A Progressive Agenda for Obama

AlterNet. Posted November 8, 2008.

AlterNet asked dozens of writers, experts and activists on key issues to write about where the country needs to go, and the priorities for Barack Obama's early days in office. This is the third collection of suggestions Read the first one here and the second here.


Gerry Hudson is an executive vice president of SEIU, where he leads the union's Long Term Care Division.

SEIU's members, including nurses, LPNs, doctors, lab technicians, nursing home workers and home care workers, work in all sectors of health care. They live the problems of the system, and they know how much change can impact their working lives and the lives of their patients.

Health care costs are rising at almost double the rate of wage increases for the average American worker. Less than half of small businesses can afford to offer insurance. We can have an impact that will benefit Americans and our economy. Here are some tangible ideas.

Prevent and manage chronic diseases: Let's help millions of uninsured children and adults enroll in meaningful coverage and engage in their care. This will help prevent, bring down the costs of, and eliminate income and racial disparities in the incidence of chronic disease.

Fix the insurance markets: Small businesses, uninsured workers, students and others may need to receive financial assistance or get enrolled in a public program that meets their needs and circumstances. We can't just build a system and expect insurers to participate without ensuring a stable risk pool.

Make government purchasing more effective: The government is the largest purchaser of health care, so a comprehensive approach should create a framework that allows the federal government to become a smarter, more effective buyer. It should set standards for health information technology and sponsor and disseminate research on which treatments work best for which patients. Let's reward providers who can report measures of quality and outcomes and show improvement over time.

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Paul Armentano, deputy director, NORML

Though it's primarily Congress, not the president, who is responsible for crafting America's oppressive federal anti-drug strategies, Barack Obama has ample opportunities to use the power of the executive office to shape a new direction in U.S. drug policy. First, he can uphold his campaign promise to cease the federal arrest and prosecution of (state) law-abiding medical cannabis patients and dispensaries by appointing leaders at the U.S. Drug Enforcement Administration, the U.S. Department of Justice and the U.S. attorney general's office who will respect the will of the voters in the 13 states that have legalized the physician-supervised use of medicinal marijuana.

As president, Obama can also support scientific, clinical research into the medical properties of cannabis by encouraging the DEA to abide by the February 2007 ruling of the agency's own administrative law judge, which found that it would be "in the public interest" to allow private entities to grow medical-grade cannabis for FDA-approved trials. Obama can also use his executive authority to encourage the DEA and the U.S. Department of Health and Human Services to review an administrative petition that is currently before both agencies regarding the rescheduling of cannabis from a Schedule I prohibited drug to a more liberal classification that would allow for its medical use by prescription. Finally, Obama can support the autonomy and health of Washington, D.C., voters by encouraging Congress to lift the so-called "Barr amendment" (passed by Congress in 1998 and reinstated every year since then), which prohibits the District of Columbia from implementing a 1998 voter-approved ballot initiative legalizing the use of marijuana by authorized patients.

One hopes that as president, Obama will use the power of the bully pulpit to reframe the drug policy debate from one of criminal policy to one of public health. Obama can stimulate this change by appointing directors to the Office of National Drug Control Policy (the so-called drug czar's office) who possess professional backgrounds in public health, addiction and treatment rather than in law enforcement.

Obama should also encourage Congress to undo some of the more egregious aspects of the 1986 and 1988 anti-drug abuse acts, such as the imposition of mandatory minimum sentencing and the racially biased 100-to-1 sentencing disparity for the possession of crack versus powder cocaine, many of which were once endorsed but are now opposed by various high-ranking Democrats, including Vice President-elect Joe Biden.

Finally, Obama should follow up on statements he made earlier in his career in favor of the decriminalization of marijuana by adults (replacing criminal penalties with a fine only) by calling for the creation of a bipartisan presidential commission to review the budgetary, social and health costs associated with federal marijuana prohibition, and to make progressive recommendations for future policy changes. Last, Obama can join with leading Democrats like House Speaker Nancy Pelosi and Massachusetts Congressman Barney Frank to offer his support for legislative efforts in Congress that call for ending federal penalties regarding the use of cannabis -- both medically and otherwise -- by adults.

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Rep. Keith Ellison, D-Minn., the first Muslim member of Congress

Begin the process to end the war.

Get a start on health care.

Restart comprehensive immigration reform.

***

Dahr Jamail, author, Beyond the Green Zone: Dispatches From an Unembedded Journalist in Occupied Iraq

With Barack Obama's choices of foreign policy advisers and hawks of old, we can rest assured that we will see no radical changes regarding his policy in Iraq or the greater Middle East. He has never called for total withdrawal of U.S. forces from Iraq, nor withdrawal of private contractors, nor of the change necessary to truly rebuild Iraq's devastated infrastructure. In addition, let us not forget he has been as hawkish regarding Iran (keeping all options on the table), and his unbridled, uncritical support for the state of Israel and the occupation of Palestine. It is already made abundantly clear by his actions, the only "change" we should expect to see from Obama in the Middle East will happen if he is forced into it from below. Meanwhile, violence continues in Iraq, where dozens are killed daily, and U.S. soldiers continue to be killed.

