Rep. Adam Kinzinger on sacrifice & public service: “If you believe in what you’re doing, it’s worth it.”

Winter 2014 Volume 48, No. 1

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4 The Fight to Rebuild Our 17 The Cost of Doing Nothing Broken Mental Health System By Mary Giliberti By Tim Murphy After years of deep budget cuts, an Over 2 million Americans with serious examination of why investing in mental mental illness go without treatment each health care not only saves money, but year. This Congressman believes it’s time to saves lives. help them, and he’s got a plan to do just that. Politics & Perspective 6 The Real Mental Health Crisis in America By DJ Jaffe 20 A Proactive Step Toward According to this expert and activist, the Better Cyber Security problem facing the nation’s mental health By Patrick Meehan system is not one of money. Rather, it’s At a time when Congress is seemingly one of misplaced priorities. paralyzed by dysfunction, progress is being made to keep America’s cyberspace secure. 10 The Wisconsin Example By Robin Vos 22 In Pursuit of the American Dream The Speaker of the Wisconsin State Assembly By Greg Smith & Roger Fortin discusses how his state is reinvesting in mental Is it possible to quantify happiness? These health care and a package of reforms that two researchers think they have developed a was recently approved. formula that will do just that.

12 “This is an issue that 24 The New Politics of Evasion found me -- I didn’t find it.” By William A. Galston & Elaine C. Kamarck A Q&A with Gordon Smith A quarter century after Democrats moved to the Over a decade after the death of his son, center to regain relevance, a look back at their this former Oregon Senator is spearheading a move and the lessons for Republicans today. campaign to raise awareness of depression and end the stigma of the disease. Sections

15 The Invisible Wounds of War 3 In this Edition By Patricia Driscoll Today, one veteran commits suicide every 29 News & Events -- Ripon Society hosts Pew 65 minutes. A look at the work being done Research for Discussion on American Electorate. to end this epidemic and care for the combat- related injuries that no one can see. 32 Ripon Profile -- Rep. Adam Kinzinger

photo of Rep. Murphy on cover and page 4 by Greg Kahn Photography, LLC

Publisher The Ripon Society Editor One Year Subscription: Comments, opinion editorials and letters Louis M. Zickar $35.00 individuals President should be addressed to: The Ripon Forum, Jim Conzelman Deputy Editor $10.00 students 1155 15th Street, NW, Suite 550, Washington, Jarrad Hensley DC 20005 or may be transmitted electronically Editorial Board to: [email protected]. William Frenzel Editorial Assistant The Ripon Forum (ISSN 0035-5526) is Thomas Tauke Stephen Jackson published by The Ripon Society. The Ripon Society is located at 1155 15th Street, NW, In publishing this magazine, The Ripon Michael Castle Suite 550, Washington, DC 20005. Society seeks to provide a forum for fresh Michael Oxley ideas, well-researched proposals, and for a Postmaster, send address changes to: Billy Pitts © Copyright 2014 spirit of criticism, innovation, and independent The Ripon Forum, 1155 15th Street, NW, Pamela Sederholm thinking within the Republican Party. By The Ripon Society Suite 550, Washington, DC 20005. Judy Van Rest All Rights Reserved Jim Murtha

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© 2014 TE Connectivity Ltd. All Rights Reserved THE RIPON SOCIETY HONORARY CONGRESSIONAL ADVISORY BOARD In this Edition U.S. Senators: Every time there is a mass shooting in America, a predictable political storyline Pat Roberts - Senate Chair Roy Blunt unfolds -- Democrats and those on the left say it’s time to pass tougher gun laws, Richard Burr Susan M. Collins while Republicans and those on the right say it’s time to reform the way we treat the Orrin G. Hatch mentally ill. U.S. Representatives: The Democrats have been fairly specific in their policy prescriptions, whether Thomas E. Petri - House Co-Chair Pat Tiberi - House Co-Chair it’s closing the gun show loophole or limiting the size of clips that are used in guns. Renee Ellmers - Vice Chair, South Cory Gardner - Vice Chair, West Republicans, on the other hand, have tended to speak in generalities about mental health Erik Paulsen - Vice Chair, Midwest reform, leaving the impression that their specific policy prescriptions on the issue are Bill Shuster - Vice Chair, Northeast Spencer Bachus vague and unformed. Marsha Blackburn Charles Boustany This past December, Congressman Tim Murphy (PA-18) introduced a piece of Vern Buchanan Michael C. Burgess, M.D. legislation that could help the GOP reverse that impression. Murphy has over three Ken Calvert decades of experience as a clinical psychologist and is helping to lead the fight for mental Dave Camp Eric I. Cantor health reform on Capitol Hill. His bill is based on two simple premises. First, the vast Shelley Moore Capito Bill Cassidy, M.D. majority of mentally ill individuals are not violent. And second, those individuals who do Howard Coble have a serious mental illness require treatment, but are not receiving it under the system Tom Cole Ander Crenshaw that exists today. Rodney Davis Charlie Dent According to longtime advocate and activist DJ Jaffe, Murphy’s plan is also based Sean Duffy Rodney Frelinghuysen on another fundamental truth about the issue -- namely, that the problem America faces Jim Gerlach is not one of dollars. It is one of misplaced priorities, where, in his words, the latest Kay Granger Sam Graves “cause célèbre” such as bullying receives the bulk of the funding and attention while Tim Griffin Richard Hanna those who are most seriously ill are left untreated and ignored. We look at Murphy’s Darrell Issa plan and this problem in this latest edition of The Ripon Forum with essays from Jaffe Lynn Jenkins Dave Joyce and the Pennsylvania crusader, himself. Mike Kelly Adam Kinzinger We also look at the steps being taken to fight mental illness in the State of Leonard Lance Frank Lucas Wisconsin, where the Assembly has approved and Governor Scott Walker has signed Kevin McCarthy into law a mental health budget increase and package of related reforms. As Assembly Patrick Meehan Candice Miller Speaker Robin Vos writes in an op-ed for the Forum, both the budget increase and Randy Neugebauer Tom Reed reform package were passed with overwhelming support, reflecting not just the Jim Renacci bipartisan nature of the issue, but the fact that those who have been affected by this Reid Ribble Peter Roskam disease come from all walks of life. Jon Runyan Steve Scalise This includes the U.S. Senate. In 2003, Gordon Smith was serving as the senior Aaron Schock John Shimkus Senator from Oregon when he received word that his son, a 21-year old college student Lamar Smith who had been battling depression, had committed suicide. Over a decade later, Smith Steve Stivers Lee Terry is spearheading a campaign as President of the National Association of Broadcasters to Glenn Thompson Mac Thornberry raise awareness and end the stigma of mental illness. He talks about this campaign in Mike Turner this latest edition, and also discusses what it means to be a member of the “fraternity of Fred Upton Greg Walden suffering” who have been impacted by the disease. Edward Whitfield For what it’s worth, I’m a member of that fraternity, too. My older brother Members of Congress (Retired): Bill Frenzel - Chairman Emeritus suffered from mental illness. He spent all of his adult life in and out of hospitals and Bill Archer halfway houses, or hiking the Appalachian Trail, where, in solitude, I imagine he found Henry Bonilla Michael Castle some relief. He was a gentle soul and the smartest member of our family. And yet Geoff Davis Mike Ferguson his temperament was masked and his intellect lost to a disease that – 30 years after his J. Dennis Hastert David Hobson diagnosis and six years after his death -- we still do not fully understand. Nancy Johnson We govern by crisis in America. It should not take another crisis – another Bob Livingston Jim McCrery shooting – to take action on this issue. To that end, we hope this edition of the Forum Robert H. Michel Susan Molinari helps further the debate and, as always, we welcome any questions or comments you Don Nickles might have. Michael G. Oxley Bill Paxon Deborah Pryce Tom Reynolds Lou Zickar Tom Ridge Gordon Smith Editor Don Sundquist The Ripon Forum Tom Tauke Robert S. Walker [email protected]

RIPON FORUM Winter 2014 3 Cover Story The Fight to Rebuild Our Broken Mental Health System

Tim Murphy

Over the last year, as chairman of the House Energy and During my investigation, one barrier repeatedly showed Commerce Subcommittee on Oversight and Investigations, up for families trying to help a loved one with a serious I embarked on a detailed review of the nation’s mental- mental illness: Families and caregivers often are unable to health system. With my 30-plus years of experience as a share vital information with a physician about a loved one’s clinical psychologist, I was profoundly shocked to learn just medical history because of the consistent misinterpretation how archaic and ineffective federal mental health policy is of the privacy rule under the Health Insurance Portability in our country. and Accountability Act (HIPAA). My legislation Easily two million patients with serious and persistent strengthens HIPAA by empowering parents to talk about mental illness, many of and receive information whom lack insight into their about a mentally ill loved schizophrenia or bipolar one, which will allow disorder, go without medical physicians to make an treatment. Why? Because accurate diagnosis. the federal government has Clarifying HIPAA never approached serious rules is only the beginning mental illness as a health of changing the paradigm care issue. This laissez-faire so those with serious mental approach to brain illness has illness are treated with directly resulted in growing dignity and compassion. rates of homelessness The legislation also and incarceration for the encourages states such mentally ill over the last as Pennsylvania to adopt 20 years. Sadly, it has also “assisted outpatient led to numerous tragedies, treatment” (AOT) laws, including 38,000 annual which ensure that mental- suicides. health providers target care The result of my and resources to the subset comprehensive review is of seriously mentally ill legislation I introduced in who have repeat visits to December titled the Helping the hospital emergency Families in Mental Health room. New York state’s Crisis Act (HR 3717). This With my 30-plus years of experience AOT statute, known as bipartisan legislation marks “Kendra’s Law,” has the most significant overhaul as a clinical psychologist, I was reduced incarceration, of the nation’s mental health profoundly shocked to learn just emergency-room visits, system since President John homelessness, and F. Kennedy established how archaic and ineffective federal substance abuse by about community mental health mental health policy is in 70 percent among the centers 51 years ago. It our country. mentally ill. refocuses programs and The current approach resources on psychiatric to mental health can best be care for patients and families most in need of services but described by its deficits: too little integration with primary who are currently the least likely to get it. My bill increases or physical care; too few psychiatric hospital beds; too few treatment options, integrates mental and physical care, and psychiatrists, psychologists, and clinical social workers, reduces barriers and the stigma associated with mental especially ones who are trained and specialize in treating illness. the seriously mentally ill.

