America has a nursing shortage’ scream the headlines. And that’s true and will be for the foreseeable future. Is the reason all to do with COVID? No, but clearly it has had a dampening impact on the numbers of nurses and their perception of whether they want to stay in the field going forward. Given that the average age of a nurse in America today is 50, for older nurses retirement has never looked so good. Like most issues when you dig a little you find many subtleties that have far reaching implications for a beleaguered medical delivery system in a society with an aging population. Patients who end up in hospitals today are often older, sicker and require more sophisticated care, taxing the fulcrum of the medical delivery system, the nurse, to an even greater degree. There is no one more able in America to explain what’s happening to nursing than Professor Peter Buerhaus, himself a nurse, a Ph.D. and an expert in the economics of the nursing workforce. By the end of this podcast you will understand the many facets of a problem that can result in care deficiencies, medication errors and fatalities if we cannot figure out a way to get more registered nurses into the field in the coming decade.
Monthly Archives: October 2021
In most states, the Department of Motor Vehicles is the poster child for government inefficiency. New systems are touted and yet the lines and the bureaucracy often grind down the citizen interacting with it. This is especially notable in a society where private companies know so much about us that the interaction with them is seamless and, at times, astonishing. Order an item today and have it arrive that same day. It became obvious to us that government had a problem during the pandemic when there were basic challenges like tracking testing data, allowing residents to schedule vaccination appointments and getting cash assistance to individuals and businesses. Some governments around the world are stepping up their technology game, but America has a way to go. For that reason Tara Dawson McGuinness and Hana Schank, our guest, have written the book, ‘Power to the Public: The Promise of Public Interest Technology’. Let’s start with the premise that government is important to our daily lives and that since we only have one we should all be invested in making it better at delivering services. That’s the essence of this podcast.
Conservatism has been the prevailing political ideology in America since the 1980’s, when Ronald Reagan’s brand came to dominate America’s political culture. It was a rather pragmatic version, often cutting deals with Democrats to get 80 percent of what he wanted. His belief that winning elections was for the purpose of governing. Much of what he was trying to do was a reaction to activist liberal initiatives from the New Deal to the Great Society. And while Reagan’s sunny side up form of conservatism gave way Donald Trump’s carnage in America pronouncements as part of his Inaugural Address in 2017, we wanted to explore the lineage of conservatism from Reagan to Trump–what they shared and where they departed in approach and substance. H. W Brands, a history professor at the University of Texas-Austin, and author of ‘Reagan: A Life’ joins us. He brings much historical perspective to this issue.
On January 6, 2021, the day our Capitol was invaded by insurrectionists, QAnon became the most violent manifestation of its most fervent fever dreams and joined with other right wing extremists of all stripes to declare that ‘the storm’ they have long talked about was here. Mike Rothschild a chronicler of the movement since 2018 and author of ‘The Storm Is Upon Us’ tells us we must take this group seriously even though this movement of lost souls and their utterances sound so outrageous and nonsensical to most of us. Even if we try to ignore them, we must acknowledge that elements of the media and the Republican Party have accepted their existence and put some of their ideas into common use. As a movement, cult and conspiracy theory of everything it is very hard to understand what’s going on with QAnon unless you have a guide like our guest to give you safe passage in and out of their rabbit holes. You will be compelled to listen.
Democrats and Republicans agree on little else, but both seem to buy into the notion that heavy expenditures on capital projects related to infrastructure will reap great dividends for the near and long term. Who can argue that new roads, bridges, water systems and broadband enhancement are not beneficial? But are the use of federal dollars, shared across the population, the best way to do it, or should there be more user fees to change the behaviors that often led to the deterioration in the first place? Clifford Winston of the Brooking Institutions, along with Trevor Gallen, wrote an article that caught our attention. It was titled ‘The Wrong Way to Pay for Infrastructure’ and stated that while we may raise the gross national product by funding infrastructure the package ‘will hurt the economy by initiating a costly and lengthy transition to build new taxpayer-funded infrastructure’. It’s hard to argue that these projects take much time, often incur substantial overruns and obstacles in siting, so we decided to have a talk with Mr. Winston to explore his contrarian point of view about this topic. Some of his reforms are intriguing and might next time lead us to a place where such gross negligence and decline might not require another huge infrastructure bill.
There are short and long term trends as it relates to migration across America. For years, the south and the southwest have been gaining population while the Midwest and Northeast have been stagnant or losing ground. And even in places like New York City, some tragic event or spate of bad governance may drive people away, but they are soon replaced by others. And the factors involved in these moves are both personal and part of a larger story. In the wake of the pandemic many of these considerations have been scrambled. If you are no longer tethered to an office, but can work remotely, that presents an array of options for you and you can focus on climate, cost of living and other elements of desirability. And while there’s clear evidence that places like Texas and Florida have made themselves havens for attracting businesses in the recent period, perhaps the winners in the next migration cycle will be those who can induce individuals to pick up and leave. And some smaller cities are doing just that with cash incentives. It’s a great topic for this podcast and we have a terrific guest, Steve Malanga, the senior editor of City Journal and George M. Yeager Fellow at the Manhattan Institute.
It’s hard to consider the place we’re in as a country and not wonder if something is lacking in the way we teach civics and United States history. ( I must have missed the chapter about trying to undo fair and free election results by storming the Capitol.) Waving the flag and spouting platitudes about the country you might wish we are is no substitute for the hard work involved in making this pluralist society work as a functioning democratic republic. Our Founders knew that our goal of a more perfect union would require much care and continuing evolution, even of the Constitution they gave us(thus the provisions affording us the opportunity to amend it). At the root of our democratic experiment was the presumption of an informed citizenry capable of making good decisions about leadership and governance. That requires the teaching of the complexity, richness and nuance of our country’s past and present. So how are we doing teaching civics and U.S. history in American schools? We answer that question today with Amber Northern of the Thomas B, Fordham Institute. She’s the senior vice president for research and unveils the results of an important study they have done on the subject.
In the Zoom era, businesses are investing millions into global collaboration technology. Yet the slickness of Big Tech stands to mask-and perhaps exacerbate the real issue: doing business across borders has less to do with technology and everything to do with being culturally agile. Instinctively we sense this. How do you react when put in a new environment where the customs and cues are not well understood? Americans in the past often assumed the world would bend to our cultural imperatives, but things have changed and we have to embrace ambiguity and develop more humility and resilience in the face of working with people in different cultures. This is not only a cross border phenomenon but applies in America too when dealing with regional, demographic and age differences. Paula Caligiuri of Northeastern University is expert in this field and has written the book, ‘Build Your Cultural Agility’. She challenges us today on the podcast to wake up our lazy brains when experiencing cultural novelty.