The resistance: Florida cities challenging MAGA guidance on LGBTQ crosswalk treatments: Update to "Attacks on American civil society to the most picayunish"

Hundreds of people turned out in a show of support for the LGBTQ+ rainbow pride intersection of Duval and Petronia streets in Key West on July 26, 2025. (Nick Doll Photography via Key West Business Guild/courtesy)

The City of Del Rey Florida, after pressure from the State DOT in response to US DOT guidance, agreed to remove "LGBTQ" painted crosswalks, which technically are not considered appropriate road treatments according to the Manual of Uniform Controlled Traffic Devices.

But they changed their minds.  From the Fort Lauderdale Sun-Sentinel, "Delray Beach changes course, will defy state and keep its LGBTQ+ pride intersection":

Delray Beach has decided to defy the state and keep its LGBTQ+ pride intersection downtown, a move that could draw scrutiny from Gov. Ron DeSantis’ administration. The decision to keep the intersection, at least for the time being, was made this week by a majority of city commissioners. 

It came three weeks after City Manager Terrence Moore ordered removal of the intersection. Moore, like officials in Boynton Beach and West Palm Beach, acted in response to a pronouncement from DeSantis’ secretary of transportation.

They are taking a big risk, considering how MAGA Florida is, and it's a definite positive sign of resistance.  The article is worth reading in full, as it describes the issues and the responses within a number of Florida's cities.

Delray Beach is not alone in resisting the early-July directive posted on social media by Florida Transportation Secretary Jared Perdue, who attached a memorandum warning non-compliant communities that they could lose state funding. Key West city commissioners voted last week to keep their rainbow intersection and fight efforts to remove it. In late July, hundreds of people gathered to show support for the city’s LGBTQ+ rainbow intersection.

In Fort Lauderdale, the fate of a segment of a road painted the colors of the rainbow progress pride flag is unresolved, with several factors complicating the issue. Mayor Dean Trantalis said he wants to preserve that section of Sebastian Street. Any decision about changing its status should be made by the City Commission, not the city staff, the mayor said.

=========================

This entry was published July 18th:

A file photo, above, shows the “Pride Progress Flag” mural on East Ocean Avenue and First Street in Boynton Beach. Now, it's no longer there. A woman, below, walks her dog at the newly painted intersection on Wednesday, July 16, 2025. (Carline Jean/South Florida Sun Sentinel) 

Besides post-hospital demotivation, another reason for not writing has been the overwhelmingly anti-progressive acts by the Trump Administration, too much to grapple with.  I wrote about this in March ("Federal government cuts target civil society").  

From the Sun-Sentinel:

The instructions came via a July 1 social media post, press release and “Dear Governor” letter from Trump Transportation Secretary Sean Duffy and a July 2 social media post from Florida Transportation Secretary Jared Perdue, who attached a detailed memorandum from one of his assistant secretaries. 

 Duffy was direct about his intentions. “Taxpayers expect their dollars to fund safe streets, not rainbow crosswalks. Political banners have no place on public roads. I’m reminding recipients of @USDOT roadway funding that it’s limited to features advancing safety, and nothing else. It’s that simple.”

So much for placemaking, traffic calming, and sustainable mobility.

This is further illustrated by proposals to cut federal funding to PBS and NPR ("Senate approves cuts to NPR, PBS and foreign aid programs," NPR).  Since the Senate agreed, it's all but a done deal.  Advocacy and action groups in all categories, such as agriculture and sustainable mobility, the arts and humanities and other areas are all losing funding.

In "Florida city removes LGBTQ+ rainbow intersection, quickly complying with state, federal mandate," the Fort Lauderdale Sun-Sentinel reports on how the US DOT and Florida DOT--both hard right Republican, have advised local governments to remove gay pride rainbow crosswalks because they are not authorized "traffic control devices."

Despite what Trump and Fox News says, cities are pretty good places to live

 About Seattle, "A Seattle visitor’s guide:  Riots, bad drivers, the big dark and overrated Dick’s burgers. Locals and experts tell the truth,." Seattle Times.

Josh Cruz, 38, head of marketing for a small software company, moved here from St. Petersburg, Fla., with his partner. Cruz belonged to a group of fans of the Tampa Bay Lightning hockey team. “One of the first literal responses I got from a conservative colleague was, ‘What are you gonna do there? Join antifa?’

“I took it to mean he watched too much Fox News,” Cruz says about his fellow hockey fan. He says his mom also asked about the protests that were portrayed as riots. “I told her the news focuses on one group of three people as the night ended, (who) did one stupid thing,” he says.

... Jeff Asher, co-founder of the firm, says, “From a crime perspective, Seattle is just like any major city. If crime is your main concern, then you shouldn’t be visiting any major American city.”

Friends and neighbors were in Portland recently it's fine, which is probably why housing prices are high ("Buying a Home in Portland Is More Expensive Than You Think") Wall Street Journal).

High demand for housing in Forest Hill Queens ("Home Buyers Are Paying Millions to Experience the ‘Fairy Tale’ of Forest Hills," Wall Street Journal).

SF isn't a cesspool.

Trump and his LA military incursions were a way to satisfy his base ("Newsom Slams Trump For ‘Brazen Abuse of Power’ as L.A. Mayor Imposes Curfew," New York Times), not based on reality ("Trump wants to 'liberate' Los Angeles, residents say 'no thanks'," Reuters), and the National Guard and Marine troops he sent there have left ("More than 1,000 National Guard troops leaving L.A. Newsom says Trump’s ‘political theater backfired’," Los Angeles Times), "Marines Will Begin Withdrawing From Los Angeles," New York Times).  

The "rioting" was limited to a couple blocks of demonstrations, with riot police and Trump's federal police and troops escalating the situation.

Although yes, Seattle, SF and Portland reached progressive overreach in the early 2020s, and the electorate dialed back, voting a bit more to the center than to the left.  This is particularly evident in Seattle.

In SF, a Levi Strauss heir connected to the business community won the mayoralty.  And the super progressive prosecutor was recalled out as crime climbed.

OTOH, also in Boston, the Downtown housing market is stagnant ("As housing prices in Mass. soar, they’ve remained stagnant in downtown Boston. Here’s what that means for the city").

It's so obvious on article comments that are negative on particular cities that the writer has no real experience with cities.  The same with Fox News and of course Trump ("‘Cesspools,’ ‘Hellholes’ and ‘Beautiful Places’: How Trump Describes the U.S.," New York Times, "Trump keeps brutalizing immigrants because he's failing at everything else," USA Today), "The politics of fear," New Yorker).

Fox trumps up crime in cities before elections especially and it probably had an effect in increasing the number of Republican House members from New York State ("Crime coverage on Fox News halved once US midterms were over," Guardian).

