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Perhaps some are jealous of what appear to be greater opportunities afforded to younger people, bemused by younger generations’ lifestyles, and fearful that their own values are seen as outdated.

The trouble was the sheer number of Boomers. As a big generation, the Boomers had achieved political and cultural dominance. They were no more self-interested than any other group, but they warped government priorities. And that was unfair to everyone else. Boomers, Willetts argued, were not okay.

Both sides claim that the other is being condescending. Some Boomers argue that the word itself has become a cover for ageism; Millennials roll their eyes and reply with the phrase that has come to encapsulate their weariness: “Okay, Boomer.”

Boomers have bent the gravity of politics toward themselves and their needs. They buy newspapers. They vote. They wield their spending power effectively. Their voice is loud. To build a fair and just society, the question then must be: On everything from elderly care to housing, how do you persuade them to vote against their own interests?

Generational arguments are essentially family dramas, with all the friction that implies.

“When we have all this power, we shouldn’t be surprised when younger people are rather resentful,” he said. “I’m surprised they are aren’t angrier.”

the rage tends to come not from Millennials, who feel disadvantaged, but from the Boomers, who feel attacked.

In Britain, for example, Boomers have opposed housebuilding, leaving the country with a chronic shortage that protects the value of their homes but traps younger people in the expensive private-rental sector. (In 1980, the average private tenant spent 10 percent of their income on rent. That figure is now 30 percent.

Boomers have successfully deterred politicians from devaluing the state pension, even as salaries and working-age benefits have stagnated. The result is that pensioner poverty has halved since 2000, whereas poverty among people of working age has risen

defensiveness can sometimes manifest as retaliatory accusations that younger generations have it easy. The intergenerational debate has spawned its own weird jargon: “Avocado toast,” for example, has become shorthand for the argument that Millennials splurge their salaries on good living, rather than saving for a home like their parents did

the problem is particularly acute in Britain, because of the country’s steep fall in home ownership in recent decades. The British rental sector is much more “mom and pop”—literally. “Something like 20 percent of Boomers have a second property that they rent out,” Willetts said. That means there is a direct transfer of wealth from younger renters to older asset-owners.

How, though, do you explain to otherwise reasonable retirement-age voters how much damage their demands are causing to their children’s generation—without completely alienating them? “In politics, you’re not a kamikaze pilot, you’re not on a suicide mission,” Willetts said. He told the Boomers that the houses they owned had been largely built in the 1960s and ’70s so their parents had somewhere to live; they now had a similar obligation to allow more building for their own kids. “That was the only argument that gave them pause,”

differences within generations do matter, though, because rich Boomers, the luckiest part of a lucky generation, will leave their money to their children, further entrenching inequality. If the value of assets is rising faster than incomes, we are heading for a society where wealth matters more, and earnings matter less. The problem will not resolve itself without intervention.

One obvious answer is to build more houses (bad news for the residents’ associations who want to preserve their unblocked views or quiet roads) and ease lending criteria for younger people, to make it easier for them to get mortgages.

Willetts has a more radical idea: Offer younger people £10,000 when they turn 30, money that they could put into a pension, use to start a business, combine into a down payment, or spend on education or training

the added cost of having to see an optometrist presumably stops many Americans from accessing the corrective lenses they need to improve their vision. Is the desirability of an eye exam performed by a medical professional a sufficient reason to prevent Americans who would rather not—or cannot—visit an optometrist from buying glasses and contacts?

it’s reasonable to assume that it has an adverse impact on many people, especially underprivileged Americans—those who don’t have insurance, have little cash, or lack the social or financial capital to navigate our country’s byzantine medical system.

many people have a financial interest in this burdensome system. If Americans no longer needed to book appointments with optometrists to buy glasses or contacts, many optometrists would see their salaries cut, and some might go out of business altogether.

Optometrists are also a source of revenue for opticians, from large chains like Specsavers to independent stores in malls and town centers across the United States. Since they often work on-site, they have an incentive to nudge their patients to buy the products on hand.

When I last went to an eye exam at a storefront optician in the United States, for example, the staff gave me the hard sell on glasses that would have cost hundreds of dollars, as well as on contact lenses that were much more expensive than identical ones sold by online retailers. Thankfully, I knew that two laws, one passed in 1997 and the other in 2003—which had, incidentally, been loudly opposed by the AOA—gave me the right to demand a copy of my prescription.

I stood firm, and later went online to order perfectly fine glasses and contact lenses at a fraction of the price. But how many customers give in to heavy-handed sales tactics?

Democrats who care about the well-being of the socioeconomically disadvantaged—and are worried about the health disparities between different ethnic groups—should be outraged by the unreasonable burden the situation places on underprivileged Americans.

