Conservative pundit David Brooks – How Democrats Won the War of Ideas

As an independent and former Republican (and Democrat), David Brooks is one of my favorite conservative pundits and authors. He is a regular participant on PBS Newhour’s Friday recap show with the more liberal Mark Shields. Like other key conservative pundits, MIchael Gerson, George Will, Ross Douthat, Eric Erickson and Max Boot, he is hoping that America votes out the incumbent president.

In his usual articulate and even-handed fashion, Brooks penned the following editorial last week called “How Democrats Won the War of Ideas.” The link is below, but I will highlight a few paragraphs for your review and comment.

“Over the last 100 years, Americans have engaged in a long debate about the role of markets and the welfare state. Republicans favored a limited government, fearing that a large nanny state would sap American dynamism and erode personal freedom. Democrats favored a larger state, arguing that giving people a basic economic security would enable them to take more risks and lead dignified lives.

That debate ebbed and flowed over the years, but 2020 has turned out to be a pivotal year in the struggle, and it looks now as if we can declare a winner. The Democrats won the big argument of the 20th century. It’s not that everybody has become a Democrat, but even Republicans are now embracing basic Democratic assumptions. Americans across the board fear economic and physical insecurity more than an overweening state. The era of big government is here.”

Brooks cites a few survey facts from last week’s New York Times/ Siena poll.

2/3 of Americans support allowing people to buy health insurance through the federal government

2/3 support Joe Biden’s $2 trillion plan to increase renewable energy and build efficient infrastructure

72% of likely voters and 56% of Republican voters favor another COVID-19 relief package

59% of Americans think government should do more to solve problems

2/3 think government should do more to fight climate change

60% support increasing the minimum wage and providing tax credits to low income workers

82% of voters and 70% of Republicans would like to expand requirements for paid family medical leave

Brooks also cites a study by the Mercatus Center which notes that Republicans are also moving left, just not at the pace of Democrats. This is contrary to what is believed by the media.

I have long said that more than 1/2 of the Republican voters are voting against their economic interests and do not know it. This survey indicates many do favor policies that would help them, but are sold a bill of goods packaged to woo their votes, but mask the purposeful deterioration of rights and opportunities.

A great example is the Affordable Care Act. When people are surveyed about the features of the act, the features receive high marks from all, including Republicans. The only feature that did not was eliminated – the mandate to buy coverage. Ironically, this elimination is the basis for 25 Republican Attorney Generals who have case to declare the ACA unconstitutional in front of the Supreme Court after the election, which should not occur as the case is not solid, but one never knows with these things. Sadly, the White House chose not to defend the law, which affects expanded Medicaid, exchange and employer-provided benefits.

Please read Brooks article below. It is very well done, as per usual.

Two articles speak volumes

Two articles are worth noting as we head into the election. The first is “Trump’s handling of coronavirus pandemic hits record low approval: Reuters/Ipsos poll’ by John Whitesides of Reuters. Here are a few paragraphs.

“Americans are steadily losing confidence in President Donald Trump’s handling of the coronavirus pandemic, with his net approval on the issue that has dominated the U.S. election hitting a record low in a new Reuters/Ipsos poll.

The poll taken Tuesday through Thursday, after Trump’s COVID-19 infection and weekend hospitalization, found 37% of American adults approved of the president’s handling of the pandemic and 59% disapproved.

The net approval rating of negative 22 percentage points is the lowest in the poll dating back to March 2 and has steadily declined over the last 10 days, as Trump’s illness and his return to work in the White House dominated news headlines.”

The second article was reported by Randy Tucker in the Cincinnati Enquirer is called “Mitch McConnell says White House’s lax COVID rules are why he hasn’t visited since August.”

“U.S. Senate Majority Leader Mitch McConnell Thursday said he hasn’t visited the White House in two months because of what he saw as lax coronavirus practices. “‘ haven’t actually been to the White House since Aug. 6 because my impression was their approach to how to handle this (pandemic) was different from mine and what I insisted we do in the Senate, which was to wear a mask and practice social distancing,” McConnell said during an appearance in Northern Kentucky.“

These excerpts and articles speak for themselves. To be frank, while bad, I am surprised the disapproval rating of Trump’s handling of the COVID-19 response is not higher. We are just shy of 218,000 deaths in America, yet that does not seem to be a problem or a debate question worth answering. It just shows how little news actually gets to people that need to see it. That is what this independent voter thinks.

https://www.msn.com/en-us/news/politics/trump-s-handling-of-coronavirus-pandemic-hits-record-low-approval-reuters-ipsos-poll/ar-BB19Q8zM?ocid=msedgdhp

https://www.msn.com/en-us/news/politics/mitch-mcconnell-i-havent-visited-white-house-recently-because-of-lax-covid-rules/ar-BB19PyTp?ocid=uxbndlbing

Just a quick refresher on the ACA animosity in the Republican Party

Our friend Scottie asked me why the Republican Party detests the Affordable Care Act (ACA) so much and wants to kill it. I have written many posts about this, but here is quick refresher.