=====

In Boston's election for mayor, Josh Kraft, of the New England Patriots and a conservative, is running, figuring he had a chance like Daniel Lurie in SF.  His polling is terrible ("Can the Josh Kraft campaign be saved?," Boston Globe).

Attacks on American civil society to the most picayunish

Update: 8/15/2025 

Some Florida cities are resisting ("Delray Beach changes course, will defy state and keep its LGBTQ+ pride intersection," Fort Lauderdale Sun-Sentinel), including Key West and others.

======

 

A file photo, above, shows the “Pride Progress Flag” mural on East Ocean Avenue and First Street in Boynton Beach. Now, it's no longer there. A woman, below, walks her dog at the newly painted intersection on Wednesday, July 16, 2025. (Carline Jean/South Florida Sun Sentinel) 

Besides post-hospital demotivation, another reason for not writing has been the overwhelmingly anti-progressive acts by the Trump Administration, too much to grapple with.  I wrote about this in March ("Federal government cuts target civil society").  

From the Sun-Sentinel:

The instructions came via a July 1 social media post, press release and “Dear Governor” letter from Trump Transportation Secretary Sean Duffy and a July 2 social media post from Florida Transportation Secretary Jared Perdue, who attached a detailed memorandum from one of his assistant secretaries. 

 Duffy was direct about his intentions. “Taxpayers expect their dollars to fund safe streets, not rainbow crosswalks. Political banners have no place on public roads. I’m reminding recipients of @USDOT roadway funding that it’s limited to features advancing safety, and nothing else. It’s that simple.”

So much for placemaking, traffic calming, and sustainable mobility.

This is further illustrated by proposals to cut federal funding to PBS and NPR ("Senate approves cuts to NPR, PBS and foreign aid programs," NPR).  Since the Senate agreed, it's all but a done deal.  Advocacy and action groups in all categories, such as agriculture and sustainable mobility, the arts and humanities and other areas are all losing funding.

In "Florida city removes LGBTQ+ rainbow intersection, quickly complying with state, federal mandate," the Fort Lauderdale Sun-Sentinel reports on how the US DOT and Florida DOT--both hard right Republican, have advised local governments to remove gay pride rainbow crosswalks because they are not authorized "traffic control devices."

A sad day for the Washington Post and Washington DC

As Jeff Bezos, owner of Amazon and of the Washington Post, announces the op-ed pages will shift to coverage on "freedom of markets" and "personal liberties"   ("Post owner Bezos announces shift in opinions section," Post, "Washington Post opinion editor departs as Bezos pushes to promote ‘personal liberties and free markets’," Guardian).

While I think it'll likely be "Wall Street Journal-lite"), it is a sad diminishment of the range of opinions offered by the paper.  It's not like I can read George Will or his politically leaning colleagues because of their arguments, but I never minded that they took up space on the pages.

With all the talk about disinformation and misinformation and the need for reliable sources of information, it's sad that the Post is throwing in with this dis- and mis-informatives, as an under-information or incomplete-information provider.  

It's not that you can't write about personal liberties and freedom of markets.  But you're telling an incomplete story if you avoid discussion of real discrimination, minoritarian rule, etc., as well as the need for regulation of markets to reduce the chance for overreach and economic collapse.

It's a long way from what the Graham Family thought were the strengths of Bezos digital knowledge in a future that was and is very uncertain for newspapers ("A Newspaper, and a Legacy, Reordered," New York Times).

From the Washington Post article, "The sale of The Washington Post: How the unthinkable choice became the clear path:"

Washington Post publisher Katharine Weymouth presented her uncle, company chief executive Donald E. Graham, with a once-unthinkable choice at a lunch meeting at downtown Washington's Bombay Club late last year. The paper was facing the like­lihood of a seventh straight year of declines in revenue, with one preliminary budget estimate showing the possibility of $40 million in losses for 2013. And despite years of heavy investment in new digital offerings, there was little sign that robust profits were about to return, she reported.

That left three choices, Weymouth told Graham. The family could continue presiding over the gradual decline of the newspaper they loved. They could move more aggressively to cut the paper’s staff more deeply than ever, hoping that they could return The Post to sustained profitability by sacrificing its longtime excellence.

Or they could sell, cutting ties to one of America’s iconic news organizations after four generations of family control in the hopes that The Post could thrive again under a new, deep-pocketed, civic-minded owner.

... Several factors allowed the deal to come together with relative speed. They included a long-standing friendship between Bezos and Graham, 68, an executive steeped in traditional newspaper publishing who had become a respected elder for a newer generation of tech magnates. Bezos was among the most successful of those, and the two men had on several occasions traded insights on their businesses.

“The Post is his baby,” Weymouth said of Graham. “He was not going to give his baby to anybody who he thought would not care for it properly.”

Looks like the baby got sold to a serial killer ("Post endorsement controversy sparks staff resignations, protests ," The Hill).

Then again, significant change was predicted, it just took 11 years to see how bad it could be ("No Change? Jeff Bezos Will Turn the Washington Post Upside Down," MediaShift).  First on the list, although actually much later:

So what can we expect to change within the next five years and why? Here are some reasonable assumptions:

The editorial policies, the coverage and the content will reflect the interests and ideologies of the owner. For the U.S. government’s hometown newspaper, that’s something to really be aware of.

Breaking free of neoliberalism

Jordan Himelfarb, Opinions editor for the Toronto Star interviews ("My dad used to run Canada’s public service. As the Star’s opinion editor, I asked him what he got wrong, how he turned left — and why he keeps needling me about my work") his father Alex, on his new book, Breaking Free of Neoliberalism: Canada’s Challenge.

Neoliberalism is not unique to the United States or the UK, it is a world-wide phenomenon.

AH: You’re right that we are living in an age of crisis which itself ought to suggest there’s something very wrong about how we have organized ourselves. Add to that our collective tool kit to address those crises has rarely been weaker. The 1980s neo-liberal counterrevolution, when governments focused single-mindedly on growth and came to see their primary role as creating the conditions for business to prosper, stripping away as many barriers to profit as politics allowed, changed not just government but the country and for that matter us. 

Freedom — economic freedom and freedom from government — became a core value. Competition would sort out the winners and losers. Inequality was not only inevitable but right. Unsurprisingly, decades of flattened taxes, deregulation, privatization, offshoring and financialization — the neo-liberal policy suite — have led to increased inequality and insecurity — and a loss of trust in our public institutions. Just look at how few people vote irrespective of the stakes and how many seem ready to burn it all down.

JH: Your book is premised on the idea that neo-liberalism has created deep inequalities, constrained our collective capacity to meet big challenges and generally spread misery and anger by undermining solidarity and turning us against one another. If it’s so terrible, why does it persist? 

