Miranda Kennedy | Vox

How UnitedHealthcare became the face of a broken health care system

2024-12-11T11:21:52-05:00

Luigi Mangione, the suspected shooter of UnitedHealthcare CEO Brian Thompson, is led into the Blair County Courthouse in Hollidaysburg, Pennsylvania, for an extradition hearing on December 10, 2024. | Jeff Swensen/Getty Images

On Monday, police in Altoona, Pennsylvania, arrested Luigi Mangione in connection with last week’s shooting death of UnitedHealthcare CEO Brian Thompson. When Mangione’s identity became public, the online reaction around Thompson’s death went into overdrive; unlike most shootings, this one has brought a stream of support for the suspected killer rather than for the victim, and Mangione’s capture has only intensified that sentiment.

Mangione, 26, has since been charged with second-degree murder in New York, among other crimes, and has been valorized as a folk hero in many corners of the internet, though the killing of Thompson, 50, has also been widely condemned. After Mangione was arrested and identified, his following on X went from a few dozen followers to more than 300,000 overnight. From a flood of supportive memes on Instagram and X to a shooter lookalike contest this weekend in Manhattan’s Washington Square Park, making jokes about Thompson’s death somehow came to be considered acceptable and appropriate.

The widespread interest in Mangione demonstrates just how much built-up hate there is toward insurance companies: Americans are infuriated about the costs and complications of health care coverage, and Thompson’s death has brought that anger to the surface. To try to better grasp the reaction among Americans, Today, Explained reached out to journalist Bob Herman, who covers the business of health care at Stat News and has co-reported several investigations about UnitedHealthcare.

Today, Explained co-host Sean Rameswaram spoke with Herman about UnitedHealthcare’s business practices, their place in the health care market, and why they have been a target of so much anger. An excerpt of his conversation with Herman, edited for length and clarity, is below. In the full podcast, we also get into who Mangione is and what we know about his motives, why it took police five days to find him, and how they eventually did, so listen to Today, Explained on Apple Podcasts, Spotify, or wherever you get podcasts.

Bob Herman

UnitedHealthcare is the largest health insurance company in America, and it is part of a bigger company called UnitedHealth Group. UnitedHealthcare covers older adults on Medicare Advantage, they cover the poor who are on Medicaid, they sell Obamacare plans, and they’re also the plans that employers offer to their workers. We’ve had a whole series this year called Health Care’s Colossus that has looked at this massive company and how it has its tentacles everywhere. A lot of people recognize it for UnitedHealthcare, the insurance company. It is not just a health insurance company — that’s what it’s most known for, that’s why it’s often reviled — but people don’t recognize all the other components that it owns. It owns a ton of medical practices. It either employs or is affiliated with one out of every 10 doctors in the country. It is the largest claims processor. They are everywhere.

Sean Rameswaram

What was your reaction when you saw that Brian Thompson had been shot last week?

Bob Herman

I’ve never covered a homicide on my beat. Normally, this is a beat filled with white-collar crime, so this definitely has been outside of the norm. My colleague and I were watching UnitedHealth Group’s Investor Day on Wednesday morning, just kind of a routine thing. It’s a big meeting every year — all kinds of investors and shareholders get together and they talk about their earnings for the year — and it’s a big cheerleading routine. Normally Brian Thompson appears pretty early on, as the head of the insurance division for United. And then about an hour in, that’s when I first got a text of a New York Post story saying that Thompson had been shot and killed. So a little bit more than an hour into it, that’s when Andrew Witty, the CEO of UnitedHealth Group, the parent company, came back out and canceled the rest of the conference. We had never seen anything like it.

Sean Rameswaram

Almost immediately, people were celebrating this homicide. What was your reaction to that?

Bob Herman

The reactions were pretty morbid. Pretty grim. The dancing on the death of somebody was pretty vile. But anyone who covers health care knows that people are fed up with the system. This is not new. This has been going on for decades. Even when the Affordable Care Act, or Obamacare, came into play 15 years ago, people still hated the system and it’s persisted since then. So people’s frustrations have been bubbling under the surface for so long. To say you were surprised by all the reactions, then I think maybe you had your head buried in the sand a little bit.

Sean Rameswaram

Before we talk about what this company does that might upset people, can you just tell us about the company generally?

Bob Herman

UnitedHealthcare is the largest health insurance company in America. They cover more people than anyone — [its coverage] includes Medicare Advantage, Medicaid, Obamacare, and all the different types of employer plans out there. And there’s a lot.

Sean Rameswaram

Which I imagine makes them pretty powerful in this market.

Bob Herman

Yeah. Now, a lot of health care dynamics are local. The fights that often occur between health insurers and providers, like hospitals and doctors, are all about who has market share in a specific area. United might not always have the biggest market share in a given area, but nationally they are very powerful, they are very profitable. There’s no way of getting around them in pretty much any market. They exist almost everywhere in some capacity.

Sean Rameswaram

And what do they do with that power? How do they throw it around?

Bob Herman

If you have a UnitedHealthcare plan, you want them to negotiate better rates for you. That’s their primary function. And so they use some of that to try and drive better deals with hospitals and doctors and other types of facilities. They’re also an insurance company and they happen to deny or delay claims as well. As an insurance company, the easiest way to make money is to make sure you’re paying out fewer dollars. Now, there are laws in place, especially a federal law that says you have to spend a certain amount of your premium dollars on care for people. You just have to do it. But insurers have an incentive to stay as close to those thresholds as possible. They don’t want to have to pay out more than they absolutely have to.

Sean Rameswaram

You just, of course, used two of the operative words in this story because as we found out, the shooter had inscribed three words on his bullets: deny, delay, and depose. Is this company known for its denials?

