What we could learn from Henry Ford -- Dec. 31, 2013 column

By MARSHA MERCER

As Congress begins the struggle over raising the federal minimum wage, we can gain some historical perspective from an event 100 years ago this week.

On Jan. 5, 1914, Henry Ford did something extraordinary, even for him.

The man who developed the Model T and the moving assembly line called a news conference in Detroit and stunned the world by announcing that workers in his factory would make $5 per day, more than doubling the average worker’s wages.

“Even the boy who sweeps up the floors will get that much,” the New York Times reporter marveled.

Every schoolchild knows that when Ford hiked wages, his employees were able to buy the cars they built, which had the salubrious business effect of increasing company sales.

The government didn’t order Ford to raise his wages, of course, but proponents of raising the federal minimum wage say doing so is a matter of fairness. Someone working full time should not live in poverty. A full-time minimum wage worker makes $15,000 a year. If she has a child, her income falls below the poverty level of $15,510 for a family of two in 2013.

Besides, and here’s where Ford’s example comes in handy, increasing the buying power of low-wage workers helps boost the economy. When people on the margin get more money, they spend it.

Thirteen states and several cities are wishing workers a Happy New Year by raising minimum wage rates in 2014. In all, 21 states will have higher hourly rates than the federal $7.25 an hour. Eleven other states and the District of Columbia are expected to follow in the coming year.

Democrats on Capitol Hill want to raise the rate to $10.10 in three steps over two years and index future increases to inflation. President Barack Obama supports the move.  

Even though polls show most Americans favor raising the wage floor, it’s a no-go in the House, where Republicans say doing so is a job-killer because employers won’t hire as many young, inexperienced workers if individual wages are higher. Economists disagree about this, but most say adverse effects of raising the wage rate are small.

In Ford’s case, there was another, more practical reason for raising workers’ pay. His primary objective was to reduce attrition, according to a corporate history. Worker turnover on the monotonous assembly lines was high. At the same time he raised pay, he cut the workday from nine hours to eight and said he’d share profit with men workers (but not boys or women unless they were supporting families. It was 1914, remember.)

Ford had innovative ways of treating employees. No one would be fired unless for “unfaithfulness or irremediable inefficiency.” If layoffs were necessary due to decreased demand, he would try to time them with the harvest season so that men wouldn’t “lie idle and dissipate their savings."

Ford’s treasurer,  James Couzens, said, “It is our belief that social justice begins at home...believing as we do, that a division of our earnings between capital and labor is unequal, we have sought a plan of relief suitable for our business.”

Newspapers hailed Ford’s generosity and humanity. Critics wondered if he was a socialist. The Wall Street Journal complained that he had brought “biblical or spiritual principles into a field where they do not belong.”

But Ford’s ploy worked as he intended. Thousands of job-seekers flocked to the Ford Motor Company employment office from the American South as well as Europe.  Turnover in the factory declined, and with an eight-hour day, Ford could run three shifts instead of two, increasing productivity. Ford Motor Company’s profits doubled from 1914 to 1916.

Today, the public is focusing on the plight of low-wage earners. Fast-food workers in at least a hundred cities have staged walkouts to call for pay of $15 an hour, and the right to form unions.

The coming struggle over raising the federal minimum wage may be mostly political theatrics in an election year, but it raises questions about work and its rewards.  It can’t be healthy to see every policy question as a game with winners and losers: If workers win, employers have to lose. Why?

As Ford showed 100 years ago, sometimes doing the right thing can make everyone a winner. The $5-a-day wage helped create the American middle class.

© 2013 Marsha Mercer. All rights reserved.

All you need to know about Washington in 2014: It's an election year -- Dec. 24, 2013 column

By MARSHA MERCER

Trying to put unlucky 2013 behind him, President Barack Obama was upbeat about the New Year.

    

“I firmly believe that 2014 can be a breakthrough year for America,” he said Dec. 20 at a White House news conference before heading to Hawaii for vacation.

“It’s probably too early to declare an outbreak of bipartisanship,” the president conceded, “But it’s also fair to say we’re not condemned to endless gridlock.”

OK, it’s the holiday season, so let’s be charitable. It’s possible that 2014 will be more productive than 2013 in the nation’s capital. But don’t bet your new MacBook Air on Democrats and Republicans suddenly discovering they have a lot in common.

Everything you need to know about 2014 in Washington can be summarized in two words: midterm elections.

Obama and members of Congress are battling for their survival. Everything they say – and they will say far more than they will do -- will be focused on winning middle-class votes. The technical term is pandering, and both parties are masters of the craft.

The stakes are large. If Obama’s approval rating doesn’t rebound from the miserable 42 percent he hit in the latest CBS News poll, he’ll be an albatross for Democratic candidates running for the House and Senate next November.  And if Republicans don’t stop playing fiscal brinksmanship games without offering alternatives, they risk writing their own political obituaries.

Some things won’t change when the ball drops at Times Square. Health care and the economy will dominate politics. Republicans will keep describing Obamacare as a train wreck and the economy as an abject failure. Democrats hope voters won’t listen once people start getting insurance coverage and the economy continues to grow.  Yes, those are big ifs.

Republicans in the Senate and House are convinced that public disapproval of the Affordable Care Act will translate into GOP votes. That means more hostile hearings presided over by House Republicans and more horror tales from Senate Republicans, although we may be spared another attempt to defund the law, given the political hits the GOP took from forcing a government shutdown last fall in a futile attempt to stop the law.

The bipartisan budget agreement this month showed that compromise is possible on Capitol Hill. An early test of whether bipartisanship will last will come over the debt ceiling. The Treasury Department says the amount the government can borrow must be increased by early March so we can continue paying our bills.

Conservative Republicans will demand budget concessions; Obama has reiterated his refusal to negotiate. Such a standoff also led to the shutdown.  

But 2014 has the added intrigue of Senate Minority Leader Mitch McConnell’s tough re-election fight in Kentucky. With only a 31 percent approval rating in his state, McConnell is the least popular senator in the land. In Kentucky, though, 31 percent was also Obama’s approval rating, which doesn’t help Democrats. 

If McConnell beats tea party challenger Matt Bevin in the Republican primary, he still has a formidable general election competitor in Democrat Alison Lundergan Grimes, Kentucky secretary of state.

For their part, Democrats on Capitol Hill will focus on working families and income inequality. A priority is raising the minimum wage. Sen. Tom Harkin, an Iowa Democrat who’s retiring, has proposed an increase from $7.25 to $10.10 an hour, which Obama supports.

