Government assistance and economic theory

Do social welfare programs help or hinder the economy? Explain how your answer is a Keynesian or Smithian. 2 paragraphs(3 pages). JK Rowling the author of the Harry Potter series who is one of the world′s richest people. Her net value is $910 million. She ranks in Forbes magazine to be #78 most powerful women in the world. Please incorporate some ideas from the readings from chapter 15 attached. 

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15Domestic Policy

L E A R N I N G O B J E C T I V E S

After reading this chapter, you will be able to:

■ 15.1 Define public policy and describe the policy- making process as it applies to American national government institutions.

■ 15.2 E xplain the principles underlying the American health-care system and the issues facing that system.

■ 15.3 Describe the environmental policies of the United States and the role of the Environmental Protection Agency in implementing these policies.

■ 15.4 Analyze American energy policy and discuss how it encourages energy independence.

■ 15.5 Describe the national policies for ending pover t y in the United States and alleviating the issues caused by economic downturns.

■ 15.6 Discuss the issues raised by immigration into the United States and the proposed reforms to the immigration system.

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What if…

Background In the United States, we have a private health-care sys- tem, but around 40 percent of Americans use government programs to pay for health insurance. That includes the senior citizens under Medicare, military veterans, perma- nently disabled Americans, children insured under the state–federal partnership program, and the poorest Americans who are covered under Medicaid, another joint state–federal program. The Patient Protection and Affordable Care Act, hereafter referred to as the Affordable Care Act (ACA), is a step toward universal health care but maintains the private health-care system. Although it requires that all Americans have health insurance, either purchased privately or through the federal or state govern- ment, it does not take control of private physicians, the prescription drug industry, or hospitals. Even after all pro- visions of the ACA are implemented, the United States will remain the only major industrialized democratic nation without a health-care system that guarantees equal access to basic health care for all citizens.

What If We Had Universal Health Care? With universal health care, everyone in need of basic medical care would have access to physicians, clinics, and hospital services. Every legal resident of the United States would receive free or nearly free medical examinations, routine phy- sician visits, well-baby care, and required tests. Most likely, prescription drugs would be available at very low cost to all Americans, regardless of their income or where they obtain their insurance. Such a health-care system would likely be paid for by a combination of taxes on workers and their employers and income taxes on all. Such a system might include the option for additional private insurance available for extra cost. Doctors might work for the state or national government, or they could remain as private practitioners.

How Does Universal Health Care Affect the Individual Patient? The National Audit Office of the United Kingdom (Great Britain, Scotland, and Wales) conducted a study of the health-care sys- tems in ten major industrialized nations in 2011, which under- scored the fact that all of these nations except the United States guaranteed universal health care. Different countries utilize various systems: Britain has state-employed doctors and state-run hospitals; France features national health insurance but private physicians who “bill” the state for their services.

Studies of universal systems show that for the average individual, good basic care is available. Infant mortality tends to decrease because all pregnant women have access to prenatal care. People with chronic diseases get more regular care and tend to do better at maintaining their health. Most nations cover the cost of prescriptions so that no individual is denied an expensive but necessary medication. However, in some nations there are long waits for advanced procedures and less availability of some of the more expensive tests and scans performed routinely in the United States. Some pro- cedures that are covered in the United States might not be covered under a national system, but it is difficult to general- ize across all nations. Americans have made clear their desire to keep their private physicians, private hospitals, and the right to access very expensive and advanced treatments. Whether Americans will be willing to trade these practices for a universal health-care system is a question yet to be decided.

We Had Universal Health Care?

For Critical Analysis 1. W hat are the advantages and disadvantages of a

universal health-care system?

2. How could the United States implement a universal health-care system and retain some of the features of the current system that are desired by citizens?

A mericans expect the federal government to pay attention to the issues that affect the lives of American citizens. The legislation and regulations passed to address these problems are usually called “domestic policy.” Domestic

policy can be defined as all of the laws, government planning, and government actions that affect each individual’s daily life in the United States. Consequently, the span of such policies is enormous. Domestic policies range from relatively

domestic policy Public plans or courses of action that concern internal issues of national importance, such as poverty, health care, and the environment.

C H A P T E R 1 5 ● D O M E S T I C P O L I C Y 525

simple issues, such as what the speed limit should be on interstate highways, to more complex ones, such as how best to reduce our nation’s contribution to cli- mate change or how to improve the performance of schools across the nation.

The question of providing health care to all Americans is a consuming national issue. In 2010, the United States adopted a major reform of our health policies, but Congress did not adopt a universal health-care system. The com- plex nature of the health policy reform legislation and the debate that accom- panied that reform effort reflect the fact that the reform will touch virtually all Americans. Like many other domestic policies, this one was formulated and implemented by the federal government but will involve efforts of federal, state, and local governments and the private sector.

This chapter looks at domestic policy issues involving health care, the environment and energy, poverty and welfare, immigration, and others. Before we start our analysis, though, we must look at how public policies are made.

The Policymaking Process ■ 15.1  Define public policy and describe the policymaking process as it applies to

American national government institutions.

How does any issue get resolved? First, the issue must be identified as a prob- lem. Often, policymakers simply have to turn on the news or look at the Internet or hear from a constituent to discover that a problem is brewing. On rare occa- sions, a crisis, such as that brought about by the terrorist attacks of September 11, 2001, or the destruction caused by Hurricane Maria in 2017, creates the need to formulate policy. Like most Americans, however, policymakers receive much of their information from the national media. Of course, interest groups are always bringing issues to the attention of Congress in hopes of influencing policy outcomes.

Consider the Affordable Care Act. President Obama made it a priority of his first year in office. The law, which was passed about 14 months later, requires all Americans to have health insurance, whether through their employer, state insurance exchanges, or a federal program such as Medicaid. Some provisions of the law took effect almost immediately, including the one that requires insur- ance companies to allow parents to keep their children on their policies until age 26. No matter how simple or how complex the problem, those who make policy follow several steps. We can divide the process of policymaking into at least five steps: agenda building, policy formulation, policy adoption, policy implementation, and policy evaluation (see Figure 15-1).

Agenda Building First, the issue must get on the agenda—Congress must become aware that an issue requires congressional action. Agenda building may occur as the result of a crisis, technological change, or mass media campaigns, as well as through the efforts of strong political personalities and effective lobbying groups.

Advocates for improved health care in this nation had called for a serious reform of the system for years. The Democratic majorities

Agenda Building (media, interest groups, social movements)

Policy Formulation (president, Congress, interest groups)

Policy Adoption (Congress, president)

Policy Implementation (executive branch, bureaucracy)

Policy Evaluation and Revision (scientists, executive branch, Congress)

Figure 15-1 ▸ The Policy Process

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in both the House and the Senate supported President Obama’s priority as they, under the leadership of the late Senator Ted Kennedy, had pushed for reform of the health system for many years.

Policy Formulation During the next step in the policymaking process, various policy proposals are discussed among government officials and the public. Such discussions may take place in the printed media, on television, and in the halls of Congress. Congress holds hearings, the president voices the administration’s views, and the topic may even become a campaign issue.

With the Democratic majorities in Congress beginning work on the legislation, Republicans quickly took the position that they opposed the reform bill, but they lacked the votes in either house to change the momentum. Interest groups, seeing that the bill had a chance to become law, offered their own proposals. As the policy was being formulated, groups represent- ing America’s doctors, hospitals, pharmacies, medical appliance makers, pharmaceutical manufacturers, and every other part of the medical industry, offered proposals and commented on the draft legislation. In some cases, groups agreed not to oppose the law if their interests were protected.1 The input of these groups into the policy formulation process is invalu- able: they know more about the health-care system than any member of Congress.

Policy Adoption The third step in the policymaking process involves choosing a specific policy from among the proposals that have been discussed. In the end, the bill passed both houses, although the margin in the Senate was very small. The progress of the bill through Congress revealed some of the intense partisan behavior that has become common in recent years. Republicans put forward alternative proposals and claimed that they were ignored by the administration and the Democrats. Democrats used all parliamentary means to pass the bill, including keeping the Republicans out of the final negotiations between the House and the Senate. This, of course, was exactly how Republicans had treated Democrats in passing the Medicare prescription drug bill in 2006.

Policy Implementation The fourth step in the policymaking process involves the implementation of the policy alternative chosen by Congress. Government action must be implemented by bureaucrats, the courts, police, and individual citizens. In the example of the Affordable Care Act, the main portion of the legislation was not to come into effect until 2014. For the most part, therefore, implementation did not begin immediately. Some sections of the bill did become effective in 2011, however, including the creation of insurance pools for people with existing conditions, new taxes on wealthier retirees for their prescription drug coverage, dependents’ eligibility for their parents’ health insurance until up to age 26, and support for the creating of electronic medical records. The actual requirement to have health

1 Lawrence R. Jacobs and Theda Skocpol, Health Care Reform and American Politics: What Everyone Needs to Know, Revised and Updated, 2nd ed. (New York: Oxford University Press, 2012).

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insurance took effect in 2014. The troubled roll-out of the federal health insurance exchange website in the fall of 2013, however, became the most noticed part of the implementation process. Republican opposition to the law did not abate, and it became a major campaign issue in every federal election that has followed. Although Republicans did gain a major- ity in the House of Representatives in that election, they could not over- turn the bill without gaining control of the Senate. However, a number of states elected Republican administrations, and 26  Republican attorneys general filed suit against the bill, challenging the individual mandate to buy insurance and the provision requiring states to expand their Medicaid rolls. The individual mandate was upheld by the Supreme Court in 2012, but the Medicaid mandate to the states was overturned, leaving that part of the law unenforceable.