Bob Herman

Every health insurance company out there is known for their denials, to some degree. Specific rates of denials are tough to come by, but insurers — especially the for-profit ones that [trade] on the stock market — have an incentive to deny care. There have been so many issues with denials over the years. My colleague Casey Ross and I reported on a big one within Medicare Advantage, the program for older adults. UnitedHealthcare is the biggest [provider] in Medicare Advantage, and over the past several years, they’ve been using algorithmic prediction, predictive tools, and artificial intelligence to basically ramp up denials specifically in post-acute care, the care that somebody gets when they leave the hospital. So especially on that side of the coin, post-acute care denials have been a very big issue for United.

Sean Rameswaram

What exactly does that mean, that they’re using algorithms and AI to deny Medicare Advantage [claims]? How do they do that?

Bob Herman

So let’s say someone goes to the hospital and then the hospital says, okay, you know, you’re ready for physical therapy, occupational therapy, speech therapy; let’s send you to a rehab facility or a nursing home. So a person will go there and they’ll start their physical therapy, and behind the scenes, UnitedHealthcare has used a tool called NaviHealth. There’s an algorithm within the company that looks at the patient’s demographics — how sick they are, their history — and tries to come up with some kind of prediction of how much time they’ll need in that nursing home. Let’s say it’s 16 days. That’s what the algorithm says — after 16 days, you should be good. Now, if it’s used as a guide, that’s fine. But in many cases, we found documents that said that United told their case managers, “You have to stick to the algorithm.”

And that’s where it becomes a problem, because if you’re saying this algorithm spits out 16 days for somebody and they’re not ready to go home on the 16th day, if they can’t even go to the bathroom themselves, if they still can’t walk around but the algorithm says it’s time to ship them out, that’s where it’s a problem. And that’s what’s happened. Then families are left with the decision of, do I pay out of pocket to stay at this nursing home to get the care that my mom or dad or grandparent needs? Or do I take them home with me and then risk having them fall or get hurt again and have to go back to the hospital or worse? So that’s how the algorithms play in those types of situations.

Sean Rameswaram

And people know this is happening and they’re mad about it?

Bob Herman

On the Medicare Advantage side, most people actually don’t. They’re not aware as much about this because the algorithm happens behind the scenes. It’s not like families are getting a sheet of paper saying, “Hey, our algorithm says you have this much time here.” They really don’t find out about this until the nursing home says, “Hey, your insurance is up and we have to kick you out now.”

The denials are very front and center in other insurance plans where they say, “I know I need this back surgery or I need this prescription,” and then United will come along with maybe a prior authorization which says, “Hey, doctor, fill out more paperwork to make sure that this person needs this procedure or needs this drug.” And then maybe they’ll come back with a denial that says, “We’re not going to cover this procedure or this prescription drug.” That’s where it’s most front and center for people, that’s where a lot of the outrage comes from: those widespread delays and denials.

Sean Rameswaram

We’re talking about our eldest citizens who are often on the receiving end of these algorithms or AI initiatives that tell them they’ve run out of care.

Bob Herman

At least in our reporting it is — for the Medicare Advantage — it is the oldest, it’s the frail, often the poor, the oldest people in this country who often have no idea that this is going on. Once they find out, they can appeal; anyone can appeal any denial. But it is such an arduous process. If you’re sick or injured, that’s not something you want to be doing, and you might not have family to help you out either. So it is very clearly a problem.

Sean Rameswaram

Is this a UnitedHealthcare-specific problem or is this a systemic problem? It feels like a systemic problem.

Bob Herman

This is systemic. This is not isolated to just UnitedHealthcare. UnitedHealthcare gets the most criticism and heat for this because they are the largest and they’re a very common provider for any workplace plan. But there are other large insurers: Cigna, Aetna, all the Blue Cross Blue Shield plans, Humana. This is just how US health insurance works. This is a systemic issue, especially for the insurance companies that are on the stock market. They have a duty to make money for shareholders. And one of the ways that they do that is by making sure that they pay out fewer claims. The most-watched number on every earnings call for an insurer is what’s called the “medical loss ratio.” That’s a number that says how much money from our premiums we spend on medical care, and lower is better. If it’s higher than expected, Wall Street freaks out. I think that kind of tells you a lot.

Sean Rameswaram

This has been an insane week for this industry. But do you think anything changes now, other than executives are going to have more security?

Bob Herman

Could this be a galvanizing event to broader health care reform? It’s certainly possible, because the American public has made their voices very clear here. But this is completely dependent on a new administration, a new Congress. This is a federal policy issue. And if Congress doesn’t act, then you’re just going to continue to see more of this — unless companies start to make changes on their own. But if they do, it’ll be around the edges. It’ll be tinkering.

The author of the seminal book about loneliness explains what we’re getting wrong

2024-11-27T17:44:14-05:00

Political scientist and professor Robert Putnam is awarded the 2012 National Humanities Medal by President Barack Obama during a ceremony in the East Room of the White House on July 10, 2013, in Washington, DC. | Pete Marovich/Getty Images

With the holiday season upon us, it’s important to grapple with the loneliness many Americans face every day. It’s often more intensely felt in the times when you are expected to be surrounded by the warm embrace of family and friends. And, increasingly, that warm embrace isn’t happening. Americans spend more time at home — alone — than they did 20 years ago, according to a recent analysis of federal data. The numbers went up dramatically during the pandemic and never came back down.

Across the board, Americans have fallen away from activities that involve or require community. Religious service attendance is down dramatically. Two decades ago, over 40 percent of US adults attended religious services every week or nearly every week. Now, just 30 percent of Americans say the same, according to Gallup polling. Other metrics of civic engagement have dropped off too: According to one AmeriCorps study, just 20 percent of Gen Z volunteer their time to help others, compared to almost 30 percent of Gen X.

Loneliness has been on the steady march for many decades, and one man has been watching its advance: Robert Putnam, a public policy professor at Harvard University and the author of 15 books, including the 2001 bestseller Bowling Alone: The Collapse and Revival of American Community. The book was based on a simple premise: Once, Americans joined bowling leagues. Now, they are going bowling by themselves. In the book, Putnam extends the metaphor to speak to all our social connections, saying that their drop-off speaks to the decline of our democracy.

