Letter to Rodney Davis on the Affordable Care Act

Below is the letter I just sent to my congressman.

I undoubted spent way more time drafting this letter than it was worth. I have no illusions that my congressman will read it and be swayed by my logic. As a practical matter, the best I can hope for is that someone on his staff will look at it carefully enough to add one tick to the column for “constituents opposed to repealing Obamacare.”

And yet, I think it was worth the effort I put into writing it—partially for my own benefit, as a way to clarify what I thought the most important points were, and partially for any local folks who might read it and be moved to weigh in with their own thoughts on the matter.

The Honorable Rodney Davis
1740 Longworth House Office Building
Washington, DC 20515

Dear Congressman Davis:

I am writing to urge you to preserve three key elements of the Affordable Care Act, which Speaker Paul Ryan’s “A Better Way” agenda does not protect: that policies cover the full range of essential care, that coverage be available at standard rates regardless of preexisting conditions, and that credits be available to help lower-income people buy health insurance.

With the Affordable Care Act’s rules, it’s possible to buy an insurance police and know that a full range of important care is covered. The “more choices” supported by Speaker Ryan’s plan would mean that people could “chose” to buy insurance with incomplete coverage. I have first-hand experience with how much work it is to analyze and compare insurance policies, trying to read between the lines to see what essential coverage is missing. The result of the Speaker’s plan would be many people who thought they were getting a good deal on their insurance would face bankruptcy because of hidden gaps.

With the Affordable Care Act, the last four years have been wonderfully free of the anxiety that any illness could turn into the “preexisting condition” that would make health insurance unavailable. Speaker Ryan’s plan to condition this on “continuous coverage” is a poor substitute. Sometimes people suffer a financial catastrophe and are temporarily unable to afford to maintain their insurance. It is terribly cruel to compound such a catastrophe with the additional penalty that health insurance—once they can afford it again—be unavailable or unaffordable.

My wife and I have modest incomes, and make some use of the credits available through the Affordable Care Act, which have made my insurance much more affordable. Speaker Ryan’s plan would eliminate these credits and replace them with a single credit which would probably be much smaller—and if as large, would be enormously generous to people with high incomes who scarcely need help affording their health insurance. The current means-tested credits seem much more likely to advance to goal of making health insurance available to everyone.

I urge you preserve these key elements of the Affordable Care Act.

Yours sincerely,

Philip M. Brewer

There are plenty of other things I might have included as well. For example, under the Affordable Care Act an older person can only be charged 3 times as much as a younger person for the same policy, whereas the Speaker’s plan would increase the multiple to 5x. If enacted, that change would cost me a lot. But I thought these were the most essential points: That insurance actually be insurance, that it be available, and that it be affordable.

Rodney Davis questionnaire response

Congressman Rodney Davis has a questionnaire asking for constituent input on questions of the day.

I filled it out some weeks ago (in mid-December) and found some of the questions to be . . . . Well, here. This is what I sent to his office after I posted my questionnaire response:

Several of the questions on your recent survey were hard to answer, because an accurate answer might be taken as supporting a position that is the opposite from what I intend. These two in particular:

“Do you believe we need to shore up Medicare so it’s available to future generations?”

Of course I support preserving Medicare. However, I would  oppose any changes in the basic design of how Medicare makes healthcare available to seniors. In particular, I would strongly oppose turning it into some kind of voucher program.

My understanding is that, together with the cost savings provided by Obamacare, Medicare is very close to being fully funded. It seems quite possible that no changes are needed going forward. Depending on the details of health care costs and payrolls in the future, it may be that some additional funding will be required, but that is the question for the future.

“Do you believe Congress must provide proper oversight of the VA to ensure our veterans are receiving the care they deserve?”

Again, providing oversight is exactly what Congress should do. However, I would oppose giving the VA additional mandates—either in terms of the care they are to provide, or in terms of the reporting they are required to provide—unless those mandates are fully funded.

I have no sense that the VA is doing anything other than providing the best care they can with the resources provided. Congress’s deeper obligation, beyond oversight, is to provide the resources necessary to care for our veterans.

I expect to go on pestering Congressman Rodney Davis on a near-monthly basis for the next two years.

Are we reaching the end of “escalate faster”?

For about a generation now the police in the U.S. have followed a general practice of escalating any confrontation, with the intention of escalating faster than the opposition can respond. This has saved lives, but I think we’ve reached the point where the negative consequences of this practice are becoming highly visible in a way that’s going to force changes.

The police still patrol in ones and twos the way they always did, but starting in maybe the 1970s they quit responding to confrontations that way. At the first sign of trouble, they’d call for backup. A confrontation with one person would be met by four or six officers. A confrontation with several people would be met by a dozen officers. A confrontation with an armed individual would be met by countless officers with rifles and shotguns.

In many cases this has no doubt saved lives. Certainly it has saved the lives of police officers, but it has probably saved the lives of suspects who were persuaded to surrender in the face of overwhelming force.

The problem with this tactic is that it’s obviously inappropriate in many circumstances. It’s basically a military tactic—hit with overwhelming force—and the general public views it that way and reacts with scorn (when used against people who are obviously harmless) together with either fear (when used against people like them) or shame (when they see it used in their name).

And that last, I think, is the change that’s going to make a difference: People feel shame when they see a rapid escalation to a disproportionate use of force done in their name, and they’re seeing it more in this age of smart phones.

So far when rapid escalation leads to uses of force that seem clearly unnecessary or disproportionate, and yet police officers face few or no consequences, people have been surprised. They shouldn’t be. The whole point is that these practices are codified in law and in the procedures the police departments follow. When the police rapidly escalate a confrontation they aren’t doing anything illegal, and they aren’t violating police department policies.

