Friday, November 23, 2018

ANS -- Why We’re Stuck With Pelosi

This is an interesting analysis of why we will end up with Pelosi as Speaker of the House again.  she has a very honed skill set, but it may be the wrong skill set for the times.  Maybe she'll change? Maybe she'll train a successor?
--Kim



BENJAMIN STUDEBAKER

Yet Another Attempt to Make the World a Better Place by Writing Things

Why We're Stuck With Pelosi

by Benjamin Studebaker

I've been asked by a few people where I stand on the question of whether Nancy Pelosi (D-CA) should return to her old post as Speaker of the House next legislative session. There are some who argue that Pelosi was an effective speaker last go around and ought to be retained, and there are some who argue that Pelosi is too right wing and therefore needs to go. My position is somewhere in between–I think Pelosi isn't very effective in today's climate but that the current division of seats in the House means that Pelosi can only really be challenged from the right, and therefore we must reluctantly put up with her.

Image result for nancy pelosi 2018

There are three main tasks for the Speaker:

  1. Pass compelling pieces of legislation through the House to demonstrate to voters that the Democratic Party has bold new ideas for 2020. The Senate and the President will not support this legislation, but in passing it the Democratic Party can shape the public discourse heading into a presidential race, in much the same way that the House Republicans shaped the discourse in the 2011-2016 part of Obama's presidency.
  2. Extract meaningful concessions from the President and the Senate in the next budget showdown.
  3. Campaign for the party effectively through public appearances and rhetoric so that in 2020 Democrats win even more seats.

Nearly everyone concedes that Pelosi is not very good at the third task. Her favorability net rating is routinely in the negative 20s, comparable to Trump's:

The case for Pelosi is usually made in terms of her ability to mobilise votes in the House caucus. She has drawn praise for her resistance to President Bush's effort to privatise Social Security in 2005 and for her ability to shunt Obama's early legislation through the house in 2009 and 2010. These were legitimate achievements in the context of the 00s. Pelosi has been good at passing mildly progressive legislation and she has been good at resisting some of the most reactionary Republican reforms.

The trouble is that this isn't really what we need from the Speaker today. The Trump administration was struggling to pass legislation even before the Democrats took the House. Much of its legislative agenda was too unpopular to pass even when Republicans controlled all the branches. We don't need a Speaker who is good at mobilising wavering Democrats to vote against Republican legislation–the House Democrats are going to oppose this administration in virtually any case, regardless of who the Speaker is. We also don't have a mildly progressive president right now, so we don't need a Speaker who is good at mobilising Democrats to pass mildly progressive legislation.

Pelosi has been effective at playing defense for the Democrats, and the Democrats have played defence for the last 40 years or so. When there's a Democrat in office, the Democrats pursue mildly progressive but not transformational reforms. Obamacare is originally Romneycare–it wasn't an especially bold or radical proposal for healthcare. The stimulus package in 2009 was helpful, but it was much smaller than many mainstream liberal economists were recommending. Conversely, when there is a Republican in office, the Democrats oppose the most reactionary and troubling legislation but they pick their battles and give ground in other areas. Pelosi stood up to Bush on Social Security, but she buckled on the Iraq War, rejecting the call to threaten to defund it almost immediately. In the 1970s, congress stood up to President Ford and refused to approve additional military action or financial aid for Vietnam, but Pelosi was unwilling to push Bush. The war continued until 2011.

The current situation calls for a stronger approach, in which the Democrats repeatedly pass bold, compelling legislation they know will never pass or become law to force the Republicans to explicitly reject policy that is widely popular. It also requires someone who is willing to use the budget as a hammer to force Trump and the Senate Republicans to take notice of Democratic priorities. In other words, we need a Democratic House caucus that behaves more like Paul Ryan's or John Boehner's Republican caucus in the 2011-2016 period than the Democratic caucus of 2007-2010. Democrats need to go on offense so that they can win more seats in 2020 and regain control of the American political conversation. They have to start forcing Trump to react to them rather than the other way around. The Democrats haven't really been driving the bus since the era of John W. McCormack–the Speaker who shepherded President Johnson's Great Society agenda and pushed President Nixon to the left across a wide spectrum of domestic issues.

