The nation’s political leadership has chosen to ignore science, rip away health insurance, eviscerate environmental and public health protections, gut the most important consumer watchdog agency, and ram through judicial nominations based on raw political power instead of public accountability.

What can be done?

States cities and counties have jumped into the mix to do what they can to offset the most egregious of Washington’s actions.  Long considered the nation’s policy “laboratories,” local governments can offer new ideas to tackle pressing problems, while mitigating some of the most disastrous actions taken by the Trump Administration and its Congressional allies.

New York State can help by instituting its own “universal” health care policies, for example.  New York has its own health exchange and doesn’t have to heed the call of the President to strip away health insurance coverage for its residents.  In the same way, states can advance environmental policies that rely on science other than ideology and greed in setting climate control targets that respond to climate change instead of ignoring it.

Local governments can take significant actions too, since they operate close to the people and can develop policies that address real problems.  The City of New York, for example, has one of the nation’s more effective campaign finance laws – a model that creates a campaign financing paradigm based on cultivating a large number of small donors; instead of the federal and state systems which encourage reliance on a small number of very wealthy donors.

New York City – the nation’s largest city – has embarked on an overhaul of its Charter; the blueprint for how its government operates.  The Mayor and the City Council are engaged in a wide-ranging public conversation on how the Charter can address the needs of its people.  So far, there will be measures on this November’s ballot to further strengthen the City’s voluntary system of public financing of elections that will make candidates even less reliant on big donors.

The City Council has begun hearings to receive public input on how the Charter may be restructured to respond to environmental and public health threats, ensure that civil liberties are protected, people are educated, expand affordable housing, reform its criminal justice system, modernize its mass transit system, and ensure that access to health care is provided to those who need it, with a focus on achieving those ends without breaking the bank.

New York City’s approach is a far cry from the national government’s dismissive approach to science, its focus on rewarding its allies even at the expense of good governance, its apparent pandering to a hostile foreign power, and its debasing of civil discourse.

Here in New York, the rhetoric of reforms usually falls far short of the reality.  The City’s open approach stands in stark contrast to the secret, often cynical, deal-making in Albany.

Of course, actions by local governments are no substitute for actions by the federal government.  One does not have to look too far into the nation’s past to see the argument of “local control” being used as a powerful tool to discriminate against American citizens.  Moreover, actions by local governments are often used to justify national inaction.

Further, federal policies do matter, whether state and local leaders like it or not.  For example, the recent Congressional tax agreement imposes a limit on state and local tax deductions, making it more economically and politically costly for state and local governments to raise revenue.  Tariffs are threatening companies and jobs across all kinds of communities, but the Trump administration proposes to protect farmers with billions of dollars in subsidies provided by urban and suburban taxpayers.  Actions by government outside the Washington Beltway alone can’t overcome national policies.  Elections do matter.

As the nation deals with the fallout from the Trump Administration, states and localities must act.  New York City’s enlightened approach stands in stark contrast to simple, anti-Trump rhetoric.  While local governments alone can’t save us, they can be the foundation on which to restore democracy while enhancing services.

Consumers shouldn’t assume that children’s products are safe just because they are available in stores.  That’s the key finding of a shoppers’ guide released last month.  The report, Safer School Supplies: Shopping Guide, identified school supplies that contained toxic chemicals.

Researchers from the United States Public Interest Research Group (USPIRG) conducted laboratory tests for toxic chemicals in popular school supplies.  The researchers tested markers (washable and dry-erase), crayons, glue (liquid and sticks), spiral notebooks, rulers, 3-ring binders, lunchboxes, and water bottles for toxic chemicals such as lead, asbestos, phthalates, benzene, toluene, ethylbenzene, xylene, and bisphenol-A (BPA).  The supplies were purchased across the country at a wide variety of stores including big box stores, dollar stores, drug stores, online retailers, and arts and crafts stores.

Among the school supplies lab tested, researchers found Playskool crayons from Dollar Tree that contained asbestos, a 3-ring binder from Dollar Tree that contained high levels of phthalates, two dry-erase markers containing other toxic compounds, and the report highlighted two water bottles that have been recalled due to high levels of lead.  This guide not only listed the potentially dangerous school supplies that was found and explained why and how the school supplies can harm students, but also lists the school supplies that tested negative for chemicals of concern.

