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President Trump’s Opioid Plan Falls Short

President Trump declared his determination to end the opioid epidemic — over the next “7 years” in a New Hampshire speech.

The location was not a coincidence. New Hampshire has the third highest rate of death by opioid overdose — ending the crisis a cornerstone of state politics.

Opioid addiction and related deaths have reached a crisis point in the United States.

The death of more than 64,000 Americans in 2016 (the last year for which there is total data) underscores the urgency of the problem.

My head was nodding in agreement as the President tick-off his administration’s planned actions:

  • Research to develop non-addictive pain medications.
  • New pain management training for doctors to discourage unnecessary use of opioids.
  • Changing Centers for Medicare and Medicaid Services (CMS) opioid prescription reimbursement policies to minimize over-prescription and over- dispensing.
  • Increased spending for in-patient treatment of addicts.
  • Increased reimbursement for mental health treatment in the Medicaid program.
  • Donations – by the manufacturer – of two boxes of the overdose antidote Narcan to every high school and college in the country.
  • Stiffer jail sentences for drug dealers.
    • Even the potential of the death penalty for drug dealers
  • New vocational training programs in prisons to help first-time offenders get the skills they need to become “productive citizens” when they leave prison.

Illegal Immigration Not the Root Cause of Opioid Crisis

And then the President went further – returning to familiar themes we hear at campaign-style rallies, reporter gaggles and other formal speeches:

  • The Opioid Crisis is worsened by Sanctuary Cities that protect MS 13 members.
  • Fentanyl is smuggled in from Mexico. USA must build a southern border wall to keep smugglers and their drugs out of USA.
  • Countries that have the death penalty for drug dealers don’t have a “drug problem”. “Maybe the USA needs a death penalty for drug dealers.”

One does not have to support Sanctuary Cities to see how coincidental the relationship between sanctuary cities and a flood of drugs on the streets of America.

MS13 is a criminal cartel formed in Los Angeles in the 1980s – who deal in drugs and other criminality because that’s where the money is! The majority of members are birthright citizens who can be imprisoned but not deported.

Didn’t Attorney General Sessions, sitting in the audience, brief the President on current law?

  • There is a federal death penalty for drug dealers who peddle more than $20 million of “junk”.
  • The majority of drug convictions are in state criminal courts muting a federal death penalty.

Time for a War on Fentanyl

116 preventable deaths every day – 365 days a year for several years is not an epidemic — it is a “black plague” requiring drastic action not “happy talk”!

Most of these deaths involve a synthetic opioid known as fentanyl.

Fentanyl is a legal drug, synthetic opioid, used in some medically appropriate anesthesia and pain killers – under government license.

The National Institutes of Health (NIH) reported an increase of 512 percent in fentanyl related opioid deaths from 2012 to 2016.

A 512 percent increase in deaths from the illegal distribution of a controlled substance is an exigent circumstance.

The distribution of fentanyl on American streets must be stopped – stopped now — stopped at the source.

Kill the Opioid Crisis at the Source: China

The principle source of illegal fentanyl, today, is China.

The opiate trade with China dates back more than two centuries to when American clipper ships made the dangerous voyage around the Cape of Good Hope to trade opiates, tea, and silks with China.

Clipper ships have been replaced with airplanes that carry cargo for the United States Postal Service (USPS).

In January,2018, following a year-long investigation, the United States Senate reported $766 million worth of fentanyl was “imported” from China via internet purchases delivered by the USPS. The Senate further reported the postal service had failed to purchase or deploy electronic tracking equipment to identify and stop suspicious packages from China or anywhere else.

According to NBC News, industrial quantities of Chinese fentanyl slip into the USA from Mexico.

This fentanyl crosses at perfectly legal ports of entry smuggled in cars or trucks. In terms the President would understand, fentanyl drives through the “gates in the wall” he wants to build.

The Rand Corporation argues, stopping drug trafficking through legal ports of entry requires the deployment of additional uniformed and trained personnel using sophisticated electronic detection equipment. Like the postal service, US Customs has failed to deploy these proven and effective assets.

China Can Stop Fentanyl Trade

The Chinese government gives lip service to cracking down on the fentanyl trade but has done little or nothing to close down a plethora of online sites in Chinese cyber-space that are selling fentanyl.

The President should impose serious and immediate trade penalties on China for their failure to crack down on the $766 million China to USA illegal fentanyl trade.

  • More than tariffs, perhaps some outright product bans.
  • Conduct an evidentiary hearing at the UN Security Council.