This half-century of civic decline is charted in a documentary about Putnam’s life that came out in 2023, called Join or Die. We wanted to hear more about the importance of a culture that embraces community activities, so we reached out to the man who inspired a thousand clubs himself. Noel King spoke with Putnam — though he prefers to be called Bob — for Today, Explained to discuss if “bowling alone” has grown even more acute, the role technology plays, and how to reverse the trend. Below is an excerpt of their conversation, edited for length and clarity. There’s much more in the full podcast, so listen to Today, Explained on Apple Podcasts, Spotify, or wherever you get podcasts.

Noel King

Volunteering is good for the person who is doing the volunteering, right? Is that a reason to volunteer?

Robert Putnam

There’s a lot of evidence that if you’re volunteering to help somebody else, you’re probably getting more benefits out of it than they are, because there are all sorts of physiological changes. People after volunteering are happier than if you hadn’t volunteered. It’s one reason to volunteer. You don’t have to choose between the reasons. In writing the book Bowling Alone, I talked about the consequences of our connections with other people, both our actual in-person connections and our connections through political organizations. And that, as a community in which people are more connected with one another, the whole community functions better, not just the two people involved in a given exchange.

Let me give an example from education. If I, as a parent, get involved in my child’s school, I join the PTA or I volunteer in the classroom, that turns out to be good for my child. But the astonishing thing is my getting involved has even more effect on the success and the happiness of other kids in the school. In the book Bowling Alone, which was written [about] 25 years ago, I talked about the decline in these connections, decline in what I called social capital. And I said, “Gosh, if this continues, it’s going to be bad for American democracy. You know, we’re going to have more polarized politics,” and so on. And the reason that there’s now a little bit of a new wave of interest in my work is that I turned out to be right. Even more right than I thought. If you’ve not noticed, American politics is in a pickle right now, and the fundamental reason for that is because for the last 30 or 40 years, we as a country have become less and less connected with one another — in my jargon, with less and less social capital.

Noel King

Does the data bear it out? Because it feels like we’re more isolated now, and it felt that way when you wrote Bowling Alone 25 years ago. Is it true?

Robert Putnam

Yes. Once upon a time there was a debate, there was a thought that maybe we don’t actually have to be in somebody’s presence. That we could see them on Zoom or social media would be just as good as actual social connections. For quite a while, the evidence has been that Facebook is not as good as bowling leagues. That is, you don’t get the same benefit from connecting with people via social media as you do from actually connecting with them face to face. That’s what the evidence has shown. I can tell you when public opinion on that changed. It was just about November 25th of 2020, at the height of the pandemic, and everybody in America realized that hugging Grandma was not the same thing as actually seeing Grandma over Zoom. And it isn’t.

Noel King

People who might otherwise not leave the house very much join Reddit communities; people have WhatsApp chat groups with their relatives in other countries. I text my 14-year-old niece, who I don’t get to see very often. I hear you saying the technology has not been good for us and I want to make sure that we’re sure about that.

Robert Putnam

I’m not saying that electronic connections are of no use to us. I’ve got lots of grandchildren and I’m texting with them or emailing with them literally every day. I’m not saying that social media or other forms of electronic connection are literally no good, I am saying they’re not as good as face-to-face ties.

Noel King

So if, currently, we’re at a low point for social connection, what brought us here?

Robert Putnam

In the beginning of the 20th century, around about 1900, America was very polarized politically. Our politics were tribal. We were very unequal. There was economically a big gap between the rich, who were living on the Upper East Side of New York, and the huddled masses, the poor immigrants on the Lower East Side of Manhattan. We were very socially disconnected. We’d had connections back on the farm, where we knew other people, whether the farm was in Iowa or in southern Italy, but we’d all moved. There had been a huge movement from the rural areas to the cities, and we did not know our new neighbors, and so we were very socially isolated. And actually, we were culturally very self-centered. We were an “I society” rather than a “we society.” We didn’t think of ourselves as having a lot in common. And then beginning about 1910 — none of these things are super exact — but about 1910, all of those things began to change and they moved in a different, better direction for a half-century or more. So from roughly 1910 to roughly 1965 or 1970, every year we became less polarized politically, less socially isolated, less unequal, or more equal, and more of a “we” society.

So we went from being an “I” society around 1900 to being a “we” society around, roughly speaking, 1965. The movements of the 1960s — which you no doubt you don’t remember, [but] I do remember that period — that was the culmination of a half-century long increase in political participation, increase in connecting with other people, increase in cooperation across party lines, increase in equality. And I have to say, this is just about the time when I personally began to vote. So you may think I personally brought these problems on America in the middle ’60s. All those lines turned and for the next half-century, up to now, every year we got more socially isolated, more politically disconnected, more unequal. We lost it all.

Noel King

Could it work to sell joining clubs, volunteering, in-person engagement as, “This will make you feel good, I promise”? And the side effect is that it’s good for society, it’s good for democracy — but if you’re going to do it, do it for yourself? Think of it as a kind of self-care.

Robert Putnam

The danger to your life expectancy from social isolation is as big a risk factor for premature death as smoking. If you did smoke and you had a choice, should you smoke? Or should you join a club? By all means, join the club! There are huge personal benefits from connecting with other people, including joining. The most important reason is actually that you should connect with other people. You will add years to your life expectancy.

Noel King

You’re going to live longer. And also you’re going to save American society.

Robert Putnam

By the way, you’re also going to save American democracy. That’s right.

Black women on Kamala Harris and their party’s future

2024-08-22T17:16:14-04:00

Rapper Lil Jon (right) joins the Georgia delegation during the Ceremonial Roll Call of States during the Democratic National Convention in Chicago this week. | Chip Somodevilla/Getty Images

By now, you’ve probably heard the message loud and clear from Democrats: This election is all about unity.

