Showing posts with label Richard. Show all posts
Showing posts with label Richard. Show all posts

Thursday, December 9, 2010

Richard (RJ) Eskow: The New Silent Majority

In 2008, Barack Obama said this: "I think Ronald Reagan changed the trajectory of America in a way that Richard Nixon did not ..." He might want to rethink that statement, especially now that he seems to be promoting policies that are opposed by large majorities of the voting public.

Obama needs to channel his inner Nixon, not his inner Reagan. It was Nixon, not Reagan, who tapped the power of the "silent majority" and changed politics for a generation to come. Today there's a New Silent Majority, and it looks very different from Nixon's. The polling results are undeniable: This Majority is looking for somebody to fight the big banks, protect Social Security, and tax the rich to fund government's vital role in society.

Somebody could transform politics with this new majority, just as Nixon did. Somebody probably will.

si·lent ma·jor·i·ty (noun): the ordinary people in a country, who are not active politically and who do not make their opinions known
- Longman Dictionary of Contemporary English

Only 4% of people polled by CBS News after November's election thought that Congress should focus on deficits, and only 2% thought Washington should make taxes its highest priority. Yet those two topics have dominated the debate ever since, all but crowding out the concerns of the majority. Politicians and the media obsessed over them and ignored the topic that 56% of the public considered its highest priority: jobs and the economy.

We've only heard serious talk about "job creation" in the last 24 hours -- and that's in the context of a tax deal! Before yesterday, any attempt to bring up the public's top priority was dismissed by Washington insiders as the irrelevant chatter of marginal extremists. "Stimulus" was a dirty word, not to be spoken in polite company. Now it's on everybody's lips - conveniently enough, just as it could be applied to extending tax cuts for the wealthy. That part of yesterday's deal was opposed by 64% of the American public.

Is it any surprise that over 70% of those polled by CBS were either "dissatisfied" or "angry" with the way Washington works? Neither Obama's base nor his fellow Democrats had a seat at the table when this deal was cut, and that's become a major news story. But seven out of ten voters weren't represented at that table, either. In the long run, that 's a much bigger story.

The New Majority

We won't go through all the numbers and charts again (most of them are here and here.) We'll just stick to the highlights, starting with this one: When asked how we should cut the deficit, the public would rather raise taxes on the wealthy than cut Social Security - by more than two to one.

That includes 71% of independents, 77% of Republicans--and 76% of Tea Party supporters. That's the populist face of the New Silent Majority.

And they really are silent, at least in Washington and on the airwaves. We've just endured a monthlong propaganda blitz, led by hyperbolic Presidential appointees, focusing on a topic that was the priority of less than one voter in twenty: the deficit. And journalists and politicos alike have been pushing the radical right-wing prescriptions of the Simpson/Bowles Commission, whose recommendations made 70% of those polled either "somewhat" or "very uncomfortable." Still, there was no stopping the deafening chant: We have to cut Social Security! We must reduce Medicare benefits! The deficit's our biggest crisis!

There wasn't even a whisper, it seemed, about the Silent Majority's cry for jobs and growth. Then, without even skipping a beat, it was announced that the trillion-dollar tax giveaway to the wealthiest Americans was being extended, adding hundreds of billions to the deficit that had been such a crisis the day before. And what was the sudden justification for this deficit-busting plan? Jobs and growth! Stimulus!

The American majority must be suffering from whiplash. It's not just the sudden reversal on the deficit. Now the story of the day is taxes - which was a top priority for only one voter in fifty.

What else does the "new silent majority" stand for, besides jobs, protecting Social Security, and taxes for the rich?

  • 72% want the government to crack down on Wall Street more than it has.
  • 81% want the government to do more to reduce poverty.
  • Eight out of ten oppose cutting Medicare.

Despite the widespread support for these views by members of both parties (bipartisanship at last!), the political and media landscapes are dominated by journalists and politicians who keep telling us these positions are "extremist" and politically unrealistic.

If this new majority could say anything at all to the nation, it might be "Hello? Is this thing on?"

Nixon's (still) the one

You'd think the President and his party would be all over this. Look what Nixon managed to do, almost by accident: He used the phrase "silent majority" in a 1969 speech about the War in Vietnam, and post-speech polling unexpectedly showed it was a huge hit with the public. Thousands of letters and telegrams flooded into the White House, spontaneous demonstrations broke out on Veteran's Day, and a poll showed a 12-point jump in his popularity, from 56% to 68% - all for a President who had barely squeaked into office a year earlier with 43.3% of the vote (to Humphrey's 42.7% and George Wallace's 13.5%).

