This is Thanksgiving week. As we all know, the first Thanksgiving happened in 1621 when the English Pilgrims and the Wampanoag people shared a three-day harvest feast in mutual harmony. As we also all know, the harmony wouldn’t last much longer.

Following the writing of the U.S. Constitution in 1787, the Continental Congress proclaimed a national day of Thanksgiving. After that, various states sometimes celebrated days of Thanksgiving, but it wasn’t until the editor of the popular magazine Godey’s Lady’s Book, Sarah Josepha Hale, campaigned for a national Thanksgiving Day to promote unity that the holiday began to gather steam. She won the support of President Abraham Lincoln, and on 3 October 1863, during the Civil War, Lincoln proclaimed a national day of thanksgiving to be celebrated on Thursday, November 26.

The holiday was annually proclaimed by every president thereafter, and the date chosen, with few exceptions, was the last Thursday in November. President Franklin Roosevelt, following a joint resolution of Congress, issued a proclamation in 1942 designating the fourth Thursday in November as Thanksgiving Day. And that’s the way it’s been ever since.

I love Thanksgiving. It’s my favorite holiday (Veterans Day is right up there with it, though). All about family and friends, Thanksgiving is the least commercial holiday in our highly commercial society.

At our Thanksgiving dinner, each member of my family, like so many others, takes a moment to describe what they are most thankful for. It’s always a touching and loving moment.

But Thanksgiving is also about giving, and in this week of Thanksgiving, 2023, I have a gift for you.

Following the horrific September 11, 2001, attack on America, I, like everyone else, wanted to do something, anything that might help. So, I did what I could. I wrote an anthem.

Recorded at Worcester’s renowned Mechanics Hall with classical guitarist Peter Clemente accompanying, I used the piece to help raise money for New York City firefighters who had suffered tremendous losses that day trying to rescue and save whoever they could.

Now, thinking about the awful battle unfolding between Israel and Hamas following Hamas’s barbaric invasion, it occurred to me that my anthem might once again be helpful, and so I offer it to all who are hurting, even despairing, over the terrible situation in which so many innocents have died or been forever changed.

Peace be with you.

My recent Insider column describing how Donald Trump and his acolytes were mimicking the cruel and dehumanizing words of Adolph Hitler and his Nazi devotees to fire up Trump’s MAGA cult was heavy with foreboding about the divisive, tar-pit-like times through which we now must slog.

With that in mind, I feel the need to offer something lighter — a lot lighter — for you to consider for some weekend reading. So, pour a libation of your choice, sit back, and let me tell you a story of a time long ago in what seems a galaxy far away. No heavy hitting today.

The Trip

When I was young my Irish Catholic family would take summer vacations during which you’d find all six of us crammed into Dad’s station wagon heading north to Canada.

On those trips, like good Catholics, we’d stop at every Canadian Cathedral we could find along the way. At one of them, one whose name I’ve managed to block from memory, my father, hoping God would make my vision better if I did something painfully devotional — I was born with astigmatism — made me join myriad other masochists climbing the Cathedral’s hundred or so granite steps on my knees. My vision did not improve and my glasses did not join the many crutches and canes hanging from the Cathedral’s walls, but my knees were sore for a week.

On one of our Canadian trips to the city of Quebec we took an apartment in the Old City at the bottom of the Heights of Abraham, the cliffs that General James Wolfe’s English troops scaled in 1759 to capture Quebec from the French general the Marquis de Montcalm’s army in The French & Indian War.

We were on the second floor overlooking an old cobblestoned street. All day long tourist-filled horse-drawn carriages would clip clop below. Every morning as the sun rose the water trucks would come, washing down the street to remove the southbound gifts from yesterday’s northbound horses. In the evenings, after touristing all day, we’d return to the apartment, and the earthy barnyard smell would give us an aromatic greeting.

On another Quebec trip, we stayed on top of the Heights of Abraham at the magnificent Chateau Frontenac hotel. I was twelve years old, and everything about the place had me bug-eyed. At dinner in the Chateau’s formal dining room six waiters in immaculate, starched white coats and black pants with creases as sharp as the edge of an ax, would continually circle the table, taking care of us. In a six-man line, they would march our meals to the table with military precision, each plate covered with a silver domed lid. With a flourish, they would place our dinners before us and then, as one, remove the lids while proclaiming, “Voila!”

But those aren’t the trips for this story. No, this story is all about a trip to New York City when I was 14-years-old.

One evening in June of 1960 during the family dinner my father said, “Tommy, your mother has a surprise for you.” Since I couldn’t recall my mother ever surprising me with anything, except for Christmas, birthdays, and those many occasions she caught me doing something I thought I had successfully hidden from her, I was both curious and wary at the same time.

And that was when Mom told me that, because I had done well throughout elementary school, she was taking me to New York City for a week’s vacation to celebrate my graduation from the 8^th grade. Just the two of us.

With the exception of Haverhill, Massachusetts, the city where I was born, population about 60,000, the only other U.S. city I’d ever seen was Boston. We’d driven there a couple of times to look at window displays at Christmas. I’d also gone to Boston on a school bus for a 7^th grade class trip to see the movie The Ten Commandments, a big deal Catholic event that was actually Jewish, not Catholic, but, true to form, we Catholics appropriated it, anyway. The Haverhill’s Jewish people gave a “what else is new?” shrug.

So, New York City was, to me, like heading off to Oz, or maybe Disneyland, which had opened four years earlier and was commonly looked upon as the 9^th wonder of the world.

A few days later, my mother took me aside to ask if I’d mind if my sister Alana went on the trip with us. Alana was to graduate from 8^th grade the following year, and, as there were three more behind her, I think Mom didn’t want to start a precedent of taking a kid to NYC every year.

As this was not a barricade upon which I was prepared to die, Alana joined the expedition.

When the day of the trip arrived, my father drove the three of us to Logan Airport. There, dressed in our Sunday best, we boarded a Northeast Airlines twin-prop plane and flew to the Big Apple. It was the first time Alana and I had ever flown, and we were as dumbstruck as a couple of Catholic kids from the Irish Acre of Haverhill ever got when, about halfway into the flight, our Stewardess — excuse me, Flight Attendant — served us lunch with ironed cloth napkins and our own little, personal, crystal salt and pepper shakers. I needn’t mention flying today isn’t what it used to be then, do I?

After lunch, I can remember standing with Alana and Mom looking out one of the plane’s small windows at New York City far below. The tall buildings that seemed crammed into and growing out of Manhattan looked small enough for me to reach out and pick up with one hand.

When we got to New York City we checked into a suite at the Statler Hilton Hotel. Then we went for a walk, an illuminating, eye-opening walk. The streets were seas of yellow taxi cabs, and it seemed as if every one of them had full-throated horns honking. Sidewalks crowded in every direction, New York City was chock full of people who did not look like us. Haverhill, very white Haverhill, had nothing like this, a phenomenon my sister and I did not appreciate until years later.

We spent the next week seeing the sights. We went to Radio City Music Hall to see a movie and watch the Rockettes do their high kick thing. Spent a day at the Cloisters. Took an elevator ride to the top of the Empire State building. Got sprayed on a boat going to the Statue of Liberty, which Alana and I climbed to the top while Mom watched from the ground. If Mom climbed a three-foot stepladder, she’d go all wobbly in the knees. At the top of the Empire State Building she’d stayed as far away from the edge railing as possible, so she was not about to climb Lady Liberty’s 162 steps.