Republicans counter that a higher minimum wage will mean that employers hire fewer workers. Both sides see the minimum wage as a potent campaign issue.

Senate Majority Leader Harry Reid says the first order of business in January will be extending long-term unemployment benefits, which Congress allowed to expire this month.  House Speaker John Boehner may go along with the extension, if spending cuts are part of the package.

Progressive Democrats, including Harkin and Elizabeth Warren of Massachusetts, are defying conventional wisdom that curbing entitlements must be part of any long-term fiscal plan.  They say Social Security benefits need to be raised, not cut.

Critics say it’s irresponsible to suggest raising benefits, which would require higher payroll taxes, and nobody, but nobody, expects anything to happen. But it does make a dandy campaign promise.

So much pandering ahead in 2014, and we haven’t even touched on 2016. Happy New Year!   

© 2013 Marsha Mercer. All rights reserved.

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Stupid spending? You decide. -- Dec. 19, 2013 column

By MARSHA MERCER

Senator Tom Coburn is making a splash with “Wastebook 2013,” his detailed list of nearly $30 billion in wasteful federal spending projects.

The Oklahoma Republican has become a hero in some quarters for his annual report, revealing the wacky ways the government spends taxpayers’ money. 

Among the 100 projects he ridicules this year:  $325,525 for a National Institutes of Health study on angry wives, $914,000 to promote romance novels, $17.5 million in tax breaks for brothels in Nevada, and $3 million for NASA research into, in Coburn’s words, “the search for intelligent life . . . in Congress.”

Good ones. The report, released Tuesday, always makes for entertaining, if annoying, reading, although few in Congress pay it much attention. That’s because most of the bone-headed spending decisions are more complicated than they first appear -- and because career politicians know it’s better to give and to receive. 

Grateful constituents remember their elected friends, come election time.

Besides, one man’s trash is another’s, well, Christmas tree.

Coburn comes across as a Grinch who’s particularly vexed that the government helps Christmas tree farmers. He scoffs at the Agriculture Department’s Specialty Crop Block Grants that go to the Virginia Christmas Tree Growers Association and five other Christmas tree groups, as well as to the California Dried Plum Board, Vermont Maple Sugar Makers Association, Michigan Maple Syrup Association, and dozens of wine promotions, among others.   

In Coburn’s home state, the Oklahoma Pecan Growers used grant money to attend international trade shows, which they said helped expand their market overseas, benefitting the state’s economy.

Altogether, specialty crop grants totaled $50 million, which tells me the government is spreading a fairly small amount to reach a lot of farmers.   

Coburn called out the Agriculture Department’s Value-Added Producers grant program that gave Glenmary Gardens in Bristol, Va., $213,000 to expand processing and marketing of locally grown fruits and vegetables for jellies, ice creams and flavored syrups.  He also disapproves of free wine and cheese on Amtrak’s Auto Train.

I had no idea my tax money was promoting American prunes in Japan or a “USA Pear Road Show” in China, but that strikes me as more wholesome and sensible than other government endeavors.

Coburn, a medical doctor, concedes that some of the projects are OK. He questions whether they’re the right spending when we’re $17 trillion in debt.  

Much of the big-dollar waste, no surprise, is at the Defense Department, which is trashing $7 billion in military equipment in Afghanistan rather than selling it or sending it home. The rationale is that it costs more to transport it than to leave it. 

Coburn is retiring next year, and one wonders who in Congress, if anyone, will chronicle waste, although Coburn followed Sen. William Proxmire, Democrat of Wisconsin, whose monthly Golden Fleece awards hitting government waste made headlines from 1975 to 1987. Proxmire died in 2005.

Some tea partiers contend Coburn’s 177-page report is itself an example of wasteful spending.  How much staff time and money does it cost to produce a report with 930 footnotes?  Couldn’t he have done it with fewer pages and less flashy graphics?

They’re good questions, but don’t hold your breath for answers.  And that’s another problem with singling out projects as “stupid” and “egregious,” words Coburn throws around liberally. Everyone has a different idea of what’s wasteful.

It’s incomprehensible to me that the State Department spent $630,000 of our hard-earned money to buy “friends” and followers for its Facebook and Twitter pages.  Or that a million-dollar bus stop with wi-fi, heated benches and sidewalks in Arlington, Va., has a roof that barely protects against rain and sun.

The reality is that most of the wasteful projects in this year’s report could appear in the next one because of the inertia of federal agencies, the near total absence of congressional oversight and political support for spending.

“The reason it’s hard work to cut spending is because somebody’s ox gets gored,” Coburn says. “Somebody doesn’t get money. Most members of Congress are more interested in getting themselves re-elected than they are in fixing what’s wrong with the country.”

Economist Milton Friedman took a philosophical approach. “I say thank God for government waste,” he said in a 1975 interview. “If government is doing bad things, it’s only the waste that prevents the harm from being greater.”

© 2013 Marsha Mercer. All rights reserved.

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Defrosting Capitol Hill? -- Dec. 12, 2013 column

By MARSHA MERCER

Asked how to start writing a novel, Ernest Hemingway supposedly replied, “First you defrost the refrigerator.”

Ah, procrastination. Everyone puts off getting to work – and Congress is the classic repeat offender. But Sen. Patty Murray of Washington and Rep. Paul D. Ryan of Wisconsin deserve kudos for defrosting the Capitol fridge – at least for a while. We can all hope the thaw lasts so Congress can do its job.

Murray, a liberal Democrat who heads the Senate budget committee, and Ryan, a conservative Republican who’s chairman of the House budget panel, did what many thought impossible. They delivered a compromise budget agreement that keeps the government open -- no shutdown! -- for two years. During a couple of months of negotiations, they reportedly bonded over football and fishing and agreed, for the greater good of the country, on a deal neither likes much.

“I see this agreement as a step in the right direction,” Ryan said Tuesday, announcing the agreement. “In a divided government, you don’t always get what you want.”

“For far too long here in Washington, D.C., compromise has been considered a dirty word, especially when it comes to the budget,” Murray said. “We have broken through the partisanship and the gridlock.”

Breaking through partisanship and gridlock, even temporarily and for a modest deal, is no small matter. Since 2011, Congress has staggered from budget crisis to budget crisis, raising the blood pressure of the business leaders and infuriating ordinary citizens. The last crisis ended in a 16-day government shutdown in October and low approval ratings for Congress.