Republicans who believe in the free market should look on this red tape as an unnecessary intrusion on free enterprise

Even in times of extreme polarization and a deeply broken Congress, this is one piece of sensible legislation that should be able to command bipartisan support

At the Interior Ministry, where she works, anger has mounted at what is seen as Mr. Cadène’s “laïcité of appeasement,” one that is more concerned with the “struggle against stigmatization of Muslims” than with upholding the Republic against “militant Islamists,” the weekly magazine Le Point reported.

Among the disadvantaged “are a majority of French Muslims, even if the situation is evolving,” Mr. Cadène said. The result, as he sees it, is discrimination that is religious and social: the inferior schools in ghettoized neighborhoods on the outskirts of big cities mean Muslim children have fewer chances.

“As laïcité is a tool to allow us all to live together, whatever our condition, it’s also necessary that we be together,” he said. “That we live in the same places. That we interact. And this happens too rarely.” A lot of schools, neighborhoods and workplaces were very homogeneous, he noted. “This insufficient social mixing spurs fears because when you don’t know the other you are more afraid.”

Or it can be philosophical, a form of emancipation against religion, a battle for enlightenment against religious obscurantism, something close to atheism. Islam, with its vibrant appeal to young Muslims, then becomes the enemy

Hakim El Karoui, a Muslim business consultant and senior fellow at the Institut Montaigne, said the problem is that laïcité has many meanings. It can represent the law of 1905, freedom of conscience and the neutrality of the state.

“It would be very dangerous to turn laïcité into a political tool,” he said. “It is not an ideology. It is absolutely not anti-religious. It should be a means to bring people together.”

Mr. Cadène’s views seem broadly aligned with Mr. Macron’s. While condemning the extremist Islamism behind recent terrorist attacks, including the beheading of a schoolteacher, the president has acknowledged failings. In an October speech he said France suffered from “its own form of separatism” in neglecting the marginalization of some Muslims.

Draft legislation this month seeks to combat radical Islamism through measures to curb the funding and teachings of extremist groups. It was a necessary step, Mr. Cadène said, but not enough. “We also need a law of repair, to try to ensure everyone has an equal chance.”

A law, in other words, that would help forge a France of greater mingling through better distributed social housing, more socially mixed schools, a more variegated workplace. The government is preparing a “national consultation on discrimination” in January, evidence of the urgency Mr. Macron accords this question in the run-up to the 2022 presidential election.

In France, saying to someone, “Tell me your laïcité and I’ll tell you who you are,” is not a bad compass.

So, I asked Mr. Cadène about his. “It’s the equality before the state of everyone, whatever their conviction. It’s a public administration and public services that are impartial. And it’s fraternity because that is what allows us to work together in the respect of others’ convictions.”

He continued: “In theory it’s a wonderful model. But if the tool is not oiled it rusts and fails. And the problem today is that equality is not real, freedom is not real, and fraternity even less.”

or many decades the model made French citizens of millions of immigrants, and it remains for many French people of different backgrounds and beliefs and skin color, a noble idea, without which France would lose some essence of itself.

“I believe that our Republic is laïque’’ — secular — “and dedicated to social justice, and that laïcité can only survive on that basis.”

This is also critical if we are to overcome the demographic hurdles our labor market faces as Baby Boomers retire and the influx of Millennials slows.

The ugly truth of our criminal justice system is that one in three Black men in the United States has a felony record, putting them at a severe disadvantage.

Admirable commitments by companies to be more inclusive in hiring must be coupled with an intentional process for second chance hiring. My research has shown that "disposable employee" labor, in which the employer is trying to get the cheapest effective wage possible through minimum wage jobs that are subsidized by temporary tax credits (Work Opportunity Tax Credits), will not work because they do not adequately distinguish who is ready for reemployment nor do they make the sufficient investment to support rehabilitation.

Done right, second chance hiring that offers the needed training and support repays the required investment with loyal, productive and profitable employees (the upfront costs can even effectively be offset by tax credits). Without such an approach, our labor force cannot hope to reflect the diversity of our population.

Employment is foundational to rehabilitation for the millions of Americans with records and the more than 600,000 who exit prisons each year.

Even those businesses such as schools, defense contractors and financial institutions that have regulatory constraints on who they can hire have important roles to play. They can support education, reentry and workforce development nonprofits or advocate for policies that improve employment outcomes. 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There are fewer and fewer senators that are from the opposite party of how their state voted for president

But the possibility that consecutive Democratic wave elections — ones in which the party has expanded its appeal to rural voters and working-class white voters — could deliver them only a narrow majority drives home the party’s disadvantage.

Senate Majority Leader Mitch McConnell has issued a series of apocalyptic warnings. Democrats are threatening to “disfigure the Senate,” he said in a speech on the Senate floor.