One of the highlights of the trip was having lunch at Rockefeller Center. It being summer, I arrived in a shirt, but gentlemen, even 14-year-old gentlemen, were required to wear jackets and ties. So, a waiter brought me one of each out of the many the restaurant kept for the ne’er- do-well not-suitably-attired crowd.

Rockefeller Center was a great place for people watching while downing an expensive lunch. We sat in the English Grill on the north end of the plaza as Prometheus watched over us. I did not spend much time looking at Prometheus. Seen one 18-foot-tall, gold-gilded cast bronze sculpture, seen them all. I was more interested in ogling the midtown Manhattan lunch crowd, all of whom seemed to ooze confidence I had never seen before. Later in life I would learn they were as insecure as everyone else; they just faked confidence better.

One day we had lunch at Tavern On The Green, the ridiculously expensive Tourist Trap restaurant, in Central Park. After lunch, we took a horse and buggy ride through the Park, during which I mentioned to Mom that the southbound end of our Central Park horse was behaving better than the Canadian variety.

The evening before we would leave Gotham and return to humdrum life in Haverhill, we had dinner at the Rainbow Room on the 65^th floor of Rockefeller Center. Standing in front of the room’s huge windows looking at New York City’s thousands of night lights far below, I became frozen. My eyes must have had the gleam a baby’s get the first time they see snowflakes falling.

The Rainbow Room was a restaurant and a night club, and after dinner we stayed to hear the Guy Lombardo orchestra play a set. At Mom’s persistent urging, Alana and I even made a poor attempt at dancing. Our years of weekly Wednesday afternoon lessons at Ruby K. O’Neill Sweeney’s Dancing Studio back in Haverhill didn’t seem to be doing us much good in the Rainbow Room.

The next day we boarded the same Northeast twin-prop plane for the trip back to what passed for our reality. The Stewardess was just as nice, the salt and pepper shakers still crystal, but something was missing. Expectation no longer sat in the air.

The memory of my trip to New York City in 1960 has stayed fresh ever since. A few years later, I would learn how privileged my upbringing had been. A humbling moment.

I wouldn’t return to New York City until another graduation, this one from high school. On that trip there’d be no Mom. My friends Dave and Greg would, on Dad’s dime, be my trip companions. I’d stay, once again, at the Statler Hilton where I’d have my own room and where we’d spend a few nights drinking in the Hilton’s Penn Bar. Didn’t do that with Mom.

During the days, we’d wander around New York’s World’s Fair recovering from the night before and ogling futuristic sights that everyone thought would one day be commonplace. Nobody required that I wear a jacket and tie on that trip.

But that’s a story for another day.

On the evening of 8 November 1923, one hundred years ago last week, Adolph Hitler and a body of heavily armed storm troopers broke into a meeting of Bavarian leaders at the Bürgerbräukelle, a beer cellar just outside Munich, and began a serious attempt to overthrow the Bavarian government and then march to Berlin to take over the country, as the Italian Benito Mussolini had done a year earlier in capturing Rome. Known as the Beer Hall Putsch, the coup attempt had not been thought out well and did not reckon with organized police who would counter it.

Overnight Hitler’s allies gathered about 2,000 armed supporters, to each of whom the Nazis paid 2 billion marks for signing up to revolt (because of Germany’s hyper-inflation, this was worth just over $3 on that day). On the morning of 9 November, Hitler and his rabble set off to capture the Ministry of War, but were met by a strong cordon of police. Nobody knows who fired first, but someone did, and for the next minute the air was full of smoke from all the bullets. Herman Göring was shot in the leg and fell.¹ Hitler was pushed down and dislocated his shoulder. When the fighting stopped, 14 of Hitler’s marchers were killed along with four policemen.

The German government put Hitler on trial in early 1924, but, because everyone knew the Nazi leader could implicate many Bavarian politicians in the Putsch attempt, he was allowed wide latitude to bully and insult prosecution witnesses, as well as to speechify, which he did incessantly. He said he was “serving the interests of Germany,” which could never be judged treasonous. “The eternal court of history,” he declared, “will judge us as Germans who wanted the best for their people and their fatherland.”

Despite the undeniable fact that members of the putsch had killed four policemen and staged an armed and treasonable revolt, both offences punishable by death, the court sentenced Hitler to five years in prison, and a cushy prison, at that — Landsberg am Lech, just west of Munich. This was a place that doled out “fortress incarceration,” a mild form of imprisonment for offenders thought to have acted from “honorable motives.” This is where Adolph Hitler and his factotum Rudolph Hess settled in to while away some time. And this is where Adolph Hitler wrote Mein Kampf (My Struggle).

After 264 days of a five-year sentence, the German government freed Hitler.

The reason I bring up this history is because in My Struggle, written ten years before Hitler and the Nazis came to power, Hitler told everyone who could read exactly what he and the Nazis would do when they ultimately took control. A poorly written book (although, after 1933, if you didn’t have a copy prominently displayed in your home a few Brownshirts might pay you a visit with unwelcome consequences), My Struggle lays out with precision the entire Nazi blueprint, including the extermination of the Jews  and other undesirables, the creation of the Concentration Camp society, and the invasion of the East to acquire Lebensraum, or the “Living Space” Hitler decided the German nation required to expand.

On 1 January 1933, the day Hitler took power, he began keeping every one of his promises first laid out ten years before. In late March of that year, the Nazis opened their first concentration camp — at Dachau, 12 miles northwest of Munich. They sent four busloads of political opponents and, yes, Jews, to the new facility while the citizens of Dachau, lining the streets, watched the parade go by. In early April, just to make sure everyone got the message, they walked four of the Jews outside and shot them each through the head.

Fanatical megalomaniacs tell you what they’re going to do, and if you let them, they do it. Adolph Hitler is not the only example I could cite.

Moving ahead 90 years, we see another megalomaniac who is telling us what he intends if restored to power. Like Hitler before him, Donald Trump is telling all of us just what we can expect if a year from now he wins the 2024 presidential election. And it should scare everyone. I urge you not to think Trump is simply hyperbolizing, exaggerating to feed his MAGA base. The man is not that subtle.

In the last week, we have learned much from the man himself, as well as from his sycophantish acolytes, his Görings, Hesses, Goebbels, and Himmlers.

On Veterans Day, the former president, in an authoritarian rant, wrote on his Truth Social platform, “We pledge to you that we will root out the Communists, Marxists, Fascists, and Radical Left Thugs that live like vermin within the confines of our country, lie, steal, and cheat on Elections, and will do anything possible, whether legally or illegally, to destroy America, and the American dream.”

He said the same thing last Saturday night at one of his cultish rallies, this one in New Hampshire. It both infuriates and saddens me that the stadium-filled crowd cheered throughout his 90 minute invective.

These are Hitler-like words. The Nazis did all they could to dehumanize Jews, Gypsies and other groups they deemed inferior. Hitler and Goebbels, especially, called Jews and other undesirables “vermin.” In addition to Jews, Hitler’s bête noire were Communists and Bolsheviks. He went after them with nearly the same ferocity as he did the Jews. Any liberal or even moderate German was in the Nazi crosshairs.

Separately,  Charlie Savage, Maggie Haberman and Jonathan Swan, reporting for the New York Times, have unearthed even more profoundly disturbing policies just waiting for a Trump second term.

They write:

Former President Donald J. Trump is planning an extreme expansion of his first-term crackdown on immigration if he returns to power in 2025 — including preparing to round up undocumented people already in the United States on a vast scale and detain them in sprawling camps while they wait to be expelled.