Pelosi has never been this kind of Speaker. She's a product of the political climate of the 80s and 90s, in which the Democratic consensus was that the bulk of their legislative agenda was too left-wing and needed to be watered down dramatically. Her instincts will be to push mildly progressive Obama/Clinton-type stuff–the kind of stuff the New York Times or Washington Post editorial pages will call "pragmatic". This stuff isn't sexy enough to help us in 2020. It's designed to make us look like the reasonable party, and that branding hasn't been working out especially well for us. Democrats lost the House in 2010, and failed to retake it in 2012, 2014, and 2016. Pelosi had many chances to adapt to the post-2008 political climate but has never really done it. The lukewarm response she and Obama had to the crisis of 2008 played a big role in the Republicans' success in 2010 and in their dominance in the years that have followed.

The trouble is that because the left has not concentrated its resources on competing in Democratic primaries, the Democratic House caucus doesn't have enough Berniecrats to effectively challenge Pelosi from the left. At this point, we can divide the House caucus into three broad camps:

  1. The Berniecrats, like Alexandria Ocasio-Cortez, who want to repeatedly pass bold left-wing economic policies through the House and force the Republicans to respond.
  2. The Clintonites, like Pelosi herself, who want the Democrats to oppose Trump in broadly the same way the party opposed Bush during his second term.
  3. The Manchinites, including the bulk of the people who have publicly indicated opposition to Pelosi. These people want the Democrats to cooperate much more heavily with Trump and triangulate significantly on economic and/or social issues. I've named them for Senator Joe Manchin (D-WV), who famously votes with President Trump about 60% of the time.

The Manchinites are so fearful of losing their seats to Republican challengers that they are willing to make concessions to the right that even Clintonites resist. Both Berniecrats and Clintonites opposed Brett Kavanaugh in the senate, but Manchin capitulated in a bid to save his seat. The problem we face is that this worked–Manchin was able to win in 2018 even as Clintonites like Joe Donnelly (D-IN), Heidi Heitkamp (D-ND), and Claire McCaskill (D-MO) lost seats. The Manchinites want to respond to Donald Trump the same way the Clintonites themselves once responded to Ronald Reagan–by slavishly co-opting the bulk of his agenda. It's an even more defensive approach than Pelosi's.

So if we are faced with a choice between a Clintonite speaker who wants to predominately play defense and a Manchinite speaker who wants to exclusively play defense, who do we choose? Clearly the Clintonite. That's why Alexandria Ocasio-Cortez has opted to back Pelosi:

The sad truth is that Ocasio-Cortez is correct–the left did such a poor job of challenging Clintonite and Manchinite Democrats in primaries that Pelosi remains the most left-wing option. And because of this, there is serious doubt that the party will be ready to go on offense in 2020, even if a Democratic President is elected.

The ultimate risk–that the Democrats win the presidency in 2020, do nothing interesting with it, and hand it back to a Republican who is even more reactionary than Trump in 2024 or 2028–remains very live. And this is why I have opposed and will continue to oppose Democratic candidates for president in 2020 whom I believe to be Clintonites or Manchinites, even if I think they can defeat Donald Trump. These people–including Kamala Harris, Elizabeth Warren, Beto O'Rourke, Joe Biden, John Kerry, Cory Booker, and many more–just aren't capable of changing the conversation, because their political instincts are too defensive, too corporate, and too conciliatory for this particular moment. We must compel the Republican Party to change, we cannot continue to play their post-Reagan discursive game anymore. It is a game only they can win.

Pelosi today, but someone better in 2020.

ANS -- Why Democrats Should Embrace a Federal Jobs Guarantee

This is interesting.  I had no idea they were tossing around the idea of guaranteeing jobs.  but it is apparently very popular on both sides of the aisle.  
--Kim



Why Democrats Should Embrace a Federal Jobs Guarantee

One notable 2020 contender is already doing it. 

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A construction worker works on the site of the SoMa at Brickell apartment building in downtown Miami. (AP Photo / Lynne Sladky)

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For decades, the idea of government-guaranteed jobs for all Americans has stalked the outer edges of political debate. It has been promoted by labor unions and has ideological support among some progressive thinkers, but in recent years hasn't been seen as a mainstream policy issue for the Democratic party. Now, that may be changing.