Policy Evaluation After a policy has been implemented, it is evaluated. Groups conduct studies to determine what actually happens after a policy has been in place for a given period. Based on this feedback and the perceived success or failure of the policy, a new round of policymaking initiatives will be undertaken to improve on the effort. Because the Affordable Care Act has not been fully implemen- ted, there has been little evaluation of the policy’s outcomes. Some health industry economists and the Congressional Budget Office have suggested that the cost will be far higher than originally estimated, whereas other sources predict it will save billions over the long term. Some believe that many small businesses will drop insurance coverage for their employees due to the high cost of the new program, but these are simply predictions for the future. As of 2016, data reveal that many more families and individuals have found health insurance coverage through Medicaid; however, premium increases for those who buy their own insurance through the state exchanges have been signific- ant. With the penalty for not having insurance still being fairly low, many younger and healthier Americans still have no insurance coverage. It will be the job of future legislators and members of the administration to propose reforms to the Affordable Care Act.

Health Care ■ 15.2 E xplain the principles underlying the American health-care system and the

issues facing that system.

Undoubtedly, one of the most important problems facing the nation is how to guarantee affordable health care for all Americans at a cost the nation can bear. Spending for health care is estimated to account for about 18 percent of the total U.S. economy. In 1965, about 6 percent of our income was spent on health care, and that percentage has been increasing ever since, exceeding 17.5 percent by 2014 and projected to reach 20 percent by 2020. Per capita spending on health care is greater in the United States than almost anywhere else in the world. Measured by the percentage of the gross domestic product (GDP) devoted to health care, America spends almost twice as much as Australia or Canada (see Figure 15-2). (The GDP is the dollar value of all final goods and services produced in a one-year period.)

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The Rising Cost of Health Care Numerous explanations exist for why health-care costs have risen so much. At least one has to do with changing demographics—the U.S. population is get- ting older. Life expectancy has gone up, as shown in Figure 15-3. The top 5 percent of those using health care incur more than 50 percent of all health-care costs. The bottom 70 percent of health-care users account for only 10 percent of health-care expenditures. The elderly make up most of the top users of health-care services, including nursing home care and long-term care for those suffering from debilitating diseases.

Advanced Technology Another reason why health-care costs have risen so dramatically is advancing technology. A magnetic resonance imaging (MRI) scanner can cost more than $2 million. A positron emission tomography (PET) scanner costs approximately $4 million. All of these machines have become increasingly available in recent decades and are in demand around the country. The development of new technologies that help physicians and hospitals pro- long human life is an ongoing process in an ever-advancing industry. New procedures and drugs that involve even greater costs can be expected in the future. It is also true that these advanced procedures are more readily available in the United States than anywhere else in the world.

The Government’s Role in Financing Health Care Currently, govern- ment spending on health care constitutes about 43 percent of total health-care spending. Private insurance accounts for about 33 percent of payments for health care. The remainder is paid directly by individuals or by philanthropy.

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Figure 15-2 ▸ Costs of Health Care in Economically Advanced Nations Cost is given as a percentage of total gross domestic product (GDP).

Source: Organization for Economic Cooperation and Development, OECD Health.

C H A P T E R 1 5 ● D O M E S T I C P O L I C Y 529

Medicare and Medicaid have been the main sources of hospital and other medical benefits for more than 100 million U.S. residents, including 47 million Americans over 65 and 61 million others.

Medicare is specifically designed to support the elderly, regardless of income. Medicaid, a joint state–federal program, is in principle a program to subsidize health care for the poor. In practice, it often provides long-term health care to persons living in nursing homes. (To become eligible for Medicaid, these individuals must first exhaust their financial assets.) Medicare, Medicaid, and private insurance companies are called third parties. Caregivers and patients are the two primary parties. When third parties pay for medical care, the demand for such services increases; health-care recip- ients have no incentive to restrain their use of health care. One result is some degree of wasted resources.

Medicare The Medicare program, created in 1965 under President Lyndon B. Johnson, pays hospital and physicians’ bills for U.S. residents age 65 and older. Beginning in 2006, Medicare also pays for at least part of the prescription drug expenses of the elderly. In return for paying a tax on their earnings (cur- rently set at 2.9 percent of wages and salaries) while in the workforce, retir- ees are assured that the majority of their hospital and physicians’ bills will be paid for with public funds.

Over the past 40 years, Medicare has become the second-largest domestic spending program, after Social Security. Government expenditures on Medicare have routinely turned out to be far in excess of the expenditures forecast at the time the program was put into place or expanded. Chapter 16

Medicare A federal health insurance program that covers U.S. residents age 65 and older. The costs are met by a tax on wages and salaries.

Medicaid A joint state–federal program that provides medical care to the poor (including indigent elderly persons in nursing homes). The program is funded out of general government revenues.

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Figure 15-3 ▸ Life Expectancy in the United States Along with health-care spending, life expectancy has gone up. More Americans are living longer due, in great part, to advances in medi-

cine. Immunizations have decreased death from many diseases, allowing more children to reach adulthood.

Source: Social Security Administration, Office of the Chief Actuary.

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discusses Medicare’s impact on the current federal budget and the impact it is likely to have in the future. For now, consider only that the total outlays on Medicare are high enough to create substantial demands to curtail its costs.

One response by the federal government to soaring Medicare costs has been to impose reimbursement caps on specific procedures. To avoid going over Medicare’s reimbursement caps, however, hospitals have an incentive to discharge patients quickly. The government has also cut rates of reimburse- ment to individual physicians and physician groups, such as health mainten- ance organizations (HMOs). One consequence has been a nearly 15 percent reduction in the amount the government pays for Medicare services provided by physicians.

Medicaid In a few short years, the joint federal–state taxpayer-funded Medicaid pro- gram for the “working poor” has generated one of the biggest expansions of government entitlements in the last 50 years. In 1997, Medicaid spend- ing was around $150 billion. By 2014, it tripled to $495 billion. At the end of the last decade, 34 million people were enrolled in the program. Today, there are more than 60  million. The increase in unemployment after the financial crisis of 2008 increased the number by 15 percent. When you add Medicaid coverage to Medicare and the military and federal employee health plans, the government has clearly become the nation’s primary health insurer. More than 100 million people—one in three—in the United States has government coverage.

Why Has Medicaid Spending Exploded? The Medicaid program has expanded over time by making more individuals and families eligible for the health insurance. Children of families making up to $46,100 per year are eli- gible for CHIPs, the health insurance program for children. As the population ages, more senior citizens are being served in nursing homes and assisted living facilities. Almost 10 million senior citizens who have limited means are now Medicaid patients. Medicaid will continue to expand over the next few years as the provisions of the Affordable Care Act take effect. For the states that have chosen to be in the federal program, eligibility for Medicaid now extends to households making 133 percent of the poverty level. The Supreme Court ruling made participation in that part of the Affordable Care Act volun- tary, so not all states have this new eligibility level.

Medicaid and the States On average, the federal government pays almost 60 percent of Medicaid’s cost; the states pay the rest. Certain states, particu- larly in the South, receive even higher reimbursements. For those states that have accepted the new eligibility level under the Affordable Care Act, the expanded enrollment will be reimbursed by the federal government completely for a few years, with a reduction in the federal share to 90 percent by 2020. States that have accepted the new plan are satisfied that the federal reim- bursement will help their bottom line. In general, the states have been finan- cially stressed by the increase in Medicaid expenditures over the last two decades. Many states have changed their eligibility rules and their reimburse- ments to health providers to try to balance their budgets. The federal govern- ment, in paying 100 percent of the bill for the new enrollees, is trying to help the states with their Medicaid budget issues.

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The Uninsured One of the driving forces for the passage of the Affordable Care Act was the  fact that more than 49 million Americans—about 18.5 percent of the population—have not had health insurance. Because about half of all working Americans have health insurance through their employers, the recession of 2008 and the loss of jobs added about 4 million Americans to the ranks of the uninsured. The primary goal of the Affordable Care Act is to make health insurance available through the federal or state exchanges to this population through a combination of incentives (subsidies) and penalties: if a person does not have health insurance, he or she will have part of his or her income tax refund withheld as a penalty. There are, however, a number of ways that an individual or family can request an exemption from the penalty.

Being uninsured has negative health consequences. People without cover- age are less likely to get basic preventive care, such as mammograms; less likely to have a personal physician; and more likely to rate their own health as only poor or fair.

A further problem faced by the uninsured is that when they do seek med- ical care, they must usually pay much higher fees than would be paid on their behalf if they had insurance coverage. Large third-party insurers, private or public, normally strike hard bargains with hospitals and physicians over how much they will pay for procedures and services. The uninsured have less bar- gaining power. As a result, hospitals attempt to recover from the uninsured the revenues they lost in paying third-party insurers.

In any given year, most people do not require expensive health care. Young, healthy people in particular can be tempted to do without insurance. One benefit of insurance coverage, however, is that it protects the insured against catastrophic costs resulting from unusual events. Medical care for life-threatening accidents or diseases can run into thousands or even hun- dreds of thousands of dollars. An uninsured person who requires this kind of medical care may be forced into bankruptcy.

Image 15-1 A doctor uses his tablet to show test results to the patient.

The bedside use of technology is

paired with electronic records that

can be accessed by the patient’s

doctors and by the patient herself.