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Anthony Papa, former prisoner and author, 15 to Life: How I Painted My Way to Freedom

If Obama wins, he should appoint a national drug czar who would take a good look at the zero-tolerance drug policies that have compromised public health and undermined our fundamental civil liberties -- someone who would not be afraid to disagree with the political rhetoric that has plagued our government for so long that has destroyed millions of lives, all in the name of the War on Drugs.

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Mark Weisbrot, Centre for Economic and Policy Research

The most immediate challenge will be pulling out of a recession that is just beginning, and has some way to go because the bursting of the housing bubble that caused the recession is only about 60 percent deflated. We will need a stimulus package of at least $300 billion to $400 billion, and we probably will need more. This should include funding for state and local governments so that they do not have to cut back on important programs and personnel; expanded unemployment insurance benefits and food stamps; moving forward infrastructure projects that are already planned; and a "green stimulus" including tax credits to make buildings more energy-efficient.

On health care, opening up a public system like Medicare for all employers and employees -- with subsidies for low-wage workers -- would be a significant step forward.

On foreign policy, a speedy withdrawal from Iraq and a negotiated end to the war in Afghanistan are urgent priorities. Washington should also repair its damaged relations with Latin America, which would include respecting the national sovereignty of left governments such as Bolivia and Venezuela. Congressman Barney Frank's suggestion of a 25 percent cut in military spending would also be a step in the right direction.

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J. Richard Cohen, president, Southern Poverty Law Center

As the next president, Barack Obama must work diligently to restore and reinvigorate the institutions that safeguard our democracy, beginning with the Justice Department and its Civil Rights Division. Under President Bush, the department was transformed into a partisan political operation stacked with ideologues and GOP loyalists. The result was that the department abandoned its historic role of protecting the rights -- and the vote, in particular -- of the disenfranchised. President-elect Obama should immediately begin to depoliticize the Justice Department and ensure a return to the standards of professionalism and nonpartisanship that have served this country so well in the past.

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Camilo Mejia, author, Road from Ar Ramadi: The Private Rebellion of Staff Sergeant Mejia

Obama was able to win the U.S. presidency by promising change, yet he endorsed the financial bailout of the banks while millions of Americans join the ranks of the unemployed and lose their homes to foreclosure. Obama promised to de-escalate the Iraq War by removing troops from that country, yet he didn't address the question of private contractors, permanent military bases or a massive diplomatic/corporate complex in the Green Zone. He also promised to shift troops to Afghanistan and to spill the Global War on Terror into Pakistan if necessary.

It will take more than promises to effect real change in American society and in the way we relate to the rest of the world, and people will have to stand up to the corporate interests behind the U.S. government, regardless of who is in the White House, for us to build a country and a world we can be proud of.

We, the people who are affected the most by domestic and international policies, who are losing our jobs to a failed, profit-driven economic system, who are losing our lives to an illegal war of aggression and to the ill treatment of returning veterans, who have caused and seen firsthand the suffering of the Iraqi and Afghan people, we at the grassroots level have the right and the moral responsibility to steer this country in the right direction.

We cannot let any president exercise the power that should be in the hands of the people. We cannot wait one minute, nor should we compromise for one second, as politicians figure out how to appease the public while catering to the corporate class. There is no such thing as a humane empire. The struggle for justice and social justice starts at home, and it is a struggle that cannot and should not wait one moment. It starts now.

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Lori Wallach and Todd Tucker, Public Citizen's Global Trade Watch division and authors of a new report, "Election 2008: Fair Trade Gets an Upgrade."

Barack Obama is the first president in modern U.S. history to campaign and win on a fair-trade platform. In the primaries, he committed in writing to, among other things, renegotiate NAFTA and other deals, repair the China trade mess and replace Fast Track. As of Wednesday afternoon, at least 85 newly elected members of Congress in 2006 and 2008 had made similar commitments.

Obama and Congress should work together to meet the public's demand for an overhaul of our failed globalization policy. The Trade Reform, Accountability, Development and Employment (TRADE) Act provides a progressive path forward on both substance and process, and is supported by a wide range of Democrats and base groups.

Additionally, Obama must work to transform the World Trade Organization and other radical deregulation pacts so that nations' non-trade, domestic policies (i.e. health care, climate change, and food and product safety, for starters) are not subject to attack or sanctions.