4 RIPON FORUM Winter 2014 The Helping Families in Mental Health Crisis Act in treating mental illness. This individual will ensure promotes integration of mental health with the rest of the federal tax dollars are spent on effective programs and medical system. It also expands the number of pediatricians treatments. and primary-care doctors trained in behavioral health so For far too long, those who need help the most have children and young adults can get immediate attention. been getting it the least, and where there is no help, there The inability to find qualified medical help deepens is no hope. We can, must, and will take mental illness the severity of damage to out of the shadows of ignorance, the human brain, making despair, and neglect and into that recovery all the more difficult. The current approach bright light of hope. It starts with Currently, patients wait on the Helping Families in Mental average two years after the to mental health can best Health Crisis Act. RF first signs of psychosis before be described by its seeing a doctor. A breakthrough treatment project at the deficits. In his sixth term representing National Institute of Mental Pennsylvania’s 18th congressional Health called Recovery After district encompassing suburban Initial Schizophrenia Episode, or RAISE, has shown Pittsburgh including parts of Allegheny, Washington, tremendous results by treating the patient earlier with Westmoreland and Greene Counties, Rep. Tim Murphy wrap-around services and low-dose medication. also serves as a Lieutenant Commander in the Navy Unfortunately, successful medical models such as Reserve Medical Service Corps as a psychologist RAISE are not getting out into the broader community. treating Wounded Warriors with post-traumatic stress The Helping Families in Mental Crisis Act places a new disorder and traumatic brain injury. Prior to serving in emphasis on evidence-based models of care by establishing Congress, Dr. Murphy, author of “The Angry Child” and an assistant secretary for mental health and substance-use “Overcoming Passive-Aggression,” was a practicing disorders, who must have clinical and research experience psychologist specializing in child and family treatment.

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RIPON FORUM Winter 2014 5 The Real Mental Health Crisis in America It’s not about money. It’s about misplaced priorities.

By DJ Jaffe

Prior to the 1960s, the United States mental health with schizophrenia have anosognosia. As a result of their budget was primarily spent providing treatment to people illness, hallucinations and delusions trump reality and with serious mental illnesses. Today, we’ve largely prevent them from recognizing they are ill. Not knowing abandoned the most seriously mentally ill and used the they are ill, they refuse voluntary treatment. John Hinckley budget for everyone else. “knew” the best way to get a date with Jodie Foster was As a result of this shift, about 200,000 mentally ill are to shoot Ronald Reagan. Russell Weston “knew” there homeless, 240,000 seriously mentally ill are in prisons, and was a “ruby red satellite” in the U.S. Capitol that could 125,000 are in jails. That’s more than three times as many be used to reverse time and shot two guards in order to as are in hospitals. find it. When people In 1955, there were are that seriously ill, half a million public voluntary services psychiatric beds for will not work. If the seriously ill – you build it, they which translated to will not come. A 340 beds per 100,000 kind, compassionate individuals. Today, system would help there are less than the most seriously ill 100,000 beds – get care, rather than which translated to pretend they don’t 17 beds per 100,000 exist. individuals. Because Congress is of this shortage, being misled by the it’s harder to get non-profit mental into Bellevue than In 1955, there were half a million public health industry, Harvard. which argues that Anyone well psychiatric beds for the seriously ill. ordinary life events enough to walk in Today, there are less than 100,000 beds. like bad grades, being and ask for treatment unemployed, having is not sick enough to Because of this shortage, it’s harder to an unhappy marriage be admitted. That get into Bellevue than Harvard. and this year’s cause makes involuntary célèbre, bullying, are admission – becoming a “danger to self or others” -- the mental illnesses worthy of Congressional funding. the only path to treatment. Hence, the “psychotic killer They ignore the homeless and psychotic who can’t get on a rampage” headlines we seem to be seeing so often treatment, sleep on the streets, forage through dumpsters these days. Community programs are no better. They for food, and scream at voices only they can hear. largely accept the highest functioning and offload the Money is not the problem – mission creep is. Mental most seriously ill to shelters, jails, prisons, and morgues. health spending totaled $100 billion in 2003, representing Programs that used to spend money treating those with 6.2 percent of all health care spending. By 2014, it is serious mental illnesses now spend those same dollars on expected to double to $204 billion. The elephant in stigma campaigns for those without any mental illness. the room is getting treatment to the most seriously Most people with mental illness are not more violent ill. Instead of treatment, the non-profit mental health than others. The same cannot be said, however, for the most industry argues for public education. This is based on the seriously ill. Up to 50 percent of the three million people mistaken assumption that the reason people do not get

6 RIPON FORUM Winter 2014 Public Psychiatric Beds per Population, 1955 and 2004–2005

State Beds per 100,000 population Beds per 100,000 population 2004–2005 beds as percentage 1955 2004–2005 of 1955 beds Mississippi 250.8 49.7 19.8% South Dakota 236.8 40.3 17.0% Delaware 359.9 33.8 9.4% New Jersey 410.7 32.4 7.9% New York 599.5 27.4 4.6% Minnesota 360.7 26.8 7.4% North Dakota 310.4 25.9 8.3% Connecticut 386.8 25.4 6.6% Wyoming 214.1 24.1 11.3% New Mexico 119.5 22.3 18.7% Virginia 315.8 22.2 7.0% Alabama 237.3 22.1 9.3% Kansas 214.6 21.7 10.1% Maryland 347.4 21.6 6.2% Missouri 291.2 21.5 7.4% Montana 303.2 20.9 6.9% Nebraska 346.7 20.7 6.0% Louisiana 282.6 20.2 7.1% Indiana 257.5 19.3 7.5% Oregon 292.8 19.2 6.6% Washington 296.9 18.9 6.4% Pennsylvania 366.7 18.9 5.2% Georgia 323.1 18.5 5.7% Tennessee 225.1 18.1 8.0% California 285.5 17.5 6.1% New Hampshire 490.7 17.2 3.5% North Carolina 232.4 17.1 7.4% Colorado 369.3 16.9 4.6% Massachusetts 462.1 15.8 3.4% Kentucky 256.2 15.6 6.1% Illinois 404.7 14.3 3.5% West Virginia 280.7 14.2 5.1% Utah 171.2 13.8 8.1% * Hawaii * NA 13.5 NA Wisconsin 405.5 13.0 3.2% Maine 331.0 12.6 3.8% † Rhode Island † 407.3 12.5 3.1% Florida 232.5 12.1 5.2% Texas 192.0 12.1 6.3% Idaho 200.5 11.3 5.6% Alaska * NA 11.3 NA Oklahoma 369.6 11.0 3.0% South Carolina 264.7 10.6 4.0% Ohio 319.7 10.6 3.3% Michigan 301.2 9.9 3.3% Vermont 342.3 8.9 2.6% Iowa 198.2 8.1 4.1% Arkansas 284.3 6.7 2.4% Arizona 172.4 5.9 3.4% Nevada ‡ 195.6 5.1 2.6%

* The District of Columbia was not included, since its public psychiatric hospital was used for many years for admissions of non-District residents and its data are not comparable with the states. Data are not available for Alaska and Hawaii in 1955, since they were not states at that time. † Rhode Island has no state or county psychiatric hospital but maintains psychiatric beds in a general hospital. Source: Treatment Advocacy Center.

RIPON FORUM Winter 2014 7 care is because they are so asymptomatic that the public that won’t happen again. needs special training to identify them, and that -- once n Create an Assistant Secretary for Mental identified -- treatment will be available. Neither is true Health and Substance Abuse Disorders – More than for the seriously ill. As Creigh Deeds learned, families anything, this individual is needed to end mission- can -- and do -- beg for treatment for loved ones already creep, reduce duplication, coordinate piecemeal federal identified as being ill. And yet they still can’t get it. agencies and stop the federal funding of non-evidenced If Congress wants to improve care, save money and based programs. But beyond that, the new Assistant reduce violence by the seriously ill, it should decrease Secretary would also be a champion of programs mental health funding and increase mental illness that help the most seriously ill, and help disburse funding. Replace mission creep with mission control. mental health block grants previously distributed That’s the idea behind the legislation that Pennsylvania by the Substance Abuse and Mental Health Services Rep. Tim Murphy introduced this past December, the Administration (SAMHSA) in order to free states Helping Families in Mental Health Crisis Act. Among from SAMHSA policies that prevent those funds from other things, Murphy’s proposal would: reaching the most seriously ill. n Get treatment to people who n Require SAMHSA and are too sick to accept voluntary CMHS to focus on serious mental treatment -- HR 3717 funds illness -- HR 3717 makes what demonstration Assisted Outpatient should be non-controversial reforms Treatment (AOT) projects. AOT to SAMHSA and CMHS. Among is limited to the most seriously other things, it requires all grants ill who have a past history of to be evidence-based, reviewed by violence, incarceration or needless persons with clinical experience hospitalizations caused by going in mental health treatment, and off treatment. It allows courts, prohibits SAMHSA from making after extensive due process, to grants not authorized by Congress. order them to stay in mandated and These reforms are needed because monitored treatment as a condition SAMHSA and CMHS fail to focus of living in the community and, on serious mental illness, fund equally important, order community programs that lack independent programs to provide the care rather evidence of effectiveness, and award than turn them away. New York’s DJ Jaffe taxpayer money to organizations that AOT program (also known lobby against treatment for as “Kendra’s Law”) reduced the most seriously ill. For homelessness, arrest, and Money is not the problem… example, in spite of the incarceration in excess of The elephant in the room is fact that getting the correct 75% each and cut costs in diagnosis is key to getting the half by reducing the use of getting treatment to the right medication, SAMHSA more expensive incarceration most seriously ill. distributes millions to and hospitalization. The “peer” groups that believe Department of Justice “psychiatric labeling is a certified AOT as an “effective crime prevention pseudoscientific practice of limited value in helping program.” people recover.” n Free parents of seriously mentally ill from n Preserve psychiatric hospital beds -- HR HIPAA Handcuffs -- Parents need information about 3717 rejects the mental health industry shibboleth the diagnosis, treatments and pending appointments of that everyone can survive safely in the community by their children in order to facilitate care. But doctors preserving a few inpatient psychiatric beds for those hide behind federal privacy standards passed as part who can’t. of the Health Insurance Portability and Accountability n Increase the role of the criminal justice system Act (HIPAA) and patient confidentiality laws included in setting mental health policies -- Many of the policies in the Family Educational Rights and Privacy Act espoused by the non-profit mental health industry, like (FERPA) to prevent parents from receiving it. School closing hospitals and making civil commitment more authorities identified Jared Loughner as being mentally difficult, increase the incarceration of people with ill and potentially dangerous before he shot Gabrielle serious mental illness. HR 3717 gives criminal justice Giffords, but HIPAA and FERPA laws kept his family powerful representation on federal advisory boards so in the dark. HR 3717 writes exceptions into the law so they can prevent these policies from being adopted.