The plans would sharply restrict both legal and illegal immigration in a multitude of ways.

He plans to scour the country for unauthorized immigrants and deport people by the millions per year.

To help speed mass deportations, Mr. Trump is preparing an enormous expansion of a form of removal that does not require due process hearings. To help Immigration and Customs Enforcement carry out sweeping raids, he plans to reassign other federal agents and deputize local police officers and National Guard soldiers voluntarily contributed by Republican-run states.

Stephen Miller is an architect of Trump’s first-term immigration policies who remains close to him and is expected to serve in a senior role in a second administration. He told the Times reporters, “Any activists who doubt President Trump’s resolve in the slightest are making a drastic error: Trump will unleash the vast arsenal of federal powers to implement the most spectacular migration crackdown in history. The immigration legal activists won’t know what’s happening.”

But that’s just Trump’s assault on immigration. As master salesman Ron Popeil used to say, “But wait, there’s more!”

In addition to mass deportations, Trump’s team also plans a new Muslim ban, tariffs on all imported goods, and “freedom cities” built on federal land. They have policy books aimed at stripping tens of thousands of career employees of their civil service protections. That way, they could be fired as Trump seeks to “totally obliterate the deep state.” He would accomplish this by reissuing a 2020 executive order known as “Schedule F.” That would allow him to reclassify masses of employees, with a particular focus, he has said, on “corrupt bureaucrats who have weaponized our justice system” and “corrupt actors in our national security and intelligence apparatus.”

He would obliterate transgender and LGBTQ+ rights to appease the Christian fundamentalists in his MAGA base.

Under the mantra “DRILL, BABY, DRILL,” he says he would ramp up oil drilling on public lands and offer tax breaks to oil, gas, and coal producers. He would roll back Biden administration efforts to encourage the adoption of electric cars and reverse proposed new pollution limits that would require at least 54% of new vehicles sold in the U.S. to be electric by 2030.

Trump has also pledged to eliminate the Department of Education and push the federal government to give funding preference to states and school districts that abolish teacher tenure, adopt merit pay to reward good teachers and allow the direct election of school principals by parents. He has also said he would cut funding for any school that has a vaccine or mask mandate, and his administration will promote prayer in public schools.

In his first term, Donald Trump appointed a number of people to his administration who pushed back and kept him relatively tethered on many issues. He was inhibited by the likes of Reince Priebus and  General John Kelly, his first two Chiefs of Staff, General James Mattis, his first Secretary of Defense, and Rex Tillerson, his first Secretary of State. That tether, fragile as it was, will not be present in his second term. If he is elected, we will experience the complete and unhinged Trump, as only those who are fiercely loyal will be allowed to serve.

Our nation has withstood many deeply troubling challenges, most notably a civil war, but that was long ago. I fear we are now complacent and completely unprepared for the second coming of Donald Trump. We have put on size-12 blinkers and no longer see, much less appreciate, the evil closing in on the nation. Witness the collective national yawn as we watch him approach 91 criminal charges and mock our judicial system in the process. And witness current polling that shows this authoritarian demagogue neck and neck with Joe Biden, even ahead, in next year’s presidential election.

I can sum up the threat of Donald Trump by saying it is a short step from rounding up all undocumented aliens to rounding up legal immigrants you don’t like to rounding up political opponents who become a nuisance, to rounding up…anyone.

________________

¹ The pain from this wound would bother Göring for the rest of his life and is the reason he became a lifelong opioid addict.

No political punching today, although this week’s alleged debate, if you can call it that, between the five remaining Republican wannabe presidential candidates chasing the Big, Overweight Orange Man (the BOOM) with 91 criminal indictments does provide plenty of fodder. And, of course, as always, there are a great many other items of more than curious interest, the finances, or lack thereof, of Speaker Mike Johnson, for instance, or the high-end brothel ring that seemed to encircle our nation’s capital. There’s a story for you.

But no. Tomorrow, 11/11, is Veterans Day. The country celebrates it today, Friday, because who doesn’t want a day off? Regardless, Veterans Day, whenever you celebrate it, is one of my favorite days of any year. In honor of all veterans, including me, I’m today republishing my Insider Post with the highest readership ever — more than 8,000 people read that one, and now those who missed it will have their own chance to learn the saga of the Calendar and the Nuts. I think I’ll make this an annual event.

So, to get us going, let me tell you a story.

Long ago, in a galaxy far, far away, a 23-year-old, newly minted, Infantry 2nd Lieutenant Airborne Ranger with my name spent a fair amount of time in a little woebegone country in Southeast Asia called Vietnam.

In Vietnam, I took command of a platoon of about 30 draftee soldiers, none of whom wanted to be there or ever understood why they were. There were no college graduates in that lot, and a few never finished high school. They were America’s flotsam and jetsam, and they all knew it. We went through a lot together, and I would grow to love every one of them.

Month after month, my guys and I patrolled the mountains in the north of South Vietnam, occasionally encountering North Vietnamese Regulars who were doing the same thing. Those were interesting meetings. We didn’t talk much when we met, but we did frequently have a somewhat frank exchange of views.

Our Platoon had some memorable moments in Vietnam, such as The March to the Sea, The Rescue, The Whistling Mortar Round, The Search for the Body That Turned Out to Be a Piece of Wood, and The Flying Flywheel. But those are stories for another day. For right now, for today, we’re telling the story of The Calendar and the Nuts.

Four months before the end of my first Vietnam tour, the Army promoted me to 1st Lieutenant, made me say “goodbye” to my guys, sent a Huey chopper to fly me out of the jungle, and gave me a staff job on Firebase Vegel in northern South Vietnam. A firebase was a temporary army camp built by the Corps of Engineers on top of a mountain. It supplied the troops in its area both logistically and militarily. And by “militarily” I mean weapons, ammunition, and helicopter gunship support and transportation. Firebases were cushier than the jungle, but often more dangerous, because they were stationery targets. That was made apparent to me a number of times in vivid ways.

My job on Vegel was to dream up crazy search and destroy operations for the “grunts” in the jungle, the crazier the better. I did my best to make them crazy enough to satisfy the Brass, but not crazy enough to get our folks killed. It was not easy.

The Army of North Vietnam and their comrades in the south, the Viet Cong, were a determined foe. They were fighting with biblical devotion for a purpose they believed in — their country. They weren’t going anywhere until the war was over and they had won. We, on the other hand, were the political pawns, the shmucks who were there because we had to be, and none of us liked it all that much. Wasn’t our country. And all of us knew, with a fair degree of certainty, the date we were scheduled to go home — if we could stay alive long enough.

With two months to go in that first tour in the country with the biggest mosquitos on earth, I began to get a bit anxious. I knew guys who had come to untimely ends with only a few days left, one, a good friend, within three hours of leaving. So, realizing I needed a diversion to take my mind off things, I decided to create one — my very own 60 day, Short-Timer’s Calendar.

I confess while deep in the jungle in the 1960s my admiration for and envy of Hugh Heffner knew no bounds. Consequently, my Short-Timer’s Calendar was the centerfold of the June 1970 Playboy magazine. To build the Calendar, I enlisted the aid of my Battalion Commander, Bulldog Carter (that’s right, Bulldog), and Buck Kernan, my partner, a West Pointer who went on to become a Lieutenant General, like his father before him. The three of us divided the luscious photo into 60 puzzle-like areas counting down from 60 to one. The trajectory of the progression became increasingly lascivious.

