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My, our arrogance

Unbelievable. I can’t believe that Donald J. Trump will be the chief executive of the most powerful country in the world. My country. Our country. A nation ostensibly based on the rule of law, human rights, justice, equality will be led by someone with no interest in those values. And, with a Congress squarely in the hands of a Republican party that has a center of gravity based in white-nationalism, the potential for harm is terrifying.

Rereading my post from yesterday afternoon is painful. What arrogance!

The extent to which this arrogance was shared across the media, elites, academics — basically everyone in my entire life — is profound. We all got it wrong. The disconnect of framing / narrative / cultural understanding of what this means for the country between Trump supporters and Clinton supporters is so deep. How will we reconcile? What do I do?

Sitting in graduate school at a major university in Boston reading social theory is starting to feel less and less relevant in the world we currently inhabit.

The Iowa caucuses and the new neoliberal movement

As I have studied equity-oriented global health delivery, it’s become increasingly clear that the concerted effort to define liberty / freedom as equivalent to and inseparable from completely unregulated “free markets” is central to understand the contest at the center of a movement for the right to health. We learned last week from Dr. Salmaan Keshavjee and his book, “Blind Spot: How Neoliberalism Infiltrated Global Health” that a handful of intellectuals gathered after WWII to mount a concerted social strategy to “win the battle of ideas” in the global forum; to fight and reverse the notion of the welfare state, New Deal policies, the specter of Communism, and social and economic rights. The Mont Perelin Society set forth a radical intellectual, but also political, social, and moral project to reshape the foundation of Western liberal thought and underpinnings of the relationship between citizen and state.

In the wake of the Iowa caucuses last night it’s important to reflect on the historical roots of neoliberalism and the legitimate social movement that is driving the modern Republican party further and further to the radical right. In the recent New Yorker article, New Koch: The billionaire brothers are championing criminal-justice reform, Jane Mayer chronicles the work of the Koch brothers, their sprawling political network, and their recent re-branding effort. Once again we see a clash of ideas and a serious social / political strategy to decouple citizens and states and move forward the radical aim of completely unfettered markets.

Of specific interest to me was an article she cites from Harvard sociologists Theda Skocpol and Alexander Hertel-Fernandez: The Koch Effect: The Impact of a Cadre-Led Network on American Politics. In it they present an in-depth analysis of the evolution, organizational components, and effects that Koch-inspired and funded organizational network has had in driving polarization and shifting the GOP rightward over the past decade+. As opposed to just looking at the funding of political campaigns, ads, think tank and policy work, they take an organizational approach to try to understand the constellation of organizations, individuals/roles/positions, and institutional effects that these organizations have had on the two traditional political parties. As they put it:

“The Koch network is not just a congeries of big money donations from the two brothers themselves, or a loose, undisciplined array of advocacy groups and political action committees to which the principals send checks. Instead, the network has by now evolved into a nationally federated, full-service, ideologically focused parallel to the Republican Party. The Koch network operates on the scale of a national U.S. political party, pledging to spend in the 2016 cycle more than twice what the Republican national committee spent in the previous presidential election and employing more than three times as many staffers as the Republican committees had on their payrolls as of late 2015 (Vogel 2015a; Bump 2014)…

In a disciplined way, the Koch network operates as a force field to the right of the Republican Party, exerting a strong gravitational pull on many GOP candidates and officeholders.” 1

They demonstrate that the fraction of resources controlled by the formal GOP party committees has dropped significantly over the past 10 years, and so has the power of these institutionalized political party channels.

Skocpol and Hertel-Fernandez show a striking drop in resources controlled by the GOP party committees.

Skocpol and Hertel-Fernandez show a striking drop in resources controlled by the GOP party committees.

They also make the argument that the Koch brothers’ funding and institutional network touch all five of the most important types of political organizations that contribute to and influence party politics:

  • Political party committees: formal RNC / DNC
  • Non-party funders: organized groups of donors that fund campaigns and political activities
  • Constituency organizations: mobilize mass bases of people (think NRA / labor unions)
  • Issue advocacy organizations: pro-life / pro-choice groups, anti-tax groups, etc
  • Think tanks: produce policy research and concepts, like Heritage, Cato, Economic Policy Institute, etc

Since 1975, the Koch brothers have catalyzed the creation and coordination of organizations that contribute to each of those key areas of party politics. At the root of this strategy is that:

“the Kochs take ideas seriously and believe that politicians “reflect” rather than create “the prevalent ideology” (see Schulman 2014: 99). The Kochs were major backers of the nation’s leading libertarian think tank, the Cato Institute, founded in 1977. Starting soon after, in 1980, they began continuous sponsorship of the Mercatus Center at George Mason University, which runs educational programs in the humanities as well as policy studies and, these days, regularly issues research and policy recommendations on major issues such as global warming. Finally, perhaps the most prominent of several family foundations is the Charles G. Koch Foundation, which regularly disburses hundreds of grants to college and university-based scholars and programs, all meant to encourage free market and libertarian ideas and policy proposals (Levinthal 2015; Schulman 2014, 264- 66).”

The Koch's creation of political organizations spanning idea creators, policy advocacy, donor coordination, constituency mobilization, utilities.

The Koch’s creation of political organizations spanning idea creators, policy advocacy, donor coordination, constituency mobilization, utilities.

Especially striking is the more recent strategic investment in a rapidly growing grassroots constituency network of mobilizing organizations.

