opposed same-sex marriage, for example, it was easy to understand your Republican friends, because your own party was no more enlightened on the issue. But that’s not the case anymore — there is a clear divide between the parties when it comes to civil rights.</p><p>I struggle with friends who say that while they support their political party they support my individual civil rights. But yet I don’t see them doing anything to help the situation within their own party. They embrace the bigotry and intolerance that has become a hallmark of Republicanism, or they just silently look the other way.</p><p>I think of the 1945 footage made by American troops of Germans being paraded into the death camps. Death camps that were literally in their own neighborhoods. Their horror and revulsion at what they saw seems real. Yet these were not remote outposts — Sachenhausen and Dachau were surrounded by houses and families — right in the middle of Berlin and Munich, respectively. Yet these atrocities went on right in front of the German people, and many of them just tuned it out. Many blamed fear of Hitler. But Hitler wasn’t an invading army from without — he was someone who rose within the ranks of German politics, and had even been jailed after the Beer Hall Putsch. They knew what he was made of. Yet they elevated him.</p><p>In Trump we have someone who lacks the ruthless focus of Hitler, who saves us often from his worst excesses by his incompetence. But what if the Muslim ban had been competently enforced? What if the AntiFa hadn’t shown up at Charlottesville? What if we didn’t keep marching? What would happen to our country then?</p><p>I consider myself part of the first third. There’s no question that LGBT rights are sufficiently fragile that if anything big happened I’d be in serious trouble. I have no choice.</p><p>I know people who worry me, because I could easily see them becoming part of the second third. In many ways they already are. They are not apologists for Trump — they are his perennial supporters. They explain away all sorts of things. They’re the people who would pull the lever for Roy Moore. They’re the people who still refuse to acknowledge Russian interference in the election. And they’re the people who have, in fits of anger, used words like “snowflake.” They might not be aware of the WW II era meaning, or they might know it. But despite the fact that they are still in my sphere, they trouble me.</p><p>It wasn’t just thugs that became Nazis. They were merchants and doctors and patriotic military who supported their government. They may have blinded themselves to the atrocities happening around them. They may have participated, deluding themselves that it was service to the Fatherland. They may just have been freed by a cruel, bigoted man at the top who gave license to such behavior, and let their darkest instincts run wild.</p><p>But most of the Republicans I know are in the remaining third. They quietly express concern about some policies. They certainly don’t behave in their private lives like the GOP platform they claim to support dictates they should. But their inaction inflicts pain on me. Why, if they believe in civil rights, for example, don’t they fight to change the platform of their party? In some ways I understand the second third better — they’re blinded by some weird combination of tribalism, suppressed racism, and nationalism. But the remaining third is awake enough to understand the injustice — to apologize for it even. But they stay silent where it matters.</p><p>It’s unfortunate to see them retreat from political life. I think part of it is that they know their party has deserted them, and they feel vulnerable in that regard. But they have far more power to enact change to save the GOP than I do. And while I may not back every Republican policy, and oppose most, I have never lost sight of the fact that one-party rule is dangerous, no matter how good the ideas may be.</p><p>They are not a silent majority, as some claim. If nothing else, the fact that Bush lost the popular vote in 2000 and that Trump lost it in 2016 make that abundantly clear. They’ve ascended to power through a system that is not just broken, but one in many ways they’ve actively helped to break. There is a lot of “both parties do it” and to some extent that may be true. But if the explanation of the wrong is that “well, the other side is wrong, too” then why not be the party that leads by example?</p><p>In 2016 we saw Evangelical leaders explain away bragging about sexual assault. In 2017 we saw them either try to thread the needle by saying they believed Roy Moore’s accusers and then say it was “too important a Republican hold the seat” or they just gave up and worked to discredit not only a large number of women, but other local civic leaders who came forward and shared their stories about Moore.