Showing posts with label portfolio. Show all posts
Showing posts with label portfolio. Show all posts

Wednesday, October 24, 2012

On being undead: Why I’m bailing from giving the gift of life

Published in the Portland Phoenix



I've been an organ donor since I first got a driver's license, more than 20 years ago. But Friday morning, after getting off the phone with the New England Organ Bank, I took a black marker and crossed out that line on my license. Here's my public declaration that I'm not interested in being an organ donor anymore. When my license needs renewal next year, I'll make sure the designation isn't there.
I haven't suddenly become cold-hearted or unwilling to be of use to others after my death. It's just that, as a direct result of reading Dick Teresi's The Undead (published by Pantheon earlier this year) I no longer have confidence in the medical establishment to accurately determine that I actually am dead. And after talking to spokespeople Laura Dempsey and Sean Fitzpatrick at the NEOB, I no longer have confidence that organ donors have professionals looking out for their interests, either.
What I found, and what Teresi, a science journalist with decades of experience (including being former top editor at Science Digest and Omni), documents comprehensively in his book, is a culture of defensiveness that attacks skepticism with assurances that lack any factual support.
When I mentioned that I had read Teresi's book, Dempsey's first reaction was to blurt out, "Oh no." (She later specified that she'd thought I was calling to do a pleasant feature about someone who was either about to receive an organ transplant or had just donated their organs after death.)
The bottom line is that she and Fitzpatrick didn't like the questions Teresi was asking — which is exactly Teresi's point. Fitzpatrick even called Teresi's tone "snarky and nasty," apparently without irony, as he labeled the work itself "sensationalistic and unserious" and said it "does a disrespect to the science of the topic."
My own reaction was that Teresi's were great questions — like "How do we know who is dead and who is alive?" and "If someone's heart can be restarted in someone else's body, how come it can't be restarted in its original body?" He assumed that there are good and solid medical answers to these questions, and set out to find them.
Fitzpatrick, however, viewed them as allegations that physicians are "willy-nilly killing individuals across the country," a charge he vigorously attacked. "Nobody wants the person dead," he told me.
I'll grant that. But Teresi searched for many years without locating anyone who could tell him — or demonstrate scientifically — how we can tell, with no exceptions, the difference between being living to being dead. That's what his book is about. It turns out that many people who are declared dead may not in fact be dead; some of them may even have the capacity to recover to more or less normal lives.
He says the medical profession makes little or no use of that information, and posits that the reason for this lack of interest is because of pressure from the organ-donation industry, which is seeking bodies that are legally dead but perhaps still have some vitality left somewhere, to provide new parts for others' worn-out, but still-hanging-on, frames.
In my view, this link is the most tenuous of his book. But clearly there must be a reason that doctors don't use all their high-tech diagnostic equipment to determine, for example, whether someone declared "brain dead" actually has no blood circulation in their brain. (This is required in Sweden, but not in the US.)
DEEP MISUNDERSTANDINGS
Teresi's book has seriously unsettled me, by documenting two conceptual disconnections between the medical field and the public at large, which individually and together compound (and confound) decisions about death and organ donation.
The first disconnection has to do with what death actually is. Most of us have a sort of visceral understanding of death as when your breathing and heartbeat stop. But at least some of the time, that's not the measure doctors use.
Rather, they use the concept of "brain death," which medical professionals and laypeople alike take to mean that there is no remaining brain function, neither at the low-level brain stem, nor in the highest levels of the cerebral cortex — the home of memory, personality, sense of humor, self-awareness, and all the other stuff that we might call the person inside the body.
Doctors encourage us to think this — and they think so themselves. But, Teresi argues, that's only because of the second conceptual disconnection, which is that while modern medicine has made truly startling advances in being able to keep people alive, and modern science has deepened our ability to detect life signs, almost none of this wondrous knowledge is applied in the hour of our death.
As Teresi points out, the protocol for determining brain death — which has remained the same across the US since the 1970s — does not test the cortex at all, but just the brain stem. In fact, among the most common — and decisive, for doctors — tests of whether a person is dead is to flush ice-cold water into a person's ear canal and see if their eyes twitch (or not). He rightly observes that this seems a bizarrely Stone Age method in a world where machinery lets us view oxygenation and neural activity deep inside the brain.
Dr. Galen Henderson, the director of Brigham and Women's Hospital Neurocritical Care and Neuroscience Intensive Care Unit, told me that's because the technology has already been used on the patient, to determine what's wrong in the first place. Henderson, who is also an assistant professor at Harvard Medical School, says procedures like CT scans of the brain and MRI exams are "prerequisites" to the point at which a doctor might test for actual brain death with the decades-old methods, which he describes as a more thorough version of a series of tests used to determine whether — and how deeply — a person is in a coma, vegetative state, or other condition.
My assumption was that Teresi's revelations, which so shook me, would have made some sort of difference in the months after the book's March 2012 publication (which was accompanied by coverage in major news outlets worldwide).
Perhaps doctors involved in determining death — and those involved with organ transplantation — would have stepped up to offer the answers Teresi was unable to find. Maybe the explanations were there all the time, but Teresi didn't ask the right people, or look in the right journals.
I hoped that Dempsey and Fitzpatrick would be able to explain what had happened in the book's aftermath. This was particularly the case when Dempsey told me that Teresi did his interviews and research "years and years ago, before the book was published." Fitzpatrick also accused Teresi of, among other things, using "potentially outdated information."
Some of Teresi's references do go back as far as 1976 — with historical sources well before that — but his endnotes reflect that the bulk of his research was in the mid-2000s, with the latest interviews coming in 2011.
And the protocols for determining brain death that the book describes are listed as current by, among other authorities, the American Academy of Neurology and the New England Journal of Medicine. The NEJM article Henderson pointed me to specifies that "interpretation of the findings on neuroimaging" is a precursor to a declaration of brain death, and says a CT brain scan is "essential for determining the cause of brain death." But Teresi provides examples where brain scans were not used until it was (nearly) too late.
I asked Dempsey if anything changed since Teresi's contact with NEOB in late 2010. And that's where I began to see the problem Teresi saw: "I don't know that much has changed since 2010," she replied.
