Category Archives: Social Democracy and Trust

Manitoba shreds the Public Trust

As faithful readers of this blog will know, I have been posting about the lack of trust among people of lower incomes in particular because they have felt abandoned by their government, the political leaders, and political elites.  Then just as I thought I was done for now on this subject Manitioba’s premier demonstrated how true this is.

I was shocked to read the Winnipeg Free Press yesterday. The paper reported on our new Conservative Premier as follows:

“As the Omicron variant roars across the province, Manitoba’s premier conceded the public—and not the government—must be responsible for limiting its spread. “This virus is running throughout our community and it’s up to Manitobans to look after ourselves,” Premier Heather Stefanson told reporters on Wednesday.”

 

I don’t deny that Manitobans must take responsibility for their own health. Failure to do so leads to all kinds of harms, but that does not mean we should be abandoned by our government for that too leads to serious harm, for all of us. This is exactly what Anita Sreedhar and Anand Gopal said in the New York Times:

“Over the past four decades, governments have slashed budgets and privatized basic services. This has two important consequences for public health. First, people are unlikely to trust institutions that do little for them. And second, public health is no longer viewed as a collective endeavor, based on the principle of social solidarity and mutual obligation. People are conditioned to believe they’re on their own and responsible only for themselves. That means an important source of vaccine hesitancy is the erosion of the idea of a common good.”

 

The Premier of Manitoba made it clear that this is exactly how she feels about Covid-19. We are on our own! It’s no wonder many Manitobans no longer believe in the common good and as a result the trust so necessary in a democracy has been shredded. It appears that this is what our Premier wants. She wants us to go at it alone.

 

What she is forgetting is that will have consequences for everyone. We all benefit from the public trust when it is robust. Then we are all prepared to do our part. Take vaccines, listen to sound advice from trusted experts, and chip in for the good of all. The Premier is forgetting that we all need to look after each other, particularly in a time of pandemic. We want others to take vaccines not just for their benefit, but our benefit too. They won’t do it if they feel abandoned. Then we when need them it will suck to be us.

 

Health is a Common Good

 

So how do we get public trust? We earn it.

Anita Sreedhar and Anand Gopal said in their New York Times article that the history of the vaccines in the US is relevant here.  In the US where vaccines have been available for as long as vaccines have been around, when vaccines for smallpox, a very deadly disease, were first introduced, In the US in the early 20th century, efforts to vaccinate people met with some strong (virulent?) opposition. But attitudes of people changed sharply after World War II. In the 1950s the government had a hard time keeping up with the demand and, this may seem shocking to us now, by the late 1970s nearly every state had laws mandating vaccinations for schools and there was very little opposition.  Why was that?  That is the big question. A Public good demanded strong public policy.

 This was the time when big government was appreciated!  That seems like forever ago doesn’t it? Governments in the west brought in ambitious social programs for things like Medicare, Old Age Security and things like that. They called it the welfare state. People loved these benefits of government. In the mid-‘60s in the US there were a number of social programs targeted at helping poor people, even black people. In the US President Johnson declared War on Poverty and pursued what he called “the Great Society.” Specific government programs sought to achieve greater public health among the poor and were very popular. As Sreedhar and Gopal said about some of the organizations created under these programs, “they embodied the idea that public health is effective only when community members share in decision making.” They demonstrated  an appreciation that health care was a common good! And that made all the difference.

As Sreedhar and Gopal said,

“The experience of the 1960s suggests that when people feel supported through social programs, they’re more likely to trust institutions and believe they have a stake in society’s health. Only then do the ideas of social solidarity and mutual obligation begin to make sense.”

 

The types of social programs that best promote this way of thinking are universal ones, like Social Security and universal health care. Universal programs inculcate a sense of a common good because everyone is eligible simply by virtue of belonging to a political community. In the international context, when marginalized communities benefit from universal government programs that bring basic services like clean drinking water and primary health care, they are more likely to trust efforts in emergency situations — like when they’re asked to get vaccinated.

 When such attitudes are present, and when the common good is respected, and not disparaged, as it has been disparaged now for about 4 decades, people trust the government and their institution’s.  They are not suspicious of them and then don’t sneer at them as they do now. The world is then a different place. I would say, then the world is a better place. And that attitude helped to make the world a better place. As Sreedhar and Gopal concluded:

“If the world is going to beat the pandemic, countries need policies that promote a basic, but increasingly forgotten, idea: that our individual flourishing is bound up in collective well-being.”