“We are in a time where our nation needs to heal, not just from the COVID, but from this leadership that encourages divisiveness,”

Bollier, at times, can seem frustrated with rural voters’ focus on cultural issues.

“When election time comes, the focus seems to be on partisan hot-button issues rather than on the most important things — a job, health care, safety. It’s disappointing.”

While Democrats have made all of these Republican-leaning states competitive, public surveys and internal polling from both parties indicates they’re not favored to win any of them.

Kander said Democratic candidates don’t need to run to the center or right to win in rural states, but that the party needs to do a better job of explaining why their policies will benefit rural communities

The rural bias of the Senate has existed for a long time, though partisan shifts have meant it only started directly damaging Democrats recently

But it’s how the Senate discriminates against racial minorities that may force the hand of a party increasingly focused on racial injustices. The average Black voter has 16% less power in determining who controls the Senate than the average American.

he average Latino has 32% less power than the average American in determining who controls the Senate

The average white person? They have 13% more power.

And this tilt against racial minorities will only grow worse in the future: Even as demographers expect the country’s population to become majority people of color around the year 2050

National Republicans have attacked Democratic candidates who support ending the filibuster, accusing them of trying to “change the rules” to pass left-wing policies.

Our real concern, the logic goes, should be for younger people who have their whole lives ahead of them and are sacrificing their economic futures to lockdowns. This collapse of the inter-generational compact has been far more effective at killing them off than any death panel dreamed up in Sarah Palin’s fevered imagination.

Similarly, ethnic and racial minorities including African Americans, Latinos/Hispanics, and Native Americans have all been disproportionately affected by COVID-19

Farm and food processing workers—dominated by Latino and other immigrant workers—are another population that has disproportionately been affected by COVID-19.

That social reciprocity has broken down to this degree ought to be an embarrassment and shame to us all.

Heavily agricultural regions like California’s Central Valleyand Washington State’s Yakima Valley have seen huge COVID spikes. In response, the U.S. Department of Labor has so far levied just $29,000 in fines against two companies, Smithfield and JBS, who have combined sales of $65 billion per year.

Adding to the misery of COVID-vulnerable populations is an unfortunate, and very human, tendency to find reasons to blame disadvantaged groups for their illness.

Reviewing the data and history pandemic discrimination, it’s hard to escape the conclusion that the majority of America has concluded that these groups—the poor, the minority, the imprisoned, and the elderly—are the “acceptable” losses.

Were the situation reversed and the white, middle aged, and middle/upper classes the primary victims of the pandemic—one of the features of the 1918 influenza—COVID-19 would be a true national emergency and there would be far less complaining about disrupted schools, work, and social life brought about by social distancing requirements and economic shutdowns

Last are the millions of Americans behind bars. Per statistics from the Marshall Project, there have been more than 121,000 COVID-19 cases reported among prisoners and more than a thousand deaths.

The message seems to be that Americans have abandoned e pluribus unum (out of many, one) for “everyone—or at least every group—for themselves.”

Pro-lifers have for decades protested American indifference to the deaths of millions of unborn children (another invisible and voiceless minority), and they have been right to do so. Where are these champions of human life when other weak and vulnerable populations are dying at the rate of a thousand a week or more?

they have been subject to injustices and disadvantages such as fraudulent lending practices, housing discrimination and aggressive policing and prosecution.

During the Great Recession of 2007 to 2010, the unemployment rate among the black population peaked at 16.8 percent, while the highest rate for the white population was 9.2 percent. During the current economic crisis, fewer than half of black adults are able to keep their jobs.

And last month he flew to his Bedminster club in New Jersey to collect checks before the September fund-raising deadline, even after a top aide, Hope Hicks, had tested positive for the coronavirus.

In private, Mr. Trump has continued to blame Mr. Parscale for spending decisions, despite the fact that the former campaign manager has said he made them all with the approval of the Trump family.

The $247.8 million he raised in concert with the party in September would have been a record before 2020. That high level of fund-raising has raised questions about his team’s spending habits, given the current cash situation.

Perhaps nothing underscores how acute and unexpected the budget situation is for Mr. Trump as much as his television ad budget. His cash on hand entering October was $40 million less than the $104.4 million he had previously reserved in television ads for the final five weeks, according to Advertising Analytics data

Over all, the data show Mr. Trump’s TV ad spending has shrunk by $23 million since Sept. 20. In that same time period, Mr. Biden has expanded his reservations by $99 million.

Mr. Trump’s campaign is not broke. The $63.1 million he had on hand entering October is nearly what Mrs. Clinton had four years ago. The campaign said no loans or deferrals had occurred this time. The problem is that his campaign initially presumed it would have far more money, and Bill Stepien, who replaced Brad Parscale as campaign manager over the summer, has spent recent months imposing cost-control measures to prevent a bigger shortfall.