Thereafter, we held a nightly, candle-lit ceremony in the bunker occupied by Buck and me.

⏺⏺⏺

But before I describe the ceremony, I have to tell you about the Macadamia nuts.

During Vietnam, soldiers who were unfortunate enough to find themselves in that hellhole were allowed a ten-day R&R (Rest and Relaxation) vacation, usually a little after the mid-point of their tour. Unmarried soldiers usually went either to Bangkok, Thailand, or Australia.

Most of the time the married folks went to Hawaii to meet their wives. So, when my turn came, I hopped a plane at Da Nang airbase halfway up the coast of the South China Sea and flew off to meet my wife, Marilyn, in Honolulu.

When we first checked into our hotel and got to our room, we discovered the hotel had left a small jar of macadamia nuts for us. Up until then I had never tasted a macadamia nut in my life, but once I tossed the first one down the gullet, I was hooked. I subsequently learned Hawaii is noted for its macadamia nuts. There’s even a Macadamia Nut Visitor Center somewhere on Oahu.

You may forgive me for saying with the exception of the inside of our hotel room and the balcony outside it on Waikiki Beach, the one with the beautiful view of Diamond Head up the coast, we never did see much of Hawaii for the first four or five days.

But toward the end of the R&R, after we’d come up for air, seen the sights, sampled the beach, and done the obligatory Don Ho nightclub show, we went to the PX (Post Exchange) at Scofield Army Barracks and bought a large jar of Macadamia nuts for me to take back to Vietnam. In Vietnam, little things became luxurious delicacies.

The next day, Marilyn and I boarded our separate planes, she to return to the civilized world of Massachusetts, and me to head back to something completely different.

⏺⏺⏺

Back to the ceremony.

The tiny bunker assigned to Buck and me had a single bunk bed. There was only one bed, because Buck and I took 12-hour shifts in the Operations Center, where we kept the world safe for democracy by prevented all the dominos Presidents Johnson and Nixon had told us so much about from falling. One of us would end his shift, head to the bunker, wave as he passed the other guy, and crash into the bed.

Every night, at 2000 hours — 8 p.m. to you — the three of us, Bulldog, Buck and I, would gather in the bunker. I had scrounged a small table which I had placed against the wall to the side of the bed. I had lovingly pinned Miss June to the wall above the table. At the appointed hour, I would light the two candles I had placed on each side of the table under the pin-up. I would open the jar of Macadamia nuts, which occupied a special spot in the center of the table, and hand each of my comrades one nut, taking one for myself. We would then spend a moment in quiet reflection, meditating on the bounty before us, after which I would, with a red marker purloined from the Ops Center, X-out that day’s descending number on Miss June’s tantalizing body.

We would then eat the nuts.

We did that for 59 consecutive nights. Fifty-nine red Xs covered Miss June. We were down to ONE! On the final night, we held a special ceremony, inviting the Battalion XO, the other six staff officers, the Battalion Sgt. Major, and the Chaplain, Father McBride, into the bunker, which became almost as crowded as the stateroom scene in “Night at the Opera.” We gave everyone a Macadamia nut that night, and, to great applause, I placed the last red X on Miss June. Even Father McBride smiled.

Then, in a service worthy of priestly ordination, I passed the jar of Macadamia nuts to Buck — who, because he still had six weeks to go, later on would replace my centerfold with his centerfold and continue the tradition. We retired my centerfold to a place of prominence on the side wall of the Ops Center, where it looked down on all the guys, and where Bulldog could see it every day, its 60 red Xs pointing the way to his bit of heaven back in the U.S. Six weeks later, Buck would hang his beside it.

The next day, I choppered south, boarded a chartered Pan Am plane with about three hundred other happy survivors, and flew home to what we called “the world.”

Since then, Macadamia nuts and I have been fast friends.

There is something weird going on in America, and it’s bewildering to many.

Studies, surveys and polls are all showing that close to 90% of us are content with our lives and believe our communities and social surroundings are just fine, thank you very much.

At the same time, when asked about the trajectory of the country as a whole, just 18% say things are going in the right direction, while a whopping 79% say things are on the wrong track. Excuse me?

Let’s dig deeper.

If you wander America conducting more than 5,000 in-person interviews to get a sense of how content people are in their own lives and how they view their local and surrounding communities, and if you ask them their views on the health of the nation, and if you further examine local, state and national election results, and if in addition you study regional economics, you might learn some interesting things.

That is exactly what the American Communities Project (ACP) has been doing for the last year, and this week ACP published a report on the results of its year-long project.

The nation’s media tend to explain the divides in the United States in binary terms — red/blue, left/right, urban/rural. News stories discuss war between two conflicting “cultures.” Sometimes the stories include a third option for “independents” or “centrists.” But the ACP’s work reveals the views of Americans to be much more layered and heavily influenced by what type of community they live in throughout our more than 3,000 counties.  Looking closer, the ACP found the picture is far more complicated.

Headed by highly-respected data journalist Dante Chinni, the American Communities Project is based out of the Michigan State University School of Journalism. Chinni and his team have gone to great lengths to show the country’s fascinating nuance. Their research leads them to conclude there are at least 15 different types of communities, including College Towns, African-American South, Evangelical Hubs, Working Class Country, etc. Here is an ACP map showing the 15 Community Types spread out around the country’s more than 3,000 counties.

On the whole, three key points emerge from the ACP data — points that resonate with dissonance. From the ACP’s report:

• Americans experience and perceive very different realities. The most pressing issues at the community level can vary greatly. And there is a perception-driven disconnect between big local and national issues. Inflation is seen as a top issue everywhere, but beyond that the numbers get very complicated. Some cite guns and gun violence. Others cite opioids and drug addiction. Taxes rate high in others. And, more broadly, there is a dissonance between national and local concerns that suggests many attitudes are driven more by perception than experience. Some issues that voters say are big ones nationally, such as immigration, don’t show up as big issues in any community (emphasis added).
• Across communities, most people believe their lives are on the “right track,” but they are deeply concerned about the direction of the country. On the whole, people seem to feel good about their individual circumstances and pretty good about their community. But the views are much bleaker when the United States is the entity in question.
• A series of statements about values reveal some broad areas of agreement — particularly around the economy and abortion. But others show wide disagreement. In total, there are nine statements in which every community type is in broad agreement (that is respondents in all types are either over or under the 50% mark). For instance, 50% or more in each community type say, “Obtaining an abortion should be a decision made by a woman in consultation with her doctor, without government’s involvement.” But 10 other statements show differences across ACP community types, some massive. “The right to own a firearm is central to what it means to be an American,” is one such statement.

The ACP project asked two overarching questions of people throughout the 15 identified Community Types. First, what are the “most important issues facing your local community?” And second, what are the “most important issues facing the country as a whole?”

As ever, there is a great divide between perception and reality. On the whole, the reality of one’s local community is undisputed, but reality beyond one’s own environment is not directly known; it is perceived and shaped by what I call the echosystem of our media, especially social media.

Take immigration and crime for example. These are two of the central talking points of the Republican Party as it lurches toward picking a standard bearer for the 2024 election, winning the Senate, and keeping control of the House.

In 14 of the 15 Community Types, the ACP project finds only 11% of Americans see “immigration” as one of the most important issues facing their local community. The one exception is the Hispanic Centers, many concentrated near the border, where 21% cite immigration. However, when the question turns to issues facing the country, the immigration number jumps to 23%, and some of the numbers are much higher. In the Evangelical Hubs, 33% say immigration is one of the most important issues.