 

The pandemic has made starkly clear how important it is to have a feeling of common purpose and a respect for the common good. We now are starting to appreciate the enormous importance of such beliefs for their absence makes the most important enterprises—public enterprises—impossible.

America, and to a lesser extent Canada, and the world, will have to realize that 40 years of conservative policies that included reductions in basic social services while their incomes stagnated and while the rich people have seen their incomes rise enormously, will exact a terrible price on society. Ripping the social fabric of a country does not come without costs. In fact, it comes with enormous costs. That can even come back to haunt the rich who benefited from the reduced taxes. Perhaps they even gained less than they lost! Sometimes it takes something like a pandemic to make it clear that we need each other. We actually are in this together. If we can’t get the poor to participate in important social programs like vaccinations, we will all be stuck with a hefty bill.

Yes, social programs cost money; so does ripping them to shreds.  We should remember not to be cycnics. For as  Oscar Wilde said, “the cynic knows the cost of everything and the value of nothing.”

A Shared reality is Necessary for Trust

 

The pandemic has made it clear that the cost of people not trusting the government is enormously high. That does not mean we should not critically examine everything they tell us.

This is the root of the problem in many parts of the world, particularly areas of great inequality of economic wealth, such as the United States, where the upper income classes and the lower income classes often don’t share the same reality. The world does not look the same from the penthouse as it does from the doghouse. Or homeless shelter. That is why they look so differently at vaccines. As Anita Sreedhar and Anand Gopal pointed out in their New York Times article:

 “As the emergence of the Omicron variant shows, vaccine mandates in the United States are not enough to solve this problem. Hesitancy is a global phenomenon. While the reasons vary by country, the underlying causes are the same: a deep mistrust in local and international institutions, in a context in which governments worldwide have cut social services”

 

In the US, unlike Canada and most other countries in the developed world, the people don’t enjoy as many public health services and they have been radically declining for about 40 years. They have only meager socialized health care. As Sreedhar and Gopal drew to our attention in their Times article,

“Research shows that private systems not only tend to produce worse health outcomes than public ones, but privatization creates what public health experts call “segregated care,” which can undermine the feelings of social solidarity that are critical for successful vaccination drives.”

 

Not only in the United States, but all countries where public health care benefits have been declining, such as Canada, feelings of ‘we are in this together’ have sharply declined. Both upper and lower classes don’t really believe this. The upper classes don’t want to be in this together, and the lower classes know very well it is not true.  They see it every day.

According to research by Sreedhar and Gopal in many developing countries people are not as grateful for aid as we in the west might expect. For example, they pointed out, the WHO has spent a lot of money promoting vaccines for polio. These are very worthy programs. We in the west know that. People in developing countries however see such programs as demonstrating mistaken priorities. They see polio as a vague threat. At the same time, they are often going hungry and they don’t see any help for that. Here is what they found:

“We have starvation and women die in childbirth,” one tribal elder told us. “Why do they care so much about polio? What do they really want?” Researchers find these sentiments echoed in poor and marginalized communities around the world.”

 

Interestingly, poor people in rich countries often feel the same way. Distrust is very difficult to overcome. Words won’t do.

The Dominant Ideology Sucks

 

Why do so many people distrust the government and the leading institutions of their country?  That is the question I have been trying to solve in my own meandering and no doubt annoying style.

 

Many people, even poor people, have been sucked in by the dominant ideology.  Such people, for example, say something like this: ‘I am not any-vaccine, I just want to exercise my personal choice.” They see everything through the lens of personal choice. Now I am also big on personal choice and being responsible for my choices, but I don’t want to forget about the common good either. Sreedhar and Gopal  interviewed a woman from the residential complex where Mr. Steed lived, Amanda Santiago and this was her attitude. Anita Sreedhar and Anand Gopal pointed this out in their essay in the New York Times about one of the residents of a lower class housing project in the Bronx: “A growing body of research suggests that Ms. Santiago’s views reflect a broader shift in America, across class and race. Without an idea of the common good, health is often discussed using the language of “choice.” We must remember all such choices, which we are allowed to make, have consequences.