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Courtney Martin, author of Perfect Girls, Starving Daughters: How the Quest for Perfection is Harming Young Women

I'm excited to see the next president assemble a gender-balanced Cabinet, but even more, to lead that Cabinet to embody a commitment to solving some of our most pervasive international challenges with the complexity and respect for reflection that has been missing the last eight years. This Cabinet will recognize that global poverty disproportionately affects women and children, that reproductive justice should be considered essential in disaster relief and peacekeeping operations, and that the Iraq War must end immediately. At home, this Cabinet will, finally, ensure that women get equal pay for equal work, and that all of us benefit from better family-friendly work policies, universal health care and an improved education system. The next president will recognize that there is no such thing as "women's issues;" there are only citizens' issues.

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Maggie Mahar, Century Foundation fellow and author of Money-Driven Medicine: The Real Reason Health Care Costs So Much (Harper/Collins 2006)

Like it or not, the next president will have no choice but to put Medicare reform near the top of his agenda. As the Congressional Budget Office recently declared: "Rising health care costs and their consequences for Medicare and Medicaid constitute the nation's central fiscal challenge."

The good news is that Medicare can tame runaway health care inflation without raising co-pays or cutting back on benefits. Washington can contain Medicare spending by:

• Allowing Medicare to use its clout to negotiate for discounts on drugs



• Eliminating the windfall bonus to private insurers that offer Medicare advantage



• Passing legislation that would create a truly independent Comparative Effectiveness Research Institute that takes a hard look at which treatments work best for a particular set of patients.

Today, the FDA requires only that new treatments be tested against a placebo -- proving that they are "better than nothing." Medicare patients deserve better value for taxpayer dollars.

Done right, Medicare reform can pave the way for universal coverage.

At $2.3 trillion a year and counting, the cost of medical care is growing so fast that it threatens to crowd out spending on education, the environment and infrastructure repair. Moreover, unlike spending to repair bridges, strengthen schools, or protect the environment, Congressional Budget Office Director Peter Orszag suggests that the "excess" growth in health care spending is not adding to the wealth -- or the health -- of the nation. "The gains from higher spending are not clear," the Congressional Budget Office noted recently. "Substantial evidence exists that more expensive care does not always mean higher-quality care."

Health care inflation cannot be ignored, Orszag added, because "If we fail to put the nation on a sounder fiscal course we will ultimately reach a point where investors (will) lose confidence and no longer be as willing to purchase Treasury debt at anything but exorbitant interest rates."

Today, investors outside the United States hold $2.74 trillion of Treasuries, or 52 percent of the $5.22 trillion in debt that the United States has issued. But now foreign buying of our Treasuries is falling. And, as Orszag has explained elsewhere, if we have to pay "exorbitant interest rates" to persuade foreign investors to continue buying our Treasuries, "over time, foreign investors would claim larger and larger shares of the nation's output and fewer resources would be available for domestic consumption." Put simply, our standard of living would fall.

Why does Orszag single out soaring health care costs as the driving force behind our fiscal woes? Because health care spending accounts for more than 16 percent of GDP, and it continues to grow faster than other sectors, outpacing both growth in GDP and workers' wages.

Some observers took Orszag's statement about the importance of health care spending as a signal that he was calling for universal coverage. He was not -- not without simultaneously containing costs. Orszag made it clear, as he has before, that if we don't put a brake on health care inflation, we won't even be able to sustain the national health care programs we have now -- Medicare and Medicaid -- let alone cover everyone: "Rising health care costs and their consequences for Medicare and Medicaid constitute the nation's central fiscal challenge," the CBO observed in a recent report. "Without changes in federal law, the government's spending on those two programs is on a path that cannot be sustained."

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Julia Eisman at Stand Up for Health Care, a project of Families USA

The year 2009 may offer the best chance in nearly two decades for bold action in response to our growing health care crisis -- a crisis that has left 45 million Americans uninsured, including 8 million children. Those who do have health insurance are paying skyrocketing premiums for plans with higher deductibles, higher co-pays and fewer benefits. Rising health care costs are adding to families' economic distress.

Meaningful health care reform should be built on a strong foundation of public programs for low-income families (Medicaid). We also need to provide a place for individuals and businesses to buy guaranteed affordable, high-quality health insurance -- either through private plans or a public plan option. There should be sliding-scale subsidies to make coverage affordable for working families, and strong rules that hold insurance companies accountable, no matter where you live or if you have a pre-existing condition. It is time we expand the State Children's Health Insurance Program so every child can visit his or her doctor.

We're confident that health care reform can happen in a new administration -- not in spite of our economic situation, but precisely because it is so important to ensure economic security for American families through quality and affordable health care for all.