8 RIPON FORUM Winter 2014 n Refocus PAIMI – PAIMI stands for the HR 3717 is supported by mainstream mental Protection and Advocacy for Individuals with Mental health organizations like the American Psychiatric Illness Program. Established with the noble purpose Association, American Psychological Association, and of providing representation to persons with serious Treatment Advocacy Center. It is supported by major mental illness who were being abused, the program has law enforcement organizations including the National morphed into a political advocacy machine that ignores Sheriff’s Association, and New York State Association the psychotic and assumes all persons with mental of Chiefs of Police. And it has passionate support illness are well enough to “self-direct” their own care. among families of the seriously mentally ill. The only PAIMI lawyers “freed” William Bruce from involuntary opposition comes from those who have benefitted from hospital care over the objections of his Mom and Dad. the mission creep or run programs that lack evidence William then killed his Mom. HR 3717 returns PAIMI of efficacy. to its original focus of helping people who need help, There is a crisis. It involves people with untreated and prohibits PAIMI groups from using federal funds to serious mental illness, not all others. Throwing money at lobby for other agendas. mental health as Congress has done will not help those with n Empower NIMH -- Under Dr. Thomas Insel, serious mental illness. Passing HR 3717 is the best chance the National Institute of Mental Health has forsaken Congress has at addressing the real problem. RF mission creep and now focuses on serious mental illness. HR 3717 turns over certain funds that were DJ Jaffe is Executive Director of Mental Illness Policy misspent by SAMHSA to NIMH, so they can find cures Org., a non-partisan, science-based think tank focused on for serious mental illness. serious mental illness (not mental health).

RIPON FORUM Winter 2014 9 The Wisconsin Example How one state is tackling the mental health crisis

ROBIN VOS

A package of bills that garnered overwhelming n Improving coordination of care among those who bipartisan support in the Wisconsin State Legislature this treat people with mental illness. session addresses an important issue in our state and country. n Increasing awareness and reducing the stigma that Mental health disorders affect millions of people every often accompanies mental health diagnoses. year, including an estimated 22 percent of adults. It can n Identifying and promoting best practices for take a toll on personal relationships, families and even the addressing the link between mental illness and substance economy. It is estimated that dependence and abuse. mental illness costs the United n Addressing mental illness States billions in lost productivity in the prison population. every year. The Speaker’s Task Force With reportedly half of on Mental Health held five public all lifetime cases of mental hearings around Wisconsin. illness beginning by age 14, Legislators heard from more than early intervention is essential. 70 experts and the public. After However, the stigma often weeks of deliberation, the task associated with mental illness force proposed reforms that were keeps people from seeking drafted into more than a dozen treatment; the median delay bills. One piece of legislation between the onset of a disorder creates a child psychiatry access and treatment is about ten years. line to help connect pediatricians The facts are daunting, but they with psychiatrists since many illustrate the need to take action. counties in Wisconsin lack even In Wisconsin, Republicans a single child psychiatrist. and Democrats agreed that our Speaker Robin Vos In order to attract doctors state’s system for treating those to underserved areas, one bill with mental illness was simply In Wisconsin, Republicans provides grants to doctors in not getting the job done. Last primary care or psychiatry to get February, I created the Speaker’s and Democrats agreed that them to practice in rural areas of Task Force on Mental Health our state’s system for treating the state. Another bill establishes and charged its chair, Rep. Erik those with mental illness was a new Treatment Alternatives Severson (R-Osceola), and and Diversions program vice-chair, Rep. Sandy Pasch simply not getting the for offenders with mental (D-Shorewood), with finding job done. health disorders to promote ways to increase access to care treatment over incarceration and improve the coordination of and hopefully reduce recidivism treatment. rates. In addition, there’s legislation that allows for more I wanted legislators to take a comprehensive look at communication between primary care physicians and mental mental health issues, which would lead to legislation to health professionals so doctors can work together in a patient’s address some of the main concerns. I tasked the 11-member best interest. When it comes to emergency treatment for a committee with recommending improvements in the loved one, a separate bill guarantees that interested parties following areas: have a right to have a judge review a three-party petition. n Eliminating barriers to treatment, and promoting Legislation also addresses the employment of individuals early and voluntary intervention for juveniles and adults in experiencing mental illness by creating five regional centers need of mental health services. around the state that will help with placement and support.

10 RIPON FORUM Winter 2014 Wisconsin’s two year budget also provided an increase of the Speaker’s Task Force on Mental Health and the in funding for mental health care. Nearly $30 million is Wisconsin State Legislature. The legislative package allocated to help meet the needs of individuals with mental and our budget initiatives are considered one of the most health concerns. Nearly $4 comprehensive packages million of that is invested in of mental health reforms Coordinated Services Teams The Speaker’s Task Force on Wisconsin has ever seen. that deal with community- Mental Health held five public Lawmakers not only increased based care for juveniles. More awareness of mental illness, than twice that amount is going hearings around Wisconsin … but we also addressed to the state’s Comprehensive After weeks of deliberation, problems relating to the access Community Services that the task force proposed to and coordination of care. help those with severe mental However, we know that illness. To help integrate reforms that were drafted into more needs to be done. In services throughout all aspects more than a dozen bills. the future, we will continue to of state services, the new look for additional avenues for Office of Children’s Mental improvement. I look forward Health is being created. In-home counseling for children to working with my colleagues on both sides of the aisle under the Medicaid program and peer-run respite centers to make further reforms and hopefully, provide a model for are both getting an increase in funding as well. Finally, the rest of the country to follow. RF approximately $12 million is being used for additional forensic units at the state’s Mendota Mental Health Institute Speaker Robin Vos is the 75th Assembly Speaker in to reduce wait times of patients and provide for timely Wisconsin. He is currently serving his fifth term in the treatment. Wisconsin State Assembly. Speaker Vos represents a I am proud of the work that was done by the members portion of Racine County in southeastern Wisconsin.

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In this system patients, physicians, businesses and government will all enjoy the rewards of high-value care. Physicians would have the opportunity to choose a payment model that reflects their specific practice setting. And this new system would foster innovation.

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This will happen. This must happen. Our patients—the 315 million people of America—are counting on it.

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RIPON FORUM Winter 2014 11 “This is an issue that found me -- I didn’t find it.” A Q&A with Gordon Smith

On the night of September 8, 2003, Senator Gordon Smith (R-OR) was getting ready for bed in his suburban Washington home when he heard a knock at his door. It was the police. They were there to inform Smith and his wife that their son Garrett, a 21-year old college student in Utah who had been struggling with depression, had committed suicide. “Shock and numbness held me for a moment above what looked to be the blackest depths of sorrow and failure,” Smith would later write in his 2006 book, Remembering Garrett. “Joy vanished and years of striving and achieving now appeared as ashes to me. Success in business, service in church, election to the United States Senate – in an instant, it all seemed meaningless, even vain. I had failed to save my own son.” For Smith, the day was both a tragedy and turning point – a day when he lost a child and gained a cause. In the years since, he has become one of America’s leading advocates for ending the stigma of mental illness. Through his current position as President and Chief Executive Officer of the National Association of Broadcasters, he is spearheading a campaign to raise awareness of the disease and provide assistance to those who need it the most. The campaign is called “OK2TALK.” Since its launch last July, local TV and radio stations across the country have provided over $35.5 million in free airtime for ads and other messages intended to make sure people have a better understanding about mental health and mental illness. The Forum recently spoke with Smith about this campaign and his experience as a former legislator and parent who has been personally affected by this disease.

RF: How has America’s mental health care system GS: The role of Congress is to think differently about changed over the past 11 years? mental health. In the past, this issue has been put in the attic. GS: It has been improving, but it has a long way to go. But it needs to be given as much attention as issues related Progress was made during my time in public service with to physical health because mental health is really a physical Senator Wellstone and Senator Domenici. Additionally, illness of the brain. I authored a significant piece of If you don’t have mental the legislation that was passed health, but seem otherwise unanimously by the United What I learned after my physically healthy, you do not States Senate -- The Garrett Lee son’s death is that mental in fact have health. The keys are Smith Memorial Act -- that led to early identification, and making additional legislative progress. illness touches nearly every sure treatment is available and Health insurance policies person and every family affordable. And I think that, in the now provide somewhat greater end, Congress should make sure parity for mental health insurance either directly or through that as part of the mental health benefits. And the Veterans associations of relatives offering, or as part of the health Administration, because of our and neighbors. offering to our citizens, mental foreign wars, has stepped up health occupies an equal place with its response to mental illness. all other kinds of health care. Additional research dollars and heightened awareness -- these things are improving. RF: Could you tell us about the mental health But the safety net of mental health in our country still awareness campaign you’re spearheading as President needs a lot of improvement, as instances like Sandy Hook of the National Association of Broadcasters? make clear. We’ve got a long way to go. GS: This was the outgrowth of the terrible tragedy at Sandy Hook. Vice President Biden called all of the RF: As a former legislator, what is the role of entertainment industry in to talk about what we could do in Congress in improving the mental health care system? response.