The Today, Explained podcast team has been at the Democratic National Convention in Chicago this week, and inside and outside the perimeter of the United Center, Democrats are buzzing with exuberance and relief: They now believe they have a real shot at winning the White House in 2024, and the party’s toughest issues are not a welcome topic of conversation.

Tonight, after accepting the party’s nomination earlier in the week from the campaign trail, Kamala Harris will appear in Chicago to close out the convention, carrying the mantle of the “renewed sense of hope” that Michelle Obama — and the rest of the Democratic Party — have bestowed upon her.

First, though, Today, Explained sat down with three Black women delegates for Harris to ask about the thorniest challenges, from Gaza policy to identity politics, that Democrats will face in these next 11 weeks before Election Day.

The delegates are:

Illinois Lt. Gov. Juliana Stratton, 58
Hala Ayala, former Virginia State General Assembly member, 51
Mo Jenkins, precinct chair in Harris County, Texas, 25

All three committed to cast their votes for Harris and consider it their role to support and defend Democratic Party policies. But we picked at the party’s scabs a little bit and found that even the most faithful Democrats were willing to acknowledge that Black voters and nonvoters are no longer the assured bloc of support they have been for decades and that the Israel-Palestine conflict has caused a worrisome fissure between the official party and young progressives.

Here’s what they had to say. You can hear more of the discussion here on Today, Explained.

Gaza and the US policy on Israel remain an open sore for young progressives

Americans’ disapproval of Israeli military actions in Gaza eased this summer, but 48 percent still disapprove, according to a Gallup poll conducted in June. This week, thousands of protesters, mostly keffiyeh-clad and young, were waiting for Joe Biden and Kamala Harris — or “Genocide Joe and Killer Kamala,” to them — in Chicago. On Monday, they gathered at Union Park and marched along a circuitous route outside the convention center to demand that the US end aid to Israel. They will march the same route Thursday ahead of Harris’s acceptance speech.

It’s a live issue for many voters, but especially people like Hala Ayala, who is of Lebanese descent.

Ayala points out that Harris called for an “immediate ceasefire” back in March, and told us she’d met Harris and felt seen on the issue of Gaza. “I took that authentically because that’s who she is, and I took that as there’s more work to be done,” she said.

The issue of Gaza is also fraught for Gen Z politician Mo Jenkins. Nearly 50 percent of Democrats or Democratic-leaning young adults under 30 say they sympathize more with Palestinians than Israelis, according to Pew. That doesn’t always line up with the party’s loyalties: The Biden administration just approved the sale of $20 billion in arms to Israel over the next five years.

When her Black constituents complain to her about pro-Palestinian activists refusing to back a Black woman candidate for president or not paying enough attention to ignored wars in Sudan or Congo, Jenkins said she tells them that she needs to join the system in order to bring about change.

When they ask why she’s leaving them in the cold, her response is: “‘I’m not leaving you in the cold … We’re going to end up in the Arctic if I don’t do the work necessary to make sure that Donald Trump does not become president.’”

The Democratic Party no longer has the default support of Black Americans

It won’t be clear until after the election whether Black voters will turn out for Harris as they have for Democratic candidates in the past, but much has been made in recent months about flagging party support among Black Americans.

Data supports the idea that the once-reliable Dem bloc has splintered considerably since 2008, with more Black would-be voters saying they plan instead to cast a vote for former President Donald Trump. This was certainly true when Joe Biden was at the top of the ticket, and now, even with Harris as the Democrats’ candidate for president, a significant share of Black voters are still leaning toward Trump.

Seventy percent of Black voters polled in July picked Harris over Trump on a hypothetical ballot, up from 59 percent who backed Biden in May and June polls, according to Reuters/Ipsos polling. But Trump’s share of the Black vote also rose slightly, to 12 percent in July from 9 percent in May and June.

Ayala, the Woodbridge, Virginia-based delegate, says the party is well aware of this shuffling of allegiances: “Yeah, there’s been a separation [between Black men and women on politics]. We’ve seen it. Like, we can’t deny that.”

Jenkins said her Black male constituents in Houston often tell her they are voting for Trump “because he put a stimulus check in my hand.” She said she’ll remind them that their checks “got delayed because he wanted his name on it. … I think it’s a confusion about the policy process.”

Her concern is whether she and other Democrats can effectively set the record straight and make a case to enough of these Trump-interested Black voters ahead of Election Day.

Identity politics could be a stumbling block

This has been a very identity- and social justice-forward DNC. That is a realm Kamala Harris is comfortable in, but it also raises the question for Democrats: Will a focus on identity help them win the White House in November?

Many analysts have urged the Harris campaign to avoid talking outright about her race and gender. We asked our roundtable about the theoretical 49-year-old white man in Michigan, a toss-up vote who has voted Democrat in the past. Will Harris talking about her identity as a Black and South Asian woman undermine her chance of getting his vote?

Stratton, the Illinois lieutenant governor, said emphatically that the Democratic Party also needs to talk about economic issues that impact the whole middle class, to draw voters like him in with discussions of “workers’ rights and making sure that we stand with organized labor. There are a number of things that we’re going to have to lay out when we talk about reducing gas prices and food prices and all of those other things.

“Those are things that everyday Americans are going to want to know.”

This story originally appeared in Today, Explained, Vox’s flagship daily newsletter. Sign up here for future editions.

The Chicago DNC everyone wants to forget

2024-08-20T11:57:22-04:00

The United Center in Chicago, Illinois, on August 16, 2024, ahead of the start of the Democratic National Convention on August 19. | John Moore/Getty Images

Chicago is hosting the Democratic National Convention (DNC) this year. It’s a return to the city for Democrats, who hosted an infamous convention there in 1968 that descended into riots in the street and chaos on the convention floor.