Senator Kirsten Gillibrand told The Nation she supports a government-backed jobs guarantee. "Guaranteed jobs programs, creating floors for wages and benefits, and expanding the right to collectively bargain are exactly the type of roles that government must take to shift power back to workers and our communities," she said. "Corporate interests have controlled the agenda in Washington for decades so we can't tinker at the margins and expect to rebuild the middle class and stamp out inequality. We need to get back to an economy that rewards workers, not just shareholder value and CEO pay."

Gillibrand is widely considered to be a front-runner for the 2020 Democratic presidential nomination, and a jobs guarantee will definitely be part of that discussion. Already, major Democratic think tanks have been prepping detailed policies for how the federal government can guarantee that every worker can get a job.

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The Center on Budget and Policy Priorities, for example, recently released a paper arguing for a job guarantee through a national infrastructure bank that would set a floor on wages and benefits. The Center for American Progress has also crafted a job-guarantee proposal it dubs "a Marshall Plan for America."

The CBPP paper* envisions an infrastructure bank that would fund vital projects and ensure that jobs are well-paid, with health insurance and paid leave. The National Investment Employment Corps would guarantee a minimum annual wage of $24,600, with opportunities to advance and health and leave benefit. The plan's mean expected wage of $32,500 a year is more than three times the highest proposed universal basic income.

The government would also be able to use this job-creating ability to expand jobs in sectors where the market won't currently invest. "You can imagine greening the entire United States," said Darrick Hamilton, an economist who co-authored the CBPP paper. "The ideas of the jobs go far beyond my imagination, and the NEIC allows communities to have a say in the projects they need."

Hamilton noted that a job guarantee "would especially benefit marginalized and stigmatized workers that face structural barriers in the private sector." As his CBPP paper notes, a job guarantee has a long history in the United States: Early versions of the Humphrey-Hawkins Act of 1978 included language that would have established a Job Guarantee Office, but it was scrapped in favor of an "incrementalist approach." There are international examples as well, from the Argentina's Jefes y Jefas program and India's and National Rural Employment Guarantee Act (NREGA) to South Korea's Moon Jae-in's responding to the country's rising inequality with a promise to create 810,000 government jobs.

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A jobs guarantee would also boost wages in the private sector, which have been depressed in part by the consolidation of large corporations. Take hospitals: As they have merged, nurses (disproportionately women of color) find it more difficult to go from hospital to hospital and leverage job opportunities for higher wages. But if nurses knew they could go get a job through the government, the private sector would face pressure to increase pay. "The corporate establishment hates full employment and has fought very hard to ensure the economy never reaches full employment—even though it's the most successful means of improving human welfare we've ever enacted," said Economist Marshall Steinbaum.

To explore the possibility of Democrats' running on a guaranteed-job plan, we asked the respected data analytics firm Civis Analytics to not only poll guaranteed jobs, but poll it in the way that would be most likely to gain opposition from voters. They asked respondents: "Democrats in congress are proposing a bill which would guarantee a job to every American adult, with the government providing jobs for people who can't find employment in the private sector. This would be paid for by a 5 percent income tax increase on those making over $200,000 per year. Would you be for or against this policy?"

We expected that in a generic scenario, people would support guaranteed jobs, but before urging Democrats to embrace it, we wanted to see if the policy might take a hit when Republicans made the issue partisan and talked about tax hikes.

The results of the Civis polling were nothing short of stunning, showing large net support for a job guarantee: 52 percent in support, 29 percent opposed, and the rest don't know. "Even with explicit partisan framing and the inclusion of revenue in the wording, this is one of the most popular issues we've ever polled," said David Shor, a senior data scientist at Civis Analytics.

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The chart below shows net support among different political groups. Clinton supporters overwhelmingly support a job guarantee (69 percent to 16 percent, with the rest unsure). High levels of support among nonvoters are particularly noteworthy. Even among Trump voters, support was only net negative of 18 points, which seems high, but 32 percent of Trump voters support a job guarantee, even with the negative framing.

In addition, the job-guarantee polls strongly across all racial groups, but through the roof among black voters (net support of 62 percent) and Latinos (55 percent). In addition, young voters love the job guarantee, with a net support of 43 percent among individuals 18–34 and a net support of 22 percent among 35–64. and net support of 8 percent among individuals 65 and older.

Chart depicting net support for a job guarantee, by presidential preference

Among the merits of the guaranteed job is that it appeals most to the voters Democrats struggled to mobilize in 2016: low-income voters, and particularly low-income voters of color. Democrats would benefit immensely from increasing the class polarization of the electorate—that is, by winning over more working-class voters at the expense of some wealthy voters.

