AMERICA IS KILLING ITSELF.  DOES ANYONE CARE?

A shorter version of this article first appeared as an op-ed piece in the Omaha World-Herald on March 7, 2023.

Americans understand the threats we face in an unsettled world.  A war in Ukraine, a worldwide refugee crisis, a crazed dictator in Russia, and a surging economic and military giant in China.  Across the globe, democracy seems in full retreat.   

But a far greater danger looms here at home. 

It’s us.  With every passing year, America keeps killing itself.

No, I’m not just talking about suicide.  For a host of reasons, American death rates are soaring.

Let’s look at some basic numbers.  By 2015, an average American could expect to live nearly 80 years.  We’ve been going downhill ever since.  This past year, life expectancy dipped to barely 76.  For native American males, the figure was a shocking 61.5 years.

What’s going on?  Certainly, COVID took its toll.  To date, over 1.1 million Americans have died from the pandemic, giving us one of the highest COVID death rates among western nations.

But there’s more to the story.  Suicides are increasing here in the states at a time when they are falling in the rest of the world.  Since 2000, U.S. suicides have jumped by 33%, and currently take over 45,000 lives each year.

Opioid overdoses are killing another 100,000 Americans.  Alcohol takes an additional 95,000.

Automobile accident fatalities increased over 10% in the past year.  With nearly 46,000 deaths, we lead the developed world in both fatality rate and absolute numbers.  Anyone paying attention on our highways knows that Americans are driving faster, angrier, and more aggressively than ever.

Obesity and poor diets also take their toll.  Over 42% of Americans are obese.  Diabetes rates are skyrocketing—along with massive costs.  Yet options for prevention and treatment are limited.  In many areas, fast food is more available than fresh groceries, and in some instances, cheaper.

Are you working two jobs and exhausted?  No grocery stores within miles, you don’t have a car, and buses are late more often than on time? That burger may be your only option.

Vaccination rates for both children and adults are plummeting, owing in no small part to a rabid anti-vaccine campaign that was well underway even before COVID.  This will mean increased deaths from diseases once considered preventable.  What happens when the next pandemic hits?  It won’t be pretty.

The role of firearms in a country that swamps the rest of the world in gun ownership must be acknowledged.  Whether measured in murders, accidents, mass shootings or suicides, guns are killing over 45,000 Americans annually.  Conservatives are quick to note high homicide rates in Democratically controlled large cities, while liberals point to statewide murder rates that are highest in solidly Republican states.  Both are correct.

Liberals maintain that bringing American gun laws more in line with the rest of the world would save lives, while conservatives counter that better mental health policy is the key.  We need both.

Unfortunately, most American politicians would rather argue about these issues than actually do anything.  The result?  They refuse to put their money where their mouth is.  Florida, for example, was one of the first states to codify “stand your ground” laws.  Since then, their firearms mortality has increased by over 32%.  Could better mental health have prevented this?  Who knows?  Florida spends just $36 per capita on mental health services, the lowest in the nation.

Let’s be clear.  Throughout the country, mental health is underfunded, undervalued, and needs far greater support.  But mental health alone won’t fix our increasing death rates.

And don’t get me started on health insurance.  According to a Harvard University study, as well as estimates by the American Public Health Association, up to 45,000 Americans die each year because of a lack of health insurance.  Research by Public Citizen indicates that as many as 33% of COVID deaths in the U.S. were tied to a lack of insurence.

Tackling any of these issues individually would be difficult enough, but in an environment in which people distrust—or even hate—science, their government, and even their own neighbors, solutions will be even harder to find.

Despite all its wealth and prosperity, America seems intent on killing itself.  Our enemies, of course, are watching all of this with glee.

We all own this.  Independent of our political passions, can we rationally discuss the root causes of our spiraling death rate and come up with realistic solutions?  Or will we continue to make excuses while America’s mortality grows?  

Christmas, 2022

In the aftermath of one of the coldest and most brutal weather events in recent history, Christmas is still arriving.  People will dig out, presents will appear, and hopefully a little warmth will return.

It hasn’t been an easy year.  Inflation, war, hunger, hatred, and a seemingly endless cycle of infectious disease.  It’s been tough.

Plenty of things will be coming at us in the year ahead.  Immigration questions, an uncertain economy, wars, and rising inequality, all occurring on an increasingly crippled planet.  For the record, I’ll have plenty to say about all of them in the months ahead.

In the meantime, a couple of readers have asked if Jesus will make another blog appearance, like he did last year in the https://afamilydoctorlooksattheworld.com/christmas-2021/ post.  So at the risk of offending anyone, here’s another letter as I imagine Jesus would likely submit.

Hello everyone.  Jesus here.  Has it actually been a whole year? 

I’m not sure I have much new to offer.  If you’re looking for some sort of additional wisdom or insight, you’re going to be disappointed.  Everything important I had to say came out two thousand years ago, and most of it you’ve either forgotten or just don’t want to listen to. 

But it still pains me to see what you’ve been doing to each other down there.  People are freezing in Ukraine, at least those who haven’t been killed in the streets.  Children are shooting each other all across America. Food is vanishing in Africa.  Cholera and anarchy are thriving in Haiti. And no one seems to notice or care.

Yes, I realize there may not be much you can do about this as individuals.  But at least you could be better to one another.

I guess that’s why I really get miffed when you use my name to justify something that’s just the opposite of what I taught.  Don’t get me started on how many religious conflicts are being fought right now. 

Eighty years ago, the Nazis went into battle with the words “God With Us” emblazoned on their belt buckles. And now, religious leaders all over the world still try to use religion to justify their little wars.  Sometimes, even the same religion in the same war. 

The Ukrainian and Russian Orthodox Churches each support different sides in the killing.  According to some Russian priests, soldiers dying in the war will have their sins absolved, as long as they’re fighting for Russia.  Not that long ago, Irish Catholics and Protestants were saying basically the same thing.

Don’t ask me where you come up with this stuff.

Much as I try to understand you people, I can’t.  Some of you self-proclaimed Christians carried crosses to the U.S. Capitol while police were being beaten.  Some prayed one minute and shouted “hang Mike Pence!” the next.

And it sure doesn’t seem like much has changed.  Just the other day I saw a bumper sticker that read “Jesus is my Lord and Trump is my President.”

Really?  Do you have any idea how insulting that sounds?  Back in Exodus, the Law says “Thou shalt not take the name of the Lord thy God in vain.”  If I wasn’t such a nice guy, that character would be driving his car straight into the Sun right now.

I could go on and on, but I won’t.  The truth is, I still have faith in you people.  There are times when I see enormous acts of kindness.  I’ve seen some of you sacrifice incredibly to help those in need.  I’ve seen tears turn to smiles with just a few words.

I just don’t understand why you don’t do it more often.  The opportunity won’t come around again.

No matter your religion, you people do have a thing for holidays, don’t you?  Christmas in a few days, just as Hanukkah wraps up. Kwanza next.  Muslims will begin the Ramadan fast in March.  Hindus will celebrate Diwali in November.

Each will underscore faith, generosity, and sharing.  I just wish they all would last a little longer.

So maybe that’s my thought for this year.  Take care of each other.  Take care of the Earth.  I don’t care how much crap Elon Musk tries to sell you, you won’t be able to bail out of the Earth and live on Mars. Take care of the place you have right now, for your children’s sake.

Maybe this letter will be an annual event if Frey keeps writing his Blog.  Who knows? 

But one thing is certain.  The acts of kindness you show to one another will last much longer than any of you will as individuals.  And those things will define your legacy to a much greater degree than who you voted for or which church you wandered in and out of.

Something to think about.

See you down the road.

Jesus

MEDICARE ADVANTAGE—WHOSE ADVANTAGE IS IT?

“. . .my experience was that it was fine unless you get sick, in which case they severely limit your options, including getting a second opinion.  I quit as soon as I could.  Do not get this plan unless you know you’ll never need any kind of serious medical care.”—Eva, a former Medicare Advantage patient, expressing her frustration with the program.

At long last, election season is over.  The shouting, screeching, wild claims and outright B.S. of non-stop political commercials are gone—at least for a short while.

But if you’re somehow missing all of that, I have great news.  You can still turn on your TV and hear a litany of monotonous, mind-numbing exaggerations.  You can still go to your mailbox and find it stuffed full of slick marketing materials.

Of course I’m talking about Medicare Advantage.  Just call our toll-free number.

As a physician and an Old Guy myself (I mean really old—I’m nearly 71, for God’s sake!) I have a real concern about the future of Medicare.  It’s been around since 1965.  Congress passed it so older Americans wouldn’t have to choose between forgoing health care and getting crippled physically, or receiving health care and getting crippled financially.

