So hello everyone, I think we're going to get started. I hope you have a libation. And so this, I'm Ann Marie Slaughter. I am the CEO of New America, and we are here to celebrate and discuss the launch of Lee Drutman's new book, Breaking the Two-Party Doom Loop. This is, it's a proud moment for us, and it's a very timely moment for this book, for reasons we will discuss. I have to start by saying that I come out of academia, I was a professor for almost 20 years, and I still live in Princeton, and when I talk to my former colleagues there and across the country about New America, and if they don't always know about New America, if they're outside of Washington, and one of the things I will very quickly say when talking to anybody from the academy is I say, oh yeah, we've got this great political reform program, Lee Drutman, he's a Berkeley PhD, and he won the Robert Dahl Award, which to anybody who is a political scientist, this is like the premier award, one of the premier awards that the American Political Science Association gives, and it immediately establishes credibility anywhere, particularly among Americanists in political science. I also then also credit Mark Schmidt, who brought Lee to us very soon after I arrived, but he is a spectacular political scientist, and his first book was The Business of America is Lobbying, which I also strongly recommend, and this book I had the great pleasure of reading in draft, and it is a very powerful argument, and again, you'll hear why, I think it makes an argument for a multi-party democracy that as an organization dedicated to American renewal, as you see outside really renewing the promise of America, in this case, the promise of American democracy, multi-party democracy is a key part of that. So without further ado, I told you Lee got his PhD at Berkeley, he won the Top Americanist Award, his other book, I should also just add that he also teaches at the School for Advanced Governmental Studies at Johns Hopkins, and he is a senior fellow at our political reform program. So without further ado, I'm gonna let Lee talk for a while, I'm going to engage him in sort of Q and A, and then we'll turn to you. All right, over to you. All right, well, thank you for that. Thank you for that incredibly generous introduction, Henry, and New America's been such a wonderful home, and it's such a wonderful organization, and I'm so thrilled to have made this my home for over five years. And I'm delighted to be with you all tonight to talk about my new book, Breaking the Two-Party Doom Loop, The Case for Multi-Party Democracy in America. So, how many of you are worried about the future of American democracy? Yeah. You gotta work on your other daughter. Me too, I'm worried, I'm worried about the future, and I'm worried about the future because I have two young daughters who are here in the front row, Elsa and Hava, say hi to everybody. And I want them to grow up in a healthy and thriving democracy, which is part of the reason why I wrote this book. So, in writing this book, I was really trying to answer three big questions. The first question is, how worried should we be at this particular moment? Second question is, why are we having this crisis at this particular time in our political history? And three, is there anything that we can do to fix it? So, the short answer to question one is, yes, we should be worried. We are in a doom loop of escalating hyper partisanship with no clear resolution, and if left to continue, it will destroy the basic fairness and shared legitimacy, which is foundational to democracy. Why now? The argument I put forward in this book is that for the first time, we have a genuine two-party system in the US with two truly distinct parties with no overlap, and it's a disaster. It doesn't work at all with our political institutions, which demand broad compromise and give and take, and it's also driving us all crazy. Can we fix it? Well, yes, I think we can, but we're gonna have to change the way that we hold elections the way we vote to allow for more parties to flourish and to break that zero-sum binary hyper partisanship that is destroying our democracy. So, let's start by discussing the problem. I think a lot of folks woke up to the idea that we might have a crisis in American democracy when they woke up on November 9th, and Donald Trump had just been elected president. But I wanna ask you all, how different would things be if Hillary Clinton had become president in terms of the health and the stability of American democracy? Would we be in a better position or a worse position? And I think by now we'd probably be on the third or fourth impeachment of Hillary Clinton. I think things would be looking very dangerous ahead of the 2020 election. And, similarly, whatever happens this November, do we think that anything will abate this escalating hyper partisanship? I'm dubious. What I see underlying the conflicts that are happening here in Washington is this escalating hyper partisanship in which we're at a moment in which the two parties have come to stand for two very different visions of America and represent two very distinct geographies. We have one party, the Democratic Party, whose core is in cosmopolitan, urban America, diverse, multicultural, engaged with the global knowledge economy. And we have another party, the Republican Party, whose core is in rural and ex-urban America, traditional, Christian, white, and increasingly left behind by the global knowledge economy. And both parties, in roughly equal balance of power in Washington, fighting out for very narrow majorities. Every election is up for grabs. And two parties have come to see the stakes as incredibly high in each election. And have come to see the other party, not just as the opposing party, but as a genuine threat. This raises the stakes of elections. It justifies increasing the aggressive political behavior. It makes both sides feel like they can't compromise with the other. There's more and more social sorting. People are more and more likely to surround themselves just with other people who share their same political beliefs, engage in only the news and the information gathering that supports them. And we have two sides that increasingly have fundamentally different relationships to the truth and facts. And that is a dangerous thing. Democracy is always involves some conflict, but when we have a conflict over a basic sense of what is fair, what are legitimate rules for elections, and we can't agree on any way to resolve those disputes, it is really hard to have democracy continue. And I think that's the dangerous moment that we're in, that's how democracies die when this intense hyper-partisanship takes over and it becomes all about winning in the short term and destroying the long term stability. So then the question is why now, why at this moment? And the argument that I put forward in the book is that for the first time, we have a genuine two-party democracy. Now some of you might say, well, haven't we always had a two-party system in the US? Well, yeah, of course we have. But for most of American political history, we had two parties that were these broad, overlapping coalitions that at a national level were somewhat incoherent and inconsistent. And that meant that a lot of people couldn't tell the difference between the two parties, which was a problem, but it did allow for flexible coalition building. And that I think worked well with our political institutions, which demand that. What's happened is that as the political parties have pulled apart completely, we've lost the space for that. And that is the new and unique thing. Now, I think a lot of folks tend to romanticize the lost era of bipartisanship, particularly the 1950s, early 1960s when there was just like tremendous overlap, broad bipartisan compromise. And I don't think we should over-nostologize that era. I mean, one reason is that voters didn't have clear choices. And even bigger reason is that a lot of that consensus was based on an agreement not to elevate civil rights to the national stage and allow the Jim Crow South to continue. And a lot of the conflict, the binary conflict we see now is a result of the realignment that began in the 1960s when civil rights entered the, we passed a lot of important civil rights legislation. And it took a long time for that realignment to happen, but eventually American politics changed as the parties changed, as the Democratic Party became more concentrated in New England