Growth of the Koch funded and coordinated grassroots network of activists.

Growth of the Koch funded and coordinated grassroots network of activists.

“But even though AFP is highly centralized like a corporation, it also has a federated structure with important state-level organizations, just like classic American voluntary associations and the U.S. governmental system as a whole (Skocpol et al. 2000). Directors and other paid staff members such as “grassroots directors” are installed in most of the states and given considerable room to monitor and influence state and local politics and weigh in locally with their state’s U.S. Senators and Representatives.

State-level AFP organizations are called “chapters,” but that is a misnomer because they are not really in any sense controlled from within the states themselves. Although AFP usually appoints directors who have experience and longstanding ties in their states, these pivotal players are not elected by in-state activists or selected through any internal decision-making process.”

Going back to Bourdieu, McAdam, and Ganz as useful theoretical underpinnings in understanding social movements, its difficult to dismiss that their description of the Koch’s sprawling political institutional network that links formal political party committees, non-party private funders, constituency/grassroots organizations, issue/policy advocacy organizations, and policy-creating think-tanks seems very Bourdieusian. It looks like an incredibly sophisticated strategy to not only play the electoral game of American politics, but a much more ambitious attempt to grow the political, social, symbolic, financial, and even cultural capital with the aim of re-writing the rules of American political game: one in which the state functionally ceases to exist.

McAdam’s political process model is also a useful analytical tool here: Hertel-Fernandez and Skocpol have identified the grassroots organizational strength of this network, shown the emerging political opportunities that the network is tapping into, demonstrated the effect of “cognitive liberation” created by think tanks and policy scholarship networks. Looking at broader political and economic trends–growing inequality, rising polarization and distrust of traditional political parties, the maintenance of Citizens United and unlimited private spending on political engagement– its hard to see how this movement might be challenged and stopped.

The victory of Ted Cruz over Donald Trump is one very practical indicator of this success. Trump, racist and deplorable as he is, is not an ideologue, but Cruz is. Ted Cruz is the kind of litmus-tested neoliberal candidate the Koch machine is designed to elect.

The American left, let alone a global movement for social and economic rights and the right to health, has nothing this robust. If Bourdieu calls for the irreplaceable role of the collective intellectual, “by helping to create the social conditions for the collective production of realist utopias… organize or orchestrate joint research on new forms of political action, on new ways of mobilizing and making mobilized people work together, on new ways of elaborating projects and bringing them to fruition”, 2 why is the right winning?

  1.  Skocpol, Theda, Hertel-Fernandez, Alexander. “The Koch Effect: The Impact of a Cadre-Led Network on American Politics” Inequality Mini-Conference, Southern Political Science Association. Jan. 28, 2016.
  2.  Bourdieu, Pierre. “A Scholarship with Committment.” Revueagone Agone 23 (2000): 205-11. Web.

Global Health: Case Studies from a Biosocial Perspective


Harvard’s EdX just launched it’s online global health course taught by Paul Farmer, Arthur Kleinman, Salmaan Keshavjee, and Anne Becker.

Anyone can register for free and participate here!

About the course:

“This introductory course is an interdisciplinary view of global health. It aims to frame global health’s collection of problems and actions within a particular biosocial perspective. It develops a toolkit of analytical approaches and uses them to examine historical and contemporary global health initiatives with careful attention to a critical sociology of knowledge. The teaching team, four physician-anthropologists, draws on experiences working in Asia, Africa, Eastern Europe, and the Americas, to investigate what the field of global health may include, how global health problems are defined and constructed, and how global health interventions play out in expected and unexpected ways. The course seeks to inspire and teach the following principles:

A global awareness. This course aims to enable students to recognize the role of distinctive traditions, governments, and histories in shaping health and wellbeing. In addition, rather than framing a faceless mass of poor populations as the subject of global health initiatives, the course uses ethnographies and case studies to situate global health problems in relation to the lives of individuals, families, and communities.

A grounding in social and historical analysis. The course demonstrates the value of social theory and historical analysis in understanding health and illness at individual and societal levels.

An ethical engagement. Throughout the course, students will be asked to critically evaluate the ethical frameworks that have underpinned historical and contemporary engagement in global health. Students will be pushed to consider the moral questions of inequality and suffering as well as to critically evaluate various ethical frameworks that motivate and structure attempts to redress these inequities

A sense of inspiration and possibility. While the overwhelming challenges of global health could, all too easily, engender cynicism, passivity, and helplessness, students learn that no matter how complex the field of global health and no matter how steep the challenges, it is possible to design, implement, and foster programs and policies that make enormous positive change in the lives of the world’s poorest and suffering people.”

Just in: Jim Kim believes in the human right to health

jim kimAt that conference in DC hosted by The Center for Strategic and International Studies that I mentioned previously on this blog, Jim Kim, the President of the World Bank Group announced that he believes that “Health care is a right for everyone, in every country, rich or poor,” Kim said in remarks today at the event in Washington. “Not providing health, education, and social protection is fundamentally unjust — in addition to being a bad economic and political strategy.”

Not surprising at all from one of the founders of Partners In Health, but fantastic that he can make these pronouncements when sitting in his role as President of the World Bank, and while working to orient the bank to focus more on enabling poor countries to push for universal health coverage.

I’ll be posting more coverage from the “Universal Health Coverage in Emerging Economies” conference soon.