Using then-new polling techniques, Nixon was able to identify this majority, appeal to it, and use it to build an unbreakable core of support. While the 1970 Congressional results were disappointing for Republicans, he went on to win a landslide victory in 1972. Even after Watergate discredited him (and to some extent his party), the "silent majority" concept allowed the GOP to build a right-wing public consensus that was unbreakable for a generation. And Republicans didn't just win elections with their Silent Majority: They won huge victories for their political principles, making them the bedrock of public opinion for decades to come. They broke down the liberal consensus and replaced it with their own.

Reagan didn't transform American politics. Nixon did.

Blue Dogma

Historians will marvel someday at our current President's iron-willed refusal to fight for policies that are both widely popular and broadly considered by experts to be the best solutions: stimulus spending to achieve jobs and growth, more regulation to reign in reckless and greedy banking, and ironclad protections for core social benefit plans. They'll wonder why deficits were given higher priority than the bleeding wounds of a jobless economy, while the deficit-busting costs of military spending and an overly privatized health care system were considered off-limits.

Most of all, they'll wonder why a month of deficit frenzy was capped by more of the same tax cuts that helped create those deficits in the first place.

And yet President Obama doesn't just fail to fight for the New Silent Majority and its positions. He gets visibly angry when he's asked about about it. The President known for keeping his cool loses it whenever the subject comes up. Why?

Part of the answer may lie in this line in an article by Matt Bai: "Privately, Mr. Obama has described himself, at times, as essentially a Blue Dog Democrat." I've differed with Bai over his own statements about postpartisanship, but he's a first-class reporter and I'm pretty confident his report is accurate.

Obama's description of himself as a "Blue Dog" feels like a marker for something deeper, a theme that runs through his life and work. Bai summarizes that theme very well. But the President, along with sympathizers like Bai and centrist advocacy groups like Third Way, seems to be falling victim to an illusion. Writes Bai: "The body of Mr. Obama's writing and experiences before he became a presidential candidate would suggest that he is instinctively pragmatic, typical of an emerging generation that sees all political dogma -- be it '60s liberalism or '80s conservatism -- as anachronistic."

That seems to be the essence of some self-image for the President, as well as many of his sympathizers and advisors. But it's a misperception. It's not "pragmatic" to reject positions that are popular with the public are most likely to improve the economy. There's something deeper going on. For the "postpartisans" I've met, and from the postpartisan manifestoes I've read, there seem to be several key elements to their worldview:

  • A strong belief that the best results are achieved by developing consensus among powerful people
  • A profound attraction to the process of consensus-building
  • A disdain for partisan debate, based on an emotional distaste for conflict that's coupled with a belief that "wiser heads" can come to a meeting of the minds
  • A strongly held belief that compromise is morally superior to confrontation
  • Self-esteem that's based on the belief that this style of leadership is inherently superior

Underlying all this seems to lie a deep need to reject the politics of past generations, regardless of whether the politics in question are right or wrong for the moment, in oder to be seen as part of "an emerging generation that sees all political dogma as anachronistic."

dog·ma (noun). something held as an established opinion ... a point of view or tenet put forth as authoritative without adequate grounds.
- Merriam-Webster Dictionary

Why does the President get so angry at "the left" that he insists on attacking it even when it hurts his own interests? Why does he reject opinions held by the great majority, including most Republicans, with disdainful terms like "sanctimonious"?

Remember, Nixon shattered the Democratic Party by linking them to "hippies." Most Americans hated longhaired demonstrators, and Nixon used that hatred to crush liberalism. But being associated with these despised, scruffy peaceniks didn't just defeat the Democrats: It traumatized them. They were painted a fuzzy-haired members of a pointy-headed elite, and it took them generations to get over the shock.

Apparently some of them still aren't over it.

Oldies

When Bill Clinton shook the hippie curse and gave Democrats their cojones back, it made sense. He backpedaled on some core Democratic positions and adopted the posture that a technocratic, bipartisan approach was the best way to solve our problems. Back then, there seemed to be a nonpolitical consensus on what was needed: Less regulation, less government, and more reliance on the "creativity" of the private sector (especially banking).

How'd that work out for you? Like we were saying, it made sense ... back then.

Bashing "the left" was a smart political strategy for Democrats when longhairs were chanting for peace in the streets (RIP, John Lennon). Maybe that's why bloggers describe this kind of left-bashing as "hippie punching." But the hippies are gone. Everybody else has moved on. Nobody's thinking about "hippies" anymore, or even about anything called "the left." They're just wondering how to pay their bills and survive their old age in a world they're increasingly likely to see as Obama's creation.

And they will see it as Obama's creation. That may or may not be fair, but think about it: How many Republicans were on TV last night pitching this deal?