and the coast and the big cities and the Republican Party became more concentrated in the South. And liberal Republicans who used to come from the coast in New England began to vanish. And conservative Democrats who came from the South and the rural, exurban parts of the country began to vanish. And I would say that there was a period, probably from the mid-60s to the late 80s, when we had something like a four-party system with liberal Republicans and conservative Democrats alongside liberal Democrats and conservative Republicans. And that four-party system, I think worked pretty well with our institutions. We got a lot of landmark legislation passed with broad bipartisan majorities. Congress was close to a co-equal branch with the presidency because Congress had strong committees and invested in its own resources. But as the four-party system became a two-party system, power in Congress became more centralized. There was more deference to the executive branch. And the diversity that powered a functional and compromise-oriented Congress began to disappear. I would say the 90s were a key turning point. And by 2010, we basically became a full, genuine two-party system. Now, civil rights was a key part of that story. The nationalization of American politics was a key part of that story. And it's a complicated story. I spent two chapters in the book detailing it. Another key piece of that story was our winner-take-all elections in which, if a party falls below 40, maybe 45%, can't win in a district or a state. So what happened was that once the Republican Party started to fall below 45% in a lot of districts, it basically said, well, we can't win. So we're going to stop investing in those races, similarly with Democrats and a lot of the rural and exurban parts. So what happened was that the party shrunk to their core. Most seats became uncompetitive. One lopsided one party or the other. Primaries became more important. And most American voters became irrelevant, because if you're not in a swing district and there are very few swing districts in swing states now, you know what? Nobody cares about your vote. Parties are not recruiting you. And no wonder voter turnout remains low. So now we're in this moment in which every election we're fighting this existential battle for the soul of the country, and everybody is forced to pick one side or the other. The true diversity of this country is not being represented. And this escalating hyperpartisan doom loop is challenging the foundations of democracy, which is a shared sense of fairness on all sides and willing to accept that the other side might have a legitimate claim to rule if they win an election. So this is a somewhat dire state that we're in. So now's the part, and I've brought you down to this, like, oh, things are terrible. Now we say, all right, well, actually, there's a solution. And I don't think it's crazy. The solution is to change how we vote and to become a multi-party democracy. I would argue that we've actually been a multi-party democracy for most of our political history. So it shouldn't be a radical thing. And there are most countries around the world. Most advanced democracies are multi-party democracies that have proportional voting systems. Now there are a lot of proportional voting systems out there. I'm not recommending that we become Israel, which has a hyper-PR system that generates too many parties and too much fracture. The countries that I have in mind, the voting systems, are more like Ireland and Australia, which use rank choice voting with some combination of multi-member districts. And that would give us a modest form of proportional representation. I think probably four to six parties. I estimate five in the book. And I think that's a totally reasonable system. And it's totally constitutional. States could do it themselves. Now the other reason why I think it shouldn't be seen as a radical change is because having gone back and looked at the debates and discussions around the Constitution, I think this is actually what the framers would have wanted had two things been the case. Had they accepted the idea that political parties are necessary and central institutions for modern mass democracy and had proportional representation been invented at the time. It wouldn't be invented until the early 19th century. It wouldn't come into use until 1899 and then spread throughout Western Europe in the first two decades of the 20th century. Now the framers, as I think most of you know, were desperately anti-political party. They wrote screeds about the dangers of political parties. But really what they were afraid of, if you read what they wrote closely, is they were afraid of just two parties. And because what they saw that happened in early republics and democracies is that civil war had basically happened when the country was split in two. And they saw self-government as a fragile thing. And the fear that they had, and I think a quite legitimate fear, is if you had a permanent faction in control of government, it would use that power to oppress the minority faction. And the minority faction would see government as illegitimate and revolt or they would have some sort of violence or there'd be a contest for power that would eventually turn authoritarian. And I think that was a legitimate fear. I think they were right about that. If you read James Madison's Federalist Number Ten, in which I think is probably one of the, if there's a single treatise that explains the theory of American government, it's that. And it's fundamentally a vision of multi-party democracy. Because what Madison is saying is look, there are factions in society and that's like a healthy thing and there's no way we're gonna get rid of that, nor should we. But the way to have democratic stability is that no faction is ever permanently dominant and no faction is ever permanently in the minority. What we should have is fluid coalition building so we can build majorities on a consistent basis and nobody ever feels like they're totally out of power and nobody feels like they're ever gonna dominate everybody else. Now, the way that the Framers went about trying to achieve something like that vision was through a separation of power systems by camera, legislature, three branches of government, federalism, and they thought that that would prevent political parties from forming. Now, they were sort of right and sort of wrong. They were wrong in the sense that political parties formed quite quickly, but they were right in the sense that that system of federalism plus all these separated powers actually kept American political parties from really ever being coherent and actually preserved something like a multi-party system for quite a long time in American political history with the Civil War being one clear exception, of course. But now that we've entered this age of true nationalization of American party politics, I don't see any going back there at least within the two party system. The Framers were also students of political science and they were drawing on the best political science of their day and I think now having seen how multi-party democracy works around the world, we have a lot of political science on it and generally on most of the outcomes we care about, multi-party democracy performs much better. So not only would it I think solve the zero sum escalation doom loop problem by creating a situation where no one party is ever trying to win some elusive permanent majority or feels like it's gonna be in a permanent minority. It would also have a number of other benefits. To me, one of the most important benefits is that it would increase turnout. If you look at proportional democracies, voter turnout is much higher. Now there are some good reasons for that. One is that when there are more than two parties, more people are likely to find a party that they feel actually represents them. A lot of people feel like neither of the two parties represent them very well even though they vote for one or the other because those are the only two choices. And in order to get multi-party democracy and you would have proportional voting which means that every vote matters. You don't have to live in one of the handful of swing districts or swing states for your vote to matter and you know what, when your vote matters, people are much more likely to vote and when your vote matters, parties and candidates are much more likely to actually work to try to earn your vote and turn you out. So I think that would be a significant benefit and just the fact that it would just much better represent the diversity of this country. This is a big sprawling diverse country that has a lot of that diversity is not represented in either of the two parties. It would also solve the problem of gerrymandering and gerrymandering is largely a feature of having single member districts with predictable partisan voting.  