In addition, the President should issue an Executive Order authorizing the Department of Homeland Security (DHS) and USPS to purchase and deploy the currently available electronic tracking equipment needed to identify suspected fentanyl shipments from China or Mexico.

The equipment must be installed and operating reliably within 90 days – by the first of July! There can be no excuses.

Then the President must activate sufficient numbers of well-trained National Guard members to support, train, and supplement the postal and customs personnel.

The goal of this effort, in addition to all the other steps the President suggested in New Hampshire, should be to reduce the death rate from 116 people per day to less than 50 per day by the end of 2018 and to reduce that number to less than 25 a day by the end of 2019.

Cutting the fentanyl supply chain is the one thing that will make the rest of President Trump’s “plan” work to eradicate death by fentanyl.

Illustration courtesy of The Brookside Associates

A Crucial Balancing Act: DACA and Enhanced Border Security

President Trump has invited an explosion in Congress with his recession of the 2012 Obama Executive Order that protected undocumented aliens who were brought to the United States by their parents when they were still children and before 2007.

There is majority public support for legislation to protect the “DACAs” (Deferred Action [for] Childhood Arrivals).

Three bills have been entered into Congressional hopper – the bi-partisan Senate Dream Act 2017, the House Recognizing America’s Children Act and the House Dream Act.

Nancy Pelosi, embolden by her meeting with President Trump, insists House Democrats will settle for nothing less than their Dream Act – which broadens the categories of eligibility beyond President Obama’s Executive Order and offers Dreamers a direct path to American citizenship.

The two other bills take a more measured approach — offering at first provisional legal status to work, travel, go to school, etc. Only after serving several years of provisional status would “Dreamers” earn a right to apply for permanent residency and eventually citizenship — hardly a “get out of jail free” card.

Initial reaction on Capitol Hill suggests that there is broad support, in Congress, for DACA-fix legislation – limited in scope and purpose.

After sixteen years of bi-partisan failure to pass such a bill what is different this time?

Passing a small, targeted immigration bill will benefit both political parties going into the 2018 mid-term elections.

Politics Makes Strange Bedfellows

Does President Trump think he can trade a DACA law for his often promised southern “border wall”? It’s possible but not realistic.

More realistically — the Republican majority in Congress knows it cannot afford to lose this opportunity to partially rebuild its relationship with Hispanic voters. But the GOP must also be responsive to its own base – which has used its votes repeatedly to demand enhanced border security first and granting legal status second.

Democrats will seek political advantage in the mid-term elections by supporting a “clean DACA law” (effectively an amnesty) that would attract more Hispanic support from the US citizen brothers and sisters of the Dreamers — even at the expense of further erosion of their traditional organized union, blue collar base in the mid-west.

Representatives and senators in the center of both parties have a clear common interest. The majority want a bill they can pass, the President will sign, and that they can defend to their constituents during the 2018 primary and general elections.

Senators as philosophically opposed as Lindsey Graham (R-South Carolina) and Diane Feinstein (D-California) have both acknowledged that only a DACA Fix that includes steps to strengthen our border security meets all three conditions.

Effective Border Security Doesn’t Mean Walls

A wall on our southern border — even if Mexico or Congress was willing to pay for it – will not secure our borders.

Fact is every year since 2007 more than half of the illegal immigrants to the USA have been airport arrival “visa overstays”.

Technology, not concrete, is the solution to our 360 degree land, air, and sea border security problem.

  1. Strengthen E-Verify

The 1986 Immigration Reform Act (aka Simpson Mazzoli) attempted to balance compassion for some two million illegal aliens who had been in the country for many years with stronger border security and enforcement measures.

The 1986 legislation defined as a crime any USA employer hiring/employing a person who could not prove they had the legal right to work (and live) in the United States.

To help employers stay “on the right side of the law”, Congress mandated the development of an electronic verification system – E Verify — every employer would need to use to verify every new employee’s “work authorization status”.

The bureaucracy took a different approach than the law required while subsequent Congresses just looked the other way.

Participation in the E-Verify System is voluntary unless the employer is a federal contractor – or in some states a state contractor. There is only limited enforcement even for federal contractors.

Any other employer can enroll to use the system on a voluntary basis with little risk of being subjected to enforcement action by Homeland Security.

Under current Homeland Security policy, even if a new hire is “non-compliant” – determined not to have work authorization – termination is not required only strongly suggested.