12 RIPON FORUM Winter 2014 The National Association of Broadcasters volunteered, belong to a “fraternity of suffering.” Could you talk with my urging, to produce a public awareness campaign. for a moment about this “fraternity” and how parents We did so, raised the money, and produced the “OK2TALK” and family members are particularly impacted by this campaign. disease? It has been a spectacular success. The PSAs suggest four GS: What I learned after my son’s death is that mental things in 30 seconds -- that it’s okay to talk about mental illness touches nearly every person and every family either health; that help is available and effective; that if you need directly or through associations of relatives and neighbors. help, you should get it; and, that if you know someone who Those who have survived the suicide of a loved one are victims is struggling, help them to get help. as well. As a result of this campaign, broadcasters have provided What I found when the news of our son’s death began over $35 million in free airtime to spread is that people from every around the country. The response imaginable walk of life could relate on our Tumblr page has been to it and had some experience with overwhelming, which makes clear a friend or loved one who suffered how serious a problem this is in our from mental illness. The fraternity of society. suffering – the fraternity of survivors of mental health -- is enormous in this RF: Which is more country. important at this point -- So we all have a stake in making education or funding? sure that the safety net of our country GS: They really can’t be includes and keeps a prominent place separated. Education is critical, for mental health care. but education takes resources. We have to take the messages of the RF: Looking back on your OK2TALK campaign, and we need son’s struggle with mental to spread them far and wide. illness, and looking at your own We need to train health care efforts to combat the disease professionals, educators and parents now, what do you hope your to recognize the signs of mental legacy will be when all is said illness and do something about it, The role of Congress is and done? whether it’s in their families, with to think differently about GS: I would hope that people their loved ones, or among their mental health. In the past, would know that this is an issue that neighbors. So I really think it’s a found me -- I didn’t find it. But it is mistake to separate education from this issue has been put in an issue on which I’ve labored long funding -- they go hand-in-hand. the attic. and, I hope, well. I also hope I’ve made a positive difference in the RF: Are there any specific lives of those who suffer like my son changes in current law that you believe should be did. I hope that many lives of our fellow citizens can be saved made to strengthen mental health care? and made better with the knowledge that mental health cannot GS: All of the laws that Congress has already passed only be restored, but that healing is possible. should be fully implemented by the Executive Branch. And I think that one of the things we need to understand in our however the Affordable Care Act is ultimately resolved, society is that mental illness is a physical illness. If we regard mental health must retain a place equal to physical health it as the physical manifestation of an illness of the brain, the in the health care delivery system of our nation -- that’s the stigma could go away. We should have the same empathy for bottom line. those who suffer mental illness as we do when loved ones suffer RF: You’ve said that you and your wife now other physical illnesses. They really are the same in the end. RF

QUICK FACTS: Since July 2013, America’s broadcasters have set aside over $35.5 million in free airtime for the OK2TALK campaign. This includes over 293,380 TV and radio airings in English and Spanish. The TV spots are airing in all 210 television markets. The OK2TALK tumblr page has received 25,374 followers, 5,600 personal submissions, more than 62,000 engage- ments, 488,000 total visits (316,000 unique), more than 1 million page views, and more than 102,000 clicks on the "Get Help" button, that takes you to mentalhealth.gov/suicide prevention resources.

RIPON FORUM Winter 2014 13

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10185377 : N J UMBER OB Date: 2-5-2014 12:57 PM 12:57 2-5-2014 Date: DRINKABLE WATER.DRINKABLE FOR A THIRSTIER PLANET. can solve anything. Solutionism. anything. solve can water, fidrinkable water. to drinking 15 of Saltwater ltering gallons water per minute. million Dow solutions like DOW FILMTEC DOW like solutions Dow The new optimism. new The ™ reverse osmosis membranes are helping satisfy the rapidly increasing demand for demand increasingrapidly the satisfy helpingare membranes osmosisreverse ® Together, science and humanity T:10.875” S:10.625” B:11.125”

www.solutionism.com ®™ The DOW Diamond Logo, the Human Element and design, and Solutionism and design are trademarks of The Dow Chemical Company © 2014

14 RIPON FORUM Winter 2014

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The Invisible Wounds of War The new optimism. new The ™ reverse osmosis membranes are helping satisfy the rapidly increasing demand for demand increasingrapidly the satisfy helpingare membranes osmosisreverse

PATRICIA DRISCOLL

Our nation has been at war for more than 12 years. troops and veterans who have suffered these hidden

® Since September 11, 2001, we have sent more than 2 wounds. The ultimate goal of Help Save Our Troops million of our sons and daughters into harm’s way. is to reduce military suicides. Through this campaign, These patriots have selflessly volunteered to defend the the AFF provides counseling services for military freedoms we hold dear as Americans. families, including children, grants for therapy and As more and more of our service members return addiction counseling, and runs a variety of recreational home, the responsibility of our nation to live up to group therapy programs to boost morale among service promises made is getting more difficult. members, veterans, and their families. One of the greatest challenges facing service Tragically, for some families, it is already too late. members and veterans In 2012, there were 349 suffering from Post- suicides among active

Together, science and humanity Traumatic Stress duty service members, Disorder (PTSD) and which is more than Traumatic Brain Injury were killed in action. (TBI) is the stigma Currently, one veteran associated with these commits suicide every diagnoses. These heroes 65 minutes, up from T:10.875” S:10.625” B:11.125” are suffering internally one every 80 minutes through no fault of their during 2012. This, own. It is easy to see too, is an epidemic the physical wounds, but that deserves national it’s impossible to look attention and needs to inside the mind of a man end. or woman who needs The Help Save Our help. Troops campaign also According to the Patricia Driscoll speaks at a Ripon Society breakfast seeks to alter the way National Institutes of discussion on September 11, 2013. that the military health Health, there are more care system deals with than 600,000 veterans the repercussions from with PTSD. In 2012, In 2012, there were 349 suicides the invisible wounds there were 50,000 cases among active duty service members, of war. The AFF is of PTSD diagnosed, and advocating for an some estimate 184 new which is more than were killed 18-month extension cases are diagnosed each in action. of TRICARE mental day. Since 2001, there health benefits, which have been more than would allow service 230,000 cases of Traumatic Brain Injury. members and veterans to access the care they so These numbers are staggering. Unfortunately, urgently need, even if the problems take root long after they’re also increasing each year. This is an epidemic. the initial injury is sustained. Now, as citizens, it’s our turn to act. This is why Another step that Congress can take is passing the we have launched the Help Save Our Troops campaign reauthorization of the TBI Act, which would allow for at the Armed Forces Foundation (AFF). grants to be extended through 2018 to provide better The Help Save Our Troops campaign proactively access to rehabilitation services. educates Americans about the invisible wounds of The AFF has also partnered with USC’s Center war, including PTSD and TBI, and advocates for those for Innovation and Research on Veterans and Military www.solutionism.com ®™ The DOW Diamond Logo, the Human Element and design, and Solutionism and design are trademarks of The Dow Chemical Company © 2014

RIPON FORUM Winter 2014 15

S:8.125”

T:8.375” B:8.625” Families in an effort to provide veterans with counselors effectiveness of hormone treatments that could improve who have served in combat situations themselves. the outcomes of people suffering from TBI. Additionally, the AFF established a partnership with These efforts rely on modest financial support the Johns Hopkins University Military and Veterans from Congress, but have the potential to drastically Health Institute to work on innovative research in tissue impact treatment for these invisible wounds. The AFF regeneration, PTSD and TBI therapies, and better ways is committed to raising awareness for these programs to diagnose these wounds. and advocating for more Doctors from Johns Hopkins research into healing the have participated in the According to the National long-term impacts. Foundation’s Congressional Institutes of Health, there The AFF prides itself Lecture series and other are more than 600,000 on returning 95 cents of programs discussing PTSD every dollar raised to and TBI and the innovation veterans with PTSD. help service members, being conducted at the veterans, and their Institute. Since 2011, the AFF has partnered with Johns families cope with the invisible and physical wounds Hopkins University School of Medicine’s Department and ensure we truly live up to our motto of “Serving of Plastic Surgery on an awareness effort for their those who Serve.” innovative hand and face transplant program. We don’t want anyone to become a statistic. We’re There are many promising advancements being here to help. RF pursued in the medical treatment of invisible wounds. A blood test is being developed in order to more accurately diagnose the severity of a TBI soon after Patricia Driscoll is President and Executive Director the injury. Research is being done to determine the of the Armed Forces Foundation.

16 RIPON FORUM Winter 2014 The Cost of Doing Nothing Why investing in mental health care saves money – and lives

MARY GILIBERTI

From 2009-2012, states cut $4.35 billion from their mental mental illness. The goal should be to divert individuals from health care budgets. Cost-cutting strategies mostly occurred incarceration into treatment and to provide supports and services without regard to cost-effectiveness or the need for strategic so they don’t enter the criminal justice system in the first place. reorientation of the mental health system. Police Crisis Intervention Teams (CIT), mental health Last year, 37 states began reversing the trend, but the courts and community services like assertive community damage has been done. It will be a long time before what was treatment (ACT) serve both diversion and prevention purposes. lost will be regained. The challenge now is to transform the With ACT, teams of mental health professionals visit individuals system while rebuilding it. One in four adults experiences a where they live rather than expecting them to come to an office. mental health problem in any given This proactive approach helps year. One in 17 lives with the most people stay on a path to recovery serious conditions. As many as one -- and protects against relapses. in five children also experience ACT programs in the Chicago mental disorders. and Rochester, NY areas have Unlike many other chronic shown savings up to $20,000 conditions, mental illness begins and $40,000 per person over the at an early age. Fifty percent of cost of hospitalizations or jail lifetime cases of mental illness sentences. begin by age 14 and 75 percent by Pre-booking diversions, age 24. Treatment from the time of including CIT, can reduce re- onset is delayed on average eight arrests by approximately 60 to 10 years. The mental health percent. In the juvenile justice care system is rigged to respond to system, services such as functional crises, rather than early screening, family therapy (FFT), a short-term sustained treatment and social intervention that focuses on family supports. Structural choices involve interaction patterns, reduce crime costs, but instead of providing and recidivism. Savings with FFT continuity of care, the system is Mary Giliberti are approximately $32,000 per fragmented and uncoordinated. person, but few communities offer Policymakers often lack The mental health care system such services. information for making sound Without early identification choices. Hard data is elusive. is rigged to respond to crises, and treatment, childhood mental Returns on investment — outcomes rather than early screening, disorders affect how children — are not accurately measured. sustained treatment and learn and behave. In turn, school Analyses across different budget systems confront higher special sectors are difficult or non-existent. social supports. education costs, increased The system begs for integrated, disciplinary issues and lost uniform, and transparent data. education time. At the same time, schools can play an important When taxpayer dollars aren’t spent on evidence-based, role in community mental health partnerships. In Minneapolis, cost-effective programs, cost-shifting occurs across different community mental health services are delivered in school systems. The criminal justice system is one of the most dramatic facilities. For families, the arrangement is convenient, requiring examples. Investing in mental health care at the front end can less time away from work. Local agencies engage young result in cross-system savings overall. In state prisons and people more effectively, and students are better able to integrate local jails, 20 percent of inmates live with mental illness. In the learning and coping strategies for school and home. juvenile justice system, the prevalence is 70 percent. Supported housing and supported employment services can Correction facilities are probably the worst places to treat also reduce cost-shifting. Supported housing costs significantly

