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We Saw The Limits

by Dr. Sandro Galea

April 2, 2020

This interview with Dr. Sandro Galea, a professor and Dean of Boston University School of Public Health, was conducted and condensed by frank news. Follow him on Twitter: @sandrogalea.

We spoke with a doctor [Dr. Michael Brumage] earlier this week working in West Virginia – he described what was happening now as evidence of a societal failing and undervaluing of public health.

I couldn’t agree more.

When we say public health, what do we mean?

I think we mean two things here. I think we mean the functional, operational mechanics of the public health infrastructure. By that I mean how city, state, and federal agencies work and interact together – and have suffered from decades of underinvestment.

With this crisis, we saw the limits of our public health infrastructure that we have underinvested in for decades.

The second part of it is public health is about health, and the health of the world around us. It's about your health and how that might help our health collectively. And it's about creating a world that generates health to build a world where we have safe housing, good schools, clean air, drinkable water, livable wages, fair economies, gender equity. These are all forces that ultimately drive health. And we have deprioritized these forces because we have focused our health thinking on a very individualized biomedical approach. This failure shows our disengagement and disinvestment from public health at both these levels, both the more mechanical core functions of public health, and the creating a healthier world aspect of public health.

Right. We need to look beyond healthcare and healthcare institutions.

Exactly.

You mentioned the coordination between hospitals, state, local, and national. How is responsibility managed and tasked both in and out of crisis? How do you help those in charge at every level?

Collectively, we need to keep reinforcing the messages of public health. Public health should be about all of us paying close attention to the foundations that generate health.

Public health should be about a relentless focus on the importance of health for all.

I think the way to do that is by being clear about the message. This is not a one off pandemic. There will be other pandemics. The only thing we don't know is when and where, but there will be others. There have been others in the past, and there will be others in the future. If this is not a wake up call for us to create a healthier world, I'm not sure what it is.

What do we know for sure we need to do to take care of the most vulnerable populations?

There's a lot to do for the care of a lot of our most vulnerable populations. We need to make sure we are paying attention to the homeless, to the low income populations, those who have unreliable sources of income, those who are in prison, and our immigrant population. And each population requires different solutions. The health equity approach means not doing the same thing for everybody, but actually paying particular attention to what needs to be done for those who are most vulnerable.

Right. This virus has made it exceedingly clear that we are only as healthy as our least healthy populations or people.

Exactly. I think that this teaches us that there is no such thing as health for one, without health for all. Health ultimately is a public good, whether we like it or not. Seeing health as a private commodity, as something that you can buy and sell, fails. Because what you can buy is healthcare, and healthcare can only help us if we're already sick. We need to move to a health system, not the sick care system. To do that, we need to invest in the infrastructure that builds health.

Do you think that the stimulus bill that was just passed does what it needs to do?

I think it's a good first step. It has provisions for individuals, for small businesses to keep people employed, and for unemployment insurance. A lot of these provisions will depend on how they're implemented. However, the stimulus bill doesn't at all affect those who are living on the margins. For example, the unemployment insurance does not affect those who do not file tax returns. Twenty percent of Americans don't file tax returns. It doesn’t do anything for you if you're an immigrant living in this country and you're undocumented. I understand why that is the case from a political perspective, but we should be clear that this is a first step. It’s a good first step from where we need to be, but it’s a first step.

I mean, 3.3 million people filed for unemployment yesterday. That was an extraordinary order of magnitude, higher than the highest at the peak of unemployment during The Great Recession. This shows that the people who are losing their jobs are low income people who already had no savings. These are people who were already living on the margins, and these will be the people who are going to be affected hardest by this.

I read something you wrote recently that addressed the mental health component of all of this. You wrote, “first it's important to disseminate accurate up to date information on COVID19 to counter the misinformation that can lead to undue fear.” What pieces of information right now are critical? Beyond what I feel is necessary, I’m also consuming a lot of information that might not be. When is it enough?

I think it's important to try to keep yourself informed, but I also think there's been a lot of information, much of it inaccurate.

People need to be sure they are listening to sources they trust, and sources that are reliable. It is up to the individual in some respects to identify sources that they consider to be reliable. But I would encourage people to, as much as possible, not filter through information, to go to sources whose biases they understand, and who they think are reliable and who are trying to help educate the public through a combination of science and reason, with a very clear moral purpose to generate health for all.

Do you have recommendations on an individual level for mitigating the difficult mental health components that come with this?

