Trump’s America

Apparently even having white skin and European origin (and a successful practicing physician!) cannot save you from Trump-empowered ICE.  Just ugh.

 Even as the issue of immigration has been central to the government shutdown in Washington, a respected doctor at Kalamazoo’s Bronson Methodist Hospital who has been living in America for nearly 40 years finds himself in jail after U.S. Immigration and Customs Enforcement agents took him from his home in handcuffs.

Lukasz Niec is an internal medicine doctor putting in long hours as a hospitalist for Bronson. His co-workers describe him as the model of what a physician should be.

And now, he is sitting in a jail cell in Calhoun County with no idea of when — or if — he will be free to return to his patients and his family.

“In 1979, my parents were both doctors left Poland and took two suitcases and two small children, my brother was five and I was six and they came here for a better life for their kids,” said Iwona Niec-Villaire Saturday as she sat next to her sister-in-law.

Now, the siblings are in their mid-40s, she is an attorney, he is a doctor — they have been in America for four decades on a permanent green card.

“He doesn’t even speak Polish,” Niec-Villaire said.

On Tuesday, as Niec was enjoying a day off with his tween girls at his home on the lake in this exclusive neighborhood near Kalamazoo, three ICE officers came to his home, told him he was being taken into custody and took him to jail.

“The question I get asked all the time is ‘Why do you think this happened?’ I just really don’t know,” said Niec-Villaire.

ICE will not comment on the case and has held no hearings. A bond hearing may not come until February, and it is unlikely it will be granted, according to immigration law experts.

“Until this gets heard, which could be up to six months, he could be stuck in a prison cell and not helping and being with his family,” said Niec-Villaire.

The only spot on Niec’s record is two misdemeanor convictions when he was 17, one for destruction of property less than $100 and receiving and concealing stolen goods.

He pleaded to these charges more than 25 years ago under the Holmes Youthful Trainee Act that allows young first offenders to avoid a criminal record if they never offend again.

But ICE — a federal agency — does not honor that state plea agreement, something Niec did not know when he took the plea, according to family.

There’s been so many breathtakingly stupid deportation cases under Trump, but this one about takes the cake from what I’ve seen.  Among other things, his family was escaping genuine 1970’s Soviet communism when it came here.  And ICE wants to throw him out for plea-bargained misdemeanors as a teenager?!  The stupid!  But this, presumably, is the America that Jeff Sessions, Tom Cotton, Stephen Miller, and yes, Trump himself, want.  Stupid America.  Again, it’s one thing to be amazingly heartless– as this clearly is– but from a policy perspective, deporting a stable, married, practicing physician because of teenage misdemeanors is about as negative on the cost/benefit as you can be.  So stupid.  So mean.  So Trump.

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Immigration, Trump, and the shutdown

Great take from Yglesias:

Trump set the current crisis in motion last September when he revoked Barack Obama’s executive order that protected DREAMERs — young unauthorized immigrants brought to the US as children — from deportation, but he offered no guidance about what he wanted to happen next, other than for Congress to do … something.

The lack of clarity emboldened immigration hardliners in the GOP caucus while simultaneously raising hopes for a deal among immigration reformers. But Trump’s intervening behavior wound up salting the earth by leaving everyone feeling that he might screw them over at any moment. Consequently, nobody is quite sure exactly who is shutting down the government or what it is the White House is trying to achieve by rejecting a bipartisan proposal that would avert a shutdown.

The country has mostly coped with Trump’s inability to do his job by outsourcing governance to congressional GOP leadership. But congressional Republicans are less unified on immigration than on most issues, and Trump is more invested in immigration than on most issues. Consequently, his actual personal leadership as president of the United States is critical to moving the system forward.

But the mere fact that the circumstances require Trump to act like a real president doesn’t change the fact that he’s a lazy, ill-informed conspiracy theorist prone to tweeting cryptic pronouncements about delicate policy issues based on Fox & Friends segments… [emphasis mine]

Trump has deeply hawkish instincts on immigration, seemingly driven by his personal and ideological racism, but he’s ill-informed on pretty much all subjects, including immigration.

And the basic problem with a DREAMers-for-wall swap is that the wall is a dumb idea that wouldn’t actually accomplish anything to reduce immigration to the United States. And if legislative protections for DREAMers ended up creating a path to citizenship, it might actually end up increasing immigration, since the new citizens could sponsor visas for relatives.

Consequently, better-informed immigration hawks like White House senior adviser Stephen Miller and Sen. Tom Cotton (R-AR) began working with Chief of Staff John Kelly to avoid the kind of deal that Trump had repeatedly suggested — and even at times explicitly agreed to in general terms.