But you can't do that in multi-member districts with proportional voting and the form of proportional voting I like is rank choice voting. Also it's much better for minority representation because people can choose their candidate of choice regardless of what district they live in. Right now we have majority minority districts which generate descriptive representation but I think at a high cost it creates largely lopsided districts which are non-competitive and it relies on self segregation which historically has worked pretty well for the black community but less and less as blacks move out to the suburbs it's never worked particularly well for Hispanic voters not at all for Asian voters and as well as other potential minorities that would not be represented in that self segregated kind of way. And one of the reasons I like preferential voting rank choice voting for minority representation is that it encourages candidates to reach out to minority communities who might not where they might not be their first choice but they might be their second or third choice and it builds these kinds of coalitions and bridges. This is why political scientists have a strong tendency to recommend rank choice voting in countries that have suffered from fractious ethnic wars or conflicts because it builds that cross-racial coalition. Yeah and again I really wanna emphasize this I think it is the vision of politics coalition building compromise fluid majorities that fits exactly with what the framers were trying to accomplish. All right so at this point you might say all right you're making total sense here I'm really with you but but all right dude you're here in Washington they can barely pass a budget on time this impeachment thing is dividing the country and we're gonna come together to do something as big as changing the way we vote like you know what are you smoking dude? All right a little bit of optimism here. So look I look at the history of American politics and I see that we have had periodic times of reform and renewal in this country in which we saw that the political system wasn't working it felt broken things felt stuck and then we went on a period of reform and we expanded how people can vote we made American democracy more democratic more inclusive and we've done it repeatedly Revolutionary War the expansion of the franchise in the 1830s the progressive era the civil rights era and in each of those times in the period leading up to it felt like things were stuck and then new social movements emerged media structures changed and new voices gained power and everybody understood that the status quo was no longer acceptable and I think we're seeing a lot of those things happening at this moment and if you do your math those periods of reform are all about 60 years apart and 1960s and on another 60 years and now we're at the 2020s so I see that happening I see the share of Americans who say they want more than two parties at its highest level ever about 67% of Americans say we ought to have more than two parties the share of Americans who are refusing to identify either as Democrats or Republicans about 45% highest ever at least in modern polling in every by almost every indicator of trust faith in government we're at the lowest levels in modern polling so there is support for this question is how I think it will begin at the States we've already seen a number of cities in act-ranked choice voting we've seen Maine in act-ranked choice voting a bunch of amazing campaigners who ran an incredible campaign to get the Maine rank choice voting referendum passed not once but twice after the legislature there tried to undo it it will probably be on the ballot in Massachusetts New York City passed rank choice voting and I just see a lot of energy in electoral reform and democracy reform generally so look big reform is not easy but we can make it happen so to conclude I mean one how worried should we be? we should be worried we should be very worried why now because this is the first time that we've had a genuine two-party democracy and it's a disaster it doesn't work with our institutions and it drives us all crazy can we fix it yes we can but it will require hard work it will require a lot of folks getting engaged getting involved talking through these issues and look it's not easy folks who had the two parties are not gonna want this change but as with all democracy reforms when people have gotten engaged when there have been large grassroots reform efforts we make change and look I think the moment the stakes are high we can't tinker on the margins anymore we need big change the levies have broken and we can't take buckets to the flood anymore we need to fix the system and in writing this book what I hope to do is start a conversation and I think this conversation starts right now thank you so I'm going to push on a couple of those points then I will turn it over to you all in about 20 minutes or so so I wanna start and before I say anything I'm just going to remind the audience I spent 25 years studying international relations to much of the American history I know I've learned from reading people likely so I am not an expert on American politics but one of the things that I often hear when you talk about this moment is different from my former Americanist colleagues and others people will say in first place it's not true the rhetoric has been terrible all along it's terrible now but it's really as you say we're looking back to sort of a mythologized harmony a bipartisan period after World War II but even more specifically why isn't this moment like 1830 where we elected Andrew Jackson he broke every norm in the book he told the Supreme Court to stuff it he horrified all the founding generation he was absolutely an outsider and really an outsider and what happened then was that we still had two parties but one party changed so we law I mean again the federalists disappear you get these sort of evolutions but you keep to two parties so why isn't that what's happening now that Trump is the version of Jackson and the Republican Party will crater or maybe the Democratic Party will crater and another party that is bigger will replace it and why won't that get us back on track? All right that's a good question we gotta go back to the 1830s when the Whigs emerged as the anti-Jackson party and then split in the 1850s over slavery so I mean I think if I get your question it's like why won't the Republican Party just why don't we just evolve to a different two parties exactly or become a different two party system and I think the challenge at this moment is one American politics is much more nationalized at this moment than it was then that means the Democratic Party was still largely a group of state and local parties and it had support throughout the country and both the Whigs and the Democrats for the 1830s and the 1840s were these sort of broad North-South coalitions and so there were a lot of tensions within the party but the tensions between the parties weren't quite as strong. I think the challenge and this is the challenge of third party generally in the US is that if you have winner take all elections it's really hard for people to take a gamble on a third party if they feel like their vote is gonna be a spoiler so if a new party emerged to challenge the Republican Party on the right would face the spoiler problem I mean a lot of Republicans have just gone along and said well this is my Republican Party I don't like the Democrats and the only party that I can support is this party and you know parties change slowly over time and you know the Democratic Party of today is quite different than the Democratic Party of 1896 but they don't change rapidly and I think the parties are reflective of the coalitions that they have and the coalition that powers the Republican Party now is largely a coalition that's older, wider evangelical increasingly left behind by the global economy and so I don't see how that party would be but they're not gonna evolve into the party that you would like to see I think the