For example, Kyrie Irving is a basketball star. He advocated for personal choice and decided not to take the vaccines. As a result, he is so far missing the entire basketball season, and he is accepting the consequences in lost earnings. He can afford it. In Steinbach we have Pastor Tissen from the Church of God restoration who used the same language of personal choice.

This is what Sreedhar and Gopal say about personal choice:

Of course, there’s a lot of good that comes from viewing health care decisions as personal choices: No one wants to be subjected to procedures against their wishes. But there are problems with reducing public health to a matter of choice. It gives the impression that individuals are wholly responsible for their own health. This is despite growing evidence that health is deeply influenced by factors outside our control; public health experts now talk about the “social determinants of health,” the idea that personal health is never simply just a reflection of individual lifestyle choices, but also the class people are born into, the neighborhood they grew up in and the race they belong to.”

 

Anita Sreedhar and Anand Gopal pointed out some important things about personal choices and Covid-19 when the social determinants of health are ignored:

 “Vaccine uptake is so high among wealthy people because Covid is one of the gravest threats they face. In some wealthy Manhattan neighborhoods, for example, vaccination rates run north of 90 percent.

For poorer and working-class people, though, the calculus is different: Covid-19 is only one of multiple grave threats.”

 

For people who live in poor areas such as the Bronx, Covid is not as big a threat as they face every day from other sources such a drug related crime, hostile police, racism, and unreasonable landlords, to name just a few. In such a context Covid is not really that scary and as a result vaccine hesitancy is not irrational.  Sometimes distrust is rational.

As a result, attitudes to Covid are quite naturally different between the lower and upper classes in such neighbourhoods. As Sreedhar and Gopal said,

“Most of the people we interviewed in the Bronx say they are skeptical of the institutions that claim to serve the poor but in fact have abandoned them. “When you’re in a high tax bracket, the government protects you,” said one man who drives an Amazon truck for a living. “So why wouldn’t you trust a government that protects you?” On the other hand, he and his friends find reason to view the government’s sudden interest in their well-being with suspicion. “They are over here shoving money at us,” a woman told us, referring to a New York City offer to pay a $500 bonus to municipal workers to get vaccinated. “And I’m asking, why are you so eager, when you don’t give us money for anything else?” These views reinforce the work of social scientists who find a link between a lack of trust and inequality. And without trust, there is no mutual obligation, no sense of a common good.”

 

The cost of distrust is enormously high, as we have been discovering.  We really should not be surprised that so many people distrust the government so much that they refuse to take lifesaving vaccines. The world’s elites are paying a big price for allowing the poor to feel abandoned. Unfortunately, so are the rest of us.

 

Low Vaccination Rates hide a profound social weakness

 

Anita Sreedhar is a primary care physician with a degree in public health and she works in the Bronx. Anand Gopal is a sociologist from my second favorite University, Arizona State University. He is also an excellent journalist who covers international conflicts such as the war in Afghanistan. They have conducted research for 5 years to learn to better understand vaccine resistance. Again, from before the arrival of Covid-19. This is what they discovered:

“We’ve found that people who reject vaccines are not necessarily less scientifically literate or less well-informed than those who don’t. Instead, hesitancy reflects a transformation of our core beliefs about what we owe one another.

Over the past four decades, governments have slashed budgets and privatized basic services. This has two important consequences for public health. First, people are unlikely to trust institutions that do little for them. And second, public health is no longer viewed as a collective endeavor, based on the principle of social solidarity and mutual obligation. People are conditioned to believe they’re on their own and responsible only for themselves. That means an important source of vaccine hesitancy is the erosion of the idea of a common good.”

 

People think they are on their own, because they have largely been left on their own. They know they can’t trust anyone else. It is all on them.

In the Unites States there has been a powerful anti-vaccine movement since long before Covid-19.

I remember one day I was at a conference at my beloved Arizona State University, and at dinner when I was chatting with the woman sitting beside my wife and I.  She seemed intelligent. After all she was an adult like me participating in a university conference with some of the top professors around the world. Both of us did not really belong there. We were ordinary citizens, but the university encouraged people like us to attend such conferences. That is why I like that university so much. I was surprised that she wanted to talk about vaccines which one of the professors had talked about as an aside. She told me she disagreed strongly with what he had said. She said  he was dead wrong when the professor said the vaccine myth that they caused autism had been debunked. (It had). But she strongly disagreed and assured me the science was firm that vaccines did in fact cause autism. (She was wrong).