That year, Americans, and especially Democrats, were up in arms over the US involvement in the Vietnam War. Democratic presidential candidate Robert F. Kennedy had been assassinated earlier that year, and the party entered the convention divided between pro- and anti-war candidates (Hubert Humphry and Eugene McCarthy, respectively). And unlike a contemporary major-party convention, 1968 wasn’t a coronation of one candidate: It would come down to how the delegates voted.

This year, protesters are out in force to raise their voices against the US involvement in the war in Gaza. Two young activists we spoke with even mirrored language from 1968, saying, “The whole world is watching.” Thousands are marching across downtown Chicago today. With that in mind, Today, Explained reached out to historian, journalist, and Chicago resident Rick Perlstein to ask whether 2024 risks a repeat of the disaster of 1968.

Listen to the full conversation and follow Today, Explained on Apple podcasts, Spotify, Pandora, or wherever you find podcasts.

This conversation has been edited for length and clarity.

Noel King

Let’s go back to the summer of ’68. What was the backdrop to the convention in August of that year?

Rick Perlstein

The Democratic Party was divided down the middle on the issue of the Vietnam War.

[The party’s infighting was] escalated by a Democratic president, Lyndon Johnson, who believed [that by supporting the war] he was continuing the wishes of the martyred president, John F. Kennedy. A lot of Democrats saw [the war] as part of this great anti-communist crusade, and a lot of people saw it as imperialism — that we were interfering in another country’s civil war. The idea that we had to get out was very prevalent on the left wing of the Democratic Party.

Johnson decided he wasn’t going to run for president. So by the time delegates arrived at the convention, Johnson’s loyal vice president, Hubert Humphrey, was the nominee apparent. He had been coerced into loyally supporting the war, even though he had grave reservations about it. The question of whether he would be nominated or Eugene McCarthy [a Minnesota senator who was vocally anti-war] would be nominated was live in the air. It looked like Humphrey had it wired, but [the struggle between the two men] was kind of a proxy fight.

At the same time, protesters from all over the country flooded in. There’s a separate Chicago context. Several months earlier that spring, there had been terrible riots [on the city’s south and west sides] after the assassination of Martin Luther King. There had been an anti-war rally a couple of weeks later, and there were terrible beatings [by police]. So there was dread and anticipation: What would happen when the city hosted thousands of protesters who were much more radical than the kind of protesters we see now? And everyone arrives in this city, which is run by this almost oligarchic mayor, Richard J. Daley, who intended no disorder in his city that he was putting on display for the entire world.

Noel King

Disorder came anyway. Tell me two things: What did Daley do to try to prevent disorder, and how did it go so very wrong?

Rick Perlstein

One of the things he did to try to prevent disorder was to string along these two groups of protesters who wanted to come to the city by not granting them official permission to sleep in Lincoln Park. And that was the intention of the group who identified themselves as “hippies.” Their idea was they represented this new youth identity that was revolutionary and was going to completely overthrow bourgeois propriety.

And another group of people wanted to parade to the convention hall, and they were much more conventionally political. A lot of them were radical revolutionaries and the kind of people who would hoist flags of the enemy in Vietnam, the Viet Cong.

Daley put his foot down and said these long-haired miscreants aren’t going to get the time of day in our city, which only ratcheted up the tensions and made them even more determined. The protesters essentially said: “We’ll sleep in the park even if you don’t want us to. We’ll march to the convention hall even if you don’t want us to. We’ll put our bodies on the line, in both cases.”

Noel King

When did the violence begin?

Rick Perlstein

Immediately. The first night of the convention, the police came to this park, Lincoln Park, on the lakefront and started rousting the people who were trying to sleep there. An impromptu confrontation [with] the police happened. That was when a young person started chanting, “The whole world is watching” as the cops started beating up hippies. A fellow named Tom Hayden, one of the leaders of the revolutionary contingent, was arrested. His comrades tried to march to the police station in solidarity with him. The guy who was running the countercultural part of it, Abbie Hoffman, joined the march. He wrote on his forehead a four-letter word starting with F, so he could subvert the images on TV, a media guerrilla warrior.

Later, the protesters wanted to walk the several miles [from Lincoln Park] to the convention hall and the city didn’t want them to do it. So there was this mounting tension.

The last day of the convention was Thursday, and that’s when they said, we’re going to walk to the convention come hell or high water. Mayor Daley says, no way. Meanwhile, his police, who have been seething since April, were feeling an itchy trigger finger. There was all kinds of fearful rhetoric on both sides.

Abbie Hoffman had promised that he was going to dump LSD into the Chicago water supply, which was a joke — it turns out there was not enough LSD on earth to affect the water supply — but the upright burghers of Chicago are terrified. And Tom Hayden would say things like, “If blood is going to flow, it should flow all over the city.” By which he meant if there are attacks on protesters, we should go in all the neighborhoods. But that was interpreted as an intent to attack innocent people all over the city.

You had this kind of enveloping dread leading up to the last day of convention, even as the debates over the platform are leading to actual violence inside the convention hall, including the arrest of Dan Rather, the CBS news correspondent, and all sorts of shoving and pushing and questions of what kind of credentials people would need, people getting beaten up for bringing protest signs inside the hall. So you had kind of these miniature civil wars breaking out inside among the actual credentialed delegates and outside among protesters and police.

Noel King

What exactly was going on inside the convention and how rowdy did it actually get?

Rick Perlstein

The most dramatic thing that happened inside the convention hall is that that Thursday night, when students were denied the right to march to the convention hall, they sat down right in front of [The Hilton Chicago] and police just started wading into the crowd and bashing people on the head. Word got into the convention hall that that was what was happening. They were doing the final vote for who would get nominated as president. There was a third candidate — George McGovern, who later won the nomination in 1972 — he was nominated by a liberal senator from Connecticut, Abraham Ribicoff. And Ribicoff said if George McGovern was the president of the United States, “We would not have to have Gestapo tactics in the streets of Chicago.” And when he said that, Mayor Daley shouted something you could not hear. Later, lip readers famously said that he had said Senator Ribicoff was “a no-good Jew bastard.”