The American Petroleum Institute, which represents the oil and gas industry, says Biden’s plan to boost renewable energy will hasten the decline of union jobs as their businesses reel from the coronavirus pandemic.

poll conducted last summer by The Washington Post and the Kaiser Family Foundation (KFF) found that a growing number of Americans describe climate change as a crisis, and two-thirds said Trump is doing too little to tackle the problem. The poll found that about 8 in 10 Americans say human activity is fueling climate change, and roughly half believe action is urgently needed to avert its worst effects.

n May, a KFF poll found ­that 33 percent of registered voters nationally said climate change is “very important” in their vote — down 10 percentage points from when the group asked the same question in February. Respondents said the economy, health care, the coronavirus pandemic, taxes and immigration were more important.

“The campaign is trying to reconcile a combination of demands that no political candidate for president to date has been able to successfully navigate,” said Jason Grumet, president of the Bipartisan Policy Center. “All [Biden] needs to do is blend the ambition of progressives and scientists with the pragmatism of organized labor, the energy industry and moderate Republicans. That’s no easy task.”

The new Biden plan includes a commitment to invest 40 percent of the clean energy money in historically disadvantaged communities — prompting Martinez to call it “the most innovative and bold plan in a presidential campaign that we’ve seen from an environmental justice standpoint.”

Biden “recognized this as a unique moment, when you could combine the economic benefit of clean energy with the environmental benefits,” Inslee said in an interview. “He had internalized that. It wasn’t just a talking point.”

The Sanders camp did secure one big win: A commitment to eliminate carbon emissions from power plants on an accelerated 15-year timeline.

“Everybody knows that Joe Biden can do a whole bunch of talking. But what he did do was that he also listened,” she said. “We needed that. We needed someone to listen.”

For example, more than a few Germans “without a migration background” find it impressive when binational children speak Spanish or English in addition to German, only to get up in arms when Turkish or Lebanese children switch to their native language in lieu of German.

But there’s also racism by minorities against mainstream society as well as against other minorities. It’s not uncommon that marriages or even friendships are forbidden not only between migrants and Germans, but also between Turks and Kurds, or Moroccans and African-Germans, or Sunni and Shi’ite Muslims, or Muslims and atheists.

After the brutal murder of George Floyd, the racism debate reignited across the globe. This is a good thing. However, as a woman with a migration background, I find the current discussion surrounding “white privilege” both ethnocentric and misleading.

Within many of these communities, the lack of integration assistance reinforces a general dismissal of the culture of their host country

To fill the void, the well-trodden reactionary, patriarchal – read: religious – structures so widespread in many of their home countries take hold. The goal here has not been to foster integration, but rather to establish a parallel society defined by the norms of the cultures from which the newcomers came, cultures that are often diametrically opposed to the democratic societies of Germany and France.

As children often emulate their parents and others in their surroundings, it begs the question: Have some migrants become xenophobes themselves? Or are all people more or less racists?

“Being white” once again dominates the discourse as human rights violations are displaced from center stage. This is the approach of several no-doubt well-intentioned anti-racist activists. But their proponents should be aware that they are once again reducing individuals to the color of their skin.

The idea here is to target the unjust system, not the people it represents. The goal should be to combat the causes and instruments that prevent the equitable and respectful coexistence of fellow humans.

The economic and linguistic integration of migrants is indispensable. But in order to become responsible citizens within mainstream society, they must come to terms with the state’s liberal democratic system of norms and find their bearings in relation to the enlightenment and the advantages of a humanist secular democracy.

The French philosopher and author Henri Peña-Ruiz recently wrote: “To effectively fight racism, there are two invaluable maxims. The first is to remain vigilant as to the singularity of the human species

The second is to reject any abstract stratification of human groups, independent of whether this may derive from assertions related to nature or culture. An individual should never be drowned in a feeling of affiliation, nor should an ethnicity be judged through a global lens.”

This underscores that a relativistic approach to culture has the further disadvantage of discouraging migrants from questioning and debating their community’s norms that may violate certain human rights. This results in the deprivation of a migrant’s opportunity to develop into a responsible citizen, which in itself is a form of racism.

Naïla Chikhiborn in 1980 in Algiers, is a cultural scientist who works as an independent advisor and consultant in the fields of integration and women’s issues.