</p><p>But regardless of Moore’s innocence or guilt, it was clear that the GOP was more than willing to look the other way, and encouraged people to do so. But there are hazards in doing so — they lost one of the reddest Senate seats in the nation. But Trump backed Moore till the end. And while I salute Kay Ivey and her Secretary of State for doing their job and signing off on the election results, the cynicism of backing more came from the highest levels of Alabama state government.</p><p>The remaining third has a lot of work to do, and a lot to answer for. If they won’t leave their party, what are they doing to change it? How easy would it have been to cut loose a candidate like Roy Moore? How easy should it have been to recognize the danger of Donald Trump?</p><p>But I think a lot of people need to go back and watch those films from 1945. It’s pretty clear that none of the Germans in them expected that outcome when they started shouting “Lugenpresse!” Or responded to Hitler’s call to “Make Germany Great Again.” Yes, their sense of national pride was wounded, and Hitler took advantage of that — but it was a willful act to disregard their own moral compasses.</p><p>We in the US are living in a dangerous time. I know which third I’m in. Do you?</p><img src="https://medium.com/_/stat?event=post.clientViewed&referrerSource=full_rss&postId=7b7512cf2bb7" width="1" height="1" alt="">]]></content:encoded>
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            <title><![CDATA[It’s time to end the notion of “the system is rigged.”]]></title>
            <link>https://medium.com/@larrydeluca/its-time-to-end-the-notion-of-the-system-is-rigged-6b3d4d9296a5?source=rss-f8856be11f28------2</link>
            <guid isPermaLink="false">https://medium.com/p/6b3d4d9296a5</guid>
            <category><![CDATA[progressive]]></category>
            <category><![CDATA[voting-rights]]></category>
            <category><![CDATA[politics]]></category>
            <category><![CDATA[democracy]]></category>
            <category><![CDATA[advocacy]]></category>
            <dc:creator><![CDATA[Larry DeLuca]]></dc:creator>
            <pubDate>Mon, 04 Sep 2017 20:22:49 GMT</pubDate>
            <atom:updated>2017-09-04T20:22:49.769Z</atom:updated>
            <content:encoded><![CDATA[<p>It’s time to end the notion of “the system is rigged.”</p><p>We need to replace it with a better slogan: “We are the system.”</p><p>Or better yet, in the Original Enlightenment English “We, the People.”</p><p>There’s a reason that those words start off the Constitution. They are the secular response to “In the beginning.” But while the Christian creation myth is one in which we are late-arriving bit players, “We, the People” *are* the creators of a secular, democratic society.</p><p>The narrative of the “rigged system” is one of self-victimization and disenfranchisement. It is the politics of discouragement and ultimately despair. It leads people to think they are powerless. And they don’t call, they don’t go to town meetings, they don’t write, and they don’t vote.</p><p>This is not to say that there is not injustice. We’ve certainly seen substantial and sustained attacks on the Voting Rights Act and its protections, and there were attacks on civil rights in many ways in the aftermath of 9/11. Many of us share concerns about systemic, institutionalized discrimination, problems of distribution of wealth, and health security in this country.</p><p>But we have a choice before us — we can adopt a passive, “the system is rigged” approach and cynically turn inward. Or we can decide that “we are the system” and examine the ways in which we can work toward change.</p><p>There is some evidence that negative messages may impair voter turnout, and that positive messages — and in particular ones that encourage accountability — may increase voter turnout (thanks <a href="https://www.facebook.com/njbattaglia?fref=mentions">Norma Battaglia</a> — the link is at <a href="https://www.gsb.stanford.edu/insights/research-backed-ways-get-out-vote">https://www.gsb.stanford.edu/insights/research-backed-ways-get-out-vote</a>).</p><p>Certainly voting is where it starts. And not JUST voting for a candidate, but applying one’s vote strategically to effect the change that one wants to see. That might mean, for example, endorsing a particular candidate in a primary to bring ideas to the center of a platform even if you think the candidate has little chance of winning the primary. But it also means being just as strategic about votes in the final election — at every level. If you’re in a solidly blue district perhaps a “protest vote” might be meaningful at the city council level, where it can influence local policy. At a national level with a sharply divided electorate, however, the calculus might change.