Congress should give Homeland Security twelve months from date of passage of new Border Security legislation to deliver an E-Verify System that is tested, proven and works.

Once tested and proven, the system must be made mandatory for all newly hired workers – every employer, everywhere – with significant civil and criminal penalties for employers that violate it.

Restricting the E-Verify mandate to new hires will protect those working without papers in the USA today – i.e. DACA’s parents – from termination because of status.

No DACAs could move from provisional status to permanent resident status until E-Verify is successively implemented, rolled out nationally and demonstrated to work – including employer enforcement.

  1. Discourage Illegal Entry with Improved Tracking Technology at Every Border

Simultaneously, Customs and Border Security must
improve its ability to electronically track arrivals and departures of tourists and other foreign nationals with temporary (time fenced) visas.

Currently, a photo is taken of every airport arrival and stored with passport information collected prior to and upon arrival.

Today, Homeland Security has no way to track where a “visitor” goes once they cross the border or walk out of the airport. It’s just too easy to blend in and stay – get a job, rent an apartment, or buy a car.

  • Congress should authorize the Attorney General to determine the Constitutionality of attaching a GPS tracking device to all foreign passports in the United States to ensure timely departures.
  1. Eyes in Sky

High tech surveillance is part of 21st century life – at the mall, the airport, the stop light, on the freeway – rendering walls historic artifacts.

Congress needs to increase funding for technology already used by Border Patrol including satellites, in the ground sensors, and drones to patrol remote stretches of both the southern and northern borders.

  • More drone operators, for example, to spot irregular arrivals faster and guide border patrol agents to apprehend them.
  • Ground level sensor technology can be more effective than walls.
  1. A Tamper-proof Internal Identification System

Homeland Security must be given a deadline to negotiate a plan with the states to issue technically sophisticated drivers’ licenses and other internal identification documents.

  • Congress first mandated a tamper-proof “National ID” following 9/11 but it has never been implemented.
  • Adding technical sophistication to our (state issued) internal identity documents will prevent the possibility of unauthorized immigrants using our air travel system – reducing the terrorist threat as well.
    • Some states currently issue Driver’s Licenses to undocumented aliens but those licenses must meet federal guidelines that insure TSA can quickly identify them as not authorized for air travel.

Tamper-proof national identification documents are, also, a defense against the growing national threat from counterfeiting and identity theft.

None of these four steps would deny sanctuary to anyone currently in the United States.

Build Public Confidence for Immigration Reform

If the public saw each step implemented, tracked and succeeding — public confidence in the government’s ability to secure our borders would grow.

Simultaneously, Congress could use the two or three years required to implement and assess the effectiveness of these first border security steps to develop a thoughtful set of next steps to fairly resolve the status of DACA’s parents and other undocumented immigrants.

Securing the border along with resolving the legal status of those who have been living in the shadows of America for many years would
build public confidence in the government’s ability to manage our immigration system.

Public confidence is the necessary pre-requisite to a comprehensive 21st century immigration reform plan.

Graphic courtesy of iconfinder.com

 

Compassion Combined with Enforcement Can End DACA Crisis

The decision of the Trump Administration to rescind the Obama era executive order on DACA without a Congressional agreement to fix the problem is baffling.

The President and the Attorney General have created yet another legislative crisis for a Congress already overwhelmed by seemingly irreconcilable differences ranging from how to increase and manage the national debt ceiling to passing a 2018 federal budget (for the first time in 8 years) as a pre-requisite for any meaningful discussion of tax reform.

After years of promises, Congress does not yet have any reasonable plan to repeal, replace or repair the Affordable Care Act.

They’ve not passed a Defense Authorization Appropriation in the face of worrisome aggressive actions and threats against the United States by nuclear capable North Korea. Not to mention the ongoing military operations in Afghanistan, Iraq, Syria and so forth.

In the face of the well documented philosophic splits inside and between both political parties represented in the 115th Congress – it is unlikely that meaningful tax reform can muster any combination of the required 60 votes in the Senate.

Adding a legislative “DACA-fix” to Congress’ already impossible 2017 to-do-list is akin to throwing a match into a house with a gas-leak so you can enjoy the fiery explosion.

DACA is a Result of 2012 Presidential Politics

President Obama insisted for four years that he “lacked the Constitutional authority” to intervene on behalf of undocumented aliens living in the United States – arguing only Congress could change the law.

But in the run up to the 2012 Presidential Election, President Obama changed his mind about the extent of his executive power to protect undocumented (“illegal”) aliens living in the United States.

