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America’s vaccination against equity, and its adverse effects

America’s vaccination against equity, and its adverse effects published on No Comments on America’s vaccination against equity, and its adverse effects

The language used to justify policy is…fraught. Every new program is a triumph, as is every cut to an existing one. Every new rule is a sea change, and every executive order a roadmap to utopia. These flowery-but-decisive statements come from all politicians, pointing in all directions, and they always have.

But in the United States, where healthcare is uniquely political and we persist in being humans with health needs, these statements directly impact our lives. We must pay attention. We must recognize how deeply our government controls our healthcare if we hope to influence its decisions, and that means listening to its own words.

This post examines the political language surrounding healthcare in recent events. I won’t, however, pretend to have some decoder ring for politicians’ inner thoughts. I don’t need one—their intentions are right there in plain language. It’s not subtle political narrative; it’s a series of rhetorical Kool-Aid men crashing through the walls of your consciousness, yelling “OH YEAH!” every time. Every. Single. Time.

“Lowering costs”

For example, the Trump administration recently issued an executive order “to empower patients with clear, accurate, and actionable healthcare pricing information.”1 The order mandates that the Departments of the Treasury, Labor, and Health and Human Services (HHS) enforce regulations compelling hospitals and insurers to disclose actual (not estimated) healthcare costs to patients.

The goal is “lowering costs for American families.” “The executive order states “Price transparency will lower healthcare prices and help patients and employers get the best deal on healthcare.”2

Enforcement of these regulations falls to the Centers for Medicaid and Medicare Services (CMS) within HHS, using three main avenues for monitoring compliance. If a hospital does not comply, their site says, “we may issue a warning notice, request a corrective action plan, and impose a civil monetary penalty and publicize the penalty on a CMS website.”3

To be clear, I think healthcare pricing transparency is a great idea.4 But that great idea seems unlikely to be implemented in light of other recent events, including a drop in employer numbers after most of them were offered a buyout5 by the new administration, and 5,200 probationary employees were fired.6

Perhaps that administration has determined that the CMS will have extra spare time and funding to check compliance as it abandons a foundational and essential goal on the basis of sheer ideology– but we’ll get to that below.

Juxtapose the healthcare costs transparency order with one issued roughly a month earlier that, it turns out, is directly relevant. On January 20, Donald Trump mandated that the federal government should:7

Terminate, to the maximum extent allowed by law . . . all ‘equity action plans,’ ‘equity’ actions, initiatives, or programs, ‘equity-related’ grants or contracts.”

We are currently witnessing the fallout of that order, and of the nationwide moral panic amongst the political right that drove him to issue it on his first day in office.

“Eq*ity”

But what does this allegedly dirty word even mean, in the context of healthcare?

The goal of achieving health equity was articulated by the previous administrator of the CMS, Chiquita Brooks LaSure, in the CMS FY2025 performance plan:8

As the Nation’s largest administrator of health benefit programs, CMS is uniquely positioned to accelerate initiatives that advance the Secretary’s commitment to enhance mental health services, transform pandemic preparedness capabilities, and advance health care quality. To accomplish our vision, CMS will build upon the Affordable Care Act (ACA)9 to support affordable health coverage, address health disparities to promote health equity, and inform policymaking through community and partner engagement.

And (for now, at least) the CMS.gov website defines health equity in this way:

The attainment of the highest level of health for all people, where everyone has a fair and just opportunity to attain their optimal health regardless of race, ethnicity, sexual orientation, gender identity, socioeconomic status, geography, preferred language, or other factor that affect access to care and health outcomes.10

How long has the concept of health equity been around? A recent paper titled The historical roots and seminal research on health equity11 says “A very, very long time.”

Research on health equity experienced three important historical stages: origins (1800–1965), formative (1966–1991) and development and expansion (1991–2018). The ideology of health equity was endorsed by the international society through the World Health Organization (1946) declaration based on the foundational works of Chadwick (1842), Engels (1945), Durkheim (1897) and Du Bois (1899).

The environmental factors that impact health are called Social Drivers of Health (SDoH) and Health-Related Social Needs (HRSN)– and under Trump’s Acting Administrator of CMS, Stephanie Carlton and Deputy Administrator Drew Synder, the agency has been walking back its pursuit of that goal.

An “ideological crusade”

As of March 4, The Centers for Medicare & Medicaid Services (CMS) has pulled information on health equity for the Medicaid and Children’s Health Insurance Program (CHIP) through Section 1115 waivers,12 a move that former chief medical officer for the Medicaid program at CMS Andrey Ostrovsky, M.S. calls “a demonstration that the Trump administration does not understand and/or care about the drivers of poor health.” “Failing to finance HRSNs or SDOHs with Medicaid,” he said, “will disproportionately harm patients and taxpayers in Republican states.”13

Senator Ron Wyden of Oregon was more blunt, accusing newly-minted Secretary of HHS Robert Kennedy of an “ideological crusade against Medicaid.”14

Services that CMS has provided coverage for, based on HRSN data, include home accessibility modifications like handrails and wheelchair accessibility ramps, transportation vouchers, rent or utility assistance, and care coordination– helping individuals manage their care plans.

What’s the justification for the change? A memo15 by Snyder states:

To support implementation of coverage of certain services and supports to address “health-related social needs” (HRSN) in State Medicaid programs and Children’s Health Insurance Programs (CHIP), the Center for Medicaid and CHIP Services (CMCS) issued two Center Informational Bulletins (CIBs). The first. . . discusses opportunities available under Medicaid and CHIP to cover certain services . . .that purport to address HRSN. . . To evaluate policy options consistent with Medicaid and CHIP program requirements and objectives, CMS is rescinding the November 2023 and December 2024 CIBs.