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The 2010 Health-Care Reform Legislation On March 23, 2010, after a long and intense battle in Congress, President Obama signed the Patient Protection and Affordable Care Act, the biggest reform of the American health-care and health insurance system since the approval of Medicare in 1965. The new legislation relies on a combination of private insurance, public programs such as Medicare and Medicaid, and new state-based nonprofit health exchanges to provide health insurance coverage to almost all Americans.2 By 2017, the number of uninsured nonelderly people in the United States dropped from nearly 43 million to 28 million, or about 10.3 percent. The Kaiser Family Foundation reported that about half of the uninsured said the cost was too high.3 According to their data, the greatest gain in the insured population was among poor and low-income households. Hispanic and African American households were more likely to gain insurance than white households. Most of these gains were due to the increased enrollment of individuals and families in the Medicaid program under the higher income levels. Clearly, the ACA has benefited the less advantaged members of the community. The Trump administration sought repeal of the ACA but Congress did not accomplish this. The American health-care program as it passed the Congress is not like the types of programs adopted in many European countries or in Canada. Western Europe, Japan, Canada, and Australia all provide systems of universal coverage through national health insurance. The government takes over the economic function of providing basic health-care coverage. Private insurers are excluded from this market. The government collects premiums from employ- ers and employees on the basis of their ability to pay and then pays physicians and hospitals for basic services to the entire population. Because the govern- ment provides all basic insurance coverage, national health insurance systems are often called single-payer plans or socialized medicine. Only health insur- ance is socialized. The government does not employ most physicians, and in many countries the hospitals are largely private as well.4

Environmental Policy ■ 15.3 Describe the environmental policies of the United States and the role of the

Environmental Protection Agency in implementing these policies.

Sixty years ago, Rachel Carson published Silent Spring, the book that can be credited with starting the contemporary environmental movement in the United States.5 Carson’s book called attention to the consequences of wide- spread use of pesticides and other chemicals that are dispersed into the water- ways and have deadly effects on fish and wildlife. Eight years later, the first Earth Day was celebrated. Later that same year, President Nixon proposed and the Congress approved the creation of the Environmental Protection Agency (EPA), an independent executive agency charged with protecting the environment and human health. Since that time, Americans have paid

2 There are many good summaries of the new legislation. Among these is one provided by the Georgetown University Health Institute, http://ccf.georgetown.edu; and the Kaiser Family Foundation, http://kff.org

3 Kaiser Commission on Medicaid and the Uninsured, “Key Facts about the Uninsured Population,” Kaiser Family Foundation, November, 2017.

4 Britain is an exception. Under the British “National Health,” most (but not all) physicians are employed by the government. 5 Rachel Carson, Silent Spring (Boston: Houghton Mifflin, 1962).

national health insurance A plan under which the government provides basic health-care coverage to all citizens. Most such plans are funded by taxes on wages or salaries.

single-payer plans A plan under which one entit y has a monopoly on issuing a particular t ype of insurance. Typically, the entit y is the government, and the insurance is basic health coverage.

C H A P T E R 1 5 ● D O M E S T I C P O L I C Y 533

increasing attention to environmental issues, and the federal government has enacted a number of specific policies intended to improve our environment.

The Environmental Movement Environmental issues are not limited to concerns about pollution and its health effects; they include the desire to save and protect natural resources. The environmental movement looks to the early part of the twentieth century for its beginnings, when President Theodore Roosevelt created five national parks and expanded federal protection to a vast area near Yellowstone National Park. The movement to protect the environment has been based on two major strands of thought since its beginnings in the early 1900s. One point of view calls for conservation —that is, a policy under which natural resources should be used, but not abused. America’s national forests, which are the responsib- ility of the Department of Agriculture, are an example of conservation in that the forests can be timbered with appropriate permits, hunting and fishing are usually permitted, and, in the West, farmers may obtain licenses to use public lands for their cattle. A second view advocates preservation. Under this policy, natural preserves are established that are isolated from the effects of human activity. The national parks and national wilderness areas exemplify this view, with all human activity except hiking and climbing restricted.

In the 1960s, an environmentalist movement arose that was much more focused on pollution issues than the previous conservation move- ment. The publication of Silent Spring; a massive oil spill off the coast of Santa Barbara, California, in 1969; and, in the same year, the fire on the Cuyahoga River caused by flammable chemicals awakened a new move- ment to control air and water pollution. Established conservation groups like the Audubon Society and the Sierra Club were joined by new groups, including Greenpeace, Friends of the Earth, and the Wilderness Society, to pressure the government to take greater action against pollution and the destruction of our environment.

Image 15-2 The Cuyahoga River in 1969—firefighters extinguish a

fire that started on the river and

spread to a wooden trestle bridge.

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The environmentalist movement focused public attention on the damage that an industrialized society can bring to the environment. In general, people are very supportive of efforts to improve the environment: a Gallup Poll taken in 2018 reported that more than 70 percent of Americans supported higher emission standards for business and industry, 76 percent favored spending more government money on wind and solar power, and 73 percent supported strongly enforcing federal environmental regulations.6 However, when asked whether they would prioritize environmental protection over economic growth, 57 percent agreed, continuing a trend that began with the recession of 2008. From 1985 until 2009, a majority of Americans prioritized environmental pro- tection over economic growth.7

Cleaning Up the Air and Water The government has been responding to pollution problems since before the American Revolution, when the Massachusetts Bay Colony issued regulations to try to stop the pollution of Boston Harbor. In the 1800s, states passed laws controlling water pollution after scientists and medical researchers convinced most policymakers that dumping sewage into drinking and bathing water caused disease. At the national level, the Federal Water Pollution Control Act of 1948 provided research and assistance to the states for pollution-control efforts, but little was done.

The National Environmental Policy Act The year 1969 marked the start of the most concerted national government involvement in solving pollu- tion problems. The Santa Barbara oil spill occurred that year, resulting in an oil slick covering 800 square miles and killing plant life, birds, and fish. Congress soon passed the National Environmental Policy Act of 1969, which established, among other things, the Council on Environmental Quality. It also mandated that an environmental impact statement (EIS) be prepared for all major fed- eral actions that could significantly affect the quality of the environment. The act gave citizens and public-interest groups who were concerned with the environment a weapon against the unnecessary and inappropriate use of nat- ural resources by the government.

Curbing Air Pollution Beginning in 1975, the government began regulat- ing tailpipe emissions from cars and light trucks in an attempt to curb air pollution. After years of lobbying by environmentalists, Congress passed the Clean Air Act of 1990. The act established tighter standards for emissions of nitrogen dioxide (NO

2 ) and other pollutants by newly built cars and light

trucks. California was allowed to establish its own stricter standards. By 1994, the maximum allowable NO

2 emissions (averaged over each manufac-

turer’s “fleet” of vehicles) were about one-fifth of the 1975 standard. The “Tier 2” system, phased in between 2004 and 2007, reduced maximum fleet emissions by cars and light trucks to just over 2 percent of the 1975 stand- ard. In 2008–2009, the standards were extended to trucks weighing between 6,000 and 8,500 pounds.

The Obama administration moved swiftly to strengthen fuel efficiency standards for vehicles and to clean up the air pollution caused by cars and trucks. In 2011, the administration issued rules that would improve the fleet

6 Frank Newport, “Americans Want Government to Do More on Environment,” March 29, 2018. http://news.gallup/poll/232007/. 7 Dennis Jacobe, “Americans Still Prioritize Economic Growth over Environment,” The Gallup Poll, March 29, 2012.

environmental impact statement (EIS) A report that must show the costs and benefits of major federal actions that could significantly affect the qualit y of the environment.

C H A P T E R 1 5 ● D O M E S T I C P O L I C Y 535

efficiency for medium and heavy duty trucks between 9 and 23 percent. In 2014, the president announced more stringent requirements for heavy trucks and buses. Although the standards will cost the industry about $8 billion for new equipment, it is estimated that the increased fuel efficiency will save the trucking industry up to $50 billion in fuel expenses in the long run.8 President Obama also directed the EPA to increase its efforts to clean up air pollution by reducing sulfur in gasoline and tightening emission standards for cars.9 In 2017, President Trump ordered a review of these standards to determine whether a rollback would be ordered.

The United States is making fairly substantial strides in the war on toxic emissions. According to the EPA, in the last 30 years U.S. air pollution has been cut in half. Airborne lead is 3 percent of what it was in 1975, and the lead content of the average American’s blood is one-fifth of what it was in that year. Airborne sulfur dioxide concentrations are one-fifth of the levels found in the 1960s. Carbon monoxide concentrations are one-quarter of what they were in 1970. The American public is increasingly aware of the need for environmental protection. To a large extent, this increased awareness has resulted from the efforts of various environmental interest groups, which have also exerted pres- sure on Congress to take action.

Water Pollution The Clean Water Act of 1972 amended the Federal Water Pollution Control Act of 1948. The Clean Water Act established the following goals: (1) make waters safe for swimming, (2) protect fish and wildlife, and (3) eliminate the discharge of pollutants into the water. The act set specific time schedules, which were subsequently extended by further legislation. Under these schedules, the EPA establishes limits on discharges of types of pollutants based on the technology available for controlling them. The act also required municipal and industrial polluters to apply for permits before discharg- ing wastes into navigable waters. Furthermore, the Clean Water Act also pro- hibited the filling or dredging of wetlands without a permit from the Army Corps of Engineers.

Perhaps one of the most controversial regulations concerning wetlands was the “migratory-bird rule” issued by the Army Corps of Engineers. Under this rule, any bodies of water that could affect interstate commerce, including seasonal ponds or waters “used or suitable for use by migratory birds” that fly over state borders, were “navigable waters” subject to federal regulation under the Clean Water Act as wetlands. In 2001, after years of controversy, the U.S. Supreme Court struck down the rule. The Court stated that it was not prepared to hold that isolated and seasonal ponds, puddles, and “prairie potholes” become “navigable waters of the United States” simply because they serve as a habitat for migratory birds.10

The Endangered Species Act Inspired by the plight of disappearing species, Congress passed the Endangered Species Preservation Act in 1966. In 1973, Congress passed a completely new Endangered Species Act (ESA), which made it illegal to kill,

8 Juliet Eilperin, “Obama to Tighten Fuel Efficiency Standards for Big Trucks,” The Washington Post, February 18, 2014. 9 Dina Cappiello, “Obama, EPA to Unveil Proposal to Clean Up Emissions,” U.S. News, March 28, 2013, www.nbcnews.com

/news/us-news

10 Solid Waste Agency of Northern Cook County v. U.S. Army Corps of Engineers, 531 U.S. 159 (2001).

did you know? The federal government owns

more than 650 million acres of

land, or roughly 30 percent of

the United States.

