The president is upset that the Supreme Court isn’t behaving like a department he personally supervises, Medicare’s AI experiment is raising questions about who pays for administrative ambition, and a federal watchdog has documented what happened inside an immigration detention center whose staff called small metal cages “calming areas.” Apparently, we need to revisit what it means to be responsible for other people.
Here on the homefront, I keep talking about taking it slow and sitting back to enjoy our time, which has been wonderful, except we live in coastal Oregon, and the sunshine is preparing to disappear. Everything I postponed in my effort to slow down now needs to happen immediately, before the rain arrives for its customary nine-month visit and begins receiving mail.
We need to finish painting the house because we decided it needed a color update, and finish painting the roof, which our resident contractor, my brother, is handling for us. The water heater needs to move to make room for stairs to the attic bedrooms, and we have acquired a coastal redwood, a western red cedar, and approximately four fruit trees without quite resolving where everybody will live.
We also need grass, because otherwise we will spend winter presiding over a mud pit, and my mister boy, my sweet baby pie, needs somewhere to run and play in the Oregon rain. I would prefer that his first explorations of the yard not require a recovery team. I have this problem where I bite off considerably more than I can chew because the idea of all the things is wonderful. My husband tries his best to rein me in, but he also likes to see me smile, which leaves him negotiating against his own interests whenever I discover another tree.
I have decided, though, that the kids aren’t going to lose their time with me because I got absorbed in making their future shelves beautiful. So I set an alarm, because my life is governed by six-minute alarms, to remind me to stop, go inside, make dinner, and spend time with them before bed. Thinking about dinner reminds me that I need to install a folding table for them, which reminds me about the finishing work on my myrtle slab for the shelves, and the cedar chest still waiting for its turn. Even my attempt to stop working has developed a project list.
We’re also planting some competition for the English ivy around our big Douglas fir, competition for the ivy, to be clear, because the tree has enough problems without me organizing a challenge to its authority. The list goes on, and honestly, I hope it never entirely disappears, although I would appreciate it occasionally allowing me to finish a thought.
Then this morning, my daughter informed me that she could put on her shoes by herself. A little later, while I was putting on mine, she came into my room and said, “Mom, actually, I like it when you help me put my shoes on.” I think my heart skipped a beat, because she is my big girl, so proud of everything she can do, and also my baby girl, who still wants me beside her while she does it. She had another wonderful morning before school, and I’m so proud of her.
So here on the Homefront, we are finishing projects, hiring the family contractor, growing the plants, making the meals, and trying to improve our situation without forgetting the people we’re improving it for. We’re getting on with life with love, which is a standard I would very much like to see reflected in the current administration. Which brings me naturally, to today’s news.
According to the Associated Press, the Supreme Court on Monday rejected the administration’s emergency effort to impose new mail-ballot restrictions for the midterm elections. Trump responded Tuesday by complaining that the justices were “not the people I interviewed.”
That is a revealing way to discuss judges whose responsibility extends beyond satisfying the man who nominated them. Apparently, somewhere between the interview and the lifetime appointment, there was a misunderstanding about who would be reporting to whom.
The proposed postal rules would’ve required changes to ballot envelopes and the submission of voter information to federal authorities. State and local officials argued that the requirements exceeded federal authority and could not fairly be implemented so close to the election. The court left the block in place, preserving existing procedures for the midterms while the litigation continues. The distinction is important because this is a consequential reprieve for voters, with the broader fight still unresolved. It also gives us a useful view of how this president understands public institutions: a decision against his wishes becomes evidence that the people making it have somehow failed him personally.
I would like election administration to be sufficiently dependable that people can spend September getting their children to school and preparing for winter without wondering whether Washington is about to invent another obstacle between them and a ballot. The ability to participate in your government shouldn’t depend on your capacity to keep up with the president’s latest grievance.
That expectation of dependable public service follows us directly into healthcare, where the consequences of a poorly designed process can arrive in someone’s body long before they appear in an evaluation report. STAT reports today that newly released records reveal a rushed and troubled launch of Medicare’s WISeR program, an experiment using AI in reviews of certain medical services. The Electronic Frontier Foundation, which obtained roughly a thousand pages through a public-records lawsuit, describes technical failures, delayed responses, and provider complaints about patients waiting in pain. One vendor warned before launch that its software would lack full functionality and hadn’t been fully tested.
The program began in January in six states, including Washington, and applies to selected services under Original Medicare. CMS says its purpose is to reduce unnecessary care, and licensed clinicians must make nonpayment determinations. Providers can seek authorization beforehand or have their claims reviewed before payment after delivering the service. Those details are important, particularly the human review requirement, because we need to understand where responsibility actually sits. An AI recommendation passes through people, policies, contracts, and decisions, and every one of those deserves scrutiny when patients can’t get timely care.
CMS also says participating companies receive a portion of the spending associated with care their reviews identify as wasteful or inappropriate and avert, with adjustments for performance. That arrangement requires serious oversight, because the financial benefit of stopping a payment is much easier to calculate than the human cost of delaying treatment.
My background is in healthcare quality and compliance, so I have several questions, beginning with why a warning that something wasn’t ready didn’t produce a sufficient pause to make it ready. Who was responsible for checking whether providers could use the system, whether requests were answered, and whether patients were being harmed while everyone worked through the problems? A patient waiting in pain is experiencing the program exactly as it exists, regardless of what the presentation promised. Calling it an experiment doesn’t suspend the obligation to care for the people inside it.
That obligation becomes especially urgent when the government has taken away someone’s ability to leave. According to ABC News, a report released Monday by the Department of Homeland Security’s inspector general found that detainees at Florida’s now-closed Alligator Alcatraz facility were confined in metal enclosures with about eighteen square feet of floor space, sometimes for nearly two hours. Staff described them as “calming areas,” while inspectors found the practice inconsistent with humane treatment.
The report also identified failures involving drinking water, hygiene, medical care, and living space. In its response, DHS emphasized Florida’s responsibility for daily operations, while Governor Ron DeSantis said the facility had aimed to exceed federal standards, acknowledging that he hadn’t read the report. There’s something notably ugly about giving a cage a name borrowed from the language of care. “Calming areas” suggests somebody considered what a distressed person needed and provided it, when the inspectors were describing confinement that threatened people’s health and safety.
The facility closed in June, but the report says questions about federal oversight and responsibility remain consequential. Closing the doors doesn’t tell us who permitted the conditions, why safeguards failed, or what will prevent the same failures somewhere else. When a government confines people, it assumes responsibility for needs they can no longer meet independently. They cannot simply leave to find clean water, arrange another place to sleep, or choose a different provider when medical care is inadequate. Their dependence makes the government’s obligation greater, however enthusiastically officials try to hand it back and forth.
These stories leave me thinking about the distance between having authority and accepting responsibility, and how much ordinary people are expected to endure while the people in charge argue about that distance. I know the house will never be entirely finished, and the plants will keep presenting themselves as excellent ideas. There will be another shelf, another coat of paint, another project I somehow believe will take an afternoon. But when the alarm goes off, I need to remember why I’m doing any of it, and go inside.
My daughter can put on her own shoes, and she still likes it when I help her. There is a whole understanding of care inside that sentence, one that leaves room for independence without treating the need for help as a failure. We deserve public institutions capable of that understanding, where a vote can be cast, a patient can receive care, and a person’s humanity survives contact with government authority. The people entrusted with power need to be answerable for what happens to the people depending on them.
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"...having authority versus accepting responsibility..." you hit the nail on the head right there!
Excellent essay, Shanley! I don’t think the regime cares whether human beings can survive contact with the govt.