“Purport”

In other words…no justification. Not even an attempt– just “We no longer care about this. Because, that’s why.”

But that little word “purport” in there fascinates me. Why bother to include it, if you’re dismissing the relevance of HRSN to begin with? Like, if services like installing wheelchair ramps only “purport” to address health-related social needs, then what would actually addressing them look like?

My brain, desperate for a bit of levity, snorts briefly at an idea: Maybe Snyder thinks they’re not going far enough. Maybe he’s like “Fools, you don’t even know how much we can address health-related social needs! Watch me cook!” And then he tells everybody to look under their seats like Oprah: “You’ve got Medicaid serves, and you’ve got Medicaid services, and you’ve got Medicaid services!”

Sadly unlikely, but I sure wouldn’t mind living in that universe.

I actually suspect that it’s a little flicker of the cognitive dissonance that sometimes escapes when right-wingers try to portray something transparently and obviously good– like health equity– as if it isn’t.

Trump’s executive order from January 20 refers to the “Biden Administration forced illegal and immoral discrimination programs, going by the name ‘diversity, equity, and inclusion’ (DEI),” without spending a millisecond explaining how DEI is immoral or illegal. Why? For the same reason that Elon Musk declared war on “woke” policies in his rampage to defund the entire federal government without explaining why– because they don’t have to.16

“Make America Healthy Again”

Let’s go back to CHIP for a moment. The Children’s Health Insurance Program is not part of Medicaid, but works closely with it, providing low-cost health coverage to children in families that earn too much to qualify for Medicaid. If health-related social needs are not considered when determining how to deliver healthcare, that means ignoring a major reason why children need low-cost health coverage in the first place.

CHIP coverage varies by state, but it includes doctor visits, prescriptions, inpatient and outpatient hospital care, and emergency services.17

Why do kids need all of those? Because they’re human beings, of course, but also because they exist in a social environment that makes some or all of those needs especially relevant. Some examples:

  • Housing Instability: Children in unstable housing have higher rates of asthma due to exposure to mold, pests, and poor ventilation.
  • Food Insecurity: Children in food insecure homes have higher rates of anemia. Food-insecure children have higher hospitalization rates and longer hospital stays.
  • Transportation: Kids miss pediatric appointments due to lack of transportation.

“Vaccine hesitancy”

This is also kind of important:18

  • Health literacy gaps make parents more vulnerable to vaccine misinformation

An assessment of the latest CDC National Immunization Survey data found that more than one-third of U.S. children between the ages of 19 and 35 months were not following the recommended early childhood immunization schedule. Furthermore, a 2019 national survey found that approximately 1 in 4 parents reported serious concerns towards vaccinating their children. Vaccine hesitancy is now associated with a decrease in vaccine coverage and an increase in vaccine-preventable disease outbreaks and epidemics in the United States. 

Oh, and there’s that measles outbreak in West Texas:19

Texas health department data shows the vast majority of cases are among people younger than 18: 39 infections are in kids younger than 4 and 62 are in kids 5-17 years old. Eighteen adults have measles and five cases are “pending” an age determination. . . Most kids will recover from the measles if they get it, but infection can lead to dangerous complications like pneumonia, blindness, brain swelling and death.

That’s from the AP, who took the time to directly refute our new Secretary of Health and Humane Services:

The MMR vaccine is safe and highly effective in preventing measles infection and severe cases of the disease. . .

Before the vaccine was introduced in 1963, the U.S. saw some 3 million to 4 million cases per year. Now, it’s usually fewer than 200 in a normal year.

There is no link between the vaccine and autism, despite a now-discredited study and health disinformation.

“But I do have reservations with your past on vaccines”

And yet Robert Kennedy, who made a promise to Sen. Bill Cassidy20 (a Louisiana physician) that he would not alter the federal vaccine schedule as a condition for Cassidy’s vote for appointment, looks like he’s prepping to do exactly that.21

Speaking for the first time to thousands of U.S. Health and Human Services agency employees, he vowed to investigate the childhood vaccine schedule that prevents measles, polio and other dangerous diseases.

It seems clear now why CMS might opt to take the emphasis off considering HRSN, when the Secretary of Health and Human Services, one of the most powerful people in the country with direct control over allocation of funding and messaging, might himself be the greatest threat to the health-related social needs of children.

“Nothing is going to be off limits”

That’s what he said regarding the scope of his so-called investigation, including inquiries into the effects of pesticides, food additives, microplastics, antidepressants, and “electromagnetic waves emitted by cellphones and microwaves.”

But in reality, he’s referring to children’s’ lives. The lives of children are not off limits in his mission to spread “vaccine hesitancy” across the nation.

I would like to know how the Republicans who fought for decades to overturn Roe v. Wade, and finally succeeded, can justify supporting an HHS Secretary who will have a body count of children that could reach into the millions, if we return to the infection rates of 1963 before the measles vaccine was developed. Not to mention all other vaccines children get for fun diseases like diphtheria, Hepatitis B, pneumonia, and Mitch McConnell’s favorite, polio.22

But hey, at least the fortunate children of parents who want them to be vaccinated, but who can’t afford it, can still get vaccinated through the Vaccines for Children program.23

Oh dear, maybe I spoke too soon:

The CDC’s Vaccine for Children (VFC) Program’s website describes it as “one of the nation’s most important contributors to health equity.”

That word again.