Meanwhile, the New Silent Majority remains silent and unrepresented in the halls of Washington. It's as if some people are too busy fighting with the phantoms of "the left" to see that times have changed. The hippie wars are over. Who's "anachronistic" now?

The North Star

What do you do when the nation's leadership see bartering with Washington power brokers not merely as a political necessity, but as a superior way of being? Voters have seen the end result of this "way," and they don't like it. People are waiting for the President to remold the Washington consensus into something that serves their interests. If compromise does that, they want compromise. If it takes a bar fight, then they want a bar fight.

But the "postpartisans" have elevated compromise from a tactic into a moral principle. That can leave them paralyzed when compromise becomes impossible, as it has now. Fortunately, there may be a way out. And the President touched on it last night, with a passing phrase that was striking and evocative. Where, a reporter asked, is your "line in the sand"?

"My job," he answered, "is to make sure that we have a North Star out there. What is helping the American people live out their lives? What is giving them more opportunity? What is growing the economy? What is making us more competitive? And at any given juncture, there are going to be times where my preferred option, what I am absolutely positive is right, I can't get done. And so then my question is, does it make sense for me to tack a little bit this way or tack a little bit that way, because I'm keeping my eye on the long term and the long fight."

The North Star is a lovely image that evokes something important. It suggests that every political tactic must be illuminated by core set of values and goals, a set of beliefs that make up a glittering pole around which all action revolves. Stars like that have guided political debate for centuries. Some people even have a name for that kind of compass: they call it a "dogma."

If the President can let go of his attachment to his postpartisan self-image and embrace the policies most Americans want and need, they can be his North Star. But to do that he'll need to get over his reflexive distaste for the "old dogma" of the "left," because that old dogma also happens to be the new political reality.

Or, as seems more likely right now, he could keep fighting the battles of the past. His own ideology may be too centrist (that is,conservative) for the times. Or he may not have the temperament for the battles he'd have to fight. If that's true, the New Silent Majority will look elsewhere. The Right hijacked part of it this year, and it's ready to do it on an even bigger scale next time.

Whatever happens, 2012 is coming and The New Silent Majority is looking for its leader. And just in cause you hadn't noticed, the auditions have already started.

________________________________________________________


(There's good reference material on Nixon and the "Silent Majority" in Nevin, M. D. , 2007-04-12 "The Making of the Silent Majority: Nixon, Polling, and Constituency Building" Paper presented at the annual meeting of the Midwest Political Science Association, Palmer House Hotel, Chicago, IL Online . 2010-01-24 from http://www.allacademic.com/meta/p196625_index.html)

Richard (RJ) Eskow, a consultant and writer (and former insurance/finance executive), is a Senior Fellow with the Campaign for America's Future. This post was produced as part of the Curbing Wall Street project and the Strengthen Social Security campaign. Richard also blogs at A Night Light.

He can be reached at "rjeskow@ourfuture.org."

Website: Eskow and Associates

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Friday, November 19, 2010

Richard C. Senelick, M.D.: Angry Patients Make Angry Doctors: Tips for Coping With the Stress of an Emergency

What happens when disaster strikes? No one goes on the Internet and orders up a stroke or brain injury. It's not something that you plan for or are prepared to cope with. As health care professionals, we deal daily with families who are angry because they didn't ask for this tragedy and are having a very difficult time dealing with it. We too are under unusual stresses with our autonomy taken away and the confines of payers (insurance companies) restricting us in ways we may feel unreasonable. Just like the families in distress, health care professionals feel a loss of control. The people who successfully navigate these events can turn a negative experience into something positive.

We know Sarah Brady had to be very angry when her husband, Jim, was shot during the assassination attempt on President Reagan. However, from this she and her husband became the leading advocates for gun control and eventually saw the Brady Bill passed. The anger was turned around into something constructive.

Patient Stories
Frequently, we just see and hear the anger, but don't really hear the story or the feelings behind the rage. Ellen had a brain injury eight years ago and she recalls: "The clock just stopped ticking the day I was injured. I no longer felt connected to my family, my friends or my job. I looked around at my family and they were all angry, but I couldn't remember the accident, so I didn't know what to be angry about. I feel an enormous loss of who I was, what I had and what I might have become. But, my family has other feelings. They are angry at the person who caused the injury. They seem angry that I don't try hard enough to get better. They get angry and embarrassed by my behavior. And, they get angry at the lack of financial resources and the poor service of the health care delivery system. My doctor thinks my parents are unrealistic and that we need to be more accepting of what my futures looks like. Everybody just seems upset and distressed."