 She was part of a growing movement of vaccine distrust that is particularly virulent in the US, but has reached as far as Canada, in particular, southern Manitoba.

Many reasons have been given for the anti-vaccine attitudes. Some have blamed online misinformation campaigns, others have blamed our tribal culture, and even fear of needles. Race has also been a factor. At first white Americans were twice as likely to get vaccinated in large part for historical reasons, such as the Tuskegee syphilis experiments on African Americans orchestrated by the government to their serious detriment. There was good reason for their suspicions and mistrust. Interestingly, that gap between whites and blacks has narrowed considerably since then. Many African Americans have been convinced to take the vaccines despite their suspicions.

All of these factors are significant, but Sreedhar and Gopal found a more significant factor. That was college attendance. “Those without a college degree were the most likely to go unvaccinated,” they said.  Why would that be. As the two said in their Times article, “Education is a reliable predictor of socioeconomic status, and other studies have similarly found a link between income and vaccination… It turns out that the real vaccination divide is class.”

Class is the culprit. And that makes a big difference as I shall try to show.

Hectoring does not work

Anita Sreedhar and Anand Gopal wrote an important article in the New York Times on the decades long shredding of trust in government among the lower classes in the United States. They started by talking about Robert Steed who lived in the South Bronx area of New York City. He lived in a public housing project where he had grown up, among poor people. During the pandemic the residential complex in which he lived was hit hard—very hard—by Covid.  Many of the people from that complex contracted Covid-19 and many suffered and died. There were posters plastered all over the complex urging the residents to get vaccinated.  You would think the sight of friends and neighbours being wheeled out in ambulances would have convinced all of the resident like Steed to get vaccinated. If you thought that you would be wrong. Steed would not touch the vaccines that could save is life or reduce the harm caused by the disease.

 

This is what he told his friends, after he contracted Covid: “I’m not going to do what the government says.” This was a simple but profound statement. He decided he would fight the government alone rather than with “help” from the government he did not trust. After all he was only 41 years old and healthy, had no underlying health conditions, and he could do his own research on the internet. He died a couple of days later in his apartment.

 

At his funeral all his friends said the same thing: they would not get vaccinated even though they had seen how quick their friend Steed died. They were shook up by his death but would not get vaccinated.

 

In the United States about 70% of Americans are now fully immunized compared to Canada, where about 80% have that status. In both countries there are stubborn pockets of vaccine resistance. No matter how often government officials tell them to get vaccinated or try to twist their arms to do that, they resist.

As Sreedhar and Gopal reported,

 

“In 2019, the World Health Organization declared vaccine hesitancy one of the 10 threats to global health. With persistent vaccine avoidance and unequal access to vaccines, unvaccinated pockets could act as reservoirs for the virus, allowing for the spread of new variants like Omicron.”

 

Please note this was before the onslaught of Covid.

 There is no one size fits all reason for vaccine hesitancy. There is a basket of reasons.  What we have been doing so far, is very unlikely to sway the opinions of these last remaining vaccine resisters. They have doubled down in their resistance with every effort to persuade them. By now those positions are so entrenched they are like religious convictions. As Anita Sreedhar and Anand Gopal said,

 The world needs to address the root causes of vaccine hesitancy. We can’t go on believing that the issue can be solved simply by flooding skeptical communities with public service announcements or hectoring people to “believe in science.”

No hectoring does not work. We need a better approach, but how do we find one?  I am not sure how we do, but I think it might help if we understand where these resisters, or at least many of them, are coming from.

Sreedhar Anand Gopal discovered some very interesting things about why people resisted. I will continue commenting on this article in my next post.

 

Rational Distrust

 

I said in my last post that during a pandemic it was vitally important that people trust their governments and their leaders.  The failure to have that has caused enormous harm. A lack of trust means public policy will not be effective and that can have immense harm. A very good example was the failure to get enough people to take vaccines, much of which was caused by people not trusting government ,health officials, corporations, or scientists.

Let me be clear about one thing, I am all in favour of distrust. After all, governments, businesses, academics, media, courts, and leaders of all sorts have done much to earn some real distrust.

