We've Had Enough With Failed Trade Policies

By Mark Ruffalo, Reader Supported News

04 April 16

any pundits were caught off-guard by the transpartisan fury over America’s trade policy rocking the presidential primary season. But it’s no surprise to me. I grew up in a working class family in Kenosha, Wisconsin. So I know why Americans have had enough of shiny promises, job-killing trade deals, and Wall Street bailouts that propel ordinary people into an economic nose dive.

Hard working Americans of all political stripes recognize when the rules have been rigged against them, because they live day-to-day with the results. No doubt revolutionary change is an appealing alternative.

Since the North American Free Trade (NAFTA) and World Trade Organization agreements in the mid-1990s, America has lost more than five million manufacturing jobs net. Millions of service sector jobs also have been offshored.

During the NAFTA era, my home state lost 68,000 manufacturing jobs — one out of seven in the state. Just one example: After Chrysler received billions in a 2009 bailout, it shut its Kenosha Engine facility, cut the last 800 jobs and moved operations to Mexico.

The damage extends beyond those who lose their jobs. They compete for non-offshorable service sector jobs, pushing down wages economy-wide, hurting communities coast to coast.

From Flint to El Paso and points beyond, Americans have been slammed by the trade double whammy: Firms and their well-paying jobs go away. Then just when assistance is most needed, tax bases shrivel so basic services get cut and infrastructure crumbles.

Bernie Sanders’ primary victories have finally forced the mainstream media to mention the millions of middle class livelihoods destroyed by trade policies. Now it’s time to face up to a second disastrous risk: These trade deals pose a direct frontal attack on a livable environment.

Pacts like the recently-signed Trans-Pacific Partnership (TPP), currently sidelined without sufficient congressional support for passage, contain thousands of pages of enforceable rules that would fuel climate chaos and empower corporate polluters to challenge environmental laws across the globe.

And if the TPP were approved, the Department of Energy would be required to automatically approve all natural gas exports to the 11 other TPP countries, eliminating our government’s ability to make decisions about our energy future and incentivizing a boom in dangerous fracking. The extreme secrecy of TPP negotiations allowed the Obama administration to claim it was the greenest deal ever. But when the TPP text was finally disclosed late last year, environmental groups that the White House claimed supported it, such as NRDC and Defenders of Wildlife, joined the Sierra Club, Greenpeace, 350.org and scores of others in opposition.

Consider just one feature that sounds like the plot of a disaster movie. The TPP would empower foreign investors to drag the U.S. government to private international arbitration tribunals whenever they claim that our environmental, energy or climate policies violate expansive new TPP foreign investor privileges. Corporations can demand unlimited taxpayer compensation based on future profits ostensibly thwarted by the policy. There is no outside appeal.

If approved, the TPP would double U.S. exposure to this “investor-state dispute settlement” (ISDS) regime. Overnight 9500 Japanese manufacturing and Australian mining giants, among other firms, could skirt our courts and laws to attack critical public interest safeguards.

It’s not hypothetical. Under similar NAFTA provisions, TransCanada is now demanding $15 billion in U.S. taxpayer compensation because our government (rightly) opposed construction of the Keystone XL pipeline.

More than half of past ISDS suits have concluded with the government losing or settling. Billions have been paid to foreign companies. Already half of the new ISDS cases filed in recent years seek to enforce corporate rights to mine, extract gas and oil, and generate energy no matter the consequences to us and our environment.

Expanding this system through the TPP would block worldwide environmental and social progress while empowering corporations to undermine existing climate and environmental policies.

Remarkably, the TPP not only omits the word “climate” from its text, but does not require TPP signatories to comply with their United Nations Framework Convention on Climate Change commitments. This despite all TPP countries being climate convention signatories.

The bottom line: Our failed trade policies imperil both Americans’ livelihoods and the health of our planet — two reasons why the more people learn, the less they like them.

The bipartisan American trade revolt now underway demonstrates that we need to scrap these bad deals and demand real change. This is no time for half measures, bland reassurances, or waiting games.