Like most legislation, it was far from perfect.  But it’s still been a godsend for millions of older Americans.  There’s a whole chapter about Medicare in my book, if you’re interested.  For now, let’s just look at a portion of Medicare.  The part you constantly see on T.V.

The part that’s threatening to bankrupt the entire Medicare program.

From the outset, private insurance companies have made money off Medicare.  Private carriers have served as “intermediaries.”  That is, they got paid to process the claims submitted to Medicare.

They made plenty of money doing this.  It just wasn’t as much as they wanted.

So the insurance industry had to find another way to get at all of those Medicare bucks.  In 1997—after intense lobbying—the industry convinced Congress to pass a plan that allowed older Americans to enroll in private programs, rather than Traditional Medicare.  Instead of paying for an enrollee’s medical expenses directly, Medicare would instead turn over a fixed sum of money to a private insurer to “manage” the patient’s care.  They called it Medicare Advantage.

From the outset, any rational person could have seen this was going to be an expensive boondoggle, but we’re not talking about rational people here.  We’re talking about Congress.  Traditional Medicare had run an overhead (even with the claims processing being outsourced) of around 2-3%.  Private insurers exceeded 10%.  Even by third grade arithmetic standards, the numbers didn’t add up.

And they still don’t.  Today, Traditional Medicare runs a 2% overhead.  Advantage plans combined overhead and profit checks in at over 12%.  That difference represents taxpayer dollars that don’t pay for health care.  Instead, they’re eaten up by TV ads, marketing, and corporate bottom lines.

But money buys influence, and the insurance industry has plenty of both.  And since its passage, Advantage plans have been marketed non-stop.  They’ve become a gold mine for private insurers, but a multi-billion dollar drain on the Medicare Trust Fund. 

But how can Advantage plans offer all of those “extras” like gym memberships, etc. and still be so profitable?  Through the twin processes of “upcoding” and “care management” (which really means denying referrals and refusing to pay for treatment).  Both are endemic in the Advantage world.

Upcoding works like this.  The money the Medicare Trust Fund pays an insurer is based on the diagnoses listed for an individual patient.  The more diagnoses, the greater the payment, whether the patient actually receives any care for those diagnoses or not. Through aggressive data mining, seniors are suddenly assigned diagnoses they’ve never heard of, never been treated for, and likely never will.  But it adds big bucks to the insurer.

How widespread is this?  According to the Office of the Inspector General, 4 of the 5 largest Advantage insurers are guilty of overbilling.  Three have been charged with outright fraud.

Multiple whistleblower complaints have uncovered a scale of fraud that’s unprecedented.  In addition to the quote at the beginning of this post, further evidence reveals seniors have been lied to about what the plan covers, whether their doctor is included, and what treatments are available.  That’s right—I said outright lies.

But they’ll be so convincing when you call that toll free number.

Estimates of how much all of this costs Medicare run upwards to $25 billion per year—money that would otherwise actually pay for care in Traditional Medicare.

But upcoding is only part of the story.  Because Advantage plans are basically managed care products (unlike Traditional Medicare), patients are only allowed to receive care through a specific insurance-designated network—and pay through the nose if they go out of network.  Claiming you didn’t know the providers were out of network won’t help.  You’ll still pay.

Think staying “in network” sounds simple?  Think again.  Some hospitals might be in network, but most of the doctors aren’t.  Sometimes the laboratory testing will be in network, but not the radiologists reading the X-Rays.  For those expenses, you’ll have to cough up the money yourself.  And you probably won’t find out until you get the bill.

And even if you stay within the network, testing, treatments, referrals, and even some admissions must first be approved by the insurer, resulting in long delays in care and often outright denials.  A recent audit found that 18% of those denials were for treatments that Medicare was supposed to cover.   And in each instance, the care was ordered by the patient’s physician.  It was the Advantage insurer who denied it.

One of the added financial drains from Advantage insurers is the fact that each year older Americans can sign up for a different plan.  That’s where the TV adds, mailings, and repeated badgering phone calls come in.  It’s high stakes marketing that gets thrown at Seniors year in and year out.  And it’s extraordinarily expensive.

“Ditch your traditional Medicare for our Advantage plan!”  “No, ditch their Advantage plan for our Advantage plan!”  “But ours gives you these benefits!”  “But we give you these benefits?”

Often these products are sold on a commission basis, where the incentive for sales reps to shade the truth to older Americans, or simply outright lie, is enormous.  And every phone call, every advertisement, every come-on, is paid from one source.  Your tax dollars.  And not a penny of it goes to pay for health care.

But don’t some of those Advantage programs say they’ll also pay for dental care?  And vision?  And home meals?  And rides to the doctor?  And trips to Mars on Elon Musk’s spaceship?

Some do, some don’t.  And nobody pays for all of it (listen closely when that commercial says “they told me I might qualify for. . .)”

But shouldn’t I want dental coverage?  Of course.  What Medicare Advantage plans do is take some of the thousands of extra dollars they receive from the Trust Fund and buy a policy that is available to everyone for $10-25 a month.  Then they pocket the rest. 

Forget the fact that I’m a doctor.  I’m also a patient.  And as a patient, I really don’t give a damn about the bells and whistles in an insurance plan.  I’m interested in something else.

Can I see any doctor I want, or just someone in my network (who may not be in the network tomorrow)?  Can I get the tests my doctor orders, or do I have to wait until the insurance company approves them?  Can I get admitted for treatment, or have to wait for the company’s OK?  How much will I ultimately be stuck paying in copays and deductibles after I’ve paid the premium—regardless of how low the premium seems at first (remember, there’s no free lunch)?

According to an investigation by the Kaiser Family Foundation, insurers are now reaping twice the profit from Advantage plans as from their non-Medicare products. 

This was never the intention of the Medicare program.  And if it continues, Medicare’s future is in serious jeopardy.  Through clever (and expensive) marketing, nearly half of all Medicare recipients have signed up for Advantage plans.  They’re wildly popular.

That doesn’t change the fact that these plans are bleeding the Trust Fund dry.

And to be honest, I’m also concerned about something other than just my own health care.  I want Medicare to be there for my children and grandchildren. 

According to news sources, some in Congress are demanding cuts in Medicare and an increase in eligibility age, claiming both are necessary to sustain the program. 

Fine.  But I hope those Senators and Representatives also realize that there are far greater savings in the $25 billion currently being lost through Advantage overpayments.  If Congress has the courage to act, these dollars could quickly be recouped by moving the program back to the far more efficient Traditional Medicare, where overbilling would cease and care placed back in the hands of health care providers.

That would go a long way toward stabilizing the Medicare program.  It could even pay for those dental benefits for all Medicare recipients.

If that were to happen, it would be a true advantage for all Americans.

TURNING BACK THE CLOCK AN HOUR—OR A CENTURY?

As should be painfully obvious by now, it’s election time.  With a total of 16.7 billion dollars spent on advertising, it’s pretty hard to escape the biased campaigning coming from all sides.

By now, I hope that all of you have voted.  Most states have provisions for early voting, or vote by mail, and we need to be exercising this right.  Nothing in the constitution says that in order to vote you are required to stand in line for an hour in the rain, while someone wearing a camouflaged mask, body armor, and carrying an assault rifle glares at you.

No, it’s your voice that’s important.  And how you express it—either in person or by early ballot—should be no one’s damn business but yours.

So it you’ve voted, all of what I’m about to say may be old news.  But because it relates to the future of our nation, it’s still important.

If you are voting Republican, you’re more likely to cite inflation and crime as your primary concerns.  You believe inflation is out of control, and it’s because of Joe Biden’s policies.  You believe Democrats are “soft” on crime, and that crime rates are out of control—especially in states run by Democrats.

If you’re voting Democratic, you’re more likely to be concerned about efforts to criminalize anything to do with abortion, and the risk to health care and our national infrastructure.

But regardless of how you vote, I hope you’re just as deeply concerned about the rising tide of hatred, suspicion, and disunity that threatens our very existence.  As I mentioned in my first post An Open Letter to the People of the United States, these things are a far greater threat to our national existence than any foreign power.

So let’s take a hard look at some of these pressing issues.  It won’t be pretty, and some of you may disagree.  That’s OK, as long as we are thinking and talking about these things, rather than shooting at one another.

 Health Care—I won’t belabor the point.  Republicans say we have the best health care system in the world.  Any honest doctor will tell you we don’t.  Our safety net is fraying, people are going without care, and even people with insurance may face bankruptcy from medical bills.  This isn’t a snowball going downhill, it’s an avalanche that will eventually crush us. 

You don’t have to read my book.  Just check this post by Dr. Josh Freeman from the University of Kansas at his Medicine and Social Justice site for more details.  Premiums are up, people are dying and insurance companies are making out like bandits . 