</p><p>But voting is just the start. As <a href="https://www.facebook.com/rachel.e.mello?fref=mentions">Rachel Mello</a> is so fond of saying, “you get one vote free. The rest you pay for.” What Rachel wisely and wryly observes is that while voting is immensely important, it’s the last step in what would hopefully be ongoing engagement. It doesn’t necessarily mean that every person phones every candidate on every issue, but it does mean that we engage in multiple ways on issues of import to us. Some of us might donate money. Others phone bank or knock on doors. Some groups get together to advocate for policy, while others work to support candidates.</p><p>Advocacy doesn’t have to be big to be effective. A lot of the grass-roots stuff that has helped the lives of so many in the LGBT community was when families stopped considering their LGBT kids a source of shame and sent them packing off to big cities or monasteries. Simply not rejecting your kid was advocacy in the 80’s. Being willing to be the parent at the church group meeting who heard nasty gossip and said, “well MY daughter is a lesbian and I don’t think that’s accurate” was INCREDIBLY courageous, and did so much good.</p><p>So we all find our ways to participate. But it starts with a recognition that while there are things we don’t like or don’t think are right, that our inaction is acquiesence. Our inertia becomes part of what “rigs the system.”</p><p>So if “the system is rigged” then it’s a good thing that “we are the system.” Because then “We, the people” can change it.</p><img src="https://medium.com/_/stat?event=post.clientViewed&referrerSource=full_rss&postId=6b3d4d9296a5" width="1" height="1" alt="">]]></content:encoded>
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            <title><![CDATA[Thoughts for a Rally]]></title>
            <link>https://medium.com/@larrydeluca/thoughts-for-a-rally-1c13168bd62c?source=rss-f8856be11f28------2</link>
            <guid isPermaLink="false">https://medium.com/p/1c13168bd62c</guid>
            <category><![CDATA[white-supremacy]]></category>
            <category><![CDATA[charlottesville]]></category>
            <category><![CDATA[protest]]></category>
            <category><![CDATA[politics]]></category>
            <category><![CDATA[progressivism]]></category>
            <dc:creator><![CDATA[Larry DeLuca]]></dc:creator>
            <pubDate>Mon, 14 Aug 2017 06:56:51 GMT</pubDate>
            <atom:updated>2017-08-14T06:56:51.334Z</atom:updated>
            <content:encoded><![CDATA[<p>I was working in the Emergency Department on election night. People came in in droves with similar complaints — “I don’t know what’s wrong, I have a headache, I’m sick to my stomach, and I can’t stop vomiting.” It took me half the evening to realize that my patients were suffering the stresses of a nation divided. The body politic had fallen violently ill.</p><p>We as a nation have been struggling to balance faith and inclusiveness, national security with our identity as an immigrant nation, to blend past cultures and new traditions. But yesterday was different. It’s been building for some time — violence at campaign rallies, disparaging remarks about Mexicans, anti-immigrant themes. With each new alarm bell the counterpunch has always been “you can’t just keep comparing people to the Nazis.” Yesterday showed not only were those comparisons apt, they were prescient. Yesterday the people linking the alt-right to Nazism and White Supremacy were the participants, with their Swastikas and their Klan regalia.</p><p>One of our most cherished ideals is that everyone in our great nation is free to engage in peaceful protest, and to express their political point of view. But as heirs of Enlightenment philosophy, we are to wage wars of ideas — to win battles with the persuasiveness of a well-reasoned argument. We might find the views of our opponents offensive or repugnant, but we support their right to express those views peacefully. There was nothing peaceful about the “Unite the Right” rally, in deed or intent. It was designed from the outset to threaten, to frighten, and to spark conflict. Clubs and shields are not tools of persuasion, but of intimidation.</p><p>We have heard an anemic defense — “both sides do it.” There may be isolated incidents of violence from both sides, but this is a false equivalence. I look to the annual LGBT pride marches that occur almost without incident around the globe every year. The symbol is a rainbow — “everyone is welcome.” I marched on January 21 as one of five MILLION people in the Women’s March. There was no violence. There were no clubs or shields or guns. The false equivalence does not hold — the organizing ethos of the Charlottesville “Unite the Right” rally shared nothing with these events beyond being a gathering of like-minded people in a public space.