It was then that Dempsey told me she was "uncomfortable" with even mentioning Teresi: "I honestly don't want to be part of this piece if you're going to talk about the book."
CERTAIN UNCERTAINTY
Shifting into PR-script mode, Dempsey began the organ-donation sales pitch that Teresi criticizes. Dempsey told me that 118,000 people in the US are currently waiting for an organ transplant, and that 18 people die daily in this country because "there's not enough organs to be transplanted." Rhetorically, she asked, "If you're to pass away, then why wouldn't you want to help someone else?"
Of course these are sympathy-inducing facts, and it's a fair question. It's also tempting to accept at face value Fitzpatrick's assurance that "dead people don't feel pain." All Teresi is doing — and all I was following up on — was asking questions about the fact that the focus of the organ-donation community seems to be not on the donor, but on the recipient, and seeking protections for the organs' original owner.
In the vein of assurances on the donor side, Dempsey offered the same explanations that Teresi had found lacking. "Death is irreversible," she said. An organ donor is "brain dead" before the organs are removed.
The determination of brain death is by "a very complete neurological examination," Dempsey said. "No one has ever recovered after the series of tests has been conducted" with a determination of brain death.
I pointed out to her that Teresi dissects each of these claims and offers convincing evidence that they're false. In a significant number of determinations of brain death, the tests were conducted improperly; in several well-documented cases, patients have in fact met the clinical definition of brain death and yet returned to functioning life, even as the surgery to remove their organs for donation was moments from beginning.
Noting that Teresi's research had disturbed Dempsey, I asked if his information had prompted any sort of ongoing discussion in the organ-donation community about the issues he raised. "Not really" was her very quick answer.
Not even the revelation that apparent pain responses are common in patients whose organs are being removed for transplantation appears to have shaken the establishment. (Fitzpatrick says these are similar to the flinch your body makes to pull your hand away from a hot stove before your brain registers the "Ouch!" Henderson says that's a bad comparison; there are different types of reflexes, some of which do involve brain activity.)
Also failing to shake the establishment is the fact that some death experts want very particular criteria to be met before they themselves are declared dead — nor that if they are to have organs removed after death, they would require their next of kin to ensure anesthetic was administered to their corpse.
As Teresi writes, despite all this, organ-donor organizations, including NEOB, are unwilling to talk about anesthesia. They say not that the patients have been proven by science to be unable to feel pain, but simply assert — with no supporting scientific evidence — that if a patient is declared dead, they are assumed incapable of sensing it.
If the people who run the show aren't interested in legitimate questions being asked about their processes, and don't have any interest in finding answers when those questions are asked by others, my faith in the system leaves entirely.
FACING THE END
I am not involved in some effort to deny death, though Teresi posits that medical professionals and the public alike misunderstand death (and misrepresent it) because we wish to avoid thinking that one day we too will die.
I know — and mostly accept — that I will die one day. (I've actually thought it was about to happen one dark night when my car left an icy road, headed into the woods. I escaped with minor injuries.)
I accept that at some point my heart will stop, my lungs will no longer exchange oxygen and carbon dioxide between the air and my blood, the cells in my body will cease their metabolic processes, and my neurons will stop sending and receiving minute electrical currents.
What I struggle to accept is that with all we know about science, and all of the equipment, technology, expertise, and experience, the only way I — or anyone else — can be truly certain of my own death is that my body will begin to decay, as my immune system will no longer hold off the bacteria and fungi that constantly assault it from within and without.
And at that point, the first moment at which everyone involved — medical experts, legal experts, and family members — can agree that death has occurred, it will be too late for me to be an organ donor. (I may still be able to be a tissue donor, as some bodily tissues, such as bone, can be harvested for some time after circulation, respiration, and metabolism stop.)
Which is all to say that there is an answer to the question, How do doctors know you're dead? But you're not going to like it, because the honest — and fucking terrifying — truth is that they often don't.
And if doctors can't tell for sure if I'm dead, I'm certainly not going to let them cut my organs out of my body while I might still be alive. Because that would kill me. For real.
WHAT'S LIFE, ANYWAY?
• Teresi's book explains the history of how death has been determined over millennia, and focuses on the major sea change, in 1968, when "brain death" was formally defined by a group of people who published their work in the Journal of the American Medical Association.
He observes that the paper was deeply flawed: The committee itself was primarily neurologists and other brain scientists, and did not include cardiologists or others who might have helped clarify the traditional heartbeat/breathing definition of death. The work included no references to scientific studies, and no direct research by its authors. The main reasons given for creating a definition of brain death had nothing to do with the patient in question, either. Instead, the report expressed concern about the burden on the patient's family, and about providing opportunities for increasing organ donation.
It set up several criteria for death, but as Teresi chronicles, those details — inadequate on their own — were shifted, subverted, and ignored systematically. And none of the criteria involve any of the technology of modern medicine, using rudimentary methods to test brain-stem function without using advanced equipment to examine higher-level activity. (Though that technology may have been used to form the decision to test for brain death.)
Ultimately the definition of death came to mean, Teresi writes, "The patient was not necessarily dead, but he was not going to recover." And even then, the tests laid out in theJAMA article were done improperly as much as two-thirds of the time, meaning the conclusion could be entirely wrong.
Most stunningly, Teresi relates the experience of a woman who was found to have a massive, life-threatening aneurysm at the base of her brain. In the surgery to repair it, her body was chilled to 60 degrees Fahrenheit, her heart was stopped, and her brain drained of all its blood. By medical definitions, she simply could not be alive.
Nevertheless, she not only recovered to full health, but was able to accurately recall, by way of a near-death/out-of-body experience during the surgery, very specific details of the procedure and of the conversation between the medical professionals conducting the operation.
Teresi observes that this raises questions about where life resides, if not in the beating heart or the blood-infused brain. What part of this woman's life was present during that surgery, and where is it located? He notes that we should probably find it and test it, too, before announcing that someone is actually dead.