You would have to be out of your mind not to distrust our leaders and institutions. Take corporations for example, when corporations pay scientists, spin doctors and ad agencies to sow distrust of science in order to slow the spread of  public policies, as corporations in the energy sector did in the case of climate change, robust distrust is entirely warranted. These corporations successfully managed to manufacture doubt in good science so that they could continue to earn profits for longer than they should have, while millions of people around the world were harmed by the delays. Those industries through their leaders’ behaviours, have earned distrust for businesses not only inside their sector, but actually, corporations in general.

Tobacco companies did exactly the same thing, by knowingly denying that their products were deadly, so that their profits could continue a little longer while people around the world were harmed as a result of their deceptions. Again, this was egregiously bad behaviour with which the public largely acquiesced.

Then there were the corporations that hid the addictive nature of the opioids they produced or were selling  for years so that they could continue to be sold while people around the world got seriously sick. Those leaders were guilty of serious malfeasance.

All of these were shockingly bad corporate citizens. There were many such loathsome campaigns. They brought all of capitalism into disrepute to such an extent that legitimate capitalist achievements have been smeared.  They have earned all the distrust they attract.

Governments have also participated in serious harms. For example, their acquiescence around the world in failing to seriously pursue corporations and individuals that hid their wealth and income in offshore accounts, thus robbing  government around the world of money they could have used to achieve their social goals, while at the same those same people often paid professionals to white wash or green wash their slimy business practices or persuade ordinary citizens to abandon worthwhile social goals.  When governments for decades granted massive subsidies to industries such as the energy sector, to inflict harm on society, or when they also for decades granted excessive and entirely unjustifiable tax breaks to the rich while vigorously squeezing the poor for every penny owed, they have earned distrust.  When governments or political leaders lied about the reality of the wars they started the way the American government did during the Vietnam, while young men and women sacrificed their lives or suffered horrendous injuries, government were rightfully entitled to all the distrust and disrespect they got.

All of these things and many more that could be mentioned, have ensured that distrust is genuinely justified—in some cases.

While I endorse distrust,  the lack of trust be rational. Not every action by every government or corporation should be distrusted blindly. I don’t support ludicrous versions of the truth such as absurd claims that there is an international cabal of Satan-worshipping pedophiles who are drinking the blood of children. When the oppositional narrative of the distrusters reaches the levels of idiocy as it has done in the United States, we must categorically reject it. Distrust must be grounded on evidence, serious claims, and critical analysis. Rebels may criticize but blanket distrust is as blind as blind trust.

Distrust (just like trust) must be rational.

St. Ronny and the rise of neo-liberalism

 

Ever since a client of mine told me earlier in the summer that he did not trust government issued vaccines I have been mulling over why that was the case. Why did he distrust government so much and stuff he learned from his friends or by doing “private research” online so little? I think that is a very important question. It is actually a much bigger question than I realized before I started looking at this issue.

 

Louis Menand wrote a fascinating article in the New Yorker about why people had lost their faith in government. Specifically, he wondered if liberals or conservatives were at fault. He noted that both liberals and conservatives in the US distrusted government:

“December, 1958, by pollsters from a center now called the American National Election Studies, at the University of Michigan, seventy-three per cent said yes, they had confidence in the government to do the right thing either almost all the time or most of the time. Six years later, they were asked basically the same question, and seventy-seven per cent said yes.

 

Pollsters ask the question regularly. In a Pew survey from April, 2021, only twenty-four per cent of respondents said yes. And that represented an uptick. During Obama’s and Trump’s Presidencies, the figure was sometimes as low as seventeen per cent. Sixty years ago, an overwhelming majority of Americans said they had faith in the government. Today, an overwhelming majority say they don’t. Who is to blame?”

 

I know I have been quick to blame Ronald Reagan and his coterie of conservatives. Now I realize the blame can be spread much more widely, though this is certainly part of the problem. Let’s start with Ronald Reagan. Reagan became wildly popular when he said “the 11 most scary words in the English language were, ‘I am from the government and I am here to help.’ ” He also made the following statement in his inaugural address In this present crisis,” Reagan said in his Inaugural Address, “government is not the solution to our problem. Government is the problem.” People began to think that governments were inherently bad and  untrusworthy.