With a guaranteed-job proposal, Democrats could win three working-class white, black, and Latino voters for every rich white voter they lost. "It's rare to see an issue with such a strong income divide. Republicans who make less than 25,000 per year are more supportive than Democrats who make more than 150,000," said Michael Sadowsky, a data scientist at Civis.

The Civis polling suggests that a guaranteed-jobs proposal could help bring voters back into the Democratic fold, or at least it won't hurt: 56 percent of Obama-to-Trump voters support a job guarantee, and only 26 percent oppose. Among nonvoters, 58 percent support the job guarantee and 15 percent oppose. The job guarantee also transcends divisions from the 2016 Democratic presidential primary: Net support among Clinton voters was 54 percent, and 61 percent among Sanders voters.

Chart depicting net support for a job guarantee, by voting pattern

American elections, as progressives have learned all too well, are not decided by the national popular vote. For that reason, our think tank Data for Progress modeled state-level support for guaranteed jobs using data provided to us by the Center for American Progress, with the help of Senior Adviser Austin Rochford. We find that the job guarantee polls stunningly well in all 50 states. Even in the state with the lowest modeled support, Utah, support is still 57 percent. Deep-red states like West Virginia (62 percent support), Indiana (61 percent), and Kansas (67 percent) all boast strong support for a job guarantee. Indeed, the places where the job guarantee is most popular might be surprising: DC (84 percent), Mississippi (72 percent), North Carolina (72 percent), Hawaii (72 percent), and Georgia (71 percent) have the highest estimates, though support is also high in solid-blue states like California and New York (both 71 percent).

Map depicting support for jobs guarantee across US states

"The results of this research were just staggering. Americans not only overwhelmingly oppose cuts to programs like Medicaid and nutrition assistance. They also support really bold progressive alternatives—including a jobs guarantee," said Jeremy Slevin, the director of advocacy for the Poverty team at CAP. "If there was any doubt as to whether progressives should champion far-reaching proposals to help people find good-paying jobs, I hope this erases it," he said.

That appears to be happening already, from Gillibrand to several congressional candidates for 2018. In deep-blue NY-14, Alexandria Ocasio-Cortez said she's proposing a federal jobs guarantee and sees guaranteed jobs as a way to set a floor on working conditions. "It's basically a public option for jobs," she said. "It guarantees a bare minimum which employment can't go below." She also wants jobs that solve externalities provided by the market, such as green jobs.

When we talked to Dan Canon, a congressional candidate in Indiana's ninth district (where Trump won by a 27 point margin), he said he enthusiastically embraced a federal jobs guarantee and talked about it frequently on the campaign trail. "It's one of those things that surprised me in how widely it has been accepted by people of all political stripes," he said. Canon connects a job guarantee to the need for infrastructure: "We have been trained out of thinking about commonsense solutions. People need jobs, what do we do? Give them jobs."

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The job guarantee could end up being a key issue in some Democratic primaries this year. Kerri Evelyn Harris, a Democratic candidate running against incumbent Tom Carper for Senate in Delaware, said, "It is time to offer American citizens guaranteed, quality jobs, with growth potential in the government sector." She added, "There are an array of areas that could use additional workers, from infrastructure to social work. A guaranteed-jobs program would not only help inject hope back into communities which have broken spirits due to decades of dismal job opportunities, but it will also help pump money into the economy by way of purchases by the newly and adequately employed."

A job guarantee offers a way for the Democratic Party to return to its roots as a multiracial working-class party. As President Donald Trump recently proclaimed, "We know the single best anti-poverty program is a very simple and very beautiful paycheck." Indeed, and the government should guarantee one.

(*Due to an editing error, Hamilton's paper for the CBPP was referred to in one instance as the "CBPP plan." It was a paper commissioned by the think tank, but does not necessarily represent CBPP's official policy stance.)

Thursday, November 22, 2018

ANS -- Martine Rothblatt: She founded SiriusXM, a religion and a biotech. For starters.

And now for something completely different.  This is a biography.  It's from 2014.  She's a pretty extraordinary person. It's pretty long.  Just for fun....  There are comments on the site.
--Kim



Martine Rothblatt: She founded SiriusXM, a religion and a biotech. For starters.

