Once again, the Alcoa sombrero

It often feels futile writing about public health and health care policy when we all know that these issues are not going to be seriously addressed, at least on the federal level, in the current political context. And of course, I'm talking about the most pressing problems facing the country: the profound social structural and economic challenge posed by an aging population and relentlessly rising costs for health care; the entwined crises of petroleum depletion and global warming, and the radical economic challenges of the coming new energy age; the gathering clouds of wider war over energy resources amid the proliferation of nuclear weapons; the threats of microbial drug resistance and emerging infectious diseases.

But we aren't even seriously contemplating these issues as a nation. Our political culture is all about tribalism, fanaticism, and kleptocracy. The party in power uses political ideas -- if you can call its empty sloganeering, fear mongering, bullying and bigotry "ideas" -- only as a means to the end of power and personal enrichment.

The artificial TV world in which American politics now happens is a perfect habitat for these tactics, but finally, the polls are showing, more and more people are seeing through the lies. The consensus expectation is for a major shift away from Republicans in November, and likely Democratic control of one or more chambers of Congress. But we also know that the ruling cabal despises democracy and the constitutional order, has absolutely no scruples when it comes to holding on to power, and cannot afford any serious investigation of its rule. So, this has a lot of people worried. I happen to be one of them.

It is essential that we be prepared for even the most shocking possibilities. We can expect massive vote suppression and fraud, and tens of millions of dollars poured into slanderous attack advertising at the last minute, when there is no time to respond. That will happen. But we also might see war with Iran, a trumped up terrorism crisis, something, anything, to terrorize the people and further hammer at the foundations of the republic. And remember -- our constitution is not our friend. They only need one more vote in each chamber to hold on to absolute power. And then what?