This article was published by the Center for American Progress.

Video: Young Muslim American Voices Interviews Rami Nashashibi

Listen to the full interview (mp3)

Rami Nashashibi is the co-founder and executive director of the Inner-City Muslim Action Network, or IMAN. He is actively engaged in African-American, Latino, and Muslim community organizing, and has recently helped launch two important initiatives: One Chicago, One Nation and Muslim Run. Rami is the author of Ghetto Cosmopolitanism: Making Theory at the Margins, and has also been an adjunct professor at various universities. He most recently participated in the seventh U.S.-Islamic World Forum in Qatar.

Nashashibi spoke with Sally Steenland on March 1 about his trip to the forum as well as his community organizing work.

Sally Steenland: Rami, you’ve recently returned to the U.S. from the Islamic World Forum in Doha, Qatar. Can you tell us what happened there? What captured your attention? Did anything surprise you?

Rami Nashashibi: This was the Seventh Annual Islamic World Forum, put on by the Brookings Institution’s Saban Center and key members of government in Qatar and across the world. What I felt immediately was the range of voices that were part of the conversation, particularly in workshops. There were grassroots activists from Senegal and Somalia, from the subcontinent, and American Muslims—all of us active in grassroots community organizing. That combination of voices produced some really inspiring and interesting conversations.

S: What were some of those conversations? What kinds of things might happen as a result of the connections you made?

R: I don’t want to lose sight of the headline components of the forum, such as the speech by Secretary of State Hillary Clinton, Senator [John] Kerry, and a televised message from President [Barack] Obama about the appointment of Rashad Hussain to the OIC, the Organization of the Islamic Conference. There’s always robust debate about certain portions of U.S. foreign policy in that part of the world, and certain segments of the Muslim community have concerns around those policies. After a year in which the Obama administration has engaged in a very deliberate outreach to Muslim communities around the world, there was lot of conversation about to what extent that has changed things.

To your question: Things were still very exploratory, but at least in the workshop I was in, there was a lot of thinking about transnational community collaborations. What kind of projects could we collectively engage in that could connect what’s happening on the south side of Chicago or Harlem with community civic projects in Senegal and Somalia? Those types of conversations allowed community organizers and activists in the room to partake in a very active way.

S: To follow up for a second—did you see similarities, differences, or connections between community organizing groups in Senegal and Somalia and things you’re doing in Chicago? Are there things that are universal, or did you think, “It’s really different for me here in Chicago than in another country?”

R: We often take the difference for granted. Obviously, some more impoverished communities and societies don’t have such a historically rich civic sector as Chicago. Increasingly, though, we’re talking about a globalized and interconnected world. The realities of young people across the world, and across Muslim communities, are shaped by the same economic and cultural forces, and they often respond to the same issues around identity, the need for opportunity, and for empowering activities that can give community members a meaningful life and a sense of dignity about who they are as Muslims.

I felt there was much more similarity with some of the community organizers in places like Somalia and Senegal and Harlem, and a lot of the conversations resonated in a way that surprised some community organizers there. There is a grassroots organizing sensibility in this day and age that is global, and part of that sensibility is this: Communities can do things and connect in ways that aren’t always dependent on the mediating institutions of large states. There are more opportunities via the web and travel than in the past. Making those connections through our conversations was a good part of what we were thinking through.

S: I want to switch for a minute and talk about the organization you run in Chicago. IMAN stands for the Inner-City Muslim Action Network. You run a community health clinic and educational programs, you work on public safety and criminal justice, and you collaborate with a variety of groups in the Chicago area. You also have a project called Muslim Run.

R: IMAN has been in existence for 13 years. We were formally incorporated in 1997, and even though we have a lot of different projects that can make it look like we’re all over the place, there is cohesion to how we work. We have a set of direct services, which include the community health clinic, career services, and transitional housing for previously incarcerated members of our community.

The second area is this very important area of organizing and advocacy. Over the years, IMAN has advocated around key social justice issues that impact low-income communities in the inner city, such as criminal justice and housing, education, or even issues around immigration and national security. We have been in the forefront of making sure that, as the voices of Muslim American activists are at the table, we do that in unison with other disenfranchised or vulnerable segments of the inner city. We very often work in alliances and coalitions.

One of our more recent campaigns is Muslim Run. It’s a campaign of health, wellness, and healing. In it we’re taking on a very sensitive issue, but one that our organization is in a strong position to take on, which is the ownership, predominantly by Arab Muslim immigrants, of liquor stores and other types of businesses in black communities. The campaign seeks to address the very real issue of food deserts—the lack of healthy food in these communities. Since we have a concern about health and wellness in the inner city, we see food access as a justice issue.

In doing so, we’re addressing ethnic-racial tensions and disconnections between predominantly Arab store owners and black community residents. We’re trying to find ways to be honest and open about the sets of conversations that need to take place—to talk about these tensions and put forward an alternative set of practices and business models that can produce better relations within the community.

S: In addition to all the issues we’ve mentioned, you also focus on arts and culture. IMAN has a street fair and a cultural café, where you feature artists and musicians and spoken word poetry. Tell us why the arts are important .

R: Arts and culture have been part and parcel of our work since our incorporation. Many of us have woven artistic expression into our programming. It was very much a part of the types of people we were reaching out to and part of our volunteer force. We formalized it about four or five years ago and have been deliberate about forming an arts and culture department. We try to draw connections between art and social justice in how we serve the community so we don’t see them as separate areas.