The Republican party has spent about ten years nay-saying the ACA. This is in addition to actual efforts to sabotage it by Senator Marco Rubio and President Donald Trump and the fourteen states who still have not expanded Medicaid. Rubio and Trump’s actions caused premiums to increase. Blue Cross and Blue Shield of North Carolina (BCBS of NC) said it was geared to have a 0% increase in 2018, but after Trump de-funded reimbursing insurers for co-pays/ deductibles for people making less than 2 1/2 times the poverty rate, BCBS of NC said it would have a 6.6% increase. Not only did Rubio’s action cause premiums to go up, it drove some insurers out of the exchanges lessening competition which also hurt consumers. *

So, to me the Republicans are so far down the path of killing something that is working pretty good (it still needs improvements), they cannot stop. And, it is apparent that Trump has an Obama obsession that he must kill everything that Obama did regardless of its level of efficacy. As a retired benefits consultant and former actuary, what the GOP came up with in 2017 to replace the ACA was god-awful. It was throw-against-the-wall planning. The fact the Republicans did not follow due process was a key reason Senator John McCain voted it down. Mind you, I fault Obama for the terrible roll out of the exchanges in 2013, but he at least involved Republicans in the planning process in very public sessions (although they were told not to vote for it).

And, here is the rub. The reason the GOP does not have a plan is the ACA is largely based on a Republican idea set in motion by Mitt Romney for Massachusetts, when he was governor. It worked so well, that Senator Jim DeMint, the leader of the Tea Party, advocated its national use in writing to President George W. Bush. And, DeMint politicked with Romney on stage in 2008, Romney’s first run for president. I recognize the ACA is not exactly the same as Romneycare, but there are a number of similar constructs.

Everything I mention above, including the DeMint piece can be found by Googling. But, here is the major concern I have. Employers have been going to more part-time and contract work forces even before the pandemic. Why? – to avoid providing subsidized health care benefits. So, to survive in this gig and part-time employment world, the ACA is essential.

Plus, the ACA imposes requirements on employer based plans as well that may go away if SCOTUS rules unwisely with the court case. Those include pre-existing condition protection, guaranteed renewability, no deductibles on wellness visits, and limitations on insurer margins in pricing, e.g. So, a bad SCOTUS ruling could impact over 200 million Americans not just those in the exchanges and Medicaid.

* Note: The reason for the premium increases are complex, so I will mention them here. Rubio led a Republican move to defund 89% of the payments to insurers for adverse selection (pent up demand for new policy holders) for the first few years, a process used when Medicare Part D was rolled out. Insurers were forced to increase premiums and some left the market with the US owing them money that was promised. The Trump change is more complex. By stopping the reimbursement to insurers for this extra benefit for low paid policyholders, the insurers still honored their commitment to the policyholders. This drove up premiums. Trump said this would only impact insurer profits, but that was not true. The CBO said it increased the annual deficit by $10 billion because the premium subsidies went up as well. The people who ultimately got screwed were those who did not get a full subsidy.

Letter to editor – health care actions speak loudly

I have written longer posts on the actions of Donald Trump, Marco Rubio and Republicans to sabotage the Affordable Care Act. What many do not know, after the election, a court case will decide its fate, brazenly brought forward by several Republican state AGs after Congress stripped away the coverage mandate during a budget vote. The following is a brief letter I sent to my newspaper.

The truth matters. Actions matter. Four years ago, Trump said we had to wait and see his healthcare plan. None existed and still does not. Three years ago Trump cut payments to insurers to fund their payment of co-pays and deductibles for ACA members making less than 2 1/2 x the poverty rate and then lied about its impact – it actually increased premiums and the deficit per the CBO.

After the election, SCOTUS will be hearing a case to rule on the constitutionality of the ACA premium subsidy after Republicans stripped away the coverage mandate, which would severely hamper the law and may lead to its end. The White House chose not to defend the law. The ACA impacts both exchange and employer benefits, three key provisions of which are allowing pre-existing conditions, requiring guaranteed renewability and requiring wellness doctor visits not be subject to deductibles.