December 12, 2014

Let's be clear: Martine Rothblatt is just plain more of a lawyer than anybody else in this town.

The 60-year-old grandmother and CEO of United Therapeutics, the Silver Spring-based biotech she founded to help save her younger daughter's life, banked $38 million last year. It made her the nation's highest-paid female executive. It also made her the nation's highest-paid transgendered person, as she had sex reassignment surgery in 1994.

In a lab on Spring Street, Rothblatt's newest project appears lifted from science fiction: disembodied but breathing human lungs, hissing away in dome-shaped incubators, part of a clinical trial attempting to mend donated but not-quite-accepted-for-transplant lungs so that they can actually be placed in living human beings.

On a Virginia farm, she's also raising genetically altered pigs, in the hope that someday their lungs (and other organs) will be modified for use in human transplant, creating a nearly inexhaustible supply of organ donors.

She just published "Virtually Human," a big-think manifesto on the rights of yet-to-be-created cyber-humans, who might one day be uploaded with all of your thoughts, dreams, memories and online activity and live for eternity as a sort-of you.

She founded a religion, the Terasem Movement, which puts together her cultural Judaism (she puts on a mean seder), Zen-like yoga and a deep belief in technology. One of the four founding beliefs: "Death is optional."

The physical manifestation of this faith is a bodyless robot, named and modeled after Rothblatt's second wife, Bina. The robot, Bina48, is just a head. It has a face made of frubber, wears a good-looking wig, has facial-scanning software in her "eyes," so that when her head whirs and clicks, then locks on your face, she's running your profile to see if she "knows" you.

Bina48 lives on a desk in rural Vermont, awaiting the day when man and machine are one.

Far-fetched?

Hey, go ahead, yuk it up. Rothblatt is buddies with Larry Page and Ray Kurzweil, who sort of run a little company called Google. Kurzweil, the futurist and director of engineering at Google, is on United Therapeutics' board of directors and thinks Bina48 is a glimpse of the future.

In the late 1980s, Rothblatt conceived of and created a crazy company devoted to the idea of worldwide satellite radio. Today that's Sirius XM. It's in your car's dashboard, next to the satellite navigation device ... and she was president of Geostar, the first company to market that, too. Her college thesis became the first private satellite phone company.

"She has to my knowledge a perfect track record in making [her] visions real," Kurzweil writes in an e-mail.

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Rothblatt dropped out of the satellite orbit because her and Bina's daughter was diagnosed at 5 with what is now called pulmonary arterial hypertension, an incurable lung disease. It progressively narrows the lung's arteries to the point of death. By 12, Jenesis would faint all the time, her life seeping away in intensive care units.

So Rothblatt sold out of Sirius, set to studying biology — the last such course she had taken was in 10th grade — and formed U.T.

Today, Jenesis is 30, in good health and does film-production work for the now-$6 billion firm. Martine led the company to developing a new FDA-approved pill for pulmonary arterial hypertension, Orenitram ("Martine Ro," backward). The stock price soared, and so did her incentive package.

Amid all this, Martine and Bina have been married for 32 years, before and after Rothblatt's gender surgery. They're so joined at the hip that the kids refer to them as "Marbina." Their younger son, Gabriel, just ran for Congress in Florida's Eighth District (Democrat, lost, but a respectable debut). When Rothblatt set up a $225,000 super PAC to fund Gabriel's campaign — without his knowledge, he says — she drew a rebuke from the New York Times editorial page for parental abuse of electoral process.

Let's see ... what else? She flies airplanes. And helicopters. Kills on the piano. Runs half-triathlons. Has several houses and apartments and says she hasn't stayed in one place more than a month in 20 years. During September and October, she and Bina touched down in Greece, Crete, Washington, Los Angeles, Bora Bora, back to Silver Spring, took the grandkids trick-or-treating in Melbourne Beach, Fla., while Gabriel was out campaigning, then flew to London and popped back to D.C.

Oh. She's taller than you, too.

You've heard this one a million times: Idealistic Young Lawyer Comes to Your Nation's Capital to Make a Difference and Gets Kicked in the Teeth. With Rothblatt, it's the real story.

She — he, then — joined Covington and Burling in 1981 as an entry-level policy wonk in telcom law. She was 27 and already on a second marriage with two kids and two more on the way. The young couple was scraping by, living in a one-bedroom flat near the National Zoo.