The bipartisan deal is far from perfect. It’s not a Grand Bargain that tames the country’s appetite for entitlement programs. It’s an OK deal that has more thorns than blossoms.

Ryan insists the deal doesn’t raise taxes, but Republicans balk at its higher airport and other fees. Democrats resent the lack of an extension of unemployment benefits for more than a million long-term jobless workers. The deal also trims pensions of younger military retirees and requires new federal workers to contribute more to their pensions.

President Barack Obama approves, saying, “This agreement doesn’t include everything I’d like – and I know many Republicans feel the same way. That’s the nature of compromise.”

My favorite comment on the deal came from Eugene Steuerle, budget expert at the Urban Institute, who told the Washington Post: "With this little package, we're not going to climb out of the hole we've dug. All we're doing is agreeing to stop throwing shovels at each other."

Members of Congress get to go home for Christmas, unlike last year. But the masters of putting off until tomorrow what they should have done yesterday have much work ahead. Their to-do list is long, starting with the farm bill, immigration reform, raising the minimum wage and tax reform.     

On C-SPAN the other morning, a viewer named Johnny from Woodbridge, Va., called Democratic Rep. John Garamendi of California on the carpet for Congress’ slack work habits. Johnny said members of Congress don’t even work 10 hours a month.

“We actually work at least 10 hours a month,” Garamendi said, although he conceded, “The amount of work is very, very slim.”

When another viewer suggested Congress should work harder earlier in the session, Garamendi said, “Congress doesn’t act much differently than most of us did in high school and college.” He sounded flip but Congress loves to bunch its work at the end.

“It’s human nature. Sort of like college students cramming for exams,” says Martin P. Paone, who retired in 2008 after 30 years on the Senate Democratic cloakroom staff.

Senate Historian Donald Ritchie notes that in the very first Congress, Sen. William Maclay of Pennsylvania complained in his diary that he was overwhelmed by bills in the last days of that Congress. Maclay said he didn't have enough time to read everything that was coming through, Ritchie said. Some things never change.

But with the 2014 congressional elections, the House is scheduled to be in session only 113 days next year, nearly two weeks less than this year. More work is likely to pile up or be postponed. Murray and Ryan may have defrosted the refrigerator, but there’s a loaded freezer waiting in the congressional garage.

© 2013 Marsha Mercer. All rights reserved.

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Moving on, a president hits the campaign trail -- again -- Dec. 5, 2013 column

By MARSHA MERCER

As I listened the other day to a politician talk about ways to strengthen the economy, a thought flitted across my mind: “This guy has ideas. Maybe he should run for president.”

Ha! OK, I knew the speaker was President Barack Obama. But after nearly five years in the Oval Office, he still manages to sound like an outsider who could do great things if only he had the chance.

And that’s why -- with a job approval rating of only about 40 percent, his signature legislative achievement still under fire and his agenda in jeopardy -- the president hit the campaign trail. He launched a three-week push ostensibly to persuade people to sign up for health care online but also to remind voters why they re-elected him just a year ago. 

Naturally, like many another political outsider, Obama has discovered that middle class frustrations “are at an all-time high.”

The botched rollout of the online health insurance exchanges didn’t instill confidence in him or the federal government, he concedes, but he insists that the law will stand and eventually will work just fine. Even so, that alone won’t cure the middle class malaise that started decades ago, he says. Malaise, by the way, is my word, not his.

   

“Their frustration is rooted in their own daily battles – to make ends meet, to pay for college, buy a home, save for retirement. It’s rooted in the nagging sense that no matter how hard they work, the deck is stacked against them. And it’s rooted in the fear that their kids won’t be better off than they were,” he said.

Candidates of both parties cozy up to the middle class, of course, but the question is how. Republicans want government to stand aside. Obama and Democrats believe government has a role in ensuring equal opportunity.

   

“A dangerous and growing inequality and lack of upward mobility…has jeopardized middle-class America’s basic bargain -- that if you work hard, you have a chance to get ahead,” Obama said Wednesday at an event sponsored by the Center for American Progress, a left-leaning think tank that has provided several Obama administration insiders.

He revived a host of ideas: increase the federal minimum wage, now $7.25 an hour; strengthen collective bargaining; end the wage disparity between men and women; tighten the tax code and use the additional revenue to rebuild roads and bridges, extend preschool to every child, and repeal the across-the-board spending cuts called the sequester. 

“I believe this is the defining challenge of our time: Making sure our economy works for every working American…And I know I’ve raised this issue before, and some will ask why I raise the issue again right now,” he said.

His critics say it’s no mystery, that he’s trying to change the subject from the health care mess and trying to give Democrats ground to stand on in next year’s midterm congressional elections. So what? 

Obama and everyone around him have apologized, and the marketplace system finally is running more smoothly. The elections in 11 months could make or break his last two years as president. He acknowledged he’s putting out his ideas as a marker.

“I realize we are not going to resolve all of our political debates over the best ways to reduce inequality and increase upward mobility this year, or next year, or in the next five years,” he says.

What’s important is “that we have a serious debate about these issues. For the longer that current trends are allowed to continue, the more it will feed the cynicism and fear that many Americans are feeling right now.”

Obama says he’s willing to work with Republicans. “If Republicans have concrete plans that will actually reduce inequality, build the middle class, provide more ladders of opportunity to the poor, let’s hear them…” And so on. “You owe it to the American people to tell us what you are for, not just what you’re against.”

But can the battle-scarred Democratic president find common ground with battle-scarred Republican lawmakers?

House Speaker John A. Boehner, R-Ohio, complains that the House has passed nearly 150 bills that he claims would help the economy, but all have died in the Senate, which is controlled by Democrats. They include multiple attempts at repealing the health law.

“When will they start listening to the American people?” Boehner asks.

It’s hard to listen when both sides have turned a deaf ear to the other.

 © 2013 Marsha Mercer. All rights reserved.

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Is kindness catching? We can only hope so -- Nov. 27, 2013, column

By MARSHA MERCER

It’s not just a bumper strip slogan. Some Americans actually do practice random acts of kindness.

At fast food restaurants around the country, some customers are paying for the orders placed by strangers in the next car.

“Drive-through generosity is happening across America and parts of Canada, sometimes resulting in unbroken chains of hundreds of cars paying in turn for the person behind them,” Kate Murphy reported last month in The New York Times.