In the major scale used to measure “racial resentment,” participants are asked to respond to questions like “Irish, Italians, Jewish, and many other minorities overcame prejudice and worked their way up. Blacks should do the same without any special favors,” and “It’s really a matter of trying hard enough; if blacks would only try harder that would be as well off as whites.” People who answer yes are more likely to harbor racial resentment than others.

this reasoning, in turn, “undergirded contentions that African Americans’ cultural deficiencies was the cause of their poverty—assertions that delegitimized blacks’ demands for structural changes in the political economy and stigmatized their utilization of welfare state entitlements.”

Even as he avoids the words black or African American, that charge—that black deficiency (or even pathology) drives black disadvantage—is the core of Sullivan’s inquiry. And his argument, unstated but clear as the blue sky, is that black Americans have only themselves and their culture to blame for continued racial inequality.

The reason we call this racial resentment and not simple “racism” is that it stems from different psychological processes. Less a belief in biological inferiority and more a moral and cultural judgment, what political scientists Donald Kinder and David Sears called “a blend of anti-black affect and the kind of traditional American moral values embodied in the Protestant Ethic … a moral feeling that blacks violate such traditional American values as individualism and self-reliance, the work ethic, obedience, and discipline.”

Had Sullivan written about the biological inferiority of black Americans, there’s no doubt it would have raised red flags among his editors. But to frame the subject as a question of black culture, well, that’s just being provocative.

the traditional “summer slide” in which low-income students lose ground during the summer months and told me: “The ‘summer slide’ is now being dwarfed by ‘Covid slide’ projections.”

it may be necessary to shut some schools. But that should be the last resort.

But after Trump, trying to project normalcy, blustered in July about schools needing to open, Republicans backed him and too many Democrats instinctively lined up on the other side.

Cities such as Boston, Philadelphia, Baltimore and Washington, D.C., have closed schools while allowing restaurants to operate.

America’s education system already transmits advantage and disadvantage from one generation to the next: Rich kids attend rich schools that propel them forward, and low-income children attend struggling schools that hold them back.

while we all want in-classroom instruction, the practical question is whether to operate schools that don’t have optimal ventilation and other protections.

In both Europe and the United States, schools have not been linked to substantial transmission, and teachers and family members have not been shown to be at extra risk (this is more clear of elementary schools than of high schools).

“Children learn best when physically present in the classroom,”

One child in eight in America lives with a parent with an addiction — a reflection of America’s other pandemic.

It’s true that Trump was simply trying to downplay the virus. If he wanted schools open, he should have fought the pandemic more seriously and invested federal money to help make school buildings safer against the virus’s spread.

Research from Argentina and Belgium on school strikes indicates that missing school inflicts long-term damage on students (boys seem particularly affected, with higher dropout rates and lower incomes as adults)

school closures may lead to one million additional high school dropouts.

acism leads to social vulnerability, she said, with people holding low wage jobs that place them at higher risk of infection and living in crowded neighborhoods and households.

situations that tend to apply more often to people of color — are getting sick and dying from Covid-19 at a much higher rate than the rest of the population.

If the C.D.C. committee follows the National Academy’s framework, 10 percent of the total amount of vaccine available would be reserved for people in hard-hit communities.

The first phase offers a vaccine to health care workers, a large group that constitutes at least 15 million people and includes low-wage workers, such as nursing assistants and housekeepers in nursing homes.

60 million essential workers who are not in health care

When the first two phases of vaccines are distributed, 1.7 million more doses would be offered to mostly worse-off Black and Hispanic communities using the vulnerability index preferred by the National Academies than with the deprivation index, he and other colleagues reported in another paper.

The allocation proposal, “is built on the assumption that people who for generations have been underserved and disadvantaged should get a leg up if we can afford it,” said Dr. Matthew Wynia, an ethicist and infectious disease physician at the University of Colorado. But, he said, leaders in some states may refuse.

Capital and Ideology, Thomas Piketty’s recent entry into the genre, places inequality as the ultimate driving force of politics, society, and religion

The Upswing proposes another, similar arc

this one is “a long arc of increasing solidarity and then increasing individualism” which “had implications for equality, for politics, for social capital, and for culture. It led to an increasingly zero-sum, tribal view of society, and, eventually, to Trumpism.”

The evidence justifying the thesis, intriguing as it is, is not nearly so strong.

The authors assign ultimate importance to the route from individualism to communitarianism and back again, called the “I-we-I” curve in their shorthand.

Was it possible for America to become a society of solidarity, a “we” society (as Putnam and Garrett term it), only because it was a Mad Men one, undergirded by the exclusion of blacks and women?

Many concurrent transformations, of course, could also have driven these trends

Putnam and Garrett nonetheless present a clear story. They propose that the communitarian ethos of the Progressive Era—of muckrakers like Ida B. Wells and Jacob Riis and social reformers like the suffragette Jane Addams and education evangelist John Dewey—is the generating impulse of the upswing. And the various traumas of the 1960s—assassinations, campus violence, the civil-rights struggle, urban riots, the Vietnamese debacle—are proposed as the instigators for the downswing.

