6. Life in the Age of Coronavirus, a California Perspective Part I: The Public Health Meltdown and Political Dysfunction

This is the first in a series of essays from a California perspective on the challenges and opportunities presented by the Covid-19 pandemic and lockdown in five key areas: (1) public health; (2) politics; (3) the economy; (4) climate change; and (5) US-China relations.

Several weeks into the Covid-19 pandemic and lockdown, it appears that America may never return to the same normal as before. Whether life in America AC (After the Coronavirus) is better or worse than life in America BC depends on the choices that we make, individually and collectively, from now on. America is facing an existential crisis the likes of which we have not seen since World War II,  maybe since the Civil War. Politics as usual will no longer suffice. A fundamental restructuring of our priorities and our politics is needed to address the crisis and its aftermath.

Over the next few weeks, I will be posting a series of essays on the lessons, challenges and opportunities presented by the concurrent crises in public health, politics, the economy, climate change, and US-China relations. To paraphrase Winston Churchill, we must not let these crises go to waste. Let’s start where the crisis began with the public health meltdown.

Crisis Number 1. Public Health Meltdown

Whether measured against expectations or compared to other developed nations, America has performed surprisingly poorly during the Covid-19 pandemic. Taking cues from the President, America wasted precious time in denial after the initial outbreak of Novel Coronavirus in Wuhan, China in early January and the first known coronavirus case in the U.S. in late January.

It did not help that the Chinese government did everything in its power to hide the truth of the outbreak’s severity until the magnitude of the disaster was too big to hide or that it allowed wet markets selling bats and other exotic wild animals that spread novel diseases in the first place. Yet public health and national security officials alerted the President and his advisers months ago about the urgency of the situation to no avail. In December 2016, outgoing President Obama briefed incoming President Trump and his transition team about a possible pandemic. But Trump either didn’t listen or didn’t understand. Shortly after taking office, he eliminated the White House and National Security Council (NSC) teams dedicated to managing pandemics and sharply reduced the budget of the Centers for Disease Control and Prevention (CDC).

In the first few days after being briefed about the outbreak in Wuhan, President Trump took advice from his remaining public health experts seriously enough that he issued a partial travel ban from China, just the type of executive action he is keen to adopt for every policy problem. Unfortunately, his limited understanding and leadership took a back seat to his petty narcissism and theatrics thereafter. Moreover, the partial China travel ban proved largely ineffective as recent studies have revealed. First, it did not prohibit Americans from returning to the U.S. from China even if they had been exposed to the virus. Second, due to lack of testing, we did not become aware until recently that the likely source of the nation’s worst outbreak in New York was a virus mutation from Europe, not China. 

Instead of following up the China travel ban by mobilizing the country to do testing and preparing hospitals for the onslaught of coronavirus patients to come, the President downplayed the crisis. Instead of spending the precious two-month lag between the virus’s peak in China and its spread to America to procure millions of Covid-19 test kits, and thousands of ventilators and personal protective equipment for health care workers and first responders by exercising the emergency powers of the Defense Production Act, the Administration sat on its hands. Instead of clear national messaging emphasizing the need for social distancing, as South Korea, Singapore, Taiwan, and Japan managed their crises to alleviate the need for more drastic economic measures, the President made matters worse by alternately questioning the severity of the crisis or falsely claiming it would all go away soon enough.

As late as the first week of March even while preparing for a partial travel ban from Europe, then White House Chief of Staff Mick Mulvaney and other Trump loyalists disputed the very existence of a pandemic - calling it a political hoax by the fake news media and Trump’s liberal enemies to defeat him in November. The President even toyed with the idea of keeping Americans on cruise ships from coming onshore for urgently needed health care because he didn’t want their cases and deaths to count against the U.S. coronavirus totals. By Easter Sunday a month later, the U.S. has 555,000 confirmed cases (31% of all cases worldwide) and 22,000 deaths, the most of any country and climbing. A Columbia University study estimates that due to low rates of testing and the absence of symptoms in most people who have the virus, the actual number of cases is probably 11 times greater (six million).

The President exacerbated an already under-prepared health care system by alternating between denial and incompetence, depending on his mercurial mood or his latest midnight tweet. After appearing at one press briefing with Dr. Anthony Fauci, head of the U.S. National Institute of Allergy and Infectious Diseases and the nation’s leading expert on pandemics, to emphasize the gravity of the situation, he abruptly changed course at the next one, saying we were overreacting – that the cure might be worse than the disease. Without benefit of data or scientific evidence, he mused openly about limiting federal social distancing guidelines to two weeks, allowing Americans to return to work and congregate together in churches by Easter.