AH: Not that hate, exploitation and misery — even globalization — somehow didn’t exist “before neo-liberalism.” But neo-liberalism did upend the post-war settlement, when it seemed that capitalism and democracy could nourish each other, that high profits and high wages could coexist, that growth would benefit everybody. Instead we have corporate concentration and extreme economic inequality and insecurity. 

And so finally to your question, I argue that neo-liberalism contains the seeds of its own perpetuation because it has undermined our collective tool kit — taxes have come to be seen as a burden or punishment, regulations as red tape and a drag on the economy, so too unions, while trust in government, in political parties, even in democracy continues to decline. Most significantly trust in one another — essential if we are to solve problems together — has been in sharp decline. So even as many have lost faith in how things are they have also, it seems, lost faith in the idea of the collective, in the possibility of doing big things together.

JH: So then, how, as you say, do we break free? 

AH: Ha. Big change is hard. But the stakes are high. (Italian political theorist Antonio) Gramsci recognized that in these in-between times when there’s a “war for position” the outcome is uncertain, things could flip this way or that. When asked if he was optimistic Gramsci responded with “pessimism of the mind, optimism of the will” — optimism is a choice, despair is not an option. But there are many reasons for hope. Big change usually starts outside of government, outside of conventional politics — in civil society. And there are many people out there fighting for better. If they were to link up and find some common ground, see how their issues link together and to the larger public issues, who knows what’s possible. Research out of Harvard suggests that if 3.5 per cent of the population join together to fight — peacefully — for change, they almost always succeed. There’s no shortage of ideas and energy.

Campus activism: potential blowback on the Republicans?

I started college in the late 1970s.  Since "the 1960s" were really from about 1964-1974, there was still a lot of recognition of that period in Ann Arbor.  

As is my want, when I was in college I became interested in how colleges work and I read a lot of the literature of the time about "college student development" especially William Perry's Forms of Intellectual and Ethical Development in the College Years: A Scheme (book, a webpage).  Others writing along these lines included Lawrence Kohlberg and Carol Gilligan.

Plus I read works like Kirkpatrick Sale's SDS and Todd Gitlin's The Whole World is Watching about "the movement."  Me and some others even brought Gitlin to campus to speak.

Perry discusses how students start at the dualism point--yes or no--move to an everything's relative position, and then, ideally, to what he called "commitment in relativism" in that you use relativistic thinking to come to a position.

Probably most university presidents aren't familiar with this literature, because I was shocked when the Penn, Harvard, and MIT presidents were grilled before Congress last November about pro-Palestinian activism on their campuses, which was pitched as anti-Semitism, that the presidents didn't reference this work ("Lawmakers question Harvard, Penn and MIT presidents on antisemitism," "The anti-college subtext to the right-wing response to Gaza protests," Washington Post). Two of the presidents ended up resigning.

Interestingly, now that I think about it, from Perry's perspective, Republicans in Congress reason dualistically, which isn't particularly sophisticated.

Roger Martin, former dean of the Rothman School of Business at the University of Toronto has a related concept called integrative thinking where people simultaneously consider multiple ideas that conflict and come up with a way to resolve them. 

In any case, you can be pro-Jew/pro-Israel, which I am, because my father was Jewish, and I remember books in our house about the Arab-Israel conflict, while recognizing at the same time that the Palestinians have a co-equal right to live, and the way that Israel treats the Palestinians is abominable.  

Sure Hamas was terrible and should be condemned, but Hamas, in effect, was created (blowback) by Israel's treatment of Palestinians.  And you can be against killing of all sorts.  I think Hamas was wrong.  And so is Israel, which has killed over 30,000 people in its war in the Gaza Strip.

I do think universities have the obligation to better integrate understanding college student development and working with students to move along the ladder of cognitive and ethical development.  Obviously that's not happening in a purposeful way in most universities, even "the best" ones.

The Columbia University president came up before Congress last week and she completely capitulated, and later asked the NYPD to remove a protest sit in student camp out staking a pro-Palestinian position ("Columbia Students Arrested Over Campus Rally May Face Other Consequences," New York Times).  

And USC told the Palestinian valedictorian that she wouldn't be able to give the traditional speech at commencement ("USC got it wrong in canceling valedictorian’s speech. Here’s what the school should do now," Los Angeles Times).  

Police officers stand near tents erected by pro-Palestinian protesters on the South Lawn at Columbia University in New York, on Thursday. C.S. MUNCY/The New York Times/Redux

Last week students were removed from an encampment at in California.

FWIW, I participated in a sit in back in the day about disinvesting from South Africa.  I'm sure the administration was indulging us, but they didn't call the police on us even though we remained in the Regents board room overnight.  

Contrast that to now sadly, as UM is considering much harsher policies ("Some concerned University of Michigan proposed policy on protests could quell free speech efforts," CBS).

I don't think students are wrong to support Palestinians.  Wrong is violence against Jews or destruction of property.  Reporting by the student newspaper at Columbia found that most of the incidents were off-campus by people not related to the university ("Rabbi advises Jewish students to ‘return home as soon as possible’ following reports of ‘extreme antisemitism’ on and around campus," Columbia Spectator).

In response to the Columbia action, students at Yale and others created tent camps supporting Columbia students and the Palestinian cause ("Students at more universities announce solidarity rallies after 108 pro-Palestinian activists are arrested at Columbia," CNN, "UM students set up encampment on Diag protesting war in Gaza," Michigan Public Radio).

Photo: A.J. Jones, Michigan Public Radio.

I wonder if this will wildcat across the country, the same way demonstrations did after students were killed at Kent State (and Jackson State) in 1970 when they were protesting against the Vietnam War  ("It began with defiance at Columbia. Now students nationwide are upping their Gaza war protests," AP).

There are protests at University of Washington today ("Student walkout: Updates as WA students protest Israel-Hamas war," Seattle Times).

However, protest has become much less effective in changing society over the years.  I don't know why exactly.  Some argue it's co-opted by elites and there's definitely truth to that.  And corporate interests are much more organized and active in protecting their interests ("The small business tyrant has a favorite political party," New York Times), "The UAW’s Chattanooga Victory: Score One for the North in Our Endless Civil War," American Prospect).

-- "How violent protest can backfire," Stanford News
-- "The end of protesting," Comment
-- "Can protests lead to meaningful changes in government policy, particularly around economic redistribution?," Brookings
-- "Do Protests Even Work," The Atlantic

Some is because back in the day there were just a few communications sources and they had disproportionate power and authority and most people read or watched them.  

But with cable television and social media and the decline of newspapers and traditional television news, effect can be dissipated, even though social media had some success wrt both Tahrir Square in Cairo and Chiapas state in Mexico.  Not to mention the development of a fabulist conservative media ecosystem.

Still, the Republican/conservative response to the Israel-Palestinian issue may in fact spark a new activism. And revive the strength of protest movements.