Sadly, beyond the nay-saying, there has been more sabotage of the ACA which increased premiums (Google Marco Rubio and risk corridors), repeal and replace efforts which were fortunately defeated, and fourteen states (including NC and SC) who still have not expanded Medicaid, a key part to help people in poverty. Health care coverage access is a major issue this coming election so says this retired benefits consultant, benefits manager and former actuary.

Eliminating the ACA which which may impact over 200 million Americans  (including the ACA requirements on employer plans) is unwise in my view, in general. But, doing so in the middle of a poorly handled pandemic by the White House with over 200,000 and growing American deaths, is plain asinine and mean-spirited.

Please feel free to adapt and use. Actions speak louder than words and my former party, the GOP, has purposefully sabotaged the right for Americans to have access to health care coverage. This is why your vote matters.

Is this what a president for the common man does?

Many of the Trump base have no idea they are voting against their economic interests. This advertised populist, common man president, fails to let folks know the following:

– in his first two hours of being president, he repealed a regulation that would have reduced homeowners insurance premiums for securing mortgages with the less than 20% down, that was scheduled to go in effect February 1, 2017. This would have helped about one million low income homeowners.

– he has hobbled the Consumer Financial Protection Bureau that was very successful, but banks and credit card companies did not like it. The CFPB penalized these companies for fraudulent and aggressive lending practices, with 95% of the fines going to cheated consumers. In short, the CFPB helps folks who are targeted.

– he eliminated a new requirement that said all investment advisors have to be fiduciaries, meaning they must put your interests ahead of their own. This was done to help investment advisors, paid by the transaction, to encourage sales that may not be in your best interests.

– he passed a tax bill that favored the elites and businesses, under the guise of helping everyone. To keep the bill down to costing only $1.5 trillion in debt, he had to have some pay higher taxes – a sneaky requirement noted that state and local tax deductions were capped at $10,000, so if you owned a house and lived in a state where income tax occurred, your tax bill may increase. Note, folks who do not itemize deductions, tended to come out ahead with the change.

– he failed to tell people (actually lying about the impact routinely) the tariffs would be paid for by consumers when importers passed along the cost. He has routinely lied saying China will pay the tariffs, but that simply is not true. Each time he said this, economists would rebut his lie.

– he also lied about an ACA change he made that increased premiums for people, saying it would only impact insurer profits. In essence, he ceased the subsidy to insurers to repay them for paying deductibles, copays, etc. for members making less than 2 1/2 times the poverty rate. Insurers honored their written commitment (Trump did not) and subsidies went up to pay for the resulting increase in premiums. BCBS of North Carolina said premiums the next year were going to increase by 0%, but with the Trump change, they went up by over 6%. The CBO said the increase in subsidies increased the deficit by $10 billion per annum and unsubsidized folk saw premium increases.

– he has advocated a COVID-19 relief bill which will prevent employees from suing employers for endangering them with COVID-19 exposure.

– finally, environmental deregulation hurts those in poverty more, as they have fewer choices as to where to live.

There is more. With his attacks on the ACA, with a pending lawsuit that would harm it, more of Trump’s base will be harmed. Plus, with his misinformation and mishandling of the COVID-19 pandemic, more people are being harmed and dying. Of all that I mentioned, his callousness and negligence in COVID-19 handling is the most prominent failure that impacts people.

So, in turn for getting protection over gun rights and attacks on abortion access, the president has largely screwed over his base and they have no idea he has.

Supreme Court rules against a GOP effort to renege on owed payments to health insurers

On Monday, the US Supreme Court ruled against an effort of several years ago led by Senator Marco Rubio to shortchange health insurers money owed to them for accepting higher risk claimants early on under the Affordable Care Act. In essence, Rubio led GOP Senators to eliminate 89% of the funding under a risk corridor agreement to tie insurers through initial adverse risk (due to pent up demand from folks who were not previously covered).

The following excerpt from an article called “Supreme Court rules government must pay billions to Obamacare insurers,” by Susannah Luthi of Politico, may be of interest.

“The Supreme Court on Monday ruled the federal government owes health insurers massive payments from an Obamacare program shielding them from financial risks after the companies accused Washington of reneging on its funding promises.

The 8-1 decision could open the floodgates for federal cash to the insurance industry. Insurers who accused the government of a ‘bait and switch’ claimed they’re owed $12 billion from the Affordable Care Act program.”