Republican Party evolve into I mean they will change I think if anything the party will become more Trump-like in the future I don't see them returning to a kind of like moderate Eisenhower Republican given who's in the party now so just to summarize that it's because it's national so it's not a coalition of very different Northern and Southern parties it's truly national and even if each party represents only 30% of the electorate and the remainder are roughly independent they're strong enough as a national that they're given our current system of voting they're not going anywhere and the other 40% are not in the middle they're kind of all over the island so that was my next question what does it look like if we do get four to five parties who many people would argue if you allowed new parties to evolve without the spoiler system which can't happen in our current electoral system there would be a big broad tent middle that 40% in the middle who are not happy and a certain number in both parties who are not happy would create a nice big centrist party why not well and I've looked at the preferences of voters and that 40% isn't centrist they're not in the middle they're some of them actually want a party that's more liberal than the Democrats some of them want a party that's more conservative than the Republicans some of them have views that don't really match where the two parties are I mean look at the success of Andrew Yang who doesn't really seem to fit the mold of either party even though he's running as a Democrat I think there are a lot of voters who are socially conservative but economically liberal and they don't really have a party so I think would be if there were another party that could be more popular than the Democrats or the Republicans that party would have emerged by now but just voters are more interesting and less predictable than a flat line with a lot of voters in the center despite lots of political science modeling so I wanna drill down more on how we get there but I do think one of the things that's important to convince people even to really buy into this vision as a possible vision is to imagine what the political landscape would look like and so you've because the other one the next things you hear is well we don't wanna be Israel you already hand you don't wanna have too many parties you also don't wanna have a prime minister who refuses to step down like Netanyahu is I mean one of the reasons that Israel is in so much trouble is just because of who Netanyahu is I think. True but they've had I mean over my lifetime or Israel, Italy, I mean countries with lots of parties and difficulties even getting a government in your world so tomorrow we adopt rank choice voting across the country with multi-member districts you say four to six parties what do you think those five parties let's stick to five would roughly look like I think it's helpful for us to imagine that political spectrum. So and in fact there's another teaser for the book when you get to the final chapter I do envision a political future in which we do adopt this and I lay out what I think the parties are but to spoil the ending. Sorry they're not gonna remember. No. So I mean I think basically what my sense is that the Democratic Party would split into two when you'd have a social Democratic Party that looks more like Bernie Sanders, Elizabeth Warren and then you'd have a new Democratic Party that looks more like Pete Buttigieg and that would be the split. On the Republican side I think you'd see like a more reformed conservative party I think like Marco Rubio and really where Marco Rubio is evolving to and actually his trajectory on the type of policies that he's supporting now are quite interesting and then I think you'd see more of like a traditional Christian free market conservative I think kind of Ted Cruz and that and then I think you'd see a kind of Trump-like populist party that is kind of like what Trump ran as not how he's governed and you know abandoned party. Yeah kind of a Steve Bannon party yeah. And I think you'd see different coalitions forming and I think you'd also see a Congress that was more decentralized, committee based like the Congress of the 60s, 70s and 80s in which a lot of landmark legislation got done and you had a lot of unlikely coalitions come together and that's how politics should work. I mean and it would be messy but politics is messy and should be messy because it's really hard to build majorities and you have to do a lot of deals and that's okay. So why don't we see that in Britain? Well Britain's not really a true multi-party system because Britain also has first passed the post elections and Britain is basically a two-party system with the Lib Dems sort of hanging out there and now the Scottish National Party. And when you say so because the first or the person who gets the majority wins the whole best day. Yeah and also I mean look at, I mean Britain you know I mean they're deadlocked but they, conservatives got like 43% of the vote and now they have a majority to go forward with Brexit even though if you probably held another referendum Brexit would lose but you know I mean so if Britain were a truly proportional system I think you'd see something like that and you'd see like a five or six parties and I think you, I mean part of the reason why they had the Brexit referendum in the first place was because you kept creating a margin threat for the conservative party and you can only have that margin threat in a first pass the post system we could talk more about British politics but I mean like I think the British politics is actually of the European systems it's most like the US because it's basically a two-party system and has historically been. So talk about then what have been the impact of the places that have adopted ranked choice voting so again I am a convert to this cause and so I end up talking to people around the country and they say you know what is the one thing you would do which you could do only one thing to fix American democracy and I say quoting Lee Grubman and the rest of our program ranked choice voting and then they say well what is that and I say it's happened in what 15 cities isn't it? Yeah I think you've had a little more now. So what's been the impact and I will say most recently in San Francisco everybody who doesn't like the attorney general they managed to just elect says see that was ranked choice voting so no system makes everybody happy but what can we say Nor should any system make everybody happy. But what can we say empirically? The evidence among the cities that have adopted it which says there are the twin cities as well and New York City now has a Santa Fe in New Mexico is that it's made campaigning less negative more cooperative voters say they're happier with it more constructive. I think we've seen an increase in the diversity of candidates more running. You know I think it's you know in some ways it's those cities are largely overwhelmingly democratic. I think Maine provides it will provide a more interesting case about how it could deal with hyper partisanship. You know I also note that Ireland has had it for almost a hundred years and I think they've largely had pretty stable productive politics. They certainly have avoided a lot of the populist backlash that has affected most of Western Europe. Australia has had historically pretty moderate stable politics. Not so much lately. Yeah not so much lately. Well they're on fire but you know. So greater civility and in part because everybody has to appeal. Everyone has to be somebody's first choice and a lot of people's second choice and possibly a bunch of people's third choice. You're trying to build expand the coalition and you're trying to reach out to different types of voters rather than just running to your base. Okay so imagine so then talk a little more about how this really could happen. And you know I guess in the progressive era we changed, we moved from, we moved to direct election of senators from senators being selected by the upper house by state legislatures. We moved to a primary system. What does it take to get from 15 cities and one state and maybe another state to really making people believe we can do this? We can be a multi-party democracy. Well it catches on as states learn from other states and I think it involves a sense that we actually do have a problem and we have a solution. And lots of countries have shifted most in the 1990s New Zealand which was the