What Was So Great About America Again?

by Kevin Lively

The re-election of Donald Trump has prompted a spectrum of reactions among those who are . . . unenthusiastic . . . at this outcome. One common reaction I’ve observed among progressive friends and those who enthusiastically rather than grudgingly vote Democrat is confusion. Many reactions are understandable: dread about the implications for climate change, concern for the human rights of undocumented migrants in the US, or a low-grade panic over the fact that the Supreme Court has literally vested the office with immunity against legal persecution for assassinations, although apparently Obama’s assassinations of US citizens get a pass. Confusion, however, is only explicable as a consequence of a media ecosystem which rarely manages to coherently discuss many of the serious issues in American society, and crucially the role of policy choices by the government under both Democratic and Republican leadership which either failed to address or directly exacerbated these problems.

As any very stable genius glancing at a red hat in public can tell you, the appeal which won Mr. Trump his first democratic victory is ultimately rooted in nostalgia. But nostalgia for what exactly? Was American really greater in the past than it is now? And if so what changed and why?

Well this is a layered question. There is of course the obvious fact that for a non-negligible share of Trump voters this nostalgia is rooted in a time before the Civil Rights Act extended de jure if not de facto equal rights to non-white, non-christian, non-heteronormative non-men. If nothing else one can look at the day one rescinding of Diversity, Equity, Inclusion and Accessibility programs across the federal government and its contractors as an appeasement to that crowd. However, while this discrimination is indisputably a crucial aspect of American society and will continue to severely negatively affect human rights in the US, it is also not the only reason for Trump’s election. This in evidence from the increases Trump made among non-white voters, although the total numbers are still biased towards white men.

For the moment however, I do not want focus specifically on the very important issue of racism and discrimination, and instead look to other causes for support for Trump, although the USA being what it is, it will still permeate the discussion. Let’s start with the short term. Assuming there was a modicum of greatness in Trump’s first term we can look to an April 2024 New York Times / Sienna poll for what voters remembered about 2017-2021. Read more »

Monday, October 1, 2018

Halting the Drug Overdose Crisis: A Doctor’s Prescription

by Carol A Westbrook

“Take two aspirin and call me in the morning” has been replaced by “Here’s a bottle of oxycodone. Don’t call me for a month.”

Two million Americans are addicted or dependent on opioid drugs. Last year, 72,000 of them died of overdoses, usually by accidentally taking too high a dose of an illicit drug. What has caught our attention is that these deaths are not the down-and-out, indigent drug addicts sprawled in dirty crack houses that are pictured on TV crime shows. They are our friends and family, teenagers and adults who unwittingly became addicted to medication that was legitimately prescribed to them by doctors.

Drug overdose deaths are rapidly increasing, as is apparent from the chart below, and are now the leading cause of deaths in adults under age 50. The cause of this epidemic is not drug pushers, or dirty needles, but the health care industry itself. It is the result of a series of well-meaning but misguided policy changes that appeared over the last twenty years that physicians such as myself were asked to implement in caring for patients with pain. Let me explain. Read more »