Regarding “crime or gun violence,” there is a similar disconnect. In 13 of the 15 Community Types, 21% of Americans rate it as one of the “most important issues.” Here, the exceptions are the African American South and Big Cities. Consider this from the Report:

But as an issue facing the country, “crime or gun violence” is nine points higher, with 30% of Americans saying it is an issue of national import. The figure jumps 14 percentage points in Rural Middle America, from 11% as a community issue to 25% as a national one. The number climbs 13 percentage points in the Exurbs, from 17% as a community issue to 30% as an issue for the country. The number jumps 12 percentage points in the blue-collar Middle Suburbs from 23% to 35%. In fact, the number of people concerned about crime as a national issue is higher than the figures for crime as a local community issue in every type except the African American South, where the number is essentially the same at the national and community levels.

What do Americans cite as the Number 1 issue facing both their local communities and the nation? Inflation. Look at the following two charts, the first asking Americans their views on five major issues within their local communities, the second asking the same questions about the nation as a whole. Note the role of inflation, as well as the differing answers regarding immigration and crime.

The ACP project validates with actual data what to many is intuitive: Americans believe what they see with their own eyes in their local and surrounding communities, but have fallen for the political propaganda spouted by far-right, conservative commentators and opportunistic, hypocritical politicians who continually paint a bleak picture of America.

Separating truths from lies has become much more difficult in recent years as more and more Americans shift away from mainstream media as a reliable place to get their news. In 2020, the Pew Research Center reported roughly a third of U.S. adults (31%) said they regularly got news from Facebook. A quarter of U.S. adults regularly got news from YouTube, while smaller shares got news from Twitter (14%), Instagram (13%), TikTok (10%) or Reddit (8%). This drift to often unreliable sources, a move deep into the echosystem, has only grown since the Pew report of 2020.

Throughout history, repeatedly spewing lies has proven quite effective at swaying the masses. Given the current diffuse and dispersed sources of alleged news with which we are constantly bombarded, it is now even easier to persuade someone into believing something they might have wanted to believe in the first place.

Americans are smart, but they are facing a cascading avalanche of mis- and dis-information. In this new era of exploding social media and artificial intelligence where anything is digitally doable, is it even remotely possible to slow, let alone reverse, what appears to be a relentless slide toward a day when perception eviscerates reality?

I wish I knew.

” We cannot solve problems with the same thinking we used when we created them. “
Albert Einstein

What Hamas did on 7 October 2023 is beyond terrorism. It is an abomination of horrific proportions. And although nearly all Israelis believe Hamas’s barbaric attack was made possible by a failure of the government, army, and intelligence service at every level, polls within Israel in the last two weeks indicate 80% think Prime Minister Benjamin Netanyahu is the person mainly responsible for this unprecedented blunder in the history of the country.

Why is this, and how does it influence the way forward after the war with Hamas ends?

A binary decision

After decades of failed policies that seemed to do nothing more than bounce around like beebees in a boxcar, doing more harm than good, Israel is now left with a yes or no binary decision: Go back to the same failed policies that led to this present untenable situation, or seriously move forward to create a two-state solution. It’s really that simple. Unfortunately, if cooler heads choose door number 2, they will face almost insurmountable challenges.

Israel’s leaders say they’ll deal with “after the war” after the war ends. However, behind the scenes, things are happening. As first reported by Bloomberg, the U.S. and Israel are in discussions regarding the establishment of a temporary multinational peacekeeping force in Gaza after the military operation, though the White House is denying that U.S. troops would be part of the potential coalition. This could either take the form of granting temporary oversight to other Middle East countries backed by international forces, granting the United Nations temporary governance, or establishing a group similar to the multinational force that enforces the Egypt-Israel peace treaty. None of these options is ideal.

The key word in the preceding paragraph is “temporary.” Whichever option leaders choose, what happens after that?

Anything that happens after that will have to involve working closely with the Palestinian Authority (PA), which was created in 1994 as a five-year bridge to a two-state solution. How naive that now seems.

From 1994 to 2007, the PA was the Palestinian governing body in both Gaza and the West Bank. In 2007, after Israel had withdrawn its soldiers and the settlements they were guarding, Hamas drove the PA out of Gaza, which left the PA in the West Bank and Hamas in Gaza.

Given the apparently early success of the Israel Defense Forces (IDF) invasion of Gaza, it is possible to imagine Israel actually decapitating Hamas. It has the firepower to do it, notwithstanding the colossal loss of innocent Palestinians, which, despite opinions circulating in the media to the contrary, I believe Israel is doing everything it can to minimize.¹ But what happens then? It is far from clear that anything better will take the place of Hamas.

Consider this. Hamas has had 16 years to create a bureaucracy to run Gaza. That bureaucracy is now large. Keeping it would mean working with around 40,000 people hired for their ideological loyalty to Hamas; dismissing it would repeat the mistake of America’s “de-Baathification” program in Iraq, which threw legions of angry, unemployed men on the streets and had terrible results for Americans and Iraqis alike.

Palestinians themselves are not united

The Palestinians have been divided for almost two decades. Though Hamas and Palestinian Authority leaders meet every couple of years to pay lip service to reconciliation, neither party has exhibited any desire to compromise. But the schism has been exacerbated by the divide-and-rule policies of Israel’s Prime Minister Benjamin Netanyahu, who thought them a useful tool to stymie the Palestinian dream of an independent state. “Netanyahu had a flawed strategy of keeping Hamas alive and kicking,” says Ehud Barak, a former Israeli prime minister, defense minister, Army Commander, and, to my mind, the Israeli leader with the clearest vision of the current situation. To put it bluntly, there is no person alive with Barak’s range of strategic, tactical and political Israeli experience. When Foreign Policy’s Editor in Chief Ravi Agrawal asked him to go deeper, he said:

“One of Netanyahu’s extreme-right ministers explicitly said that Hamas is an asset and the Palestinian Authority is a liability—rather than the other way around. Netanyahu pushed this policy for at least the last five years. He basically decided that in order to effectively block any possibility of moving toward a two-state solution, which he hates for some reason, we have to strengthen Hamas and weaken the Palestinian Authority. He was yielding to Hamas’s demands and keeping them alive and kicking and paying them protection money through the Qataris. That was a very bad policy that many of us, including myself, explicitly attacked and described as a grand negligence of our interests.”

This divide-and-rule policy contributed to Hamas’s savage and sadistic attack on 7 October. And it has permeated all of government. In an effort to further weaken the Palestinian Authority, the far-right Finance Minister Bezalel Smotrich, who is also a minister in the Defense Ministry responsible for policy in the West Bank, recently opted to suspend the transfer of nearly $150 million in tax revenues to the PA — a major source of income for the nearly destitute governing body in the West Bank. Secretary of State Antony Blinken confirmed during a Senate hearing this week that the Biden administration urged Israel to unfreeze the funds, among other actions necessary to provide the PA with the resources it needs, but the ultra-nationalist Smotrich has thus far refused to do so. Blinken described this as, “Another aspect of the problem.” That is an example of a diplomat being diplomatic.

Those aren’t the only funds aimed at helping Palestinians Smotrich has held up. Israel’s previous government had allocated Arab municipalities $85.5 million for educational programs in East Jerusalem. Moreover, additional funding was allocated for higher education preparatory programs for young Palestinians, designed to enable students from East Jerusalem to study in preparatory programs at Israeli academic institutions. None of those funds have been released by Smotrich, who is also a settler in the Israeli-occupied West Bank² and the leader of the Religious Zionist Party. He is noted for his far right extremist views, especially with respect to Palestinians. He told Arab Israeli lawmakers in October 2021, “It’s a mistake that Ben-Gurion didn’t finish the job and didn’t throw you out in 1948.”