With both our economy and environment at risk, Americans can no longer remain silent. We must send a strong message to current policymakers and candidates alike that the people and the environment come first. Those who trade away our jobs, our economy and our environment to the highest bidder must be stopped.

Do You Own a Gun? Why Your Kid's Doctor Needs to Know.

By Angelica Zen and Alice Kuo, The Washington Post

04 April 16

o you have guns in the home?” It’s a standard question pediatricians ask patients and their parents, an entry into a conversation about storage and safety.

“Of course not — we don’t believe in that,” answered one mother who came to our practice with her 7-year-old.

Her son looked up from his iPad and grinned. “But Bobby’s dad has a really cool gun! Bobby showed it to me last week.”

“What do you mean?” his mother asked. “A toy gun?”

“No, a real one!” he boasted, before returning to his game. His mother sat in wide-eyed silence.

When a Florida pediatrician asked the same question — “Do you have guns in the home?” — during a checkup in 2010, the reply from a mother of three was sharp: None of your business. She objected to the query as “very invasive,” complaining to her local newspaper, “Whether I have a gun has nothing to do with the health of my child.”

And so began what’s come to be known as the Docs vs. Glocks dispute. In 2011, after a lobbying push by the National Rifle Association, Florida passed the Firearm Owners’ Privacy Act, restricting physicians from asking about gun ownership and from counseling about gun safety in routine appointments. Potential penalties include fines, suspension and loss of a medical license. A federal judge blocked the law as an unconstitutional restriction of doctors’ speech. Then an appeals court panel overturned the ruling, emphasizing patients’ rights to own guns and to privacy.

This Florida case is just the latest example of how the politics of guns have affected physicians’ ability to bring science to bear on what experts can see plainly: That gun violence is a public health issue. The full U.S. Court of Appeals for the 11th Circuit is now preparing to hear the case, and legislators in at least 12 states have expressed interest in similar bills. So it’s worth correcting what lawmakers and the court panel misunderstand about the doctor-patient relationship and about the relevance of firearms to pediatric care — in a country where more than 2 million children live in homes with unsecured guns.

First, there’s the suggestion that a doctor merely asking about guns infringes on the right to bear arms, because of how much power doctors supposedly have over patients. The court panel wrote: “When a patient enters a physician’s examination room, the patient is in a position of relative powerlessness. The patient must place his or her trust in the physician’s guidance and submit to the physician’s authority.” To support this contention, the court cited a 1994 law review article that describes how the doctor-patient relationship forces patients to “suspend their critical faculties” and limits their “ability to question physicians and redirect the course of a conversation.”

Most doctors nowadays would laugh at that idea. Perhaps there was a hint of truth to it in 1994 — two years before WebMD went live, and when less than 12 percent of U.S. households had Internet access. But long gone are the days when whatever a doctor said was law. Today, patients and their families are active participants in their medical care. They do their Internet research and come in with long lists of questions. And they don’t hesitate to make their views known, in the exam room and on Yelp, when they aren’t satisfied with the answers.

Rather than trying to get the parents who come to our practice to submit to our authority, we try to build partnerships with them based on mutual trust and a shared interest in the well-being of their children. Sometimes we and the parents disagree — about vaccines, for instance. But we talk through their questions and concerns and try to come up with an approach everyone is comfortable with. We might settle on a plan to space out vaccinations over a longer period of time, say, but to make sure a child is caught up by kindergarten.

We wouldn’t instruct gun-owning families to give up their firearms, nor would we expect them to listen to us if we did. But we and the parents have a mutual interest in preventing gun accidents involving their children. That’s what we want to discuss. The point is not to pass judgment or to chastise people for their practices. It is to ensure that our patients, the children, have long, healthy lives.

Florida’s law allows an exception to the restrictions on talk about guns if a doctor “in good faith believes that this information is relevant to the patient’s medical care or safety, or the safety of others.” In the latest legal brief, filed with the court on Monday, the state reiterated that doctors needn’t worry about disciplinary action as long as they stick to good-faith inquiries.

What does that really mean? What if a parent, like the mother in Florida, declares that “Whether I have a gun has nothing to do with the health of my child”?