Although the conservatives have some advantage in that the winter term is almost over, and students would tend to go back home for the summer.

=====

FWIW, a lot of my peers at the time thought that activism in the 1960s had failed.  I used to respond, "the US got out of Vietnam, what do you mean?"  But definitely after the US took out the troops, the big reason or impetus for activism faded.  But at least when I was at school there were two more waves, Divestment from South Africa and then US involvement in Central America, specifically El Salvador.

The Toronto Public Library has launched a new collection featuring books banned, challenged or censored across North America.

 

-- "It’s never been more important to protect the right to read," Toronto Star

Buckhead District of Atlanta looks to secede from Atlanta

Predominately white district ("Richest Atlanta District Inches Closer to Seceding From City," Bloomberg).  A kind of edge city, but within the city, not on the outskirts of the metropolitan area.  It's competitive with Downtown for commercial property location and development. It accounts for 38% of the city's tax revenue.  So its leaving would cripple the city economically.

Definitely counter to my call for cities and counties to merge, to create bigger, more viable polities.

It's being pushed by the State Legislature, especially the Senate.  The House may oppose, but unlikely.  The city would be forced to divvy up civic assets at a price favoring Buckhead.

It seems pretty ugly.

Seattle Times column on the impact on Washington State from Idaho's anti-public health policy: States as "laboratories of autocracy"

 Back when government was not about culture wars but helping people, there was the phrase "states as laboratories of democracy" referring to how many best practices adopted by the federal government, like Social Security, were pioneered by states acting innovatively.  (Although this at times was difficult for states because they didn't have the funding capacity possessed by the federal government.)

-- "A Progressive Call to Arms: Laboratories of Democracy," Harvard Political Review

In our heightened political environment, since the Obama Administration, Republican-led states have have used their ability within the federalism system to be resistant to change.  This was particularly pronounced with states being resistant to Medicaid expansion as a part of the Affordable Care Act ("State Politics And The Uneven Fate Of Medicaid Expansion," Health Affairs).

But also in a significant expansion of States suing the federal government over progressive policies.  (Similarly, Democratic run states frequently sued the Trump Administration over its practices.)

Now, states like Florida, Texas, Idaho, and Oklahoma on health care, immigration, election rules, abortion, public health, and other topic areas, are actively restricting rights, programs, and access.  

A new book out calls such states Laboratories of Autocracy ("How the states have become "Laboratories of Autocracy"," Salon).

The Seattle Times is a newspaper with center-right politics.  

So the column by Danny Westneat, "With COVID-19 and now abortion, WA is Idaho’s civilization. Can that hold?," is striking in how it describes the negative impact on Washington state health care systems from Idaho's backwards policies on covid 19 vaccination now, and likely anti-abortion policies in the future.

From the article:

The pandemic fractured America. It exposed, and then accelerated, the widening of some cultural and political chasms between the red areas of the country and the blue. 

The hope was that as the disease crisis subsided, these cracks might shrink back to something more resembling “normal.” But what if a larger seismic event has been triggered that now can’t be, or won’t be, stopped? 

I’ve been wondering this with respect to our neighboring red state, Idaho. 

Recently the news came out over there that during the delta phase of the pandemic last fall, Idaho in desperation had shipped more than 2,000 patients to Washington because its hospitals were so overwhelmed with unvaccinated COVID-19 sufferers that they had to ration medical care. 

“During this period, Washington Gov. Jay Inslee criticized Idaho’s leadership for ‘clogging up’ his state’s hospitals,” the Idaho Capital Sun reported. “Data from Idaho’s and Washington’s health departments back up this criticism.”

The news organization looked at patient-transfer data and found that, even as Idaho’s Republican political leaders resisted many COVID control measures and the state was among the worst for getting vaccinated, its sick residents were being exported for care to hospitals here, mostly in Spokane but also to both Harborview and the UW Medical Center in Seattle. 

This had a predictable ripple effect. “Today in my state, Washington citizens in many cases cannot get heart surgery, cannot get cancer surgery that they need, because we are having to take too many people of unvaccinated nature and unmasked, many of whom come from Idaho, and that’s just maddening frankly,” Inslee said at the time. ... 

I’m recounting this tale of political malpractice because, incredibly, it’s all about to be repeated — except with abortion this time. 

Idaho lawmakers just banned abortions there after about six weeks of pregnancy. They added one of those vigilante clauses that deputizes family members to sue doctors for damages. The law was stayed temporarily by the courts last week, but it’s similar to a Texas law that the U.S. Supreme Court allowed to stand. 

Already Idaho women are coming to clinics in Washington. A reproductive care clinic in Pullman reports 43% of its patients now are from Idaho. This past week, Planned Parenthood began renting space near the Idaho border in Oregon to get ready for women making abortion treks over from Boise. 

Idahoan demand for abortions here is expected to increase fourfold if the ban is upheld there, according to a forecast from an institute that studies reproductive health care.

Conclusion.  Increasingly, we are becoming two nations.  And it does not bode well.  Why is it that "state's rights" concepts are mostly being pushed not to improve the quality of people's lives but to diminish quality of life.

High school student activism in York County, Pennsylvania reverses book ban

This week's Philadelphia Inquirer columnist Will Bunch's e-letter has a bunch of great content including on how Joe Manchin totally fails to represent West Virginia when it comes to the state's great needs--it's got the fifth worst level of poverty in the country.

Students, parents and educators gather outside the Central York School District Educational Service Center to protest the district's banned resources list on Monday, Sept. 20, 2021, in Springettsbury Township. 

Organizers of the protest brought along some of the books that are currently on the district's banned resources list.  Photos: Dan Rainville, York Daily Record.

Bunch writes about how school boards are capitulating to conservative parents angry about mask mandates and "critical race theory." 

He calls our attention to how high school students in the Central York School District in York County, Pennsylvania successfully organized against a school board "freeze" on books about the country's difficult history with race, racism and segregation ("Central York students speak out against book ban," WGAL-TV).  

Actions included protests and a campaign to stock Little Free Libraries with the banned books.

More than 200 pro-expression parents, as well as the author of two of the "frozen" books, came to Monday night's board meeting, where the school board then reversed its decision ("Central York school board votes unanimously to rescind book ban: 'It has taken far too long'," York Daily Record).

Organizing matters.

Rather than capitulate to the loony right wing, organize [fight] back.

=====

Elsewhere in Pennsylvania, other "organizing" efforts against the "Big Lie" include the PBS station in Harrisburg--the state's capital--mentioning the participation of elected officials complicit in the Big Lie, when reporting on them ("Countering the big lie: WITF newsroom’s coverage will connect lawmakers with their election-fraud actions," WITF-TV/PBS).   