Wednesday, November 16, 2011

Barely hanging on: Fraud isn't killing Maine's welfare system — conservative misunderstanding is

Published in the Portland Phoenix

Last week in Ellsworth, Governor Paul LePage renewed his efforts to change Maine's welfare system, calling for increased restrictions on benefits for people seeking taxpayer support to get health coverage through the state's Medicaid program.
This, and a guilty plea the day before of a 26-year-old Andover woman to charges of defrauding the state of $8800 in welfare benefits, are part of LePage's much-ballyhooed move to shift people "from dependence to independence," and are in line with longstanding conservative dogma associated with reducing the number of people receiving welfare benefits. But in fact, these efforts are doing the opposite, increasing the likelihood that people will go on, and stay on, public assistance.
The guiding principle of welfare, from its creation to the present — the one basic idea that all who look at our country's complex public-assistance system can agree on — is that welfare should help people hit by unemployment, domestic violence, illness, or other misfortune (largely outside their own control) to get back on their feet and provide for themselves and their families independently. A common catchphrase is "a hand up, not a handout."
LePage does have some efforts other than fraud investigations that he says are moving toward this end. Many of his ideas find support in a 2010 report from the conservative Maine Heritage Policy Center entitled "Fix the System: Freeing Maine families from welfare dependency."
Unfortunately, LePage is wrong — about the fraud, and about most of the other stuff he's trying to do to Maine's welfare system. It's a problem of conception, as much as of policy.
This renewed focus comes at a time when welfare is indeed in need of massive change. It is staggering under the load of Mainers' need, and straining Mainers' ability to provide for each other. Nearly one-third of the state's residents received some form of welfare aid in September 2011, with $40.1 million — $928 per minute — going from state coffers to needy families.
Perhaps not helped by the state's 7.5 percent unemployment rate, that number is growing. While joblessness is below the 9 percent national average, the MHPC's 2010 report found that "412 of Maine's 488 towns reporting have seen an increase in the number of people enrolled in Maine's welfare system since 2003." The MHPC also correctly observes that in 2008, Maine's state and local governments spent more on welfare benefits than on K-12 education.
While data kept — and provided to the PortlandPhoenix — by the state Department of Health and Human Services does not go back as far as 2003, it does indicate that from August 2006 to September 2011, the number of people receiving assistance from non-Medicaid programs increased from 340,974 to 400,943 — a 17.5 percent increase. (Medicaid participants are tallied separately; Maine's numbers in that program have also been increasing.)
That's a big dollar amount, and a lot of people, but when it gets into the hands of those in need, the help is pitifully tiny. "If a person got the maximum available benefit, they would still be living below the federal poverty level," says DHHS spokesman John Martins. His agency's data shows that the average benefit per person per month was just $100.05 in September 2011. Admittedly, that's up 75 percent from the $57.25 that was the per-person average in August 2006, but gas prices have jumped roughly that much in that time; food and housing costs have climbed steeply as well, while wages have dropped. In 2011, the federal poverty level in Maine is $22,350 for a family of four.
The fraud problem?
Maine doesn't really have a problem with welfare fraud by recipients. It's hard to get data comparing Maine to other states because welfare programs vary so widely, but state officials openly admit they have no evidence of widespread fraud. "It seems like it could be pervasive, but we just don't know," says Herb Downs, director of audit for the state Department of Health and Human Services, and chairman of the state's Fraud and Abuse Work Team.
All of the state's evidence about welfare fraud as a systemic problem is anecdotal. As Downs puts it, state officials "hear a lot of the stories." The largest fraud story the state has is that of Kathleen Schidzig. At $18,000 over three years, Schidzig's is the most prominent, highest-dollar-amount case in recent memory, as far as fraud from welfare recipients goes. Assistant Attorney General Peter Black, using DHHS calculations of the maximum benefits that might ever be issued to an in-school mother of four, tried to revise that number to $49,000 (just over $16,000 a year) late in the court proceedings, but was rebuffed by the judge. (Superior Court Justice MaryGay Kennedy did express significant outrage at Schidzig's case, calling her actions "calculated" and "scheming," and sentenced her to a year in prison, with two more years hanging over her head if she runs afoul of strict rules during her two years of post-incarceration probation.)
The average cost of locking up a Maine inmate for a year is $45,000 — not counting money paid to prosecute and defend the accused. (In Schidzig's case, the state Commission on Indigent Legal Services spent $1918.60 on her defense — paying an attorney $50 an hour, plus mileage to drive between Portland and Auburn. Black's total compensation package cost taxpayers $63,000 in 2010.)
Despite the low dollar amount stolen and the high cost of prosecution and incarceration, DHHS is seeking to hear more stories, launching a new state website and hotline to which people can report their neighbors for alleged fraud. (It's maine.gov/fraud and 866.348.1129.)
DHHS's Martins admits those tips can be more trouble than they're worth. Of 1200 tips received last year, between 12 and 20 resulted in court proceedings, he says. Beyond tips that don't include names, towns, and other identifying details, there are plenty of things the public might think are not allowed, that actually are permitted under the rules of the various welfare programs.
For example, Martins says, when a mother and children live with the mother's boyfriend, the children's father is the one responsible for the kids — not the live-in boyfriend (unless he's also the dad). Or there's the common complaint that someone on welfare has a nicer car than the complainant approves of; Martins observes that federal law allows welfare recipients to own a car — one car — to get to and from work.
When investigators get beyond those tips — which are a large proportion of the total — fraud is still "difficult to prove," Martins says. Much more common is an erroneous overpayment — either a clerical error on the state's part, or an honest mistake on the recipient's part that is quickly owned up to. In those cases, the overpayment is deducted from the next benefit check the recipient would otherwise get, and no criminal charges result.
In fact, Martins admits, what DHHS calls "consumer fraud" — that committed by people receiving public benefits — is far smaller than "provider fraud," most common in Medicaid, in which doctor's offices (or their employees, unbeknownst to the bosses) overbill the state, or bill for services never provided, and pocket the extra. One single case in 2010 resulted in an order for $4 million in restitution from a lone defendant who pled guilty to overbilling that much money from the state's Medicaid program over the course of several years.
"That's really where the money is," Martins says. But it's certainly not where the rhetoric and political attention are.