The lone dissenting vote was from Justice Samuel Alito who said the insurers were getting a “windfall.” No, Justice Alito and Senator Rubio, they are getting what was promised in writing.

People could easily dismiss this as a fight that does not concern them. That would be a misjudgment. The Republican Senators led by Rubio screwed Americans to win a political argument in attempt to sabotage the ACA. Why do I say that? As a consequence, these insurers had to raise premiums that impacted unsubsidized folks and caused an increase to the offsetting premium credit under the ACA for the subsidized folks. That subsidy increase in turn increased our budget deficit. It also forced some insurers to exit the ACA with the US government owing them money, which hurt competition.

Sadly, all of the efforts noted above, which the Supreme Court just overturned, are true. That is a reason for the near unanimous vote. I encourage you to Google “Marco Rubio and ACA Risk Corridors” and read as much as you like. What frustrates this retired benefits consultant, manager and actuary is very few people know they got screwed. The following links to this article and one of my many pieces on shoring up the ACA are below.

https://www.politico.com/news/2020/04/27/supreme-court-rules-government-must-pay-billions-to-obamacare-insurers-211184

https://musingsofanoldfart.wordpress.com/2019/07/19/please-stabilize-the-affordable-care-act-now-to-help-americans/

Near universal health coverage achieved in six states and DC

An article by Michael Rainey of The Fiscal Times (see link below), called “How six states achieved near universal coverage” noted the success of covering at least 95% of their people. These six states are Hawaii, Iowa, Massachusetts, Minnesota, Rhode Island and Vermont. The District of Columbia also fits the bill. Per the article:

“A half-dozen states and the District of Columbia have health care insurance rates of over 95%, achieving near-universal coverage. Three researchers at the University of Pennsylvania — including Ezekiel Emanuel, a key architect of Obamacare — said Monday that the Affordable Care Act has everything to do with those results.

Here’s how the states achieved such high insurance rates, according to the authors:

Expanding Medicaid: States that expanded their Medicaid programs as allowed under the ACA had about half the uninsured rate (6.6%) in 2018 as states that did not do so (12.4%). ‘Nearly 5 million people would gain health insurance if the remaining 14 states expanded Medicaid,’ they write.

Extending enrollment periods: High-coverage states countered the Trump administration’s efforts to shorten enrollment periods and reduce informational assistance.

Lowering premiums: States enacted additional subsidies and reinsurance programs to keep premiums low, a crucial factor in maintaining insurance coverage from year to year.

Simplifying options: Some states limited the number of options available to counteract “choice overload,” which can reduce signups through consumer paralysis.

Maintaining individual mandates: Five low uninsured states maintain some kind of individual and employer mandates, which may help persuade healthy people to sign up.

The lesson, the authors say, is that near-universal health coverage can be achieved without national legislation. ‘While it is easy to dismiss the ACA and focus on the promise of Medicare for All, there is a more straightforward path to universal coverage,’ they write, ‘adopting a handful of relatively simple policies and programs at the state level can ensure health insurance coverage for nearly all Americans.’”

This article echoes what can be achievable if Medicaid is expanded and the other above steps are taken. The three states who drag the results down for the country – Texas, Florida and Georgia – did not expand Medicaid nor run their own Healthcare exchanges. Of the six states over 95%, it should be noted Iowa and Hawaii use the federal Healthcare Exchange, while the other four run their own exchanges.

I have long said Medicare for All is something to be explored, but it requires detailed analyses (and time) of its costs and impact. In the interim, I have strongly advocated improving the Affordable Care Act. The goal is access to care, in my view. The employment paradigm has been changing for some time, where fewer full-time workers are being used than before. We are seeing several industries move to a largely part-time workforce, such as in the retail, restaurant, and hospitality industries. We have seen contractual employment continue as well as the growth of gig economies. Health care access needs to come from somewhere.

What I do not care for is the hyper-politicization of this topic. Republicans (including the president) have actively sabotaged the Affordable Care Act, cutting funding to insurers, not mentioning the negative talk about it. It has still survived. Some Democrats choose to throw progress out and go full bore with Medicare for All. Again, that is a detailed undertaking and no candidate can accomplish this without buy-in from both parties.

So, let’s improve what we have. States who have not expanded Medicaid have been economically short-sighted and harmed their citizens. I have argued for repaying insurers who were harmed by the reneging on funding commitments, inviting them back into markets. Where choice is not available, introduce a Medicare option. I would also lower the eligibility for Medicare to age 60 or 62.