Arts and culture becomes a critical vehicle for asserting a very unique identity. It becomes a bridge connecting communities to one another. It becomes a space for discussing a whole range of issues and relating them to the broader community so they don’t get isolated or “Muslim specific.”

For over six years, every other month now, our Community Café brings in artists, performers, poets, and activists together with scholars. People and performers come from across the country for a really inspiring evening. Our other signature event, which has been happening every other year since the first year of our incorporation, is “Taking It to the Streets.” We bring thousands of people to a park once associated with the stoning of Martin Luther King here on the South Side of Chicago and turn it into, for at least that day, a vision and symbol of what the Muslim community of America could look like as it works in partnership with brothers and sisters and other faith communities for the greater good.

S: I want to turn to a frustration for a minute. You have said that even though people like yourself—Muslim Americans across this country—are very active in social justice issues, you lack visibility and your voices don’t always get heard. Why do you think that is?

R: In part, the “Muslim issue,” as it gets defined, especially since 9/11—but even before—was often conflated with a geopolitical crisis and with peace in the Middle East—and since 2001, with issues of civil liberties and national security. Until that point, the Muslim community was generally not that well known. It was an invisible community. The larger and more historical presence of African-American Muslims was not discussed much publicly outside references to the Nation of Islam, even though they comprise a small sector of the African-American Muslim experience.

After 9/11, so much of the public narrative was fixated with immigrant Muslims in relation to national security and the eroding of civil liberties. Those are important stories, but what happens in that process is that it obscures the very real presence of American Muslims who have been active for decades doing phenomenal and often very difficult work, making coalitions and alliances that address housing and criminal justice and the day-to-day issues that impact not only Muslims but their neighbors. That has been frustrating, but increasingly there’s been honest dialogue among more responsible folks in the media and major institutions to identify those voices and bring those stories to light.

There’s certainly a long way to go before we shift the larger paradigm, but the American public is becoming more familiar with the fact that we do have a very vibrant, dynamic American Muslim community—that Muslims who live with us are trying to make this a better place for all of us.

S: I want to focus on community organizing and policy advocacy. In some ways those are very connected, but a lot of times they are quite separate, and there are tensions between them. For instance, you can be effective organizing at the community level but don’t always get your voice heard at the policy levels where decisions are made. Likewise, at the policy end, things can go slowly, and you have to make compromises. You’re representing a community, but the urgency of their issues doesn’t always get translated into policy. How do you fit all of that together?

R: We approach policy very much from a community organizing vantage point. We’re a grassroots community organization. Our offices are not on the 13th floor of a building downtown. We are right in the community. So we are held accountable by a base that wants to make sure that they are not only connected to the issues we are advocating, but are helping lead the agenda and are educated about the issues. We begin at the grassroots and think about how to build power.

The way we build power—which we translate as the ability to act and move a grassroots agenda—is to identify leaders in the community most affected by those issues, build a base, and connect that base to larger bases in the city. We form alliances that can collectively advance a vision that can translate into policy, and we link up with experts and folks who are thinking from the policy-down perspective. Then you have a strong, potent mix of the policy wonks with the grassroots community, and you can advance a vision for change that is holistic.

That’s what we’re beginning to see in Chicago and Illinois, and that really excites us. For example, tomorrow we are going to be part of a 250-member delegation that’s sending 50 leaders to Springfield—a multiethnic, multiracial delegation who’ve been working together under the umbrella of the United Congress of Community and Religious Organizations. IMAN was a founding member, along with four or five other community organizations in Chicago.

We’re disseminating the first-ever grassroots human rights policy guide for racial equity. There are 49 pieces of legislation we’ve identified, but more importantly, a framework that connects issues like education and immigration and criminal justice with national security and housing, so that as communities of color, we don’t find ourselves disconnected from one another’s issues or pitted against one another. We thought it was critical to advance a unifying framework, and then through that framework, devise a policy agenda.

When we go to Springfield, they see that we’re members of the American Muslim community—we’re not strangers to them. And more importantly, they don’t see us in isolation—we come with the black church, we come with Latino community groups, and they know that our voice is part of a larger, collective set of voices. They have to take us seriously. And that helps change the way in which we engage in politics here in the state. It’s what makes the work we do inspiring and important, and it’s something people get excited by when they become a part of it.

S: Another new project you’re doing is One Chicago, One Nation.

R: That is a collaboration with another Chicago-based organization that has a nationwide and international following, the Inter-Faith Youth Core, headed by Eboo Patel. We are also collaborating with some major philanthropic partners, the Chicago Community Trust and One Nation, which is based in Seattle. The project seeks to provide a broad space for connections through movie making, through developing community ambassadors and leaders through training developed by the Inter-Faith Youth Core and other partners. We want to create a generation of interfaith community activist leaders who can make connections between communities and translate them into projects that have lasting effect.

Another part of One Chicago, One Nation is a series of mini-grants that are given to different partners across the city who submit the most dynamic and engaging projects. The film contest I mentioned has upward of $25,000 in rewards and the opportunity to have your film judged by some very prominent folks like Danny Glover and others in the industry. It’s a project that has brought together some major institutional players, along with grassroots folks, to make connections and advocate for a vision that is united around creating better societies.

S: I want to ask you a personal question. How did you come to do this work?