The Republican approach is that the “free market” will somehow fix this.  It hasn’t.  And it won’t.

Medicare and Social Security—Both of these programs are paying out money faster than they are bringing it in. That’s not sustainable.

Democrats have proposed securing additional funding from other sources (nobody pays into social security on the basis of their stock market profits, for example) to fully fund these programs.

Republicans have proposed cutting benefits and raising the age to qualifying for benefits.  That won’t hurt high rollers, but it’s going to impact people who’ve struggled their whole lives.  The rationale that eligibility age should go up because people are living longer needs to be reassessed, too.  Life expectancy in America isn’t increasing, it’s decreasing.  One more bit of evidence that America is backsliding.

Which of these two approaches is best?  Your vote will decide.

Inflation—As the impact of the COVID pandemic slammed the world’s economy, and Russia’s invasion of Ukraine sent food prices soaring, inflation has taken its toll.  Most recently in the U.S., it has hit 8.2%.  Gas prices are down substantially from their peak, but other prices continue to rise.

Republicans contend this is all Joe Biden’s fault.  Their reasoning is that COVID relief programs were too generous, leading to “too much money” floating around, which has in turn led to an inflationary spiral.

Sorry, but this doesn’t hold water.  Many other countries that didn’t have programs nearly as generous as ours are seeing even higher inflation.  Britain recently hit 10.1%.  The entire Euro zone averages 10.7%.  And be glad you don’t live in Turkey, which checks in at a cool 80% inflation rate.

As a reminder, Joe Biden isn’t president of any of those nations.  Even the ones with higher inflation.

The real question isn’t so much what our economy is like compared to two years ago.  It’s where would we be if the Republicans were in charge?  Somehow miraculously better?  The same?  Or possibly even worse than European countries?  That’s what no one seems to want to consider.

Crime—In the past year, the overall crime rate has increased, although violent crime is down.  Republicans have always made hay by saying Democrats are “soft” on crime.  But most crimes are state-to-state issues.  So where are the most violent crimes occurring?

Basically, in Republican controlled states.  The seven states with the highest murder rates are all solidly Republican, with Mississippi leading the way.  My old home state of Missouri comes in fourth, which shouldn’t be surprising.  Among all major American cities, St. Louis’s murder rate is the highest, with Kansas City consistently in the top ten.

It’s hard to make a valid argument that Democrats in Washington are responsible for crimes that should be at the forefront of Republican-led state legislature’s agendas. And according to some analysis, the most rapid post-pandemic rises in crime have occurred in rural areas, rather than cities.

Without a doubt, there are things we can do to better address crime.  Police officers need better training and certainly better pay for the risks they must take.  Prisons need more focus on rehabilitation and not just a “lock-em-up and let ‘em out when they’ve served their time” approach.  Violent criminals should be the focus, rather than minor violations.

In Maricopa County, Arizona, Sheriff Joe Arpaio was the poster-child for “get tough” policies.  He made prisoners sleep in tents in the desert, wear pink underwear, and eat lousy food.  His thinking was if you make incarceration tough enough, no one will break the law again.

It didn’t work.  His prisoners committed just as many crimes when they got out as did prisoners who hadn’t received the “special” treatment.

Take your pick.  A focus on improved training, compensation, and rehabilitation, or a focus on just building more prisons and locking more people up until they’re released to go back to criminality?  Your vote will decide.

Women’s Health? or Abortion!Abortion!Abortion! (Select one, depending on your view)—This pretty much sums up the two official positions of the political parties.  I’ve already talked about abortion here.  But it’s important to keep in mind that many of the same voices that scream about abortion being murder also want to restrict access to birth control, cut funding for women’s health, hold women to a different standard than men (think that big orange-haired guy who brags about his sexual conquests), and slash benefits to pregnant women and children.

I don’t think I have to paint a picture about which Party takes which of these positions.

Climate—The earth is warming significantly, glaciers are melting, weather is being disrupted, “thousand year” floods and hurricanes are now happening every few years instead, and lives are being destroyed.  Mosquitos resistant to insecticides are rapidly spreading through Africa and bringing with them soaring malaria rates.  These critters could well wind up in the U.S., too.

Sorry, but building a wall won’t keep any of them out.

According to Democrats, we’ve kicked the can down the road too long and need to address the threat.  According to Republicans, the economic costs are too great, and besides, it’s not real anyway.

Who’s right?  You’ll decide that with your vote.  But remember, it’s only your children’s and grandchildren’s future that hangs in the balance.

Science—I’m going to be blunt.  I’ve got pretty strong feelings about this.  I’ve devoted my life to science.  My inspirations were my high school science teachers, L.D. Young and T.J. Beach.

Science and scientific research helped us win the Cold War, raise our standard of living, and basically change the world.  It has the potential to transform our energy requirements, protect our environment, and improve our health.  But we have to follow the evidence instead of what we want to “believe.”  Millions of lives have been saved by vaccines.  Millions more have been lost because of lies told about vaccines.

One party wants to fund scientific research, give scientists the latitude to explore their fields, and allow scientific education to permeate our schools.

The other party wants to cut funding, demand that scientists not research fields that conflict with conservative political “beliefs,” and severely restrict what scientific facts can be taught in our schools.

Once again, I don’t think I have to tell you which party is which.

There are plenty more issues that divide the two parties, but I think this will do for now.  In general, mid-term elections are no big deal, and the turn-out isn’t great.  But this year the stakes are much higher.

There are no elections on the face of the earth that the world follows more closely than those in the United States.  On Tuesday, the world will again be watching.  What direction will America take, and how will it impact billions of others on the planet?  The world watches and waits.

Early Sunday morning, Daylight Savings Time goes away.  We’ll set things back an hour.

Fine.  But on Tuesday, will we set things back a hundred years?

WHAT DOES IT TAKE TO MAKE A LIVING WAGE?

Recently, I was asked by Nebraska Appleseed to write an opinion piece regarding a proposal to raise the Nebraska minimum wage.  I immediately contacted my old friend John Kretzschmar, the Founding Director of the William Brennan Institute for Labor Studies at the University of Nebraska.  He’s spent a career dealing with the status of American workers and is far more knowledgeable than me. Together, we put together an article that appeared in the Omaha World-Herald.  There’s a link to the actual article below.

In the meantime, there’s plenty about the minimum wage that simply couldn’t be included in the paper because of space limitations.  So here’s some additional information.

First, the national minimum wage has been in place ever since the Federal Government instituted it in 1938 at a whopping 25 cents an hour.  And ever since, its detractors have been trying to convince us that it’s all some sort of communist plot.

Their thinking goes something like this. If employers have to pay their workers a little more, they’ll either have to fire some of them or not hire anyone else.  In other words, you can’t raise wages and maintain profits.

It sounds plausible, but in each of the instances the minimum wage has been increased, no one has demonstrated any sort of consistent adverse effect on employment, incomes, or other major economic factors.

Every economic change, whether public or private, has winners and losers (just ask anyone who used to work at Sears, K-Mart, or Toys-R-Us).  Short term, some jobs transition.  The long-term consequences are usually different.  And no one has been able to clearly demonstrate that increasing the minimum wage, or for that matter, even having a minimum wage in the first place, has had a negative effect on the economy.

But isn’t raising wages substantially something that’s bad for business?  Is it even possible for a business to increase wages and increase profits at the same time?

History says yes.  Enter the picture, Henry Ford.

In 1914, Ford shocked the world when the company announced that it was doubling the salary of its workers.  That’s right, doubling—as in a 100% raise. 

In Ford’s words “It is our belief that social justice begins at home. We want those who have helped us to produce this great institution and are helping to maintain it to share our prosperity. We want them to have present profits and future prospects. … Believing as we do, that a division of our earnings between capital and labor is unequal, we have sought a plan of relief suitable for our business.”

The Wall Street Journal, along with several other newspapers, went nuts.  Ford had “committed economic blunders, if not crimes,” the Journal’s editorial page screamed.  The conventional wisdom was that Ford would be bankrupt within a year.

Instead, the opposite happened.  Turnover at Ford factories fell sharply, reducing training costs.  Ford workers poured more money into the local economy.  And many of them bought cars themselves—Fords.

Within two years, Ford doubled its profits.

Let’s get one thing straight, though.  The bit about Ford doing this from a concept of “social justice” is a load of crap.  If you look up “nice guy” in the dictionary, Henry Ford’s picture won’t be there.

He was a bigoted, anti-Semitic racist.  He even purchased his own newspaper, The Dearborn Independent, to spread his racist views. He hated the prospect of his workers organizing, and hired Harry Bennett, once described as “America’s most reviled corporate thug” to ambush, beat, and sometimes kill workers who got out of line. 

So what was the real reason Henry Ford massively raised wages in 1914?  Simple.  He knew it would be good for Ford. 