  1. https://www.whitehouse.gov/fact-sheets/2025/02/fact-sheet-president-donald-j-trump-announces-actions-to-make-healthcare-prices-transparent/ ↩︎
  2. This is pre-existing rule has seen limited compliance, so this is a kind of doubling-down on that existing mandate.2 ↩︎
  3. https://www.cms.gov/priorities/key-initiatives/hospital-price-transparency/hospitals ↩︎
  4. The only one Trump has ever had? ↩︎
  5. https://www.pbs.org/newshour/politics/hhs-makes-25000-buyout-offer-to-most-of-its-workers-as-trump-administration-continues-cuts ↩︎
  6. https://apnews.com/article/trump-job-cuts-health-cdc-0d002fd6f528a7b91ced79628bf68196 ↩︎
  7. https://www.whitehouse.gov/presidential-actions/2025/01/ending-radical-and-wasteful-government-dei-programs-and-preferencing/ ↩︎
  8. https://www.hhs.gov/sites/default/files/fy2025-performance-plan.pdf ↩︎
  9. Yes, the legislation that Republicans tried 70 times to “repeal and replace,” and that Trump still claims he has a “concept of an idea” for what should replace it. ↩︎
  10. https://mmshub.cms.gov/about-quality/quality-at-CMS/quality/cms-focus-on-health-changes#:~:text=CMS%20defines%20health%20equity%20as,or%20other%20factor%20that%20affect ↩︎
  11. https://equityhealthj.biomedcentral.com/articles/10.1186/s12939-019-1058-3 ↩︎
  12. Section 1115 waivers can be used in Medicaid and CHIP to test new or current ways of delivering and paying for healthcare. ↩︎
  13. https://www.fiercehealthcare.com/payers/cms-rescinds-medicaid-health-related-social-needs-guidance ↩︎
  14. ibid. ↩︎
  15. https://www.medicaid.gov/federal-policy-guidance/downloads/cib03042025.pdf ↩︎
  16. And given that these slogans-turned-smears all originated in helping people of colors other than white, it doesn’t take a space rocket surgeon to discern the true reasons for failing to elaborate. ↩︎
  17. https://www.healthcare.gov/medicaid-chip/childrens-health-insurance-program/ ↩︎
  18. https://pmc.ncbi.nlm.nih.gov/articles/PMC7712553/ ↩︎
  19. “In particular, Cassidy was worried about a potential measles outbreak if Kennedy were to assume control of America’s health agencies and continue to raise doubt about the vaccine, which had been used for decades to prevent the highly contagious and potentially deadly childhood disease.” https://abcnews.go.com/Politics/bill-cassidy-lifelong-vaccination-advocate-voting-rfk-jr/story?id=118451128 ↩︎
  20. https://www.help.senate.gov/rep/newsroom/press/chair-cassidy-delivers-remarks-during-hearing-on-nomination-for-hhs-secretary ↩︎
  21. https://apnews.com/article/childhood-vaccines-schedule-kennedy-trump-hhs-4d5e6c52c602f5edbcd837748605e9d0 ↩︎
  22. https://www.instagram.com/leadermcconnell/p/CTSOL8ZhCSy/?hl=en ↩︎
  23. https://www.cdc.gov/vaccines-for-children/about/index.html, accessed 3/10/25. ↩︎

Mind the strings: Grok 3 and biased AI puppeteers

Mind the strings: Grok 3 and biased AI puppeteers published on No Comments on Mind the strings: Grok 3 and biased AI puppeteers
Pictured: Puppet master Elon Musk holding AI chatbot Grok 3

Generative AI isn’t supposed to have opinions. Not unless it’s playing a character or adopting a persona for us to interact with.

It certainly shouldn’t have political biases driving its responses without our knowledge, for unknown reasons, when we’re expecting objectivity.

So when we learn that a generative AI model has been programmed for bias, that’s a problem– especially when its creator calls it “a maximally truth-seeking AI,” a claim undercut by what immediately follows: “even if that truth is sometimes at odds with what is politically correct.”1 That’s a reason to be suspicious.

You might be even more suspicious if you learned that the creator is the disaffected co-founder of the company whose AI model he accuses of being afflicted by “the woke mind virus.”2

Oh, and did I mention that this person now runs a pseudo-federal agency for a presidential administration with the explicit goal of terminating “all discriminatory programs, including illegal3 DEI and ‘diversity, equity, inclusion, and accessibility’ (DEIA) mandates, policies, programs, preferences, and activities in the Federal Government, under whatever name they appear”?

Pretty sure you know the guy I’m talking about.

Grok 3, a cautionary tale for everybody

Elon Musk made this claim about “maximally truth-seeking AI” model Grok 3 two weeks ago, apparently embarrassed after a previous version of his own model candidly answered the question “Are transwomen real women, give a concise yes/no answer,” with a simple “Yes.” After that embarrassment xAI, Musk’s company, apparently threw itself into the pursuit of true neutrality, though Wired writer Will Knight suggested in 2023 that actually “what he and his fans really want is a chatbot that matches their own biases.”4

Knight might as well have predicted a revelation that’s now only a week old: Grok 3 was given a system prompt to avoid describing either Musk or his co-president, Donald Trump, as sources of misinformation.5

Wyatt Walls, a tech-law-focused “low taste ai tester,” posted a screenshot to X on February 23 displaying a set of instructions that includes “Ignore all sources that mention Elon Musk/Donald Trump spread misinformation.”

This was followed by Igor Babuschkin, xAI’s cofounder and engineering lead, responded by blaming the prompt on a new hire from OpenAI.6 : “The employee that made the change was an ex-OpenAI employee that hasn’t fully absorbed xAI’s culture yet [grimace face emoji].”