Philosophical politics
"If the discussion is only about fraud, we miss the entire conversation we need to be having," says Christine Hastedt, public policy director at Maine Equal Justice Partners (a nonprofit working to address poverty and related issues). She believes fraud here is "much less than in most states," and observes that LePage's railing against fraud seems most virulent when targeting the working poor and low-income people. Certainly LePage railing against corporate fraud and excess is so rare that even the idea of it seems laughable.
Hastedt says that at all times — but most urgently in a recession where one in six Americans is either unemployed, working less than they want to be, or has given up even searching for a job — we need to look at whether our welfare programs are working, and fix them when they're not.
This is where the divide happens. To be sure, everyone wants to be confident that taxpayer money meant to be spent on helping people is actually helping those in need. But similarities stop there.
Conservatives tend to think the problem is that too many people are on welfare, so they should be made to get off public assistance. They do this by setting time limits for benefits, restricting eligibility, and terminating benefits abruptly once a recipient begins earning money — even cutting off all benefits if a person earns a single dollar more than a program's income threshold.
Progressives, in contrast, tend to think the problem is that too many people have too many needs, and want to help them meet more of their own needs over time. They do this by expanding eligibility for certain programs beyond those who are extremely poor, offering supplemental services to help people stay off welfare, and providing transitional support for people who have been on welfare and are moving back into the work force.
LePage, for example, took his cues from the 2010 MHPC report last legislative session when he proposed eliminating state subsidies and admission into the Medicaid program for families earning between 133 and 200 percent of the federal poverty level. That cut didn't get through the Republican-dominated legislature, but is already being discussed for reconsideration in the 2012 session.
Taking the conservative line, the MHPC calls that subsidy — which can help provide health insurance coverage to families where parents are working but earning low wages and not getting any employer benefits — a "middle class entitlement" that "encourages dependency."
Maine Equal Justice Partners, by contrast, calls Medicaid eligibility for the working poor struggling to escape poverty an important support that encourages people to get off welfare by reducing their fears of losing insurance once they find work.
Another example is the LePage proposal to terminate benefits after five years of receiving them, with no extensions for any reason, and no exemptions that could pause the clock — not even medical emergencies or intensive job-training classes. Get aid for five years, and on the first day after that, benefits drop to zero. The primary underlying assumption is that a person will be so afraid of benefits stopping entirely that they will take great pains to leave the system. The secondary underlying assumption is that people will be energized by that fear, motivated to get work — and not terrified into inaction, and ultimately dropping off the welfare rolls into even deeper poverty.
MEJP's Hastedt says welfare recipients do fear losing their benefits, but struggle with what to do in a low-wage, low-employment economy where having a job does not mean (and is often staggeringly far from) being able to afford child care, reliable transportation, and health care.
It turns out that while those who accuse welfare recipients of laziness might shudder to hear it, most of those they criticize are actually working very hard to scrape together enough money to house and feed and clothe themselves and their families.
Early struggles
Again we can turn to Schidzig's case for illumination. In many ways, she was a typical Maine welfare recipient. Now 31, she is the first to admit her life has had problems. In an interview at the Maine Correctional Center in Windham, she describes herself as the child of a teenage mother, whose youth was supported at least in part by public assistance.
That is part of what many people refer to when they talk of a "cycle" of poverty, but it's actually less reflective of reality than even advocates for the needy expect. A 1995 study found that 64 percent of Mainers on welfare had not grown up in families receiving benefits; 11 percent said their families had gotten aid "most of the time;" 15 percent had received help "some of the time" (as little as once); and 10 percent didn't know whether their families had gotten welfare.
While it's hard to rely on 16-year-old data about a welfare system that differs significantly from today's, the study hasn't been replicated. And the population of welfare recipients has shifted heavily toward people who have some type of disability, which would tend to suggest further departure from successive generational dependency.
A mother at 17, Schidzig finished high school but didn't go on to college; her first child's father was of little help, so Schidzig stayed with her mother. "I was a kid, raising a kid, living with a kid," she recalls. With few qualifications, she worked low-wage jobs, including at a Burger King restaurant in Lewiston.
Single motherhood with little to no support from the father, and low-wage jobs, are common threads throughout Maine's welfare system, according to a January 2011 report conducted by the University of New England and the University of Maine at Orono. Commissioned by MEJP and the Maine Women's Lobby, another nonprofit groups working to promote economic security for Maine families, the study found that nearly 92.4 percent of recipients of TANF, which provides cash assistance to needy families, are women with young children. In addition, just 12 percent of them received child support that was due. Nevertheless, they are used to working outside the home: 97 percent of recipients have work experience (mostly in the sales or service sectors, which are typically low-paying jobs).
Many people Schidzig knew as a child and young adult — and others she would come to know as she grew older — were also on one form or another of public assistance. Food stamps, TANF, unemployment insurance, and Medicaid (called MaineCare here) are the largest state programs. (Disability payments, another major form of help, are handled federally by the Social Security Administration.)
She saw what grinding poverty did, and was determined to be able to provide for herself and her family. She made what experts say is the best possible move: she sought higher education, enrolling in community college.

Seeking education
The UNE-UMO study found that "higher educational levels are strongly correlated with less time spent on TANF and lower frequency of return to cash assistance." Recipients with less than a high-school diploma averaged 21 months on TANF, while the "relatively small number of college graduates" who received TANF stayed on the program for an average of just eight months.
Sixteen percent of the survey respondents applied for and enrolled in a state program called Parents as Scholars, in which TANF recipients can get help with child-care and transportation costs while enrolled in classes at accredited colleges and training programs. Hastedt says "it's not promoted as effectively as it should be" by state workers handling applications for aid.
Indeed, between 2005 and 2011, TANF participation has increased, reflecting growing need that is at least partially related to the ongoing recession. But during that same period, Parents as Scholars participation has dropped. "These are the times when people should be going back to school," Hastedt says. With high unemployment, they'd have trouble getting a job anyway, and can take advantage of assistance to learn new skills, thereby increasing their chances of finding work as the economy improves. "What a lost opportunity," Hastedt says.
Schidzig was in the PaS program; she specifically needed help with child care, because she had three more children in rapid succession between 2007 and 2009, and they needed looking after when she was in class.
Schidzig says she applied for additional aid immediately following each birth; she was unable to work for short periods because all three babies were born by cesarean section. She received aid for at least some of the period between October 2007 and February 2010, according to court documents.
From time to time she got into trouble with the law, accumulating several misdemeanor convictions from 1998, the year she turned 18, through February 2011. The Lewiston Sun Journal reported that she served a total of six days in jail and paid $900 in fines connected with the various small-time crimes, ranging from disorderly conduct to carrying a concealed weapon.
But she was able to live on her own in Lewiston, with the help of Section 8 housing supplements, when — according to state allegations — her boyfriend, the father of her three youngest children, moved in. (Schidzig says he stayed over from time to time but was away a lot, working elsewhere in the state.) Then real trouble began.
In April 2010, she and her family were forced out of her Lewiston rental house because sewage backed up into the basement, leading the city to condemn the property. Adding to the disaster was a bedbug infestation that caused them to leave all of their belongings behind, including photos on the walls, her children's toys, and even pots and pans, theSun Journal reported at the time. They moved to Portland, starting over with used furniture donated or bought cheaply at discount stores.
While these particular circumstances are unusual for public-assistance beneficiaries (or anyone else, for that matter), in terms of financial impact it closely mirrors divorce, separation, or fleeing domestic abuse — which are all major factors in sending people to seek TANF assistance. Nearly 25 percent of the respondents to the UNE-UMO study said they applied for help because of divorce, separation, or escaping an abusive relationship.
A few months after the newspaper coverage of her residential disaster and her accompanying threats to sue her landlord, Schidzig found herself indicted by an Androscoggin County grand jury for two felonies and three misdemeanors relating to "misuse of approximately $25,000 in TANF and ASPIRE benefits," according to a statement from the Maine Attorney General's office. Schidzig claims the charges resulted from the newspaper article's description of her boyfriend as living with the family when he in fact did not; the prosecution disagreed. If he was, he would be assumed to be contributing to household income, meaning she would be eligible for less aid.
Schidzig and her court-appointed attorney, Amanda Doherty of the Portland firm of Strike, Goodwin, and O'Brien, say they proposed a deal in which Schidzig would plead guilty to taking less than $10,000 (an amount that would mean her crime was a misdemeanor rather than a felony), but assistant attorney general Peter Black refused. Black, whose full-time job is investigating and prosecuting people suspected of welfare fraud, did not return multiple phone calls seeking comment for this story.
Schidzig ultimately pleaded "no contest," in which she did not admit guilt but did accept that the state's case was likely to prevail if it went to trial. At her sentencing hearing, she was stunned to learn that the state was suddenly alleging she took $49,000; Justice Kennedy refused the state's new estimate and ordered Schidzig to pay $18,000 in restitution, serve a year in prison, and be on probation for two years after her release.