first pass the post system changed. They adopted the German system of mixed member proportional which is also I think a good system. And they changed because people in for a period of time people in New Zealand were deeply dissatisfied with how the government was working and a movement built and eventually reform became a popular cause so that politicians adopted it. Reform was also a popular cause in the progressive era and there was just sort of a reform. It's sort of like the old Hemingway line about how did we go broke? Slowly and then all at once. For a long time it feels like nothing is happening but pressure is building. And then when a moment comes it feels like we actually can do reform. We can change this. Reform can happen quickly. And I'll say one thing about the Trump presidency is I think he's opened up the range of the possible. And now I think for a long time a lot of people say oh our system's fine. We don't really need to do any big changes. And the number of people who say they've been radicalized over the last few years kind of blows my mind. And so I think we're at a moment when people are open to bigger ideas. And those are the moments when change happens. When the status quo becomes intolerable people stop tolerating it. All right I'm gonna turn it over to all of you. I have more questions but I'm certain that the audience does. So just wait until the microphone comes to you here first and then just please identify yourself. Angela's coming. I have Richard Coleman retired from Festive and Border Protection. I'm wondering about policy and I'm wondering about demographics.  It's all about who you are, it's identity politics. I think the Post once ran a series and they identified 12 different distinct political groups and where they were located in the United States. Going into Spain you look at the five different parties I believe that we're all fighting over 15% or 16%, whatever. So all of that leads me to looking at I guess with the Obama administration when he was elected twice, 60%, 60% of the white vote in each of his elections was for somebody other than him. So he was never legitimate. Your question please, just come to a question. Well the question is, now I'm leading into the question is the New York Times had a little quiz. Take this quiz, two questions. It'll tell you whether you're Republican or Democrat. And it was basically your race and where you were in terms of your religious values, whether something religion was important to you or not. So I think to me if you were looking at votes counting political parties aren't gonna answer the problem. If you wanna feel like your vote counts, get rid of the electoral system where every single vote in every county and every state matters. And the majority actually wins. This is the only election that I know of in the United States where the majority loses. Okay, so it's a good question about the electoral college. The question is about the electoral college? Yeah, we should abolish it. But it's in the Constitution so it's really hard to abolish it especially since abolishing it would benefit one party over the other. In the other issue that you raised is this idea that partisanship has become so linked with religion and race and identity.  And it makes it so that the other side feels very different. That used to be that we had a lot of cross cutting identities that different identities pointed in different ways but by stacking all those identities on top of each other, we've created this condition in which the other feels very different and the threat of the other side being in power means that my side is gonna be oppressed and is not gonna have any say. And that creates a dangerous, dangerous binary because it raises the stakes of elections to this incredible height which justifies increasingly anti-Democratic attempts to game that. And to me, I mean look, one of the challenges that our country faces is we're trying to become a multi-ethnic democracy and that is a hard thing to do. But the most dangerous thing to do in that process is to divide the country in half and say, okay, on this half are all the people who like diversity and wanna make us more diverse and are diverse themselves. And on this half are all the people who think we were better when America was like a white Christian nation. And go fight it out to see who gets total control of the country. Like, you know, you wanna, I mean, and I think in a multi-party system you would have, and you know, one myth about a multi-party system is that you're just gonna have ethnic party and that's not the case in European multi-party democracy. What you have is actually, and then you have people, different ethnic groups. There's actually a lot more diversity in the black community than is represented. A lot more diversity in the Hispanic community. And I think you'd see more of that ideological diversity play out and you'd have different parties competing for those votes and you wouldn't feel that one side was gonna be oppressed. I mean, I feel like we can't have a multi-ethnic democracy. I look at New York City, I look at Los Angeles. I mean, those are multi-ethnic democracies and what those cities and other cities have in common is that no one race is in a clear majority and no one race is in the minority. Everybody's in the minority and you have to actually build coalitions across racial groups to get anything done. And that takes me back to Madison's Federalist Number 10, which is basically that theory in multi-party democracy. So the answer is not that we shouldn't do it, it's that it's too hard. Bruce. Thank you. Bruce Jettelson from Duke University. You know, the point you started with, I thought was a really important point for, to emphasize as you go into it, which was it's not all about Trump, right? And that in many ways, Trump has effect not just cause and that many of the issues that he tapped into further were there before him, right? The, you know, your UC Berkeley economists, you know, I know Sian and Gabrielle Zuckman have all this data about the widening of the inequality gap going back to the mid-70s and the first trade bill that got a lot of opposition was 1974. And we've really gone through this big transition in our place in the world, not because of the Kleinism, but because the world has changed and that 1945 to 70s or 80s period was really unique. And so the question really is, how does changing the political engineering, is there an incentive structure there for some of these parties to really tap those underlying issues? I mean, Australia is a good example.  But you still didn't have the incentives for parties to really get at the core issues that are driving the problems in society. So do you go into how this would actually create incentives and the capacity to have greater ability to get coalitions to deal with these underlying problems? So the core issue is being climate, inequality, immigration, you name it. You know, all these are hard issues, but what I see is that in our binary two-party system, none of it is getting addressed. There's just constant gridlock and the numerator of bills passing and shrinking and the denominator of problems mounting is increasing.  They're doing a lot better on climate. Immigration, you know, I think is a challenge everywhere, but we're stuck and we need to create a space for new coalitions to form to try to tackle these problems. And maybe they won't succeed and maybe the problems are too overwhelming and liberal democracy is at its demise. In that case, I better leave here and go find my bunker somewhere in Northern Canada and see y'all later. But, you know, I'm still hopeful that we'll solve these problems. So not a panacea, but better than what we've got. Yes, exactly. There in the, yes. So one question I have. Just introduce yourself, please. Oh, I'm Burke Urban-Trap. My question is about, so if we make these changes to the system, there's still a really big winner-take-all prize in the presidency. So how do you see that interacting with a more responsive and, like, more parties in a congressional space? Yeah. I was gonna ask you that question. Yeah, it's a great question. And yeah, I mean, I think having a strong winner-take-all presidency is somewhat dangerous and probably one of the reasons why the U.S. is such a strong two-party system. But in terms of, on the comparative scope of presidentialist democracies, the U.S. presidency is actually somewhat weak. And one of the reasons why the president has