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harm, or otherwise “take” a species listed as endangered or threatened. The government could purchase habitat critical to the survival of a species or prevent landowners from engaging in development that would harm a listed species.

The ESA proved to be a powerful legal tool for the ecology movement. In a famous example, environmental groups sued to stop the Tennessee Valley Authority from completing the Tellico Dam on the grounds that it threatened habitat critical to the survival of the snail darter, a tiny fish. In 1978, the U.S. Supreme Court ruled in favor of the endangered fish.11 Further controversy erupted in 1990, when the Fish and Wildlife Service listed the spotted owl as a threatened species. The logging industry blamed the ESA for a precipitous decline in national forest timber sales in sub- sequent years. Recently, the Fish and Wildlife Service proposed removing the protected status of wolves in some western states. Whereas cattle- men and hunters praised the idea of shooting wolves that preyed on cattle and sheep, environmental groups claimed that the wolf population was not yet strong enough to allow hunting.

The ESA continues to be a major subject of debate. However, signs indic- ate that the government and environmentalists may be seeking common ground. Both sides are shifting toward incentives for landowners who parti- cipate in protection programs. “Regulatory incentives really do result in landowners doing good things for their land,” said William Irvin of the World Wildlife Fund.12

Sustainability Before the mid-1980s, environmental politics seemed to be couched in terms of “them against us.” “Them” was everyone involved in businesses that cut down rainforests, poisoned rivers, and created oil spills. “Us” was the government, and it was the government’s job to stop “them.” Today, most Americans support legislation to cut down on pollution, to save green areas, and to encourage the recycling of waste. Around the globe, individuals, governments, and businesses have come to believe that the earth’s resources are limited and that the survival of the planet depends on moving toward a sustainable society.

Sustainability means achieving a balance between economic and social activities and nature that will permit the healthy existence of both. In terms of public policy, it means that societies act in such a way as to maintain healthy supplies of air, water, and the natural resources that make modern life pos- sible. The United States adopted a policy of sustainability in 2007, with an executive order requiring all federal agencies to “conduct their environmental, transportation, and energy-related activities . . . in an environmentally sound, economically and fiscally sound, integrated, continuously improving, efficient, and sustainable manner.”13

At the federal government level, this order directed agencies to buy effi- cient vehicles, recycle products, and enforce legislation aimed at increasing

11 Tennessee Valley Authority v. Hill, 437 U.S. 153 (1978). In 1979, Congress exempted the snail darter from the ESA. In 1980, snail darters were discovered elsewhere, and the species turned out not to be endangered.

12 “Endangered Species Act Turns 30 as Environmental Strategy Shifts,” The Charleston Post and Courier, Charleston, SC, January 2, 2004.

13 “Sustainability,” Environmental Protection Agency statement, www.epa.gov/sustainability/

sustainability Achieving a balance between societ y and nature that will permit both to exist in harmony.

C H A P T E R 1 5 ● D O M E S T I C P O L I C Y 537

sustainability. The order was rein- forced by another in 2009 issued by President Obama to increase efforts to reduce greenhouse emissions. At the state and local level, sustainability means increased recycling efforts, legislation that has banned the use of nonrecyclable plastic bags, efforts to increase composting, and reduction of waste for landfills. Both in Europe and the United States, corporations have responded to the call for a more sus- tainable society by developing more compostable or degradable products. As shown in the screen capture, the Environmental Defense Fund uses the  internet to advertise its platform and gain supporters.

Do Elections Really Mean Policy Changes? As soon as the president of the United States is inaugurated, he or she can begin issuing executive orders and asking the new cabinet secretaries and directors to enforce or rescind the regulations posted by the prior administration. In the case of the 2016 election, most of these changes will be directed at domestic policies, and there could be large policy swings ahead.

The contrasts between the Republican and Democratic presidential nominees on many important domestic poli- cies were quite striking. Let’s take health care, for example. The Democratic nominee for president, Hillary Rodham Clinton, supported the Affordable Care Act as passed in the first two years of the Obama administration. It is likely that she would have continued its implementation with some changes for improvements. She was challenged in the political campaign by Senator Bernie Sanders, who pro- posed substituting a national health-care plan like those offered by most European nations. Such a plan would cover all Americans. In contrast the Republican nominee, Donald Trump, who campaigned on a platform of “scrapping” Obamacare and substituting individual choice of policies, health savings accounts, and other free-market mecha- nisms. The difficulty in forecasting exactly how a new pres- ident would affect health policies is that the Affordable Care Act is so complex and the financial mechanisms are so

deeply embedded in the tax code that changing to a new system is very difficult.

There were similar differences between the Democratic nominee and the Republican nominee in 2016 on environmen- tal policies, tax reform, economic policies, and energy poli- cies. It is important to remember, though, that large changes in policies will require legislation from the Congress which must be negotiated through both houses. Interest groups will lobby intensely against large changes simply because they want to protect the status quo, including ben efits and loop- holes previously incorporated in laws or regulations. Even with a Republican Congress, President Trump was unable to repeal the ACA. He did roll back regulations in other areas by execu- tive order.

Election 2016

For Critical Analysis 1. Does a “ landslide” presidential election automati-

cally give the new president the power to insist on changes in domestic policies?

2. Will the 2020 presidential campaign find the same differences between the Republican and Democratic nominees?

From the Web ▸ The Environmental Defense Fund uses its website to increase public support for its legal actions to protect the environment.

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Global Climate Change A major source of concern has been the emission of pollutants into the air and water. Each year, the world atmosphere receives 20 million metric tons of sul- fur dioxide, 18 million metric tons of ozone pollutants, and 60 million metric tons of carbon monoxide. A majority of climate scientists believe that these pollutants are the cause of global climate change, and a warming climate will represent a major threat to human survival on the planet. International efforts to limit the output of pollutants, especially carbon dioxide from vehicles and power plants, have been controversial but are widely supported by citizens throughout the world.

The Kyoto Protocol In 1997, delegates from around the world gathered in Kyoto, Japan, for a global climate conference sponsored by the United Nations. The conference issued a proposed treaty aimed at reducing emis- sions of greenhouse gases to 5.2 percent (below 1990 levels) by 2012. Only 38 developed nations were mandated to reduce their emissions, however—developing nations including China and India faced only volun- tary limits. The U.S. Senate voted unanimously in 1997 that it would not accept a treaty that exempted developing countries, and in 2001 President Bush announced that he would not submit the Kyoto protocol to the Senate for ratification. By 2007, 124 nations had ratified the protocol. Its rejection by the United States, however, raised the question of whether it could ever be effective.

Even in those European countries that most enthusiastically supported the Kyoto protocol and signed it, the results have not been overly positive. By 2008, it became clear that 13 of the 15 original European Union signatories would miss their 2010 emission targets. At the same time, two nations that are considered to be “developing nations,” China and India, have seen their emissions increase dramatically, but they were not required to abide by the protocol. In May 2011, the potential impact of the Kyoto agreement was severely diminished when Canada, Russia, and France announced that they were withdrawing from the agreement.

COP21: The New Agreement After years of discussion and attempts to forge a replacement agreement for the Kyoto document, representatives of 195 nations agreed to a new regime for addressing climate change. The his- toric agreement was named COP21 referring to the twenty-first meeting of the Conference of Parties (COP). Rich and poor nations agreed on the overall framework of the plan, including the goal of limiting the increase in global tem- peratures to less than 2 degrees Celsius.14 All of the nations who signed the accord committed to public pledges of reducing their carbon emissions and providing data on their progress. Each nation’s pledge will be reviewed every five years. Richer nations have committed to providing up to $100 billion per year to poorer nations to help them in this effort, although that pledge is non- binding.15 Although many of the nations’ pledges are subject to their own local issues, the 2015 agreement marked the first time all of the parties agreed that global warming is a serious threat.

14 Lynne Peeples, “Historic Climate Change Agreement Adopted in Paris,” Huffington Post, December 12, 2015. http://www .huffingtonpost.com/entry/climate-change-paris_us_566c2048e4b0e292150e169b

15 Jeff Tollefson and Kenneth R. Weiss, “Nations Approve Historic Global Climate Accord,” Nature, December 12, 2015. http:// www.nature.com/news/nations-approve-historic-global-climate-accord-1.19021

Beyond Our Borders

C H A P T E R 1 5 ● D O M E S T I C P O L I C Y 539

The European Community has shown a remarkable ability to agree on energy conservation and environmental goals and to make considerable progress toward attaining these goals. Following the publication of the European Commission’s report on sustainable energy in 2006, the European Parliament began considering the situation and acting upon it in 2007. This confederation of nations agreed to cut greenhouse gases by 20 percent by 2020 and to work for a new treaty to follow the Kyoto accords that would further decrease such emissions by 2030. In addition, the European Community has taken a number of steps to help its citizens make “green decisions” to conserve energy in the home and on the road.

Almost every type of appliance sold in Europe is tagged with an Energy Efficiency Rating, which grades the appliance on a scale of A to G on energy efficiency and carbon dioxide impact. The nations agreed that all new buildings and those undergoing substantial remodeling should be more energy efficient and install the most energy-efficient heating and air-conditioning systems available. In future years, Europeans will be able to buy cars and trucks that are increasingly effi- cient and better for the environment as well. The agreement among the nations sets carbon dioxide emissions standards for all new cars and requires manufacturers to further cut emissions by 1 percent per year, every year, until 2020.