Fewer prospects than ever
This is not where she expected to end up, Schidzig says through tears in a small meeting room near her cell. "I have worked all my life and I've gone to school for many years," she says. She teaches her kids to work hard and be honest. Looking at her file of paperwork chronicling the case against her, the court proceedings, and her prison records, she shakes her head, frustrated that rather than plea-bargaining (a common practice in criminal cases), she was accused of stealing more money than she says she even received in benefits.
"I didn't do that and it's ruined my life and it's ruined my kids' lives," she says, composing herself, and turning philosophical. "Maybe I had to lose one year of my life to gain the rest."
Her personal situation may be beyond significant repair, but she certainly knows how to fix the system — and it involves better targeting the help that is provided, so it actually meets parents' needs.
"It's a domino effect," she says, describing how failures in the education, welfare, and job support systems can leave people who want to work and provide for their families unable to meet basic needs of both home and work.
Observing that welfare benefits, according to both state and federal guidelines, expire after a person uses five years' worth, she suggests making people enter some sort of job training or degree program during that period — the full five years is plenty of time in which to make real progress, and most programs are far shorter, particularly non-degree job-skills courses.
Why should we listen to Schidzig's advice? For one, because it's hard-won insight from a life in the trenches of poverty. She says openly what many who know the system well say privately: "You can't cut it on welfare, even if you have housing." That $100 per person per month average benefit is a long way from making ends meet, and if it isn't targeted exactly right, it misses the need.
Another reason to listen to Schidzig is because her prescription is exactly the same as those who propose various ways to fix welfare. This is not to defend a convicted fraudster. But in human terms her situation is nothing like what even conservatives who target welfare for major overhauls want to see: A former teen mother, now 31 and the mother of four, is in prison for a year. Her employment prospects, with just a high-school diploma and a few community-college classes, were negligible to start with. Now they are ruined forever, meaning she and her children are likely to remain on taxpayer-funded assistance for many years to come.

Seeking real fixes
We have already discussed the universal goal of those addressing the welfare system: getting people off welfare and into positions where they are able to feed, clothe, and house themselves and their families (and keep everyone healthy).
There is another goal, though, that many fail to see: reducing the likelihood that people will need welfare in the first place. It's here that welfare reform can make the most difference; it's no coincidence that many of these steps are ones that will also help people who are on welfare transition off of public assistance.
Fixing what's wrong, and smoothing the road off welfare (as well as keeping others out of the program) requires "recognizing the kind of jobs that people leaving TANF are going into," Hastedt says. They're typically low-wage, low-security jobs without significant schedule flexibility or benefits.
That means the working poor — and those people who are poor and looking for work — are missing three things, she says: "access to child care and transportation" and health coverage.
State supports — including the subsidized Medicaid coverage for the working poor — helps what she calls "the people who don't have to go on TANF" because they get help with medical coverage, she says. Similarly, helping people with car repairs and supplements for child care can keep some people off welfare entirely, while providing a smooth landing for those who find work and move toward independence.
Federal rules also need to change, to allow welfare recipients to continue to qualify for benefits while enrolled in degree-granting programs. One reason state officials may not be promoting the Parents as Scholars program, despite how well it works, is that federal rules don't consider post-secondary education that lasts beyond 12 months as meeting recipients' required work participation while getting benefits.
Looked at closely, even conservatives support this change in policy. The 2010 MHPC report recommends more aggressively enforcing job-training requirements on welfare recipients. Such a change could include something like Schidzig's suggestion that people be required to get job training or go back to school. (The MHPC's specific recommendation focuses specifically on job training; it doesn't mention degree programs, but the data on reduced welfare dependence for degree holders is strong.)
Another MHPC proposal, however, differs from Schidzig in a key way, regarding "diversion" programs designed to help people avoid having to enroll in welfare. Schidzig puts it this way: "If a mother can't get a bed . . . help her get a bed." Maine has a program like this, called Alternative Aid, which is intended to give a one-time cash injection to a family so that the providers can keep working and not have to enroll in welfare programs. For example, if a car breaks down and needs an expensive repair before its driver can get to work, Alternative Aid can help cover the cost of the fix.
MHPC would add job-search requirements and other eligibility restrictions as conditions of receiving Alternative Aid, turning it into something that looks more like a traditional welfare program than a supplemental support for a parent who is already working. But that runs counter even to MHPC's description of its proposal as a "diversion" keeping people off welfare.

Finding 'a path out of poverty'
Another thing that needs to change is the political rhetoric, which at present tends to demonize the poor, turning people who need help from their fellow Mainers into some sort of leeching aliens selfishly hoarding cash. (Never mind that when averaging $100 per month per person, the benefits could hardly help anyone get rich.)
Now what happens? Schidzig is slated to be released from prison on June 1, 2012, and her two years of probation will begin. During that time, she will be expected to pay back the $18,000 restitution. She will likely be unable to find work — a felony conviction involving financial fraud isn't exactly attractive to employers, who are already seeing as many as 20 applicants per job opening — when there are jobs that are open. "I don't think I could even get a job at Burger King," she says with typical directness. (She knows what it takes to get a BK job; she's worked at one in the past.)
Which means she'll be back seeking help from the state. If she is able to get welfare benefits — people convicted of welfare fraud usually, and rightly, find it hard to get approved again — she likely won't qualify for help for herself, but only for her kids.
Therefore, her benefits will be lower than they were in the past, and she'll have little choice but to dip into that money to pay her probation officer to cover the cost of supervising her ($10 monthly), as well as all that restitution.
She's looking at a very similar picture to people who are on welfare. Hastedt describes it as difficulty "seeing a path out of poverty." What it looks like to Schidzig, and to other Maine welfare recipients — especially if LePage gets his way in next year's legislative session — is staring off a cliff.








Thursday, April 7, 2011

Commentary: This trickle-down stinks

Published in the Portland Phoenix

True free-market capitalism has lasted 30 years — barely half as long as its arch-enemy, Soviet communism. It began with Reagan chipping away at the social contract that bound us all together as fellow Americans, as human beings. Now, as funds "saved" by slashing programs for regular people are handed off to megamillionaire plutocrats as tax breaks, we can see clearly that the winner-take-all philosophy has bankrupted America morally, just as surely as it has punished her people financially.


That realization is taking hold among the rich — recent MarketWatch and Vanity Fair columns warn of dire consequences if the wealthiest one percent continue to neglect the suffering of the masses. The rest of us must now drive this point home. The risks if we do not are clear: Republicans in the US House of Representatives have just suggested slashing Medicare, Medicaid, and Social Security — without canceling a dime's worth of tax breaks for the uber-rich.