Facing a tougher than expected 2012 re-election challenge from Mitt Romney, he used Executive Orders to protect two classes of illegal immigrants from deportation proceedings and grant them temporary work permits – a total of more than three point six (3.6) million people.

  • Deferred Action (for) Childhood Arrivals (DACA)
  • Deferred Action (for) Parents (of) Americans (DAPA)

The Supreme Court agreed with President Obama’s first position — ruling DAPA and some parts of DACA to be unconstitutional in 2015 but left limited DACA protections in place.

While some might ascribe cynical political motives to President Obama we can all agree that, as a parent himself, he believed it is unfair to punish children for the sins of their parents.

The 600,000 to 800,000 young people who remained eligible for deferred action are between 18 and 30 years of age, originally brought to the United States illegally by their parents when they were children. They’ve grown up in the United States. Many have siblings born in the United States who are citizens.

These young people know no other country than the United States. There are, except for their immigration status, indistinguishable from their classmates, neighbors, work place colleagues or citizen spouses.

Some don’t even speak the language of the country of their birth.

The young people who have “come out of the shadows” by applying for a two year renewal work permit under DACA are contributing members of society.

They are caught in the limbo of Congress’ bi-partisan failure to frontally address a United States Immigration System that is completely broken and politicized – an impasse that has existed continuously since 2004 through majority Republican and majority Democratic congresses.

Immigration Reform Begins One Small Step (Bill) at a Time

As soon as Attorney General Session announced a planned end to the deferral program, members of both parties in Congress rushed to find a camera to promise a quick bi-partisan legislative solution to the DACA problem.

The White House press secretary even urged Congress to immediately pass comprehensive immigration reform.

But, if it were so easy – wouldn’t Congress have done it in 2004 or 2007 or 2010, 2012? The devil is in the details.

The history of comprehensive immigration reform – last enacted in 1986 – does not inspire confidence in the American people.

The 1986 “carrot” — amnesty to some two million undocumented aliens — was implemented right away but the “sticks” of stronger border control and stepped-up interior enforcement – E Verify (Employment Eligibility Verification) – have never been fully implemented.

The result is an estimated 11 million more undocumented immigrants today who point to 1986 Simpson-Mazzoli as evidence they have a “right” to legal status.

As a nation we just don’t do comprehensive well. Instead of one big omnibus bill that will never be fully understood or implemented, Congress should start with several, more modest, single purpose bills that can be fitted together in an interlocking immigration reform package — implemented, measured, tracked and enforced one step at a time over several years – starting with DACA.

Bi-Partisan Incremental Deal

The American people have shown in recent Politico polling support for – and our economy needs — more skilled and younger immigrants who can assimilate into American culture – the definition of a Dreamer (DACA).

A bi-partisan poll of the American political center taken by NBC News and Esquire Magazine in 2013 demonstrated a willingness to grant legal status (even eventual citizenship) to undocumented immigrants living in the United States for many years if the government can demonstrate the border is secured against further unauthorized immigration.

The Trump Administration created a “Dreamer crisis” and then gave Congress six months to “fix” the problem. That’s not constructive.

The Trump Administration must work with Congress to fashion a legislative process which builds the trust of the American people and sets the stage for future legislation to modernize our antiquated immigration system.

A reform bill that conveys legal status to qualifying Dreamers who arrived in the USA before 2007 linked to a companion bill focused on improved northern, southern; land, sea and air border security seems a good place to start.

 

Graphic is courtesy of the Delgado Law Group — with thanks

Trump versus the People

4th of July weekend – the time we commemorate the moment American patriots threw off the shackles of a crazy English King George III and began the world’s longest experiment in democratic republican government.

While the rockets are firing into the sky, we should take a moment to wonder much longer we can claim to be a functioning democratic republic unless our elected officials turn from fighting each other to fighting for us.

Average earnings of Americans have continuously declined since the late 1970s.

The health care industry puts profits over the quality and quantity of American lives.

Our tax system favors the richest among us against everyone else.

Our infrastructure is decaying and crumbling:

  • Water Supplies
  • Flood Control
  • Power Grid
  • Roads
  • Bridges
  • Public Transit
  • Airports
  • Sea Ports

Good, middle class American industrial jobs are disappearing faster than innovation can replace them.

Immigration is flooding the top and bottom of our society sandwiching and compressing the middle class – upon which the fabric of democratic government depends.

Our nation is not secure – not from foreign adversaries, not from domestic terrorism, not from a debt crisis much worse than 2008.