Ford’s decision proved the fallacy of the “Gee, if we have to raise wages we’ll automatically lose money” thinking. 

Economics is a complex field, full of human variables.  It’s not a hard-science, and every honest economist knows this. 

A scientist can predict what will happen when two particles collide.  But when humans with their own biases collide?  That’s much less predictable.  It’s what makes psychology, sociology, and economics more subjective, and in many ways, much more difficult.

And in all my reading, I’ve yet to find convincing evidence that paying a living wage ends up being an economic negative in the long term.

As a nation, that’s where our focus really needs to be.  On the future, and not just next quarter’s report to corporate shareholders.

So enough background.  Here’s the article. 

Nobody Loses When Everyone Makes a Living Wage

Donald R. Frey and John Kretzschmar

Dr. Frey is Professor Emeritus of Family Medicine at the Creighton University and Mr. Kretzschmar was the Founding Director of the William Brennan Institute for Labor Studies at the University of Nebraska-Omaha. The views expressed here are theirs personally, and not necessarily those of their respective institutions.

With the upcoming midterm election, Initiative 433 will also appear on the ballot. Its passage would incrementally raise the minimum wage in Nebraska from its current $9 dollars an hour (an amount unchanged since 2016), to an eventual $15.

Nebraskans are fond of describing our state as “The Good Life.” But let’s be honest. No one can live The Good Life on $360 dollars a week. We’re not talking about extravagance. For Nebraskans, a good life means honest, hard work that at least allows us to put food on the table, a roof over our heads, educate our children, and provide for decent healthcare.

According to an analysis by the Massachusetts Institute of Technology, such a living wage for a typical Nebraska family is $30,847 annually. Do the math. That’s $14.80 an hour.

Initiative 433 would benefit thousands of working Nebraskans, but its effect would be especially important for women and young parents. Child poverty would immediately decline.

Families living paycheck to paycheck would finally get a little breathing room. A set of bald tires might finally be replaced. A broken washing machine is repaired. And there’s one more important benefit. The pride and dignity that one feels in providing a decent life for their family. How do you put a price tag on that?

Unfortunately, every time the subject of raising the minimum wage comes up anywhere in America, the same old excuses keep getting rolled out. Unemployment is going to rise. Workers will get laid off. Businesses will go belly up.

We’ve been hearing all of this for decades. Nebraska has raised its minimum wage seven times in the past forty years. Nationally, it’s been raised at least 22 times since 1938. And with each increase, none of the predicted disasters followed. Not once was an increase in the minimum wage shown to cause an economic downturn. Not once was it demonstrated to cause a rise in unemployment. In fact, recent economic developments in Nebraska have shown just the opposite.

Once the current minimum wage of $9.00 an hour was implemented, Nebraska’s low unemployment decreased even further. New business start-ups increased by 4%. The total number of Nebraska businesses grew by 2.7%.

Everyone won. Nobody lost.  In a consumer driven economy where consumer spending accounts for about 70 percent of GDP, the BEST friend of Main Street merchants is a well-compensated workforce.

The American economy is one of the most robust, vibrant markets in the world. But if you were to actually believe the arguments of the minimum wage detractors, you must assume that our economy is strong only because we can suppress wages to the point that workers must ask for handouts in order to survive. You must believe that only if significant numbers of Americans are paid less than a living wage can businesses survive.

This is wrong. Our businesses are stronger than this. And our nation—and our state of Nebraska—is better than this.

Changes in the minimum wage in surrounding states have shown similar economic positives. Raising the minimum wage doesn’t just improve people’s lives. It contributes to a vibrant and growing economy that ultimately pays dividends for us all.

We urge the voters of Nebraska to support Initiative 433. It’s the right thing to do for all of us.  Because nobody loses when we all make a living wage.

Midlands Voices — Initiative 433 Pro: Nobody loses when everyone makes a living wage (omaha.com)

READ BEFORE BANNING

Recently I was talking to someone about education.  Before long, he was lecturing me on critical race theory, sex education, Marxism (apparently, it isn’t enough to just smear something as “communist” these days) and something called a “woke” curriculum, which he couldn’t actually define.  Then he launched into libraries.

Parents should have control over what their kids read, he said.  And if that means banning certain books from libraries, so be it.  

I was a little taken aback.  “Like what books?”

He rattled off a half dozen, only two of which I’d actually heard of. 

“Have you read any of them?”  I asked.

Now it was his turn to look shocked.  “Of course not!” he said.  “Why should I?  Everybody knows they’re bad for kids.”

“Well, maybe you should,” I replied.  “That way, find out for yourself.”

By now he was turning red and starting to stammer.  Then I asked him a far more important question.

“So Bill (his name’s not really Bill), what was the last book you read?”

His stammering stopped, and he just stared at me.  “Come on Bill,” I said.  “You can remember all those Facebook and Twitter posts.  But how about your last book?” 

He turned and stormed away.  The reason was pretty obvious.  Bill couldn’t remember his last book.

Maybe I take all of this differently than most people.  I grew up in a family where the act of reading was considered almost sacred.  My Father was the first in his family to graduate from high school.  I was the second.

My Mother was fortunate enough to complete college. Both she and my father were emphatic that reading was the most important single factor in determining where you ended up in life.  Yes, they recommended plenty of books, but their message to me was much more basic.

Read every damn book you can get your hands on. 

No matter the author, no matter the subject.  Read.  And keep reading.  Then talk about it.

They trusted that if I read enough diverse opinions by enough diverse authors, I could sort out the contradictions on my own.  The local library was my source of knowledge (thank you, Miss Marie Ohlhausen).  The idea that any book would be “banned” there was simply out of the question.

The last thing my parents cared about was preventing me from reading.

My, how times have changed.

Recently, armed protesters demanded that an Idaho library remove over 300 books from its shelves.  Turns out, none were even in the library.

Florida banned over 50 math books because they were somehow connected to critical race theory.  What’s race got to do with math?  Beats me.  Ask Ron DiSantis. 

Closer to my home in Nebraska, a story about a York County farm family was selected by The Nebraska Center for the Book, an affiliate of the Library of Congress, for its “One Book Nebraska” award. 

The award was never presented.

Why?  Nebraska Governor Pete Ricketts refused to issue the necessary proclamation.  According to the Governor, the book’s author, Ted Genoways, had been critical of President Trump and was an “activist.”

Activist?  There goes any award to Carl Sandburg, Sinclair Lewis, John Steinbeck, or for that matter, anyone describing the teachings of Jesus Christ.

And what did the Governor have to say about the book itself, “This Blessed Earth: A Year in the Life of an American Family Farm?” Nothing.  He never read it.

Sadly, this has been going on for centuries.  A lot of it doesn’t make much sense.  George Orwell’s classic “1984” was banned in the Soviet Union because it was deemed anti-communist.  Some libraries in Texas and Florida have taken it off the shelves because they viewed it as pro-communist.  Some books have been banned in certain areas for being anti-black, and in others for being anti-white.

Book banners of all political persuasions frequently lift a single passage out of a text, ignore the book as a whole, and demand the book be removed.  I’ve read a book many times that vividly describes rape, torture, incest, and murder.  It’s called the Bible.  Should we ban it?

Sorry, but reading a book by Karl Marx won’t turn you into a communist.  Reading a book by Ayn Rand won’t turn you into a fascist.  Reading about a gay kid won’t make your kid gay.  Reading the Bible won’t make you a Christian.

What books will do is make you think.  The rest is up to you.

And if our world has a shortage of anything these days, it’s critical thinking.  Instead of removing books, we should be encouraging one another to read and write more.

Recently, the Grand Island (Nebraska) Northwest High School journalism class published an article in their school paper The Viking Saga.  The piece titled History of Pride was sandwiched between articles on the school’s FBLA program success and the local skeet-shooting club.  Unfortunately, an LGBTQ article was too much for local authorities. 

Not only did they shut down the school paper, they cancelled the entire journalism program.  So much for critical thinking.

But this is exactly the sort of thing book banners do. 

So here’s a suggestion.  The next time you might be inclined to ban a book, try reading it first.  Then make up your own mind. 

It might just surprise you. 

ARGUING ABOUT THE DEATH PENALTY:  HOW TO TALK YOURSELF HOARSE, PISS OFF YOUR FRIENDS, AND ACCOMPLISH NOTHING

Some of the most knock-down-drag-out arguments I’ve ever heard have had to do with the death penalty.  People get pretty worked up.

And to bolster their arguments, folks start pulling out all sorts of ostensibly sacred texts and writings.

“The Bible says Thou Shalt not Kill!”  “No, that really means Thou Shalt not Murder!”  “The Bible says An Eye for an Eye!”  “But it also says Love your enemies!”  “Well, Jesus said if you had anger in your heart, it was the same as murder—should we execute every angry person?”