R: It wasn’t just one or two things. I grew up the son of two parents who were very much shaped by the conflicts in the Middle East. My mother was born in May of 1948. She was actually born while fleeing from her village—her mother gave birth as they were fleeing, and they were among the first refugees to come to the southwest side of Chicago. My mother grew up there. My father is from Jerusalem. He passed five years ago, but was also intensely shaped by the politics of that region. He worked as a delegate for the Jordanian embassy for a long time in different parts of the world. They divorced when I was young, but I grew up informed by both of their experiences and was nomadic until I came back to the United States to live and go to school when I was 18 or 19 years old. I was here in Chicago and have been here for the most part ever since.

Immediately I was struck by something I had never experienced, and that was a city that was both very exciting and inspiring, but also very segregated and ethnically divided. I spent a lot of time trying to wrap my mind around that, and befriended some very seasoned community activists who had been making connections between the challenges for African-American and Latino communities. They became mentors for me in understanding and inspiring me not to just philosophize but to think about how to get out into the community—to think about an activism that is both idealistic and pragmatic.

Chicago has an extraordinarily rich history of community activism and organizing, from Jane Adams to Saul Alinsky to the Black Panthers and everyone in between—not least of which is the story of Barack Obama and his organizing on the South side of Chicago. So being in Chicago—there’s something in the water here.

I’d never intended to remain in this work. I was an English and international studies double major and was thinking about things that would land me in international policy. But I ended up in the community and have been here since. That also informed my decision later to pursue a Ph.D. in sociology and urban ethnography at the University of Chicago. Both my intellectual pursuits and my community organizing have been grounded in the experience of thinking about what it means to be a Muslim on the South Side of Chicago.

S: Chicago is lucky to have you and your good work. I have one more question: As you read the headlines and walk the streets of your neighborhood, it’s quite clear that it is a very discouraging and hard time for people. When you look at how hard you work and how difficult things are, what gives you hope?

R: There are days when that walk is more difficult than others. Not only do you have to contend as an American Muslim with headlines about the way Muslims are being framed in the media, but for people who are working here at IMAN, you’re talking about foreclosures and abandonment and violence. In the last couple of years, these issues have really taken a toll on communities, and that can be very depressing. What continues to give me hope are the opportunities that come along with this work—the people you come across, just extraordinary people who are very inspiring. That is also part of the larger story of Islam in America that continues to inspire me and has not been understood.

There’s still a lot of anxiety about the question, “Can you trust the Muslims in America?” For many of us, a lot of the stories we see are stories of transformation, stories of inspiration, of people who have transcended the difficulties of their circumstances and found ways to give back to their community. They have found ways to be as optimistic and positive as you could possibly be in some of the more difficult environments. It’s those individuals, whether they’re Muslim, Jewish, or Christian. We’re lucky on the southwest side of Chicago to have very real and organic relationships with all three communities that lends us the hope that this work will make this a better community and country for all of us.

Listen to the full interview (mp3)

Sally Steenland is Senior Policy Advisor to the Faith and Progressive Policy Initiative at American Progress. 

More on this topic:

• Video: Young Muslim American Voices Interviews Rami Nashashibi
• Video: Young Muslim American Voices Interviews Mohamad Chakaki
• Young Muslim American Voices Are More Important Now than Ever by Rev. Susan Brooks Thistlethwaite, Sally Steenland, Marta Cook, and Eleni Towns
• Young Muslim American Voices Call for Inclusion and Respect by Sally Steenland

This article was created by the Center for American Progress Action Fund.

Read the full column at CAP Action

Let's go under the hood to understand this collapse of support. President Obama repeatedly stated during his campaign and postelection that he would deal with immigration reform in his first year. Spanish-language media dubbed this "La Promesa de Obama," or "Obama's Promise." The problem that Obama faces with La Promesa can be witnessed in a September interview of Obama by Jorge Ramos, a Univision news anchor who is watched and trusted by millions of Latino Americans.

But what I wanted to ask you is about what Latinos call, "La Promesa de Obama"—Obama's promise. On May 28 you told me, and I am quoting, "What I can  guarantee is that we will have in the first year an immigration bill that I strongly support." And then I asked again, "in the first year?" And you said, "Yes, in the first year." This is your promise and the question that many of them have is: Are you going to keep your promise? Can you do it before January 20?

Read the full column at CAP Action

This article was published by the Center for American Progress.

The Obama administration announced 120 high-level goals for government departments and agencies as part of the president’s fiscal year 2011 budget this year. This is a welcome step—defining what government is trying to achieve is essential if public money is to be used wisely. But setting goals can only ever be the first step. What matters most is whether departments and agencies actually accomplish the goals. That requires a culture change across government, with a much stronger emphasis on delivering outcomes for society.

This strong emphasis on “delivery” of goals was new—government’s key focus was not to be the laws it passed or the programs it administered but the outcomes it achieved for society. That required a culture change across government departments. Central to driving this change was a new unit set up by Prime Minister Blair in the days after the election. The Prime Minister’s Delivery Unit led by Professor Michael Barber went about its task by asking those responsible for delivering targets a set of simple but challenging questions about their strategy for achieving the goals—the effect was a significant culture change across the senior ranks of the British government.

The corollary department in the United States is the small but powerful Office of Management and Budget, which has a difficult task over the coming weeks. It has little expertise in how to achieve the goals, but it still has a crucial role to play in holding government agencies accountable. Both OMB director Peter Orszag and the administration’s Chief Performance Officer Jeff Zients must develop a framework that genuinely holds agencies to account without micromanaging the process of delivery. They would do well to learn from the U.K .experience in developing this framework.