“We really don’t know why it’s happening but if I had to guess, I’d say there is just a lot of stuff going on in the country that people find discouraging,” Mark Moraitakis, director of hospitality at Chick-fil-A, told Murphy, adding, “Paying it forward is a way to counteract that.”

“Pay it forward” refers to repaying a kindness by doing something kind for another person.  The concept was popularized by a 1999 novel by Catherine Hyde Ryan and movie starring Kevin Spacey and Helen Hunt. A high school teacher challenges his students to change the world. One boy helps three people and asks each of them to help three more people…You see where this is going.

Moraitakis is onto something.  People like helping others – on their own terms. Compulsory kindness doesn’t cut it.

You don’t see many people paying it forward in Washington, a city famous for pay backs. But when legendary comedian Carol Burnett came to town last month to receive the Mark Twain Prize for American Humor, she showed how it’s done.

Burnett asked that Rosemary Watson, a comedic newcomer who does dead-on impersonations of Hillary Clinton and other prominent female politicians, be given the chance to perform at the Kennedy Center awards gala.  The two had never met. Watson had written Burnett a fan letter, and Burnett had watched Watson’s videos on YouTube. Impressed, she wanted to give a boost to the younger woman’s career.    

“The thing is, you pay it forward,” Burnett said.”Because when I got started, somebody gave me a break when I was 21 years old, and I wanted to go to New York.”

Paying it forward can be as simple as letting someone go ahead in line at the grocery store. Many people pay it forward with their time. It turns out there are special benefits for people who volunteer.

The December issue of Oprah Winfrey’s O Magazine touts “Four Amazing Health Benefits of Helping Others.”  Studies show that volunteers may live longer, be happier, manage their pain better and lower their blood pressure more than non-volunteers.

Many people prefer to pay it forward with cash. Individual charitable giving rose almost 4 percent last year but still lags its pre-recession peak. This is one area where young people are a shining example.

Nine of 10 kids between the ages of 8 and 19 give to charity, according to a recent study by the Women’s Philanthropic Institute at Indiana University’s Lilly Family School of Philanthropy.

Parents, take note:  Moms and dads who talk to their children about giving to charity significantly increase the likelihood that the children will give. Talking may be more influential than parental role-modeling of charitable giving, the report says.

We all have a chance to pay it forward on Giving Tuesday -- the Tuesday after Thanksgiving. It’s a day to give back at the start of the holiday season, after our two biggest days of getting, Black Friday and Cyber Monday.

Giving Tuesday was created last year by Henry Timms of the 92^nd Street Y, a cultural and community nonprofit center in New York City.  He’s the son of one of my closest friends, but I’d be writing about this brilliant project anyway.

In its first year, Giving Tuesday raised $10 million for more than 2,500 nonprofit groups. More groups are participating this year. Giving Tuesday doesn’t collect the money. Its genius is that it encourages each person to choose a favorite charity and publicize the choice on social media.

If you’re interested in paying it forward, join the movement. It might make you feel as good as those you help.  

©2013 Marsha Mercer. All rights reserved.

The endangered art of writing by hand -- Nov. 21, 2013 column

By MARSHA MERCER

When President Barack Obama composed his thoughts about the Gettysburg address, he wrote much as Abraham Lincoln did 150 years ago.  He used pen and paper.

     

The White House Tuesday released both the handwritten and typed versions of Obama’s essay. Had Obama, or more likely an aide, simply typed the tribute on a laptop and hit Send, the text would have been just another news release.  Instead, many people stopped to read the handwritten page.

In our aggressively digital age, the handwritten note or essay may be as practical as a top hat, but no writing is more personal.  (OK, writing a check for the electric bill is hardly personal, but online banking has freed people from most check-writing.)

   

When we handwrite a letter, we send something beyond the words. Holding the same paper, the reader glimpses the fallible human being who held the pen.  For example, the president sometimes forgets to cross his Ts. This may not come as a surprise.

It’s rare for most adults to take the time to find pen and paper, wait for thoughts to flow and put them down – although we can. Sadly, we’re in danger of losing the art of writing by hand.

Schools long ago let penmanship slip. Cursive writing is so foreign that some children can’t read the handwritten letters their grandparents send.  Parents have to translate.

The Common Core educational standards for grades K-12 dropped penmanship in favor of keyboarding as an important skill. Everyone needs to use a computer keyboard, of course. Word processing is the inelegant term for what we do at the keyboard. We produce a commodity called content.

We moderns talk and type constantly, but our tweets and status updates are often out of our hands before our brain has registered the meaning of our words.

Must our choice be keyboard or pen? Why not both? Among the 45 states that have adopted Common Core standards, seven want to reinstate cursive writing instruction, the Associated Press reports. They are California, Idaho, Indiana, Kansas, Massachusetts, North Carolina and Utah.  

In North Carolina, the “back to basics” educational movement means that students are learning to write by hand and to memorize the multiplication tables.  Proponents say cursive writing helps eye-hand coordination and improves reading and writing. Critics say practicing cursive script is irrelevant, similar to using an abacus or slide rule. 

While that debate simmers, we all could learn from the presidents who believed in the power of the handwritten word.

Ronald Reagan was a prolific letter writer, penning thousands upon thousands of letters. In the White House, he turned his handwritten letters over to typists who prepared them for mailing. The former president was 83 when he wrote by hand the poignant letter telling Americans that he was in the early stages of Alzheimer’s disease.

“I now begin the journey that will lead me into the sunset of my life,” Reagan wrote on Nov. 6, 1994. “I know that for America there will always be a bright dawn ahead.” He died in June 2004. His letters have been gathered in several books. 

The letters of President George H.W. Bush, another prodigious correspondent by hand, were compiled in “All the Best, George Bush: My Life in Letters and Other Writings,” published earlier this year.

Obama has had a habit of reading 10 letters a night from citizens, and he responds by hand to a lucky few.  Some recipients burst into tears and vow to save the president’s missives for posterity. Human nature being what it is, though, others race to see how much the letters will fetch from online auctions.

Speaking of which, earlier this year Obama’s half-brother put two of the president’s hand-written notes for sale for $30,000.

Such commercialism cheapens the seller but not the handwritten word or the writer. 

Obama’s handwritten essay about the Gettysburg address at 150, along with similar essays by several former presidents and other notables, will be on display at the Lincoln Presidential Library in Springfield, Ill.