It would be odd if the lawmakers intended to exempt the standard pediatrician questions that motivated the law in the first place. Indeed, the court panel determined that “a reading that information about firearm ownership is relevant in every case” would make the law “superfluous.” The court interpreted “relevant” to mean based on “some particularized information about the individual patient, for example, that the patient is suicidal or has violent tendencies.”

But beyond responding to immediate warning signs, responsible doctors need to be able to counsel patients on matters that pose the greatest statistical risks to their health and well-being. Heart disease is the leading cause of death in Americans 65 years and older, so doctors talk to their elderly patients about healthy eating habits, regular exercise and smoking cessation. For children between the ages of 1 and 14, the leading cause of death is unintentional injury, a category that includes car accidents, suffocation, burns, drowning and gunshot wounds.

As pediatricians, we counsel parents about all of these issues. We explain how to properly install car seats. We caution against children playing with plastic bags. We teach about safe water temperature. We discuss safety around pools.

Gun safety is no different from any of these topics. Comprehensive numbers on gun accidents are hard to come by, in part because National Rifle Association lobbying and limited funding has deterred the Centers for Disease Control and Prevention from conducting firearm research. But outside research found that in 2015, children accidentally shot themselves or someone else at least 278 times, averaging more than five times a week. By some estimates, keeping guns locked up and unloaded could prevent 70 percent of unintentional shooting deaths among children.

Sometimes parents aren’t aware that their gun storage practices are unsafe. During one recent appointment at our clinic, a mother said she wasn’t sure if there were any guns in her home. Her father is a police officer, she said, and there might have been one or two in a closet. In a 2006 study published in the Archives of Pediatrics and Adolescent Medicine, nearly a quarter of parents who reported that their children had not handled a household gun were contradicted by their children.

When doctors provide brief counseling about gun safety, families with guns are more likely to follow safe storage practices. In Florida alone this year, that counseling might have prevented the death of 6-year-old A’letha Burke, who accidentally discharged a gun she found under a sofa; it might have prevented 2-year-old Ethan Walker from shooting himself in the face with a gun he found in his grandfather’s truck; it might have prevented Jamie Gilt’s 4-year-old son from accidentally shooting her from the back seat.

That last incident attracted national attention because Gilt (like some of the parents who object to physician questions) is a gun rights activist. And there was more than a hint of just-deserts judgment in the media coverage. “Yet Another Gun Owner Gets Shot by Her Own Kid,” Mother Jones reported. The Washington Post went with the headline: “?‘My 4-year-old gets jacked up to target shoot,’ mom brags hours before he shoots her.”

If the gunshot wound had been life-threatening, or if the child had shot himself or a neighbor, you’d expect the headlines to take a different tone. But even if the child didn’t injure himself physically, that doesn’t mean he’ll be unscathed. Florida’s Department of Children and Families is investigating. The boy could be removed from his mother over this, or, if the family remains intact, it could be subject to years of home visits and monitoring. Shortly after the shooting, the boy’s grandmother told Britain’s Sun newspaper that he was enjoying a pancake breakfast and had “no idea what he did.” Yet once he’s old enough to understand, he could be scarred emotionally — by an episode that wasn’t his fault.

Would a mother who is so ardently pro-gun have listened to a doctor’s counsel about gun safety? Her 4-year-old wasn’t strapped into his booster seat when police arrived, suggesting a broader lack of attention to safety. Perhaps a doctor’s advice would have made her more mindful. Perhaps not. Either way, though, Gilt probably wouldn’t be intimidated by a doctor’s questions. Her mother told the Sun: “All the gun control people are jumping on this, but it will not change her opinion about owning guns. She is very pro gun and will not change her opinion about owning them.”

Again, for us as pediatricians, the issue isn’t ownership, it’s safety. And when we’re able to talk to parents about gun storage, we have the potential to save lives.

That mother who came in with her 7-year-old? She called our office a week later to report what she’d learned. Apparently the boys had used a ladder to retrieve a gun kept on a high shelf in the friend’s garage. The mother talked to the friend’s father, who had no idea that the shelf was so easily accessible to them. He apologized profusely. And then he purchased a safe to lock up his gun.