USPIRG sent 27 school supplies to an independent laboratory to test for chemicals of concern. The problems they found included:

• Six types of crayons were tested for asbestos and one tested positive for tremolite. Asbestos is a known carcinogen and can lead to serious health conditions, including lung cancer and mesothelioma.
• 3-ring binders. Three 3-ring binders were tested for phthalates, and one tested positive for phthalates. Studies have linked phthalates to asthma, childhood obesity and lower IQ scores.
• Two brands of dry-erase markers for toxic compounds and phthalates, which tested negative for phthalates but positive for the toxin compounds. Those chemicals include benzene, xylene, and toluene.

The researchers tested other products, which were free from toxic chemicals and lead.

Government is supposed to ensure that products sold are safe.  This shoppers guide shows that consumers can’t rely on that protection.

And there is evidence that the situation is going to become worse.

The Trump Administration is loosening regulations to allow for the use of asbestos.  According to media reports, on June 1^st, the Environmental Protection Agency (EPA) authorized a rule that allowed the distribution of products containing asbestos on a case-by-case basis.  It’s part of a broader strategy by the Trump Administration to allow greater use of this toxin and others like it.

Asbestos was widely used in ship boiler rooms, manufacturing plants and building insulation up until it was completely banned in most countries in the 1970s.  The U.S. severely restricted its use without completely outlawing it.  Asbestos poses a major health risk for everyone who comes into contact with it, both directly and indirectly.

It’s clear that the public should not be expecting greater protections from the federal government and instead will have to hope that state and local governments fill the public health gap.

In addition, the public will have to be more educated about its purchases.  In terms of school supplies, parents and teachers should use the USPIRG shopping guide, released jointly with NYPIRG.  This report is available at https://www.nypirg.org/pubs/201808/NYPIRG_Toxics_in_Back_to_School_Supplies_FINAL_2018.pdf.

In addition, the Healthy Schools Network has released a “tool kit” for parents, other caregivers and teachers to help them understand school health issues.  Access the tool kit here: http://www.healthyschools.org/coalitionactionkit.html.

The presence of toxic hazards in school supplies highlights the need for constant vigilance on the part of government agencies and the public to ensure that school supplies containing toxic chemicals are removed from store shelves.  The only thing kids should be exposed to in school is learning.

The crisis in the cost of medicines in America is well-known.  Americans spend more on prescription drugs — average costs are about $1,100 per person per year — than spent anywhere else in the world.  And the prices can be staggeringly high.  For example, cancer drugs in the U.S. routinely cost $10,000 a month.

These costs are often not directly borne by the average American who has insurance coverage.  Generally speaking, private insurers and government programs pick up the biggest share of the bill.  However, high drug costs directly impact health care premiums and taxes – both of which are rising.

Those rising costs impact the financial stability of the nation.  Why is this the case?  Unlike other countries, the U.S. doesn’t directly regulate medicine prices.  In Europe, governments negotiate directly with drug makers to limit the cost to their state-funded health systems.  In the U.S., drug companies can more or less set whatever price the market will bear for those receiving medicine through the Medicare program.  Private payors, such as employer health plans, typically negotiate discounts for their enrollees.

As a result, patients in the U.S. directly pay about 17 percent of prescription medicine costs out of their own pockets.  In a 2013 survey, one in five adults in the U.S. said they failed to complete a prescribed course of medicine because of cost.  The figure was one in ten in Germany, Canada and Australia.

If private employers negotiate for the price of medicines and states limit drug choices to help offset costs, who looks out for those without health insurance coverage or for seniors whose costs aren’t fully covered under Medicare Part D?

Other than possible help offered by drug companies or pharmacies, New Yorkers without coverage are left to comparison shop for the lowest drug prices.  The state of New York tries to assist that effort by collecting drug prices for the most widely prescribed drugs.

Under New York law, the state Health Department has created a website to allow consumers to comparison shop for the most frequently prescribed medicines.  The website allows consumers to search as many as six medications simultaneously by zip code, county or city.  For consumers who lack adequate coverage for prescription drugs, the Department’s website could yield considerable savings.  The law also requires that at the checkout area of each pharmacy a written notice must be provided informing consumers about the availability of the website.  (The website can be found at: https://apps.health.ny.gov/pdpw/SearchDrugs/Home.action.)

The need that could be filled by this program is real.  According to recent U.S. Census information, over one million New Yorkers lack health insurance, meaning they must pay full retail price for prescriptions, and – as mentioned earlier – seniors in the Medicare “doughnut hole” also face cost pressures for medicines.