You don’t have to be famous to pick up a pen and write. Your handwritten words are just as priceless.  

© 2013 Marsha Mercer. All rights reserved.

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Thanksgiving -- to shop or not to shop? Nov. 14, 2013 column

By MARSHA MERCER

Shopping on Thanksgiving Day is a recent – and regrettable – trend, but there’s nothing new about retailers trying to maximize the number of shopping days between Thanksgiving and Christmas.

In the 1930s, business interests persuaded President Franklin D. Roosevelt to alter the calendar, and therein lies a cautionary tale.

By the tradition established by Abraham Lincoln, Thanksgiving was on the last Thursday of November, although there was no law. Starting about 1933, the National Retail Dry Goods Association began agitating to advance the holiday’s date to help spur sales as the country tried to emerge from the Depression.

Roosevelt finally agreed in 1939, when the last Thursday fell on Nov. 30, just 24 days before Christmas. He announced in August that Thanksgiving would be on Nov. 23.

The New Yorker explained that “Americans traditionally delay their Christmas shopping until after they have eaten their turkey, and when, as would have happened this year, the period is narrowed down to scarcely more than three weeks, the retail business takes a beating.”

Roosevelt’s proclamation applied only to the District of Columbia and federal workers, but it started a war over those seven days. A front page headline in The New York Times read: “Shift in Thanksgiving Date Arouses the Whole Country.”

Among the aggrieved were makers of calendars and schedulers of school vacations and college football games. Half the governors chose different dates for Thanksgiving, so people were perplexed about when to celebrate. The turkey growers, though, said they’d have no problem fattening up the birds a week early.

Indignant Republicans claimed the president had assumed dictatorial powers.  (Sound familiar?) The mayor of Atlantic City said residents could eat twice – on Thanksgiving and “Franksgiving.”

The Rev. Dr. Norman Vincent Peale, who later would popularize “positive thinking,” preached that it was “questionable thinking and contrary to the meaning of Thanksgiving for the president of this great nation to tinker with a sacred religious day on the specious excuse it will help Christmas sales.”

Citizens on both sides of the issue flooded the White House with letters and telegrams.  From South Dakota came a letter urging the president to remember that “we are not running a Russia or communistic government.”

For more reaction, take a look at documents in the Franklin D. Roosevelt Presidential Library and the National Archives, including an article in the Archives’ Fall 1990 Prologue magazine by the late historian G. Wallace Chessman, all available online.

So, did changing the date work to boost sales? Not really. Business analysts said retail spending was about the same in 1939 as in 1938. In states with an early Thanksgiving, sales were more spread out; in late Thanksgiving states, spending was more concentrated in the week before Christmas.

Two years later, as confusion still reigned, FDR announced his “experiment” of changing the date had failed. Congress officially made Thanksgiving the fourth Thursday in November.

That, of course, didn’t fix the shopping dilemma. Thanksgiving 2013 is Nov. 28, which means about a week less of prime holiday shopping. Many who work in retail will have to cut their Thanksgiving celebrations short and head to the mall.

More big chain stores are starting Black Friday sales on Thanksgiving, including Macy’s, Walmart, Target, Best Buy, Kohls, JC Penney and the Gap.

So does opening on Thanksgiving Day boost overall sales? Not really. Analysts say it just cuts sales on the actual Black Friday. Last year, when a few retailers took the bold step of opening on Thanksgiving, holiday sales were up 3.5 percent over 2011. That was a smaller gain than in 2011, before stores opened on Thanksgiving, when sales rose 5.6 percent over 2010.

Retailers keep encroaching on Thanksgiving because they face ever stronger pressure from online merchants. And, let’s face it, some people do like to shop on Thanksgiving. They tend to be between 18 to 34, which is also the largest group of Black Friday shoppers.

Some marketing analysts predict that in five years Thanksgiving will be just another shopping day.

Enjoy your pumpkin pie while you still can – before galloping commercialism triumphs over tradition.

© 2013 Marsha Mercer. All rights reserved.

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Gettysburg address still powerful at 150 -- Nov. 7, 2013 column

By MARSHA MERCER

Rarely has a president been so wrong.

“The world will little note nor long remember what we say here…” So Abraham Lincoln predicted in his brief, eloquent speech at the dedication of the cemetery in Gettysburg on Nov. 19, 1863.

The sesquicentennial of the Civil War mostly has commemorated bloody battles. Now we turn to the powerful words that shaped our views.

    

At Gettysburg National Battlefield Park, Dedication Day ceremonies are Nov. 19. A series of lectures, book-signings and other events Nov. 16 to 23 will commemorate the Gettysburg address.

 

The address is one of the most noted and quoted speeches in history, but Lincoln wasn’t the main speaker that day. The orator was Edward Everett, a former senator and secretary of state who delivered a two-hour address. We laugh about long-winded Everett, but, historian Garry Wills reminds us, in the 19^th century lengthy dramatic speeches were a kind of performance art.

Four months earlier, on July 3, 1863, the Union had won the three-day Battle of Gettysburg. More than 50,000 Confederate and Union troops were dead, captured, missing or wounded. Bodies that had been hastily buried in makeshift graves on the battlefield were still being interred in the new Soldiers’ National Cemetery.

Lincoln had been invited to make “a few appropriate remarks.” His 272-word speech changed forever the way Americans think about our country and the Civil War.

“Up to the Civil War `the United States’ was invariably a plural noun: `The United States are a free country.’ After Gettysburg it became a singular: `The United States is a free country,’” writes Wills, author of the 1992 book “Lincoln at Gettysburg.”

In his remarks, Lincoln reached back to the Declaration of Independence to reframe the war as a fight for liberty and freedom. The nation was “conceived in liberty and dedicated to the proposition that all men are created equal,” he said.

And, “we here highly resolve that these dead shall not have died in vain, that this nation under God shall have a new birth of freedom, and that government of the people, by the people, for the people shall not perish from the earth.”

Lincoln did not mention the Emancipation Proclamation. In effect for less than a year, it had freed many, but not all, slaves. The war would grind on for two more years, but in two minutes, he assigned surviving Americans the task of renewing the promise of freedom for all. His critics were livid. Some complained that the president was deliberately misleading the public about American history. The country was founded on the Constitution, which had avoided any mention of equality.

A Chicago newspaper called the address “a perversion of history so flagrant that the most extended charity cannot regard it as otherwise than willful,” historian David Herbert Donald writes in his 1995 book, “Lincoln.”