I am not saying Reagan caused the problem, but the neo-liberal ideology was given a big push by him in the US,  Margaret Thatcher in the UK and Brian Mulroney in Canada. At about that time a serious decline in trust in government began.

Yet as Menand pointed out, Reagan a very popular President, one of the most popular ever and who later became an icon of conservatism in America, did not remove one major government program! Why? Because people realized government delivered some pretty good and important things and programs. Really until then most people understood the benefits of public health care as we have in Canada and to a more limited extent in the United States, and understood the importance of schools, libraries, armed forces, police forces, fire fighters, social assistance to the needy, public parks and many other public goods. It was difficult to persuade people to believe that government is all bad.

But things have changed Bigly. Now they have more trust in Amazon, or Facebook, Wal-Mart, Canadian Tire, ExxonMobil, Safeway, or any other company than the government? How can that be?

Even during the 8 years that Reagan was President of the United States the trust index for government never rose above 45%. In the last 14 years it has never been higher than 30%. That is not a lot of trust!

How is this significant? The absence of trust in government has been disastrous during the pandemic.  During a pandemic if public health officials are not trusted, people won’t follow their instructions and we will all suffer. That is the problem.  And, as we have seen, it is a big problem. That is why it is so important to look at this issue.

Why do so many people distrust government and what is the significance of that?

 

Trust, Mistrust and a Monstrous God

 

One of the things that is so interesting about this pandemic is the astonishing fact that so many people mistrust so many so deeply. The distrust is virtually unshakeable. I am trying to understand why that happens. And it happens a lot where I live, in Southern Manitoba.

This has caught me by surprise. Or at least it once did. After nearly 2 years of this pandemic, it no longer surprises me. I expect it. I am surprised when someone demonstrates trust.  I think it has something to do with the deeply felt religious beliefs in our community, but that still does not explain it.

Here is what Winnipeg Free Press reporter Dylan Robertson said about exactly this issue:

“Manitoba children could qualify for COVID-19 vaccines within weeks, but evangelical parents might not let their kids roll up their sleeves.

In a recent Probe Research survey shared with the Free Press, two-thirds of evangelical Manitobans said they “worry about the long-term effects of COVID-19 vaccinations in children,” compared with 41 per cent of overall respondents.

In addition, 49 per cent of those identifying as evangelical said COVID-19 as an issue was “overblown,” compared with 28 per cent of the overall population.”

 

What would lead Manitoba parents to distrust government or the authorities so much that they would put the lives of their children in danger when the overwhelming weight of scientific evidence, and by now, real life experiences, make it so clear that not taking vaccines is a dangerous choice?

The Free Press  interviewed Rick Hiemstra, research director of the Evangelical Fellowship of Canada and this is what he said, “A lack of trust and polarization have come home to roost.” So many of these evangelicals now identify with their group—Christians who don’t trust vaccines. They don’t trust  scientists. No matter how many of them. They don’t trust the government. Instead, they trust what other members of their tribe has told them or trust what they have “learned” from their own “research” on the Internet. And they do while they put the lives of their children in danger.

Here is what a local theologian said as reported by the Winnipeg Free Press,

“Evangelical scholar Nicholas Greco said numerous factors cause that gap, from a desire to rely on God for healing, to science clashing with creationism, to general skepticism of media and government.

Evangelicals often are reflective of a social and political conservatism, which calls for smaller governments (and) personal autonomy, but also tends to lead to a mistrust of government,” said Greco, who is provost of Providence University College in Otterburne.

Greco, a long-time communications professor, said there’s a perception the government wants to control everyone, and that the media is overhyping the virus as part of some sort of conspiracy.

“The rhetoric I hear from many of my colleagues… is that we don’t want the government to have further control, because if they do, we will lose our freedoms,” he said.

The evangelicals believe conspiracy theories rather than scientists and they believe it so strongly they put the lives of their children in danger. It is like an article of their faith that vaccines are untrustworthy, and no reasoning, no data, or no actual experiences will shake them from their convictions.

Here is what the Free Press reported, “At a recent panel, one congregant said everyone who got the vaccine is going to die within a few years, and that they’ll all go to hell.”

As an aside, think for a moment about what a monstrous God this person believed in—a god who would punish someone for eternity for doing what our scientists have strongly recommended.

It is as if denial of vaccine efficacy has become part of their religious faith.