But as the number of confirmed cases and the death toll spiked in late March, White House coronavirus task force coordinator Dr. Deborah Birx conceded that even under a best case scenario where the whole country shelters in place for one to two months, the U.S. would still likely suffer between one and two hundred thousand deaths by August. More pessimistic scenarios showed a range of one to two million deaths. With nowhere to hide, the President changed his mind yet again and decided social distancing was probably here to stay through the for a few weeks or months. Maybe, just maybe, he was starting to understand the reality that the economy will not recover until we get the coronavirus under control.

Yet remarkably, the President faults everyone but himself, refusing to acknowledge any responsibility for the inadequate federal response or even the importance of having a national response despite commandeering the daily coronavirus task force briefing and turning it into a combination reality TV show and campaign rally. Apparently, he does not understand that when President Truman said “[t]he buck stops here” he meant that the President not only has to make decisions but also accept the ultimate responsibility for those decisions or the failure to make decisions. Instead, Trump singles out particular states for praise or condemnation like Caligula ruled Rome, dangling ventilators, personal protective equipment (PPE) and other medical supplies in front of governors as carrots and sticks depending on how much they praise or criticize him.

With little help from the President, America has responded on a piecemeal basis, state-by-state and region-by-region, until social distancing eventually has become commonplace in most of the country. Recent statistics prove that the states and regions where distancing measures were introduced sooner have been more successful in flattening the curve of new cases compared to lagging states. California Governor Gavin Newsom was the first to issue a statewide stay-at-home order, and most states starting with Washington soon followed to the benefit of their residents, while other states dawdled.

Surveys have shown that people’s opinions about the severity of the health crisis have unfortunately broken down along political lines, with a significantly higher percentage of Democrats willing to accept the recommendations of public health authorities about the severity of the epidemic, compared to Republicans. Of course, some of this difference in attitude can be explained by geography. Statistically, Republicans tend to live in more spacious rural and suburban areas that are not at as high at risk of spreading the infection as more congested urban areas where Democrats predominate.

Some of this difference can also be explained by the President’s efforts to downplay the health threat and to worry more about the economy. How else to explain that most of the laggard states were led by Trump loyalists, exemplified by Florida Governor Ron DeSantis and Georgia Governor Brian Kemp who awaited a signal from the President to inoculate them from criticism on the right for issuing statewide stay-at-home orders. Not until the number of coronavirus cases and deaths exploded in their states did the President finally give them the political cover to act. To justify his inaction, Kemp claimed he didn’t know until the first week of April that Covid-19 could be spread by people who were asymptomatic, a fact that just about every other literate American has known for two months. This flimsy excuse suggests either an outright coverup or extreme ignorance borne of blind allegiance to the anti-science rhetoric of Trump cultists and too many Republican elected officials.

This kind of politicking has a real cost in lives. Consider the impact of divergent actions taken by the governors of two similar, neighboring states - Kentucky and Tennessee. Kentucky Governor Andy Beshear was one of the first to issue a statewide stay-at-home order while Tennessee Governor Bill Lee was one of the last. Kentucky has one of the lowest per capita rates of coronavirus in the nation while Tennessee has nearly double Kentucky’s rate. Things may get even worse for states that lagged because confirmed cases lead to hospitalizations and deaths that won’t show up in the statistics for weeks. And for the poor folks who contract the disease, Kentucky is one of the few red states that opted for Medicaid expansion under Obamacare. Alas, Tennessee is one of 18 red states that has not. Based on initial data, it appears that lack of healthcare insurance may be a factor in the significantly higher rates of Covid-19 cases and deaths among poor and minority populations.

Fortunately, not all Republican governors followed the dubious lead of Tennessee,  Georgia, and Florida. Notably, Governors Mike DeWine of Ohio and Larry Hogan of Maryland have shown tremendous leadership in their respective states. Moreover, not all Democratic officials have covered themselves with glory. New York City Mayor Bill DeBlasio reacted much more slowly than the San Francisco Bay Area and Seattle, two metro areas that were confronted early on with a spike of coronavirus cases but were more successful at bending the growth curve to avoid the mayhem seen in other cities. Of course, density and other factors undoubtedly play a role as well.

