The following program is a PBS Wisconsin Original production.
>> A new Year ushers in a new legislature at the State Capitol
and a new Congress in Washington. But echoes of an
insurrection four years ago reverberate in today's political
divide. [MUSIC]
on "Here& Now", we take a closer look at the core issue. Growing
that political divide. [MUSIC]
could ease the impact of medical debt. News of hospital closures
rocked central Wisconsin one year ago. How was the area
faring? And the threat of a declining population has experts
looking 25 years into the futur? It's "Here& Now" for January
10th. provided by the Focus Fund for
Journalism and Friends of PBS Wisconsin.
>> Nearly 1600 people have been charged for their actions at the
storming of the nation's capitol
on January 6th, 2021, in the largest investigation in U.S.
History. All of them could be pardoned by president elect
Donald Trump as he prepares to take office in ten days. 11
Wisconsin residents have been convicted on charges ranging
from unlawful entry on restricted grounds to assaulting
officers while armed with a dangerous weapon. One man
serving a three year sentence in federal prison pepper sprayed
officers bragging in a Facebook message, quote you charge that
line and start spraying. They start running for cover like
you're coming at them with an A. What leads someone to violently
breach the U.S. Capitol? Four years later, president elect
Donald Trump speaks of pardoning insurrectionists because he saw
January 6th as a day of love. Whether that or a day of shame,
what particularly drives his supporters all the way to his
reelection? Research into that may surprise you. Here to
discuss is UW-Madison professor of sociology Chad Allen
Goldberg. And thanks very much for being here.
>> Thank you for having me. >> So the kind of running
political theory has been that Donald Trump won reelection on
the message of fixing inflation and the economy. But but
describe what you researched and what it showed.
>> Yeah. Well, we tested three theories. So one is this
economic populism theory. A second theory is what we call a
kind of political alienation theory, which we try to
distinguish from the first one. So if the first one is about
economic grievances, the second one, the idea here is that
people support political outsiders like Mr. Trump,
because they're alienated from political institutions or from
government. They feel like they're not. Well represented or
that these institutions are not looking out for people like
them. And then a third theory that we tried to test is a kind
of a status threat theory. So basically the idea here is that
demographic changes in American society, cultural changes in
American society, have threatened the status of
dominant groups in our society. And that that is what's driving
support for Mr. Trump. Now, none of these theories are mutually
exclusive. It could be combination of things, right?
The theory that we found the most support for is this status
threat theory. So we looked at indicators of status threat and
the survey data. So for example, people who say who are asked the
question, do you agree with the statement that cultural, racial
diversity is important for America? Sort of what they say
in response to these kinds of questions. Questions about
religion, questions about gender, why is it important to
understand this? I think it's important because as, as as
virtually everyone recognizes, since 2016, there's been
dramatic changes in American politics and when Mr. Trump won
the 2016 election, people could say, well, maybe this is an
aberration. Maybe after this, when Mr. Biden was elected in
2020. Maybe there's a return to normalcy. But it seems clear,
given Mr. Trump's reelection in 2024, that there are fundamental
changes afoot in American politics. So as political
sociologists, we think it's important to try to understand
what are the forces, what are the mechanisms driving this and
how they're reshaping American politics. So the breach on the
US Capitol began with the Trump led conspiracy that the 2020
election was stolen. >> How was that kind of outsized
response informed by a threat to people's status?
>> Yeah, I think one of the key factors here is feelings about
immigration. So American immigration law was reformed in
1965. This led over time to significant flows of immigration
from new sources into the United States. This took decades for
the effects to fully manifest. It was a gradual process, but
there are significant. There are significant changes going on in
terms of the in terms of the proportion of Americans who are
foreign born for example, some people have compared the current
situation to the situation in the United States in the early
1900s, when there was also a major upsurge of nativism,
leading to the national origins, quotas legislation. In 1921 and
1924, which essentially slammed the doors for immigration for
decades. So we think it's connected to this theory of
status threat. And in that way, and I have seen some research
indicating that among those who participated in the January 6th
insurrection, motivations. Key motivations included the idea,
the belief that the 2020 election was stolen and also
concerns about immigration. So we think that this is something
that's that's consistent with the status threat theory.
>> So the status threat theory. According to your paper,
includes features of racism, sexism, xenophobia, as well as
cultural and moral traditionalism. Yeah. I mean, to
put it bluntly, yeah, I think it's important to emphasize that
the way that we conceive this, it's a combination of several
different sorts of status threats.