On and on it goes, and no one convinces anyone of anything.

If we’re honest, though, the issue of the death penalty breaks down around three basic questions.  The first question has long been answered.  The second question—the one everyone wants to get worked up about—will never be answered.

But it’s the third question that’s by far the most important.  And it’s the one everyone wants to run away from and avoid.

We’ll get to those in a minute.  First, maybe we should recap how we got here.

Humans have been imposing penalties for breaking laws ever since they started inventing laws.  And one such penalty was death.   

One of the oldest set of laws is the Code of Hammurabi, written over 3,000 years ago.  It listed death as the penalty for over twenty violations.  Interestingly, murder didn’t make the list.

This continued for centuries.  Over time, it got to be even more hardcore.  In colonial Virginia, you could be executed for stealing grapes or trading with the local Indians. 

But by the late twentieth century, capital punishment in America had pretty much been confined to First Degree Murder.  Most developed countries had done away with it, but for better or worse, the U.S. has persisted to this very day.

So what are the three big questions about capital punishment, and why do they matter?

Question number one is whether the death penalty is a deterrent.  That is, if I’m about to murder someone, do I suddenly stop and say “Oh my God, I might get the death penalty, so I’m not going do it!”

This has never made much sense.  People resorting to murder generally don’t think this way.  Plus, there are plenty of real-word examples of how this doesn’t work. 

I live in Nebraska, barely a stone’s throw from Iowa.  In many cases, a criminal has abducted someone in Iowa (where there’s no death penalty) and murdered them in Nebraska (where there is).  Obviously, the death penalty didn’t make much difference.

So toss out the deterrence argument.  The second question is the one everyone loves to go round and round about.

Is the death penalty moral?  It’s a philosophical and ethical question, and I’m sure as hell no philosopher or ethicist.  And neither are most other people.

You can rant, rave, and shout about this all you want.  Jump up and down, scream, and wave your arms if you’d like.  The only thing you’ll do is make yourself hoarse, and you won’t change anyone’s mind.  The question of the death penalty’s morality can never be answered in any universal way.  People will simply believe whatever they want to believe.

Which brings us to the third question, the one no one wants to talk about.  It’s neither philosophical nor ethical.  Instead, it’s a blunt, in-your-face proposition.

How many innocent people are you willing to kill in order to execute the guilty ones?  Yes, you read that right.

Be careful how you answer it.  Because if you say “none,” you’ve just expressed your opposition to the death penalty.

Why?  Because the death penalty is imposed by the criminal justice system.  And our system of justice is administered by human beings, not by gods (OK, we have some Supreme Court Justices who think they’re God, but that’s a separate issue).

And if seventy years on this planet has taught me anything, it’s that human beings screw up.  Big time.

In the criminal justice system, this means that sometimes guilty people will go free (think O.J. Simpson) and sometimes innocent people get convicted.  And if you’re convicted of murder, you could well wind-up dead.

I’ve testified in court numerous times, and I suppose I’m about as familiar with the system as anyone who’s not directly involved in either law or law enforcement.  I’ve even been a defendant a couple of times in medical malpractice suits.  True, my life wasn’t on the line—just a bunch of money that an insurance company might have to pay.  But I still took the whole thing very personally.

Which brings us to the ultimate wildcard in the whole justice system.  The jury.

If you’re on trial, the first day in court will likely be involved with selecting a jury.  And each side—the prosecution and the defense—will do everything they can to get a “favorable” jury.

That is, a jury that might be inclined to be either for or against you.

Are you black?  How many of the selected jurors are actually racist?  Are you gay?  How many of the jurors are closet homophobes?  How will that impact their thinking?

Remember, if it’s murder you’re accused of, it’s only your life that’s on the line.

The fact is, there are no totally “impartial” juries.  They all have their own lives.  They all have their own prejudices. 

They’re all just humans.  And they’re all being asked to render judgement.

I remember my first malpractice trial.  Jury selection was in full swing and we had a lunchtime recess.  Immediately, all of the lawyers started calling everyone they knew who might have insights into prospective jurors.

“Fred?  Sam Davis.  We have a trial downtown and Mike Thompson is a prospective juror.” (All names are made up, by the way).  It looks like he works for you.  Here’s what the case is about.  How do you think he’d be inclined to look at a matter like this?”

For an hour this went on, call after call.  The other Doctors and I looked at each other, baffled.  One of the attorneys noticed this, then said bluntly, “You may not realize it, but this may be the most important thing that happens in this trial.”

Jury selection.  Choosing a presumedly impartial group of people to hear the facts.  And who was chosen might be the most important thing in the trial?

I felt like a football player who’d just learned that the most important thing that would happen in the game wasn’t how well he played, but who won the coin toss.  It wasn’t exactly reassuring. 

None of this is meant to demean the jury system.  Juries are made up of sincere human beings.  But they’re still human beings, nonetheless.  And they’ll still make mistakes.

Add to all of this the impact of the nature of the murder.  The more heinous the killing, the more the public wants the perpetrator off the streets.  The more law enforcement wants the crime to be solved.  The more the prosecutor wants a big win.

Being a prosecuting attorney is often the launch pad for a political career.  Solve a big case and put the “XYZ Killer” away?  The next step up might be State Attorney General.

Then United States Senator.  Then maybe President.

Plenty of smart, ambitious people harbor these hopes.  And there’s nothing wrong with that.  But couple such ambition with a mentally challenged defendant, being tried on largely circumstantial evidence, and being represented by an overworked, stressed public defender, and mistakes will happen.

Add to all of this the pressure that law enforcement feels.  From the moment the crime is discovered, they’re under the gun to solve it.  Often, they’ll have hunches about who the murderer might be.  They’ll apprehend him or her, and subject them to questioning.  Their goal?  Get them to confess.

This is supposed to involve the officers writing down what the suspect says, then getting him to sign a confession.  But not always.  If the officers feel strongly that the suspect is guilty in their eyes, they’ll have a confession ready to go.  They’ll pressure the suspect to sign it.  Even if it takes hours.

Just north of my hometown is the city of St. Joseph, Missouri.  In 1978, a four-year-old child was found sexually assaulted and brutally murdered in the river bluffs just outside of town.  Immediately, suspicion fell on a 25-year-old mentally impaired, bisexual man who had a local reputation as a Peeping Tom.  In 1970’s Missouri, that was enough to get you labelled a creep.

He was brought in, questioned, and signed a confession.  Just before his trial, he recanted his confession, and said it was coerced. 

Yeah, right.

He was found guilty, sentenced to life (this was during a time when the death penalty was suspended), and promptly carted off to the State Penitentiary in Jefferson City.  Everyone breathed a sigh of relief.

Four years later, an identical murder occurred.  The police were stunned.  This wasn’t a copycat.  There were details about the first murder that had never been made public, and were now a part of this murder, too.

The wrong man had been convicted.  The real killer was still on the loose.

I won’t go into detail, but thanks to some determined detective work, the real killer was found.  He’d been a person of interest early in the first murder investigation, but went off the radar as soon as the first suspect was apprehended.

Now feeling himself cornered, the actual murderer confessed to both killings.  And to at least 16 others around the country.  There may have been more.

How many of those murders occurred during the four years when he should have been in prison, if the wrong man hadn’t been convicted?  Who knows.

In Michigan, a similar case occurred.  A young woman was horribly raped and murdered.  The police were convinced they’d arrested the murderer.  After hours of questioning, he signed a confession.  Later, at his trial, he claimed he was tricked into signing a paper he was told wasn’t a confession.

Yeah, right.

When the judge sentenced him, he said, “Young man, you have committed the vilest crime I’ve ever seen in all my years on the bench.  My only regret is that the state allows me only to sentence you to life without parole, and I cannot sentence you to death, which is what you deserve.”

A few years later, the real killer was identified.  Several officers admitted they’d indeed misled the original suspect into signing a false confession.

And the judge who made the comment at sentencing?  Not surprisingly, he’s now a staunch opponent of the death penalty.

Dozens of people—some would say hundreds—have been sentenced to death row, only to be released when the real killer was found.  Fine.  Justice was done.

But this brings up a much more troubling question.  How many innocent people have actually been executed?

Who knows?  It’s not something the legal system likes to talk about.

So I’ll just give you one possible example.  In 1991, Cameron Willingham’s home caught on fire.  Running outside to find his children, Willingham realized they were still inside.  The house was ablaze.  Neighbors and rescuers held him back as he screamed and tried to get inside the flames.

He had lost his three children.  Then he was arrested.

A state Arson Investigator testified that the fire was intentionally set and fueled by an accelerant.  In addition, prosecutors claimed that Willingham had set the fire to cover up abuse of his children.  The whole crying and screaming to save his children thing had been a ruse.