I remember being struck by the power of the approach that Barber invented when I was working as an official in the British government back in 2001. By asking three sets of difficult but very simple questions, the Delivery Unit changed the way that we thought about our jobs. The three themes were:

• What journey are you trying to make in terms of the goal? Where are you now and what’s the destination?
• What’s your strategy to get there? Why do you think your interventions will work?
• How will you monitor progress as you proceed? Do you have the capacity to adjust your strategy as you go along?

Where’s A? Where’s B?

How do you plan to get to “B”? Will it actually work?

For each intervention, you were asked what contribution it would make to accomplishing the goal—for example, if you were considering traffic calming measures to reduce road deaths, you were asked to estimate how many deaths you thought that will avoid. If there remained a gap to be bridged, you needed to decide what other interventions you would pursue to meet your target. For each of these, you were asked what contribution they would make and when. Doing this allowed you to draw a line that set out how the target would be achieved over time and the contribution that each measure would make—effectively a route, or trajectory, to get from “A to B.”

None of this was easy. In the past, government agencies in the United Kingdom rarely had to estimate the actual effect that each measure would have. And the evidence base to do so was often sketchy. But posing a set of difficult questions in this new approach made public servants think hard about the nature of the problem they were trying to solve and develop creative solutions to address it. The team responsible for reducing vehicle crime, for example, started by developing a sophisticated understanding of what factors that influenced car crime—they realized it was much more complex than they had initially thought. This led to a strategy that included working with vehicle manufacturers to improve vehicle security standards, launching awareness campaigns for motorists to encourage them not to leave valuables visible, and collaborating with the car parking industry to reduce the risk of crime from parking garages, among other measures.

The key was identifying a strategy that was likely to work—and if that meant innovative approaches, that was fine. Public servants in the old model might have focused on measures such as stronger penalties for those who engage in vehicle theft, or increasing the number of police officers focused on vehicle crime. These tactics came naturally to a law enforcement ministry and were guaranteed to get positive media attention. But the new approach changed the central question from being “what will you do?” to “why do you think it will work?” It did not matter whether the strategy would attract media headlines or be politically popular—what mattered was whether there was reason to believe that it might succeed. And the strategy was extremely successful in this particular case—the target was to reduce vehicle crime by 30 percent over six years, and the team actually accomplished 46 percent.

Of course, in some instances, it was hard to identify measures that you could say had a high likelihood of success. But rather than just inventing ideas and hoping, the new approach encouraged you to experiment with the ones that were most promising and see whether they worked before adopting a full-scale rollout.

Adjust your route as you go along

The plan had to be lived, and you were held accountable to it in real time. If you estimated that traffic calming would reduce road deaths by 3 percent, but it only declined by 1 percent as a result of the measures, you had to decide what to do about it. Perhaps it was because traffic-calming schemes had been delayed in their implementation—in which case, how did you intend to get them back on track? Or perhaps traffic-calming schemes were proving less successful than hoped for, in which case did they need to be a less prominent part of the strategy?

The new approach also required that there be a lead official for accomplishing each goal and a named official responsible for delivering each measure that formed part of the strategy. This team was to meet regularly and review progress, and in doing so, draw up an assessment of how things were going and where there was a need for more attention. The team was asked to produce a report every six months summarizing the progress they had made on each goal, and the overall likelihood of successfully accomplishing the goal. These reports were then audited and revised by the central unit and presented to the prime minister for review. The prime minister would meet with responsible ministers on the most prominent targets to discuss progress and satisfy himself that enough was being done to address any shortcomings.

Simplicity—the key to driving culture change

This simplicity was key to the approach’s success. The targets I worked on were not ones that the central team had prioritized, and so I got little direct attention. But I still knew the questions they wanted me to answer, and so did every senior public official. The central team had managed to rapidly spread awareness of the questions by repeating them regularly. And because the questions were so clear, they forced honesty in the dialogue between departments and the center of government. We were taught almost by osmosis the importance of focusing on delivery and what that meant.

The approach has evolved since 2001. There is now a stronger emphasis on deploying strategies that are likely to work and do so at the least cost. The newer fiscal environment has meant that approaches need to pass this value-for-money test, too. There is also a stronger realization that the most difficult problems require agencies to work with each other, and as a result the most recent set of targets were almost all interdepartmental by nature.

There is also a new understanding of the importance of government working with citizens to make a difference. Strategies to reduce childhood obesity, for example, are not something that belong to the health department alone—they need to belong to food, education, and other departments, too. Nor can these strategies be something the government does to society; they need to be undertaken with families. This leads to a greater emphasis on working with communities to develop solutions that are most likely to work with responsibility for success shared between government and citizens.

The Internet has also made it much easier for government to communicate with citizens and equally easy for those who are affected by government to play in role in shaping its services. But the basics of the approach remain unchanged—clarity about the goals, adopting strategies where the evidence shows they are likely to work, and refining the approach constantly to ensure that it actually accomplishes the goal.

Orszag and Zients could certainly learn from the British experience in moving forward. The key must be to ask agencies “why do you think your strategy will accomplish the goal?” rather than “what will you do?” And as time progresses, “is your strategy working?” or if things have gone off track, “how will you adjust your strategy to ensure that it accomplishes the goal?”

If the questions are kept simple but challenging, they will ensure there is a real focus on the importance of delivering the goals. And they may even lead to a lasting culture change across government where the focus is on doing what works to accomplish the goals rather than pursuing strategies that just sound like they might work.