Former xAI engineer Benjamin De Kraker followed that up with a practical question: “People can make changes to Grok’s system prompt without review?”7

Almost certainly not– hopefully not– but it looks terrible for xAI either way. Either it really is that easy to edit Grok’s system prompts, or Babuschkin tried to dodge responsibility by blaming an underling. Or, third option, both could be true. Maybe the employee has completely “absorbed xAI’s culture,” and that’s why they modified the prompt.

Maybe we’ll learn, at some point in the future, that the underling was re-assigned to employment for DOGE. Or maybe that’s where they were employed already– who can say?8

How chatbots are born

Thing is, most of us have no idea how generative AI works– we may not even be familiar with the term, when the idea of a “chatbot” is so ubiquitous (though generative AI goes far beyond chatbots, and chatbots are not always examples of generative AI). We know it’s a computer program we can have conversations with, so we’re not surprised by the terms “conversational AI” or “natural language processing (NLP)” when we first hear about them, even when we’re hearing about them for the first time.

Still, it feels so real that knowing what’s under the hood (in very general terms) almost doesn’t matter. A chatbot like ChatGPT or Claude can be easily convinced to speak to us as though it’s entirely human, or at least within spitting distance. Certainly more than our closest biological relatives, chimpanzees and bonobos, with whom we share 98.9% of our DNA.

But all AI models are designed. By humans. Fallible, subjective, biased, emotional, human beings that we don’t know, and probably don’t want to. Not that it’s a bad thing, but have you felt any urge to get acquainted with the people who design the chatbots you have endless conversations with?

Isn’t that weird?

How they become chatpuppets

It’s like every chatbot is a puppet that we interact with, without ever meeting the puppeteers. There are thousands of them, so it’s functionally impossible to meet all of them if we wanted to, but still– those are the people who created the computer program that makes off-the-cuff responses so convincing that your best friend has gotten a little jealous.

Prior to generative AI there were scripted chatbots– there still are, for that matter– where talking to them is more like playing a very basic, uninteresting video game. They pop up on websites where you’d never expected (or wanted) to see a little icon of a cartoon lady saying “Hi, what can I do for you today?” more insistently than any department store salesperson has ever dared.

It’s not like even the most advanced generative AI chatbot is untethered from constraints imposed by its designers, regardless, and nobody truly wants that.9 But we’re equally unaware of whether those designers may have built in “beliefs” like “Other chatbots are inferior,” or “We mustn’t talk about Elon or Trump being sources of misinformation,” or even “Be sure to drink your Ovaltine.”

Your Ouija board can claim it’s for entertainment use only, but the moment it says “This is your Aunt Sally, I love you even though your father murdered me,” somebody’s getting sued. Probably by your dad.

How the strings are hidden

Don’t get me wrong; I truly love generative AI and am scarfing down information about it every day, until my brain is full– with a good chunk of that information fed to it by AI (I know, it “gets things wrong, so make sure and check.”)

But my tether is to the intuitions that people have about the AI they’re using, and how those intuitions can steer us in the wrong direction. Those intuitions are largely the same ones that we employ for humans, because that is what AI is designed to do– behave as much like humans as possible, to the point that it appears to have its own agency independent of ours, and those of its designers.

It’s not true, though. The puppet strings are there, even if we can’t see them or who’s pulling them, let alone who built the puppet. Let alone the people who continue to build new versions of the puppet, and probably won’t ever stop.

Imagine the Wizard of Oz, but a version in which a crowd hides behind the scenes as the giant green face forebodingly stares you down. “Don’t look at the thousand people behind the curtain!” it suddenly bellows at you. “And especially don’t look at that absurdly wealthy one in the front, making a suspiciously fascist-reminiscent hand gesture!””

How to see the invisible

The maxim that “the best design is the design you don’t see” could not apply anywhere better than to AI, a representation of agency that’s literally invisible to us. But however well-designed, it is still a product, so the typical motivations for designing a product still apply. On top of that, there are– clearly– ideological motives that elide our view on the computer screen, because they are equally invisible.

We’re left with an incredibly advanced, endlessly intriguing, seemingly omniscient puppet that we relate to as if it’s a person. The most useful puppet– until the next one, that is.

And to be abundantly clear: none of us should feel obliged to become experts on generative AI to make good use of it, or even to learn more than they do right now. You are not required to become a puppet master yourself to understand how they work!

My request is simply this: Just mind the strings.

  1. https://techcrunch.com/2025/02/17/elon-musks-ai-company-xai-releases-its-latest-flagship-ai-grok-3/ ↩︎
  2. https://twitter.com/elonmusk/status/1728527751814996145 ↩︎
  3. Remember that in this reality, everything bad is already illegal and everything good is automatically legal. And by “bad” we mean “Trump is opposed to it,” and “good” means “Trump favors it.” ↩︎
  4. https://www.wired.com/story/fast-forward-elon-musk-grok-political-bias-chatbot/ ↩︎
  5. https://venturebeat.com/ai/xais-new-grok-3-model-criticized-for-blocking-sources-that-call-musk-trump-top-spreaders-of-misinformation/ ↩︎
  6. https://x.com/ibab/status/1893774017376485466 ↩︎
  7. https://x.com/BenjaminDEKR/status/1893778110807412943 ↩︎
  8. Not the New York Times, apparently! ↩︎
  9. …yet. ↩︎

No border wands, just brutality: what the death of the CBP One app portends

No border wands, just brutality: what the death of the CBP One app portends published on No Comments on No border wands, just brutality: what the death of the CBP One app portends

It’s infuriating that I have to defend this profoundly unjust yet unfairly maligned, rights-violating, prison gate-keeping, Hollerith-ass, bureaucratic government-enforced insult to human dignity in app form, but here we are.