Quick hits (part II)

1) Jordan Weisman on an intriguing theory for why it is so hard for Americans to get a decent raise– monopsonies.

2) Really, really interest take from a physician on how we got this point in the opioid crisis:

On another front, the campaign to assess pain as the fifth vital sign in the hospital took off in the late 1990s, with the Joint Commission, the hospital accreditation body, publicizing this concept in 2001. The idea was to assess the level of pain as frequently as the patient’s blood pressure. If the patient didn’t speak English, she could point to a picture of a person grimacing in pain. It has been reported that the Joint Commission even distributed a pamphlet produced by Purdue that played down the risk of addiction. The Commission hasn’t addressed that specific charge, but they released a statement last year denying that their standards contributed to the opioid epidemic.

The problem is that unlike the other four vital signs—blood pressure, heart rate, temperature, and respiratory rate—pain is not something that the nurse or doctor can measure. It is a subjective judgment, based on the patient’s self-report and so-called “pain behavior.” I don’t feel your pain: I can’t. Patients who want narcotics become excellent actors. During one of my earliest years in practice, an agent from the Drug Enforcement Admin-istration called to warn me that a man who had come to me with a biopsy report of kidney cancer, saying he had to change doctors because he was now on Medicaid (a common problem), had forged the report, was faking his pain, and had already been to several doctors in the area. At the other extreme, a patient with a ruptured appendix and a rigid abdomen assured me that he didn’t need treatment—because, it turned out, he was undocumented and feared hospitalization…

Lembke outlines what steps we can take to cope with addiction in our practices, but she also admits, “There is an unspoken tension underlying the hidden forces driving the epidemic: doctors are increasingly asked to care for people with complex biopsychosocial problems (nature, nurture and neighborhood) without also being given the tools, time or resources to accomplish this task.” Medical students complain that primary care has devolved into social work, but is it social work to search for root causes rather than simply prescribe or cut? Dr. Francis W. Peabody, a prominent physician in the early twentieth century, wrote, “One of the essential qualities of the clinician is interest in humanity, for the secret of the care of the patient is in caring for the patient.”

3a) Just so we’re clear– work requirements for Medicaid are an absolutely horrible idea and abysmally stupid public policy.

The problem with the latest twist in Republicans’ effort to pare the social safety net is that removing the poor’s health insurance may not just make their life more difficult.

It might kill them.

It is well known by now that health insurance saves lives. A review of recent research in the Annals of Internal Medicine concluded that the odds of dying for non-elderly adults are between 3 and 41 percent higher for the uninsured than for the insured.

Work by Katherine Baicker, now at the University of Chicago, with Benjamin Sommers and Arnold Epstein at Harvard found that Medicaid expansions in the past significantly reduced mortality. Their research, they concluded, “suggests that 176 additional adults would need to be covered by Medicaid in order to prevent one death per year.”

It doesn’t take a leap of imagination to figure out what might happen if 100,000 people were to lose their coverage.

3b) And the simple truth is, the more paperwork and bureaucracy you require, the harder you make it for deserving, qualified recipients.  Of course, to those who hate the working poor, that’s a feature, not a bug.  The Upshot:

But a large body of social science suggests that the mere requirement of documenting work hours is likely to cause many eligible people to lose coverage, too.

“Without being tremendously well organized, it can be easy to fail,” said Donald Moynihan, a professor of public affairs at the University of Wisconsin-Madison, who is writing a book on the effects of administrative burdens. Researchers have studied the ways complexity can reduce sign-ups for workplace pension plans, participation in food stamps and turnout in elections, he noted. “These sorts of little barriers are ways in which humans get tripped up all the time when they’re trying to do something that might benefit them.”

Anyone who has ever forgotten to pay a bill on time, or struggled to assemble all the necessary forms of identification before heading to the D.M.V., is likely to sympathize with how administrative hurdles can stymie someone. But these may be especially daunting for the poor, who tend to have less stable work schedules and less access to resources that can simplify compliance: reliable transportation, a bank account, internet access. There is also a lot of research about the Medicaid program, specifically, that shows that sign-ups fall when states make their program more complicated.

4) Why 12-step programs work for some people, but not others.  One thing is clear– foreclosing the option of medical treatment with those with narcotic addictions (as so many uninformed people in the system insist upon) is just plain stupid.

5) The bright future of solar power may not be all that close.