Google’s ambition to digitize millions of books has yielded a database that the curious can use to check trends in English usage over decades with only a few keystrokes. Putnam and Garrett rely on this tool to track the rate of usage of “we” compared to “I”—and find that the resulting curve traces the familiar U-turn that recurs everywhere else in the book.

Similar accounts of increasing selfishness fossilized in Google Books data have been offered before, most notably by the psychologist Jean Twenge, but they do not seem to be taken that seriously by many linguists.

My brief experimentation also showed that writers also discuss “you” more than “I” these days. From these analogies, one could conclude the exact opposite: a resurrected communitarianism after all.

Other attempts at constructing a meta-narrative for American history, like the recent These Truths by Kemper professor of American history Jill Lepore, place at their center the crisis of race and the centuries-long inability of whites to accept blacks as equal.

What evidence is there that, in the midst of all of these bewildering changes, it was really “most fundamentally the self-centeredness” that accounted for present-day malaise?

the argument is that “America took its foot off the gas”—so the drive toward equality decelerated and stalled. “As that ‘we’ came apart, racial progress in many important realms came to a halt,” they claim

This is certainly true in some respects. But it does feel like a disservice to give the overriding impression that to be black in 2020 is only marginally better than it was in 197

In fact, there has been substantial convergence in life expectancy, high-school graduation rates, and voter turnout between black and white Americans, for example. And the notion that the communitarian ethos of the “we” society reinforces the drive toward equality for the disadvantaged is difficult to square with the continuous progress of women,

By reaching further back in time than most academics ever venture (because data are scant and require more care to interpret), he and Garrett are able to focus on a more positive period in which the United States was broadly improving, when children could expect almost surely to earn more than their parents, and Congress was not wrecked by partisanship. It cannot be wrong to yearn for a time when progress was palpable, when projects like the Great Society were being proposed and enacted. Even if we do not precisely know the reasons for the upswing all those years ago, one happened all the same.

For many patients and their families, hospital fees are already complicated, opaque and stressful. The Kingsburys show just how little control consumers have.

None of this has been clear to consumers—until this year. Hospitals and insurers have long set prices through confidential negotiations. Starting Jan. 1, hospitals were required to make their prices public under a Trump administration policy that sought to expose the sector’s pricing to greater market pressure.

Compliance with the rule has been spotty, but the available data show that prices vary widely among the plans that negotiate contracts with hospitals. While the data remains difficult for consumers to use, knowing the full range of rates could ultimately help patients negotiate their bills.

Healthcare economists note that prices in other sectors, such as airlines, can also vary for the same service, but hospitals’ steep prices mean the dollar difference between the highest and lowest rates can amount to tens of thousands of dollars. “The order of magnitude of healthcare costs is different,”

Even within an insurance plan, prices aren’t consistently low or high. A plan’s prices for one service can be among the lowest a hospital negotiates, but among the highest for another,

A person insured by Minnesota-based HealthPartners would have received the most favorable price for a hospital stay because of back problems, but the cost of an emergency room visit with the same insurance was among the highest, according to the Journal’s analysis of the data.

When insurance didn’t cover some treatments, the Journal found, Avera McKennan Hospital set its own prices that ranked among the highest anywhere in the U.S. in the Journal’s analysis.

The LifeShield price of about $780 amounted to a discount of 53% off the hospital’s charge. Ms. Kingsbury paid all of it because her plan’s benefits didn’t cover the rest of the bill. The insurance was exempt from some federal rules that protect healthcare consumers. LifeShield didn’t respond to requests for comment.

Ms. Kingsbury earned roughly $17,700 last year, tax records reviewed by the Journal show. Her husband, who is retired, received about $22,800 in yearly income from Social Security. They bought insurance in 2019 from LifeShield National Insurance Co.

The range of prices is the product of a complex interplay of multiple payers and hospitals, and a lack of competitive pressure to hold down costs, economists said. Rates have been determined by trade-offs at the bargaining table between hospitals and insurers—such as an offer of cheaper prices in return for more business—and by market power, with higher prices where hospitals dominate.

Hospitals and insurers ultimately bargain for prices to meet financial targets for revenue and profit, said David Dillon, a healthcare actuary with the consulting firm Lewis & Ellis Inc. “It is kind of as simple as both sides of the table have their revenue requirements,” he said.

“The market for healthcare just doesn’t look at all like the market for tomatoes because somebody else is literally negotiating and purchasing on your behalf,” Mr. Cooper said.