Federalism is no excuse for the appalling lack of presidential leadership and the federal government’s failure to lead a planned, coordinated response to a public health emergency. The nation’s relatively swift response to past pandemics such as Ebola, SARS, and swine flu shows that we are capable of performing better even under our piecemeal federalist system. However well our public health system has performed in the past, the Covid-19 crisis has exposed the current system as woefully unprepared and under-resourced, a situation compounded by relentless Republican efforts since Reagan to gut and discredit most federal programs other than the military. The right-wing tendency to deny scientific consensus whenever it suits their political interests has now culminated in a president whose deep aversion to independent professional expertise throughout the “deep state” is exacerbated by his willingness to appoint unqualified, incompetent, and/or self-dealing sycophants to replace them.

But aside from the fixable flaws of our emergency response system, it is this nation’s singular failure to establish universal health care for its citizens that continues to stand out among all developed nations. Democrats and Republicans have battled over healthcare for 60 years, first over Medicare, then Medicaid, and more recently over universal coverage. When Obama was elected in 2008, his highest priority legislation aside from the economic recovery following the 2008 Great Recession, was to expand healthcare coverage. In 2009, Congress debated three primary healthcare strategies to achieve universal coverage: (1) regulating the existing employer-based, private healthcare insurance system to cover more people and provide better coverage; (2) offering a public option in addition to private insurance by extending Medicare to people under 65 and/or expanding Medicaid benefits; and (3) the single payer “Medicare for All” system, which in its “purest” form advocated by Senator Bernie Sanders would replace all private health insurance with a federal government-run healthcare program.

Although most Republicans followed then Senate Minority Leader Mitch McConnell’s pledge to block any and every thing that Obama proposed, some Republicans initially engaged with then-majority Democrats in a policy debate over the first option, particularly since it originated as a Republican policy alternative to the public option back in the 1990s when First Lady Hilary Clinton led the Clinton administration’s healthcare reform effort. In fact, future Republican presidential nominee Mitt Romney had signed similar legislation called “Romneycare” when he was Governor of Massachusetts.

In the end, the Patient Protection and Affordable Care Act of 2010 (commonly known as “ACA” or “Obamacare”), passed Congress without a single Republican vote. With the exception of the individual mandate, it has endured for 10 years despite numerous partisan court cases seeking to overturn it. The Supreme Court’s 2012 decision to uphold Obamacare on a 5-4 vote is certainly not guaranteed given the two Trump appointees to the Court since then. However, most of the key provisions of Obamacare, particularly the prohibition on insurers’ denying coverage for preexisting conditions, the retention of children up to age 26 on their parents’ policies, the minimum coverage requirements for essential health services, vaccinations, preventive exams, and screenings, the prohibition of annual and lifetime coverage caps, federal subsidies for lower income people, and Medicaid expansion, have now become widely accepted and would be very difficult to remove, both politically and economically.

As a result, Americans benefit from better coverage during the current health crisis than they would have 10 years ago. Nevertheless, the system is still largely employer-based and with millions of Americans now unemployed, that is a big problem. There are a number of other significant problems and loopholes, not the least of which is that prescription drug costs have skyrocketed over the last 10 years.

So, what should be done?

First, we should start by electing a new president and congressional majority who are willing to learn from our unpreparedness for this pandemic and to plan and prepare a more urgent and coherent national response.

Second, we should empower a panel of independent medical, national security and economic experts to perform a rigorous post-mortem of America’s inadequate response to the crisis to provide the new President and Congress with the analytic data and recommendations they need to equip the CDC, hospitals, medical providers, and other agencies with the tools and resources they need to treat the ill, bend the curve, and test, trace, and track cases to mitigate future crises. There should still be room for flexibility for state and local responses, but those decentralized responses should be aimed more at executing and fine tuning the federal plan and developing innovations, rather than substituting for the lack of federal leadership. With a viable national plan in place and all fifty states working together as partners rather than competing for ventilators and PPE, we could then enlist the private sector in a more targeted way to partner with government to develop effective and innovative solutions.

Finally, we must transition to universal health care. America can no longer afford to be the only developed nation without universal health care. With a new President and Congress in place after November, the only question should be whether to adopt the public option or a Medicare for All plan. Let’s have a good strong debate for several months, culminating in the passage of legislation a year from now that adopts a path forward, including a transition plan.