Willingham maintained his innocence.  He’d never abused his children, he said.  And he had no idea how the fire started.

Yeah, right.

The jury didn’t buy it.  Willingham was convicted and sentenced to death.  After his final appeal was rejected (by the politically-ambitious Texas Governor Rick Perry), he was executed.

Soon thereafter, the truth began to come out.  The Arson Investigator who testified the fire had been set was found to be incompetent.  An independent investigation revealed there was no evidence the fire had been set, and bad wiring was the more likely issue.  As a result, other cases where the Investigator had testified were thrown out, too.

But of course, it was too late for Cameron Willingham.  In addition, it was learned that the prosecutor in the case deliberately withheld evidence that could have led to an acquittal.  The prosecutor was eventually disbarred from practicing law after another murder conviction where he had misled the court was overturned.

But again, it came too late for Cameron Willingham.

I could go on and on, case after case.  I hope I’ve made my point.  If someone is wrongly convicted, and years later found to be innocent, you can always apologize, shake her hand, and let her out of prison.

But if she’s been executed, it won’t do much good to dig her up out of the ground.

Maybe some people do deserve to die for the horrible things they’ve done.  I won’t argue that point.  As a physician, I’ve dealt with the aftermath of some of those horrible things.  But we all need to come to terms with that third question I raised earlier, the question seemingly no one wants to look in the eye and confront.

How many innocent people are we willing to kill in order to kill the guilty ones?  Because until we have the moral courage to confront that question, I’m not sure we have any business carrying out the death penalty.

A few times a year, something I write winds up in the Omaha World-Herald, our local newspaper here in Omaha. It’s the leading newspaper in Nebraska, and has a steadfast reputation as a moderately conservative publication. What this means in today’s terms, of course, is that Far-Right MAGA and Q-Anon types think it’s just this side of The Communist Manifesto.

Sorry, it’s still a fairly conservative paper. Nonetheless, they’ll still publish guest articles by people like me, especially when they speak to issues that are in the headlines. So here it is, pretty much as printed, with just a couple of additions:

CARRY A GUN AND DON’T WEAR A SEATBELT

July 26, 2022

The author is Professor Emeritus of Family Medicine at the Creighton University School of Medicine, and the author of “Pay Me Now or Pay Me Later: One Physician’s Guided Tour Through an Insane Asylum Called American Health Care.”  This article represents the author’s personal views and are not necessarily those of Creighton University.

Much as this may shock younger readers, there was a time, some forty years ago, when seatbelt laws were controversial.  The notion that the evil government, whether national, state, or local, would “mandate” seatbelts was viewed by some as one step away from communism.

Just as we’ve seen many times since, the issue of “you can’t tell me what to do!” was way more important than “what’s the right thing do?”

Some people wouldn’t admit to opposing seatbelt laws from a personal standpoint.  Instead, they needed a different excuse–seatbelts weren’t just ineffective, they were dangerous.

Here was their claim.  They knew somebody who knew somebody who’d been in an auto accident.  At the moment of impact, just before the car burst into flames, the driver had been thrown safely out of the vehicle and landed at a safe distance.  There, they watched as their car exploded before their eyes.

The person telling the story would then lean forward, scowl and say, “and you know, if that guy had been wearing a seat belt, he’d be dead!  Burned alive!  That’s why I’ll never wear a seatbelt.”

Did this actually happen?  Who knows?  If the window had been open (and it must have been a mighty big window), the exit angle perfect, and the ground about as soft as a pile of compost, maybe.

Don’t get me wrong.  Anything is possible.  Wherever you’re reading this right now, a piano might come falling out of the sky and land on your head.  But it’s pretty unlikely.

Today we know from years of experience that if deaths have occurred from wearing a seatbelt, those numbers are far fewer than the lives saved by seatbelts.  The evidence is so compelling that even those who’d sworn they’d never wear one now strap one on without a second thought.

All of this should come to mind when considering America’s last mass shooting (at the rate we’re going, there’ll be plenty more by the time this is printed).  A gun-carrying citizen killed the shooter in an Indiana mall.  The young man who stopped the shooter was praised.

Gun advocates were quick in their response.  “You see!  The only thing that stops a bad guy with a gun is a good guy with a gun!”

The facts tell a different story.

According to the Advanced Law Enforcement Rapid Response Training Center, fewer than 3% of all active shooter incidents over the past 20 years ended with a civilian firing back.  The incident in Indiana, along with the tragic mass shooting in Superior, Nebraska, are exceptions rather than the rule.

The notion that if everyone runs around packing a firearm we’ll all somehow be safer doesn’t hold water.  Weapons don’t fire themselves.  They’re fired by human beings.  And if you’ve been around as long as I have, you know human beings do some incredibly stupid things.

I grew up around guns in rural Missouri.  They were no big deal one way or the other.  But no one thought of carrying them in malls, grocery stores, churches, or restaurants.  Back then, if you insulted someone, cut somebody off in traffic, or otherwise crossed someone, the worst you’d wind up with was a bloody nose or busted lip.  People usually cooled off, shook hands, and moved on.

That doesn’t happen when a gun’s involved.

Let’s be honest.  Most shootings occur because good, upstanding, law-abiding citizens are placed in overwhelmingly stressful situations.  They lose their job.  Their spouse cheats.  Their partner leaves.  Someone cuts them off.  They think someone has ripped them off.

Maybe they just see a stranger’s face at the door. . .

Put a gun in the mix, and you know what comes next.  It happens every day.   

Yes, mental health is important, and desperately needs more resources.  But it’s not the primary cause of gun violence.  A recent Public Pulse writer lamented the fact that suicide is now the third leading cause of death among American young people.

The number one cause?   Gunshot wounds.

Despite what many would like to believe, this isn’t because American kids are somehow different.  Throughout the developed world, young people watch the same television, the same movies, play the same video games, and listen to the same music.  They’re wracked with the same self-doubts, subjected to the same bullying, and feel the same need to prove themselves.

They just don’t kill each other nearly as often.  

So if you carry a firearm, at least know the facts.  Yes, there’s always a tiny chance you may use it to take out a “bad-guy.”  But you are much more likely to use that gun—intentionally or unintentionally—on yourself, a family member, or someone you know.

That’s not being anti-gun.  That’s just being factual.

And while you’re at it, you can go without wearing a seatbelt, too.  There’s always that slim chance you’ll get thrown out the window.  But don’t count on it.

The only difference is, by not wearing the seatbelt, the only one who gets hurt is you.

Midlands Voices: Carry a gun and don’t wear a seatbelt | Columnists | omaha.com

THE DAY I MET CLARENCE THOMAS

Imagine for a moment you’re a baseball player at third base.  Your take your lead.  The batter hits the ball deep to the hole at shortstop, and you break for home.  The throw comes in and you slide under the catcher’s tag.

“Out!”  The umpire yells. 

You’re baffled and angry.   You knew you were safe.  Later, someone tells you the umpire had already pumped his fist before the ball even got to the plate.  “He’d already made the call,” your friend says.  “Whether you were really safe didn’t matter.  He’d made up his mind before you were even there.”

I can think of no better analogy to describe the recent decisions of the U.S. Supreme Court.  In theory, the Court is supposed to be like an umpire.  When a case is heard, they use the Constitution as a strike zone to call balls and strikes.    The whole thing should be fair, honest, and above-board.

Here’s the problem.  Depending on the Court’s political make-up, they can change the strike zone at will.  How they interpret the Constitution can vary wildly.  Depending on their purely ideological views, they may call a pitch down the middle of the plate a ball, and one thrown at your head a strike.

Recently, the Court has overturned 50 years of precedent, and allowed state governments to dictate the practice of women’s health care.  Common sense environmental protections have been scrapped.  The Voting Rights Act has been gutted.  Thomas Jefferson’s dream of separation of church and state has been mocked (do you really think that if a coach had been fired for a post-game Muslim prayer the Court would have done anything?).  Guns are more important than dead babies.  Elections can now be bought, sold, and traded like baseball cards.

And in poll after poll, each of these decisions was contrary to the wishes of the American people.

Strike three, American values.  You’re out and the inning is over.  Next batter—a radical right-wing agenda.  And now the strike zone changes.

So maybe I should go ahead and talk about the title of this post.  For over 30 years, Justice Clarence Thomas has carved out an ever-widening record of judicial extremism.  And for just a few moments, our paths crossed.

Here’s the story.

When I was a Creighton Vice-President, I had a monthly meeting with the University President in his office (of course it was “his” office—Creighton has never had a woman President, because women can’t become Jesuit priests—don’t get me started).  To get to the office, I had to climb a couple hundred stairsteps.  I was running late one morning, as usual, and chugged up the last few steps.