Noel King

What else was going on outside the convention center?

Rick Perlstein

The marchers massed several miles down from the convention hall. The police are standing in the street in their way. The protesters try to walk around the policemen, and the policemen chase them back across the street. Next, the students did a sit-in strike, blocking the street right in front of the TV cameras, and hundreds of white-helmeted Chicago police just methodically started taking their nightsticks and beating these seated protesters. Police wagons lined up and they would grab young people by the scruff of their necks and throw them into police wagons. When there were enough for them to be full, they would throw a tear gas canister inside, and then smack the door closed.

This was all on TV. It was on all three channels. And there was this terrible backlash. The majority of the country very much believed that the Chicago police were in the right and the protesters were in the wrong. That was the very backlash against the forces of civil rights and anti-war activism and cultural shifts that Richard Nixon was running for president on, as the Republican candidate.

Noel King

We decided to do this episode about the ’68 convention months ago, even before this year’s convention seemed exciting, because we kept reading in op-eds, “The DNC is in Chicago. 2024 is like 1968.” How much do you believe that to be true? And what is causing people to make that comparison?

Rick Perlstein

Until I started getting these calls from folks like you, it never occurred to me to understand the 2024 convention in my city, Chicago, by going back to what I studied and wrote [about] 1968. To me, everything from how presidents get chosen now compared to then; how protests in the street work now compared to then; how politicians respond to protests; how the entire apparatus of law enforcement and security work compared to then; how Chicago works, are just so different.

One of the things that made 1968 so shocking and galvanizing was that you could go into a convention and you didn’t know whether the presidential candidate was going to be Hubert Humphrey or Eugene McCarthy. Part of what the protesters were trying to do was influence how the convention would come out. Maybe there was a glimmer of possibility that that might have happened before the Democratic Party lined up behind Kamala Harris and Tim Walz.

History is a process, it’s not parallels. We can’t have 1968 again because we already had 1968. A lot of the things that happened in 1968 are inconceivable in 2024. It doesn’t mean that interesting and even melodramatic and even possibly violent things might not happen in 2024, but those will happen for 2024 reasons. Those won’t happen for 1968 reasons.

Correction, August 20, 12 pm ET, 2024: A previous version of this post misstated the last time the convention was held in Chicago.

Why Israel can’t destroy Hamas

2024-05-29T15:28:06-04:00

Palestinians fled to safe areas with what they could take with them following the Israeli army attack on a refugee tent encampment in al-Mawasi area in Rafah, Gaza, on May 28, 2024. | Ashraf Amra/Anadolu via Getty Images

The calls for a ceasefire in Gaza are getting louder around the world. In Canada, Foreign Minister Melanie Joly just added her voice, saying “The level of human suffering is catastrophic.” The International Court of Justice has called on Israel to immediately halt its offensive in Rafah just a few days after Spain, Norway, and Ireland recognized an independent Palestinian state.

That happened just a few days before an Israeli airstrike in Rafah on Sunday killed dozens of Palestinian refugees. Israel called the strike a “tragic mishap” but says the strike also managed to kill two Hamas officials.

Israeli Prime Minister Benjamin Netanyahu has repeatedly said that a top goal of his war in Gaza is to eliminate the leadership of Hamas, but Israel is nowhere close to doing so. The top leadership of Hamas is still intact.

Today, Explained co-host Sean Rameswaram reached out to Mairav Zonszein, a senior Israel analyst with the International Crisis Group, to talk about the situation. Listen to the full conversation and follow Today, Explained on Apple podcasts, Spotify, Pandora, or wherever you find podcasts.

This conversation has been edited for length and clarity.

Sean Rameswaram

Can you tell us why Israel has failed to destroy top Hamas leadership?

Mairav Zonszein

When you get down to the nitty-gritty of how the Israel Defense Forces defines the war goals, they specifically talk about taking away the governing and military capabilities of Hamas. We’ve heard a lot of very incendiary rhetoric — destroying Hamas, destroying Gaza — but when you actually break it down, they want to remove Hamas as a power in the Gaza Strip. And they largely haven’t been able to do that.

There’s two main reasons for that.

One is that it’s very difficult to take apart a non-state terror group that has taken root inside a very small, urban, densely populated area when they’ve been there for almost 20 years. Hamas has taken many, many hostages; to this day there are over 100 hostages still in Gaza. It seems pretty likely that the Israeli military has had a difficult time getting to Hamas leadership and key players because they probably are surrounded by hostages. And as much destruction and devastation and killing that we’ve seen, I think there would have been probably even more if those hostages weren’t there and they wouldn’t have to worry about that collateral damage.

So that’s one main reason. The other is that Netanyahu specifically had a very clear policy of keeping Hamas in power and also of trying to contain Hamas, because Hamas is a very good excuse for Israel to continue on its path of settlement, expansion, occupation, and rejection of a Palestinian state.

As long as Hamas is there, Israel doesn’t have to get into any kind of peace process, any kind of serious political negotiation. It doesn’t have to take the Palestinian demands for a state, for liberation, for rights as seriously. Even if we assume that Netanyahu is committed to getting rid of Hamas, he has an interest in staying in power now, and the best way to stay in power is to keep the war going on and on.

Sean Rameswaram

Has it worked at all? Have they gotten any of Hamas’s top leadership?

Mairav Zonszein

They’ve gotten to some of the senior commanders in charge of certain aspects of the military wing of Hamas, but nobody in the inner circle who makes the decisions. And they are very interested in getting to those people, not just because they’re the people making the decisions, but because of revenge, that they need to take these people out in order to have at least a symbolic victory.