RIPON FORUM Winter 2014 17 less than homeless shelters or jails or hospitals. Louisiana, that states will gain resources from expansion and individuals Tennessee and Utah are among states with model programs. with mental illness will be able to get care earlier. Large, urban states do not have a monopoly on innovation. Even in states that have expanded Medicaid, it is critical to Only about 20 percent keep co-pays low, since of individuals living with they otherwise serve as mental illness are employed. Only about 20 percent significant disincentives About half of these work of individuals living with mental for people seeking help full-time. The vast majority illness are employed … The vast when they need it. Mental want to work and would be illness and poverty make successful with supported majority want to work and would be it very difficult for some employment services, but successful with supported employment individuals to obtain only two percent receive continuous treatment. It is them. Communities lose services, but only two percent important to eliminate any economic earning power. receive them. financial barrier to getting Costs increase for programs care. Failure to do so such as Supplement Security Income (SSI), Social Security will result in increased costs to criminal justice and emergency Disability Income (SSDI), Medicaid and Medicare. providers. Medicaid is the single largest payer for state mental health Investing in evidence-based services and supports and services and tends to serve those people with the most severe providing accessible early care will yield long term benefits. illnesses. However, many individuals with serious mental illness Our current system is spending significant resources for poor have difficulty completing the process for obtaining SSI, which is outcomes. We can do better. RF a pathway to coverage under Medicaid. Overall, almost 40 percent of people living with mental illness are uninsured. Expanded Mary Giliberti is the Executive Director for the National coverage will help many of them get care. Cost studies indicate Alliance on Mental Illness (NAMI).

Retail’s Leading Brands Speaking with One Voice

24 Hour Fitness Worldwide, Inc. Christopher & Banks Corporation Gap Inc. NIKE, Inc. Save Mart Supermarkets 7-Eleven, Inc. Claire’s Stores, Inc. Giant Eagle, Inc. Oriental Trading Company, Inc. Sears Holding Corporation Abercrombie & Fitch, Co. Costco Wholesale Corporation H-E-B Payless ShoeSource, Inc. Signet Jewelers, Ltd. Advance Auto Parts, Inc. Crate & Barrel The Home Depot, Inc. The Pep Boys – Manny, Moe & Jack Staples, Inc. American Eagle Outfitters, Inc. CVS Caremark Corporation Hy-Vee, Inc. PETCO Animal Supplies, Inc. T-Mobile USA Inc. American Signature Furniture Delhaize America IKEA North America Services, LLC PetSmart, Inc. The TJX Companies, Inc. Apple Inc. Dick’s Sporting Goods, Inc. J.C. Penney Company, Inc. Publix Super Markets, Inc. Target Corporation AutoZone, Inc. Dollar General Corporation J. Crew Group, Inc. RadioShack Corporation Tractor Supply Company Belk, Inc. Dollar Tree Stores, Inc. Jo-Ann Stores, Inc. Recreational Equipment, Inc. (REI) Ulta Salon, Cosmetics & Fragrance, Inc. Best Buy Co., Inc. Express, LLC L Brands, Inc. Regis Corporation Unilever Big Lots Stores, Inc. Family Dollar Stores, Inc. Lowe’s Companies, Inc. Rite Aid VF Corporation Blain’s Farm & Fleet, Inc. Foot Locker, Inc. Meijer, Inc. Rooms To Go, Inc. Walgreen Co. Cabela’s Gabriel Brothers, Inc. Michaels Stores, Inc. Ross Stores, Inc. Wal-Mart Stores, Inc. Canadian Tire Corporation, Limited GameStop NEXCOM Safeway, Inc. Whole Foods Market, Inc. CarMax, Inc.

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RILA is proud to support the Ripon Society.

18 RIPON FORUM Winter 2014 we can prevent traffic deaths why not diabetes? If we can use public policy to change attitudes and behavior around using seat belts, we can use it to limit the societal costs of type 2 diabetes. Right now, 11 million older adults in Medicare have diabetes and another 20 million – 50% of the age 65+ Medicare population – are at risk of developing diabetes. Implementing evidence-based prevention methods could reduce the rate of diabetes and its complications, which would save thousands of lives and billions of dollars annually. Diabetes prevention is a smart investment.

Support the Medicare Diabetes Prevention Act, S. 452/H.R. 962. Make the National Diabetes Prevention Program a covered benefit for Medicare enrollees at risk for diabetes. Personal responsibility, the private sector and the federal government working together will make a difference.

The National DPP is a public-private partnership overseen by the Centers for Disease Control and Prevention to bring proven diabetes prevention programs to communities across America. To learn more, visit www.DiabetesAdvocacyAlliance.org and click Policy Priorities. Diabetes Advocacy The Diabetes Advocacy Alliance™ (DAA) is a coalition of patient, professional and trade associations, nonprofit TM organizations, and corporations united in their effort to elevate diabetes higher on the national agenda. Alliance RIPON FORUM Winter 2014 19 Politics & Perspective A Proactive Step Toward Better Cyber Security

PATRICK MEEHAN

Congress is a reactionary body. In my time in shopping season, sophisticated hackers gained access the House of Representatives, I’ve experienced both to the payment and order processing systems of retail the frustration of gridlock and the joy of substantial giant Target. The personal information of as many as legislative progress. In most cases, regardless of 110 million Americans may have been victims of the the outcome, the challenges we’ve embraced as a cyber attack. lawmaking body have been largely driven by events. Virtually overnight, the personal financial data It is rare indeed that Congress addresses a of nearly one out of every three Americans was problem before an event occurs. However, over the compromised. Names, credit card numbers, addresses, past year, the House Committee on Homeland Security phone numbers and e-mail addresses -- all are at risk. has been doing just The thieves who stole that. Together with this information may Committee Chairman not use it right away. In Michael McCaul, we fact, the lasting effects have orchestrated of the data breaches will over 300 meetings, not be clear for months events, and hearings and even years. Families with government, hoping to apply for a industry, and privacy mortgage or buy a car stakeholders and will find their credit in experts to help form tatters. Others will learn comprehensive, level- that credit cards and headed legislation that bank accounts had been will help to mitigate, opened in their names, or and more importantly, that criminals had used prevent, a cyber attack their identity as an alias on our nation’s critical after being arrested. infrastructure. Savings accounts and I am pleased to retirement funds could say that in February, A recent poll of national security be drained long after the Committee the initial data was unanimously experts by Defense News ranked compromised. passed the National cyberwarfare – not terrorism, a As frightening as Cybersecurity and nuclear Iran or a rising China – as these consequences Critical Infrastructure may be, the threat of Protection Act the greatest threat to the United cyber attack could lead (NCCIP). This States and its interests. to far greater disasters. important bipartisan State-sponsored hackers legislation will supported by countries protect America from a cyber attack on our critical like Iran and China could hobble our power grids, infrastructure, while prohibiting any new government communications networks and financial systems. It’s regulations. no surprise then that a recent poll of national security This is an issue that Congress must address before experts by Defense News ranked cyberwarfare – not an attack happens. As we all know, this past holiday terrorism, a nuclear Iran or a rising China – as the

20 RIPON FORUM Winter 2014 greatest threat to the United States and its interests. Homeland Security Committee, but enjoys another Federal policy should encourage collaboration rarity – the support of both industry and privacy between the private sector and law enforcement, and advocates. The ACLU called NCCIP “both pro-security it should do it in a way that builds trust and fosters and pro-privacy.” information sharing between government and industry. As Chairman of the Cybersecurity Subcommittee, This is the strategy that I am unwilling to stand the NCCIP Act seeks speechless when asked to employ – without Federal policy should encourage “what did you do to compromising the collaboration between the private prevent an attack?” privacy of American Let us take this unique citizens, or imposing sector and law enforcement, and it opportunity to be a expensive and should do it in a way that builds proactive, productive, burdensome mandates and protective Congress. on job creators. trust and fosters information sharing Together, we can unite With NCCIP, between government and industry. our nation against those Congress has a rare who wish to do us opportunity to show harm. RF foresight, and act in a responsible manner to protect our nation. Furthermore, as a recent column in The Patrick Meehan represents the 7th District of Hill put it, “cybersecurity could be the next bipartisan Pennsylvania in the U.S. House of Representatives. breakthrough.” The NCCIP Act not only garnered He serves as Chairman of Homeland Security support from every Republican and Democrat on the Subcommittee on Counterterrorism and Intelligence.