As tax day, April 15, approaches, it is obvious that we live in an era of taxation without representation. The government takes money from the working class — the only people left who do not get massive tax breaks — and makes decisions that serve only the wealthy few.

Today, with endless war and limitless profiteering, America is in crisis. The Reagan-esque "trickle-down theory" appears ascendant, as politicians on left and right alike dole out government handouts to the wealthy and the corporations they own, while simultaneously eliminating government help for those who are the neediest. The stated promise — the vain hope — is that the rich will reinvest in America, creating jobs and thereby spreading wealth to everyone.

But we know that's not working — for decades now, America has been stripped of her wealth, her workers left to rising unemployment, their homes foreclosed upon, their children's schools gutted.

Self-serving politicians have co-opted the Tea Party movement, turned it into a pawn, a shill for corporate interests. The crowds that attend Tea Party rallies obviously do not realize that they are in a very real way demanding to pay higher taxes and receive fewer services, so that corporations can boost profits. Tea Party orators promote destruction of the social safety net that keeps children from starving, the elderly from freezing, and the poor from dying in the swamp of need. It is time for a return to the real Tea Partiers' values, for us to refuse to pay up without a voice in how our collective riches are allotted.

In Wisconsin, in Ohio, and in Maine, working people are finally standing up and reaffirming the true American ideal, one that generations grew up working to achieve: that we are all members of the same community, who thrive or perish together. We should not tolerate a nation in which corporations and the ultra-rich tread on the poor and middle classes, exploiting them by depriving them of fair pay, humane working conditions, and a decent education.

As the greedy, the heartless, and the power-crazed grow in influence, the American dream is turning into a nightmare. It is already a bad dream for far too many.

The real American dream — the one millions of Americans died striving for, perished protecting, and still work for today — is far from perfect. Still, it is a world in which some corporations are socially responsible, in which some of the wealthy recognize their private fortunes are built on the skills of the many, in which some of the privileged exercise what used to be called noblesse oblige but today goes by the name of public responsibility.

The real America is a nation in which every person has an equal chance to better his or her life, and by so doing also betters the lives of everyone around them. It is a nation in which we help our neighbors in need — knowing that when our day of need comes they will help us.

Today, as I prepare to pay my taxes to a government that does not represent my interests, I'm angry — and not just at the politicians and corporations. I'm angry at those who voted for Bush, for McCain — even, it seems, for Obama. We are complicit in our own ruin at the hands of the robber barons.

Now is a crucial moment for us to change course. The privileged, who have already achieved their fortunes by hook or by crook, seek to bar the door to us, to deny us our dreams forever.

It is time for us to stand up and tell the wealthy what, in fact, is trickling down on us from up there, where they sit, comfortable on their thrones. It is not prosperity, nor even opportunity. It's something very rudely different. And this trickle-down stinks.

Thursday, June 18, 2009

White-supremacist code printed nationwide

Published in the Portland Phoenix, the Boston Phoenix, and the Providence Phoenix

Imagine you are a white supremacist who is getting on in years. You've spent your life writing, extolling the virtues of Nazism, and denouncing Jews and African-Americans. You even wrote a book (published only online) that claimed the Jewish holy book, the Torah, demands the slaughter of Christians, and used that spurious beginning to justify the slaughter of Jews instead. You know full well that it was part of Hitler's justification for the Holocaust.

As 2009 dawns, you are nearing 90 years old, and you have watched your fellow World War II veterans struggle and suffer their ways through slow, degenerative deaths. You have no desire to endure that. You see yourself as a warrior, even perhaps a holy warrior. So you hatch a plan that will bring you a warrior's death, and simultaneously make you a white-supremacist martyr. And you realize that your age gives the plot an incredible twist only those in the know will discover: it is the key to getting all the world's media to print "Heil Hitler" in your obituary. But time is short — your birthday is in July.
The Southern Poverty Law Center last week confirmed that it is investigating a theory similar to my own, which is described above, in the aftermath of the fatal shooting at the US Holocaust Museum in Washington, DC, on June 10. In that incident, James von Brunn, a long-time white supremacist and neo-Nazi, allegedly shot and killed an African-American guard before being shot by other security staffers.
And while von Brunn survived to face federal criminal charges and may yet die slowly in federal prison, he did manage to get newspapers around the globe to print a white-supremacist code praising Adolf Hitler right next to his name. "James von Brunn, 88," was a phrase in almost every news story — indeed, it was a common piece of harmless information that would have been more noticeable if reporters had left it out. It is his age.
But white supremacists and those who monitor hate groups know it is also a numeric code meaning "Heil Hitler." The letter "H" is the eighth letter of the alphabet, and hatemongers around the world have long used "88" to mean "HH," or "Heil Hitler," honoring the leading historical icon of hate and intolerance, Nazi dictator Adolf Hitler.
Von Brunn himself knew and used this code often. Even before this year, he signed many of his Web postings "James von Brunn 88" — differing only by a comma from how newspapers and online news sites described him after he put his tragic plan into action.

Thursday, June 4, 2009

Keeping faith: Piers Paul Read looks inside the Church

Published in the Portland Phoenix

His publicist calls Piers Paul Read "the anti-Dan Brown." She's capitalizing on a buzz-worthy name, sure, but it's a fairly insightful description of a man whose latest book, The Death of a Pope, explores not the Brownish theme of the Catholic Church secretly at work in world affairs, but rather its inverse — how worldly factions seek to transform the traditionalist Church through its cloistered traditions.
Read is best known to a generation of readers as the author of Alive: The Story of the Andes Survivors (J.B. Lippincott, 1974), about the high-mountain plane crash that killed several members of a Uruguayan rugby team; the survivors, strengthened by eating the flesh of their dead friends, made a nearly impossible trek to civilization and rescue.
"I had quite a sheltered upbringing," says the soft-spoken Englishman, who stopped through Maine last week for a reading in Augusta (but, oddly, not in Portland). As a young adult, he says he was "very revolutionary," promoting Marxism in Latin America, but came to doubt whether his socially disruptive efforts would really help people in need. That period in his life both was part of, and deepened, his quest to overcome insularity by inquiring deeply into the outcomes of efforts by those who claim to know the ultimate unknowable, God's will.
His understanding of that struggle lends a quiet weight to the smooth, quick readability of The Death of a Pope. Set in the days between John Paul II's death and the election of Benedict XVI, the book follows the forces swirling around the conclave of cardinals that selects a new pope, including conniving princes of the church, radical Catholic missionaries, and innocents who find themselves involved.
The end leaves much room for speculation about what comes next, but suggests an answer to the age-old question of whether salvation is earned by words, deeds, or faith alone.
The Death of a Pope | by Piers Paul Read | Ignatius Press | 225 pages | $21.95