The Legislature fought back by cutting its small appropriation to state public television and radio services ("State funding for Pa. public broadcasting eliminated in new budget," Pennsylvania Capital-Star).

Similarly, the Philadelphia Inquirer refuses to call what conservative legislators are doing wrt election reviews an "audit" because what they are doing doesn't meet the basic definition of what an audit is ("Words matter. So these journalists refuse to call GOP election meddling an ‘audit’," Washington Post).

Ockham's Junkyard as a form of political reasoning

From ClubStreet Post

Ockham's Razor is a concept put forward by William of Ockham in the 1300s, that the simplest explanation for a phenomenon is the most likely to be correct.  From the Merriam-Webster Dictionary:

Definition of Occam's razor: 

a scientific and philosophical rule that entities should not be multiplied unnecessarily which is interpreted as requiring that the simplest of competing theories be preferred to the more complex or that explanations of unknown phenomena be sought first in terms of known quantities.

The way Republicans and the radical right offer explanation, especially media personalities like Tucker Carlson (there was no insurrection, etc.), Sean Hannity (Trump's Big Lie that he didn't lose to Biden, etc.), Laura Ingraham (Democrats are socialists, hydroxychoroquine, etc.), Alex Jones ("crisis actors" fake they are victims of school shootings, etc.) to me is more an example of 

Ockham's Junkyard:

that the most convoluted, fabulist, insane, ridiculous, and fact-less explanation is the truth.

Quality of messaging: fact-based versus post-truth Republicans

-- "Post-truth politics and why the antidote isn’t simply ‘fact-checking’ and truth," The Conversation
-- "Defining Post-truth: Structures, Agents, and Styles,"  Ari-Elmeri Hyvönen
-- "Truth vs. Lies," October 2020 special issue, Scientific American

Yesterday, the Washington Post released a blockbuster, "I just want to find 11,780 votes’: In extraordinary hour-long call, Trump pressures Georgia secretary of state to recalculate the vote in his favor," a story with the audiotape of a call made on Saturday by President Trump to Georgia's Secretary of State, asking him to come up with 11,780 votes in Trump's favor, so the previous decision awarding the state's electoral votes to Biden could be challenged.

-- "Here’s the full transcript and audio of the call between Trump and Raffensperger"

(I listened to most of it, and while Trump was repetitive and evasive and a wack job, I wouldn't say he sounded "mentally ill," as many others have said.)

Today, a different Georgian election official had a press conference ("Trump made false claims in call pressuring Georgia secretary of state to undo Biden win, official says," NBC News) where he refuted each of Trump's fallacious claims.

What struck me was the "presentation board" he used to support his presentation.  It's matter of fact.

NBC News photo.

I thought back to the Republican campaign by members in the House of Representatives to impugn witness Michael Cohen testifying about his experiences working for and with Donald Trump ("'Liar, Liar, Pants on Fire,’ and Other Contentious Exchanges From Cohen’s Congressional Hearing," New York Times). Here's the quality of their presentation boards.

Reuters photo.

We're not a Mean Nation because the Democrats aren't running on a hard left agenda

While it looks that Biden will win--not just the bare minimum of electoral votes, 270, as the addition of Nevada and Arizona to his win column looks quite certain, but because it appears that while extremely close, Georgia (16 electoral votes) and Pennsylvania (20 electoral votes) are likely to move to the Biden win column as well, giving him a comfortable total--there are plenty of negative indicators:

1. the failure to flip Republican-held Senate seats
2. the loss of Democratic-held House seats in conservative leaning districts
3. the fact that in losing, Trump garnered more votes that Obama did in winning the 2008 election (although the US population is 27 million people greater today, 12 years later).

In the Guardian, Nathan Robinson, editor of Current Affairs, argues that the reason the election is so close is because the Democrats didn't run a truly progressive, hard left campaign  ("Trump should have lost in a landslide. The fact that he didn’t speaks volumes").

The headline is right, but the argument, while righteous and I'd love to believe it, is flawed.  

Sure, that the election is close speaks volumes, there are plenty of lessons for messaging and programming.

But if 69+ million people voted for Trump, it's not like a goodly number did so because they didn't think that the Democrats weren't progressive enough--that they thought that the Republicans can do a better job bringing about universal health care, a $15 minimum wage, and a strong public health response to the coronavirus ("The Counties With The Worst Coronavirus Surges Overwhelmingly Voted For Trump," AP).

Senate.  I am floored at how many Democratic Senate candidates that were touted as able to win got absolutely crushed:

• Montana, Bullock got 45% of the vote
• Iowa, Greenfield got 45% of the vote
• Kansas, Bollier got 41% of the vote
• Maine, Gideon got 43% of the vote
• South Carolina, Harrison got 41% of the vote
• Texas, Hegar got 44% of the vote
• + reporting on Espy in Mississippi said he had a chance in Mississippi.  He got 42.5%.

The North Carolina race is close.  And maybe if Cunningham hadn't sent texts of a sexual nature to a woman not his wife (comparable to Comey's October surprise in 2016), he could have squeaked it out.  He's 97,000 votes short, with 300,000 votes to be counted.  It seems too big a deficit to make up.

The only saving grace is Georgia.  Because of a Libertarian candidate, it appears that Senator Perdue won't win 50% of the vote, leading to a runoff.  

Since the Georgia special election for the second seat is already going to runoff, having two Senate races on the ballot in January could actually get Democrats out to vote, when traditionally Democratic turnout for January runoff elections tends to be diminished.

House.  And many Democrats lost Congressional seats in Republican leaning seats (" Even if Trump loses the election, the next Congress will be even Trumpier," NBC)..

There's no way the disaffected but voting segment of the electorate voted Republican because they offer a better agenda for the working class, one that is more progressive.

For example, Republican Will Hurd barely won his Texas border district last election.  By fewer than 700 votes.  He didn't run again.  But the Republican easily won, by not quite 10,000 votes, which is much more than a handful.  Xochitl Torres lost in Arizona.  Some of the seats in Southern California that went Democrat in 2018 appear to reverting back to Republican this year (although maybe those seats will see saw from election to election?)

Can a progressive agenda succeed?  Do I think that a progressive agenda can resonate with good chunks of the Republican-leaning precariat electorate?  Yes I do.

These two graphics show the Presidential vote ("Let’s get ahead of it: A map of the early 2020 results by population, not acreage," Washington Post).  The first is by county or "acreage."  The second is weighted for population.

But there's no question it's not being articulated particularly well ("Why Joe Biden is better than Donald Trump for the US economy," Guardian).  And that includes people like AOC and Elizabeth Warren, not just Biden 

People live precarious lives because economic forces favor capital, not labor.  