In the hallway was a very large, imposing man in an expensive suit, walking slowly along while he glanced about.  I wondered for moment if he might be lost, so I said “Hi, can I help you find anything?”

He just stared at me for a few seconds, then kept on walking.  I came close to saying, “OK, be an asshole,” but held my tongue.  In retrospect it was probably a good thing.

I had my meeting with the President, then walked back out into the reception area.  Several people were crowded around a little round guy with a big smile, who was standing next to a primly-dressed woman, who was gazing around the room with a plastered-on prom-queen-candidate grin.  She looked to be at least a foot taller than the little round guy.

A woman from the University’s Public Relations office stepped forward and said, “this is Dr. Frey, our Vice President for Health Sciences.   Dr. Frey, I’d like to introduce Justice and Ms. Clarence Thomas.”

I was taken aback.  I’d never been introduced to anyone famous before, and figured it probably wouldn’t happen again (been right so far).  I smiled and said “good to meet you” or something like that.

I must say Thomas was very engaging at first.  He had a warm smile, and said something like, “health sciences?  A lot going on in health care now.”

I smiled and sighed, “Oh, yeah, there’s a lot we’re dealing with right now.”  I was thinking about our medical school, which had been losing money for years, and had recently merged with another local health system.  The whole thing had been a colossal struggle.

But Thomas was thinking of something else.  He smiled even more broadly, leaned forward and said, “yeah a lot more ‘regs now, right?”  At that point, it hit me that he was actually talking about the recently passed Affordable Care Act (AKA Obamacare), for which the Justice would later use every conceivable legal excuse to overturn.  I was a little taken aback. 

“Well, yeah, I suppose,” I shrugged. “But at least 20 million Americans have health care coverage now who didn’t have it just a few years ago.”

I could tell right away it was the wrong thing to say.  Immediately, Thomas’s body stiffened, his smile evaporated, and he glared at me like I’d just puked on his shoes.  There was an awkward moment of silence, then I mumbled something like “well, good to meet you, sir, enjoy your time at Creighton,” or something equally lame.

I was headed toward the door when I noticed the same big imposing dude in the expensive suit (now recognizable as a Thomas bodyguard) standing off in the corner staring at me.  As I walked past, I wanted to say, “yeah, you and the horse you rode in on, pal,” but didn’t.

All of that was years ago.  Since that time, the United States Supreme Court, already lurching toward the right, has veered headlong into far-right extremism.  And at every turn, Justice Thomas has been the most extreme of the extreme.

Perhaps we should change the name of the body from the Supreme Court to the Extreme Court.

In the recent decision that struck down Roe v. Wade (known in legal circles as Dobbs v. Jackson Women’s Health), Thomas opined that the Court’s decision could also set the stage for states banning gay marriage and making contraception illegal.  Apparently, in his view, those would be good things. 

So how did we wind up with a situation where nine individuals, whose elitist backgrounds (all are graduates of either Harvard or Yale Law School) give them the intellectual tools to twist the Constitution into supporting any of their own political beliefs, and effectively overturn anything Congress or the President decides?

Our nation was built around the concept of separation of powers.  The Executive branch, headed by the President, the Legislative branch, headed by Congress, and the Judicial, with the Supreme Court squarely at the top, were meant to “check and balance” one another, like a three-legged chair.

But what happens when one of those legs gets out of balance?  The chair begins to totter, and ultimately collapses.  And anyone watching the Supreme Court can see the collapse coming.

With nine Justices, the opinions (and political views) of just five individuals can overturn any law passed by the people.  That’s exactly what’s happening.

The Constitution provides for a Supreme Court, but doesn’t specify the number of Justices.  The number nine has been around for years, but certainly isn’t sacred (despite what conservatives may insist).  The most serious flaw codified in the Constitution, though, has nothing to do with the Court’s size.  It’s the term of the Justices.

They serve for life, which wasn’t such a big deal when life expectancy in this country was 38 years (as it was in 1776).  But it sure is now.

Appoint a Justice in his or her 40’s today, and you’ll lock in a political view for the next 40-50 years, no matter how the people vote.  And appoint three and you can pretty much determine the Court’s temperament (and, bluntly, their decisions) for the next two generations.  No election required.

So when does a replacement happen?  When a Justice retires or dies, which is purely the luck of the draw.  With our current life expectancy, it’s happening less and less often.  And if the Senate refuses to even consider a nominee?   It gives the next President even more power (feel free to Google “Moscow Mitch McConnell” if you need a reminder).

This, of course, is what occurred under Donald Trump, a president that more Americans voted against than for.  Three hard-right appointments were made, joining the existing above-named Thomas, as well as two other right-wing Justices who’d been appointed by another president who’d also failed to win the popular vote.

In blunt terms, these six individuals have more impact on lurching our nation away from its values than anyone—including the President.

But how did these people get approved by the Senate?  Basically, by lying.

Time and time again, during their confirmation hearings, the recent appointees described Roe v. Wade as the “law of the land” which should stand.  But in truth, they were chomping at the bit to overturn it.

What else were they lying about? Who knows?

I’ve discussed my concerns about the abortion decision earlier, but my friend and colleague Dr. Josh Freeman perhaps described it best.  “Make no mistake:  this Supreme Court decision is that the opinions of some people are worth more than the lives of others”

To say America is getting fed up with all of this would be an understatement.  Much has been written about the low approval ratings of the current President, which stand at 39%.  What many don’t realize is that the approval of the Supreme Court has plummeted to 40%.

That’s right.  The Supreme Court is now as popular as Joe Biden.  

You can vote Joe Biden out of office, if you’d like.  But the Supreme Court?  Sorry, you’re stuck with them for life.

In response to the Court’s abortion decision, the White House issued a rule that requires States to make abortion available in medical emergencies (i.e., to save the life of the mother).

This of course, has made several far-right Attorney’s General furious.  They’ve sued to stop it.  And they may get a test case soon from Indiana.

You’ve probably read about it.  A young girl just shy of her tenth birthday was raped in Ohio (despite what FOX News initially claimed) and became pregnant. The child travelled to Indiana, where an abortion was performed.

For anyone who wasn’t paying attention in high school science class, a ten-year-old girl’s body is not meant to carry a baby.  Complications can be disastrous.   If there’s ever a circumstance where even the most rigid abortion opponent should realize that an abortion is necessary, this is it.

Of course, this apparently doesn’t apply to the Attorney’s General of Indiana and Ohio, who are more intent on investigating the Doctor who performed the procedure than anyone else.  It’s likely legal action could be taken against the physician.  If this occurs, the decision could possibly wind up before the Supreme Court.

Will the Court look that little girl in the eye, tell her that her pregnancy was just her tough luck, then punish the Doctor, setting a precedent that could affect all future childhood rape victims?  Who knows?

But given the veracity of the Court’s recent decisions, I’m not optimistic for that little girl.

So what happens next?  Expanding the Court should certainly be considered, but term limits for each Justice should absolutely be at the top of any reform proposal.  The original Constitution set no term limits for the office of President.  It wasn’t until the Twenty-Second Amendment that the current two-term designation came into place.  Currently, a national effort is under way to pass such an Amendment limiting Congressional terms, as well.

Fine.  But if you’re going to limit two legs of our three-legged chair of checks and balances, you sure as hell should be doing the same for the remaining leg—the Supreme Court.

Currently, nine individuals are effectively determining the laws of this country, under the guise of “interpreting” our laws.  And some of those individuals will continue their assault on democracy for decades.  No matter your political views, this does not bode well for American democracy.

Sooner or later, a current Justice will resign or croak.  When that happens, the makeup of the United States Senate and White House will determine whether American justice begins to move back toward a well-reasoned center, or continues its lurch toward a nationalistic and fascist right.

So vote.  Vote like your life depends on it.  Because it does.

Oh, and one other thing.  That primly dressed woman with the plastered-on-smile I mentioned earlier?  She’s better known as Ginni Thomas.  As wife of Justice Clarence Thomas, she has immediate access to one-ninth of that all-powerful Court, and is considered a cornerstone in a violent, far-right movement that has been labeled “Christian Nationalism.”  She actively worked to overturn a democratic election, texted her “love” for the insurrectionist mob attacking our capitol, and supported a far-right coup against the American government.  She even invoked the name of God to justify her actions.

Apparently, her view of Christianity doesn’t include Exodus 20:7.

FORWORD

Several people have asked if I’m going to write my thoughts on the most recent decisions of the unSupreme Court, which included abandoning women’s rights, giving a thumbs-up to destroying the environment, and allowing just about anyone to carry any gun anywhere at any time (just days after a mass murder of children in Texas). I’ll have plenty to say about all of that later.