This column focuses on how it felt to be an official working in the United Kingdom in the context of the Prime Minister’s Delivery Unit. I am extremely grateful to Sir Michael Barber and Ray Shostak, the current head of the Delivery Unit, for commenting on an earlier draft of this piece. This piece omits a great deal of the detail, but for a fuller discussion of the U.K. approach, refer to Sir Michael Barber’s excellent book, Instruction to Deliver: Fighting to Transform Britain’s Public Services, published by Metheun.

Jitinder Kohli is a Senior Fellow at the Center for American Progress.

This column is part of the Doing What Works project, which focuses on government reform and efficiency. Click here to learn more about Doing What Works.

See also:

• Slay the Sacred Cow by Sima Gandhi

Is Dick Ackerman still working for the Orange County Fair Board?  And was in he in the meeting on March 10 with Fred Aguiar?  What was discussed in the meeting with Fred Aguiar?  Those were the questions asked by board member David Padilla during the March 11, 2010 meeting of the Orange County Fair Board. The meeting was called on 10 days notice to discuss plans to convert the Fair into a citrus fair, a different type of fair allowed under California law.

David Padilla pressed CEO Steve Beazley for clear answers about the Ackerman and Aguiar issues.  Beazley claimed he took the meeting to "gather information" and not as representing Fair Board.  Beazley confirmed he met with Aguiar but that Ackerman was not with him.  Padilla asked for that a report on the matter be brought to the regular board meeting on March 25.

The meeting with Aguiar and possibly Ackerman centered around creating a citrus fair to replace the Orange County Fair.  A citrus fair is allowed to use state property to conduct their business but is run by a private non-profit group which is allowed to appoint their own members and create their own bylaws. The citrus fair board members are subject to the Brown Act, but are not subject to many of the other laws that the current Fair Board must follow.  Additionally, the creation of a citrus fair would allow current fair staff to retain their jobs and their pensions as citrus fairs can buy into the CalPERS system.

The ploy to create a citrus fair is just another way for the Fair Board to form a non-profit corporation to grab control of the Fairgrounds. Under this scheme, they won't have to buy the property to use it and will have minimal public oversight.  The Board voted to move forward with exploring the formation of a citrus fair and evaluating other governance structures. David Padilla was the only member voting against the measure.

Download 207_agda_10_03_March11BoardMaterials  A discussion of forming a citrus fair is in the packet.

The next board meeting is on Thursday, March 25, 2010 at 10 AM at the Administration Building off Arlington.  The report on the meeting among Steven Beazley, Fred Aguiar and Dick Ackerman will be ready.

This article was published by the Center for American Progress.

So ABC News apparently thinks it’s appropriate to invite former political advisor to George W. Bush, Matthew Dowd, to guest host ABC’s “This Week” next week. Dowd found himself on the outs with Bush when he joined ABC in 2007, but he has never denounced the political principles that led him to join the most right-wing administration in American history to begin with. Nor insofar as I am aware, has he demonstrated any particular commitment to the principles of journalism. According to The Huffington Post, he remains a corporate consultant for ABC, and an ABC spokesperson says that Dowd can be depended upon to provide “independent and fair analysis on issues confronting the country...He has tremendous ability to speak to and understand all sides of an issue.”

We’ve seen this movie before. MSNBC had to drop Richard Wolffe as a substitute host for Keith Olbermann over this issue exactly. Wolffe had a consulting business going, and hetouted his role as an MSNBC analyst on the firm’s website. (Of course when you’re hosting “This Week,” you don’t need to tout it to clients. It’s known.)

And again, I haven’t seen enough of Dowd’s analyses to make an informed judgment about whether he has dropped a lifetime of political beliefs and can remain neutral—or at least appear to on TV. But it’s been an unfortunate rule of thumb that when right wingers are hired as news analysts, they are hired to propound their beliefs, and when liberals get the nod, they are expected to denude themselves of any previous insight into the way the world works.

Consider as a couple of not-so-random examples two appearances on two networks with two famous hosts by the extremist and occasionally delusional Republican ex-presidential candidate Rudy Giuliani. The man who likes to call himself “America’s mayor” went on ABC’s "Good Morning America" and insisted, “We had no domestic attacks under Bush; we’ve had one under Obama.” Alas, this nutty statement went entirely unchallenged by the show’s host George Stephanopoulos, who happened to be a long-time Democratic aide to various congressmen and to President Clinton.

I was reminded upon hearing Giuliani’s statement of another of his appearances, this one just before Christmas in 2001. He was on NBC’s “Meet the Press” to discuss America’s response to the 9/11 attacks with First Lady Laura Bush and Cardinal Theodore McCarrick of the Archdiocese of Washington. Rudy found himself being ask by Tim Russert, a former aide to liberal Governor Mario Cuomo and Senator Daniel Patrick Moynihan, whether George Bush had been given the election in 2000 despite having lost the popular vote by divine intervention. I swear I’m not making this up. There was no mention of the antidemocratic shenanigans of the likes of Katharine Harris and Antonin Scalia and the mobs who interfered with Florida vote counting. Interestingly Mrs. Bush demurred at this crazy question, but Rudy took the bait. “I do think, Mrs. Bush, that there was some divine guidance in the president being elected,” was his expert opinion.