6) Great excerpt from Frum’s new Trumpocracy book in The Atlantic:

Election 2016 looked on paper like the most sweeping Republican victory since the Jazz Age. Yet there was a hollowness to the Trump Republicans’ seeming ascendancy over the federal government and in so many of the states. The Republicans of the 1920s had drawn their strength from the country’s most economically and culturally dynamic places. In 1924, Calvin Coolidge won almost 56 percent of the vote in cosmopolitan New York State, 65 percent in mighty industrial Pennsylvania, 75 percent in Michigan, the hub of the new automotive economy.

Not so in 2016. Where technologies were invented and where styles were set, where diseases cured and innovations launched, where songs were composed and patents registered—there the GOP was weakest. Donald Trump won vast swathes of the nation’s landmass. Hillary Clinton won the counties that produced 64 percent of the nation’s wealth. Even in Trump states, Clinton won the knowledge centers, places like the Research Triangle of North Carolina.

The Trump presidency only accelerated the divorce of political power from cultural power. Business leaders quit Trump’s advisory boards lest his racist outbursts sully their brands. Companies like Facebook and Microsoft denounced his immigration policies. Popular singers refused invitations to his White House; great athletes boycotted his events. By the summer of 2017, Trump’s approval among those under thirty had dipped to 20 percent.

And this was before Trump’s corruption and collusion scandals begin to bite.

Whatever Trump’s personal fate, his Republican Party seems headed for electoral trouble—or worse. Yet it will require much more than Republican congressional defeats in 2018 to halt Trumpocracy. Indeed, such defeats may well perversely strengthen President Trump. Congressional defeats will weaken alternative power centers within the Republican Party. If they lose the House or the Senate or many governorships—or some combination of those defeats—then Republicans may feel all the more compelled to defend their president. The party faithful may interpret any internal criticism of Trump as a treasonable surrender to Nancy Pelosi and Chuck Schumer. As the next presidential race nears, it will become ever more imperative to rally around Trump. The more isolated Trump becomes within the American political system as a whole, the more he will dominate whatever remains of the conservative portion of that system. He will devour his party from within.

7) Oh, man, I loved this story on how airport runways are numbered and how the numbers have to change as the magnetic pole of the earth shifts.

8) Chait with a good take on Trump’s fear of sharks:

It is perfectly characteristic of Trump’s mind that he would be manipulated by television this way. Sharks are not, in fact, a significant source of danger. Sharks kill about one American per year.

But sharks do look very scary, and the right combination of dramatic video and ominous music could persuade a gullible television viewer to fear and even hate them. Like, say, the kind of person who spends hours watching Fox News and is manipulated into hating and fearing immigrants or Muslims or the New Black Panther Party.

9) Emily Willingham on the non-binary brain, “Misogynists are fascinated by the idea that human brains are biologically male or female. But they’ve got the science wrong.”  In the end, though, it seems pretty obvious that male and female brains are essentially overlapping curves.

10) Greg Sargent on the intensity gap:

There’s something else vital to understand: Not only does Trump have high disapproval, but the intensity of his disapproval is unusually high, as well. For all the time news organizations spend writing “In Trump Country, Trump Supporters Support Trump” stories, intense dislike of Trump may be the most powerful force in the U.S. electorate right now. Consider these figures (I’ve added in some other recent polls):

  • Pew: 27 percent strongly approve of Trump’s performance, 47 percent strongly disapprove
  • NBC: 26 percent strongly approve, 51 percent strongly disapprove
  • Quinnipiac: 29 percent strongly approve, 49 percent strongly disapprove
  • Marist: 23 percent strongly approve, 39 percent strongly disapprove
  • LA Times: 15 percent strongly approve, 42 percent strongly disapprove…

Now let’s think about how this picture of energized, angry Democratic voters and Republican voters who still support Trump but aren’t so enthusiastic about it could play out in November. Despite the fact that the president is on everyone’s mind, the calculation is different for voters of the two parties. A Democrat can deliver Trump a crushing blow with their vote, because if their party takes back one or both houses of Congress, the effect will be seismic. Not only would the GOP legislative agenda be immediately dead, but with their newfound subpoena power, Democrats could start investigating this administration from tip to tail.

But if you’re a Republican voter who’s only marginally motivated by protecting Trump, what would drive a burning desire to turn out and vote GOP in November? On the party’s big issues, many of the questions have been settled.

11) Pew on the lives of dads:

I’d put myself in the “about right” category.  Of course, after weeks like this one with a holiday and three snow days, it was the “too much” :-).

12) Can the rest of the state Democratic parties learn from the success of the Alaska Democratic party?  Probably.  But Alaska is also pretty unique.  Very interesting story in Politico.

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