The cost for the scan under LifeShield was $1,497, almost half the price charged under Avera. However, Ms. Kingsbury’s plan at LifeShield was exempt from Affordable Care Act rules to prevent gaps in coverage. LifeShield didn’t cover this scan. So Avera charged Ms. Kingsbury the price it sets for patients not covered by insurance, at $8,451, one of the highest prices in the Journal’s analysis of publicly available rates nationwide.

“Healthcare is a service and it can be an expensive service, especially for a serious condition. That’s why health insurance exists,” said Avera spokeswoman Ms. Meyers. “It is important for consumers to understand what they are buying and the coverage it provides.”

The Journal compared Avera McKennan’s 2019 PET CT price for Ms. Kingsbury with the price Medicare would pay, as calculated by price-comparison startup Turquoise Health Co. The hospital’s cash price for Ms. Kingsbury in 2019 was 5.7 times the Medicare rate, according to the Journal’s analysis using newly public data collected by Turquoise. That’s one of the highest multiples of any of the more than 1,200 U.S. hospitals in the analysis.

By contrast the illiberal left put their own power at the centre of things, because they are sure real progress is possible only after they have first seen to it that racial, sexual and other hierarchies are dismantled.

The attack from the left is harder to grasp, partly because in America “liberal” has come to include an illiberal left

a new style of politics has recently spread from elite university departments. As young graduates have taken jobs in the upmarket media and in politics, business and education, they have brought with them a horror of feeling “unsafe” and an agenda obsessed with a narrow vision of obtaining justice for oppressed identity groups. They have also brought along tactics to enforce ideological purity, by no-platforming their enemies and cancelling allies who have transgressed—with echoes of the confessional state that dominated Europe before classical liberalism took root at the end of the 18th century.

Superficially, the illiberal left and classical liberals like The Economist want many of the same things. Both believe that people should be able to flourish whatever their sexuality or race. They share a suspicion of authority and entrenched interests. They believe in the desirability of change.

However, classical liberals and illiberal progressives could hardly disagree more over how to bring these things about

For classical liberals, the precise direction of progress is unknowable. It must be spontaneous and from the bottom up—and it depends on the separation of powers, so that nobody nor any group is able to exert lasting control.

The most dangerous threat in liberalism’s spiritual home comes from the Trumpian right. Populists denigrate liberal edifices such as science and the rule of law as façades for a plot by the deep state against the people. They subordinate facts and reason to tribal emotion. The enduring falsehood that the presidential election in 2020 was stolen points to where such impulses lead. If people cannot settle their differences using debate and trusted institutions, they resort to force.

Classical liberals believe in setting fair initial conditions and letting events unfold through competition—by, say, eliminating corporate monopolies, opening up guilds, radically reforming taxation and making education accessible with vouchers.

Progressives see laissez-faire as a pretence which powerful vested interests use to preserve the status quo. Instead, they believe in imposing “equity”—the outcomes that they deem just. For example, Ibram X. Kendi, a scholar-activist, asserts that any colour-blind policy, including the standardised testing of children, is racist if it ends up increasing average racial differentials, however enlightened the intentions behind it.

Mr Kendi is right to want an anti-racist policy that works. But his blunderbuss approach risks denying some disadvantaged children the help they need and others the chance to realise their talents.

Besides, society has many goals. People worry about economic growth, welfare, crime, the environment and national security, and policies cannot be judged simply on whether they advance a particular group.

Classical liberals use debate to hash out priorities and trade-offs in a pluralist society and then use elections to settle on a course.

It also involves making an example of supposed reactionaries, by punishing them when they say something that is taken to make someone who is less privileged feel unsafe. The results are calling-out, cancellation and no-platforming.

Progressives of the old school remain champions of free speech. But illiberal progressives think that equity requires the field to be tilted against those who are privileged and reactionary

That means restricting their freedom of speech, using a caste system of victimhood in which those on top must defer to those with a greater claim to restorative justice

The illiberal left believe that the marketplace of ideas is rigged just like all the others. What masquerades as evidence and argument, they say, is really yet another assertion of raw power by the elite.

Milton Friedman once said that the “society that puts equality before freedom will end up with neither”.

Illiberal progressives think they have a blueprint for freeing oppressed groups. In reality theirs is a formula for the oppression of individuals

it is not so very different from the plans of the populist right. In their different ways both extremes put power before process, ends before means and the interests of the group before the freedom of the individual.

Countries run by the strongmen whom populists admire, such as Hungary under Viktor Orban and Russia under Vladimir Putin, show that unchecked power is a bad foundation for good government. Utopias like Cuba and Venezuela show that ends do not justify means

And nowhere at all do individuals willingly conform to state-imposed racial and economic stereotypes.