Countries have differing standards, but all of the European Union members have agreed to try to reduce waste and increase recycling. If you live in Germany, for example, your neighbors have strong expectations that you will reuse, recycle, and sort your garbage. Virtually every German neighborhood or apartment building has five different bins outside, all color-coded to help you dis- pose of your waste properly. You will use the yellow bin for any kind of food packaging, the blue bin for paper and cardboard, the “bio” bin for leftover food waste, and sep- arate bins for clear, brown, and green glass. A black bin is also available for those who are too lazy to separate or have something that does not fit. Switzerland and Denmark also have extremely high rates of recycling waste products from households. In some nations, there are complaints that the government does not provide enough bins for trash or does not pick up the materials properly, whereas in other nations, citizens are fined for not separating their trash.

Not only do the European nations pride themselves on their “green” habits, but the European Commission makes public everyone’s results on the various measures it has adopted. If you go to the website for Europe’s Energy Portal (www.energy.eu/), you will find scorecards for gas and oil prices, energy dependency, CO

2 emissions,

and renewable energy production for each nation. Imagine a report card on the American states that would give the same kind of measures!

How Green Is Europe?

Image 15-3 These recycling bins in Wales, United Kingdom, are typical of those found in many European countries. Citizens are asked, at a minimum, to sort their waste into paper, plastic, glass, and compostable food items.

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For Critical Analysis 1. W hy do you think the European nations have

been able to agree on such progressive measures in energ y eff iciency and env ironmenta l protections?

2. Do you think government regulations and fines are the best way to gain citizen compliance with energy and environmental goals?

540 P A R T V ● P U B L I C P O L I C Y

The Global Warming Debate Although the majority of scientists who per- form research on the world’s climate believe that global warming will be signif- icant, there is considerable disagreement as to how much warming will actually occur. It is generally accepted that world temperatures have already increased by at least 0.6 degrees Celsius over the last century. The 2014 report by the United Nations Intergovernmental Panel on Climate Change continued to pre- dict increases ranging from 2.0 to 4.5 degrees Celsius by the year 2100. The latest Intergovernmental Panel on Climate Change (IPCC) raised the risk level for global warming and linked weather-related disasters to climate change, but other scientists are more cautious about the link between climate change and any increase in strong storms, flooding, or tsunamis because comparative his- torical data is only a few hundred years old.16

Global warming has become a major political football to be kicked back and forth by conservatives and liberals. Some conservatives have seized on the work of scientists who believe that global warming does not exist at all. (Some of these researchers work for oil companies.) If this were true, there would be no reason to limit emissions of carbon dioxide and other greenhouse gases. A more sophisticated argument by conservatives is that major steps to limit emissions in the near future would not be cost effective. Bjørn Lomborg, a critic of climate change, believes that the world is spending too much of its resources on combating climate change when there are other much more pressing global problems to solve, including poverty, the spread of disease, and malnutrition.17

Energy Policy ■ 15.4  Analyze American energy policy and discuss how it encourages energy

independence.

The United States has always had enormous energy resources, whether from coal, oil, natural gas, or alternative sources such as wind or solar power. However, for most of the last 150 years, the American economy has been primarily dependent on fossil fuels, namely oil, coal, and natural gas. It is important to think beyond our cars and our appliance-filled homes. Energy is necessary to power all factories in the United States and to keep all forms of transportation moving. In some cases, fossil fuel is the raw material for objects in our daily lives. Plastics, polystyrene, the case for your iPad—all are made from petroleum products. Although support for alternative sources of energy is very strong across the nation, becoming less dependent on fossil fuel products will require a long-term strategy. If you look at Figure 15-4, you can see the percentage of energy used by the various sectors of the American economy.

Energy policy—laws concerned with how much energy is needed and used—and the regulation of energy producers tend to become important only during a crisis. In 1973, the Organization of Petroleum Exporting Countries (OPEC), the cartel of oil-producing nations, instituted an embargo

16 Seth Bornstein, “U.N. Scientific Panel Releases Report Sounding Alarm on Climate Change Dangers,” Huffington Post, March 30, 2014, www.huffingtonpost.com/green/ or, for a different view, Bjorn Lomborg, “Climate Change Misdirection,” The Wall Street Journal, January 23, 2013. http://www.onlinewsj.com/news/articles

17 See Bjorn Lomborg, How to Spend $75 Billion to Make the World a Better Place (Copenhagen, Denmark: Copenhagen Consensus Center, 2014).

energy policy Laws concerned with how much energy is needed and used.

C H A P T E R 1 5 ● D O M E S T I C P O L I C Y 541

on shipments of petroleum to the United States because of our support of Israel in the Arab–Israeli conflict of that year. President Nixon declared that the United States would achieve energy independence by reducing speed limits and meeting Corporate Average Fuel Economy (CAFE) standards by a certain time.

In 1977, President Carter also found himself facing shortages of oil and natural gas. The Department of Energy was created, and numerous pro- grams were instituted to assist citizens in buying more energy-efficient appliances and improving the energy profile of their homes. In addition, legislation created the National Petroleum Reserve, and incentives for

Image 15-4 In 2013, a chemical plant in West Virginia along the Kanawha

River spilled millions of gallons

of waste into the river, forcing

hundreds of thousands of residents

to find other sources of water for

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Figure 15-4 ▸ U.S. Energy Consumption by Economic Sector, 2017

Source: “Energy Consumption Estimates by Sector,” U.S. Energy Information Administration, Monthly Energy Review. http://www.eia.gov/consumption/

542 P A R T V ● P U B L I C P O L I C Y

researching alternative forms of energy were instituted. Over time, Americans sought to replace their smaller, more efficient cars with sport utility vehicles (SUVs) and light trucks. Airline traffic grew. Suburbs were built farther from cities and jobs. America’s dependence on foreign oil has grown, as has the nation’s overall appetite for energy.

In 2017, the United States consumed about 20 million barrels of petro- leum per day, with half of this used as gasoline for transportation. Of those 20 million barrels per day, only 16 percent was imported, an historic low. As has been the case for many decades, the United States is the third largest producer of oil but the largest consumer among the major producers. In fact, the United States has increased domestic production by about 1 million bar- rels a day over the last three years as prices increased around the world. From the 1970s until about 2003, the price of crude oil averaged less than $40 per barrel. In the last 10 years, the price of crude oil per barrel has reached more than $100 per barrel as demand for the product around the world has grown. When the price of crude rises, it becomes economically feasible for less productive wells in the United States to begin pumping oil again; individual consumers look for ways to cut their use of gasoline and drive down demand for oil; and, most importantly, industries that use oil to produce energy or other products switch to less expensive fuels. Of course, a decrease in the price of oil has the opposite effect. When crude oil prices fell below $40 per barrel in 2015, domestic gasoline dropped to just over $2 and oil production dropped as well. If you look at Figure 15-5, you will see that 31 percent of the nation’s energy came from natural gas in 2017. As natural gas has become more abundant due to fracking, the cost has fallen and a number of power-generating plants have switched from burning oil to burning natural gas to produce electricity.

Coal

Nuclear 20%

Hydropower 7.5%

Renewables 10%

30%

Petroleum/gas0.5%

Natural Gas32%

Figure 15-5 ▸ Sources of Electricity Generation, 2017

Source: “What Is U.S. Electricity Generation by Energy Source?,” U.S. Energy Information Administration, 2016; http://www.eia.gov/tools /faqs/faq.cfm?id=427&t=3

Energy and the Environment Because of the effects of producing energy and burning fuels, energy policy is deeply entangled with environmental policy.18 Using gasoline to power a car is the normal practice. However, burning gasoline produces serious emissions that contribute to the buildup of smog in the atmosphere. Through a series of laws passed over the last 20 years, the EPA has forced cities to implement procedures to reduce smog and to require cleaner-burning gasoline. In addi- tion, Congress has mandated that 10 percent of fuels sold in the years to come include ethanol as an ingredient. In response, the production of corn, which is used to make ethanol, has shot up, but still not enough is being grown to over- come the accompanying rise in price.

18 For a comprehensive look at all energy resources in the United States, go to the website of the Department of Energy: www .energy.gov/energysources

did you know? Americans consume 26 percent

of the world’s energy.

Politics in Practice

Promised Land, the 2012 film written by Matt Damon and John Krasinski, tells the story of two corporate salespeople who visit a rural Pennsylvania town in an attempt to buy drilling rights from the local residents. Damon stars as one of those salespeople sent by his employer, Global Crosspower Solutions, to quickly and cheaply persuade landowners to sell mineral rights leases that grant drilling rights to his employer. Krasinski stars as an environmental advocate who starts a campaign against the company.

The film was criticized by the energy industry for its por- trayal of hydraulic fracking, claiming that it oversimplifies the issue, but it succeeded in starting a conversation about a very real issue. Hydraulic fracking makes it possible to tap into natural gas reservoirs, but only once gas companies have convinced landowners to allow them to drill.

Political films such as Promised Land face a difficult road to success. Although Syriana, which was produced by and starred George Clooney, received a strong critical response, it also did not gain a huge audience, likely due to its complex exploration of petroleum politics and the global influence of the oil industry. Promised Land drew mixed critical reviews, perhaps because it was not a strong enough critique of the energy industry. The movie provides an accurate portrayal of the political process that is occurring across the United States as communities make decisions about natural resource extrac-

tion while they are under pressure from economic and envir- onmental groups.

Recently, more issues involving fracking have come to light. The state of Oklahoma, which has welcomed the industry and benefited from energy extraction, has experi- enced a series of small earthquakes. Scientists are trying to discover whether the deep drilling and injection of salt water into the wells is destabilizing the earth or whether the earthquakes would have occurred without any fracking. The possibility that drilling techniques cause earthquakes could make “selling” energy extraction to communities much more difficult.