Yes, absolutely. I think that, number one, people need to stay connected in this time of physically and socially distancing as much as possible. People need to maintain a community of their friends, their loved ones, and their workplaces. Number two, people need to be educated and realize that symptoms of depression and anxiety are common at a time like this. We need to be educated and aware of the challenges that those symptoms can pose. Number three, people need to be able to go to a health provider to get help if their symptoms start to impair their ability to get on with their life. Number four, I think people need to maintain healthy routines. People need to continue to exercise, to continue to maintain daily routines.

You spend your life in public health, do you see a way out of this? I think a lot of the anxiety is that it's all indefinite.

I mean, by the grace of God we will emerge from this and we will survive. I think that the key question is how we deal with the long term consequences of this. The long term consequences are going to be very much consequences of the economic slowdown and the people who are affected by that. Number two, how do we make sure that when the next pandemic hits, and it's good to remember that there will be a next pandemic, right? There will be. The question will be have we learned our lesson and built a world that's better able to handle a crisis.

I would go back to these two pillars that spoke about at the beginning of this interview. One is the, the actual public health mechanics of dealing with the pandmeic. And number two is creating a world that is resilient that has the pieces in place so that we are healthier. Those are the questions.

Right. And you're hopeful?

I prefer optimism. I think optimism is a form of resistance in the face of dark times. So yes, I am optimistic.

Voting in Wisconsin

by J.B. Van Hollen

October 27, 2020

This interview with J.B. Van Hollen, the Republican Attorney General of the state of Wisconsin from 2007 until 2015 and cochair of VoteSafe Wisconsin, was conducted and condensed by franknews.

J.B. | In my role as Attorney General, I took the significance of elections and voting extremely seriously. I made sure that our ballots were as secure as possible to ensure that we didn’t have voter fraud, and also to give everyone who is entitled to vote, an opportunity to vote.

VoteSafe is a national organization. I was asked to be co-chair of this coalition along with the current Attorney General of the opposite political party, Josh Kaul. We have many active and outspoken Republicans and Democrats that are a part of our organization. VoteSafe was formed to be a bipartisan voice to encourage people to vote and to inform them of how they can do so in a safe and secure manner.

The Wisconsin primaries were a rough trial run of voting during COVID. What did Wisconsin install to ensure there is a difference between the primaries and the general?

In-person polling places have done a good job of implementing separation and sanitization. They let one person into the polling place at a time, and that person votes on their own. Once they're gone, workers will sanitize the polling location. Everything that was touched or close to the previous voter will be sanitized. While they take the opportunity to sanitize, the next voter shows their identification through a glass window to the poll worker. Then, they come into the polling location and the process repeats itself.

Do you need a specific excuse to obtain an absentee ballot?

You don't need to have a specific excuse — anyone who is registered in Wisconsin can get an absentee ballot.

You request an absentee ballot either in person or through the mail. The envelope has to be signed and addressed by you, and it has to include a witnesses’ name and address. The ballots can then be dropped off at a municipal clerk's office, at several drop boxes around the state, or they can be mailed back.

Is this a new process for Wisconsin?

We have had an absentee balloting process for as long as I can remember the state of Wisconsin. We're not concerned about it functioning well because we've used it for so long. The only concern that people seem to have in Wisconsin about absentee voting is the numbers of absentee ballots being requested and submitted. These are extremely high numbers compared to the past.

Right. Nationally, it seems that we are being fed two concerning narratives about the election — the threat of voter suppression and of voter fraud. Do you think there is a threat of either of those things in Wisconsin?

In Wisconsin, I feel very good about things. I think voting in Wisconsin is about as secure as probably any state, and also about as accessible as any state.

I worked very hard to implement a photo ID requirement for voting quite a few years ago. People who don't have photo IDs can get them for free through the Department of Transportation in Wisconsin. And on the other end, we have many, many different groups out there trying to register voters and encouraging them to vote.

Voter ID laws are among the most contested points of voter suppression. You spoke about counteracting ID restrictions by setting up a program so that you can get IDs you can get for free. Why do you think that is necessary? Do you see that sort of tradeoff in any other areas?

Well, the other thing is that since the polling places could move slowly, there might be long lines. But you don’t have to get into the polling place by the end of voting hours, you just have to have been in line. This is how we are trying to ensure that even if the lines might be going a little bit slower, people's ability to vote is not restricted.

Are there any other important dates in this process that readers should take note of?

It is important that people cast their absentee ballots sufficiently in advance of election day to ensure they are counted.

Right now, there is a legal debate over whether ballots that are postmarked on election day but received after can still be counted. The latest ruling is that they cannot be — ballots need to be received at the clerk's office by election day.

Even though you technically have up until five days before election day to mail them, there's no guarantee the ballots are going to get there in time. It is important not to push dates.

Do you or does VoteSafe take any position on that ruling?