become so central and so powerful is because Congress has expanded its role as the first branch of government. And so, and that largely has to do with the polarization in Congress, and I lay that out a bit more in the book. So part, actually, before I wrote this book, I spent a lot of time thinking about how could Congress be more powerful at an institution because I do believe that Congress should be the first branch. It's the most representative, diverse branch, and we shouldn't put so much power on one person. And I realize that polarized Congress is a dysfunctional Congress, and the only way to get Congress to be more functional is to make it less polarized, make it more committee-based and invest in itself more. And that's how I got started thinking about, well, what can we actually do to solve this problem? And then I became convinced that happy party democracy was the answer. So I think the balance of power has to shift. I think another way to think about it is that in a two-party system with a strong presidency, either Congress is of the same party in which case they basically write a blank check for the president or the Congress is of the other party in which case they oppose everything. And force the president to do whatever he or she can by executive order. And again, we had a reasonably strong president from the mid-60s through the 80s, although the presidency certainly became stronger. And the president had a bargain with Congress. I mean, I'm old enough to remember when Bill Clinton said, hey, I'm still relevant. So... But let me push you on that. So when I think about this, I assume multi-party all the way to the presidency. In other words, that if you are running for president, you have to convince the voters of a majority, but they can come from multiple parties. Yeah, so you'd have to build... You'd have to build coalitions. In other words, so in some ways, the fight that you're seeing happening within the primary would simply happen at the national level where one person, I mean at the post-primary level, where one person says, I've got to get some number of Democrats and socialists, some number of moderates, some number of whatever else. You might promise to appoint different people of different parties to the cabinet. You know, I think the presidential, you'd have a focus on congressional reform, voting reform, because it's constitutional. I mean, to change how we elect the president would require a constitutional amendment. Maybe we'd eventually get there with rank choice voting. Maybe for the presidential level, you could have fusion balloting, like they have in New York, where you can get endorsed by different parties and be on different lines, you know, but I think that would logically follow. So I mean, I mostly focused in this book on the historical development of how we got here sort of a broader theory and trying to enact reform that we can do constitutionally, and states can do, too. Yes, Kevin. So you meant the... This introduction. Sam Hammond from the Niskanen Center. In Federalist 10, in wanting to view to what the Founders actually intended. But if you look at Federalist 55, Madison Cruelly intended Congress to have, for apportionment, to actually keep Congress representative, but over the years, so from the founding into the 1800s, the average Congressperson, the average House of Representative member, represented about 60,000 people. Today, the typical member of the House represents about three-quarters of a million people. And if we kept pace with the increase of Congress, today's House of Representatives would have about 6,000 members. Now, obviously... Please, good with that. Yeah, I'm for that. Yeah, so I was posing this as, you know, obviously not mutually exclusive, but what would that do in your expert estimation to affect our polarization? Yeah, I mean, I'm a fan of increasing the size of the House. I agree with Madison that the Representative should be close to deal with the U.S. as an incredible outlier in having 750,000 constituents. Remember, the next largest is... Well, actually, India is larger, but they're mostly a federal system. The next largest is, after us, is Japan. Most European countries have like about 100,000. And had something, and this is a fun fact that I have in the book, had Connecticut ratified what was originally Madison's First Amendment, which was to limit the size... Originally it was 30,000. Madison's First Amendment was, you know, for the first 100 members, 30,000, for the next 140,000, and then no bigger than 50,000. And that was ratified by enough states except Connecticut, which like, it only passed one House and then, so that was the original First Amendment. And the original Second Amendment became 27th Amendment. But, yeah, yeah, I'm in favor of it. I recommend... Originally I was gonna recommend 1,600, but then a few people said, nobody'll take you seriously, go for something more moderate, so I went for 700, which was in line with the Key Root Law, which is a nerdy political science thing that predicts the size of the House based on population. But yeah. And that would give us a House of how many? 700. Which I think is reasonable. So yeah, I think it would... I mean, I also advocate getting rid of primaries. I think increasing the size of the House and getting rid of primaries would both contribute to more multi-partism. But yeah, I think members of Congress should be closer to the people. So I'm all for that. I'm trying to pay attention here, too, okay. Hi, my name's Laura Crowell, and I'm curious what you think what happened to the trend of our elect officials being in the business of being re-elected instead of actually being there to solve the issues of the people they're elected to represent. That's his first book, or part of it, but it's a great question. The business, I mean, as opposed to... I mean, I think those things shouldn't be mutually exclusive, and presumably if you're representing people well, you should get re-elected, and the way to get re-elected is to be responsive to your constituents. But I think there's a few problems that get in the way of that. One, as Henry kindly teased my first book, Business of America is Lobbying, is that we have a huge, tremendous influence of lobbyists in Washington who have incredible influence over what gets written. Two is the polarization problem where they can't do a whole lot because they're trapped in this broad, polarized system. And three, also a function of the Winner-Take-All system is the fact that most districts are not competitive, so most districts are democratic plus 10 or more, Republican plus 10 or more.  And so there's not a whole lot of accountability within our electoral system for members of Congress to be responsive. And also as trying to be responsive with just two parties, that there's just a lot of people who they're not gonna represent because they have to try to represent so many people. So I think it's always a challenge having people who are representative. I'm not sure if members, I think they'd like to be more representative, but it's not all of them. Hi, Laura, is that from Irax? So you started by framing it as a way to go back to a good and healthy democracy. And you mentioned that ideological overlap is a good way to do it. But at the time, again, a lot of times in our history when there was ideological overlap, a lot of people did not have rights. So like when could you point to a time when we actually did have a healthy democracy and what really makes a healthy democracy?  