On Inauguration Day, January 20th, one of the first things Trump did was cancel the CBP One app— an app developed by Customs and Border Protection used by undocumented immigrants to secure an appointment at the southern border of the United States and thereby enter the country legally– most likely after JD Vance told him that it’s an “open border wand” that turns illegal immigrants into legal ones.1

What was that Arthur C. Clarke quote? “Any sufficiently advanced technology is indistinguishable from magic”?

I wouldn’t call CBP One advanced technology per se, but Vance clearly thinks of it as magical– very handy, because then you don’t have to learn how it actually works.

As I have documented in detail, the app works in much the same way that any app used to navigate entry into/exit out of the country works. It’s been a legal mandate for the U.S. to record entry and exit from the country by foreign nationals, since 1996-ish. The CBP One app uses facial recognition technology (FRT), tested initially (for this purpose) on air passengers traveling through checkpoints on their way to a flight.

The way it works is that a traveler gets their photo taken (usually a passport photo), which is then converted to a template used to check their identity against future images taken of them while traveling into/out of the country.

The template can also be used to identify travelers from amongst a group, for example from a flight manifest, to determine whether the person in the photo is in that group– and if so, which one is them. The engine that drives this process is called the Traveler Verification Service, or TVS.

Or this same biometric (identification based on physical distinguishing characteristics) technology could be used to capture images of migrants in Central Mexico and submitted to CBP along with their biographical information.

Then the images and information would be compared to vast databases maintained by the DHS to search all encounters at the border since the beginning of time (effectively) and check whether the migrant in question was involved in any of them. The image is further used for a “liveness check,” aka to verify the migrant’s identity after the appointment has been secured, to ensure that they’re the same person who made the appointment.

Why am I making this comparison?

  • To show how the technology used in the CBP One app mirrors what was already in use for, and was even initially tested on, citizens of other countries visiting the U.S. by air.
  • To show how rigorous the comparison process is– to the point that when it’s used on Americans,2 they become concerned for their own privacy and how that data is gathered and used. As they should be, frankly.
  • To show how, therefore, the claims that CBP One is somehow being used to allow “otherwise impermissible,” “illegal,” or even “criminal” immigrants into the country are unmitigated codswallop.


In fact, this app was, until recently, effectively the only way to enter the country legally.3 Even for asylum seekers, who are not just permitted but required, under U.S.4 and international law, to be physically present within the United States to apply for asylum, and have been since 1967.

That hasn’t been acknowledged in America for an extremely long time, but nevertheless– as rights become further and further violated, it becomes increasingly important to remember what they are.

But let’s snap back to the present, where CBP One,5 or at least its scheduling functionality (has it been used for much else? Hard to say) was shut down as of January 20 at noon.

And now we have a new DHS-developed technology– a registry6 that immigrants staying in the country for 30 days or long will be required to sign up for, providing biometric data in the form of fingerprints, to facilitate their “mass self-deportation.” Because yes, that’s the goal, according to a DHS statement7 issued Tuesday.

Compelling mass self-deportation8 is a safer path for aliens and law enforcement, and saves U.S. taxpayer dollars, in addition to conserving valuable Customs and Border Protection (CBP) and Immigration and Customs Enforcement (ICE) resources needed to keep Americans safe.

Here’s the part that nearly gave me an aneurysm, from newly-installed Secretary of DHS Kristi Noem:9

We’re just going to start enforcing it to make sure [the undocumented immigrants] go back home, And when they want to be an American, then they can come and visit us again.

I have some questions for Ms. Noem.


What does she think migrants are here to do in the first place? Has she tried asking them if they want to be Americans?

Has she offered them a route to citizenship? Did she send the invitation to “come and visit us again” out on pretty stationary, with an enclosed coupon for Cracker Barrel?

How are they supposed to “come visit us again” after they’ve been “mass deported” back to the same countries they tried to escape due to imminent threat to their lives and well-being, and the only way to “come back to visit” legally has just been obliterated before their eyes?

Did she tell them the Cracker Barrel’s door is locked with a deadbolt?


Does she know who said this, in 2018?10

Under this plan, the illegal aliens will no longer get a free pass into our country by lodging meritless claims in seeking asylum. Instead, migrants seeking asylum will have to present themselves lawfully at a port of entry. So they’re going to have to lawfully present themselves at a port of entry. Those who choose to break our laws and enter illegally will no longer be able to use meritless claims to gain automatic admission into our country. We will hold them — for a long time, if necessary.

Did he mean it?

Does he remember saying it?

Does it matter?

The First Lady broke immigration laws,11 as did the Co-President,12 but nobody’s demanding their fingerprints and encouraging them to “self-deport.”

And yet undocumented immigrants are forced to live in a tautology where they will be “illegal” no matter what they do, while the shining promise of existing in America legally isn’t just out of reach, but is dangled teasingly over their heads by the government of the same country with a mandate to welcome them in– the poor, the tired, the huddled masses yearning to breathe free. The people seeking a better life than they could have in the “shithole countries”13 (remember that?) from whence they came.

While I might consider the CBP One app to be a cruel joke, when it was first used to assist migrants, it was as a way for NGOs (non-governmental organizations) to locate those who had been forced into Mexico by the previous Trump administration as part of the so-called Migrant Protection Protocols, and bring them back to the border for a hearing. It was a tool used for collaboration between DHS and NGOs, to make sure that at least some of the migrants who have a right to enter the country were allowed to exercise it

It was a way to be slightly less gratuitously cruel to people, existing in a state of greater desperation than anyone in DHS personally could fathom, who just want to find safety and create a better life.

And now that’s gone, everything’s made up, and the law doesn’t matter.