These are practical options that may move the needle upward like in those six states. Let’s talk about that.

https://finance.yahoo.com/news/6-states-achieved-near-universal-224827646.html

Two rising sea stories from today

In my newspaper today, two articles caught my eye about the impact of rising seas. The first is an editorial entitled “Rising seas eroding coastal property values,” written by Orrin Pilkey, the co-author of a study of this subject.

The other is an article called “Highest tide in 50 years swamps Venice,” by Elisabetta Povoledo of The New York Times. Beginning with the sensational, per Povoledo, “The Mayor of Venice, who said that the city ‘was on its knees’ has called for a state of emergency and the closing of all schools after the Italian city was submerged under…an exceptionally high tode – the highest in 50 years.”

At six-feet, the rising sea level in Venice waa the most since 1966. Yet, per the article, “Last year, as severe weather in Italy killed 11 people, ferocious winds drove the high tide in Venice to more than five feet above average sea level.”

In Pilkey’s editorial, the study was reported in his book with Keith Pilkey called “Sea level rise: a slow Tsunami on America’s shores.” “The First Foundation, a non-profit research group with flood risk, analyzed 13.3 million real estate transactions, and compared the results to 25.6 million properties along the east coast and Gulf coast of the US. They concluded that there was a $15.8 billion loss in home value appreciation between Maine and Texas from 2015 to 2017.”

Pilkey made reference to increasing “sunny day flooding.” They note the sunny day flooding will increase even more until it becomes more permanent. In essence the sea water comes up through the storm drains in the street leaving standing water. A key quote toward the end of the article is a warning. “I know that if my family were living in or near a sunny day flooding area, I would urge them to sell and leave.”

Low lying coastal cities are at great risk. Global climate scientists have long said the City of Miami is the most at risk city in the world. Miami Beach is already seeing many more days of sunny day flooding. The state that had the most property loss in value is Florida. I would hope the leaders of that state would be banging the drum the loudest. As for Venice, they rely so much on tourism. Yet, that future looks to be at grave risk given its low sea level status.

Note: Below are two links to these articles:

https://www.newsobserver.com/opinion/article237245139.html

Note further: A famous climate change “denier” in words does not match his rhetoric with his actions. Per a Politico article in May, 2016 entitled “Trump acknowledges climate change — at his golf course:”

“The New York billionaire is applying for permission to erect a coastal protection works to prevent erosion at his seaside golf resort, Trump International Golf Links and Hotel Ireland, in County Clare. A permit application for the wall, filed by Trump International Golf Links Ireland and reviewed by POLITICO, explicitly cites global warming and its consequences — increased erosion due to rising sea levels and extreme weather this century — as a chief justification for building the structure.” These actions support the concerns of the Pilkey study of property values being at risk due to sea level rise.

The most realistic path to ‘Medicare for All’ says a former Insurance CEO

I said back in 2010 to a healthcare consulting colleague, we will eventually need to consider national health insurance, but it won’t happen. When he asked why, I responded the “Healthcare industrial complex is too powerful.” People forget the reason we have the Affordable Care Act is CFOs were tired of rising healthcare costs to their bottom line.

Healthcare is a complex topic and the ACA added to that complexity. It has since gotten better, but we need to shore it up to stabilize it more, rather continue to allow it to be diminished as its opponents have down for several years.

But, national health care under the banner of “Medicare for All” is worthy of consideration with data and analysis. This retired actuary, benefits consultant and benefits manager supports data driven analysis to improve what we have and consider more substantive changes. JB Silvers, a former health insurance CEO and professor of health care finance at Case Western University, penned an article called “The most realistic path to ‘Medicare for All'” in The New York Times earlier this month. Here are excerpts from the article:

“Much to the dismay of single-payer advocates, our current health insurance system is likely to end with a whimper, not a bang. The average person simply prefers what we know versus the bureaucracy we fear.

But for entirely practical reasons, we might yet end up with a form of Medicare for All. Private health insurance is failing in slow motion, and all signs are that it will continue. It was for similar reasons that we got Medicare in 1965. Private insurance, under the crushing weight of chronic conditions and technologic breakthroughs (especially genetics), will increasingly be a losing proposition.

As a former health insurance company C.E.O., I know how insurance is supposed to work: It has to be reasonably priced, spread risks across a pool of policyholders and pay claims when needed. When companies can’t do those fundamental tasks and make a decent profit is when we will get single payer.