Promised Land: The Politics of Energy

For Critical Analysis 1. How can a town judge the trade-off between

energy extraction such as fracking and protecting its environment?

2. To what extent is the local debate over fracking, wind farms, or the installation of a field of solar panels made more difficult because the United States has no comprehensive energy policy?

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The United States continues to pump oil from existing wells and offshore platforms. However, more areas exist where oil could be found and extracted, but in most cases, environmental risks would be incurred. Following the oil spill in Santa Barbara, California, from an offshore drilling rig, most Americans welcomed laws that forbade drilling in new areas off Florida, Louisiana, Texas, and California. In addition, large areas of the Arctic National Wilderness Reserve (ANWR) have been protected from oil explora- tion. In 2010, the clash between environmental protection and the need for energy sources came to a head in the Gulf of Mexico at a drilling rig named the Deepwater Horizon. The rig, leased by British Petroleum, was drilling for oil more than a mile deep in the ocean when a “blow- out” of oil and gas occurred. The blowout preventer—a multimillion-dollar, five-story apparatus on the sea floor— failed, and the rig exploded. In the weeks and months that followed, millions of gallons of oil and gas spewed from the well as attempts to cap it met limited success. President Obama convinced BP to set aside $20 billion in a fund to compensate Gulf residents for losses in wages and business revenues.

Another dilemma facing the United States involves domestic power production and the need for cleaner air.

The majority of electric power generated in the United States comes from coal-fired plants in the Midwest and central regions of the nation. For many years, these plants spewed carbon emissions into the air. As scientists became aware of the impact of these emissions on the environment, new laws required the plants to reduce their emissions by installing scrubbers or, after reaching the legal “cap” on their carbon emissions, buying or trad- ing for the right to produce more. The EPA under the Bush administration issued regulations for coal-burning plants that reduced their burden of meeting the standards. States that felt they received the most damage from some of these emissions sued to make the EPA issue standards that meet the letter of the Clean Air Act. The Supreme Court agreed with these states, and the EPA began to prepare stricter standards. The Obama admin- istration issued draft regulations for existing power plants in 2012. After receiving more than 2 million comments from the industry and the public, the administration announced a revised set of regulations in 2013. The pro- posed regulations required new gas or coal-fired power plants to meet much higher standards for carbon emissions. Following his campaign prom- ise to aid the coal industry, President Trump ordered the repeal of Obama’s Clean Power Act, eliminating many of the new controls on coal-fired power plants.19

Nuclear Power—An Unpopular Solution One strategy for reducing carbon emissions of coal-fired plants and also the environmental and human risks of coal mining is to increase the number of

19 Associated Press, “Trump EPA Plan will roll back Obama standards on power plant emissions,” The Guardian, October 7, 2017.

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increased dramatically due to

the use of “fracking” to release

gas from layers of shale deep

beneath the earth’s surface. This

hydro-fracking well is being drilled

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C H A P T E R 1 5 ● D O M E S T I C P O L I C Y 545

nuclear power plants in the United States. Nuclear power plants are very efficient and emit very low levels of greenhouse gases. The accident at the Three Mile Island plant in Pennsylvania in 1979, followed by the disaster at the Chernobyl, Ukraine, plant in 1986, undermined public confidence in nuc- lear energy.

The United States for many decades was alone among industrialized nations in its fear of nuclear power, but given the concern about carbon emis- sions from the coal-fired plants, the United States began to license the con- struction of new nuclear plants in the early 2000s. However, after a tsunami destroyed a huge coastal area of Japan in 2011 and caused the meltdown of a nuclear plant, the Japanese have begun to have serious concerns about their dependence on nuclear power. Even in Europe and the former Soviet Union, where hundreds of nuclear plants have operated safely for decades, the radi- ation release from the Japanese plant has renewed the demand to reduce the number of nuclear plants in operation.

Alternative Approaches to the Energy Crisis Several alternative sources of energy can be used to reduce the nation’s dependence on fossil fuels. Huge wind farms in California generate energy for cities there. Research continues on harnessing the power of the ocean waves to produce electricity and the most efficient ways to use geothermal energy from below the surface of the earth.20 The technology does not yet exist to use any of these sources to produce the quantity of energy needed to replace our coal plants or other current energy sources. And, in some areas, citizens con- sider wind farms extremely disturbing to the environment and area wildlife.

20 For a discussion of these new technologies, see Jay Inslee and Bracken Henricks, Apollo’s Fire (Washington, DC: Island Press, 2007).

Image 15-6 Japanese journalists inspect the remains of the

Fukushima Daiichi nuclear power

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the 2011 tsunami. The release of

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to reconsider its dependency on

nuclear energy.

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The rising price of gasoline spurred a much greater demand for hybrid automo- biles and for smaller, more fuel-efficient cars. In addition, people began to ride motor scooters and bicycles for city commutes and increased their use of mass transit. The Obama administration has sought comprehensive energy legislation from the Congress since the president’s inauguration. Members of the administra- tion and of Congress realize that both energy needs and environmental concerns must be addressed in the same legislation. Proponents of a “cap and trade” sys- tem want industries to account for their carbon emissions through a market system, as in Europe. The opponents of such a system believe that it will drive up energy costs because costs will be passed down to the ultimate consumer. Energy legislation stalled in the Congress in 2010 and no new plan has been passed.

Poverty and Welfare ■ 15.5  Describe the national policies for ending pover t y in the United States and

alleviating the issues caused by economic downturns.

Throughout the world, poverty has historically been accepted as inevitable. The United States and other industrialized nations, however, have sustained enough economic growth in the past several hundred years to eliminate mass poverty. Considering the wealth and high standard of living in the United States, the persistence of poverty here appears bizarre and anomalous.

A traditional solution to poverty has been income transfers. These are methods of transferring income from relatively upper-income to relatively poor groups in society, and as a nation, we have been using such transfers for a long time. Before we examine these efforts, let us look at the concept of poverty in more detail and at the characteristics of the poor.

The Low-Income Population We can see in Figure 15-6 that the number of people classified as poor fell steadily from 1961 to 1968—that is, during the presidencies of John Kennedy

income transfer A transfer of income from some individuals in the economy to others, generally by government action.

Image 15-7 Many environmentalists and commentators suggest that a

much greater use of wind power

could reduce the nation’s depend-

ence on fossil fuels. This California

windmill farm produces energy for

Palm Springs. However, windmill

farms cannot be successful every-

where in the United States.

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C H A P T E R 1 5 ● D O M E S T I C P O L I C Y 547

and Lyndon Johnson. The number remained level until the recession of 1981– 1982, during Ronald Reagan’s presidency, when it increased substantially. The number fell during the Internet boom of 1994–2000, but then it started to rise again. The percentage generally has been below 15 percent. In 2014, about 46.7 million Americans, or about 15 percent, were classified as poor. The eco- nomic downturn and increase in unemployment sent the rate to the highest it has been since 1997. Even though economists declared that the recession had ended and recovery was beginning, the number of poor increased by more than 6 million between 2009 and 2012. For many of these Americans, family savings were exhausted, unemployment benefits had expired, and the hope of a job was fading. Many Americans who turned 62 applied for early retirement and their reduced Social Security benefits, and others claimed permanent disability.

The threshold income level that is used to determine who falls into the pov- erty category was originally based on the cost of a nutritionally adequate food plan designed by the U.S. Department of Agriculture in 1963. The poverty level is adjusted each year for changes in the consumer price index. For 2018, for example, the official poverty level for a family of four was about $25,100.

The official poverty level is based on pretax income, including cash but not in-kind subsidies—food stamps, housing vouchers, and the like. If we correct poverty levels for such benefits, the percentage of the population that is below the poverty line drops dramatically.

The Antipoverty Budget It is not always easy to determine how much the government spends to com- bat poverty. In part, this is because it can be difficult to decide whether a

in-kind subsidy A good or service—such as food stamps, housing, or medical care— provided by the government to low- income groups.

45

40

35

30

25

20

15

10

5

0

1959 1965 1970 1975 1980 1985 1990 1995 2000 2006 2012 2016

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e n

t, N

u m

b e rs

i n

M il li o

n s

43.1 million

12.7%

Year

50

Number in poverty

Percent in poverty

Figure 15-6 ▸ The Official Number of Poor in the United States The number of individuals classified as poor fell steadily from 1961 through 1968. It then increased during the 1981–1982 recession. After

1994, the number fell steadily until 2000, when it started to rise again. The recession that began in 2008 spurred an increase to a 50-year

high in the number of poor Americans.

Note: The data points represent the midpoints of the respective years.

Source: U.S. Census, “Poverty Status of People by Age, Race, and Hispanic Origin, 1959–2014,“ http://www.census.gov/hhes/www/poverty/data/historical/people.html; U.S. Census, “Income, Poverty and Health Insurance Coverage in the United States, 2014,“ September, 2017.

548 P A R T V ● P U B L I C P O L I C Y

particular program is an antipoverty program. Are grants to foster parents an antipoverty measure? What about job-training programs? Are college scholar- ships for low-income students an antipoverty measure?

President Trump’s 2018 budget allocated a little less than $1 trillion, or about one-third of all federal expenditures, to federal programs that sup- port persons of limited income (scholarships included).2 1 Of this amount, $403 billion was for Medicaid, which funds medical services for the poor, as discussed earlier. The states were expected to contribute an additional $150 billion to Medicaid. Medical care is by far the largest portion of the antipoverty budget. Other items include food stamps and housing programs.

