January 6 must teach Americans to protect our democracy

This article is part of a collection on the events of January 6, one year later.  Echo essay by President Jimmy Carter  published in The New York Times.

President Jimmy Carter

One year ago, a violent mob, guided by unscrupulous politicians, stormed the Capitol and almost succeeded in preventing the democratic transfer of power. All four of us former presidents condemned their actions and affirmed the legitimacy of the 2020, election. There followed a brief hope that the insurrection would shock the nation into addressing the toxic polarization that threatens our democracy.

However, one year on, promoters of the lie that the election was stolen have taken over one political party and stoked distrust in our electoral systems. These forces exert power and influence through relentless disinformation, which continues to turn Americans against Americans. According to the Survey Center on American Life, 36 percent of Americans — almost 100 million adults across the political spectrum — agree that “the traditional American way of life is disappearing so fast that we may have to use force to save it.” 

The Washington Post recently reported that roughly 40 percent of Republicans believe that violent action against the government is sometimes justified.

Politicians in my home state of Georgia, as well as in other states, such as Texas and Florida, have leveraged the distrust they have created to enact laws that empower partisan legislatures to intervene in election processes. They seek to win by any means, and many Americans are being persuaded to think and act likewise, threatening to collapse the foundations of our security and democracy with breathtaking speed. I now fear that what we have fought so hard to achieve globally — the right to free, fair elections, unhindered by strongman politicians who seek nothing more than to grow their own power — has become dangerously fragile at home.

I personally encountered this threat in my own backyard in 1962, when a ballot-stuffing county boss tried to steal my election to the Georgia State Senate. This was in the primary, and I challenged the fraud in court. Ultimately, a judge invalidated the results, and I won the general election. Afterward, the protection and advancement of democracy became a priority for me. As president, a major goal was to institute majority rule in southern Africa and elsewhere.

After I left the White House and founded the Carter Center, we worked to promote free, fair and orderly elections across the globe. 

I led dozens of election observation missions in Africa, Latin America and Asia, starting with Panama in 1989, where I put a simple question to administrators: “Are you honest officials or thieves?” At each election, my wife, Rosalynn, and I were moved by the courage and commitment of thousands of citizens walking miles and waiting in line from dusk to dawn to cast their first ballots in free elections, renewing hope for themselves and their nations and taking their first steps to self-governance. But I have also seen how new democratic systems — and sometimes even established ones — can fall to military juntas or power-hungry despots. 

Sudan and Myanmar are two recent examples.

For American democracy to endure, we must demand that our leaders and candidates uphold the ideals of freedom and adhere to high standards of conduct.

• First, while citizens can disagree on policies, people of all political stripes must agree on fundamental constitutional principles and norms of fairness, civility and respect for the rule of law. Citizens should be able to participate easily in transparent, safe and secure electoral processes. Claims of election irregularities should be submitted in good faith for adjudication by the courts, with all participants agreeing to accept the findings. And the election process should be conducted peacefully, free of intimidation and violence.
• Second, we must push for reforms that ensure the security and accessibility of our elections and ensure public confidence in the accuracy of results. Phony claims of illegal voting and pointless multiple audits only detract from democratic ideals.
• Third, we must resist the polarization that is reshaping our identities around politics. We must focus on a few core truths: that we are all human, we are all Americans and we have common hopes for our communities and our country to thrive. We must find ways to re-engage across the divide, respectfully and constructively, by holding civil conversations with family, friends and co-workers and standing up collectively to the forces dividing us.
• Fourth, violence has no place in our politics, and we must act urgently to pass or strengthen laws to reverse the trends of character assassination, intimidation and the presence of armed militias at events. We must protect our election officials — who are trusted friends and neighbors of many of us — from threats to their safety. Law enforcement must have the power to address these issues and engage in a national effort to come to terms with the past and present of racial injustice.

Lastly, the spread of disinformation, especially on social media, must be addressed. We must reform these platforms and get in the habit of seeking out accurate information. Corporate America and religious communities should encourage respect for democratic norms, participation in elections and efforts to counter disinformation.

Our great nation now teeters on the brink of a widening abyss. Without immediate action, we are at genuine risk of civil conflict and losing our precious democracy. Americans must set aside differences and work together before it is too late.

Maine Writer P.S. - Thank you Mr. President! 

Advocating for Mental Health Care - a health parity issue opinion

An opinion column jointly authored by Mrs. Carter and Patrick Kennedy, two important advocates for Mental Health care.  Although Republicans talk about mental health, they and their insurance company lobbyists do very little to support access to quality and affordable mental health care.  