Chris Matthews, who was also an aide to a top Democratic politician Tip O’Neil, has demonstrated a similar tendency to fall in love with right-wing politicians. George W. Bush reminded him of Ernest Hemmingway, he said. Really. Here’s Matthews’s tough-minded critique of Bush’s ability to throw a strike at Yankee Stadium: “There are some things you can’t fake,” he explained breathlessly. “Either you can throw a strike from 60 feet or you can’t. Either you can rise to the occasion on the mound at Yankee Stadium with 56,000 people watching or you can’t. On Tuesday night, George W. Bush hit the strike zone in the House that Ruth Built...This is about knowing what to do at the moment you have to do it—and then doing it. It’s about that ‘grace under pressure.’”

Then there was Bush’s now infamous “Mission Accomplished” moment. Matthews loved that one too. “He looks great in a military uniform. He looks great in that cowboy costume he wears when he goes west,” he cooed. “We’re proud of our president. Americans love having a guy as president, a guy who has a little swagger, who’s physical, who’s not a complicated guy like Clinton…women like a guy who’s president.”

And don’t think that this was just a one (or two) night stand with a single conservative pretty boy. Matthews found himself love struck over and over. He found himself among those who pondering, “like the cut of John McCain’s jib, his independence, his maverick reputation.” Of Mitt Romney, he observed, “He’s got a great chin, I’ve noticed.” And don’t get him started on Rudy. The guy, insisted Matthews, is a “perfect candidate”—the one who “looks like a president,” who “acts and talks like a president,” who “rises to the occasion” and is “the one tough cop who was standing on the beat when we got hit last time and stood up and took it.” And top it all off, Matthews said, he got “that pee smell out of that subway.”

OK, just one more example: Remember that nutty speech Sarah Palin gave in Alaska last summer when she said she was quitting the job she had been elected to do because, well, it had become inconvenient, what with all her other opportunities on Fox and such? Most people’s response to this strange sight was either laughter or bafflement. But if you happened to be watching “Morning Joe”—as I was in an airport that morning—what you saw was the former conservative Republican Congressman Joe Scarborough, now host of the show, and his sidekick Mika Brzezinski, explaining that old Bush line about who and what was a “real American.” Brzezinski said people attended Palin rallies during the campaign because “they agree with her.” Brzezinski added, “Look at the polls out there. Look at where people stand on life. Look what real Americans think...In the cities where there are a little more liberal elite populations, you’re not going to find what’s representative of America.”

In fact, if you look at the polls today Sarah Palin is one unpopular lady, both with real Americans, and the apparent fake kind. But remember also that Brzezinksi is supposed to be the liberal counterweight to Scarborough—who is actually a quite credible potential Republican presidential candidate in 2112—on a network that is treated in the media as a liberal counterweight to the crazies at Fox, where Palin is now employed. And yet even here, we have ex-Republican politicians promoting other ex-Republican politicians and insulting the patriotism of everyone who dares to disagree. So the rule is apparently that when liberals go on TV they are expected to sound like conservatives, and when conservatives go on TV they are expected to sound like conservatives.

This problem is actually increasing in importance because, as a recent New York Timesarticle noted, more and more politicians are playing the role of media analysts for networks eager to blur the line between commentary and propaganda. Brian Stelter noted that in addition to Scarborough—who appeared on a podium with George W. Bush in 2004 while working for MSNBC, and the far-right presidential candidate Patrick Buchanan, who also works for the allegedly over-the-top liberal MSNBC—“Fox News employs Sarah Palin, Mike Huckabee and Newt Gingrich, and MSNBC until recently employed Harold Ford. A former Fox analyst, Angela McGlowan, recently entered a House race in Mississippi.” CNBC’s Larry Kudlow might run for Senate. And Lou Dobbs is thinking of running for president.

“It’s a little awkward,” admitted David Bohrman, the Washington bureau chief for CNN to the Times. These networks “probably ought to realize that they’re being taken advantage of a little bit.” Another network official, this one demanding anonymity added, “Some like to joke that every time Fox puts them on TV, they are making a de facto in-kind contribution to their future campaigns.” Yeah well, in the meantime, someone might want to take note of the fact that with just a few exceptions, all of those contributions are going to only one party.

Anyway, best of luck, Matthew. I’m sure you’ll feel right at home.

Eric Alterman is a Senior Fellow at the Center for American Progress and a Distinguished Professor of English at Brooklyn College. He is also a Nation columnist and a professor of journalism at the CUNY Graduate School of Journalism. His most recent book is, Why We’re Liberals: A Handbook for Restoring America’s Most Important Ideals. His “Altercation” blog appears sporadically here and he is a regular contributor to The Daily Beast.

by Paul Kiel, ProPublica

This article was published by ProPublica.

We’ve created a resource page on the government’s loan modification program that puts all of our reporting in one place. Take a look. For those looking for a rundown, below is our summary of the program and the problems it has encountered.

Mortgages that are owned or guaranteed by government wards Freddie Mac or Fannie Mae are automatically eligible. Other mortgages are eligible only if the servicer has signed a contract with the Treasury Department. More than 100 servicers have signed up. Mortgage servicers are the companies that specialize in collecting payments and handling individual accounts; they are frequently subsidiaries of banks, but sometimes are stand-alone companies.

We at ProPublica have been closely covering the problems that homeowners have encountered since the program’s launch. Delays and frustration have been common: Homeowners and housing counselors frequently complain that servicers lose financial documents and make mistakes. Many struggling homeowners have waited several months for an answer from their mortgage servicers.