The Republicans have been successful at wedge politics in creating a "coalition" made up of a chassis of angry mostly white and/or rural voters, topped with a body comprised of corporate ("How the Koch brothers built the most powerful rightwing group you've never heard of," Guardian), wealthy ("How Greenwich Republicans Learned to Love Trump," New Yorker), and other conservative interests ("The Unseen Agenda Behind Trump: Destroy the Public Realm to Free the Rich," CounterPunch; "Dark Money Funds Campaign Pushing Supreme Court to the Right," Between The Lines).

As long as the white precariat doesn't want people other than themselves to benefit from government programs ("Why More White Americans Are Opposing Government Welfare Programs," NPR), it is difficult to define a unifying progressive agenda.  

For Democrats and Progressives to be successful going forward, especially at the level of the House and Senate and state legislatures, Democrats and Progessives must redefine and re/build a positivist consensus about what the USA is about. 

Identity politics and singular versus plural identities. A big problem is that "identity politics" in the way that it tends to be defined in the US, is exclusionary in that people focus on their separate identity without also acknowledging an identity as part of a greater whole ("book review of Identity and Violence," New York Times; "Modeling Plural Identities and their Interactions").

After all, the US motto is e pluribus unum--from many, one.

Instead we're very much a divided nation.

-- "This Election Highlights How Divided the Nation Remains:  In many places, the results confirmed that red America is growing more red and blue America more blue," Wall Street Journal

Disturbing research on OxyContin shows the problems of prescription drugs as a "market" and perhaps why we should have a national health system

If you consume media targeting older demographics, you are familiar with advertising for prescription drugs.

It can be fun to make fun of the names, the ads, and to be concerned about the various side effects of the drugs as outlined in the ads.

But there is no question that demand for such drugs increases as a result of the advertising.

A couple weeks ago, the New York Times published a story, "Damage From OxyContin Continues to Be Revealed," featuring the results of various research studies about OxyContin, the addictive prescription drug that is widely abused, reaping great profits for Purdue Pharmaceuticals, the company that made and marketed it.

Research results include:

• Perdue marketed the drug in states that had fewer regulatory requirements, with a finding that distribution was twice as high in the lightly regulated states concomitant with higher rates of addiction
• per capita OxyContin use was up to 250% higher in the states with lighter regulations
• 65% of the increase in overdose death rates was tied to the introduction and marketing of OxyContin
• because of the high rate addiction, when the formulation of OxyContin was changed, making it less satisfying to existing addicts, the shift to heroin as an alternative led to a skyrocketing of heroin use, a tripling of overdose deaths and a massive increase in Hepatitis B and Hepatitis C infections.

It definitely puts the whole system of pharmaceutical marketing under a scary light. And shows how the profit motive shapes the demand for particular drugs in ways that may have little to do with promoting positive health outcomes ("The Promotion and Marketing of OxyContin: Commercial Triumph, Public Health Tragedy," American Journal of Public Health 99:2 [2009]; "Propaganda that Masqueraded as Pharmaceutical Marketing," Psychology Today).

===========
Special addition on hydroxychoroquine and remdesivir

Obviously, we want cures for covid19, but the promotion of hydroxychoroquine has become political, pushed by financial and conservative interests as a potential victory for President Trump and as a way to push to the side the recognition of the management failures of the Trump Administration in reacting to the pandemic.

Politico reports ("Coronavirus gets a promising drug. MAGA world isn't buying it") that conservative  media remains wedded to hydroxychoroquine promotion in the face of more positive reports on remdesivir, which are promoted by more traditional scientific and medical experts.

That being said, remdesivir helps people recover more quickly, but it doesn't necessarily reduce the death rate ("Remdesivir Trial Missed a Huge Opportunity," Bloomberg).

Fortunately, it looks like there may be better drug candidates ("Old Drugs May Find a New Purpose: Fighting the Coronavirus," New York Times; "High hopes for Covid-19 vaccine developed by Oxford scientists," France24). But regardless it will take quite some time for a vaccine to be developed, to find drugs that may help those who become sick, etc.

But it's also pretty damning that a cure becomes more about politics and less about science. From the Politico article:

Indeed, the same segment of the right that claimed scientists and the media were deliberately downplaying hydroxychloroquine in order to hurt Trump’s standing are now the ones downplaying remdesivir. On Fox News, Laura Ingraham suggested that remdesivir, as a newer drug being produced by the pharmaceutical company Gilead Sciences, could be unsafe and expensive. Those who initially helped raise the profile of hydroxychloroquine raised doubts about the remdesivir studies.

The unexpected reaction appears to stem from the differences in how the two drugs came into the public spotlight. Hydroxychloroquine bubbled up through the MAGA grassroots — little-known investors promoted it online, got on Fox News and suddenly the president was talking about it from the White House. Remdesivir’s progress came through a government-funded trial that had the blessing of Dr. Anthony Fauci, the bête noire of Trump hardliners who blame the government’s top infectious disease expert for undermining the president and causing unnecessary economic damage with his social-distancing guidelines.

Using the coronavirus public health restrictions as a way to renew a Tea Party-like conservative anti-government movement

1.  Republicans constantly fighting community organizing of the poor.  A few days ago, the World Channel (which shows documentaries among other programming, and is broadcast on HDTV subchannels of PBS stations, although not in the DC area) rebroadcast an episode of the documentary series Independent Lens about the fall of ACORN, the community organizing group with affiliates in many states focused on a poor people's agenda, including voter registration, fighting foreclosures, etc.

-- "ACORN and the Firestorm," Independent Lens, PBS
-- "Filmmaker Q&A"

Republicans had been aiming at ACORN for years because they didn't like their voter registration efforts.  Going after ACORN was a form of "voter suppression."

The organization dissolved after a somewhat faked set of videos were released by alt right journalist James O'Keefe, alleging the group was willing to help a pimp get a housing loan to set up a brothel.

But at the same time, ACORN had  management issues because of the "distributed" nature of its organization, and was already in internal turmoil because of embezzlement by one of the organization's founders, which had been covered up by another of the organization's founders and they were brothers.

The organization collapsed.  Although many of the affiliates reorganized and incorporated under other names, with the loss of a nationally-focused infrastructure.

Years ago, I got into an argument with John Atlas, author of a book about the organization--he's featured in the film--and father of one of the producers.

I said "ACORN knew they had a target on their back.  So they needed to be squeaky clean.  And the embezzlement, which was covered up by the founder, would have probably sealed their doom anyway."

He scoffed, blaming that on constant Republican/conservative opposition, but I thought that was too facile.

2.  The Tea Party as an organized response of conservatives to the Democratic Party.  Plenty has been written about this, including many books.  A article by Harvard researchers published in the political science journal Perspective on Politics, "The Tea Party and the Remaking of Republican Conservatism," was the kernel of one of those books.

In short, business interests backed up by conservative media interests fomented the Tea Party as an attack on President Obama and the Democratic Party.