Thank you to President Jimmy Carter and to Mrs. Rosalynn Carter for your humanitarian careers. This opinion about Mental Health care is another example of how Mrs. Carter continues to advocate for people who are suffering from mental illness. By the way, I still regard Mrs. Carter's book "First Lady From Plains" to be the best #1 "First Lady books".

This echo opinion was published in the The Washington Post and other newspapers: 

Patrick Kennedy is the author of “A Common Struggle: A Personal Journey Through the Past and Future of Mental Illness and Addiction.” 

Almost 10 years have passed since Congress required that insurers offering mental-health services for illnesses of the brain, such as depression or addiction, do so no more restrictively than illnesses of the body, such as diabetes or cancer. And yet, most insurers today still do not comply with the law.

Mental-health parity is more important now than ever before, considering the rising numbers of overdoses and suicides nationwide. But state and federal investigations have shown that mental-health and addiction treatment are frequently far more onerous to manage.

This has become an issue of human rights. Too often, people seeking these treatments are denied coverage or don’t receive enough treatment because of insurers’ overly aggressive managed-care techniques and subsequently die from overdoses or suicides. In other cases, families — desperate to keep their loved ones alive — take out second mortgages, deplete retirement accounts and drain college funds to pay for treatment services their plans won’t cover.

To disrupt this vicious cycle, we must confront the reality that our current system of insurance-based health care oppresses those with mental-health and substance-use disorders.

Violations of mental-health parity laws can take many forms. Insurance companies frequently limit how long and how often patients can receive care through rigorous pre-authorization requirements. Patients also face narrow networks of mental-health providers; complicated drug formularies that limit prescription coverage; and requirements to try less expensive treatments before pursuing the most evidence-based treatment recommended by their doctor.

The ordinary consumer has no idea what to do when coverage is denied. Most don’t even know when a parity violation has occurred. That’s because health-insurance companies rarely provide specific information regarding details of a denial, which makes it difficult for consumers to file an appeal and alert regulators. In other cases, “medical necessity” review criteria are disclosed but incorrectly applied. As a result, confused patients and their providers are unable to challenge denials in a meaningful way — unaware of the resources available for help.

In no other health-care situation would this be acceptable. People with mental-health and addiction challenges deserve equal access to care. We must bring transparency to a system that counts on silence and confusion to save money.

The problem starts with the complexity of the law itself and the way our insurance system works. It took many years for the federal government to develop regulations to implement mental-health parity as mandated by Congress, and there are still gray areas on which many in the health-care industry disagree. These lack of guidelines and inconsistencies in compliance programs have contributed to poor enforcement efforts.

But there is hope. Federal and state regulators continue to issue more regulatory guidance, and representatives from the insurance industry, health-care providers and consumers are helping to develop the first set of comprehensive mental-health parity accreditation standards to be released this fall. Meanwhile, states such as Colorado, Delaware, Illinois, Tennessee and Rhode Island are developing their own solutions to increase access to mental-health and addiction treatment.

Some people decry the cost to achieve mental-health parity. But, ironically, neglecting to enforce the law is actually costing the federal and state governments billions of dollars. Patients who are depleted of resources often turn to Medicaid or other government-funded programs for assistance with treatment. Lack of coverage also leads to more people being incarcerated, which carries an exorbitant price tag for taxpayers. The Centers for Disease Control and Prevention estimate that the total economic burden of prescription opioid misuse in the United States is $78.5 billion a year, including the costs of health care, lost productivity, addiction treatment and criminal-justice involvement.

And yes, while any insurance mandate is likely to increase insurance premiums in the short term, we must consider the bigger picture. Costs for mental-health and substance-use disorder treatment are much higher once a condition or disease worsens. The ability to proactively address mental health and addiction — along with any other health condition — would help to alleviate this and improve clinical outcomes. We should also prioritize evidence-based treatments and technology to minimize costs.

It is easy to forget, amid the complexities of our health-care system, that real human lives are at stake here. Parents should not have to face financial ruin to save their children’s lives, especially after paying into an insurance plan for years. Sadly, this is happening across the nation.

Attitudes toward mental health and addiction are finally changing. Stigma and discrimination are no longer acceptable. Our system must catch up.

Rosalynn Carter, former first lady of the United States, is an advocate for mental-health care through the Carter Center. Patrick J. Kennedy, former U.S. representative, D-R.I., from 1995 to 2011, is the founder of the Kennedy Forum and an author on mental illness and addiction.