Basic Welfare The program that most people think of when they hear the word welfare is now called Temporary Assistance to Needy Families (TANF). With the passage in 1996 of the Personal Responsibility and Work Opportunity Reconciliation Act, popularly known as the Welfare Reform Act, the govern- ment created TANF to replace an earlier program known as Aid to Families with Dependent Children (AFDC). The AFDC program provided “cash sup- port for low-income families with dependent children who have been deprived of parental support due to death, disability, continued absence of a parent, or unemployment.”

Under TANF, the U.S. government turned over to the states funds targeted for welfare assistance in the form of block grants. The states, not the national government, now bear the burden of any increased welfare spending. If a state wishes to increase the amount of TANF payments over what the national government supports, the state has to pay the additional costs.

One of the aims of the Welfare Reform Act was to reduce welfare spend- ing by limiting most welfare recipients to only two years of assistance at a time and imposing a lifetime limit on welfare assistance of five years. The Welfare Reform Act has largely met its objectives. During the first five years after the act was passed, the number of families receiving welfare payments was cut in half. The 2018 federal budget allocated $15.1 billion to the TANF block grants.

Welfare Controversies Whether known as AFDC or TANF, the basic welfare program has always been controversial. Conservative and libertarian voters often object to wel- fare spending as a matter of principle, believing that it reduces the incentive to find paid employment. Because AFDC and TANF have largely supported single-parent households, some also believe that such programs are antimar- riage. Finally, certain people object to welfare spending out of a belief that welfare recipients are “not like us.” The bulk of TANF recipients, however, are single mothers with children; thus, basic welfare payments in the United States are relatively low when compared with similar payments in other industrialized nations. In 2018, the average monthly TANF payment nation- wide was about $700; however, some states have benefits as low as $300 for a family of three.

21 This sum does not include the earned income tax credit, which is not part of the federal budget.

Temporary Assistance to Needy Families (TANF) A state-administered program in which grants from the national government are used to provide welfare benefits. The TANF program replaced the Aid to Families with Dependent Children (AFDC) program.

did you know? The Greenville County

Department of Social Services

in South Carolina wrote to a

food stamp recipient, “Your

food stamps will be stopped . . .

because we received notice that

you passed away. May God bless

you. You may reapply if there is a

change in your circumstances.”

C H A P T E R 1 5 ● D O M E S T I C P O L I C Y 549

Other Forms of Government Assistance The Supplemental Security Income (SSI) program was established in 1974 to provide a nationwide minimum income for elderly persons and persons with disabilities who do not qualify for Social Security benefits. The 2018 budget allocated $52 billion to this program.

The government also issues food stamps, benefits that can be used to purchase food; they are usually provided electronically through a card sim- ilar to a debit card. Food stamps are available to low-income individuals and families. Recipients must prove that they qualify by showing that they have a low income (or no income at all). Food stamps go to a much larger group of people than do TANF payments, including the unemployed and single adults, groups that have expanded during the recession. The number of recipients of food stamps more than doubled since 2003, from 19 million to 45 million, or one out of seven Americans. The food stamp program has become a major part of the welfare system in the United States, although it was started in 1964 mainly to benefit farmers by distributing surplus food through retail channels.

The earned income tax credit (EITC) program was created in 1975 to help low-income workers by giving back part or all of their Social Security taxes. Currently, about 15 percent of all taxpayers claim an EITC, and an estim- ated $56 billion per year is rebated to taxpayers through the program.

Homelessness—Still a Problem The plight of the homeless remains a problem. Some argue that the Welfare Reform Act of 1996 has increased the number of homeless persons. No hard statistics on the homeless are available, but estimates of the number of people without a home on any given night in the United States range from a low of 230,000 to as many as 750,000.

It is difficult to estimate how many people are homeless because the num- ber depends on how the homeless are defined. There are street people — those who sleep in bus stations, parks, and other areas. Many of these people are youthful runaways. There are also the so-called sheltered homeless — those who sleep in government-supported or privately funded shelters. Many of these individuals used to live with their families or friends. Whereas street people are almost always single, the sheltered homeless include many famil- ies with children. Homeless families are the fastest-growing subgroup of the homeless population. The homeless problem pits liberals against conservat- ives. Conservatives argue that there are not really that many homeless people and that most of them are alcoholics, drug users, or the mentally ill. In con- trast, many liberals argue that homelessness is caused by a reduction in wel- fare benefits and by expensive housing.

Some cities have “criminalized” homelessness. Many municipalities have outlawed sleeping on park benches and sidewalks, as well as panhandling and leaving personal property on public property. In some cities, police sweeps remove the homeless, who then become part of the criminal justice system. In general, northern cities have assumed a responsibility to shelter the home- less in bad weather. Cities in warmer climates are most concerned with a year- round homeless problem. No new national policies on the homeless have been initiated, in part because of disagreement about the causes of and solu- tions for the problem.

Supplemental Security Income (SSI) A federal program established to provide assistance to elderly persons and persons with disabilities.

food stamps Benefits issued by the federal government to low-income individuals to be used for the purchase of food; originally provided as coupons, but now t ypically provided electronically through a card similar to a debit card.

earned income tax credit (EITC) program A government program that helps low-income workers by giving back part or all of their Social Security taxes.

550 P A R T V ● P U B L I C P O L I C Y

Immigration ■ 15.6  Discuss the issues raised by immigration into the United States and the

proposed reforms to the immigration system.

Time and again, this nation has been challenged and changed—and culturally enriched—by immigrant groups. Immigrants have faced the problems involved in living in a new and different political and cultural environment. Most of them have had to overcome language barriers, and many have had to deal with dis- crimination because of their skin color, their inability to speak English fluently, or their customs. The civil rights legislation passed during and since the 1960s has done much to counter the effects of prejudice against immigrant groups by ensuring that they obtain equal rights under the law.

One of the issues facing Americans and their political leaders today is the effect of immigration on American politics and government. Other issues are whether immigration is having a positive or negative impact on the United States and the form immigration reform should take.

The Continued Influx of Immigrants Today, immigration rates are among the highest they have been since their peak in the early twentieth century. Every year, more than 1 million people immigrate to this country, and people who were born on foreign soil now con- stitute more than 10 percent of the U.S. population—twice the percentage of 30 years ago.

Minority Groups’ Importance on the Rise Since 1977, four out of five immigrants have come from Latin America or Asia. Hispanics have overtaken African Americans as the nation’s largest minority. If current immigration rates continue, by the year 2060, minority groups collectively will constitute the “majority” of Americans. If Hispanics, African Americans, and perhaps Asians were to form coalitions, they could increase their political power dramatically and would have the numerical strength to make significant changes. Many commentators predict that the longtime white majority will no longer domin- ate American politics.

The Advantages of High Rates of Immigration Some regard the high rate of immigration as a plus for America, because it offsets the low birthrate and aging population. Immigrants expand the workforce and help support through their taxes government programs that benefit older Americans, such as Medicare and Social Security. If it were not for immig- ration, contend these observers, the United States would be facing even more serious problems than it already does with funding these programs (see Chapter 16). In contrast, nations that do not have high immigration rates, such as Japan, are experiencing serious fiscal challenges due to their aging populations.

Attempts at Immigration Reform A significant number of U.S. citizens, however, believe that immigration—both legal and illegal—negatively affects America. They argue, among other things, that the large number of immigrants seeking work results in lower wages for Americans, especially those with few skills. They also worry about the cost of providing immigrants with services such as schools and medical care.

C H A P T E R 1 5 ● D O M E S T I C P O L I C Y 551

Before the 2006 elections, members of Congress were in favor of enact- ing a sweeping immigration reform bill, but unsurprisingly, the two houses could not agree on what the bill should do. No law passed. Later in the year, however, Congress did pass legislation authorizing the construction of a 700-mile-long fence between the United States and Mexico. The fence is to be a real fence in some areas and a “virtual fence” using cameras and surveil- lance technologies in other areas. Although a combination of physical fence and “virtual” fence has been completed from San Diego, California, to Yuma, Arizona, President Obama ended any further construction, leaving about 1,450 miles of border without a fence or electronic monitoring.

By 2008, the debate seemed to have changed, with virtually all presidential candidates supporting legislation that would tighten the borders, force employ- ers to check the papers of their workers, and eventually build a path to citizen- ship. As the recession deepened in 2008 and 2009, many undocumented workers left the United States to return to Central America, and the problem of a “flood” of undocumented workers seemed to dissipate. Comprehensive immigration reform, although supported by President Obama, was not a priority on his first-term agenda. However, a number of states began to pass laws to curtail the activities of undocumented workers. In 2010, Arizona passed a law requiring state and local police and law enforcement officers to check individu- als’ citizenship or residency papers if they had been stopped on suspicion of an offense. The law, which requires local officials to enforce federal law, sparked a national debate. President Obama ordered the Justice Department to investig- ate whether the Arizona law was constitutional, and demonstrations against the law took place in many cities. In July 2010, Federal District Court Judge Susan Bolton issued a preliminary injunction blocking the most controversial parts of the law while allowing others to take effect, including one that bans cities from refusing to cooperate with federal immigration officials. The case was appealed by the state of Arizona and reached the Supreme Court in 2011. In June 2012, the Supreme Court held that a number of the provisions of the law were

Image 15-8 The U.S. Border Patrol picks up a group of undocumented

immigrants, including adults and

children, near McAllen, Texas.

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552 P A R T V ● P U B L I C P O L I C Y

unconstitutional, although the decision upheld the portion of the law allowing police officers who had stopped an individual on suspicion of a crime to ask for proof of citizenship or residency if they suspected the person was undocu- mented. The Obama administration announced that the federal offices in Arizona might not cooperate with police who made such arrests.

The Obama administration followed a two-pronged approach to dealing with undocumented workers. It stepped up raids on companies suspected of employing a number of such individuals and, if they were found, deported the workers. However, by 2011 the administration announced a policy that suspen- ded deportations of individuals who had not committed crimes. In 2012, the president, by executive order, suspended for one year any deportation of a young adult who had been illegally brought to this country by parents before the child was 16  if that young person had finished high school or was in post-secondary school or the military or gainfully employed. He ordered fed- eral agencies to issue work permits to such individuals if they were under 30 years old and had no serious criminal record.