Crisis Number 2.  Political Dysfunction

The coronavirus and lockdown have also laid bare longstanding cracks and fissures in America’s constitutional foundation eerily similar to the circumstances at the heart of my novel, THE BLUE SKY REBELLION, published last fall. In the novel, America’s existential crisis is caused by climate change, terrorism, and an economy in free fall, rather than a pandemic and lockdown, but the dysfunctional nature of national politics is the same in fact and fiction. In both cases, politicians skilled at playing upon voters’ worst instincts have learned to manipulate a dysfunctional political system straining at its limits to govern a diverse twenty-first century population of 330 million people spread across the continent under a Constitution that hardline conservatives believe should be strictly interpreted by eighteenth century standards—when four million mostly English descendants plus slaves lived along the east coast and only white men voted.

At the heart of THE BLUE SKY REBELLION is the notion that our two-party system, which is not required but is enabled by America’s winner-take-all electoral system, is a big part of our problem. Perhaps it is time to reboot the Constitution to provide the legal and political tools necessary to solve twenty-first century problems and reshape American politics by synthesizing the best of the Democratic Party’s principles of equal opportunity, human rights, shared responsibility, and respect for nature, with the Republican party’s traditional emphasis on individual liberty, free trade and free market principles. In short, we need all Americans working together to form a more perfect union.

Why is America’s constitutional framework failing?

In the current crisis, the failure of presidential leadership has exacerbated our nation’s piecemeal, state-by-state approach to emergency response. But even before the current crisis and long before Russian bots intervened on social media to disrupt the 2016 election, Americans were losing faith in their government. Presidential elections, in particular, are no longer representative or democratic. With each succeeding election, the presidential campaigns focus more and more on a handful of  “battleground” states, relegating most of the country to secondary status. Why? Because the public does not directly elect the President. Even though nearly three million more people voted for Hillary Clinton, the popular majority is stuck with Donald Trump because of a Rube Goldberg contraption of a voting system created 240 years ago as a compromise with rural, slaveowner states who were worried about the more populous North banding together to elect a President over the South’s objection, and maybe even voting to take away their slaves.

Second, although the nation’s voting systems and procedures vary wildly from state to state, they invariably produce low voter turnouts and election results that are at risk for computer hacking and corruption. Laws and customs such as burdensome and unnecessary voter identification requirements, holding Election Day on a Tuesday when many poor and working-class people have a hard time getting to the polls, gerrymandering legislative districts for blatantly partisan purposes, and prohibiting convicts from voting, combine to suppress voter turnout in general, but have a disproportionate and discriminatory effect on Black and Hispanic voters, in particular.

The Wisconsin primary election on April 8, 2020 registered a new low in the pantheon of voter abuse - denying voters a chance to vote by mail and forcing them to choose instead between their health and standing in crowded lines at understaffed polling places during the height of a pandemic. With social distancing likely still required or advised in the general election in November and with postponement not a viable option as it was in the spring primaries, it will be even more important to move to voting by mail as the primary method of voting. We cannot afford to see the fictional postponement of the presidential election from THE BLUE SKY REBELLION become a reality.

But those are not the only flaws in our electoral process. The two-party, winner-take-all system has often stifled the best candidates from stepping forward and has tended to squash compromise or moderate candidates.

Third, Citizens UnitedBuckley v. Valeo, and other Supreme Court decisions have struck down all attempts to place monetary limits on campaign contributions and spending, allowing large moneyed interests to effectively buy elections. Money should not equate to speech. Every mature democracy save ours has found a way to stem this kind of undemocratic power. Our political cronyism has more in common with the oligarchies of Russia and Hungary.

Fourth, too many politicians reject science and expertise, especially when it comes to climate change, foreign policy, military intelligence, and public health. This failure is particularly apparent on the Republican side, but some Democrats also ignore scientists and experts on other issues when it is convenient to do so.

Finally, there is an increasing lack of civil and intelligent discourse of ideas, which has been exacerbated by the increasing appearance of “fake news” and the decreasing tendency of the mainstream media to do their job. The media do not fact check often or timely enough and frequently draw false equivalencies in the name of "balance".

What can be done to solve these problems?

First, we should adopt an Equal Rights Amendment to guarantee equality under the Constitution regardless of sex. This has little to do with the current pandemic aside from the fact that a majority of the population is female, but it is critical, nevertheless.