Smotrich is an example of the type of hurdle good people will encounter after the war as they try to put the political toothpaste, now oozing all over the carpet of Israel, back into a new and improved diplomatic tube.

Another problem with relying on the Palestinian Authority is the age of Mahmoud Abbas, the PA’s president since 2004. He is now 87 and has no clear successor. None of his would-be replacements inspires much enthusiasm or confidence. Yet, any two-state solution will have to involve a strong Palestinian Authority, which, at the moment, is politically weak and just about broke. Consequently, if it is to be involved in moving forward after the fighting ends, somehow it must be financially and politically strengthened significantly. And soon. A very tall order.

According to Ghassan al-Khatib, a former Palestinian minister, “The whole idea of the Palestinian Authority is that it’s a transition towards a Palestinian state. If there’s no political horizon, then the whole Palestinian Authority becomes irrelevant.”

For anyone who’s paying attention, the IDF’s invasion of Gaza and defeat of Hamas is the easy part. When “after the war” finally arrives, the real battle begins. That is when Israel, Palestinians, the rest of the Middle East, the U.S., and a good part of the remainder of the world will face a daunting task, indeed.

If political leaders lack the courage to galvanize and develop a viable two-state solution, the current horror will be nothing more than an obscene preview of coming attractions.

______________________

¹ According to Ehud Barak, the main command center of Hamas in the Gaza Strip is underneath the Al Shifa Hospital, the biggest hospital in Gaza.

² The UN Security Council, its General Assembly, the International Red Cross, and others have all agreed settlements on the West Bank and the Golan Heights violate Article 49 of the Fourth Geneva Convention. Doesn’t matter to Smotrich and his colleagues now leading Israel. They just keep building new ones.

Over the last few decades, America’s public health system has become woebegone, fragmented, uncoordinated, and overly complicated. But there is one light in the vast dark, a more than 50-year functioning network that could point the way forward to better days.

Federally Qualified Health Centers (FQHCs) are primary care clinics first established in 1965 as part of President Lyndon Johnson’s War on Poverty. They provide primary care services in underserved areas. They are community-based and receive funding from the Health Center Program of the Health Resources and Services Administration. FQHCs, also known as Community Health Centers (CHCs), must meet stringent requirements, including providing care on a sliding scale fee structure based on a patient’s ability to pay and operating under a governing board that includes patients. Specifically, at least 51% of their Boards must be patients.

By law, FQHCs must treat anyone, regardless of the ability to pay.

This nation-wide program has expanded over the years, and between 2007 and 2014 grew by 82%. Yet, in the last ten years funding has stalled, and a number of clinics have had to close due to lack of funding, which is a shame.

There are 1,368 FQHCs in the country. Most have a number of locations, called Service Sites, bringing the total health care locations to 14,200. They welcome people with insurance, but their main targets are poor people who could otherwise not afford health care. Currently, their patients number about 30 million.

In addition to Community Health Centers, the Health Center Program also funds Rural Health Centers, whose mission is to increase access to primary care services for patients in rural communities. This challenging mission is made more difficult by significant shortages of staffing in rural areas.

Federally Qualified Health Centers and Rural Health Centers are funded annually by congressional approval, and lately the funding has become contentious as Republicans strive to cut back on governmental costs. Additionally, Section 330 of the Public Health Service Act provides grant awards to eligible health centers and outlines the requirements the centers must meet to be eligible.

Don’t feel bad if you’ve never heard of Federally Qualified Health Centers. They give meaning to the cliché, “flying under the radar,” but these health care providers are critically important to people who have nothing else, the people whose Primary Care Physician is the local hospital Emergency Department, the most costly place to get health care in the universe.

Right now, Congress is once again debating future funding for Federally Qualified Health Centers and Rural Health Centers. More than 500 local, state and national health-care organizations are urging congressional leaders to ramp up federal funding, which is set to expire when the recently passed Continuing Resolution, the one that got Kevin McCarthy fired, expires on 17 November. Yesterday, the group sent a letter to key lawmakers arguing for $5.8 billion for each of the next three years, which is about a billion more than originally contemplated by the House of Representatives.

Congress should cough up the money. In 2021, community health centers were estimated to save a total of $25.3 billion for the Medicaid and Medicare programs.¹ In 2019, community health centers generated $63.4 billion in economic activity, with $32 billion of that coming from supporting local businesses.² Clearly, in addition to strengthening health care for our neediest population, these health centers are a good investment for the nation.

Community health Centers are ubiquitous throughout the country. For example, in my home state of Massachusetts, there are 52 community health center organizations providing high quality health care to some one million state residents through more than 300 sites statewide. For perspective, there are 351 cities and towns in Massachusetts.

Given the woeful state of our nation’s public health system, as was amply demonstrated by our response to COVID-19, you would think it might be a good  idea to consider a Community Health Center model as we attempt to make health care better and more equitable for all.

Just a thought.

______________________

¹ Robert Nocon (Kaiser Permanente Bernard J. Tyson School of Medicine). “Testimony on Community Health Centers: Saving Lives, Saving Money before the United States Senate Committee on Health, Education, Labor and Pensions Committee.” (2 March 2023)

² “Community Health Centers Are Economic Engines” (National Association of Community Health Centers, October 2020)

If it wasn’t apparent before, it certainly is now. The Republican Party, in electing Louisiana’s Mike Johnson Speaker of the House of Representatives, served notice today that its preferred position is filial, with heads bowed, genuflecting before the throne of Donald Trump.

Johnson’s qualifications for the post are minimal. A 51-year-old former conservative talk radio host and one-term Louisiana state representative, he is now in his fourth term as a Member of Congress. He ran the Republican Study Committee, a group of socially conservative lawmakers, and served as vice chair of the House Republican caucus, a low-ranking party-leadership post. Johnson has never chaired a congressional committee and will be the least experienced speaker in 140 years.

As Speaker, Johnson will need to oversee a large staff and manage a substantial national fundraising apparatus—and he is far from a prolific fundraiser, which is a key responsibility for party leaders. His campaign raised about $1.3 million in the 2022 election cycle, a fraction of the $28 million raised by former Speaker Kevin McCarthy’s campaign.

But Speaker Johnson does have one supremely important qualification for his new job—he is a dyed-in-the-wool acolyte of Donald Trump and the cult of MAGA.

So, what’s his record in Congress?

Johnson was a key player in former President Trump’s efforts to overturn the results of the 2020 presidential election. He not only voted against certifying the 2020 election results, he also helped rally over 100 House Republicans to sign a brief in support of a Texas-led effort to get the U.S. Supreme Court to overturn election results in four states won by then-candidate Joe Biden. Asked last night by a reporter about his role in attempting to overturn the election, Johnson responded “next question” as Republicans beside him booed.

Johnson supports rigid restrictions on abortion rights, as well as the rights of LGBTQ+ Americans. He has won consecutive A-plus ratings from Susan B. Anthony Pro-Life America, a Washington-based nonprofit that opposes abortion rights.

Last year, he introduced legislation that would have banned federally funded institutions from even discussing sexual orientation and gender identity. He has been a fierce opponent of gender-affirming care for trans youth.