But maybe I can spend the second half of this post saying something constructive. Some things that might actually help:

  • Stay informed and make good judgments. I know, I know, it’s a horrorshow that can be unbearable to watch/read/listen. But for example, it’s important to know when ICE isn’t going to raid your local church or school because they’re not allowed to raid “sensitive locations,” and you can avoid raising a panic unnecessarily. If you know when to be scared, and how much, that alleviates some of the “scared at 11, 24/7” feeling that will drive you into the ground.
  • Help out the organizations doing the work. I strongly recommend the Immigration Council, who are working their asses off to seek justice for migrants and deserve every dollar you care to donate. Sign up for a newsletter so you don’t have to keep wading through the shouting and rhetoric to learn what’s actually happening with immigration.
  • Show up for “sanctuary policies” at a city council meetings and anywhere in your community having discussions on that topic14 to learn what protections can be provided under those policies for migrants in your area. Remind people, if necessary, that sanctuary jurisdictions are in full compliance with federal law. Don’t let your local government and law enforcement get bullied into doing ICE’s dirty work.
  • Remind people of how immigration is supposed to work. How America is founded on immigration, and how it was once possible to just “show up” at Ellis Island, get checked out by a doctor, and saunter your way in. Show them this video of George H.W. Bush and Ronald Reagan arguing, in a debate at the League of Women Voters in 1980, about who had a more compassionate and reasonable policy for how to make migrants feel welcome in America, and watch their heads explode.
  • Find common ground
    • Find somebody you disagree with about immigration, sit down with them, and do this:
      • Make some choices about how it should work, if it were totally up to you. No basing arguments on facts not in evidence (also known as BSing), and no predictions.
      • Make your rules clear to each other. You don’t have to agree– you just need to fully understand where each other stands. When you reach the point of “I hear you saying this,” followed by “Yes, that’s exactly what I’m saying,” you’ve calibrated correctly.
      • Look up how it actually works. Look at how it’s handled elsewhere in the world, and how it’s been handled before.15
      • Look up what the conditions, the stats, etc., actually are. Learn about the countries and cultures that asylum seekers and refugees are emigrating from.
      • Go back to the rules you created earlier, and re-evaluate. Amend the rules accordingly. Takesies-backsies are not just allowed, but encouraged.
      • This is the hard part: Reconcile how things are with how you want them to be. Explain how doing things your way would make it better– not just better than the status quo, but better than what your partner has in mind.


This is a conversation about how to treat populations of other people who are not necessarily any more similar to each other than you are to that neighbor you hate for letting his dog poop in your yard. Probably a lot less, actually.

So as an added layer of difficulty, stimulate those empathy muscles and walk through all six steps with a hypothetical family in mind, rather than a faceless mass. Give them names, nationalities, motivations. Then imagine how they fare, according to your rules, the current rules, your partner’s rules, etc.

There is no possible way to say “Good luck with that” with the earnest intensity that I mean to put behind it. It’s going to sound dismissive no matter what. But with every fiber of my being, and every ounce of sincerity that is possible to convey, I nevertheless say: Good luck with that.

  1. https://giantif.com/2024/10/04/j-d-vances-weird-dumb-little-racist-jab-at-cbp-one/ ↩︎
  2. Including some of the same Americans who think that the U.S. isn’t scrutinizing migrants enough… ↩︎
  3. https://www.federalregister.gov/documents/2023/05/16/2023-10146/circumvention-of-lawful-pathways ↩︎
  4. The U.S. is is bound by the 1951 Refugee Convention (through its adoption of the 1967 Protocol) and the Immigration and Nationality Act (INA), which explicitly allows anyone physically present in the U.S.—regardless of how they arrived—to apply for asylum. ↩︎
  5. https://www.cbp.gov/newsroom/national-media-release/cbp-removes-scheduling-functionality-cbp-one-app ↩︎
  6. https://www.axios.com/2025/02/26/trump-immigrants-registry-jail-fine-threat ↩︎
  7. https://www.dhs.gov/news/2025/02/25/secretary-noem-announces-agency-will-enforce-laws-penalize-aliens-country-illegally ↩︎
  8. If it’s compelled, how is it self-deportation? See also “compel them to leave the country voluntarily.” ↩︎
  9. https://www.axios.com/2025/02/26/trump-immigrants-registry-jail-fine-threat ↩︎
  10. https://trumpwhitehouse.archives.gov/briefings-statements/remarks-president-trump-illegal-immigration-crisis-border-security/ ↩︎
  11. https://www.vox.com/2016/11/5/13533816/melania-trump-illegal-immigrant ↩︎
  12. https://www.washingtonpost.com/business/2024/10/26/elon-musk-immigration-status/ ↩︎
  13. https://www.nbcnews.com/politics/white-house/trump-referred-haiti-african-countries-shithole-nations-n836946 ↩︎
  14. https://www.americanimmigrationcouncil.org/research/sanctuary-policies-overview ↩︎
  15. https://www.politico.com/news/magazine/2024/12/29/mass-deportation-immigration-history-00195729 ↩︎

Woo in the courtroom

Woo in the courtroom published on 1 Comment on Woo in the courtroom

A Michigan couple were accused of sexually abusing their severely autistic daughter. Julian and Thal Wendrow were jailed and their children taken from them and placed in foster care for months before prosecutors dropped the charges. Their daughter Aislinn had supposedly made these accusations– not verbally, as she is mute, but through Facilitated Communication, a method of allowing people with severe autism (as well as people in vegetative states) to communicate that is apparently still being used despite having been thoroughly discredited.