</p><p>It is all too easy in reducing Nazism to a caricature of evil to forget that that extreme ideology rose in the middle of a nation that was a democracy before the rise of Adolf Hitler. To forget that there were protestors. To forget that Hitler wrote “Mein Kampf” in jail after a failed coup attempt. To dismiss the fact that families and friends were divided on the rise of the Third Reich. To underestimate the persistence of fascism. The question on all of our minds tonight should be, “how did the voices of Germans opposed to Nazism get silenced? And how do we avoid repeating their history?”</p><p>It is often said that “For evil to triumph, all that is necessary is for good men to do nothing.” It has been repeated by many great orators, from Edmund Burke to Winston Churchill to JFK. It has seeped into our collective unconscious to rail against complacency when there is desperate national or international need. It may have called you here tonight. Thank you all tonight for DOING SOMETHING.</p><p>No matter who you voted for in the last election, we must pull together as a community and as a nation. You may bristle at the idea of one more concession or still feel rightly aggrieved, but I appeal to you to see the greater good and duty that transcends any candidate, and any election cycle. If you lean conservative but are upset by the turn of events, I appeal especially to you, because you might be able to find inroads that those of us who were on the other side of the aisle could not.</p><p>In one of the most memorable but often misquoted moments of the 2016 election, Hillary Clinton talked about:</p><p>“ the basket of deplorables… The racist, sexist, homophobic, xenophobic, Islamophobic — you name it….And unfortunately there are people like that. And he has lifted them up.”</p><p>As of yesterday, we can no longer deny that reality. It is clear from the headlines of the Daily Caller and statements from David Duke that the alt-right believes the country’s current political climate makes democracy ripe for the taking. But there was still more:</p><p>“Now some of those folks, they are irredeemable, but thankfully they are not America….that other basket of people….Those are people we have to understand and empathize with as well.”</p><p>An imperfect message perhaps, but a call in the midst of it all to rise up and be empathetic. To find common ground. To reject the violent extremism without leaving behind the people themselves.</p><p>We don’t always understand each other. We speak of “mansplaining” and “whitesplaining.” These ideas are useful to the extent that they call our attention to the imperfect ways in which we work together — but we must never lose sight of the fact that we are working TOGETHER. Toward a more perfect union.</p><p>I am as imperfect, too, and no doubt I will offend someone, somehow. But I take solace in the words of Bette Davis, who said, “If you offend no one, you must be doing something wrong.” Davis wasn’t arguing to be offensive as an end in itself. She was reminding us that while we might upset someone by expressing our beliefs, that the greater sin was in being so blandly inoffensive that you didn’t stand up for justice in order to avoid offending someone acting in an unjust fashion.</p><img src="https://medium.com/_/stat?event=post.clientViewed&referrerSource=full_rss&postId=1c13168bd62c" width="1" height="1" alt="">]]></content:encoded>
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            <title><![CDATA[The Misguided Mantras of “Freedom” and “Choice” in Insurance Mandates]]></title>
            <link>https://medium.com/@larrydeluca/the-misguided-mantras-of-freedom-and-choice-in-insurance-mandates-eef6a8847205?source=rss-f8856be11f28------2</link>
            <guid isPermaLink="false">https://medium.com/p/eef6a8847205</guid>
            <category><![CDATA[healthcare]]></category>
            <category><![CDATA[aca]]></category>
            <category><![CDATA[trumpcare]]></category>
            <category><![CDATA[obamacare]]></category>
            <category><![CDATA[gop]]></category>
            <dc:creator><![CDATA[Larry DeLuca]]></dc:creator>
            <pubDate>Mon, 31 Jul 2017 02:54:35 GMT</pubDate>
            <atom:updated>2017-07-31T02:54:35.037Z</atom:updated>
            <content:encoded><![CDATA[<p>So I’m reading the National Review this weekend, and it’s their post-mortem special on what went wrong with ACA repeal. It’s by turns insightful, funny, infuriating, and sad.</p><p>But few things are more maddening and illogical than the discussion about how it wasn’t that we were robbing Americans of insurance, but that we were robbing them of “choice” by forcing them to subscribe. In the Libertarian fever-dream of limited government (which, curiously enough, shares a great deal of political real estate with classical Marxism), people need to be “free” to decide if they want healthcare insurance or not.