>> So sometimes people will want to say, wow, Trump. Mr. Trump
was elected because of racism in the electorate or among his
supporters, or because of sexism or because of Islamophobia or
Christian nationalism. Are the kinds of things we thought. It's
important to look at these various kinds of status threat
together, and to see how they might be coming together to
reinforce a sense of being under siege among some Americans.
>> How does history treat January six?
>> That remains to be seen. Of those voters who say they think
American democracy is under threat, roughly half of them
supported Mr. Trump. This, I think, is a very troubling and a
very dangerous situation that the reactions to January 6th,
the insurrection are so divided along partisan lines. But I
think we can say that if trends continue the way that they are
and especially if Mr. Trump follows through with his vow to
pardon those who were convicted in the January 6th insurrection,
this will simply exacerbate and worsen the situation that have
described. It will deepen the partisan division around this,
and it will make it even less likely that January 6th will
lead to some kind of national unity and resolve.
Unfortunately. All right. >> Chad Allen Goldberg, thanks
very much. >> Thank you to letters keep
coming to you from the hospital about the balance you owe.
>> Well, this week, the Biden administration announced unpaid
medical bills will no longer appear on credit reports
removing $49 billion in such debt from the credit reports of
15 million Americans. And nearly 400,000 people in Wisconsin.
Medical debt lowers credit ratings, preventing people from
getting loans, renting apartments, even getting a job
here with his reaction, attorney Bobby Peterson from ABC for
health, a nonprofit public interest law firm in Madison,
and Bobby, thanks for being her. >> Thanks for inviting me.
Appreciate it. >> So when you heard about this,
what was your reaction? >> I thought it was great. I
think, you know, getting medical debt off of people's credit
report is a real positive move in the right direction. You
know, a lot of times people don't choose to get ill or
sickness or working with a family member that has big bills
because of illness or sickness. And to have that compromise your
credit report. I think, is just in the wrong direction. It's not
a good indicator of credit worthiness. Oftentimes. So
removing it, I think is definitely a move in the right
direction. >> You call the current system
an electronic debtor's prison. How so?
>> Well, if you think about it, you know, in the old days they
would you didn't pay your bills. They locked you up and threw you
in prison until you paid your bills. Today it's a situation
where you have electronic handcuffs on and electronic
debtor's prison. It's your credit score. If your credit
score doesn't meet the certain metrics that people want, you
can't get a car apartment. You can't get a job sometimes. And
so it really is an electronic debtor's prison that traps
people sometimes in poverty, by eliminating medical debt from
this equation, I think it can lift a lot more people out of
this. Electronic debtor's prison. And give them an
opportunity to move forward to get credit. Apartment jobs,
things like that. I mean, the estimates are that people's by
removing medical debt from their credit scores, could raise their
credit score by up to 20 points. >> So what incentive, though,
remains for getting people to pay their medical bills?
>> Well, I mean, I think that, you know. Part of the issue with
medical bills is that we have such a confusing, complicated
system that trying to understand it and figure it out at the
front end is extraordinarily difficult for most. Consumers,
particularly if you're sick, if you're helping a family member
trying to work through that, it's impossible. What a lot of
people don't understand is that those decision makers are saying
no to coverage. That usually results in bills that aren't
paid. And so when those bills don't get paid, it's a cost for
all of us. We've talked before about, you know, the hospital
association does an annual uncompensated care report in
Wisconsin that uncompensated care report was about $1.4
billion in 2023. That's money that just isn't getting paid. We
also know that that medical billing and medical debt,
sometimes there's so many mistakes made in the process
that people are billed inappropriately. So again, it's
not a good measure sometimes of someone's credit worthiness
because errors mistakes our solution to this is to really
work at the front end of the process, try and help people
avoid that medical debt before it becomes a bill. Streamline
the system and simplify the system a little bit more in your
experience with clients, how does the debt mostly accrue and
mostly for whom? For a lot of people that have ongoing chronic
medical conditions, people that have children with special
health care needs, adults with disabilities because they are
high users of the system, they end up getting in those more
encounters result in more bills and medical debt. And, you know,
it's not just hospital debt. It's prescription drug debt.
It's going to physicians. It's going to physician groups,
dental bills, all of that accumulates. And it just becomes
a lot for people to try and deal with and try and work through.
>> So this is a Biden rule. How likely might it be that it's
overturned by the incoming administration? I'd say there's
a good chance that it might get overturned.
that's going on right now is filed a day after the rule was
published, and the rule doesn't take effect until 60 days after
publication. So the rule was published on Monday, 60 days
later. The rule will take effec. A lawsuit was filed in Texas. So
we've seen this before. So a little bit of venue shopping
there to find a judge that might be likely to overturn it. We
don't know that that's going to happen, but we suspect that was
part of the strategy. We also know that the congressional
Review Act gives Congress an opportunity to review these
administrative rules within 60 days to be able to overturn
them. It has to be approved by the House. The Senate, and
signed by the president. There's very narrow margins. So, you
know, medical debt is one of those issues that does have some
bipartisan appeal. So maybe it'll make it through. But I'm
not I'm not super optimistic about that.