The program suffers from a lack of transparency and accountability, say advocates for troubled homeowners. They complain that there’s no effective recourse to challenge wrong decisions. Aspects of the program also remain secret, like the formula used to determine whether a loan qualifies. Treasury hired a group at Freddie Mac (yes, that Freddie Mac) to audit the program, but it was criticized in its first months for having unqualified personnel. And while Treasury has threatened to penalize servicers that don’t abide by the program guidelines, no such penalties have yet been handed down. Homeowners accepted into the program first go through a three-month trial period; if they stay current on their payments, provide the relevant documents, and still qualify, they are supposed to then be awarded a permanent modification. But for those homeowners who’ve made it into the program’s trial period, the difficulties do not cease.There have been significant backlogs at a number of banks and servicers, particularly the largest: Bank of America, Citigroup, JPMorgan Chase and Wells Fargo. Some homeowners have been stuck in the trial for as long as 10 months, with several potentially adverse consequences.

As a result, the number of homeowners who’ve run the gantlet and emerged with a permanent modification has been proportionately small. As of the end of January, there had been just 116,297 permanent mods out of the 3.4 million mortgages eligible for the program. That said, the program has provided significant savings to homeowners (about $522 a month, on average), even if that relief has been tenuous.

The program provides a system of incentive payments to servicers, investors (which could be a bank or the owners of a mortgage-backed security), and homeowners for performing a permanent loan modification or pursuing another foreclosure alternative. Here’s our interactive list showing how much money has been allocated to each servicer.

Write to Paul Kiel at paul.kiel@propublica.org. 
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A new study from the Pew Center on the States, The Cost of Delay:  State Dental Policies Fail One in Five Children, shows how children's teeth are being neglected.   Losing teeth, even baby teeth, makes it harder to chew, and may cause avoiding eating fruits and vegetables because they are too hard to chew.  Healthy teeth are more than cosmetic. Cavities can lead to abscessed teeth, which are painful and must be pulled. Left untreated, an infected tooth can lead to an infection which spreads to the brain and can lead to death.  In 2007, a 12 year old Maryland boy died after an infected molar was left untreated, which allowed the infection to grow and spread to his brain. 

The Pew report used eight widely accepted criteria for measuring the success or failure of children's dental health programs.

1. Dental sealant programs are in place in at least 25% of the high risk schools. Dental sealants are a highly cost effective way to prevent cavities in children.
2. Dental sealants can be applied by hygienists instead of dentists.
3. Fluoridated drinking water is available to at least 75% of citizens on community water systems.
4. The number of children receiving Medicaid dental services meets or exceeds the national average of 38.1%.
5. Dentists who see children on Medicaid are paid at least the national average reimbursement rate.
6. Medical care providers who are not dentists can be reimbursed for preventive dental services.  In some parts of the country, there is a shortage of dentists.  It is estimated that 6600 dentists are needed to fill the gaps in coverage across the nation.
7. New primary care dental providers have been authorized by the state.  These are similar to nurse practitioners who are allowed to provide some primary care but refer more complicated cases to a physician.
8. State submits screening data to a national database for tracking.

California succeeds in having sealant programs, allowing hygienists to apply sealants, tracking data, and paying medical providers for early preventive dental care.  California fails in the number of community water systems providing fluoridated water, on Medicaid issues, and authorizing new types of primary care dental providers. For the full California scorecard, follow this link.

Octogenarian Had Planned for Everything - Until a Stroke Put Her in Limbo

by Susan Brink

This article was published by Kaiser Health News.

Part of an occasional series on end-of-life care.

What would Bunny want them to do? Phil Olenick, 59, and his brother Steve, 57, knew that modern American medicine can offer few compassionate exits from this life. Artificial measures in the intensive care unit at Brigham and Women’s Hospital in Boston — things like ventilator-assisted breathing or feeding tubes — stood a chance of prolonging life for Bunny Olenick but in a condition they knew she would abhor.

In the era of modern medicine, there is often no easy way to navigate between an acceptable quality of life and a death with dignity. That was underscored by two recent studies in the New England Journal of Medicine showing that some aggressive measures might actually increase pain and speed declines among frail elderly.

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But palliative care specialists, relatively new players on the health care scene, offer comfort, support, pain control and, if requested, spiritual counsel to people such as Olenick’s family, helping them sort through often confusing and ambiguous medical options. Unlike hospice care, which requires patients to forgo aggressive medical care, palliative care allows patients to continue any level of medical care they desire. They help people make tough decisions that are less about dying than about how they want to live at the end of their lives. 

Palliative care specialists also have strong opinions about how the American health care system should be changed to help people confront the realities of their illnesses, grapple with their fears and ultimately be at peace with their decisions. In their vision, medical decision-making for critically ill patients would include information about options at the end of life. 

Over the summer, the end-of-life issue touched off a political firestorm over the health care reform proposal being debated in Washington. The Democratic provisions included allowing Medicare to pay for periodic end-of-life counseling, but former Republican Gov. Sarah Palin of Alaska said the legislation would lead to "death panels."

Some critics remain concerned that legislation that requirement reimbursement for palliative care could nudge people toward discontinuing aggressive medical care. "I would want to make sure that legislation would not tilt the decision-making," says Dennis Smith, senior fellow in health care reform at the Heritage Foundation. Any end-of-life decision, he says, must rest with patients, their families, their doctors and their spiritual advisers with no outside pressure. 

Supporters argue that palliative care strives to get patients and their families talking about their own values and wishes, and then carry them out. Studies show the frank discussions that palliative care engenders can ease pain, forestall guilt and increase the chances of a peaceful death. And, significantly, they can save money. 