National Cybersecurity and Critical Infrastructure Protection Act of 2013 Summary of Key Provisions

• Prohibits new regulatory authority at DHS and is budget neutral;

• Codifies and strengthens the National Cybersecurity and Communications Integration Center, a federal civilian, transparent interface to facilitate real-time cyber threat information sharing across critical infrastructure sectors;

• Establishes an equal partnership between private industry and DHS, and ensures that DHS properly recognizes industry-led entities to facilitate critical infrastructure protection and inci- dent response;

• Codifies and strengthens the successful aspects of the National Infrastructure Protection Plan, a public-private partnership framework that has been supported by the private sector since 2003;

• Codifies the Cyber Incident Response Teams to provide timely technical assistance, crisis management, and actionable recommendations on cyber threats to critical infrastructure own- ers and operators on a voluntary basis;

• Ensures that the National Cybersecurity Incident Response Plan is regularly updated and exer- cised in coordination with federal, state, local, and private sector stakeholders;

• Codifies DHS operational information security activities to protect and ensure the integrity and resiliency of all federal civilian information systems and networks (.gov); and,

• Amends the SAFETY Act to establish a threshold for qualifying cyber incidents so private enti- ties can voluntarily submit their cybersecurity procedures to the SAFETY Act Office to gain additional liability protections in the event of a qualifying cyber incident.

RIPON FORUM Winter 2014 21 In Pursuit of the American Dream

GREG SMITH AND ROGER FORTIN

The concept of the American Dream has unique and The ADCI is comprised of 35 unique “dreams ongoing relevance to our nation’s history. The individual within the Dream,” with each being measured and scored dream for a freer, better, and more fulfilled life was present separately. These dreams range from conventionally defined from the start. It evolved from the hearts and souls of American Dream aspirations such as home ownership and millions of people who built this country. The Dream has the attainment of a good job to other concepts not often lured tens of millions of people of all nations to America. In included in the American Dream discussion such as social many ways, the study of America is a story of individuals of status and safety in travel. Collectively these unique dreams different creed, race, gender, ethnicity, and class attempting are categorized into five unique American Dream sub- to pursue their dreams. indices which represent an individual’s personal economy, So, with this individual pursuit of a better life as the well-being, trust in institutions, attitudes towards diversity, back drop, researchers at Xavier University in Cincinnati, and physical environment. Though one sub-index is not held OH, set out to quantify to be more important the ubiquitous concept than another in of the American survey development, Dream. After 3 years the fact remains that of research and testing, the sub-indices are they established the unevenly balanced. American Dream The overarching Composite IndexTM dream of a healthy (ADCI) in July 2011. personal well-being This instrument is the largest sub- was built on public index based on the views and opinions number of unique about the American dreams that it reflects, Dream. Created from which is followed, a statistically validated in descending survey instrument, order, by personal the ADCI gauges the economy, trust in country’s current and Fundamentally, the American Dream institutions, diversity, collective sentiment and environment. regarding the extent is about hope – the hope that every Therefore, as we to which people living individual of whatever status has the look for the largest in the United States chance to be all that he or she can be. driver of the Dream, are achieving their we find it exists in American Dream. The one’s contentment, 139 question survey reaches at least 1,000 respondents health, and prosperity in life. It is important to note that each month from across the nation using the demographic this hierarchy was not built deterministically. It is the direct spectrum of the most recent United States Census. Each result of the sentiment of people pursuing the American survey question response is scored on an increasing sentiment Dream. scale from 0 to 100 and averaged across all responses. The One of the more interesting findings from the ADCI is outcome is a personal American Dream score that indicates that Americans consistently rate attitudes towards diversity how far along, as a percentage, individuals are in achieving higher than all other sub-indices. As such, assimilation of their American Dream. The monthly volume is aggregated differences with others and attitudes towards diversity is the and scored on the same scale to create the ADCI. area where Americans are furthest along in their Dream quest.

22 RIPON FORUM Winter 2014 Respondents also exhibited very positive sentiment regarding are only 38.74% of the way to living in a society where they their personal well-being. Unfortunately, the dreams of having can fully trust the government. Prospectively, this can be a strong personal economy and a society where one can trust viewed as good news as there is plenty of room to grow in institutions lag significantly behind. They are currently the this area. largest American Dream inhibitors for people living in the Fundamentally, the American Dream is about hope -- the United States. Within these broad segments, respondents have hope that every individual of whatever status has the chance indicated that they struggle the most with financial security, to be all that he or she can be. It is America’s highest aspiration trust in government, and trust in business. Improvement and promise and is inextricably bound to our nation’s ideals in these three domains will most quickly and effectively of freedom, equality, justice, and opportunity for all people. improve the quality of life of people living in America and Individuals’ pursuits, collectively, constitute the moral and better enable the pursuit of the American Dream by everyone. economic engines that drive this nation forward. As the As of January 2014, the ADCI stands at 65.17. This means ADCI surveys show, there is a direct relationship between the that, as a nation, we are 65.17% of the way to fully achieving number of individuals who pursue the American Dream and the American Dream. There is both good news and bad news the health of society. in this reading. To begin, the average ADCI score from 2011 The greater the number of people who pursue their to the present has increased each year. Thus, the overall quality dreams, the healthier America’s economy is. Therefore it is of life of people in America is steadily improving. Moreover, not surprising that the ADCI has proven to be an excellent their personal economies have improved in near lockstep predictor of key economic activity. Ultimately, if our nation with the overall quality of life during this time and serve as can effectively address the lack of trust we have in our a key driver of the ADCI increase. Unfortunately, the other institutions, individual economies will improve and so too overarching sub-indices are not behaving in the same manner. will the quality of life of people living in America. RF The trust Americans have in institutions has regressed over the last year and a half, largely driven by the lack of trust Greg Smith is the Chair of the Management Information people have in government. The trust in government measure Systems Department, and Roger Fortin is the Academic Vice stands at 38.74, which indicates that Americans believe they President and Provost for Xavier University.

The Ripon Society Ideas that matter since 1962. “Over the course of the 50 years that Ripon has existed, it really has been very helpful in terms of shoring up our party – frankly helping to broaden our party.” Speaker John Boehner January 22, 2013

Founded 1962. www.riponsociety.org

RIPON FORUM Winter 2014 23 The New Politics of Evasion New thinking and favorable demography have largely addressed the Democrats’ old problems. Now it’s the Republicans who can’t face reality.

WILLIAM A. GALSTON & ELAINE C. KAMARCK

As veterans of an eight-year struggle to reimagine for whom “Back to Reagan” is a mantra that soothes and reinvent the Democratic Party, we look at today’s and cures. But we are as far away from the end of the Republicans with a wry sense of recognition. Much of Reagan Administration as Democrats were from FDR at what we wrote about our party a quarter of a century ago the beginning of the Nixon Administration. Reaganism applies with only minor modifications to the contemporary applied conservative principles to a specific historical GOP: an unattractive message, outdated policies, adverse situation. If Reagan reappeared today, his principles demographics, and a fatally flawed political strategy, would be the same, but many of his proposals would not. among other similarities. Now as then, the losing party is As long as Republicans imagine that the party’s 1980 talking to itself more than it is listening to the people. Now platform will solve either today’s public problems or their as then, a party wrestling with defeat is hampered by an own political problems, they’ll continue to struggle. entrenched base that Another popular resists change and but counterproductive punishes those who tendency is to blame try to bring it about. the messenger rather In our experience, than the message. successful reform of a Throughout the New political party requires Deal, Republicans a number of difficult convinced steps: diagnosing themselves that the party’s ills; Franklin Roosevelt discarding backward- was a snake charmer looking policies; who had bewitched restating the party’s the people and that all principles in terms would be well once that attract rather than he passed from the repel skeptics; and scene. It took Harry crafting proposals Truman’s unexpected that address the broad Reagan was to Democrats as FDR was victory over Tom population’s problems to Republicans — a great communicator Dewey to convince and concerns, not Republican leaders just those of core whose rhetorical gifts sugar-coated a pill that their problems supporters. Reform that they believed the people otherwise went deeper, requires, as well, setting the stage an organization that would not have swallowed. for Eisenhower’s serves as a focal point successful battle for reformers, helps incubate new ideas, and leads the battle against Robert Taft. Ike’s program of “Modern Republican- for their adoption by the party. And it requires, finally, ism” ended the party’s battle against the New Deal and standard-bearers who understand the reform agenda and restored it as a serious national competitor. can explain it clearly to party leaders, to the rank and file, Reagan was to Democrats as FDR was to Republicans and ultimately to the entire electorate. Money, technology, — a great communicator whose rhetorical gifts sugar- and tactics matter, of course, but only within a broader coated a pill that they believed the people otherwise would reform strategy. not have swallowed. Not until Michael Dukakis’ startling Judged against this template, the reform of the defeat at the hands of George H.W. Bush did Democrats Republican Party is taking, at most, its first halting steps. begin to realize that their problems might be more than A politics of nostalgia still attracts too many Republicans, cosmetic.

24 RIPON FORUM Winter 2014 Once again, the same drama is playing itself reservations about the Republican Party begin with social out. Many Republicans (including their presidential issues such as same-sex marriage, they hardly end there. nominee) believed up to Election Day that victory over These voters also believe that the wealthy should pay higher Obama was assured. Recovery from recession was slow; taxes; that Republicans don’t want to help them pay their unemployment remained high; household incomes were student loans; that reducing the size of “big government” is depressed; the President’s approval ratings hovered around much less important than attacking entrenched interests on 50 percent. As the returns rolled in, recriminations began: a broad front; that they will be better off under Obamacare; The wealthy Mitt Romney was miscast in hardscrabble that the wars in Iraq and Afghanistan were mistakes that the populist times; he stood mute in the face of the Obama United States should not repeat; and that, along with same- campaign’s summer onslaught; and he destroyed himself sex marriage, immigration reform functions as a “gateway with his “47 percent” video, the economic equivalent of issue.” Even when they disagree with Obama’s policies, Todd Akin’s remarks on rape. most young voters at least give him credit for trying to fix There is some truth to all this, of course, but it was problems, while Republicans are seen as mostly negative, mostly a diversion from the basic point: The Reagan often harshly so. agenda was played out, and the Tea Party’s Wahhabi-style Toward the end of the CRNC report, the authors drive to restore pure, uncompromised conservatism had implicitly question their party’s dominant narratives. led the party away from, Their most recent rather than toward, commissioned survey an electoral majority. compared a wide range Tacitly acknowledging of broad narratives this reality, party leaders that Republican began to think out loud. candidates could use. While a report from the The winners among Republican National young voters: creating Committee focused jobs and economic mainly on mechanics, growth, tackling the its authors forthrightly tough problems that stated that “America will face the next looks different” and generation, and giving drew some obvious hardworking people the policy implications. opportunity to advance. In particular, they The losers: protecting stated, “We must Not until Michael Dukakis’ startling Americans’ liberty embrace and champion and the principles comprehensive defeat at the hands of George H.W. of the Constitution, immigration reform. If Bush did Democrats begin to realize promoting liberty we do not, our Party’s and reducing the role appeal will continue that their problems might be of government, and to shrink to its core more than cosmetic. protecting families and constituencies only.” core American values. The authors also While the authors don’t acknowledged the force of generational change: “[T] spell it out explicitly, the conclusion is inescapable: The here is a generational difference within the conservative messages that have dominated the Republican Party since movement about issues involving the treatment and the the beginning of the Obama Administration are turning off rights of gays—and for many younger voters, these issues young adults. (The attack on big government is especially are a gateway into whether the Party is a place they want unpopular with Hispanics.) To summarize the report in to be.” language that its authors would surely reject, George W. A subsequent report from the College Republican Bush was more right than wrong, and the Tea Party is more National Committee (CRNC) underscored this point. In wrong than right. findings based on two commissioned surveys and other data, the report documented the sizeable gap between Reform on the Horizon? young voters’ perceptions of the Republican Party and their In this context, it is hardly surprising that the party’s own preferences and beliefs. While not ignoring problems leading thinkers are beginning to weigh in. In an article rooted in technology and branding, the report paid the most entitled “Reaganism After Reagan” published in February attention to policy-based difficulties. While young voters’ 2013, National Review’s Ramesh Ponnuru commented,