>> All right. Well Bobby Peterson, thanks very much.
>> You're welcome. >> It was just about one year
ago. That Sacred Heart and Saint Joseph's hospitals in Eau Claire
announced they would close along with Prevea clinics in the
region. About a month later, Governor Tony Evers signed
legislation to provide $15 million for Western Wisconsin
hospital funding, but that money has been tied up over political
fights and landed in the courts after Evers sued for release of
the money. >> The last budget on this was
not what the people in Eau Claire, at least the ones that
talked to us and that included health care folks. They wanted a
broader use of that money. So no, I mean, we're well past the
ideas somehow I'm going to undo that veto. We need to get that
money out joint finance Committee does not have the
legal authority to do what they did. And so we're looking
forward to a resolution in cour. >> So western Wisconsin has yet
to see the $15 million to help shore up health care access. But
in the intervening months the region has stepped up. Without
it, the Eau Claire area Chamber of Commerce formed a recovery
task force right after news of the hospital and clinic closure.
David Minor is president and CEO of the Chamber. He joins us now
with an update on how health care needs are being met. Nearly
a year after the hospitals pulled out. And David, thanks
very much for being here. >> Absolutely. Good morning to
you. >> Well, what happened in the
last year to help fill the void of these closures? Well, really
several things took place. >> You know, once we stepped up
the task force, Mayo Clinic, Marshfield Clinic, Oak Leaf
Clinic, they really took on the brunt of trying to absorb as
much as they can. And again, we knew going into that that there
was no way they could absorb all of it. But once we had a handle
on what they could do and the expansions of their work, then
we tried looking at other entities, other businesses that
could come to the area and start to fill in some of those other
pieces. So it's been a slow process. It still happening as
we talk, but it's we're we certainly haven't recovered
fully, but we're we're in a good shape. Overall. I would say. But
still a lot of work yet to be done. And there are even new
hospitals being envisioned to be built. Correct. So again, oak
leaf network, what they did is they formed a coalition of co-o.
They are currently looking at building a new hospital. They
have found a location in the Lake Haley area between Eau
Claire and Chippewa Falls. They've been doing a lot of due
diligence. They're also currently looking at standing up
Saint Joe's Hospital up in Chippewa Falls, which would be a
bridge from now to when the new hospital and they're fundraising
takes place. And the it spirals out of Wausau is looking at
building a hospital up in the Chippewa Falls area. So again, a
lot going on. You know, a lot of it for us in the task force is
standing back and allowing them all the opportunity to do what
they need to do. But for us, it's about, you know, when we
look at going down in March for our Chippewa Valley rally.
Making sure that when we talk health care, we're very specific
about what are we asking for and what those entities may need to
help them continue that expansion and or to grow their
capacity to be able to handle all of the issues that still
need to be resolved. >> What are you asking for
specifically? >> That's a magical question. I
don't necessarily have an answer to it, but what we're looking at
is what will those entities nee? Are there pilot programs per se
that could be launched here? Also, one of the things that has
has been launched in this area is a rural health care
initiative, looking at what is rural health care going to look
like in the future, and can we help develop it here? So part of
that may be going down looking for funds to help invest in tha.
We will have probably a better answer to that question in the
next 30 days or so. But really, working with all those partners
to understand what do you need, how do we put that together as a
region and make that one large request?
>> I know that there are still gaps in care in the region.
Notwithstanding all of these entities standing up, you know,
in this way, you mentioned birthing centers. What's the
situation there? >> Again, we in the beginning,
Marshfield took on more, Mayo took on more, and things. But
that gap hasn't completely filled. So we do know and we
have heard stories that we're expectant mothers have had to
either be taken up to Duluth, over to the Twin Cities, other
areas, so that is, you know, outside of some of the cancer
patients as well. Those are areas we know that need some.
Immediate concerns to be addressed. So we're not having
to ship them out of our area. >> We talked earlier in this
program about medical debt and charity care. How sustainable in
your mind is the health care industry. Between that and
reimbursements for that care, I think one of the things that has
to happen is an honest discussion in Washington, D.C,
and Madison about reimbursement rates for Medicare and Medicaid.