No. One of the goals of our group is to keep it nonpartisan. All we're doing is as a group is saying that we have very, very good voting laws currently in Wisconsin, and if you follow those laws, your vote is going to be counted and it's going to be safe and secure. Any of these other laws just expand your abilities. Follow the law and it really won't matter to you what these rulings are.

What is the point of restricting the ballots that count in that way?

You know, I really don't know what the argument is other than getting a more rapid, timely response, and to know what the election results are moving forward. Obviously, if absentee ballots can be counted for six days after the election, the entire election of a president of the United States could be in limbo for six days while the country waits for the Wisconsin vote to come in.

Got it. As Wisconsin is such a critical state, is there anything that readers should know or that the public should be watching?

Not really. I think we're going to have a high turnout. We know that there is going to be a lot of absentee ballots cast, and you can't even start counting or looking at those absentee ballots until election day. It is important to note that it could be the next day or even beyond before we have vote totals.

Disputed Elections

by Lawrence Douglas

October 26, 2020

This interview with Lawrence Douglas, professor at Amherst and author of Will He Go, was conducted and condensed by franknews.

You wrote a book recently called, Will He Go, about what may happen in a contested election. What are you most concerned about this election cycle?

We have never had a sitting president or even a candidate for higher office who is telling the American people that our electoral system lacks integrity. This is unprecedented in American history and has been a pretty constant message emerging from Trump. He has consistently said that the only way for our electoral system to demonstrate its integrity is for him to win and if he loses it is proof that the election was rigged.

We can look back to his claims about the popular vote being stolen from him in the 2016 election. We can look back to when he refused to say that he would accept the outcome of the election in 2016 during a debate with Hilary Clinton. We can look back to when he was a candidate for the Republican nomination, and lost the Iowa caucus to Ted Cruz. The very next day he was out there tweeting saying, "I didn't lose the Iowa caucus, Ted Cruz stole it. The results should be tossed out." He has consistently spewed an unprecedented, toxic message.

Can he, or any other president in power, refuse a transfer of power?

My primary concern is that he might do something to muddy the waters as to who has won the election if it hinges on tight margins in a handful of swing states like Michigan, Wisconsin, Pennsylvania, and North Carolina.

It is not unlikely that he might have a lead on November 3rd, given the fact that his supporters are more likely to vote in person than Biden supporters. Trump supporters are more than twice as likely as Biden supporters. Trump could try to leverage that lead and claim that he's been reelected and that any coming mail-in ballots have been irretrievably corrupted by fraud.

At one point does this “muddying of the waters” turn into a power grab? When does the rhetoric shift into political gain?

In key swing states, there are going to be millions of mail-in ballots. There's no doubt that there'll be instances of mistakes in counting those ballots. Any mistake will create an opportunity for Trump to spin that into a conspiracy theory. We've already seen him do that in Luzerne County, Pennsylvania. A part-time election official who had been on the job three days accidentally threw out nine mail-in-ballots, seven of which apparently had Trump's name on it, and in the first presidential debate, Trump used that instance of harmless error as evidence of a grand conspiracy. And it's not just that Trump was making those claims. We saw that the Department of Justice under Barr launched a formal inquiry into those nine discarded ballots, which gave a sense of legitimacy to the claim that there was some kind of larger malfeasance behind this action.

It's not just a rhetorical move, there could be a real political payoff for him.

What role do you see the courts playing in scenarios like that?

It is certainly going to be the case that the courts will play an important role. There is already a lot of litigation coming through the courts, and there is no doubt that there is going to be more in the wake of the election. Again, a lot of the litigation will be focused on these key swing states.

Both sides will bring various court challenges regarding the qualification or disqualification of mail-in-ballots. There are technical reasons for disqualifying mail-in-ballots, including things like if the ballots were submitted in an untimely fashion or if the signature on the envelope doesn't match a signature on state records. And regardless of the actual outcome, these cases will slow the final count. I think any kind of delay works to Trump's favor — in that it permits him to continue to perpetuate a narrative that he has been reelected and that the mail-in-ballots are fraudulent.

At what point does litigation reach the Supreme Court? Do you anticipate that happening and does that concern you?

It is not entirely clear if or when the Supreme Court would step in to resolve these sorts of disputes.

But, they are already involved to an extent. The Supreme Court just ruled that ballots in Pennsylvania will be counted if they are received within three days of Election Day even if they do not have a legible postmark. One possibility is that Amy Coney Barrett could be a deciding vote, and it remains to be seen whether she would recuse herself or not. That is concerning to me.