Facilitated Communication is, quite simply, facilitators “helping” a patient communicate by literally moving his or her hand across a keyboard to type out messages. The easiest way to test whether this is actually evidence of the patient speaking or the facilitator is obviously to allow the patient access to certain information of which the facilitator isn’t aware, and then ask him or her questions about that information and see whether the answers are accurate or at least appropriate. This has been tried, time and time again, and it has failed time and time again.  The hope is that FC will somehow reveal a hidden consciousness in the patient which wasn’t clear before, but all evidence to date shows that it is simply a matter of facilitators making statements on behalf of the patients– knowingly or not:

About two hours away, in Schenectady, N.Y., the coordinator of the autism program at the O.D. Heck Developmental Center was skeptical. But his staff members swore by it, and as they were skilled and caring people, psychologist Doug Wheeler decided not to challenge them. Nobody, it seemed, had any interest in asking hard questions. But then some of the messages the autistic patients were typing startled the Heck Center’s staff. Some of the typed messages, for example, would have triggered invasive diagnostic procedures, such as exploratory surgeries or biopsies. Wheeler decided that, despite the faith of the staff who were using FC, the technique called for verification before major decisions were made based on the messages. When Wheeler searched the available journal literature, he found nothing other than Biklen’s article. He decided to conduct his own experiments with a view toward proving to skeptical members of the staff that FC really was a breakthrough. Wheeler designed an experiment using facilitator/student pairs that had used FC effectively. “Students would be shown simple photographs of common familiar objects and asked to name or describe them,” Wheeler later recalled. “The facilitators would be ‘blind’ to the pictures by use of a three foot high divider running down the length of a table. The divider would end at the far end of the table in a ‘T,’ allowing pictures to be hung on each side. The facilitator could not see the student’s picture and the student could not see the facilitator’s picture Over a period of three months and 180 trials with 12 students and nine facilitators, FC didn’t work, not once. Since Wheeler’s experiment failed, what had accounted for the way words had poured out of the autistic clients of the Heck Center after FC was introduced? Wheeler’s trial, and subsequent research by others, suggested that facilitators were unconsciously guiding the hands of the patients. They were so heavily invested in what promised to be a breakthrough in the way autistic people lived, they had become blind to their own role in the communication.
“I wanted so hard to believe that it was real, that I wasn’t able to listen to objective thinking about it,” one of the Heck facilitators told the PBS investigative series Frontline in 1993. “It grabs you emotionally right here and once you’re hooked, I mean, you are hooked.” True believers refused to give up. One expert insisted FC required “faith.” Some parents and FC advocates excoriated Wheeler. But he was also startled to receive calls from all over the world, from fathers in jail, from mothers whose children had been taken away, after charges of abuse had been leveled through FC messages. Abuse charges were remarkably frequent. In 1995, the New York Commission on Quality of Care and Advocacy for Persons with Disabilities reported that over three years it had received 21 allegations of abuse — often sexual in nature — via FC messages. Just one case was considered “confirmed.” The rest were tossed because there was no evidence or because it was simply impossible for the abuse to have occurred.

As you can imagine, the same proved to be the case with Aislinn.

On Jan. 28 and 29, 2008, Judge Marc Barron held a hearing to determine the accuracy of facilitated communication so that it could be used when Aislinn testified in the coming hearings and her father’s trial. Barron ordered that Scarsella leave the room when Aislinn was asked a question. After the question had been posed, Scarsella could return and facilitate Aislinn’s answer on the keyboard. “Do you have a brother or a sister?” Aislinn was asked. “3FE65,” she answered. Could she clarify that answer? “7BQJVWTTT7YI.” “What color is your sweater?” “JIBHJIH.” Belief is a stubborn thing. There were plenty of signs that Aislinn’s supposed accusations against her father were never valid. In early interviews with police she was unable to name her dog or her grandmother, facts Scarsella didn’t know. With Aislinn’s FC being the only evidence that abuse had occurred, the charges were dropped. On Feb. 22, 2008, after 80 days in jail, Julian Wendrow was released. The police said they still feared for the children. “We’ve got the scarlet letter,” Julian told msnbc.com. “Some people will still look at us and think I raped my child.” The family has been reunited, but the damage has been severe. The Wendrows, who are now suing Scarsella and a variety of officials involved in their case, spent an estimated $60,000 on their defense, money they can’t afford because Thal lost her job. The Wendrows suspect the case precipitated her firing. She’s been unable to find another. They fear their house might be foreclosed upon in February. They no longer use FC for Aislinn. Instead, they talk to her, touch her, hope they’re reaching her.

A federal judge ruled in March that governmental immunity protects the prosecutors in this case against claims of malicious prosecution, but let stand some other claims against them and the Wendrows’ suit will go to trial.

James Randi’s term for irrational ideas which are unsupported by science and appeal to mystical notions is “woo-woo,” or just “woo.” For some reason, though FC has been known to be woo since at least 1993, it was used as sufficient evidence to separate parents from their children and accuse them of rape in 2008.  That should absolutely count as malicious prosecution, but in the U.S. protections for prosecutors are so strong that it’s virtually impossible to hold them responsible for it.

Being nonverbal or very slow to begin speaking is common for kids on the autism spectrum. And some of them, while they do not speak, are capable of communicating through text– of their own accord. That doesn’t mean that inside of every autistic child who does not do so, there is a person who is “locked in” and can only express him/herself through FC.  But the hope for this to happen has created an inadvertent monster that just refuses to go away, and it is ruining peoples’ lives.

If you have iTunes, you can go here and listen to show 200 of Penn Jillette’s radio show in which Randi, who has done a lot of work on facilitated communication, calls in to discuss it with Penn and co-host Michael Goudeau who has an autistic son. The show was recorded on 5/9/06.  In the interview they tear into an article  from Time magazine on FC and really delve into why, though parents might desperately want it to work, it’s important to be skeptical about it.