A recent review of what pharmacies are charging showed a shockingly large range in retail prices across the state.  In fact, a recent survey of prices posted on the state Health Department’s website by the New York Public Interest Research Group, in some cases consumers could be paying as much as $200 more for the exact same prescription in the exact same region.

NYPIRG reviewed fourteen regions of the state and examined the prices for six of the most frequently prescribed medications.  NYPIRG found an enormous range in prices charged, with the greatest disparity of $207 in prices for Advair Discus in Manhattan.  In the city of Albany, the drug Advair Discus had the greatest range in price – a difference of nearly $154.

Clearly, it pays for consumers to shop smart.  Yet, those comparisons only work if the public knows of the existence of the program.  Under New York State law, each pharmacy is required to post a sign alerting the public to the drug pricing website.  Yet, when NYPIRG spot checked that requirement, it found that only about 40 percent of the pharmacies had the required signage.

Given that at least one million New Yorkers need to know the costs of their medicines, the state must do better.  If costs are too high, those who can’t afford medications often go without.  Not taking needed medicines can result in devastating consequences.

Of course, expanding coverage is the best response, but in the meantime, New York must make sure that this program works.  New York should publicize the website, make sure pharmacies are conspicuously displaying the website information and come up with an easier-to-remember website address so the program can benefit all New Yorkers who could use some help shopping for prescriptions.

Last week was a big one for Democrats in New York.  The contested primaries for Governor and Attorney General hit a peak as the candidates for those offices slugged it out in televised debates two weeks before the state primaries on Thursday September 13^th.  In both debates, the issue of corruption in state government was a major topic.

In both debates there were accusations and pledges to be tough, but it was in the Attorney General’s debate that the issue of what to do about corruption received the most air time.

Even the most casual observer of New York State government knows that corruption has been a persistent problem.  The evidence is overwhelming: A former governor was forced to resign, another had to pay a fine for lying under oath, a Comptroller was sent to prison, top aides to the governor have recently been convicted, the two former leaders of the legislature are facing prison time, and scores of additional lawmakers have gotten into hot water for unethical acts.

In most cases, it was a federal prosecutor, not a state watchdog, that investigated and brought action.  Yet, on paper New York has quite a few ethics enforcers – for campaign finance, for agency misdeeds, for monitoring quasi-governmental public authorities, and for the ethics of public officials and lobbyists.

But in most cases, those watchdogs have ignored or overlooked the high profile cases brought by the feds.

In the Attorney General debate, it was the state’s leading ethics watchdog – the Joint Commission on Public Ethics – that was the candidates’ primary punching bag.  All candidates claimed support for eliminating the JCOPE and replacing it with something independent.

You see JCOPE is a creature of political compromise.  It has a board of 14 members (by the way the largest such Commission in the nation) who are direct appointees of the governor and the legislative leaders.  All of the leaders are subject to oversight by JCOPE.

During the negotiations over cobbling JCOPE together back in 2011, all of the leaders were likely afraid that one individual would come to dominate the Commission and that they could face a threat from such an entity.  As a result, the Commission is designed to give the governor or each of the leaders enough votes on the Commission to stop certain investigations.

Essentially, JCOPE was designed as a political entity, not an independent one.

At the Attorney General debate, there was considerable agreement among all the candidates that JCOPE had to go and be replaced with an entity that was independent of political influence.

But what should an independent state ethics watchdog look like and how can it be designed to be independent?

Reformers have been hard at work trying how to do just that.  After all, someone has to appoint Commission members, how can the entity be independent?

One model is the state’s Commission on Judicial Conduct, a body that oversees judges and yet is made up of a majority of non-judicial appointees – all with required standards of independence.  The Commission was established in the state Constitution, another benefit to its independence.

Using the Commission on Judicial Conduct as a model, reformers advanced a plan that would replace JCOPE (and some other state watchdogs) with a new ethics commission, in which the majority of the appointments would be made by the courts, not the governor and the Legislature.  In that way, the new ethics commission would be sufficiently independent of those that they monitor.  In addition, the members and staff of this new entity would be prohibited from communications with their appointing authorities.  Finally, the proposal protects the budget of the new ethics watchdog, which offers insulation from another way in which political pressure can be brought.

Of course, nothing will change without the public clamoring for change and a real debate.  And even the best of laws are not effective unless they are adequately overseen by independent, well-resourced, watchdogs.  The good news is that the statewide candidates in both parties are talking about reforms.  It remains to be seen if that rhetoric leads to real changes next year.