Enter King Donald

In complete frustration the American people took a chance – electing a businessman/TV personality best known for the phrase “you’re fired” to occupy the highest office in the land.

A business person, voters reasoned, would shake up the impenetrable institutional government – Washington, D.C. – and might bring opportunity back to the American heartland.

Hillary Clinton was the epitome of that fossilized, institutional government – explaining why Donald Trump is now residing at 1600 Pennsylvania Ave.

Accepting the Republican nomination, Donald Trump promised to be the “voice of the forgotten” American.

But he has forgotten that promise.

This man — whose actions have the potential to impact every person on earth — listens only to the voice of accolades and acolytes.

Fail to flatter and you will be fired. Ask James Comey!

Personal presidential loyalty tests have stalled State Department policy nominees denying Secretary Tillerson the staff he needs to navigate a world fraught with challenges – several of which could easily erupt into shooting wars involving the United States.

Presidential briefings must be kept short because the president has a “limited attention span” – when he listens to his advisers at all.

The Trump Cabinet agenda includes some praise worthy ideas and initiatives but they are completely subsumed by President’s impetus behavior, incoherent tweets, and blatant nepotism.

This Form of Governance Can’t Continue

The President’s tweets demonstrate the significant mismatch between the skills the President gained as the “boss” of a small, family-owned business with a deceptively large bottom-line and those needed by the Chief-Executive-Officer of the United States – the titular “leader of the free world”.

The celebrity business man had a reputation for personal charm that masked unethical business practices and a penchant for “getting even”.

His tweets attacking the press call into question his understanding of the roll of the press. As far back as the 1763 Tea Party the press has been an institutional “opponent” intended to keep the government honest.

Following his Inauguration, @realDonaldTrump tweets demonstrated the depth of the President’s narcissism and how much of that narcissism is driven by deep seated insecurity. Something that voters did not expect!

Some tweets have been simply self-destructive, while others demonstrate a lack of impulse control. The tweeted potential of White House tapes gave James Comey the idea to leak a contemporaneous memo to New York Times (via a cutout).

Voila – instead of suppressing the “Russia investigation” those tweets prompted the appointment of a special counsel more interested in determining whether the President “obstructed justice” than clearing him of charges of “collusion” in the 2016 election.

This week’s tweets concerning the hosts of MSNBC’s Morning Joe are further evidence of the President’s lack of self-discipline, lack of self-awareness, misogyny, bullying and limited acquaintance with the truth.

Those are not the skills of a national leader. Leaders accept the role of criticism as part of the job! Criticism forces self-awareness, begs the question “what-if”.

History demonstrates criticism becomes the genesis of consensus – which has been the life’s blood of the American experiment with representative democracy.

Criticism forces our leaders to re-examine their own beliefs and – perhaps — to alter them. They are not, after all, infallible.

American democracy flourishes when our leaders acknowledge their own fallibility and, as a result, are able to listen, facilitate and bring together the people and their representatives — whose disparate ideas and experiences hold the common kernel of solution.

Instead, this President’s tweets have, sadly, become the “bright shiny object” sowing confrontation and confusion instead of building consensus.

Donald Trump has no real beliefs and no grasp of policy. For example – one day championing a Republican health care plan and the next day calling it cruel and on day three championing total repeal of the law it claims to “fix”.

Convene the President’s Club

It is time for the Presidents’ Club to convene a meeting with their latest member. These five former Presidents are best positioned to evaluate the potential of this President to grow into the office he now inhabits.

They will put the best interests of the nation before all other considerations.

If they conclude the President is “unfit” – that he lacks the skills and personality characteristics needed to learn to lead the nation and is unwilling to learn – he must go.

The 25th Amendment to the Constitution was ratified for just such a situation.

Some Democrats in the House of Representatives have formed a committee to investigate invoking the 25th Amendment against President Trump. They should stand down – their efforts are blatantly political and this is not a time for politics – but for patriotism.

In this case, if the five members of the Presidents’ Club were to find Mr. Trump “unfit” to discharge the duties of the office of President of the United States, they could petition the Congress to create a law to empower them to petition for the President’s removal.

Such a law would have to have some stringent requirements for removal that would protect the process from accusations that the motives were political.

And the five former Presidents (3 Democrats and 2 Republicans) would need to meet directly with the American people and make a detailed, objective and impartial case for removal.

Then Congress would need to vote yes or no to remove the President

in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defense, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity

Fireworks photo courtesy of mountvernon.org