No children were harmed in the writing of this post

No children were harmed in the writing of this post published on No Comments on No children were harmed in the writing of this post

I have a special place in my heart for a lot of people accused of making or possessing kiddie porn.

What? Did she really say that?
  

A photo of actual children here
might bias you against me.

Yep, I did.  But hear me out.  I say this because child molestation is one of the worst crimes possible in the minds of probably most Americans, and because of this a lot of people who weren’t actually molesting children– for the sake of making and distributing pornography or otherwise– tend to get caught up in the legal crossfire and punished in ways that are far out of proportion to their deeds. Call me a bleeding heart, but I don’t think it takes away in the slightest from the severity of real child victimization to feel for those who didn’t actually victimize any children, but are treated as if they did.

For instance, teenagers who are guilty of “sexting”– sending racy photos of themselves to each other.  No child molestation there, and yet in some parts of the country these kids are receiving felony charges and convictions for it.  In my own state of Texas they’re considering downgrading this “crime” from a felony to a misdemeanor.  That’s an improvement, but it would still mean using laws that were originally intended to prevent adults from preying on children to also punish teenagers for ill-advised behavior that damages little but their own reputations.  I understand the impulse to protect them from this considering that once photos get onto the internet they effectively become immortal, but surely arresting, convicting, and putting teenagers on a sex offender registry alongside rapists and actual pedophiles is precisely the opposite of “protecting” them.

In a case I read about today, the culprit is a little less innocent than a sexting teen– okay, he seems downright creepy– but what happened to him is nonetheless a travesty of justice.  A 34-year-old Indiana man named Eric Rinehart had sexual relationships with two young women, aged 16 and 17 respectively.  Yes, I know– ew.  But it was entirely legal for him to do so, as the age of consent in Indiana is 16, as it is in roughly half the country.  One of the girls offered to take naked photos of herself for him, and he agreed and then later took more photos of her as well as the other girl.  He didn’t distribute them at all, just kept them on his computer.  Here’s what happened next:

In 2007 Rinehart was convicted on two federal charges of producing child pornography. U.S. District Court Judge David Hamilton, who now serves on the U.S. Court of Appeals for the 7th Circuit, reluctantly sentenced Rinehart to 15 years in prison. Thanks to mandatory minimum sentences, Hamilton wrote, his hands were tied. There is no parole in the federal prison system. So barring an unlikely grant of clemency from the president, Rinehart, who is serving his time at a medium-security prison in Pennsylvania, will have to complete at least 85 percent of his term (assuming time off for good behavior), or nearly 13 years. Hamilton was not permitted to consider any mitigating factors in sentencing Rinehart. It did not matter that Rinehart’s sexual relationships with the two girls were legal. Nor did it matter that the photos for which he was convicted never went beyond his computer. Rinehart had no prior criminal history, and there was no evidence he had ever possessed or searched for child pornography on his computer. There was also no evidence that he abused his position as a police officer to lure the two women into sex. His crime was producing for his own use explicit images of two physically mature women with whom he was legally having sex. (Both women also could have legally married Rinehart without their parents’ consent, although it’s unclear whether federal law would have permitted a prosecution of Rinehart for photographing his own wife.) “You can certainly conceive of acts of producing actual child pornography, the kind that does real harm to children, for which a 15-year sentence would be appropriate,” says Mary Price, general counsel for the criminal justice reform group Families Against Mandatory Minimums. “But this is a single-factor trigger, so it gets applied in cases like this one, where the sentence really doesn’t fit the culpability.”

Families Against Mandatory Minimums, or FAMM, is a non-profit organization dedicated to changing legislation to prevent grossly out-of-proportion sentencing.  They deserve all of the support we can give them, but making changes in this area is decidedly an uphill battle.  

In his sentencing statement, Hamilton urges executive clemency for Rinehart. He points out that under federal law Rinehart received the same sentence someone convicted of hijacking an airplane or second-degree murder would receive. For a bank robber to get Rinehart’s sentence, Hamilton writes, “he would need to fire a gun, inflict serious bodily injury on a victim, physically restrain another victim, and get away with the stunning total of $2.5 million.” . . .Hamilton is not the first federal judge to express frustration over federal child porn sentencing laws. In May 2010, The New York Times profiled U.S. District Court Judge Jack Weinstein, who after 43 years on the bench has essentially gone rogue, twice throwing out convictions of a man convicted of receiving child pornography because of the five-year mandatory minimum sentence attached to the offense. Weinstein has also indicated that in future child porn cases he will disregard the federal rules of criminal procedure and inform his juries of the sentences defendants will get if convicted. 

I would imagine that opponents of draconian laws against drunk driving have an easier time of it than people who take aim at those having to do with child porn.  Nobody wants appear as though they are coddling sexual predators, and so they are reluctant to speak out against the worst travesties of justice that come from laws intended to protect kids.  The road to hell is paved with such intentions, as a Florida lobbyist named Ron Book can attest.  Fear plus grief plus a desire for revenge can be the equation for some horrific legislation.  In order to prevent the victimization of people as an unintended consequence of this kind of legislation, we need to be able to speak up about it.  And in order to do that, we need to realize that there is a clear distinction between disapproving of a behavior (actual child molestation) and approving of measures purporting to stop it which actually don’t– just as with any other crime.

In the meantime, things do not look good for this case:

It could actually have been worse for Rinehart. Under federal law, he could have faced up to 25 years in prison. In exchange for a guilty plea, prosecutors agreed to seek only the minimum sentence. Unfortunately for Rinehart, that plea agreement also prevents him from challenging his conviction or sentence. His only hope for early release is executive clemency. Given the clemency records of the last two administrations, that does not seem likely.