Tea-party protesters in Denver, April 15, 2009.
PHOTO: ANDY CROSS/THE DENVER POST VIA GETTY IMAGES.

I always thought it was ironic that Tea Party activists stated they acted because "the government is taking over the economy through the Federal bailout/stimulus" in response to the Great Financial Crisis.  The government being equal to "socialism."

Ironically, from the standpoint of Marxist theory, it wasn't socialism and government takeover at all, but yet another example of the response to a "Capitalist Crisis" where business is bailed out by government ("THE GLOBAL CAPITALIST CRISIS: Whose Crisis, Who Profits?," International Review of Modern Sociology 38:2 Autumn 2012).

What's happening is business takes over government.  Not the other way around.

(During the GFC, many corporations walked away from commercial mortgages, with little real consequence, while individual homeowners were told that to renege on their commitments was a moral failure.)

As a result, the bailout was shaped to favor business interests--most, not all, of the corporations benefiting didn't have that many restrictions on what they did.  Bailing out of the banks did not require a whole lot of help to individual house owners who lost out to foreclosure.

And the Tea Party has been a force for fierce anti-government policy and rhetoric ("The Tea Party Succeeded, but Not at Policy," Wall Street Journal; "5 years later, here's how the tea party changed politics," CNN; "The Tea Party Didn’t Get What It Wanted, but It Did Unleash the Politics of Anger," New York Times).

Of course it didn't change "politics" in terms of policies favoring business, because business interests organized the creation of the Tea Party, to serve business interests.

Editorial cartoon by Dave Granlund featuring Fox News personalities who have advocated against stay at home orders.

3.  Protests against coronavirus restrictions in Maryland, Michigan, Texas, Virginia, Ohio, California, etc. as the next iteration of the Tea Party anti-government backlash.  A few days ago, fomented in part by President Trump ("Trump Encourages Protest Against Governors Who Have Imposed Virus Restrictions," NYT), other re-election campaign interests, Fox News ("Protests against stay-at-home orders during coronavirus") and other conservative media organizations, there have been protests in various state capitals over the impact on the economy from business shutdowns ("Michigan's protests are a bellwether of an increasingly dangerous partisan divide," CNN; "Coronavirus Outbreak Eases in New York as U.S. Protesters Push Against Restrictions," WSJ; "What's Driving The Right-Wing Protesters Fighting The Quarantine," NYT).

Protestors in Huntington Beach, Calif. protest state closures on April 17. Photo: Jeff Gritchen/MediaNews Group/Orange County Register via Getty Images

It's not like these protests are big.  Nothing like the Women's Marches after the election of Trump and since, which brought tens of thousands and hundreds of thousands of people out to protests.

At least judging by this Axios roundup of photos of demonstrators at these protests.

Most of the protesters in Annapolis, Maryland didn't even get out of their cars ("Streets of Annapolis filled with cars in protest against Maryland coronavirus restrictions," Annapolis Capital-Gazette).

A message from a ReOpen Maryland supporter is seen on the back of a truck around Church Circle in Annapolis on Saturday, April 18. ReOpen Maryland is protesting the mandated closure of businesses due the coronavirus pandemic. (Brian Krista/Baltimore Sun Media Group)

Still, as the energy of the Tea Party opposition has faded--look at the success of the election of a Democratic Supreme Court Justice in Wisconsin despite all the roadblocks put in the way of this by the Republican-controlled legislature (itself in power because of extreme gerrymandering).

I can't help but believe these protests are merely the next generation iteration of anti-government pro-conservative party identity building as a way to build momentum for the November election, in the face of the disastrous "management" of the coronavirus response by the Trump Administration.

In short, this isn't an "ad hoc" grassroots response by "concerned citizens."

It's fomented by  media and business interests that in general, don't care too much about the interests of "the people."

Some of the conservative calls for "opening the economy" have been couched in concern for the unemployed and the likelihood of "deaths of despair."

I read a comment on a Washington Post article making the point that it wasn't like these interests cared about such deaths before ("Farmer suicide deaths alarm rural communities in the Midwest," South Bend Tribune).

Conclusion: "The politics of anger" need to be constantly stoked in order to maintain rabid opposition to Democratic policies that in normal circumstances, help the protesters.

By making it out that recipients of help are both "the other" and "undeserving" the politics of anger are heightened.

From the New Yorker article "Arlie Russell Hochschild’s View of Small-Town Decay and Support for Trump":

Hochschild noticed that Tea Party enthusiasts and traditional conservatives gave her accounts of American society that boiled down to a single “deep story.” This story was that America, which was once characterized by hard work, was now characterized by cheating; the image that Hochschild chose was that of people cutting in line. For Hochschild’s subjects, the line-cutters were African-Americans, promoted by affirmative action, she writes, but also “women, immigrants, refugees, public-sector workers—where will it end? Your money is running through a liberal sympathy sieve you don’t control or agree with.” President Obama, in this vision, was the man controlling the line, waving the line-cutters ahead—“their president, not your president.” Hochschild shared this analogy in e-mails to the plumbers and insurance brokers she had met. “I live your analogy,” one wrote back. “It’s my story,” another said. A third wrote, “You’ve read my mind.”

A Trump Unity sign on a trailer is shown parked at the [coronavirus restrictions] protest in front of the Michigan State Capitol in Lansing. Paul Sancya/AP

Not that President Trump reads, but maybe he should look at the Utah Leads Together Plan response to the pandemic

Trump ("Trump says he wants the country 'opened up and just raring to go by Easter,' despite health experts' warnings," CNN), Texan Lt. Governor Patrick ("Texas' lieutenant governor suggests grandparents are willing to die for US economy," USA Today) and others don't seem to have much of a plan in terms of their response to the coronavirus.

There has been a lot of coverage about how governors and mayors are far ahead of the federal government in terms of response.  It appears that Utah needs to be on the list, as its just released plan for dealing with the coronavirus, Utah Leads Together, seems to be significantly ahead of President Trump and state officials like Dan Patrick.  From the document:

The Utah Leads Together plan is based on the premise that every Utahn plays a role in Utah’s health and economic recovery. We lead together. To be successful Utahns must take three major actions:

1. Rigorously follow public health guidelines and measure transmission rates
2. Stay engaged with the economy
3. Assist those in need

It's a framework organized in three phases:

1. Urgent
2. Stabilization
3. Recovery

Thinking about the pandemic in these terms makes response much more graspable.

"The receipts" on Fox News: coronavirus as hoax versus a real concern

Washington Post video editor JM Rieger created a video with before and after video from various Fox News on-air personalities calling covid-19 a Democratic Party anti-Trump hoax versus a crisis.