RIPON FORUM Winter 2014 25 “Today’s Republicans are very good at tending the fire of ers, whose antipathy to Obama spilled over into a general Ronald Reagan’s memory but not nearly as good at learning anti-government stance. Pawlenty’s candidacy quickly from his successes. They slavishly adhere to the economic collapsed, but the woes of the working class remain, program that Reagan developed to meet the challenges of offering opportunities to conservative reformers willing the late 1970s and early 1980s, ignoring the fact that he to challenge entrenched economic orthodoxies. largely overcame those challenges, and now we have new A third strand of conservative reform, mainstream ones.” Ponnuru concluded with a flourish that verged on rather than populist, tries to build on what George W. heresy: “In his first Inaugural Address, Reagan famously Bush got right. In March 2013, two veterans of the Bush said that ‘government is not the solution to our problem; Administration, Peter Wehner and Michael Gerson, government is the problem.’ The less famous yet crucial published a lengthy essay, “How to Save the Republican beginning of that sentence was ‘in our present crisis.’ The Party—A Five-Point Plan.” They began by noting question is whether conservatism revives by attending to key shifts in the country since Reagan: Demographic today’s conditions, or becomes something withered and changes were working in favor of Democrats, and the dead.” end of the Cold War reduced the credibility of the classic If “Back to Reagan” Republican “tough won’t do as a strategy on defense” stance. and budget cutting has Echoing Ponnuru, they hit a political wall, commented: “[I]t is no what comes next? wonder that Republican Since Romney’s defeat, policies can seem stale; several strands of they are very nearly conservative reform identical to those have emerged and offered up by the party gotten a new hearing. more than 30 years Rand Paul is trying to ago. For [today’s] move libertarianism Republicans to design into the Republican an agenda that applies mainstream, and recent to the conditions of controversies over 1980 is as if Ronald drones and surveillance Reagan designed his have given him the agenda for conditions opportunity to enhance that existed in the his national visibility. Once again, the same drama is Truman years.” For conservatives, the playing itself out. Many Republicans Gerson and road to reconnecting (including their presidential nominee) Wehner went on with young adults starts to propose new with libertarian-leaning believed up to Election Day that approaches in five stances on social and victory over Obama was assured. areas: focusing on the national-security issues. economic concerns Another brand of of working- and conservative reform tilts toward economic populism. A middle-class Americans; welcoming rising immigrant large piece of the Republican base has only modest levels groups; pushing back against hyper-individualistic of education and income. Mitt Romney had nothing to say libertarianism by demonstrating the party’s commitment to them, which helps explain why millions of white voters to the common good; engaging social issues in a manner stayed home last November. Back in 2008, however, two that is aspirational rather than alienating; and harnessing young conservatives, Ross Douthat and Reihan Salam, their policy views to the findings of science. While they had already diagnosed the problem. In Grand New Party: aren’t always clear about the specific policy implications How Republicans Can Win the Working Class and Save of these approaches, they do endorse breaking up the big the American Dream, they advocated the selective use banks and enacting comprehensive immigration reform. of government to reweave the fabric of civil society Describing opposition to gay marriage as a “losing battle,” and address the neglected economic needs of downscale they note tartly (and correctly) that “it is heterosexuals, Americans. Former Minnesota Governor Tim Pawlenty not homosexuals, who have made a hash out of marriage,” took up their cause under the banner of “Sam’s Club and they suggest that Republicans and conservatives conservatism” during his brief 2012 campaign, but he might more usefully focus on strengthening marriage in could not channel the anger of Republican primary vot- all its forms.

26 RIPON FORUM Winter 2014 Gerson and Wehner offered not only policies, but a a quarter of a century ago, but it was necessary for us to theme as well: “The Republican goal is equal opportunity, say it. We’re waiting for our counterparts among today’s not equal results. But equality of opportunity is not a natural Republicans and conservatives to do the same. state; it is a social achievement, for which government shares There’s something else missing as well – a focal some responsibility. The proper reaction to egalitarianism institution that brings reformers together to craft new is not indifference. It is the promotion of a fluid society in policies and the political strategies needed to make them which aspiration is honored and rewarded.” effective, first within the party, and then for the entire If there were a political equivalent of intellectual country. So far, the Republican intellectuals seem to operate property, we could sue for patent infringement, because in a vacuum. They have little formal connection to the these sentiments can be found, party’s elected officials or nearly verbatim, in numerous its organizations. It will be DLC documents from the late a sign of seriousness when 1980s on. The resemblance is Republican dissidents are no coincidence: Along with willing to devote their energies Tony Blair’s New Labour, and resources to creating an Gerson and Wehner cite the organization devoted to party DLC and Bill Clinton as their reform and protecting it from models of successful party being strangled in the cradle, reform. Not surprisingly, we as the defenders of entrenched think they’re on to something. arrangements will surely try Despite this intellectual to do. If Republican leaders ferment, the transformation and candidates try to improve of the Republican Party has their party’s fortunes without barely begun. There’s no changing its orientation, they substitute for a leader with the will surely fail. guts to break with outdated Much is at stake, not just party orthodoxy, as Clinton for Republicans, but for the did on trade, fiscal policy, entire country. The polarization welfare, and crime, among of our party system has other issues. And he did more thwarted action on critical than that: In the famous Sister challenges and has exacerbated Souljah episode, he spoke public mistrust. As long as our out against a tendency in parties remain at roughly equal the party’s base that crossed There’s no substitute for a strength, our institutions can the line from protest to leader with the guts to break only work when adversaries extremism. Mitt Romney with outdated party orthodoxy, are willing to debate fiercely— and the other contenders and then reach honorable for the 2012 Republican as Clinton did on trade, fiscal compromises. A Republican nomination had numerous policy, welfare, and crime, Party dominated by a new opportunities to do just that, generation of reform-minded and they ducked them all. The among other issues. conservatives who care more incredible statements about about solving problems than women and rape by two Republican Senate candidates scoring points would be a huge step toward restoring a federal could have served as a Sister Souljah moment for Romney. government that can govern. RF But rather than using these to mount a full-throated pro- test against extremism in the Republican Party, he offered William A. Galston is the Ezra K. Zilkha Chair and a mild rebuke that did nothing to undo the damage or to Senior Fellow in the Governance Studies Program at change the trajectory of the campaign. As long as aspirants the Brookings Institution and College Park Professor for party leadership flinch from confronting their angry at the University of Maryland School of Public Policy. base, the American people will continue to see Republicans Elaine C. Kamarck is a Senior Fellow in the Governance as an uncompromising, uncaring, and retrograde force. Studies Program and the Director of the Management And until party intellectuals are willing to go beyond and Leadership Initiative at Brookings. This is an policy prescriptions and call extremism by its rightful name, excerpt of an essay that originally appeared in the Fall it is unlikely that any candidate will be willing to do so. 2013 edition of Democracy: A Journal of ideas (www. The phrase “liberal fundamentalism” made us few friends democracyjournal.org).

RIPON FORUM Winter 2014 27 28 RIPON FORUM Winter 2014 News & Events “The Numbers Don’t Lie” Ripon Society hosts Pew Research for Discussion on American Electorate

WASHINGTON, DC -- With the mid- 2). As an example, he pointed to a Republican Party during this time term elections less than seven months December poll which revealed that 42 and feel that, in many ways, the away, The Ripon Society hosted a percent of Republicans disapproved party is not conservative enough. luncheon discussion on February 19 of the job their party’s leaders were Although they still vote fairly reliably to look at the American electorate and doing in Congress. By contrast, Republican, they now call themselves how political trends may impact the 68 percent of Democrats approved independents, and express a lot of prospects of the Republican Party in of the job their leaders were doing. criticism of Republican leaders.” November. Similarly, 70 percent of Democratic- Despite this deficit, Dimock The discussion was stated that there were entitled, “The Numbers still several areas in Don’t Lie.” It featured which Republicans hold a presentation by Dr. a clear advantage over the Michael Dimock, Democrats. For instance, the Vice President more Americans (45- of Research for the 35 percent, to be exact) Pew Research Center, think the GOP does a who, among other better job of dealing topics, discussed the with the federal budget GOP’s image among deficit than Democrats Americans, the issues do. Republicans also in which Republicans hold an advantage (42-38 are viewed favorably, percent) in dealing with and how young people the economy. Despite view not only the party, the fact that the party but government. has spent so many years “The basic political pushing to keep taxes low, landscape right now Michael Dimock. the GOP is surprisingly still has a bit of a tied with the Democrats Democratic tilt to it,” (41-41 percent) on which Dimock stated (see next “The basic political landscape right party is better able to deal page, Figure 1). “While now still has a bit of a Democratic with the issue of taxation. the trend is toward On the issue of health independents, you’ve tilt to it.” care, Dimock noted that still got about an 8-point although public support Democratic edge in of the Affordable Care party identification. I think some leaning independents had a favorable Act is falling, Republicans continue of this reflects the fact that the view of the Democratic Party, to lag behind Democrats (37-45 Republican Party’s brand in the while barely half – 53 percent -- of percent) when it comes to which public eye remains meager. There is Republican-leaning independents had party is better able to deal with the less confidence in the party, and more a favorable view of the GOP. issue. This is especially true among negative perceptions of Republicans “This deficit reflects a dynamic young Americans, whose increasing than Democrats.” that has been going on since the skepticism of Obamacare is matched Dimock noted that some of the second term of the Bush Presidency,” by their skepticism of the Republican deficit that the GOP faces in this Dimock observed. “It involves what brand. regard is internal and comes from we refer to as ‘lapsed Republicans’ “I don’t think it will surprise within the party itself (see Figure – people who got frustrated with the anyone to hear that the political