Her doctor is upset. He's busy, having to see more patients in the same day for less money. He can't just order the tests that he wants because he has to ask permission. Ellen's family is constantly calling with the same questions and they just "don't seem to get it." "Why don't they just accept the way things are and make my life easier?" On a particularly bad day, Ellen's father suggested that her doctor didn't care enough and that he was having a lawyer look into the case. The usually patient doctor lost it, yelling at Ellen's father and telling him to get a new doctor if he didn't appreciate what he was doing and particularly since he had mentioned the "L-word," a lawyer.

Ellen's family and the doctor's reaction are not unusual. They are both dealing with real losses. Mothers tell me constantly how they look at their injured child and know it is someone that they love deeply, but that the person they are taking home from the hospital after a brain injury is someone else. They have lost part of the person who used to be. Both the family and the doctor have lost control of the situation and both are angry.

2010-11-15-ANGERSHUTTER1.jpg


Why Are They Angry?

  • Both have a perception of having lost control of the problems that are causing them distress. Families may feel swept up in a system that doesn't care or can't make their child better. Doctors share the same concerns and frustrations, having to adapt to a new way of delivering care that seems to move them out of a position of control.

  • Parents may feel responsible that a child had an accident. A wife may be angry with the patient for getting sick. A husband is mad because his wife is not supposed to get sick. The doctor is upset because she has done everything she knows to do and the patient isn't improving. She's not used to being a target for people's anger and wants to be the recipient of their praise for a job well done.

  • Society gets angry for having to deal with difficult people who can't just fit into the system. Look at the anger of employers towards the American's with Disabilities Act. Why should I have to make concessions? Is it my fault that Ellen is different?

  • Families and patients are angry with a public that tends to patronize the disabled and look at them as "less than whole." I have parents who want to put a sign on their disabled child that says, "He is not retarded!" This, in and of itself, reveals their own prejudice toward our citizens with mental handicaps. It is not easy.

  • Everybody is troubled by the "miracle stories" that show up on the front page of the newspaper tabloids and on the latest television gossip shows. Health care professionals resent the "false" expectations that are being set. Families are particularly upset because the miracle didn't arrive at their home.


Coping With Anger
Iris Dement, one of our most soulful singers, wrote a song that could be the anthem for patients and doctors: "Easy's gettin harder every day." Ms. Dement can be hard to reach, so I sat down with Hal Hoine Ph.D., Director of Rehabilitation Psychology at the Rehabilitation Institute of San Antonio (RIOSA). Although Ms. Dement clearly identifies the problem, Dr. Hoine gives us ways to cope and deal with our anger. In particular, health care professionals need to realize that these strategies also apply to them, not just to patients and families.

Take Control
People have the perception of having no control and being attacked. You need to identify those things that you can control, make a list of those things that fit into two columns -- those things you have control over and those you don't. Identify strategies to get input into the system. Education and information are power. Families and professionals are helpless when they don't understand what is going on and don't know how to access the necessary tools to manage a difficult situation.

Illogical Thinking
Under the enormous stress of terrible tragedies, we don't always think logically. We feel responsible for events when we are not. The parent didn't cause the accident and the doctor is not responsible for an insurance plan that doesn't provide adequate coverage. Talk about the anger. Identify the sources of distress. Help all involved to think logically about an illogical circumstance. Frequently no one is to blame. Rabbi Kushner wrote the wonderful little book, "When Bad Things Happen to Good People." It is natural to shift blame to a God who doesn't care, a doctor who is inaccessible, or an insurance plan that is heartless. It is natural to shift blame, but not constructive. We need to acknowledge self-responsibility and the difficulties it proposes.

The White Coat
As health care professionals we frequently hide behind the white coat and feel that it allows us to be immune from the wrath of angry families and patients. It should add responsibilities. Health care professionals need to listen and let their patients and families ventilate. Never argue! We want to talk angry families out of their position and convince them that we are right. The younger the doctor or therapist the more difficulty they have in this role. This is not a contest. The white coat comes with an obligation to absorb the abuse and anger. When the angry family refuses psychological help or counseling, we accomplish nothing by abandoning them or getting angry ourselves. Continue to listen, encourage the patient and family to gain control and continue to constantly educate them. Understand your own feelings when a patient or family ventilates and gets angry; remember that you are the outlet for their anger. If the doctor or therapist is having difficulty controlling their anger, they should seek help. There are seminars and courses for professionals. We frequently ask the family to seek help, but how often do we seek it for ourselves?

Maintain Hope
It's like walking a tight rope or precipice at times, maintaining hope while trying to give patients and families a realistic view of the future. It's hard work for everyone, holding on to hope can be essential, but difficult. It's our job to intervene at the person's current level of distress and disturbance, understanding not only their feelings, but our own. Control the anger.

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