In the meantime, if you’d like to read an incredibly insightful commentary on the Court’s decision, check out Dr. Josh Freeman’s blog post Abortion is health care. It must be safe and legal. Josh was the Chair of Family Medicine at the University of Kansas for many years. He’s seen more in his time than I’ve seen in mine. He knows what he’s talking about.

But I’ve been promising to announce the winner of America’s Dumbest State award for some time. So here it is. And if you are from this state, I apologize. But I’m afraid there’s not much in the post below that isn’t accurate.

AND THE WINNER OF AMERICA’S DUMBEST STATE IS. . .

First, let’s get one thing straight.  I’m not speaking from the standpoint of self-righteousness.  I was born in Kansas, a state where the legislature massively slashed taxes, blindly assuming that it would bring progress and prosperity to everyone.  Instead, it wound up nearly destroying their public schools.

Ultimately, even a decidedly conservative legislature had no choice but to undo all of the tax cuts.

I was raised in Missouri, whose legislature nearly passed a bill prohibiting doctors from performing surgery on women with ectopic pregnancies, since the embryo might be “alive.”  For the record, the mortality rate for women with untreated ectopic pregnancies is 100%.

I currently live in Nebraska, where its billionaire Governor (daddy’s money) was recently locked in a no-holds-barred, multi-million-dollar campaign with a billionaire ex-President (also daddy’s money, for the most part) to see whose far-right flunky would be nominated as the state’s next governor (hint:  the ex-president lost).

So it’s not like I’m associated with states that are paragons of reasoned thought.  However, if we look at our nation, state by state, and consider the really stupid things that have been done, one stands out.

Let’s take a look at how that state might describe itself.

FROM THE DEPARTMENT OF TOURISM OF THE GREAT STATE OF FLORIDA

Welcome to Florida—The Stupid State!

Hello everyone.  We know that many of you may be more accustomed to our previous slogan, The Sunshine State.  But that’s so yesterday.  We wanted a new slogan, one that really represents what we’re all about down here.

And let’s face it—wisdom and knowledge are really overrated!  Ignorance is bliss, so they say, and on behalf of our great Governor, Ron DeSantis, we’d like to welcome you to the most blissful state in America.

Take education, for example.  It’s not what you learn that’s important, it’s what you don’t learn that really matters!

Yes, we’re talking about sex and race.  We’ve been at the forefront of the “Don’t Say Gay” movement in our schools.  And we’re so adamant that critical race theory can’t be discussed, we’ve insured that virtually any discussion of race can be grounds for prosecution.  We make sure our students are protected from any of this stuff.

It’s not that we’re opposed to sex education, it’s just that it must be done the right way.  That means abstinence only education.  And that’s what we teach our students.  None of that talk about those heathen contraception methods—we just tell kids to refrain from sex.  And we’re sure that approach works.  Yes, we know those communist public health people point out that we’re in the top 10 states when it comes to teenage pregnancies.  But what do they know?  We think we’re doing just fine.

Oh, and then there’s science.  Yeah, maybe kids should learn about gravity, but that’s about it.  Here in Florida, we have laws in place that allow parents to challenge schools over teaching irrelevant facts about climate change, evolution, and atheist stuff like quantum physics.  We protect our children!  Why, we even banned over fifty math books.  You can’t get any more stupid than that!

We’re also home to the Centner Academy, a private institution founded by a multi-billionaire to indoctrinate—uh, we mean educate—well-off youngsters.  The Academy bans masks, isolates students who’ve been vaccinated for COVID (even though they’re not infective and can’t harm other children), refuses to hire teachers who’ve been vaccinated, and has special window coverings to protect kids from evil 5-G waves.  Yes, we know many of their former teachers describe the Academy as basically a cult.  But Governor DeSantis supports it!  And that’s good enough for us!  After all, if you’re paying upwards of $30,000 a year to send your little Johnny or Suzie here, you ought to make sure they only learn what you want, right?

And speaking of COVID, there’s no question we’ve had the greatest response of any state in the country.  Unlike those liberal wussies in California, we’ve refused to mandate masks and vaccines, refused to shut down any place of business, and we’ve done just fine.  OK, there’s that little detail about having a mortality rate 50% higher than California, as well as having our hospitals overflowing with COVID cases, especially our ICUs.  But it’s like guns, it’s just the small price we pay for our freedoms.

So we’ve installed an anti-vaxxer, Dr. Joseph Ladapo, as State Surgeon General, and he’s making sure Governor DeSantis’ policies are being carried out.  And not just with COVID.  Vaccinations of all types are down throughout the state.  If that’s not a great example of personal freedom, what is?  And if we wind up with more sick babies, well, we’ve got plenty of doctors.  Or at least we did.

But since we’ve mentioned guns, let’s talk about them, too.  We’re one of the most gun friendly states in America, and damned proud of it.  Come to Florida, and you can defend yourself—no questions asked!  Since passing our “stand your ground” law in 2005, gun deaths in our state are up by over 32%.  Yes, there was that incident where a gun toting neighborhood vigilante stalked an unarmed black man for blocks before shooting him dead, but what do you expect?  He was wearing a hoodie, for God’s sake!  And the jury certainly wasn’t impressed.

And that theatre situation—the one where two people were arguing, and one threw a bag of popcorn at the other, who in turn pulled a gun and shot the first man dead in front of his family?  That popcorn might have had anthrax, or even AIDS!  Besides, another jury of our finest citizens found that shooter innocent, too, so what’s the big deal?

A few years back, our legislature even passed a bill that said any doctor who asked a parent if they had a gun in the house could be prosecuted (stupid doctors, thinking a child who finds a loaded gun might actually hurt themselves!).  But to our utter shock, some left-wing judge said the law violated free speech.  What’s this nation coming to, when doctors can actually ask questions?

So come to Florida and bring your guns!  We won’t mind if you use them.  And if anyone says anything, just tell them you’re “a good guy.”

But if you’re thinking of opening or moving a business here, remember this.  We don’t want our businesses expressing any political opinions—especially one that disagrees with our esteemed Governor.  We revoked Disney’s special tax status because they expressed displeasure with our “don’t say gay” laws.  Yes, that dumped over a billion dollars in bond debt on the people of the Orlando region, but sometimes you have to do what you have to do.

And those sissy Tampa Bay Rays?  Speaking out about gun violence and children being killed!  Who cares?  In any case, we shut them down right away by threatening to pull the funding for a sports facility.  Next time they’ll know better, and act the way true Florida athletes should—just sing the National Anthem, play ball, and shut up.

But what we’re most proud of is our handling of the Special Olympics.  The organization was going to hold its 2022 Games in Orlando, and had the audacity to require its athletes to be vaccinated against COVID!  As we’ve said, we don’t care what science says, we don’t tolerate mandates!  Who cares if some of those kids might be immune compromised and COVID might kill them?  That’s their problem, not ours!

So we threatened Special Olympics with a $27.5 million fine, and boy did that ever shut those little brats down!  Oh, the liberal media made a big fuss about it, calling us callous and uncaring.  But we don’t care.

Because we’re Florida.  We don’t have to.

So come on down and move your business to Florida, we’d love to have you.  Just make sure you keep your mouth shut after you get here.

And don’t believe everything you hear about us when it comes to school shootings, either.  We know what’s really important—mental health.  It’s just that we don’t want to pay for it.  Yes, we’ve been ranked 49^th out of all 50 states when it comes mental health funding per capita.  But that’s not what’s important.  Our hearts are in the right place.  And more importantly, our guns are everywhere.

And we know how to handle voting, too.  No voter fraud here, because there won’t be that many votes!  We’ve made it legal for partisan election “observers” to operate inside polling places, reduced the number of ballot drop boxes, more than doubled the red-tape involved in requesting a mail-in ballot, and now require more rigid voter ID laws than ever before.  Will this make it more difficult for the poor and elderly to vote?  Who cares?

We’ve also recently passed a bill that would make it illegal to transport undocumented people within Florida.  Yes, we know there are thousands of law-abiding essential workers in our state that this would impact, but again, that’s not our problem.  We don’t want immigrants here.  Keep Florida white!  And forget all those studies that show that U.S. citizens are more than twice as likely to commit crimes as immigrants.  We don’t have time for pesky facts.

There was a time when we welcomed all those fleeing violence in Cuba to our state.  But now it’s time to slam the door on all that.

What more can you ask for when it comes to Stupid?  We’re the nation’s role model.  And to let you in on our special secret, we think our wonderful Governor, Ron DeSantis will be the Republican nominee for president in 2024.  Then, all of the incredible things happening in Florida can be available to the entire nation!

So, while you’re visiting, pull up a chair, grab a drink, and settle in on the beach (with your gun, of course).  Relax, take it easy, and don’t worry about thinking.

After all, you’re in Florida.  The Stupid State.