</p><p>There are several problems with this argument. Let’s start with the fact that while removing the individual mandate might allow people the “choice” of not purchasing insurance, this does NOT translate into the “CHOICE TO FOREGO HEALTHCARE.” People without insurance make up as much as 10–20% of Emergency Department visits a year (and that can be much worse in poor communities).</p><p>Why do people with no insurance come to Emergency Departments? Not because it’s cheaper — the costs of emergency care are far higher than outpatient settings, as acuity is higher and there’s more overhead. Not because their disease is well-managed — more often it’s because they have either an unexpected acute condition, or a chronic condition that is not being managed has spun out of control. So again, the cost becomes higher, in human terms as well as financial ones.</p><p>While people like Rand Paul tell blatant lies like “no one ever died from lack of access to healthcare” the data tells us otherwise. Prior to EMTALA (The Emergency Medicine Treatment and Labor Act, also known as the anti-dumping law) it was demonstrated that by failing to stabilize patients before transfer the mortality DOUBLED. These patients were still getting care at charity hospitals — but the time delay to transfer without stabilizing care first resulted in a significant increase in mortality.</p><p>The real complaint isn’t that people don’t want insurance, or don’t want healthcare. The problem once again rests with affordability. While ACA slowed the growth rate of premiums and has added access to care for tens of millions, it has not halted the progressive rise in costs. Many of its best cost-saving proposals — such as a public option, which would have controlled costs through enormous collective bargaining power — were jettisoned in the vain effort garner some Republican support for the plan. Continuous legal attacks on every aspect of the system, and the famous and vaunted “choice” of many Republican governors to refuse the Medicaid expansion, have hurt the system and prevented optimal functioning.</p><p>So Republicans offer people a ridiculous choice — a way to opt out of paying insurance premiums or fines in the short term. But what about the long term? What about when they run out of their blood pressure medications? Or the allegation that “people who lead good lives” don’t need insurance? On at least one occasion in my busy Emergency Department I’ve had to take care of both the drunk driver and their victim in different rooms at the same time.</p><p>The Republican effort thankfully has failed for the time being because the choices being offered are all morally repellant. It is an American value that we don’t let people die in the streets for lack of access to healthcare. It’s embedded in our anti-dumping law, EMTALA. But while EMTALA says the Emergency Department must evaluate you and stabilize you if you show up, it doesn’t pay for the care that an uninsured patient receives. So hospitals remain on the hook regardless for delivering care that would be much less costly and in many cases unnecessary if we would simply tackle the problem head-on and ensure that all our citizens had access to primary care.</p><p>There’s a reason that most states require auto insurance. Unexpected things (like car accidents) can happen, and the driver needs to be covered in advance so that they can help themselves and anyone else who might be involved in a collision. It has been suggested that mandatory auto insurance is not an affront to liberty because people can “opt out” of driving. While this may be true, the analogy falls apart when it comes to healthcare. No one can “opt out” of life. And unexpected things (auto accidents for one) can happen even to people who aren’t driving.</p><p>Until we are willing to literally let people die on the street we are very unlikely to save money by limiting peoples’ access to insurance with the hope it will control healthcare costs. If we get to the point of repealing EMTALA and being willing to let people die because they lack insurance then we are no longer worthy of being considered a developed nation.</p><p>It’s time to stop pretending the “choice” is about buying insurance. The “choice” is about whether we will answer the moral call to provide healthcare for our citizens. EMTALA has already shown that we have answered in the affirmative. The rest of it comes down to the details of finding ways to increase access and affordability. Given that EMTALA provides universal access (albeit in limited and unfunded ways) it seems the most sensible courses of action are to a) fund that mandate; and b) fund alternatives (like universal access to primary care) that make the delivery of good care and the maintenance of good health universal and more affordable.</p><img src="https://medium.com/_/stat?event=post.clientViewed&referrerSource=full_rss&postId=eef6a8847205" width="1" height="1" alt="">]]></content:encoded>
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