Before arriving in Congress, he worked for a socially conservative legal advocacy group, wrote for his local paper defending laws that criminalized same-sex sexual relations, and expressed fervent opposition to same-sex marriage, CNN reported today. “Homosexual relationships are inherently unnatural,” he wrote, before going on to warn that legalizing same-sex marriage could be a slippery slope to allowing “a person to marry his pet.”

Johnson’s foreign policy positions could also become a divisive issue for him to navigate, as he has expressed opposition to continued funding for the war in Ukraine.

Matthew Green, a politics professor at Catholic University who authored a book on the historical role of House Speakers says, “The speakership is unique in the amount of skill that’s required to do well, and some of that comes from experience. It’s through experience that you learn the ins-and-outs of House procedure, you learn more about your colleagues, and you also get to know the dynamics of working with the Senate and with the White House and with the press. Those are things that Speakers have to deal with to a much greater degree than a rank-and-file member.” And, until this morning, that’s what Mike Johnson was—a rank-and-file Member. Now, he’s Clerk-of-the-works, chief cook and bottlewasher, El Supremo.

Asked today about working with Johnson on spending issues, Republican Sen. Susan Collins of Maine told CNN that she doesn’t know him and was going to Google him. That ought to tell you everything you need to know abut the 57th Speaker of the House of Representatives.

Over the recent past, the Republican Party has demonstrated considerable opportunistic ingenuity, but severely limited foresight. After 234 years as a nation, that ingenuity and lack of foresight have brought us to—Rank-and-Filer Mike Johnson.

The MAGA takeover of the Republican Party is complete.

Friday, in the U.S. House of Representatives, chaos continued unabated.

The good news was Republicans did not elevate pugnacious Ohio Representative and alleged sexual-abuse-enabler Jim Jordan to the Speakership. The bad news is they didn’t elevate anyone else, either. After a five-hour, no-holds-barred meeting of their conference, Jordan was sent to the sidelines. His vote total dropped in each of the three rounds of voting. You’d think that would tell him something.

It is clear Republicans had absolutely no plan for moving forward after Florida’s Matt Gaetz engineered the ouster of Kevin McCarthy two weeks ago, because McCarthy committed the unpardonable sin of working with both Republicans and Democrats to keep the government open for 45 days in order to (perhaps) pass the 12 Appropriation Bills required to fund the 2024 fiscal year. This has led to the current globally embarrassing situation in which Republicans now look like flies circling a lampshade, bumping into each other in their frenzied panic.

And McCarthy’s allies insist on blaming the Democrats for their ex-leader’s dismissal. If the congressional dems had just played ball with Republicans and voted to keep McCarthy Speaker, everything would be pleasantly hunky-dory now.

People, how on God’s green earth did we ever get into this mess? Better question: How did a group of Donald Trump sycophants on the ideological far-edge fringe of society ever worm their way into the U.S. House of Representatives in the first place?

I suggest we have reached this sorry point, because America has now become two countries in all but name only. There is a Red Country and a Blue Country, and they continue to diverge from each other more every day. One of the countries, the Blue, is growing more prosperous, the other, the Red, more poor, falling farther behind.

So, let’s unpack the diverging countries.

There are more than 3,000 counties in America. If we look at how those counties, the blues and the reds, voted in the most recent two presidential elections, something becomes immediately apparent. Blue counties, although far fewer, are growing, red counties are not.

The following chart from the Brookings Institute and the New York Times paints a stark picture of the difference in the size of the counties voting for Joe Biden and Donald Trump. Note the largest county in the country voting for Trump was Suffolk County, New York, which is located in the easternmost part of Long Island. After Suffolk, counties voting for Trump diminish in size almost to the point of invisibility and irrelevance, but there are more than 2,000 of them.

The nation’s economic geography remains rigidly divided. Biden captured virtually all of the counties with the biggest economies in the country (depicted by the largest blue tiles in the graphic above).

By contrast, Trump won thousands of counties in small-towns and rural communities with correspondingly tiny economies (depicted by the red tiles). Biden’s counties tended to be far more diverse, educated, and white-collar professional, with their aggregate nonwhite and college-educated shares of the economy running to 35% and 36%, respectively, compared to 16% and 25% in counties that voted for Trump.

The Blue counties, despite recognized problems Republicans highlight every chance they get, are highly diverse and comprise America’s 2023 economic engine, excelling in technology, medicine, banking and biotech industries, to name just a few. Red America has historically relied on Agriculture, Mining and basic manufacturing, which has been disappearing over the last two decades. In 1998, 18.1 million Americans were employed in the manufacturing industry, representing 11% of the total workforce. By comparison, in 2018, 13.5 million Americans were employed in the manufacturing sector, representing only 6.7% of all jobs. However, passage of the Inflation Reduction Act of 2022 (which not a single Republican Representative or Senator voted for) is reviving manufacturing in both Blue and Red America. The law has already unleashed a manufacturing renaissance by nearly doubling the amount of manufacturing construction in just one year, with forecasts of even higher growth in years to come. Blue America made this happen, not Red, even though both prosper from it.

Manufacturing aside, Blue and Red America reflect two very different economies: one oriented to diverse, often college-educated workers in professional and digital services occupations, and the other whiter, less-educated, and more dependent on “traditional” industries.

The economic positions are eye-popping when viewed through the lens of congressional districts.

In the 2010s, median household income began a steady separation, which shows no signs of slacking. But we can go even more granular to show the divergence.

Republicans in Red America represent an economic base situated in the nation’s struggling small towns and rural areas where the population yearns for the safety and security of the 1950s. Prosperity there now seems out of reach for many, and the leaders of the Republican Party, for some unknowable reason, have no desire to consider the policies of the nation’s thriving metropolitan centers. That is not a scenario for economic consensus or achievement.

Jake Grumbach, a University of Washington political scientist who studies the differences among states, has written that red states, as a group, are falling behind blue states on a broad range of economic and social outcomes—including economic productivity, family income, life expectancy, and “deaths of despair” from the opioid crisis and alcoholism.

Consider the following:

• The gross domestic product per person and the median household income are now both more than 25 percent greater in Blue America than in Red America;
• The share of children in poverty is more than 20 percent lower in Blue America than Red, and the share of working households with incomes below the poverty line is nearly 40 percent lower;
• Health outcomes are diverging too. Gun deaths are almost twice as high per capita in Red America as in Blue, and the maternal mortality rate in Red American states with abortion restrictions is three times higher than Blue America;
• The COVID vaccination rate is about 12 percent higher in Blue America, and the per capita COVID death rate is about 30 percent higher in Red; and,
• Life expectancy is nearly three years greater in Blue America (80.1 years) than Red (77.4), and in the poorer states of Red America, like Mississippi and Louisiana, the divergence is much greater.

But the cost of living is higher in Blue America, and people, especially older Americans, are leaving for the lower taxes and costs of Red America, but lower life expectancy can make the move a bad decision for many. Young professionals with children are staying, though, for the better educational opportunities.

Why have the citizens of Red America put up with second place in so many critical areas?

Since early in the 19th century, people of the southern states have marched to their own drummer. Their addiction to the agricultural allure of cotton and the slavery that economically supported it set the south on a track of agricultural dependence that carries through to this day. For example, during the Civil War, 84 percent of the South’s population was engaged in agriculture, compared to only about 40 percent of the Northern population. Today, the South, with 47% of all of the nation’s farms, is still home to more farms than anywhere else. The South also has the largest percentage of small beginning farms. In fact, most of the farms in the south are small. Agricultural reliance has contributed to Red America being slower to embrace the policies that have led to Blue America’s economic dominance.