Consensus usually means that a lot of people are being left out and I think politics should be about conflict and representing diversity. I would say that the time probably that things worked best was probably from mid-60s post-civil rights into the late 80s when I feel like Congress did pass a lot of landmark legislation and there were overlapping coalitions. And I mean, look, it's not perfect. And I think we're constantly evolving to be a more representative democracy and a healthier democracy, expanding the rights that we give to people. And yeah, for a lot of our history, American democracy has been incredibly unfair system to a lot of people. I mean, it was a lot of consensus when it was a bunch of old white men from the South who could get together in a room and say, all right, this is what we're gonna do. Okay, great, any objections? And anybody who would have objected wasn't in the room. So yeah, I mean, I take your point absolutely. I don't think American democracy has achieved its full potential. I think there's been times when it's worked better or worse. But I believe in the progress of humanity and the progress of our country. And that's why I'm an optimist. Let me push on that for a minute because as part of your question, there could be a tension between being maximally representative and maximally effective. And indeed, Catherine Gale, who we both know, believes she wants ranked choice voting, but she says just ranked choice voting will make you more representative, but it will not get you to better solutions to actual problems. And so she talks about, I guess, the top two. She has sort of, she has tweaks on the, or top four tweaks on the system. Talk about that for a minute. I mean, so when I think about democracy, I immediately think you want to be maximally represented. You want to include, you want to represent as many people as possible, but I can also say just based on smaller organizations that, you know, having everybody in the room representing everybody, sometimes nothing gets done at all. So how do you... Yeah, I mean, and this is true for, this is absolutely true for organizations, you want to be inclusive, but you want to have some rule for making decisions. And, you know, I think democracy shouldn't necessarily be efficient. I mean, you, in order to make policy that's lasting and legitimate, you want to include as many people as possible. You can't always include everybody. You've got to make some hard choices at some point. And, you know, they're going to be, they're always going to be winners and losers, but, you know, I think the challenge is in creating a system of play in which the winners can be winners on some issues and the losers can be losers on other issues, that there are no permanent winners or losers on all issues. And I think the danger of the two-party system is that it runs the risk of one side feeling like they're always going to be the losers, or that working with our political institutions, nobody's the winner.  We've got time for just a couple more questions. They're in the back, and I will come forward at the time. Hi there. My name is Jeremy, and I'm from Fairboat. So I'm wondering, so it seems like a challenge is it would be better if the reforms you talk about were passed in a bipartisan way, but of course we're in the doom loop right now. So do you think it would be a problem if these reforms were passed on a strictly partisan basis? You could look back to post-Civil War at the Republican Party at the time, Party of Lincoln, implementing a lot of significant reforms, obviously on a more one-party basis. So how do you navigate that tension and could it be viable to pass something on a party-on-basis? Yeah, I mean, I think it would be foolish to pass this on a party-on-basis. I think one of the, to me, there are a broad number of democracy, pro-democracy reforms, and almost all of them are associated with the Democratic Party right now, and that is very dangerous. I think one of the things that should elevate this set of reforms is it doesn't have partisan valence, nor should it. It's equal opportunity to destroyer to both Democrats and Republicans. You know, I basically view, should treating it as a kind of peace treaty between both sides and say, look, you can't win this trench warfare. So let's just expand the sphere, allow some new coalitions to form. And I think certainly the folks who run the Republican Party are gonna hate it. The folks who run the Democratic Party are gonna hate it. But I think there are a lot of folks in Congress and in state legislatures who feel like this system is messed up. And a lot of folks come to Congress and say, all right, I'm gonna come here, I wanna solve problems, and I wanna get some stuff done. And they go about and they find some issues and they try to find people on the other side to work with and reach out.  You're blurring the message, we can't do this. And if you keep doing this, we're gonna cut off the majority PAC support for you. And then their constituents say, what are you doing? You're compromising with the enemy? And so, I think that although, I think the support for this will have to come from folks within both parties who feel really dissatisfied. And I talk to a lot of folks in both parties who are really dissatisfied.  So a lot of folks on the left who like this reform because they feel like their party has been taken over or their side is not represented. And a lot of people who just look at it on its face and say, yeah, this just makes a lot of sense. So I think that that's the challenge is to keep it from being a partisan issue because once it becomes a partisan issue, then all of the partisan brains kick in and then suddenly this is a liberal plot to destroy a Republican. And then, it's just like everything else. And then we're. Yes. My name is JJ and I'm from Sunset for Poverty and Equality. Thank you for the talk. And I have to say, I'm not fully convinced. And one part of it is that if I could ask you to do a premortem. So imagine everything has gone wrong with a multi-party system and a representative and what would that look like? And is that worst case scenario better than what we have currently? There's a kind of pointy to something that's a bit more optimistic than what we have now. I mean, I think you can convince me to go towards one-party technocratic state and what we have now, but is it actually better, you know, a multi-party system in a worst case scenario than what we have now? Good question. Yeah, I mean, sure, I could envision scenarios in which things are our worst. Yeah.  But what would be the worst outcome of a multi-party system?  I mean, the worst, I mean, the case against it would be that basically, there's so much fracture that the president just takes on autocratic power and just tries to dissolve Congress. And I mean, that's sort of, I guess, that's sort of what the risk is now to some extent. I mean, that's, you know, in Latin American countries that have multi-party systems, that sometimes- That are president? That are presidential, that's sometimes what's happened, that, you know, or it just becomes incredibly corrupt because the president tries to buy off a bunch of different parties in order to get into her legislation path.  But I don't think we're Brazil or Chile. I mean, I think we have an incredibly strong tradition of democracy in this country. Most people are not longing for authoritarianism. They're longing for a functional and representative Congress. And we are a wealthy, highly educated nation and I don't see us dissolving into chaos. I think it's the political system that is creating this rather than the underlying dynamic of the country. All right, I'm gonna ask last question right here and it has to be a positive one because we can't end on that note. But it was a very good question. Bring it home. Mr. Positive here. No, it's not fair, ask your question. Xander Ernest, University of Michigan. So I was hoping you could talk a little bit about how you think this kind of reform comes about in, you're talking about coming up from the States, right? How it happens in a place like Kansas or Oklahoma or right, like the sort of story you told was like, it's not a partisan politician, kind of both parties have said we can't win this trench warfare. So we're gonna sort of institute a new system. But you know, in about 20 states, Republicans have won the trench warfare. They have a trifecta and about a dozen democratic states, they've also won. And so like what are the incentives for politicians in those states to enact electoral reform or for voters to demand that kind of reform if they're voting for parties that are winning and then they're sure a single party rule's working for them? In some ways those states might actually be more likely to enact reform because in, I mean, Kansas, good example, you had basically a split in the Republican Party between the moderate Republicans and the co-backed Republicans.  The only one that still has it is Cambridge, a bunch of Cleveland, Cincinnati, but a couple of those cities, black people started getting elected under the new rules and then the establishment shut that down.  