What Would Bunny Want?

Like most families with a terminally ill loved one, Olenick’s sons were not thinking about money. They were thinking about what she would want. 

Their mother, whose passions were the arts and progressive politics, had lived an active and intellectually engaged life. Bunny lived about half of her life in New York, where she was assistant director of an art center on Long Island. When she and her family moved to Boston, settling in Brookline, she worked as an executive producer at the public television station, WGBH, where she created cultural programming including ice ballets, musicals with political themes and Soundings, a series designed to make the music of contemporary composers understandable. 

She became tech-savvy enough to exchange daily text messages with her son Steve, a lawyer in Hubbardston, Mass. Her son Phil, president of the recording company Audiolink, and his fiancée Gwen Frankfeldt, live in nearby Cambridge and were frequent visitors to her Brookline apartment. 

Steve and Phil Olenick paid close attention to her every move and gesture following her stroke. Unsure if she was asleep or unconscious, Bunny's sons saw that she wouldn’t wiggle her toes on command — but she would return a hand squeeze. She repeatedly pulled out a temporary feeding tube. 

Olenick had done all she could to give her family instructions about her death. She had spoken to her sons about her wishes, filled out an advance directive, a living will, and had named her sons as health care proxies — all legally accepted documents and procedures designed to insure that a person’s end-of-life wishes are spelled out and honored. Yet even they weren't prepared for the many difficult questions they faced. 

'Why Am I Still Here?'

Bunny Olenick’s sons knew of her longstanding wish not to live in a highly dependent state. A few months before her stroke, when she fell and suffered a broken pelvis, thumb and upper arm and a detached lens in one eye. She spent five days in an intensive care unit, followed by seven weeks in a rehabilitation center. When her ophthalmologist told her that her vision would not get better, she was distraught. “I remember her saying, ‘Why am I still here?’ ” says Phil Olenick. 

She never recovered fully, couldn’t drive any longer, was annoyed by her walker, and sometimes didn’t have the energy to join her friends in lunch or discussion groups. 

Her sons saw her gestures and her rebellion against the tubes in her body as indications that she was ready to die. It was time to be direct. “Do you want to live?” her son Steve quietly asked her. She shook her head “no.” To convince himself that she understood, he persisted. “Do you want to die?” he asked. She nodded her head, “yes.” 

He was as sure as he’d ever be. “I could see that she was afraid she’d live,” says Steve. “I kept saying, ‘Don’t worry, Mom. We’ll do what you want.’” Phil told her that her granddaughter, Jean, away at college, was on her way. 

Her sons said that before her stroke, they had believed that they understood her wishes. Yet when they examined the decision-making grids and flow charts of her written instructions, they were confused about the details of the many complex options. She had decided that she didn’t want to be intubated or put on life support. Did that preclude temporary nasogastric tubes for nutrition? A respirator was against her wishes, but what about a short-term oxygen mask? 

One neurologist told them it could be months before they knew the extent of her potential recovery. Another neurologist said it was unlikely she would regain the abilities to get out of bed, communicate or feed herself. A nurse was even more pessimistic, “saying, ‘I’ve seen a lot of this and, believe me, she’s not going to get better,’ ” recalls Steve Olenick.

With uncertain medical opinions, they called on Dr. Muriel Gillick, a palliative care specialist. “She was very neutral, very supportive,” says Steve Olenick. “By no means did she ever suggest that our mother shouldn’t be treated.” 

She encouraged them to explore tough questions. How much function would Bunny Olenick need to regain in order to live a life she would deem satisfactory? How would she feel about living bedbound, either in a nursing home or with around-the-clock home care? She explained that when a neurologist talks about partial recovery, the doctor may mean wiggling a toe, not walking, talking, eating and interacting. 

“She was dying, and would die no matter what they did,” says Gillick. “The issue wasn’t whether she would live or die. It was what the path was going to look like.” 

'This Is A New Experience For Mankind'

A range of studies since 2000 have shown that palliative care programs increase patient comfort and relieve symptoms while improving the lives of caregivers and families. 

The programs also save money. A study of 25,000 patients reported in the Sept. 8, 2008, Archives of Internal Medicine found that those who received palliative care and were discharged cost almost $1,700 less than those who didn’t receive palliative care. Among patients who died in the hospitals, those who received palliative care cost an average of nearly $5,000 less than those who did not receive such care. 

The savings come, in part, when patients and their families choose less aggressive treatment. In his book, “Hard Choices for Loving People,” chaplain Hank Dunn describes both the benefits and potential hazards of typical end-of-life aggressive medical treatment. For example, less than 2 percent of frail, elderly patients survive a CPR attempt, and those who do could suffer broken ribs, punctured lungs or irreversible brain damage. 

Yet in hospital intensive care units, short of a specific “do not resuscitate” order, CPR is the default response when a heart stops. “I think it’s insane that we offer patients and families interventions that have a 1 percent chance of doing any good, are extremely expensive and just don’t work,” says Gillick. 

It is that type of intervention that Bunny Olenick’s sons sought to avoid. 

Steve and Phil knew that there was a window of time following her stroke when their mother might die gently, and it was during that period that they decided to forego treatment for her in the hospital’s intensive care unit. 

She was moved to a medical ward and put on comfort care. Four days after her stroke, Jean arrived. She brushed her grandmother’s hair and spoke softly. And as though waiting for that last good-bye, on Dec. 22, 2008, Bunny Olenick died peacefully.