Sean Rameswaram

It sounds like you’re saying that it’s not really plausible to fully eradicate Hamas. Is that what you’re saying?

Mairav Zonszein

Yes, and there’s a few reasons for that.

First of all, you have the strongest military in the Middle East fighting for almost eight months now. Let’s say half of the casualties — which is over 35,000 — let’s say half of those are Hamas militants, it’s still not a number that can really take apart an organization necessarily. Maybe it’s enough to not allow Hamas to operate as a military anymore or to attack Israeli border communities anymore. That’s possible. I think the war goals and the rhetoric were way higher than Israel could have made good on. They promised things that they just couldn’t deliver on.

Sean Rameswaram

How does the United States feel about Israel’s strategy with Hamas at this point?

Mairav Zonszein

In some ways, President Biden has been talking out of two [sides] of his mouth. The US has fully supported Israel — diplomatically, politically, economically, militarily — throughout this war. It also purportedly supports Israel’s war goals of getting the hostages back and destroying Hamas. But how Israel has waged its war is where certain former generals and certain Biden administration people have said, you could do it in a different way.

As this war has gone on, I think the US — and to some extent in Israel as well — were probably surprised that they didn’t make more inroads. As the election year in the US started, they started to realize that they really need to at least provide the appearance of making things better on humanitarian issues.

The US has come out and said, You need to have a better plan, you have to figure out who’s going to take over. The US and pretty much all of Netanyahu’s war cabinet has come out saying, Even where you have been able to take out Hamas, you have nothing to fill that vacuum. There’s no alternative. You’ve rejected any kind of plan. I think the US is very frustrated with the fact that there’s no exit strategy, no end game, and no political postwar vision for Gaza.

Sean Rameswaram

How are Palestinians feeling about Hamas at this point?

Mairav Zonszein

Before October 7, the highest death rate for Palestinians in 20 years was happening in the West Bank. You have settler militias, you have total restrictions on freedom of movement. They’re in a very precarious and horrible place. And the Palestinian Authority that runs certain aspects of life in certain areas of the West Bank has become pretty much complicit in Israel’s occupation, so they don’t have anyone representing them.

So Hamas represents the only entity that has challenged Israel on its very violent and systematic repressive policies. Now, that doesn’t mean that people love all of Hamas’s tactics, but Hamas is the only entity that has stood up to Israeli impunity. I think in some ways Israel was hoping that the worse it got for Gazans, the more they would rise up against Hamas. Maybe they were hoping for chaos that would create such havoc that Hamas would have to concede power.

Sean Rameswaram

Is it all but certain that Hamas will still be standing come the end of this war?

Mairav Zonszein

It’s hard for me to predict because some people in Israel — even putting aside Netanyahu — are really committed to removing Hamas from power, even if it takes years, even if Israel has to be in rolling operations and some form of occupation for many years.

You have a real security issue and an internal domestic crisis, that Israelis have lost total confidence in the ability of the state to protect them. And that’s a real issue that the political and the military echelon need to deal with. So they’re committed to removing Hamas at some level. But there’s also a reality to deal with, and I think some military intelligence officials have already understood that Hamas will remain there on some level.

The question is, how do you leverage that, or maneuver that, in a way that works? Even if the Hamas current regime somehow surrenders or is exiled or removed at the end of this, there’s still going to be Hamas people, Hamas approaches, and Hamas ideology.

The Palestinian issue was pushed under the rug, US presidents have completely denied that it is an issue, Israeli prime ministers and consecutive governments and Israeli society have decided that it’s not an issue they need to deal with.

That hubris and that impunity led us in many ways to October 7, so that’s something that Israelis are going to have to reckon with now. The world is reacting very strongly to years of occupation with no price to pay and unfortunately, the price now is very, very high.

Correction, May 29, 3:30 pm ET: A previous version of this post included a line suggesting that support for Hamas is rising. While it remains high, support is not rising.

Student protests are testing US colleges’ commitment to free speech

2024-05-24T09:56:40-04:00

Columbia University students participate in an ongoing pro-Palestinian encampment on their campus following last week’s arrest of more than 100 protesters, on April 25, 2024 in New York City. | Stephanie Keith/Getty Images

Student protests are heating up around the country, just as the school year is winding down.

At Columbia University in New York, a deadline is nearing for the administration to clear the student encampment off the campus lawn. The NYPD chief of patrol defended his department’s actions earlier this week in arresting over 100 student protesters on campus, writing “Columbia decided to hold its students accountable to the laws of the school. They are seeing the consequences of their actions. Something these kids were most likely never taught,” in a post on X.

But the root of all the arrests and protests at Columbia is, arguably, free speech. In testimony before the House Committee on Education and the Workforce in Washington, DC, last week, Columbia President Minouche Shafik struggled to walk a line between ensuring student safety and protecting academic freedom. “We believe that Columbia’s role is not to shield individuals from positions that they find unwelcome,” she said, “but instead to create an environment where different viewpoints can be tested and challenged.”

In light of the fierce debate over campus speech and student safety, Today, Explained reached out to the president of the American Association of University Professors (AAUP) Irene Mulvey to get her view on the state of free speech on college campuses. AAUP is a nonprofit organization comprising faculty and other professionals in academia whose stated mission is to protect academic freedom and support higher education as a public good. Mulvey shared her insights into whether Columbia and other institutions where crackdowns of protests are happening are living up to those ideals.

This conversation has been edited for length and clarity. —Miranda Kennedy

Sean Rameswaram

Has protecting academic freedom and supporting higher education become more difficult since October 7?

Irene Mulvey

Yes, it has become more difficult since October 7. Although I would say our job of protecting academic freedom and protecting higher education from outside interference has always been difficult. There’s always been political interference into higher education, and that’s why we were founded. In the past, the interference into higher education has been targeting individual professors, you know, a wealthy donor doesn’t like somebody’s research and they want to get them fired. Or somebody speaks up at a faculty meeting, criticizing the administration and the administration doesn’t want them to get tenure.