Donald says Wilbur F. Storey also wrote that the soldiers who perished on the battlefield died “to uphold the Constitution and the Union created by it,” not to “dedicate the nation to `the proposition that all men are created equal.’”

It seems odd in our word-flooded society that a few simple words could have such lasting impact. Our politicians blab constantly, their every forgettable syllable and gesture recorded, tweeted and analyzed.

In contrast, there’s no definitive account of the Gettysburg ceremonies. We don’t know when Lincoln wrote his remarks. Historian Wills dismisses as a silly myth the familiar story that the president scribbled his remarks on scrap paper on the train from Washington. At least five handwritten, slightly different copies survive.

The crowd interrupted Lincoln multiple times with applause -- or not at all, depending on who’s telling the story. The Associated Press reporter who transcribed Lincoln’s speech inserted brackets five times to indicate applause, but years later said he’d arbitrarily included the brackets and wasn’t sure there had been any applause, says historian Glenn LaFantasie.

   

Some say Lincoln thought the speech a failure. “That speech won’t scour!” he supposedly said afterwards. “Scour” referred to plows used on the prairies that failed to turn over the heavy soil, Donald explains. Wills says Lincoln was satisfied with the speech.

One thing is clear. When we read the address 150 years later, Lincoln’s ideas still speak to us. It’s well worth remembering the power of words.      

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So sorry -- apologies matter -- Oct. 31, 2013 column

By MARSHA MERCER

In the health exchange website debacle, Washington has moved through denial, anger and finger pointing. Now we’ve hit the apology stage.

On Wednesday, Kathleen Sebelius, the secretary of health and human services, called the online marketplace where people were supposed to be able to compare and buy insurance easily starting Oct. 1 “a miserably frustrating experience for way too many Americans.”

“You deserve better,” she said at a House Energy and Commerce Committee hearing. “I apologize.”

And when the terrier from Tennessee, Republican Rep. Marsha Blackburn, snapped at Sebelius, asking who was responsible for the mess, Sebelius said, “Hold me accountable for the debacle. I’m responsible.”

A day earlier, Marilyn Tavenner, administrator of the Centers for Medicare and Medicaid Services, the agency responsible for setting up the online marketplaces, also apologized.
  

“To the millions of Americans who’ve attempted to use HealthCare.gov to shop and enroll in health care coverage, I want to apologize to you that the Web site has not worked as well as it should,” Tavenner said at a House Ways and Means Committee hearing.

President Barack Obama, while stopping short of an actual apology, has said “nobody is madder than me.” He apparently can’t brake for pronouns at a time like this.

Seriously, the president must be mad at himself for letting this fiasco befall his signature legislative achievement. It’s his legacy at stake. Obama struck a confident note Wednesday in Boston, insisting that the rollout problems are solvable. A lot is riding on whether the website is running smoothly Nov. 30, as promised,

In his speech at Faneuil Hall, Obama sought to clear up confusion about his oft-repeated promise that people could keep their insurance under the new system. Some people who buy health insurance on the individual market have received cancellation notices. Obama explained that a few policies fail to meet consumer protection standards in the health law, but the people will be eligible for better coverage and possibly for premium subsidies.  

Typically, embattled public figures follow the old legal advice to doctors facing malpractice claims: “Defend and deny.” Testifying before Congress, the lawyered-up contractors who engineered the troubled marketplace avoided showing even a smidgen of remorse.  

When a top-level public servant like Sibelius has the wit to apologize and sound sincere, she conveys the sense that she gets it, that she knows real people are being hurt by her agency’s ineptitude.   

Don’t get me wrong. An apology – many apologies -- from Washington won’t shorten anyone’s wait on HealthCare.gov or pay the insurance premium. People want results; they want their government to work.

At the same time, though, people should realize that Obamacare is a moving political target.

“We did not wage this long and contentious battle just around a website,” the president says. As rocky as the rollout of the exchanges has been, the president insists, the Affordable Care Act is already working to make insurance more readily available and affordable. That, of course, won’t satisfy the law’s foes.

Obama repeatedly says he’ll work with anyone who wants to fix the law, but congressional Republicans have no interest in mending it. If it’s not the website, it’s the canceled policies or the cost of premiums or something else. The GOP needs to be accountable too.

Where,Republicans, is your long-promised alternative to the health law? Let us see it – or help fix what’s broken.    

A president saves his apologies for big moments. Obama reportedly apologized to irate German Chancellor Angela Merkel after news broke that the United States had been listening to her phone calls for years. He apologized Oct. 8, during the government shutdown, for the unfolding fiscal dramas in Washington.

“To all the American people: I apologize,” he said, but he couldn’t resist turning the apology into a rebuke, saying what he needs to do is to break his foes of their bad habits in negotiations.  

Speaking of apologies, I’ve yet to see tea party Republicans apologize for shutting down the government or 
sending the world’s blood pressure sky high with games over raising the debt ceiling.

An apology is not a solution, but it is a start. It takes guts to say you’re sorry. Who’ll be next?

© 2013 Marsha Mercer. All rights reserved.

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Battle of man vs. machine hits insurance exchanges -- Oct. 24, 2013 column

By MARSHA MERCER

President Barack Obama has called in the cavalry to fix the health exchange rollout fiasco. He has a new tech czar and “some of the best IT talent in the country” working 24-7 to remove the chewing  gum clogging the system.   

Too bad Obama can’t fix human nature. People naturally resent playing by tech rules, even when it’s in their best interest. More on that in a minute.

Congressional hearings with political overtones are investigating the botched healthcare.gov website. Contractors who engineered parts of the contraption blame each other and the federal government. Republicans, and even a few Democrats, want the head of Health and Human Services Secretary Kathleen Sebelius. She will face the wrath of the House Energy and Commerce Committee next week.

The Centers for Medicare and Medicaid Services, which was in charge of the rollout, went ahead with it despite warnings the system wouldn’t work.

An insurance executive who was involved in an industry testing group told The Washington Post that it was clear a month before the launch that CMS was still working on how the exchanges would handle enrollment, federal subsidies and the security of consumers’ personal information, such as income.

That’s a lot. But the last item -- security of personal information – is most crucial. Millions of people have to give up their birth dates, Social Security numbers, employment and income information to sign up for insurance. For people to sign up, they must be confident the government will keep their sensitive information safe.   