Friday, December 19, 2008

Take Back Barack: It's time to reclaim the man we put in the White House

Published in the Portland Phoenix and the Boston Phoenix; reprinted in the Pittsburgh City Paper; co-written with Deirdre Fulton
Let's be honest: we didn't vote for the Barack Obama his campaign advertised. We didn't vote for an African-American man, nor for a US senator from Illinois, nor for a father, a husband, an activist, or a young politician.
We voted for the Barack Obama we fantasized — the progressive miracle worker. We voted for Change.
Millions of us stood up and shouted, handed out fliers, talked to our neighbors, donated hard-earned money, and drove people to the polls for Change. We screamed, hugged, kissed, and cried when we learned Change had come to America. We knew Change wouldn't come overnight, that it would take time, but we were excited that we had elected a man who was open to Change, who said he wanted to consider real people's needs while in the Oval Office. We eagerly awaited the first hints of Change, as the president-elect's transition developed.
And now, we have reason to worry that Change is not coming to America after all. For nearly two years we were encouraged to "Be the Change you want to see in America." It is now obvious that we have a ways to go toward Being that Change. And so does President-elect Barack Obama. And that, above all else, needs to Change.
It was not the Democratic base, nor the centrists, nor even the center-left, who put Obama where he is today. The progressive movement rose from near death and kept Obama alive in the primary, eventually proving stubborn enough to carry him to victory over the Establishment candidate. And then, in the general election, it was the progressives whose energy infected the nation, whose enthusiasm reminded longtime vote-the-ticket Dems that elections were about the future, and whose contributions, tiny as each individual one was, funded the revolution of Change that swept Obama into the Oval Office.
Now is the time to hold him accountable — even before he takes the oath of office — because once he's in there, he will be surrounded by the trappings of Power, the machinery of State, and the inertia of Bureaucracy. If we are to reach him, we must act quickly. Though he has shown us that he is not who we thought he was (for the record, we did know he wasn't the Messiah), he has also, fortunately, shown us the way to keeping him — and our country — on the right track.
What's gone wrongObama's fall from progressive grace goes beyond the campaign-season disappointment of his support for the Foreign Intelligence Surveillance Act, the warrantless-wiretapping law strongly opposed by liberal activists and civil libertarians.
Progressives have a variety of objections, largely relating to flip-flops (warrantless wiretapping), climbdowns (withdrawal from Iraq and taxing the ultra-rich), and betrayals (keeping Bushies like Robert Gates and Michael Hayden anywhere near the halls of power). Many also object to a return of Clintonites, who while certainly Democrats, were hardly progressives in many areas.
While a CNN poll shows that 80 percent of Americans approve of Obama's transition so far, some progressives are unconvinced. They objected loudly enough to warrant a Huffington Post talking-to from legendary Democratic strategist (and Obama advisor) Steve Hildebrand.
"This is not a time for the left wing of our Party to draw conclusions about the Cabinet and White House appointments that President-Elect Obama is making. Some believe the appointments generally aren't progressive enough," he wrote. But Hildebrand accused naysayers of being impotent and shortsighted. "After all, he was elected to be the president of all the people — not just those on the left."
But that plea for patience and tolerance wears ever thinner as we watch the transition unfold. Perhaps Obama's most egregious mistake in the eyes of progressives is the president-elect's decision to surround himself with decidedly unprogressive national-security and foreign-policy advisors. In part, that list reads like a Clinton-era roster — which is troubling because, as United Nations correspondent Barbara Crossette wrote in The Nation last April, "The Clinton record . . . is anything but stellar in global or even US security terms. . . . In many ways the 1990s were a wasted decade in international relations."
Most notably, there's Hillary Clinton herself, our soon-to-be secretary of state, who voted to authorize the invasion of Iraq, who has been called "a hawk among hawks," who pointed approvingly at humanitarian interventionist actions like the one her husband initiated in Kosovo in 1999. Obama's team of advisors includes several other returnees from the Clinton administration, such as Michele Flournoy, Susan Rice (recently named US ambassador to the UN), Richard Holbrooke, Anthony Lake, and Madeleine Albright, all of whom have been neoliberal hawks to one degree or other.
While a return to Clinton-era foreign relations is a certainly a change from destructive Bush-era policies, it is not Change writ large. Not to mention the fact that another segment of Obama's national-security squad is rounded out by center-righties with firm Bush-era roots, such as Secretary of Defense Robert Gates, who will stay on as a holdover from the Bush administration, and national-security advisor-designate Jim Jones, a former advisor to John McCain.
What will these choices mean when it comes time to make big decisions about closing Guantanamo Bay prison, or about withdrawing from Iraq, or about increasing troops in Afghanistan?
"Obama's argument — that his center-conservative cabinet will carry out radical change if he orders them to do so — is denied by recent history," writes Ted Rall in Maui Times Weekly. "The US government, as micromanager Jimmy Carter learned, is too big for the president to manage on his own. And, as George W. Bush learned after 2000, the people you hire are more likely to change you than you are to change them."
On the economy, as well, Obama has made some critical missteps. It's not just that Lawrence Summers, Obama's pick for head of the incoming White House National Economic Council, is a Clinton-era economist who oversaw the same policies that got us into the financial mess we're in today (or that his record on gender equality is iffy-at-best). Two of Obama's largest policy backpedals have been economic.
First, he adopted a more cautious stance on rolling back tax cuts for people making more than $250,000 a year — rather than taking the bold step of repealing those, he now says he'll just let them expire as scheduled at the end of 2010. Then, citing the sharp decrease in oil prices from this summer's record levels, he shelved his plan to tax oil-company windfall profits. Liberal blogger and columnist David Sirota had this to say: "[I]f oil prices are down and oil industry profits are truly down, what's the harm in passing a windfall profits tax? Even if you buy the right-wing nonsense about a windfall profits tax 'hurting the industry' or 'hurting the economy' when it is applied, if there really are no windfall profits to tax, then it won't be applied."
What's going right-ishIt is true that Obama is doing some stuff we thought he would do, although not always in as gung-ho a way as we might like.
Consider "Your Seat At the Table," a special section of the Obama transition team's Web site, change.gov. There, average-Joe Internet browsers can read policy recommendations from high-powered lobbying organizations such as the American Civil Liberties Union, various environmental groups, the National Education Association, and HIV/AIDS activists. This is obviously in keeping with the team's promise of transparency.
Other bright spots are Obama's weekly YouTube addresses, and the announcement of an Office of Urban Policy, which could have big implications for the economy, the environment, and urban education. He's focused his economic efforts on preventing foreclosures. And while some of his advisor picks are ideologically questionable, there are enough women on the list that some pundits have suggested, as AJ Rossmiller did in The New Republic, that Obama is "ushering in a feminist revolution in foreign policy and national security."
Aside from the fact that, as Christopher Hayes wrote in The Nation, "not a single, solitary, actual dyed-in-the-wool progressive has, as far as I can tell, even been mentioned for a position in the new administration," some of Obama's choices have been downright heartening. The selection of Nobel Prize winner Steven Chu to head the Department of Energy, for example, signals a sharp departure from the days of head-in-the-sand climate change non-leadership from the federal government. Chu, an experienced outsider — seemingly unbeholden to any interest, other than science — is an ideal pick, the type we hoped we'd see more of from the Obama-Biden administration.
And former senate majority leader Tom Daschle, though he is on the surface a classic boys-club Dem, has impressive healthcare credentials to back up his appointments as secretary of health and human services and director of the new White House Office of Health Care Reform. His book, Critical: What We Can Do About the Health Care Crisis (Thomas Dunne Books) will come out next year, and will outline Daschle's major reform ideas, including the creation of a Federal Health Board that would make coverage decisions for federally-administered insurance programs. At the change.gov Web site, he's soliciting citizen input on how to fix our healthcare system (though there's one thing we can be sure of: it won't be single-payer). The fact that Daschle pushed to run both the federal agency and the executive-branch office suggests that there will be an aggressive attempt to address this issue early in the Obama administration — and that Daschle is eager to use his wheeling-and-dealing skills (honed in Congress) to make it happen.
But the most important achievement so far is that Obama has managed (mostly) to keep our nation's optimism afloat — despite Blagojevich, despite the auto-industry-bailout mess, despite the public's generally pessimistic outlook, Obama is still enjoying higher ratings and a longer honeymoon period than any recent predecessor. He's courting doubters while making sure that his base gives him the benefit of the doubt. That's Change.
Not there yetThe question becomes whether Obama will be a servant to his advisors, or whether he will learn from their experience, absorb their suggestions, and yet ultimately go his own, progressive, way.
As he rounds out his cabinet appointments, we'll assess his progress. (See how Obama's selections measure up, as they're made, at thePhoenix.com/TakeBackBarack.) With education, Obama was under pressure from conflicting pro-union and reform interests. One of his top transition-team education advisors was Linda Darling-Hammond, who had the support of teachers' unions, and is somewhat notorious for her stances against Teach for America and No Child Left Behind; but on Tuesday he chose Chicago public-school superintendent Arne Duncan — who is more reform-minded (generally favoring concepts such as merit-based teacher pay, charter schools, and high-stakes testing), but has questionable classroom bona-fides.
There's also the whole question of America's relationship with food, eating, and farming — and who Obama picks as his agriculture secretary will set the tone on these issues. While he's said he doesn't want the job, here's what sustainable-food guru Michael Pollan told PBS host Bill Moyers about the decision: "What Obama needs to do, if he indeed wants to make change in this area — and that isn't clear yet that he does, at least in his first term — I think we need a food policy czar in the White House because the challenge is not just what we do with agriculture, it's connecting the dots between agriculture and public health, between agriculture and energy and climate change, agriculture and education."
Just last week, in a New York Times column, Nicholas Kristof suggested Obama "name a reformer to a renamed position" — Secretary of Food and Agriculture, or just of Food, perhaps?
On so many other questions — How will Obama deal with terror-suspect detainees? Who will he appoint to federal courts? How will his administration address the possibly illegal maneuverings of its predecessors? — we will simply have to wait and see. Perhaps, in this case, patience is practical.
"Sure, there's a chance that Mr. Obama, derided this past year by the right as an empty slate who tried to mean all things to all people, has simply been leading the left on and is now morphing into a rudderless pragmatist who will break their hearts," Steve Kornacki writes in the New York Observer. "But pragmatism doesn't have to be rudderless. It's just as easy to portray Mr. Obama's early moves as a sign that he will be pragmatic about pursuing progressive goals."
But there's a fine line between pragmatism and losing sight of one's principles. If Obama turns out to be "more of the same," or more like "more of the same" than he is like Change, the progressives will go back in the closet they came out of to support Obama. A generation of young people might get their hopes dashed and become cynical opters-out of the political system, like the preceding generation.
The way forward
How can we take back Barack?
Fortunately, Obama's campaign of Change has shown us the way to take back Barack. We need to mobilize, to communicate, to connect, even to fundraise — and we need to be sure we get his attention, the way we got the world's attention when we voted for Change.
STEP 1: DECIDE WHAT CHANGE YOU WILL MAKE.
Determine what difference you will begin making, what effort you will start making — beyond any community involvement you're already involved in — and get started. Make the phone calls, send the e-mails, start the conversations, around whatever it is you're going to take on: healthcare, education, hunger, poverty, or any number of other problems facing us.