-- "Sean Hannity denied calling coronavirus a hoax nine days after he called coronavirus a hoax"

My "net assessment" of the US response to covid19

In the Washington Post, columnist David Ignatius ("Where would the U.S. stand in a post-pandemic assessment?") discusses the "Net Assessment" process created by the Department of Defense to assess the comparative likelihood of the US and the USSR to survive nuclear war.

He opines about a net assessment comparing the response of China and the US to the coronavirus.

Here's my not particularly detailed response:

China has an authoritarian government that withheld information, endangering their citizens. But they did respond, eventually.  And their scientists communicated about the situation and the virus in scientific circles early, giving a leg up to creating tests and more quickly understanding the nature of the disease.

Photo: Rex Features.

Neoliberalism: the emphasis on the market at the expense of government.  Since the era of Thatcher and Reagan, neoliberalism has resulted in the denigration and defunding of government in the US ("Neoliberalism's 'trade not aid' approach to development ignored past lessons: Neoliberal development policy was radical and abstract, but its uncompromising approach proved dangerous in the real world" and ">Neoliberalism – the ideology at the root of all our problems," Guardian). From the first article:

At the heart of the new right project was a particular constellation of ideas and policies known as neoliberalism. Neoliberalism is often used today as shorthand for any idea that is pro-market and anti-government intervention, but it is actually more specific than this. Above all, it is the harnessing of such policies to support the interests of big business, transnational corporations and finance. It seeks not so much a free market, therefore, as a market free for powerful interests.

From the second article:

So pervasive has neoliberalism become that we seldom even recognise it as an ideology. We appear to accept the proposition that this utopian, millenarian faith describes a neutral force; a kind of biological law, like Darwin’s theory of evolution. But the philosophy arose as a conscious attempt to reshape human life and shift the locus of power.

Neoliberalism sees competition as the defining characteristic of human relations. It redefines citizens as consumers, whose democratic choices are best exercised by buying and selling, a process that rewards merit and punishes inefficiency. It maintains that “the market” delivers benefits that could never be achieved by planning.

Attempts to limit competition are treated as inimical to liberty. Tax and regulation should be minimised, public services should be privatised. The organisation of labour and collective bargaining by trade unions are portrayed as market distortions that impede the formation of a natural hierarchy of winners and losers. Inequality is recast as virtuous: a reward for utility and a generator of wealth, which trickles down to enrich everyone. Efforts to create a more equal society are both counterproductive and morally corrosive. The market ensures that everyone gets what they deserve.

Extreme Republican ideology.  With the rise in extreme Republican ideology--dating to Newt Gingrich's Speakership if not before ("How Newt Gingrich Destroyed American Politics," The Atlantic), and the most recent Presidential election, the US has a viciously incompetent federal government that failed to maintain public health monitoring and surveillance systems, and through continued incompetence spreads misinformation through the President, even though somewhat crippled federal agencies are reacting, although local and state agencies are more in the lead because of the vacuum of leadership and competence.

Public health and health care is not an integrated system.  The US has adopted an approach generally and specifically in terms of health care to governance and funding that de-emphasizes the importance of surveillance and stocking slack resources to be able to respond to pandemics in a timely fashion.

I can't remember the article I read, but it made the point that "the US doesn't have a health care system, it has various disconnected marketplaces."

Rural areas have been particularly hard hit ("The Quiet Crisis Of Rural Hospital Closures, Kaiser Health) and because rural Republican states have declined to expand health care access to the poor.

But plenty of urban hospitals have closed ("Hahnemann University Hospital Closure: What Philly Is Losing," Philadelphia Magazine; "St. Vincent Medical Center closes after a century, shocking community," KCRW/NPR)sometimes because they are owned by for profit firms, or because the cost of uncompensated care is high and threatens the financial health of university parents.

These 2019 entries include links to past entries concerning health care matters in the DC area:

-- "Another example of a failure to do public capital planning in DC: Council votes to stop funding United Medical Center
-- "Community health improvement planning"

This has resulted in a continued reduction in the number of available hospital beds and usually a decline in the number of ICU beds as well.  Per capita numbers for the US lag countries with national health systems.

More recent efforts to tie public welfare health coverage and food assistance to employment, making it more difficult for immigrants to get citizenship status if they've received public benefits increase the likelihood of poor health outcomes.  Not to mention the difficulties of applying for benefits--most states haven't adopted best practice computerized systems, and have closed offices where people normally apply, etc.

Difficulty of responding extranormally when circumstances warrant.  Plus the bureaucratic nature of agencies tends to make it difficult to respond in innovative ways let alone with alacrity in extranormal situations (e.g., compare South Korea or Taiwan's response to that of the US, and the testing creation and approval process; cf. the debacle concerning expanding the Seattle Flu Study to test for coronavirus, etc.).

Need for a national health care system.  How the US health care system is set up disincentivizes people to get "wellness" care because of copayments, missed work and loss of income, lack of sick leave, etc.

Ideally, a net assessment would be like Britain's health services assessment during WW2 ("Want, disease, ignorance, squalor and idleness: are Beveridge’s five evils back?," Guardian) because in moving people from cities to the country, they realized that the country was underresourced in terms of health care systems and that people weren't very healthy.

That resulted in the creation of Britain's National Health Service in 1948.

(How health care is delivered in the US needs to be reorganized, in three tranches for normal care: (1) wellness care; (2) management of chronic disease; and (3) catastrophic care; alongside a more robust public health system.)

Globalization and the precariousness of work.  The problem with globalization isn't necessary globalization, that is the economic and social interconnectedness, although this can be simultaneously strengthening and weakening--but because it was paired with the adoption of neoliberal principles and the simultaneous disruption to and elimination of a social safety net.

The loss of the safety net has heightened effects because of the change of the nature of work and the organization of the economy away from large employers, who traditionally provided health insurance (and pensions) in the US system.

Globalization made work more competitive, led to the migration of large scale industry to countries with cheaper labor, putting many people out of work, especially in center cities where manufacturing had been concentrated.

Replacing labor with capital.  Plus alongside globalization you have an increased focus on capital and mechanization, the simultaneous upskilling of jobs while also eliminating or outsourcing jobs whenever possible.

For example, an auto plant probably has 25% or fewer workers than it did 30 years ago.  In Flint, which had a peak GM employment of over 80,000 people (+ the multiplier effect of 3.0 add on jobs at suppliers), today there are fewer than 9,000 GM jobs.

Although some of that is because GM spun off its part manufacturing into separate firms including Delphi--still the overall number of jobs has been reduced by more than 50%).

More recently, IT, telecommunications and software has led to the elimination of jobs (such as in human resources, accounting, etc.).

People out of work, low wages, and limited social safety provisions are vulnerable.  This creates a fragmented society and economy that is economically and socially vulnerable to exogeneous shocks--climate change; financialization; pandemic; etc.