Idealistic Young Lawyer went nowhere at Covington. When I called the firm recently to chat with someone who remembered her work there ... no one did.

"They wanted me to lobby for broadcasters against the beginnings of satellite radio," Rothblatt offers, "and I was all for the other team."

She quit after 12 months and enrolled in the graduate astronomy program at the University of Maryland. Mom, Dad and the kids piled into married student housing.

This slightly idealistic poverty was nothing new.

Rothblatt was born in Chicago, raised in San Diego and Los Angeles, the grandchild of Jewish immigrants from Eastern Europe. Dad Harold worked as a dentist at a labor union, and mother Rosa Lee worked as a speech therapist.

Marty, as Rothblatt was called, and a sister, Janet, were the only children in a household that believed in faith, decency and hard work.

"There was no cursing, not even 'damn,' and the children were expected to be courteous," says Rosa Lee Rothblatt, now retired and living just outside Los Angeles in a house with Bina's mom, Bertha. "They were to study, and they knew to volunteer their time to charitable causes."

(Rothblatt's father is deceased; her sister politely declined to comment for this story.)

The family was observantly Jewish — Marty played the theme from "Exodus" at the bar mitzvah — and lived on modest means.

Marty enrolled in UCLA but quit after a year to travel on the cheap with buddies. Van rides across Europe, selling the van in Turkey, teaching English in Iran, touring eastern Africa ... wound up living in a ratty house in the Seychelles Islands, which was supposed to be cool. It wasn't.

While there, a buddy took Rothblatt to a U.S. satellite installation. There — right there — is where she says her mind took an exponential leap forward, imagining how close future worlds really were.

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Marty went back to UCLA with a wild new energy and a family in tow. The marriage to a Kenyan woman soon collapsed, but Marty raised their son Eli on his own. Father and son lived in dire, if self-imposed, poverty while dad spent seven years going through undergrad, law and the MBA programs.

"Martine wanted to do things on her own," her mom remembers.

"Literally the starving student," remembers Paul Rosenthal, then chairman of the communications school. "I remember her wearing one checked shirt and pair of jeans every day. It may have been all she had."

Charlie Firestone remembers Marty clearly — "the most brilliant student I had in 13 years of teaching at UCLA law school. ... Just a fascinating mind."

It was 1979 when Marty met Bina, a real estate agent, at a mixer in Hollywood. The two shared an instant attraction and mutual life circumstances: Bina was a single parent, too, of a young daughter named Sunee.

They soon married, moved to D.C., cross-adopted Eli and Sunee and eventually had Gabriel and Jenesis.

By the mid-1980s, Rothblatt was getting a reputation among the space law cognoscenti for brilliance and knowledge of FCC regulations and of the intricacies of broadcasting wavelengths.

"A conceptual genius," says Tobey Marzouk, partner at Marzouk & Parry, who was legal partners with Rothblatt in the 1980s. "Her ideas were quantum leaps of the technology at the time."

Rothblatt was hired as a lobbyist for a fledgling concern called Geostar, initially a satellite tracking service for trucking companies.

Rothblatt worked insane hours — going to the office about 2 a.m. for a day's research and planning before the doors opened seven hours later — but the family was tightknit. Bina had converted to Judaism and often worked as his de facto office manager. Bina's mom, who had moved in with them, watched the kids.

On Friday evenings, they would have "love night" at home. It began with a family song:

Love night, love night, love is all around

love night, love night, here love can be found

family is our source of our strength

forever we are one and the same

love night, love night, love is all around

"That was at the dinner table," says Gabriel Rothblatt, 32, now a father of four and living in Melbourne Beach. "We'd all have dinner or go out to dinner, sitting around the table, bless the bread and light the candles. We'd go from oldest to youngest and everyone say what love meant to them this week. It was an opportunity for everybody to speak while everyone else is quiet, but it was also a session to reflect on the meaning of love during the previous week and how it affected you."

By the early 1990s, Rothblatt had founded CD Satellite Radio, a forerunner of satellite worldwide radio, then changed the name to Sirius, for the brightest star in the sky. Rothblatt came out first to Bina, announcing an affinity for wearing dresses, and Bina said it was no big deal. The kids were not exactly thrilled — some friends stopped coming over, some people stared at Martin in a dress — but they told the kids not to worry. Martine was always going to be their dad, Bina was always going to be their mom, and stupid people were always going to be stupid.