In 2017, President Trump announced that he was ending this program, known as DACA, in six months. The Congress attempted to write legislation to reform immigration but failed within the six-month window. A federal judge overturned the president’s rule and DACA appeared headed for a lengthy legal battle.

The Range of Federal Public Policies The U.S. government implements policies that have been legislated by Congress across the entire spectrum of American life. Think about federal policies that affect colleges and universities: Title IX programs ensure that women have equal opportunities to play intercollegiate sports, and programs from the Department of Veterans Affairs provide tuition benefits for returning military veterans and for members of the reserves and the National Guard. Almost all aspects of the federal student loan program are regulated by the

Image 15-9 A Newtech Recycling employee collects e-waste during

Somerset County’s recycle e-waste

program at Newtech Recycling,

Inc., in Somerset, New Jersey. The

federal government regulates the

rare minerals used in the manufacture

of electronics such as these.

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C H A P T E R 1 5 ● D O M E S T I C P O L I C Y 553

federal government, from eligibility for a subsidized loan to the requirement that colleges keep accurate records of student attendance and dates of with- drawal from class.

The national government implements important policies to support the agricultural industry in this country, to keep the treatment of labor unions fair, to support school systems in their reform efforts, and to assist states to build and maintain highways and bridges. In these times of rising public deficits and seemingly expanding federal programs, a majority of Americans say that gov- ernment spending and programs should be cut, but the only program a major- ity of Americans agree should be cut is foreign aid to other nations, one of the smallest government programs in existence.

Key Terms domestic policy 524 earned income tax credit

(EITC) program 549 energy policy 540 environmental impact statement

(EIS) 534

food stamps 549 income transfer 546 in-kind subsidy 547 Medicaid 529 Medicare 529 national health insurance 532

single-payer plan 532 Supplemental Security Income

(SSI) 549 sustainability 536 Temporary Assistance to Needy

Families (TANF) 548

Chapter Summary ■ 15.1 Domestic policy consists of all of the laws, gov-

ernment planning, and government actions that af fect the lives of American citizens. Policies are created in response to public problems or public demand for gov- ernment action. Major policy problems discussed in this chapter relate to health care, poverty and welfare, immig- ration, the environment, and energy.

■ 15.2 The policymaking process is initiated when poli- cymakers become aware—through the media or from their constituents—of a problem that needs to be addressed by the legislature and the president. The process of policymaking includes five steps: agenda building, policy formulation, policy adoption, policy implementation, and policy evaluation. As the proposed policy is formulated and debated during the adoption process, the views of the public, interest groups, and the government are heard.

■ 15.2 Health-care spending represents about 18 percent of the U.S. economy, and it is growing. Reasons for this growth include the increasing number of elderly persons, advancing technology, and higher demand because costs are picked up by third-party insurers. A major third party is Medicare, the federal program that pays health-care expenses of U.S. residents age 65 and older. The federal government has tried to restrain the growth in Medicare spending, but it has also expanded the program to cover prescription drugs.

■ 15.2 About 15 percent of the population does not have health insurance—a major political issue. Most uninsured adults work for employers that cannot afford to offer health benefits. Hospitals tend to charge the uninsured higher rates than they charge insurance companies or the government. The United States has chosen to adopt a plan that combines government-required health insurance, private and public insurers, and private provision of ser- vices. Most Americans prefer this approach because they wish to choose their own medical providers.

■ 15.3 Pollution problems continue to plague the United States and the world. Several significant federal acts have been passed in an attempt to curb the pollution of our environment. The National Environmental Policy Act of 1969 established the Council on Environmental Quality. That act also mandated that environmental impact state- ments be prepared for all legislation or major federal actions that might significantly affect the quality of the environment. The Clean Water Act of 1972 and the Clean Air Act amendments of 1990 constituted the most signifi- cant government attempts at cleaning up our environment.

■ 15.4 Energy policy in the United States has generally sought to stabilize the supply of cheap energy to meet the demands of Americans. When energy sources are threatened, new policies have been adopted, such as increasing ef ficiency standards for automobiles, fund- ing research on new technologies, and suppor ting the

554 P A R T V ● P U B L I C P O L I C Y

use of alternative energy. All energy policies are deeply interconnected with environmental issues because the use of fossil fuels contributes to air pollution and climate change. Reducing the use of energy and using new technologies for cleaner energy make all energy more expensive for Americans.

■ 15.5 Despite the wealth of the United States as a whole, a significant number of Americans live in poverty or are homeless. The poverty threshold represents the income needed to maintain a specified standard of living as of 1963, with the purchasing-power value increased year by year based on the general increase in prices. The official poverty level is based on pretax income, including cash, and does not take into consideration in-kind subsidies.

■ 15.5 The 1996 Welfare Reform Act transferred more control over welfare programs to the states, limited

the number of years people can receive welfare assist- ance, and imposed work requirements on welfare recipi- ents. The act succeeded in reducing the number of welfare recipients in the United States by at least 50 percent.

■ 15.6 America has always been a land of immigrants and continues to be so. Today, more than 1 million immigrants from other nations enter the United States each year, and more than 10 percent of the U.S. population consists of foreign-born persons. Civil rights legislation has helped immigrants overcome some of the effects of prejudice and discrimination. Today, the controversy centers on a reform of our immigration legislation that will improve our system for temporary workers and enable undocumented immig- rants to have a path to citizenship.

Selected Resources

PRINT RESOURCES Avery, Samuel and Bill McKibben.  The Pipeline and the Paradigm:

Keystone XL, Tar Sands, and the Battle to Defuse the Carbon Bomb (Washington, DC: Ruka Press, 2013). This book researches the economic, ecological, political, and other issues behind the Keystone XL pipeline. The authors, through scientific evidence, link the proposed pipeline to global climate change.

Desmond, Matthew. Evicted: Poverty and Profit in the American City (New York: Crown, 2016). How important is housing policy to ending poverty in the United States? Desmond follows the sto- ries of families who are evicted from their homes in Milwaukee and the issues faced by landlords. The book provides a com- pelling look at the realities of the lives of poor tenants.

Edelman, Peter. So Rich, So Poor: Why It’s So Hard to End Poverty in America (New York: The New Press, 2013). A longtime advocate for ending poverty presents the evidence that the poor and people of color in the United States are continuing to fall behind the better-off Americans. He argues that the very structure of the economy leads to this state of affairs.

Emanuel, Ezekiel.  Reinventing American Healthcare: How the Affordable Care Act Will Improve Our Terribly Complex,

Blatantly Unjust, Outrageously Expensive, Grossly Inef- ficient, Error Prone System (New York: Perseus, 2014). Dr. Emanuel, an adviser to the Obama White House and con- tributor to the writing of the Affordable Care Act, presents his view of how the new health legislation will greatly improve the efficiency and effectiveness of the health-care system.

Gold, Russell.  The Boom: How Fracking Ignited the American Energy Revolution and Changed the World (New York: Simon and Schuster, 2014). An investigative reporter, Gold traveled to the oil and gas fields and interviewed executives, workers, and environmentalists to describe how the new ways of pro- ducing energy are changing the world economy.

Laufer, Peter and Markos Kounalakis. Calexico: Hope and Hysteria in the California Borderlands (Sausalito, CA: PoliPointPress, 2009). Calexico is a news-gathering travelogue that explores the California–Mexico border region, a land of its own inhabited by people who experience the immigration crisis in all its dimensions every day. Laufer is a foreign affairs journalist and radio commentator; Kounalakis is the president of the Washington Monthly.

MEDIA RESOURCES Climate of Doubt (PBS 2012)—In this documentary film, the focus

is on the competing groups that espouse global warming and the “deniers” who oppose this idea. Economic inter- ests clash with pure activists. https://www.pbs.org/video/ frontline-climate-doubt

Escape Fire (2012)—An award-winning documentary examin- ing the inefficiencies and cost of the American health-care

system. The film notes, we have a “disease care” system, not a health-care system. http://www.escapefiremovie .com/

Gasland Part II (HBO 2013)—HBO’s Gasland II presents even more evidence about the dangers of fracking and the false sense of safety and environmentalism that the drillers and industry project. http://www.gaslandthemovie.com/home

C H A P T E R 1 5 ● D O M E S T I C P O L I C Y 555

Promised Land (2012)—A film starring Matt Damon and John Krasinski that explores a conflict in a small town over fracking.

Sicko—A 2007 Michael Moore film critical of the U.S. health- care industry. Rather than focusing on the plight of the unin- sured, Moore addresses the troubles of those who have been denied coverage by their insurance companies.

In his most outrageous stunt ever, Moore assembles a group of 9/11 rescue workers who have been denied proper care and takes them to Cuba, where the government, perfectly aware of the propaganda implications, is more than happy to arrange for their treatment.

ONLINE RESOURCES Department of Energy, Energy Information Agency—compiles

every possible statistic on energy use, mining, drilling for oil, and the like: www.eia.gov

Environmental Protection Agency—the department charged with implementing the federal regulations regarding air and water pollution, its website documents current programs and gives valuable information about many environmental topics: www.epa.gov

Institute for Research on Poverty—offers information on poverty in the United States and the latest research on this topic: www.ssc.wisc.edu/irp

National Governors Association—bipartisan organization of the nation’s governors that promotes visionary state leadership, shares best practices, and speaks with a unified voice on national policy, such as the current status of welfare reform: www.nga.org

U.S. Census Bureau—reports current statistics on poverty in the United States: https://www.census.gov/topics/income- poverty/poverty.html

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