And those things—laws and procedures—are what need to change. Fortunately, in a democracy, when the public decides something ought to change there is a real chance of change forthcoming.

So, what do we do instead? We can go back to what policing ought to be—attempting to deescalate confrontations, reserving escalation for cases where public safety really requires it.

There are many instances where violence is a possible result—where somebody is angry or drunk or stoned or stupid or having a psychotic break or just a really bad day. In many instances violence could be avoided with deescalation.

For a very long time—as long as there has been government, right up until recent decades—escalation had to be slow, because the communication options and the manpower available didn’t allow for rapid escalation. There tended to be one representative of the government—a sheriff or tax collector—who kept order largely through moral suasion, together with having some call on overwhelming force (in the form of a posse or a platoon of redcoats or something). Unless a situation was such that calling in the marines would be appropriate, it pretty much had to be handled through deescalation rather than escalation.

Many of the lives saved by rapid escalation are police officers’ lives. Many of the people who will be saved through deescalation are not especially sympathetic—the petty criminal, the drunk, the mental patient, the burly man who is developmentally disabled. But others are, and we’re beginning to see the losses as part of a pattern, rather than as a series of unfortunate incidents.

When a guy has a stroke at the wheel of his car, manages to stop it, but is unable to respond to a police officer’s instructions (“Show me your hands! License and registration! Get out of the vehicle!”), what is the police officer’s appropriate response? Knowing the situation, obviously calling an ambulance. But under current polices there’s far too much chance that the guy will be dragged out of his car, roughed up, and dumped in the drunk tank until brain damage from the stroke is irreversible. Or, if he doesn’t have white skin, very possibly shot instead.

Now that we’re seeing people die at the hands of the police, and now that we’re hearing the testimony that these killings are legal and are in accordance with police department policy, we may finally see some changes in the laws and the policies.

Because that, rather than feelings of anger or shame, is what will make the difference.

A shift to deescalation will probably mean that people will die who might have lived. But people are dying now. People will die either way. A shift to deescalation may mean fewer people will die. It will almost certainly mean that fewer people will be shamefully killed in my name.

The other reason to raise chickens

Backyard Eggs
Backyard Eggs

So, the Champaign City Council legalized backyard chickens a while back. You have to file a form, pay a one-time fee, and get a notarized permission slip from your landlord (if you’re a renter), but it all looks quite doable. As I’d mentioned when I wrote about the issue before, this would have been a determining factor in my willingness to buy a house in Champaign, and now it isn’t. The fee isn’t cheap ($50), but figured into the cost of buying a house, it’s insignificant.

But thinking about the fee got me to thinking about why one raises chickens in the first place.

Probably most of the people in Champaign who want to raise backyard chickens are yuppy locavore types looking to reduce their food-miles to minimize their carbon footprint and know that they’re eating organic and cruelty-free. More power to them. But there’s another category of people who might raise backyard chickens: poor people.

Someone who’s poor—someone whose budget barely stretches to cover their other expenses, someone who’s on food stamps, someone who uses a food pantry—is another person who might find raising backyard chickens very attractive. Eggs don’t cost much, but someone who raised chickens might be able to save a few dollars a week and get some high-quality protein and have a surplus that they could share or trade. But a $50 entry fee just about blocks this reason to raise chickens.

I guess I’m not really surprised. Local politicians in Champaign have a lot of incentive to help upper-middle class people eat local and organic—those people vote. They probably don’t feel the same pressure to help poor people get a little high-quality food as cheaply as possible, because poor people don’t vote as much—and when they do vote, the legality of backyard chickens probably isn’t a top issue.

It does bug me just a little that Champaign (which thinks of itself as conservative place) has created this whole big-government scheme with forms and approvals and fees and regulations on chicken coops, while Urbana (which thinks of itself as a liberal place) doesn’t have any of that stuff, just a general rule against letting your animals become a nuisance. But that’s just me, asking for consistency from politicians.

So, half a cheer for Champaign legalizing backyard chickens, even if they came up with a way to do it that only helps yuppy locavores and not poor folks.

Would we lose internet service if there were riots?

All the smart folks on twitter have been asking questions along this line. If we had civil unrest, would the government try to cut off our internet access? (I have no doubt that if they tried, they’d succeed. Internet and cell phone providers are regulated companies; they’d roll over in two seconds.)

I think that would be bad.

First of all, it would be unconstitutional. At a minimum, such an action would infringe several first amendment freedoms: speech, press, assembly, and to petition the government.

More important, in a stable democracy like the US, I think internet and cellular service would be at least as much a stabilizing force as it would be a destabilizing force. In the event of civil unrest there would be many powerful voices calling for calm and for non-violence. Shutting off the internet would silence those voices along with the voices of those trying to organize protests.

So, I just sent this note to my congressman, urging him to take steps to protect citizens’ access to telecommunications services:

Prompted by the recent news that the Egyptian government cut off internet and cell phone connectivity for its citizens, it occurred to me that this tool of repression should not be available in the United States.

At a minimum, I urge you to oppose any legislation along the lines of last year’s “Protecting Cyberspace as a National Asset Act,” but I think you should go further.

I’d very much like to see legislation that would specifically bar the government from shutting down internet or cellular connectivity for US citizens, and that would bar telecommunication providers from “voluntarily” complying with “requests” from the government that they stop providing connectivity to persons in the US.

Of course, legal solutions only go so far. They would be much strengthened by technological solutions. Cell phones and internet access points can be designed to mesh with other nearby devices. That would make it vastly more difficult for a top-down order to shut down connectivity—hopefully, difficult enough that governments wouldn’t even try.

[Updated 30 January 2011: Here’s a list of ad-hoc meshing protocols that might serve as a basis for making a top-down shutdown impossible.]