What we’re seeing now is an escalation in that the entire enterprise of higher education as a public good in a democracy is being attacked. We’re seeing attacks at the state level with legislation that will censor content — we call these educational gag orders, where there’s legislation that says what can be taught in a college classroom. That’s just outright censorship and the kind of thing you see in an authoritarian society, not a democracy.

The House Committee on Education and the Workforce has dragged these presidents in front of the committee for a performative witch hunt of a hearing. And that is an escalation because those are private institutions. So it’s a remarkable escalation for the federal government to be intruding into what’s happening at private colleges.

To think about how professors are feeling about these protests, we need to think about how professors feel about higher education. And what professors are thinking [is] that in higher education, we should have a robust exchange of ideas in which no idea is withheld from scrutiny or debate.

Our students have very strong feelings about what’s happening in the Middle East. They are attempting to have that robust exchange of ideas about what’s happening. And I think as faculty members, we support that. Students on a campus, the students are learning from professors. They’re learning how to conduct research on their own. They’re learning how to analyze arguments. They’re learning how to think critically about complex matters.

And they have thoughts about what’s happening in the world [and] on their campuses, with regard to what their campuses are doing to support what’s happening in the Middle East. Faculty members are supportive of this. This is what academic freedom means.

Sean Rameswaram

So it sounds like you don’t support the president of Columbia University calling in the NYPD to make arrests at a peaceful protest.

Irene Mulvey

That’s an understatement. I think what the Columbia president did was the most disproportionate reaction that I’ve ever seen. My understanding is these were peaceful protesters on an outdoor lawn on a campus where they pay a lot of money to attend, and she had them deemed as trespassers and invoked a statute where she has to argue that they are a clear and present danger to the functioning of the institution in order to allow the NYPD on campus.

The most important thing is her response is doing the opposite of what’s supposed to happen on a campus. Her response silenced the voices of the students. Her response suppressed the speech and suppressed the debate. It’s the absolute opposite of what should happen on a college campus, and it was extremely disappointing.

Sean Rameswaram

If you had been in her position as the president of Columbia, and you were dealing with these protests and people [are] saying they feel unsafe, that there’s antisemitic slogans, that there was a protest outside where a Jewish student was told to go back to Poland, how would you have navigated these competing forces?

Irene Mulvey

Yeah, well, it’s not easy. Let’s be clear, there’s no easy answer to what’s going on here. But the principle behind anyone’s response should be education, should be speech, should be debate, should be ideas being put up for justification. And, you know, there could be some kind of forum for the students.

Of course, they have to protect the safety of all students. But if the way you’re choosing to keep students safe is by suppressing somebody else’s speech, that’s a false choice. You don’t have to suppress speech to keep students safe. I agree that these are difficult situations. And I know all of these campuses where these things are happening — Columbia, NYU, Yale — these campuses and these presidents will espouse academic freedom and free speech at the drop of a hat. But if you’re not standing up for those principles at times like these, then those words are completely meaningless.

Sean Rameswaram

It’s interesting because I think what we’re seeing here is the clearest evidence that we haven’t quite figured out where the line is on protecting students versus free speech versus the open discussion of ideas. I think the president of Columbia, Minouche Shafik, made that point in an op-ed in the Wall Street Journal, that universities haven’t figured this out. The Supreme Court hasn’t figured this out, and it shouldn’t be on universities to figure this out.

Do you have some idea of where the line is between the open academic discussion of ideas and something that could be dangerous for students and thus not permitted?

Irene Mulvey

The way to think about it is in situations like this where there are polarized views, there are really strong feelings for very good reasons. Not all the speech is going to make you comfortable. Academic freedom and free speech can be messy. And so I think you have to err on the side of allowing the speech and allowing the debate and allowing the discussion. When it veers into something that doesn’t feel good, then someone should speak up and say that. But silencing voices because you don’t like what they’re saying is a very dangerous, slippery slope that we do not want to get onto.

Sean Rameswaram

One thing I’ve found heartening following these protests on college campuses for six months is that they’ve mostly been peaceful. Now, that being said, if I’m a Jewish student walking across campus and someone says, “Go back to Poland!” I might start to feel unsafe. If I’m a Muslim student and someone’s doxxing me because of my attending a protest, I might start to feel unsafe. How do college administrators navigate safety, which feels sort of amorphous sometimes, in a free-speech environment?

Irene Mulvey

Administrations — universities — have an obligation to address issues of harassment and hate speech through their policies that have been in place for decades. Because hate speech didn’t just arrive on campus since October 7. We’ve had to address issues like this for decades. So campuses have policies to address issues like that, and their obligation is to keep the campus safe.

For the most part, I feel the protests that I’ve seen have been peaceful. But again, it’s a messy situation. The important way to handle it is to stand back on principles of academic freedom, free speech, and keeping the campus safe, and addressing issues of hate speech through policies that are developed with the faculty.

Sean Rameswaram

You were a professor of mathematics for 40 years — for four decades. I imagine before that, maybe you were a student at a college protest, trying to voice your opinion and embracing free speech. Do you think with all the perspective that you have that this is just a rough patch that we get over and we’re stronger because of it? Or do you think we’re really going to get bogged down here?

Irene Mulvey

Oh, that’s a good question. I did participate in protests as a student during the Vietnam War. I was in high school. But this is definitely a rough patch. And where we come out on the end of it is an open question.

I think what’s happening is part of an agenda to control what happens on campus, not just about the history and policies of Israel. What’s happening now is part of a larger movement, the anti-DEI movement, the anti-CRT movement, which is intended to censor or control what can be learned in a college classroom and what can be taught on campus. I think that’s the real danger, that broader movement, which I think would really damage higher education and the role it’s supposed to play in a democracy — to be a check and balance on politics.

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