And that leads to another issue. As bad as the tech problems are, the inevitable conflict between man and machine is more troublesome. The insurance marketplaces – like other online accounts – safeguard personal information by requiring customers to answer security questions to verify their identity.

Big problem: Many people are flummoxed by online security questions, The Wall Street Journal reported Wednesday.

Among the questions: What was your high school mascot? Favorite childhood superhero? Street you lived on in third grade?

“I don’t think they took baby boomers into account when they invented those questions,” a 58-year-old massage therapist in Texas told the Journal. Margo Benge said she gave up when she could answer only two of the 12 possible questions – and she needed to answer three.  “I barely remember two weeks ago, let alone childhood,” she said.

And I thought it was just me.

I’ve been resisting online security questions for years. The problem is the questions sound so reasonable.  In what school did you start first grade?

Anyone would know that, right? Not necessarily. An Air Force brat, I went to 10 schools before I graduated from high school. I don’t remember a thing about my school in first grade, except that it was in Germany.

The street I lived on in third grade? No clue. It was in Maryland.

Favorite color? It varies.

Favorite song? Movie?  Ditto. Ditto.

In California, the state’s insurance exchange presents 30 security questions; shoppers must  answer five, the Journal reported. Among them: “What is your significant other’s favorite color?” and “what is your youngest child’s birth weight?” And the ever popular: “What color was your first bicycle?”

These are details a machine can summon effortlessly. It’s not as easy for men and women. Life is messy. Our memories overlap, fade and reconstitute.     

Best friend? Don’t make me choose.

Please don’t misunderstand me. I want websites to do whatever they can to assure privacy. But many web-savvy people say the questions don’t stop determined hackers anyway. Sarah Palin’s email was hacked by someone who found out her birth date, ZIP code and the name of her high school – information that’s widely available on Google and Facebook.

Here’s a solution. Anyone can arbitrarily decide from today forward that he or she had Miss Raven as first grade teacher, lived on Lenore Street in third grade and rode a red bike to Edgar Allen Poe Elementary School.  Stumped by security questions? Nevermore.    

We humans just have to remember what we made up. We can make a note. On paper.

© 2013 Marsha Mercer. All rights reserved.

We all pay for shutdown in dollars and trust -- Oct. 17, 2013 column

By MARSHA MERCER

President Barack Obama says there were no political winners in the crisis over the federal government shutdown and debt limit. Most Americans, regardless of their political persuasion, probably agree.

In Washington, though, every moment has a winner and a loser. Once the latest financial calamity was averted, most political analysts thought the president was a winner because he showed some spine, gave up nothing and kept his signature health care legislation intact.

Conservative Republicans, on the other hand, were losers because they totally misread the political landscape. Their ill-conceived attempt to defund Obamacare shut down the government, idled 800,000 workers for 16 days and hurt the economy – but it yielded only a minor tweak in the health care law. People who seek subsidies to buy insurance on the exchanges will have to provide income verification.

Some tea party Republicans cling to the fig leaf notion that their failed fight over the shutdown actually awakened the nation to the evils of the Affordable Care Act and support will blossom.  Really?  

Meanwhile, every Democrat, Republican and independent coast to coast will pay the cost of the federal shutdown in dollars -- and also in the incalculable currency of trust.

The pricetag of the latest shutdown hasn’t been released, but two shutdowns lasting a total of 26 days in 1995-96 cost more than $1.4 billion, the Congressional Research Service reported. That’s $2.1 billion in current dollars. Most of the money went for back pay for furloughed federal workers.

The dollar waste is unnecessary and maddening. Trust in our institutions and government is in short supply.  

To squander the people’s trust hurts our political system and is heartbreaking.  

“The American people are completely fed up with Washington,” Obama said Thursday.  He’s right, of course, but it would be nice if he or anyone else could say that Washington has learned from its misadventure and will work to rebuild the trust it has squandered. There are only glimmers that some in Congress have learned lessons.   

In reaching the deal, members of Congress did what they should have done months ago. They did their jobs. 

The bipartisan agreement reopened the government and raised the debt limit, allowing the United States to pay the bills it racked up with two unfunded wars and an unfunded Medicare drug benefit. It’s merely a reprieve that postpones the fight. In two months or so, we may face another fiscal crisis. 

The plan Obama signed Thursday funds the government through Jan. 15 and raises the debt ceiling through Feb. 7. On the way there, a bipartisan, bicameral budget conference is supposed to come up with a long-term plan on tax and spending policies by Dec. 13. The two Republicans on the conference committee voted against the bill ending the crisis, and the two Democrats voted for it. That’s hardly a promising sign.

A glimmer of hope is the 14 centrist senators led by Sen. Susan Collins, Republican of Maine, who worked together on an agreement that served as a point of departure for the final deal. The centrists were disappointed their plan didn’t prevail, but they pledge to keep working together.   

The next round of negotiations could take place in an even  more acidic political atmosphere because of the calendar.  

Obama chided Republicans on Thursday, saying, “You don’t like a particular policy or a particular president, then argue for your position. Go out there and win an election. Push to change it. But don’t break…what our predecessors spent over two centuries building.”

Some analysts say the looming 2014 congressional elections could have a sobering effect on conservatives in the House. In most congressional districts, though, a Republican incumbent fears a challenger from his right more than a Democratic one. For most House members, compromise in Washington can be a terrible career move.

Traditionally, people hate Congress but like their own member of Congress. That may be changing. About three in four people said they want to see most members of Congress defeated next year. And about four in 10 said they’d like to retire their own member of Congress, a new Pew Research Center survey found.

It’s very possible that we’ll  lurch once again from one financial crisis to the next. That not only would be a shame but would be a drain on what’s left of trust in government.

© 2013 Marsha Mercer. All rights reserved.

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My latest on aarp.org: http://bit.ly/15J5t25

What You Need to Know About This Year's Medicare Open Enrollment Period

If you have Medicare, you don't need to participate in the new health insurance marketplace

by Marsha Mercer, AARP, October 15, 2013

During Medicare's open enrollment period you can shop for Medicare Advantage and Medicare Part D prescription drug plans, or keep the coverage you have. — Richard Drury/Getty Images

If you’re a Medicare beneficiary, here’s something for your autumn to-do list: Go Medicare shopping.

Subscribe to the AARP Health Newsletter

Review your benefits and costs for 2014, compare alternatives and decide whether to keep or change plans during Medicare’s annual open enrollment period Oct. 15 through Dec. 7.