>> It just it has to happen. They're not sustainable. You
know, you can't tell a business to only charge 40 some percent
or 50% on the dollar and expect it to last long term. We know
that that was part of the reason why Hshs had left. So that
conversation has to take place. But we're also looking at some
in Wisconsin. We're looking at some other opportunities. Are
there ways for us to free up more federal dollars that are
already there, but that could be brought back to our state? And
again, that may be done on a pilot program.
>> Okay. Just briefly, what has this past year been like for
patients, providers and citizens? There? I don't think
people really, truly understand the impact of losing to
hospitals and 7 or 8, ten clinics.
a lot of anxiety, a lot of sleepless nights, but also, I
don't think everybody understands how well this
community and this region pulled together to do everything we
could to make it the best we could. It wasn't perfect and is
not, but I cannot thank the people in this area enough for
what everybody has done from all sides, to get us to this point.
All right, David Minor, thank you very much. Thank you. Have a
good day. >> Wisconsin's population is on
a steep decline. The latest projection from the state
Department of Administration shows Wisconsin's population is
expected to decline by nearly 200,000 residents by 2050. It's
all about aging and babies and migration in and out of the
state. But what are the implications for Wisconsin in
the face of a population drop off? We turn to Dale Knapp,
director of forward Analytics. And thanks very much for being
here. >> So we just kind of named what
we think is going on, but what are the drivers of population
decline in Wisconsin? >> Well, you know, the baby
boomers that, that that demographic, you know is one of
the drivers that they're now entering their, their later
years. But really the big the two big drivers of this
population decline that we're now beginning to, to see is the
lack of, of babies. We've seen the number of births drop every
year, but two since 2007. The births in 2000, 23 were the
lowest since 1942. That's amazing. And then the other
piece is the other component is migration. We saw big net
migration into the state, into the 1990s, and it's lagged ever
since. And when you have the demographics that we do kind of
baked into our future growth or no growth, you need migration
into the state to fill those gaps. And we're not seeing that.
>> Where are population declines happening fastest in the state?
They're happening fastest in the rural North.
>> You know, they've been that's been going on for 20 years. Slow
growth and then some decline. We saw a bump in this last decade
in the census in a number of counties in the north. But it
was really all baby boomers that have retired moving north, which
doesn't help for workforce. And those key things that they need
to, you know, for, for their economy. But, you know, as they
age, that's going to, you know, they're going to move on as
well. So, so certainly people have been talking about this for
a long time. >> We have known it has been
coming, but is it worse than expected in your mind?
>> No, I don't I think it's a little bit worse because of the
decline in births. Births generally move up and down in
kind of cycles. And when birth started to decline in 2007, I
think most demographers thought, you know, that was going to be
temporary. It was going to be, you know, six, seven, eight, ten
years. And it's not been it's continued. And it's happening.
Happening everywhere. And unfortunately, there's really no
signs that that's going to change in the near future. And
so I think that's the that's the part that has sort of surprised
us over, over the past, you know, 5 or 6 years and has made
the projections as you look out, look, you know, much worse.
>> So what are the implications for population drop offs of this
magnitude? >> Well, you know, there there
there's a lot of implications. I think the number one that you
look at is workforce. Our 25 to 64 year old population is
expected to decline by almost 200,000. Just in this decade.
And then more over the following couple of decades. We're already
looking at labor shortages everywhere throughout the state,
so it's not only going to continue, it's likely to get
worse. And then when you look a, you know, especially the
declines in births, the impact there on schools whose funding
is tied to enrollment, we're likely to continue to see
declining enrollment there. And financial challenges for our
schools. >> So meanwhile, Dane County is
the total outlier with big projected population gains by
2050. What sets Dane County apart, and can it be replicated?
>> Well, I think you know, one of the. Dane County is unique in
that it has both. It's the home of state government and it has
the major university. And I think when you look around the
country, you'll see that those counties that have that are
generally more prosperous and growing and so Dane County has
all of that. It kind of makes it a little bit recession proof to
some degree, because you don't have the economic fluctuations
of laying off people as much with with government. And so
that's that's part of it. But it's also, you know, it's become
a place that has a lot to offer in terms of recreation and
activities and restaurants. ET cetera. And so people look at it
and, you know, they see it as a, as a great place to, you know,
raise their kids whether they want to be in a more urban area.
Madison, Or in one of the a little bit more outlying
communities. We will obviously be watching
these numbers. Doyle Knapp. Thanks very much. Thanks for
having me. For more on this and other issues facing Wisconsin,
visit our website at PBS Wisconsin. Org. And then click
on the news tab. That's our program for tonight. I'm
Frederica Freyberg. Have a good weekend.
[MUSIC]
>> Funding for "Here& Now" is provided by the Focus Fund for
journalism and Friends