It’s already a tough business to be in. Right now the payment system for health care is just a mess. For every dollar of premium, administrative costs absorb up to 20 percent. That’s just too high, and it’s not the only reason for dissatisfaction.

Patients hate paying for cost-sharing in the form of deductibles and copays. Furthermore, narrow networks with a limited number of doctors and hospitals are good for insurers, because it gives them bargaining power, but patients are often left frustrated and hit with surprise bills.

As bad as these problems are, most people are afraid of losing coverage through their employers in favor of a government-run plan. Thus inertia wins — for now.

But there’s a reason Medicare for All is even a possibility: Most people like Medicare. It works reasonably well. And what could drive changes to our current arrangement is a disruption — like the collapse of private insurance.

There are two things insurers hate to do — take risks and pay claims. Before Affordable Care Act regulations, insurance companies cherry-picked for lower-risk customers and charged excessive rates for some enrollees…”

There is only one solution: pooling and financing many of the risks related to chronic and acute health care issues. A study by my former company noted generally 15% of participants drive 80% of the claims costs in any given year. It may not be the same 15%, but with major chronic issues, some could continue to be in the mix. The principle of insurance is to pool those risks, so that good risks can moderate the higher risks.

The ACA uses the private insurance system, exchanges and expanded Medicaid. Unfortunately, there are about 15 states who still have not expanded Medicaid. Medicare for All would consolidate the risk into one place, eliminating the profit load and reducing the relative administration cost of insurance companies. I have suggested for several years to do a pilot and expanded Medicare eligibility from age 65 to age 62, or even lower. This would let us measure the impact of such a change.

Yet, what we don’t need is this to become political. What people do not realize is the ACA has been sabotaged on several occasions by my former party which drove some insurers out of the market and increased premiums for everyone else more so than they otherwise would have been.

So, let’s cut to the chase and study options. And, politicians should let people who know what they are doing do the analysis. The ACA was made too complex and the exchange roll out was botched. On the flip side, what the GOP did in 2017 was sloppy and poorly staffed, so what was voted on woulf have been harmful to many.

Our children deserve better

Two time Pulitzer Prize winner Nicholas Kristof wrote an editorial earlier this week in The New York Times called “Our children deserve better.” It is a clarion call to our nation showing the plight of kids in America.

Here are a few quotes to frame the issue:

“UNICEF says America ranks No. 37 among countries in well-being of children, and Save the Children puts the United States at No. 36. European countries dominate the top places.

American infants at last count were 76 percent more likely to die in their first year than children in other advanced countries, according to an article last year in the journal Health Affairs. We would save the lives of 20,000 American children each year if we could just achieve the same child mortality rates as the rest of the rich world.”

“Half a million American kids also suffer lead poisoning each year, and the youth suicide rate is at its highest level on record….The Census Bureau reported this week that the number of uninsured children increased by 425,000 last year.”

These are different views and sources of the threats to US children that note we have a problem. Another source I read a couple of years ago noted America has a much higher maternal mortality rate at child birth than other civilized countries, which further endangers children as well as the mothers.

Yet, these issues are not being discussed in the halls of government. We have a poverty problem in our country with too many living in or just above poverty levels. We have not expanded Medicaid in fifteen states whose numbers are worse than these national numbers per capita. We have not addressed our national water crisis which has a Flint, MI like exposure to lead in too many cities and a volume of available fresh water issue in other places. We have not invested as we should to diminish crime and provide more opportunities for jobs in disenfranchised areas. There are several pockets of success that can be emulated in more cities.

We also need to address better gun governance, especially with the number one gun death cause by far being suicide and a non-inconsequential accidental gun death rate. And, we have not dealt with the continuing and rising exposure to technology and artificial intelligence which have taken and will take even more jobs in the future. Finally, there is that climate change thing we need to deal with.

These are real problems. And, they will get worse. Data driven analysis of causes and solutions are needed. They are both multi-faceted. Investing more now, will save huge amounts later. This is not just an urban issue, it is rural one as well. The opioid crisis is rampant in these impoverished rural areas, for example.

None of the solutions will fit on a bumper sticker. And, political attempts to oversimplify issues should be questioned. Here is an easy contradiction to spot – if people believe gun deaths are a mental health issue, then why the effort to eliminate or not expand mental health benefits?

Please make your legislators aware of these issues and ask pointed questions. These questions deserve answers, not bumper sticker slogans. These concerns deserve to be talked about, studied and acted upon.