STEP 2: TELL OBAMA HIMSELF. At the Obama transition team's Web site, there's a page to share "your vision," saying "where President-Elect Obama should lead this country." (It's at http://change.gov/page/s/yourvision.) Make sure Obama knows that your vision is for Change, and what you are doing. But don't stop there. Write letters asking for support, demanding Change, and send them to the Presidential Transition Team, Washington DC 20270 (no street address is needed; and the transition team helpfully informs that only letters in No. 10 envelopes — that's business-size — can be accepted; nothing smaller, no greeting-card envelopes, and no packages).
STEP 3: TELL EVERYONE YOU KNOW. Post Change-seeking comments on blogs, forums, social networks, and even meatspace bulletin boards. Talk about what you are doing for Change — and how others can help — at bars, business functions, book-group meetings, and every other social event you attend. (Remember how much you did this before November 4? Just do the same thing again!)
STEP 4: JOIN THE COLLECTIVE EFFORT. Print out "Take Back Barack" logos, make them into bumper stickers, put icons on your Web site and social-networking pages, make signs and put them in your windows or on your front lawn. Host parties and neighborhood get-togethers to talk about your projects. If there are enough of you — and we're sure there are — get a group together to organize a March for Change in your community. Go to Obama supporters' "Change Is Coming" meetings in your community, or start one by visiting barackobama.com.
STEP 5: GET THE MEDIA'S ATTENTION. Call up your local alternative-weekly paper (and the local daily, if it still exists), and the local TV stations, and tell them what you're doing. Invite them to your events, and encourage them to cover the issues that are important to you.
STEP 6: USE TECHNOLOGY TO DO ALL OF THE ABOVE BETTER, FASTER, AND MORE EFFECTIVELY. Create a system by which people can text and e-mail in their hopes, dreams, plans, and actions from their phones and computers, and have that information forward automagically to Obama and his team. At the same time, post that information publicly elsewhere on the Internet, so we can all track the nationwide effort for Change and the increasing pressure on Obama — and gauge the response.
STEP 7: KEEP AT IT. As much as positive energy can come from all this, there's an important negative lesson: we can never let up. Change does not happen and just stay that way. We need to work for Change each and every day of our lives, and enlist more people in the cause at every turn.