Second, we urgently need electoral reform, starting with dumping the Electoral College in favor of a national popular vote for President. We should eliminate party caucuses and require direct primaries in all states, which should be uniform from state to state and run by region, rather than allowing Iowa and New Hampshire outsized influence. This year’s Democratic primary in particular showed the Iowa caucus and New Hampshire primary to be a colossal waste of time. Other examples of urgently needed voting reforms and security measures include holding Election Day on a Saturday or Sunday or making Election Tuesday a holiday; establishing absentee and early voting as the norm throughout the nation; shortening the election campaign season and ensuring equal time for candidates who reach a minimum level of support; establishing a national threshold to ensure every state meets certain minimum requirements of election security and efficiency; and increasing the Justice Department’s monitoring and oversight duties to act swiftly to eliminate voter suppression programs wherever they rear their ugly head. Of these reforms, only the elimination of the Electoral College requires a Constitutional Amendment; the others just require common sense. Even the electoral college change could be achieved without a constitutional amendment if enough states sign on to the multi-state compact to award all state electors based on the results of the popular election.

States should also take advantage of our federalist system to be more proactive in experimenting with other electoral reforms. For example, California and other states have proven that citizen involvement in the drawing of legislative districts help moderate the more extreme and anti-democratic elements on sides of the aisle. In California and other states, voter initiatives have instituted other measures such as open primaries that allow candidates to run for a particular office without respect to their party affiliation. Open primary voting has long been used in City Council and local elections because it tends to elect more moderates and less partisan extremists and to reduce the rancorous partisanship so evident in Congress. Florida and other states have tried to broaden the electorate by passing voter initiatives to allow voting by felons, except those convicted of heinous crimes such as murder and rape. It is ironic that a criminal conviction does not preclude someone from running for president, yet it prohibits most felony convicts from exercising their sacred right to vote. Public funding of campaigns has also been tried in a number of states to partially offset the influence of special interests in politics.  

Another idea used in Oakland, San Francisco and many other cities, is Instant Runoff Voting, which replaces the primary and general election cycle with a single vote in which people rank the candidates in order of preference (or just the top two). Ballots are initially counted for each elector's top choice only. If no one wins 50 percent on that count, then the last candidate is removed and the ballots recounted to see if anyone wins 50 percent, and so on until there are only two remaining, as needed. Abraham Lincoln was nominated for President at a Republican convention using a similar system when no one got 50 percent on the first two ballots. States could also look to France, England and other European countries for an alternative winnowing process in which the runoff election between the top two candidates is held just weeks after the primary election, thereby shortening the election season and the opportunity for mischief.

Third, we should place monetary limits on campaign contributions and spending. If the U.S. Supreme Court does not overturn the Citizens UnitedBuckley v Valeo, and other court decisions that invalidated legislation placing monetary limits on campaign contributions and spending, we should do so by constitutional amendment. Money should not equate to speech and corporations are not voting citizens.

Fourth, we should amend the Second Amendment to remove the confusing language about militias while reaffirming the right to keep and bear arms as a conditional right, subject to reasonable regulation of guns and ammunition ownership, use and sales by the states and federal government to protect public health and safety.

Fifth, we should expressly include in the Constitution certain inalienable rights and duties to respect our fellow human beings which have been historically protected by the Supreme Court but sometimes placed in jeopardy. For example, the fundamental human rights to privacy, health, and safety trace back to well before the Declaration of Independence and have been expressed in countless statutes, regulations, policies, and judicial decisions since the founding of the Republic. President Franklin Roosevelt’s ardent defense of the “Four Freedoms” (freedom of speech and religion and freedom from fear and want) in his 1941 State of the Union address became the theme of the Allied World War II campaign and formed the basis of the Universal Declaration of Human Rights adopted unanimously by the UN General Assembly in Paris in 1948. Equally important, the duty to respect nature and manage all living species and natural resources in a sustainable manner, which grew out of the environmental movement and was reinforced by the growing threat of climate change, has been adopted by virtually all nations of the world. The UN’s “Millennium Declaration” listed humanity’s primary values as freedom, equality, solidarity, tolerance, respect for nature, and shared responsibility.

These measures alone would not solve all of our nation’s problems, but they would help create a political environment more conducive to solving the complex problems America faces in the 21st Century.