This year, Medicare’s open enrollment overlaps with open enrollment for the new insurance marketplaces or exchanges created under the Affordable Care Act, also commonly referred to as Obamacare — but don’t let that throw you. Medicare’s 50 million-plus beneficiaries, most of them seniors, will steer clear of the marketplaces.

Got questions? Here’s what you need to know about Medicare’s open enrollment in the marketplace era.

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Q: I have Medicare. Can I use my online state insurance marketplace to compare and buy a Medicare Advantage, supplement or prescription plan?

A: No, the marketplaces (also known as health exchanges) are not for Medicare beneficiaries. They are mostly for uninsured Americans and do not offer Medicare Advantage, medigap supplemental policies or Part D prescription plans. Medicare is not changing because of the marketplaces. For a medigap or Medicare Advantage plan, consultwww.medicare.gov.

Q: What if I mistakenly sign up for insurance on the marketplace, will my Medicare coverage be automatically canceled?

A: No, if you have Medicare coverage, you won’t qualify for insurance on the marketplace. But if you do sign up for a plan accidentally, cancel the marketplace policy.

Q: But I’m a Medicare beneficiary, and someone contacted me and said I could buy insurance through the marketplace. What’s up?

A: It’s illegal for someone to knowingly sell a Medicare beneficiary a marketplace plan. Watch out for scammers during open enrollment. Do not share your Medicare number or personal information with anyone who says he or she can sell you a plan through the marketplace.

Q: Can I get the premium tax credit that people get when they buy insurance on the marketplaces?

A: If you’re enrolled in Medicare, you’re not eligible for the tax credits that some people qualify for on the marketplaces, but you already get a substantial break on costs. The overall costs of care under Medicare Part B, which pays doctors’ visits, and Part D, the prescription drug benefit, are subsidized 75 percent from federal general revenues. Plus, if you’re a Medicare beneficiary with limited resources and income, you may qualify for low-cost Part D drug coverage under the Extra Help program. Go to www.ssa.gov, call 800-772-1213 or visit your local Social Security office.

Next page: More about Medicare and the health insurance marketplace. »

Q. I’ve just become eligible for Medicare, but I haven’t signed up yet and haven’t started collecting Social Security. Can I choose coverage on the marketplace instead of Medicare?

A. Yes, but be aware that if you fail to sign up for Medicare during your initial seven-month enrollment period — the three months before the month you turn 65, your birthday month and three months after your 65th birthday — you may have to pay a late enrollment penalty for as long as you have Medicare. Also, if you don’t enroll in Medicare Part B during your initial enrollment period, you can sign up only during what’s called the general enrollment period — Jan. 1 through March 31 — and your coverage won’t begin until July of that year.

More Medicare

• Money-saving changes come to Medicare
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Q: I’ll turn 65 next year and will become eligible for Medicare, but I don’t have health insurance now. Can I use the marketplace?

A: Yes, you’re uninsured and can buy a plan on the marketplace now that will be effective Jan. 1. Once you receive Medicare coverage, you should cancel the marketplace plan.

Q: I’m 65, a legal immigrant with a green card and have lived in this country for three years. Can I get Medicare coverage?

A: No, Medicare requires that you have lived in the United States continuously for five years. You may qualify for a health insurance plan on the marketplace, which does not have a residency waiting period.

Q: I’m 65 and Medicare-eligible, but I’m still working and covered by my employer’s health plan. My employer says she may terminate the company plan next year. What are my options?

A: If you didn’t sign up for Medicare Part A or Part B when you were first eligible because you were covered by a group plan based on current employment — yours or a spouse’s — you can sign up for Part A or Part B (or both) anytime you’re still covered by the group plan or during an eight-month period that begins the month after your coverage ends.

Q: I’m eligible for Medicare but didn’t sign up on time, and I haven’t bought insurance through the marketplace. Will I have to pay a fine?

A: Yes, if you’re uninsured and don’t qualify for an exemption to the requirement that everyone carry health insurance in 2014, you will have to pay a penalty. Exemptions include being a member of a federally recognized Indian tribe or having income too low to file a tax return.

Q: I have only Medicare Part A. Do I need to buy more insurance to meet the legal requirement that I have insurance?

A: No, whether you’re in a traditional Medicare or a Medicare Advantage plan, you meet the insurance requirement.

Q: I’m 60 and retired, but I’m too young for Medicare. I get my insurance through my former employer’s retiree health plan. Do I need to get additional coverage on the marketplace to comply with the health law?

A: No, retiree plans generally meet the requirement.

Next page: So many choices ... where should you begin? »

Q: What happens during the regular annual Medicare open enrollment?

A: Medicare beneficiaries can change their health and prescription plans for the next year. Changes go into effect Jan. 1. You can: 

• Change from original or traditional fee-for-service Medicare to a private, managed-care Medicare Advantage plan
• Change from a Medicare Advantage plan back to traditional Medicare
• Switch from one Medicare Advantage plan to another
• Switch from a Medicare Advantage plan that doesn’t offer drug coverage to one that does
• Switch from a Medicare Advantage plan that offers drug coverage to one that doesn’t
• Join a stand-alone Medicare prescription plan
• Switch from one prescription plan to another
• Drop your prescription drug coverage altogether

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Q: I’m not thrilled with my plan, but there are a lot of choices. Where do I start?

A: Use the Plan Finder tool at www.medicare.gov to compare costs and benefits for each plan available in your area. Details of 2014 plans are available now. If you need personal help, call your State Health Insurance Assistance Program (SHIP). Contact information is at www.shiptalk.org. If you have Medicare Advantage or a Part D prescription drug plan, you should have received a notice of changes for 2014 in the mail. It will tell you whether your premiums, deductibles, copays and benefits will change next year.

Q: Can’t people change their Medicare coverage later than December?

A. Yes, between Jan. 1 and Feb. 14 every year, people with Medicare Advantage plans can leave their plans and switch to traditional Medicare, if they choose. In specific circumstances, such as a move, people can change Medicare coverage anytime.

Q: I’m happy with my current Medicare choices. What do I do during open enrollment?

A: Not a thing. Your current choices will continue next year.

Q: Where can I find more Medicare information?

A: For enrollment information, go to Social Security’s website, www.ssa.gov or call 800-772-1213. For coverage information, go to www.medicare.gov or call 800-MEDICARE (800-633-4227).

Marsha Mercer is a freelance writer in the Washington, D.C., area who covers health policy.