Obviously, the nation needs a strong farming industry, but the South’s attachment to small farms, rather than the larger variety with greater scale and profitability as the Midwest has demonstrated, condemns it to a somewhat stifled farming economy.

For what other reasons would the people of Red America, who are just as smart and talented and ambitious as their peers in Blue America, be content with putting up with the inertia of the status quo? I think they have slowly fallen for the tripe dished out to them by politicians who stoke their emotions. Since humanity began walking upright it has been ridiculously easy to persuade people into believing something they wanted to believe in the first place — even if it ran counter to their self interest — and this is happening every day in rural Red America where a large swath of the population desperately wants to go back to the good old days of Leave It To Beaver. It’s almost as if political leaders in Red America have somehow convinced their rural constituents that Salvatore Dali’s melting clocks are actually reliable timepieces.

The problem we all face now is that, given the differing and deeply held beliefs of Blue and Red Americans, there doesn’t seem any way forward out of this impossible situation. In this forest of chaos there must be a road to sanity somewhere, but the leaders we’ve sent to Congress couldn’t find it if you gave them a highlighted map and Sacajawea to lead them.

Meanwhile, today, the House of Representatives will once again convene for another demonstration from the Republican Field Manual, Chapter Seven: Instructions for assembling a political circular firing squad.

As Gaza burns and Israel wreaks mighty vengeance on the terrorists of Hamas (as well as innocent Palestinians), America is beset with its own set of domestic calamities, which, in any other era might be appreciated for the looming catastrophes they are, but now get the banal, desensitized response, “Oh, another crisis?”

As I write this, Republicans in the House of Representatives are hurtling down their own moronic, no-bottom rabbit hole, looking to do all in their power to make the U.S. Congress an even bigger global laughing-stock than it already is. These folks are like a dog with four back feet, each wanting to go in a different direction.

Ex-Ohio State University assistant wrestling coach and alleged sexual-abuse-enabler Jim Jordan is a little more than a heartbeat away from becoming Speaker of the House, second in line to the presidency. “Do you really want a guy in that job who chose not to stand up for his guys?” said former OSU wrestler Mike Schyck, one of the hundreds of former athletes and students who say they were sexually abused by school doctor Richard Strauss and have sued the university. “Is that the kind of character trait you want for a House speaker?”

Jordan says he never knew anything about it. His players say he’s lying. America yawns.

Meanwhile, over in the health care sector, Rome is burning.

Despite a steady drop in life expectancy over the last few years, the U.S. continues to spend nearly twice as much on health care as the average for the rest of the world’s developed countries. Consider this chart as backdrop for everything else that follows:

In the mid-1990s, I was a Trustee at a major teaching hospital in Massachusetts, a state with some of the best healthcare in the world. But there was a problem, and we all knew it. We were facing a shortage of primary care doctors, even as the nation’s healthcare intelligentsia had recently realized the importance of the field and were engaged in a solid effort to grow it. It was a noble effort, but while the industry established the Primary Care doctor as the gatekeeper and patient health strategist, it eventually came to treat that same Primary Care doctor as healthcare’s bastard stepchild. Too many patients, too many insurance requirements, too little time, all for too little money. Those chickens have come home to roost.

More than 145,000 healthcare practitioners, about half of them physicians, left the industry in the two-year period from 2021 through 2022, threatening access and quality, according to a report published Monday by Definitive Healthcare, a healthcare intelligence company.

Sixteen thousand of the health care providers who left were Primary Care doctors, 11,000 were psychologists or psychiatrists. About 9% of all healthcare workers who left the industry were licensed clinical social workers. Of the physicians and mental health practitioners who remain in the healthcare field, the average age is nearly 60. “Staffing shortages will deepen over the next few years,” said John Markloff, Definitive Healthcare’s senior director of data strategy.

And Primary Care shortages are more acute in rural areas than urban. The Health Resources and Services Administration has designated 7,200 regions across the country as Health Professional Shortage Areas, nearly all of them rural. “Generally, people who live in rural America are sicker, older, and come from a lower socioeconomic level,” says David Schmitz, MD, chair of the Department of Family and Community Medicine at the University of North Dakota and past president of the National Rural Health Association. “They are less well insured and tend to suffer from a lot of chronic diseases. And, by nature of where they are, it’s often difficult for them to access healthcare, even basic primary care.”

And Behavioral Healthcare suffers from the same shortages. Half of U.S. counties do not have a clinical psychologist, a psychiatrist or an addiction medicine specialist, which disproportionately affects low-income patients, according to data from George Washington University.

Why these shortages? Well, we could start with money.

According to the Medical Group Management Association, the median income of specialists is nearly twice that of primary-care physicians. The Group reported median income in 2021 for Specialists in the U.S. was $384,000, as opposed to $212,000 for Primary Care physicians.  To put even a finer point on it, the highest-paid gastroenterologists make about $846,000 a year; the highest-paid internists about $352,000 (in large urban areas). Think about that the next time you prep for a colonoscopy.

Moreover, the very factors that tend to make rural patients sicker are also those that make it difficult to recruit and retain healthcare providers for those areas, says Amitabh Chandra, director of health policy research at Harvard University’s John F. Kennedy School of Government.

“There are likely a lack of jobs in many of these places, as well as lower quality schools and housing,” he says. “Doctors know better than anyone the importance of good healthcare to a thriving community. Will they be comfortable moving to an area, and raising a family, in a place where you can’t get great hospital care — or perhaps any hospital care at all within a hundred miles?”

And here’s another shortage problem. More than 2,500 OB-GYNs and 2,800 anesthesiologists departed the healthcare field in 2022, according to the Definitive Healthcare study. Rural hospitals are struggling to maintain maternity wards as waning volume craters revenue, making it harder for these hospitals to continue caring for pregnant patients. This means maternity patients, like everyone else in most rural areas seeking care, must travel longer distances for it, which often leads to poorer outcomes. As I have written before, the U.S. has the highest rate of maternal mortality among developed nations.

Like so many things, all of this makes no sense at all.

So, what can be done?

Healthcare is so upside down in the U.S., nibbling around the edges won’t help. Although what we really need is a Marshall Plan for healthcare, which would cost a lot of money, I fear edge-nibbling is about all we can do — if we’re lucky.

After all, consider what it took, after over a decade of trying, to get Congress, through the Inflation Reduction Act, to allow Medicare to negotiate the price of a measly ten drugs for 2026. And that new-found ability to control costs may disappear if pharmaceutical companies and the Chamber of Commerce win lawsuits they have brought.

Consider all the effort Republicans put into their year-after-year attempts to repeal the Affordable Care Act (ACA), effort that could have gone into so much more productive work.

Consider Republican governors’ ferocious resistance to expanding Medicaid in their states through the ACA to get health care to the people who need it the most, but cannot afford it. After nine years, ten states still refuse to take the money the ACA offered.

Consider the ridiculous fact that, despite 91 charges in four criminal indictments, Donald Trump will be the likely nominee of the Republican Party for President next year. What would a second Trump term do to (not for) American health care, given the brick-throwing destruction of his first term. His first Executive Order, signed within hours of taking office, aimed at repealing the Affordable Care Act.

And consider that today, 18 October 2023, Jim Jordan may be elected Speaker of the United States House of Representatives.

In our polarized, sclerotic, even paralyzed, society none of this makes any sense. But here we are.