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Janet Nudelman, Breast Cancer Fund

A growing body of scientific evidence links synthetic chemicals to breast and other cancers, as well as to fast-growing health problems including obesity, developmental delays, autism and infertility. In order to prioritize disease prevention by taking some decisive steps in his first 100 days, it is crucial that the next president:

• Endorse Congressional efforts to ban the toxic, hormone-disrupting chemical Bisphenol A from food can linings and baby bottles



• Support legislative and administrative policies that bar cosmetics manufacturers from selling personal care products that contain toxic chemicals



• Back federal programs that protect our nation's air, water and land from toxic contaminants



• Fully fund public health programs that track disease rates alongside environmental exposures and that ensure that children, pregnant women and workers are protected from toxic exposures that may harm their health



• Support the overhaul of our broken chemical regulatory system and work for broad-based chemical policy reform



• Ensure that the new national War on Cancer includes a strong commitment to reducing cancer rates by funding research efforts that identify and eliminate the environmental links to cancer

***

Pacific Institute founder Dr. Peter Gleick

The next administration must:

• develop a comprehensive national water policy, with a new bipartisan Water Commission for the 21st century



• Spotlight national security issues related to water



• Expand the role of the United States in addressing global water problems



• Integrate climate change into all federal water planning and activity

We have limited and unevenly distributed fresh water resources, and they are used inefficiently and ineffectively -- in part because of the lack of basic national water policy. The next president faces challenges around our freshwater supply and management with diplomatic, economic, political and public health ramifications; comprehensive and sustainable national water policy must be an early priority.

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Stephen Zunes, professor of politics and chair of Middle Eastern Studies at the University of San Francisco

Nowhere else has the Bush administration caused so much suffering, damaged America's standing and created conditions that will threaten our national security interests for decades to come than in the greater Middle East.

Nowhere else does an Obama administration need to make a more dramatic reversal of U.S. foreign policy. As a candidate, Barack Obama promised not just to end the war in Iraq, but end the mindset that led to the war Iraq. If he is serious about such a shift, his administration must do the following:

In Iraq, Obama must announce an immediate halt to offensive military operations, formally renounce the intention of establishing a permanent military presence or control of the country's national resources, and began a phased total withdrawal.

An Obama administration must place priority on a comprehensive strategy against the biggest threat to security: the proliferation of nuclear weapons, reminding Americans that Iran is not the only country currently violating UN Security Council resolutions regarding its nuclear programs and insisting that India, Israel and Pakistan -- which are in violation of UNSC resolutions -- live up to their obligations as well.

Indeed, an Obama administration should endorse the establishment of a Nuclear Weapons-Free Zone for the Middle East and South Asia, which would link up with already existing NWFZs in Africa, Southeast Asia, the South Pacific, Latin America, Central Asia and Antarctica -- the entire Global South. Such a proposal is already supported both by U.S. allies like Egypt and Jordan and by traditionally more hostile regimes like Iran and Syria. An Obama administration must also get serious about the United States fulfilling its own obligations under the Non-Proliferation Treaty and get serious about disarming our nuclear arsenal as well.

Obama should renounce his earlier pledge to send an additional $30 billion of U.S. arms in the coming years to the Middle East at taxpayer expense without condition on a government's adherence to international standards for human rights. Instead of sending still more arms to that already overly militarized region, however, an Obama administration should announce a comprehensive program for a reduction of arms, working with other arms exporters on strict limitations on all arms transfers.

And, instead of continuing U.S. support for Israel's occupation policies, an Obama administration should instead back the sizable number of Israeli progressives who recognize that Israeli security and Palestinian rights are not mutually exclusive but mutually dependent upon the other. Obama should announce his support for a peace agreement based upon the December 2003 Geneva agreement and other initiatives by Palestinian and Israeli moderates, renounce the illegal colonization and territorial expansion outlined in Israel's convergence plan (which was endorsed by both the Bush administration and virtually all of the leading Congressional Democrats), and take a leading role in the peace process which recognizes that. He should also recognize that just as occupation, colonization and repression can never justify terrorism, neither can terrorism justify occupation, colonization and repression.

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Sarah Anderson, Global Economy Project director, and Sam Pizzigati, associate fellow of the Institute for Policy Studies

John McCain gleefully derided Barack Obama during his campaign's final weeks for "believing in redistributing the wealth."

So, apparently, do the American people. Obama's stunning victory gives him what no president has had in more than half a century: a mandate to cut the rich down to democratic size.

Since the 1970s, America's rich have more than doubled their share of the nation's income and wealth. The resulting concentration of power has, for a generation now, been tilting the political deck against average working families.

Obama has so far pledged to support an assortment of "tax the rich" measures. But these proposals, taken together, would not do much more than undo George W. Bush's giveaways to the rich.

The Obama administration should go further to roll back the radical upward redistribution that began with the Reagan administration. Societies really do work better when we spread wealth around.

              

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