When populists put partisanship before truth, they sabotage good government. When progressives divide people into competing castes, they turn the nation against itself. Both diminish institutions that resolve social conflict. Hence they often resort to coercion, however much they like to talk about justice.

populists and progressives feed off each other pathologically. The hatred each camp feels for the other inflames its own supporters—to the benefit of both. Criticising your own tribe’s excesses seems like treachery. Under these conditions, liberal debate is starved of oxygen

Aspects of liberalism go against the grain of human nature. It requires you to defend your opponents’ right to speak, even when you know they are wrong. You must be willing to question your deepest beliefs. Businesses must not be sheltered from the gales of creative destruction. Your loved ones must advance on merit alone, even if all your instincts are to bend the rules for them. You must accept the victory of your enemies at the ballot box, even if you think they will bring the country to ruin.

Too many left-leaning liberals focus on how they, too, want social justice. They comfort themselves with the thought that the most intolerant illiberalism belongs to a fringe. Don’t worry, they say, intolerance is part of the mechanism of change: by focusing on injustice, they shift the centre ground.

Yet it is precisely by countering the forces propelling people to the extremes that classical liberals prevent the extremes from strengthening. By applying liberal principles, they help solve society’s many problems without anyone resorting to coercion

Only liberals appreciate diversity in all its forms and understand how to make it a strength. Only they can deal fairly with everything from education to planning and foreign policy so as to release people’s creative energies.

The experience of nearly 250 years is that the first type of movement generally succeeds: emancipation, suffrage, civil rights, marriage equality. They have aimed to build the country up, and bring Americans more closely together, on foundations already in place.

The second type — from the Confederacy to the white supremacy of the Jim Crow era to militant Black nationalism in the 1960s — always fails. These movements want to tear things down, divide Americans, reject and replace our national foundations.

What’s wrong with a movement that, on its narrowest terms, aims to make Americans more aware of racial injustices, past and present? Nothing. In cases like those of Eric Garner, George Floyd and Ahmaud Arbery, non-Black America has had a long-overdue education about the fact that Black lives can still be subject to the same casual cruelties of a century ago.

like many movements that overspill their initial causes of action, Wokeness now connotes much more than an effort to reform the police or denounce racial injustice when it occurs. It is, instead, an allegation that racism is a defining feature, not a flaw, of nearly every aspect of American life, from its inception to its present, in the books we read, the language we speak, the heroes we venerate, the roads we drive, the way we do business, the way we select for merit and so on.

The insult turns to injury when it comes to the solutions Wokeness prescribes, and in the way that it prescribes them.

The problem with the allegation isn’t that it’s flatly wrong: America’s past is shot through with racism and, as Faulkner put it, “The past is never dead. It’s not even past.” But the allegation is also incomplete, distorted, ungenerous to former generations that advanced America’s promise, and untrue to the country most Americans know today.

Wokeness operates as if there had been no civil rights movement, and that white Americans hadn’t been an integral part of it. It operates as if 60 years of affirmative action never happened, and that an ever-growing percentage of Black Americans don’t belong to the middle and upper class (and that they are, incidentally, concentrated in the American South). It operates as if we didn’t twice elect a Black president and recently bury a Black general as an American icon.

It operates as if, in city after city, American police forces aren’t led by Black police chiefs and staffed by officers of diverse backgrounds. It operates as if white supremacy is still being systemically enforced, while ignoring the fact that a previously marginalized ethnic minority, namely Asian Americans, enjoys higher income levels than white Americans.

Above all, Wokeness pretends that incidents such as George Floyd’s murder, which are national scandals, are actually national norms

Most Americans, I suspect, not only sense the falseness of the allegation. They are, increasingly, insulted by it.

it is a prescription, not for genuine dialogue and reform, but for indoctrination and extirpation, based on a relentless form of race consciousness

A typical example: The American Medical Association recently published its “Guide to Language, Narrative and Concepts,” which includes such recommendations as replacing the term “disadvantaged” with “historically and intentionally excluded,” “social problem” with “social injustice,” “vulnerable” with “oppressed,” and “blacklist” and “blackmail” with words that don’t suggest an association between the word “black” and “suspicion or disapproval.”

This isn’t silly. It’s Orwellian. It’s a blunt attempt to turn everyday speech into a perpetual, politicized and nearly unconscious indictment of “the system.” Anyone who has spent time analyzing how the totalitarian regimes of the 20th century operated will note the similarities.

Ultimately, though, Americans are still free to reject the Woke ethos, even if they sometimes have to leave their institutions as a result.

This is why Wokeness will fail. For every attempt to cancel certain writers, others will publish them. For every diktat to fix language by replacing some words with others, people will merely find more subversive ways to say the same thing.

In the long run, Americans have always gotten behind protest movements that make the country more open, more decent, less divided. What today is called Woke does none of those things. It has no future in the home of the free.