RIPON FORUM Winter 2014 29

NUMBERS, FACTS AND TRENDS SHAPING THE WORLD

Michael Dimock, VP-Research Presentation to the Ripon Society and RAMS, Capitol Hill Club, Washington DC Feb 19, 2014

PAGE ONE: PARTY IMAGES, LEADERSHIP AND ISSUES leanings of the Millennial generation are very Democratic,” Dimock Figure 1: Party Identification Trends Figure 2: Party Favorability and Leadership Approval stated. “This is a generation that is

very diverse – 41 percent are non- 45 % Among inds white. This is also a generation that Lean Lean 40 Total Rep Dem Ind Rep Dem is not as skeptical of government as I 38 Favorable view of… % % % % % % other generations. In fact, when you 35 D The Republican Party 35 74 12 31 53 13 talk about the generational divide in 32 politics, we’re at an unusual moment 30 The Democratic Party 47 7 87 39 17 70 where we have an older generation R 25 that has been consistently anti- 24 Approve of the job each is doing government and a younger generation 20 that is unusually pro-government.” Republican leaders in Congress 21 42 12 17 29 11 To that end, Dimock pointed to a 15 survey last fall that asked Americans Democratic leaders in Congress 34 9 68 20 4 42 10 whether they favored a bigger NUMBERS, FACTS AND TRENDS SHAPING THE WORLD PEW RESEARCH CENTER/USA TODAY Dec. 3-8, 2013. government that provided more 5 Michael Dimock,services, VP or-Research a smaller government that provided fewer services (Figure 3). 0 PresentationMillennials to the Ripon were Societythe only and age RAMS,group Capitol Hill Club,1992 Washington1996 2000 DC 2004 2008 2012 Feb 19, 2014 where a majority (55 percent) favored having a bigger government. That PEW RESEARCH CENTER Aggregated surveys from each year. PAGE ONE: PARTY IMAGES, LEADERSHIP BasedAND on generalISSUES public. said, Dimock also pointed to another poll which revealed that Millennials, Figure 1: Partyfor all their Identification pro-government leanings, Trends Figure 2: Party Favorability and Leadership Approval also have an entrepreneurial spirit and Figure 3: Figure 4: 45 % appreciation of the private sector, with Democrats Have Image Advantage Among indsRepublicans Hold on Many Issues 76 percent agreeing that, “The strength Lean Lean 40 % saying each party … Total Rep Dem Ind Rep Dem% saying each party could do a better job dealing with … of America is mostly based on the 38 Diff Favorable view of… NUMBERS, FACTS% AND TRENDS% SHAPING% Both/ %THE WORLD% % 35 success of American business.” Rep Dem Neither/ R-D between Both/ Dimock made his remarks The Republican Party 35Party 74Party 12 DK31 diff53 13 Young vs. Rep Dem Neither/ R-D 32 Party Party DK diff 30 before a crowd of over 150 Ripon % % % Total PAGE 3: GENERATIONAL DIFFERENCESThe Democratic Party Total47 187- 29 8730 -4939 50-1764 70 65+ % % % Society members and Congressional Is more willing to work 25 ChiefsFavor of gay Staff. marriage He (willMay 13)make a 24 with other party 51 27 65 52 21=10054 D+2545 Federal39 budget deficit 45 35 20=100 R+10 +14 Approve of the job each is doing Economy 42 38 20=100 R+4 20 similar presentation at The Ripon Is more concerned with

More people of different races marrying each other is a Society’s 4th Annual Legislative and Republicanneeds leaders of people in Congress like me 2132 42 52 1216=100 17 D+2029 11Taxes 41 41 17=100 Even 43 60 47 36 29 +17 15 Communicationschange for the Directors better (SymposiumSep 11) One Is more extreme in its Immigration 38 39 22=100 D+1 on Leadership, which is scheduled Democratic leaders in Congress 34 9 68 20 4 42 positions 54 35 12=100 R+19 Health care 37 45 18=100 D+8 10 to Morebe held women on March in the 7th workforce at George change for the better (Sep 11) 73 82 73 72 62 +9 PEW RESEARCH CENTER/USA TODAY Dec. 3 -8, 2013. Washington’s Mount Vernon. RF Is more influenced by Poverty DiffDiff 33 46 21=100 D+13 5 Section Diff Immigrants strengthen our society (Nov 13) lobbyists NUMBERS,NUMBERS, FACTSFACTS49 AND47AND TRENDSTRENDS57 30 SHAPINGSHAPING23=10055 THETHE WORLDR+17WORLD41 39 PEW RESEARCHbetweenbetween +8 CENTER Jan. 15-19, 2014.

Diversity & Religion Diversity 0 Figure 3: Generational DifferencesGoverns in a more honest Figures Young Youngmay not vs.addvs. to 100% because of rounding. 1992 1996No religious2000 2004 affiliation2008 (2012)2012 and ethical way 20 31 32 41 28=10021 D+1015 9 +12 PAGEPAGE 3:3: GENERATIONALGENERATIONAL DIFFERENCESDIFFERENCESToward Government TotalTotal 1818---2929 3030---4949 5050 ---6464 65+65+ TotalTotal PAGE 3: GENERATIONAL DIFFERENCES PEW RESEARCH CENTER Aggregated surveys from each year. Can better manage federal Prefer… Bigger govt providing more services 40 55 42 32 26 Based on general public.FavorFavor gaygay marriagemarriage (((MayMay 13)13) government 5151 40 6565 41 20=1005454 D+14545 3939 +15

+14+14 Smaller govt providing fewer servicesPEW (Sep RESEARCH-13) CENTER Jan.51 15-19, 2014.37 49 60 61

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The strength of this country is mostly based on the success

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Business and theBusiness M and the M BusinessBusiness and the M and the M 60 66 60 62 52 Business and the M wealthywealthy (Jan(Jan(Jan 14)14)14) +6+6 A A freefree marketmarket economyeconomy needsneeds govtgovt regulationregulation toto 6363 7272 6161 6262 5454 +9+9 serveserve thethe publicpublic interestinterest (May(May(May 12)12)12) RIPON FORUM Winter 2014 31 Name: Adam Kinzinger Occupation: U.S. Representative, Illinois’s 16th District You became an elected county official at the ripe old age of 20. What did this early experience teach you? Being elected to a local office at such a young age taught me the importance of being accessible to my constituents. I saw just how important it is to bring the government back to the people and to be a valuable resource for the same folks who elected me. I believe this philosophy allows me to make a positive difference in people’s lives and enables me to well serve the people of the 16th District. Your desire to serve others is evident in your distinguished public service and military record. What advice would you give to those seeking to give back to their country? If you believe in what you’re doing, it’s worth it. Giving back to your country, or community, is simply one of the most rewarding experiences one can do with their time and energy. When I speak to high school students trying to figure out what to do with their lives, I always tell them to chase their passion, not a paycheck. I hope everyone can find it their duty to in some small way improve the lives of those around them. With 24/7 news coverage and social media everywhere in our lives, why do you think Americans feel so disconnected from Washington these days? What can be done to reverse that trend? You’re right. It seems that we are more heavily bombarded with information these days than ever before. With one news story after the other focused on the latest crisis, it is easy for the average person to feel disconnected and disenchanted with Washington. But, I hope people can find optimism in their own representatives; to know that they are being heard and that it is worth being engaged. I think a way to reverse the trend is to be more selective of the information one consumes. I promise not every headline is bad, and there are plenty of good people doing great things out there. If you look for the good, you’ll find it. A question about foreign policy -- amid increasing violence and reports of a resurgent Al-Qaeda in Iraq, what do you believe America’s role in that country should be moving forward? Al-Qaeda is the #1 enemy to the United States; as such we need to ensure that Al-Qaeda does not feel safe wherever it operates. Our country has sacrificed a lot in order for a free Iraq, and now we must protect it. If we are going to live up to our commitments, we need to push Al-Qaeda back. I believe by using limited airstrikes, and by allowing our strong intelligence assets to work with the Iraqi government, we can ensure Al-Qaeda has no significant presence in Iraq again. As Americans, we must keep our commitments to the world to regain the trust of our allies, and for our enemies to fear us. You have been targeted by some special interest groups for not being conservative enough. Yet, in a divided government, the need for compromise has never been greater. How have you tried to strike this careful balance? I serve the people of the 16th district, not special interest groups. As representative for the people of the 16th district, I try to serve as humbly and honorably as I can, regardless of politics. I believe we can stand firm in our principles while also recognizing the need for incremental progress. No deal will ever be perfect. In divided government, it is easy to vote no; getting to yes is the hard part. Finally, many have tabbed you as an up-and-comer in the conference. How do you manage these lofty expectations with the basic challenges of a second-term Member? My focus in Congress is getting the folks of the 16th District back to work, reigning in government spending, and ensuring we pass down to the next generation a country stronger and more free than the one we were given. I believe that if I stay focused on those important issues and vote my conscience, I will be able to consider my time in politics a success, no matter what happens.

32 RIPON FORUM Winter 2014 RIPON FORUM Winter 2014 33 The Ripon Society 1155 15th Street, NW Suite 550 Washington, DC 20005