Right. Are there mechanisms the Constitution puts in place to prevent a refusal to transfer power? In ways you think might be outside the scope of what is contested in this election, in what ways does the Constitution ensure a peaceful transfer of power and the preservation of democracy?

Neither the Constitution nor federal law does a whole lot.

The president can't delay an election, only Congress can. January 20th, inauguration day, is a hard stop, set in the Constitution. If Trump loses, he becomes a civilian at noon on January 20th. If there is no decision either amongst the electoral college or between Congress by the inauguration, we go by the terms of the Presidential Succession Act of 1947, and Nancy Pelosi would be sworn in as the acting president. But beyond that, the Constitution and federal law don't do a lot to secure the peaceful transfer of power; they presuppose it, as opposed to securing it.

A number of people, particularly those from other countries have asked, when do you get a re-vote? In a parliamentary system, you can call for new elections, but we don't have anything like that. There is no plan B.

Are there other times in our nation’s history, where the electoral system has been stretched and tested?

The two elections that came the closest to genuine electoral meltdowns are the race between Hayes and Tilden in 1876, and the race between Bush and Gore in 2000.

In 2000, the swing state was Florida. The entire election was going to turn on what happened in Florida, where the count was mired in litigation and confusion for 35 days after the election. Finally, the Supreme Court stepped in and basically stopped the Florida recount that had Bush with a 537 vote lead.

But, it is wrong to say that the Supreme Court brought closure to that electoral dispute. What brought closure was the fact that Al Gore graciously conceded, and he did so to put the interest of the nation ahead of his own political fortunes.

It's impossible to imagine Trump acting in that fashion.

The election of 1876 was even more complicated. Three states couldn't decide who had carried their state and submitted conflicting electrical certificates. That particular electoral dispute was resolved by a one-off electoral commission, and it wasn't resolved until two days before the inauguration. I should say that the actual compromise was a disaster, particularly for the Black citizens of the United States. Democrats agreed to recognize the Republican winner, Hayes, in return for the removal of federal troops from the South, paving the way for the creation of the Jim Crow era.

You can imagine a similar situation in 2020. If you get conflicting electoral certificates in swing states, the key swing states, Wisconsin, Pennsylvania, Michigan, and North Carolina, all have Republican legislatures and Democratic governors. And you can imagine a hold up in Congress, especially if Congress remains divided as it is now. It is important to note that it is not the present Congress that will be deciding things, it will be the newly elected Congress.

Which puts a new emphasis on down-ballot races.

Absolutely. These down-ballot elections could be hugely important, particularly in respect to the composition of the Senate. But, to make things even more complicated, these senate races could also be mired in counts and recounts involving mail-in-ballots. It's not necessarily clear that we will even know what the composition of the Senate is, come January.

Clearly, this election is unlike anything we have ever seen before. There is distrust on both sides. Do you think we can recover from this?

It's true that it's not only the Republicans who have lost trust in the electoral process, Democrats have lost faith as well. However, there is a real asymmetry in the reasons for that loss of trust. We know that there's no reason to doubt the integrity of mail-in-ballots. Trump's attack is baseless. His own FBI director has said there's no evidence whatsoever of any kind of a concerted effort to rig the election with mail-in ballots. On the other hand, the Democrat's concern over voter suppression is legitimate. There is a long history of Republican lawmakers trying to suppress votes, particularly of black voters, poor voters, and other ethnic minorities who tend to vote overwhelmingly Democratic.

For constitutional democracy to survive, people need to have faith in the electoral process, and they need to have faith in the trustworthiness of its outcomes.

It's absolutely essential that, regardless of the result of this election, we try and restore that faith. There are things that we can do to restore that faith. We can work really aggressively to protect the right to vote, we can try to invest in election infrastructure to ensure it is not vulnerable to hacking, and we can get rid of the stupid electoral college — which is an archaic, anti-democratic, dysfunctional, and dangerous mechanism by which we elect the president.

Speaking to the asymmetry — do you think that says something about the cultural and political propensity of Republican voters, or a larger shifting American penchant towards authoritarianism?

I am not sure I could necessarily say that there is a willingness amongst a certain number of Republicans to support authoritarianism, but one thing I do think is fair to say is that there is this incredibly siloed media environment.

A large number of Americans are being fed misinformation. Democracy presupposes that people make informed choices based on accurate information.

If you're being fed disinformation, you're incapable of making an informed choice and that's an incredibly dangerous thing for democracy. I think we can stay with that observation — that the American public is not getting accurate information, and they are making their political conclusions and decisions based on misinformation campaigns.

frank news is dedicated to storytelling across all mediums. A space for debate, discussion, and connection between experts and a curious readership. Topics are presented monthly with content delivered daily.

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