Cambridge. But the point is, in those cities, the coalition that pushed reform was the minority party plus a faction of the majority party. So like in California would be another ripe case. Democrats are a very big party, but there are big splits and one of those factions is gonna feel like, well, I'm left out. And despite being in the majority party, I don't actually have power. So they would benefit, the minority party would benefit and they could roll the plurality of the majority that, or maybe the majority of the majority, which would be a minority, which could roll. So, sorry, that's a lot of...  I mean, it's not easy, but I could see it happening. Also, there are 27 states that have initiatives and that's how it got past a million. I don't think Kansas or Oklahoma have initiatives, but a lot of states do. How many states did you say? 27. So that's, there's my... So thank you all. I will say just in closing, it's a great book. I urge you to read the book and send it to your friends in relations. One of the things I like most about it, having tried to preach rank choice voting and then explain it for the last three or four years, I'm getting better at it, but I really do think the concept of a multi-party democracy, I think the way Lee frames this is the right way to talk about it. There are different ways to get there, there are different systems, but the point is there's nothing in our constitution that says we have to be a two-party democracy and the lesson of this book was for a long time we've been a nominal two-party democracy, but actually we have been a three or four-party democracy and we've been able to compromise. We are now in a place where those two parties can't do that. And to me, when I think about the kind of renewal of our politics to say to our public, why shouldn't we're a far more pluralist nation, let's be a multi-party democracy, is the kind of message you can talk about and get people excited about and then we can worry about the details. So this book I hope is a big part of launching that conversation and we thank you. Thank you, Anne-Marie. And enjoy, have another drink.


For by grace you have been saved through faith, and this is not your own doing. It is the gift of God, not the result of works, so that no one may boast. For we are what He has made us, created in Christ Jesus for good works, which God prepared beforehand to be our way of life. Ephesians 2, 8 through 10. In confirmation, my pastor said we believed in down religion. God comes down to us. We don't earn salvation. And this is good news. Salvation isn't something to work for, to brag about, to wait for, to happen sometime in the future. It is finished. And we respond in love and service. Free.


So, for alpha thalassemias, alpha thalassemia is a deletion on chromosome 16. You can see several different types of alpha thalassemias, and we'll discuss those here in just a minute. There are two different types of deletions that you can have as well on a minor thalassemia, and those are cis deletions and trans deletions. The cis deletion, which means it's on the same chromosome, are often seen in Asian populations. And then the trans deletions, where it's on an opposite chromosome, all on chromosome 16, are often seen with African Americans. So let's look at the four different types of alpha thalassemias. So first to start off, your normal genetic makeup is the four alpha chains. If you are missing one of those alpha chains, that is an alpha thalassemia minima. This basically is going to be silent. It is someone that is a carrier and a carrier only, and they typically don't show any symptoms. When we move to deleting two of the alpha chains, you can have trans. See here where this is on two different chromosomes. Or you can have cis, where it is on the same chromosome. Both of these translate into an alpha thalassemia minor, and your symptoms are usually mild. It gets you a mild, microcytic, hypochromic anemia, and that's about all you deal with. When you delete three of these chains, and you are left with only one alpha chain, that is HBH disease, or hemoglobin H disease. This gives you a moderate to a severe microcytic and hypochromic anemia. And when all of your alpha chains are deleted, that is known as HB-Barts, or hemoglobin-Barts disease, and that is not compatible with life, causing hydrops phitalis. Of note, during hemoglobin-Barts disease, during the fetal stage, before the spontaneous abortion can occur, we do see an increase in the gamma globulin genes. Alright, let's move on and discuss beta thalassemias. Beta thalassemias are a chromosome 11 point mutation, and it's often seen in Mediterranean populations. There are two different types of beta thalassemias, major and minor. In the beta thalassemia minor, you're just seeing the beta chain is underproduced, and it is often usually asymptomatic. You don't see a lot of symptoms with this due to missing one beta chain. For beta thalassemia major, you have the beta chain is completely absent. In a peripheral smear, you're going to see target cells and anisopoichlocytosis. For the target cells, that is often seen in liver disease, post splenectomy, thalassemias and hemoglobin C, as well as our beta thalassemia. For the anisopoichlocytosis, what that term means is a variance in shape and size of the red blood cell. This variance will require blood transfusions to correct any issues with. You'll see on X-ray a crew cut skull. This crew cut skull is due to a marrow expansion for creating more blood cells when the marrow expands because of the poor red blood cells that are produced. We also do see hepatosplenomegaly, and as you can see here in this photo, this is a picture of a spleen that was removed from a child. The spleen is grossly enlarged due to the poor red blood cells due to his beta thalassemia. There is also an increased risk of parbo B19 induced aplastic crisis. Mostly this is going to be due to the spleen not functioning correctly. The spleen does help reduce the risk of parbo B19 problems. Your fetal hemoglobin is increased during the first six months of life, and that is actually protective of the disease with beta thalassemias. After those first six months, you do lose some of that protection and will require a treatment of blood transfusions, and the only curative treatment is your bone marrow transplant. Moving on to lead poisoning. Lead poisoning will cause a decrease in heme synthesis that is because of the inhibition on the ALAD hydrogenase and the ferrochilatase enzymes. You'll also see ribosomal RNA degradation being reduced with lead poisoning, and this causes basophilic stippling, which we'll see a picture of here in just a moment. The symptoms for lead poisoning spell out LEAD, and these symptoms are lead lines on the gingiva, which are Burton lines, and then you have lines of lead on the long bones. So as you can see over here in this x-ray, those are lead lines that are indicative of lead poisoning. The E in lead symptoms is encephalopathy, as well as erythrocyte basophilic stippling. You can see at the head of these arrows over here, the basophilic stippling A in lead poisoning symptoms is abdominal colic and cideroblastic anemia, which we will discuss here in just a few moments. The D is drop, so you have wrist drop and foot drop.  This leads to succimer, which is used for chelation in children. Oftentimes, lead poisoning is seen in older homes prior to the 1970s in the paint. The paint will chip off, the children will eat the lead, and then that can cause lead poisoning. Some cheap toys as well is often seen with lead poisoning, although the new regulations have decreased that significantly. Moving on to cideroblastic anemia. Cideroblastic anemia has three different causes. The first is genetic, and this is an X-linked defect in the ALA synthase. It can be acquired in a myelodysplastic syndrome, or it can be a reversible cause of the cideroblastic anemia, which is most commonly due to alcohol. This can also be seen with lead poisoning, as I just mentioned. And B6 deficiency, copper deficiency, drugs such as isoniazid or lenezolid can also cause a cideroblastic anemia, so don't always assume that it's alcohol because there are multiple potential causes for a cideroblastic anemia. Looking at the labs for cideroblastic anemia, the iron is going to be increased.  Using a Prussian blue stain, we see a ring cideroblast, as you can see here in this picture. There's a ring around that cell. And on a peripheral smear, that is where we see the basophilic stippling that we saw on the previous slide. The treatment for cideroblastic anemia is pyridoxine. Pyridoxine is also known as vitamin B6, and that is actually a cofactor in the ALA synthase, which as we discussed above, the genetic factor of an X-linked issue in the ALA synthase gene.