The gender switch led to Martine's first manifesto-type book, "The Apartheid of Sex." It argued that people come in vast ranges of sexualities and that two genders simply could not describe the reality.

The book got a $100,000 publishing contract. Sirius went to its IPO. Rothblatt earned millions.

She was 40 years old.


James Zhan, left, and specialist Sam Popa work on a lung being kept alive and restored in an incubator at United Therapeutics, which is pioneering new methods for lung transplant. (André Chung/For The Washington Post)

Psshhhttt, hsshhhttt. Pssshhttt, hssshhtttt.

Most likely, you've never been in a room with a disembodied set of lungs, watching it breathe via a ventilator. It's kind of creepy, the sides coming together, all wet and fleshy and fluffing back out again. ...

We are in a high-tech lab of Lung Biotechnology, a subsidiary of U.T. We are checking in on Rothblatt's clinical trial to reclaim marginal lungs not accepted for transplant.

The facility is just across from the company's Spring Street headquarters. In a sealed room that looks like a surgical suite — tubes and air lines and flat screens displaying real-time medical data, everybody wearing paper overalls and masks and booties — are said lungs, in a circular glass incubator.

Yesterday, they were breathing in the chest of a 56-year-old man, a 30-year smoker and drug user.

Last night, he died of a stroke.

This morning, they're here.

They're big — huge, actually, because the lungs tend to expand when not compressed by the rib cage — and the clear plastic dome fogs with condensation.

The staff, led by Thomas Hartnett , has been running fluids and medication through the lungs to maintain and assess them while removing excess fluids. A broncoscope with a tiny camera runs through the main passageways, offering views of the interior.

The data they're picking up goes to the cloud, so any doctor on the system with Internet access — even a smartphone on a golf course — can determine if it might work for transplant.

Should the process be approved in the United States, it would significantly reshape the high-pressure ecosystem of lung transplants.

About 8,000 lungs are donated each year. But on average over a decade, only 1,600 find continued life in someone else. There are six to eight hours to make the switch — a huge network of jets, helicopters, ambulances and surgeons are on call — yet more than two-thirds are not, in the final analysis, approved for transplant.

Rothblatt's project is to preserve those marginal donations — out of body for up to 24 hours — so that they might be maintained while a suitable recipient is found.

The process is legal in Canada, and Rothblatt's company is among a few trying to win FDA approval. It has worked on more than 40 lungs since May, practicing and documenting results. Once the process is approved, the company will start putting the lungs in patients on a trial basis.

"The idea is to get 40 or 50 donated lungs per week," Hartnett says. "About 2,000 a year. That would double the number of transplants."

And, as he points out, that's no small thing: Transplants are for end-stage lung disease. People who do not get them in time — and there's a long waiting list — do not live.

There are many diseases that can result in the need for a full or partial lung transplant. One of them is pulmonary arterial hypertension. Because it has no known cure, a lung transplant may someday be required for the very soul of the company.


Bina and Martine Rothblatt with daughter Jenesis, whose illness inspired the founding of United Therapeutics. (Photo courtesy of Jenesis Rothblatt/for The Washington Post)

Jenesis Rothblatt comes walking down a Bethesda sidewalk on a mid-autumn evening to meet for dinner. The impression is not of a lung patient. She's tall, vibrant, angular, strikingly attractive, high cheek bones, bright smile.

"I haven't fainted in 10, maybe 12 years," she says, sitting down, ordering a glass of red.

She started getting short of breath at about 5, on family skiing trips. Later, the spells would come at random. "I'd start to hear something like the tinkling of fairy dust, if that makes any sense. Then I'd see little dark spots, going from the outside in, until it was one big black spot."

She'd faint, dropping as if shot.

Bina, on the terror of the time: "I was doing her hair one time, just combing it out, and she just collapsed. Right through my hands, I couldn't catch her. She was out."

The medication at the time was not particularly effective. There were I.V. pumps, her parents waking her in the night to give her medication.

Rothblatt left Sirius, desperately trying to find better treatment. But the disease had about 3,000 patients in the United States — it was so rare and treatment so expensive that major pharmaceutical companies weren't interested. Rothblatt pestered experts, set up a foundation and sent out requests for proposals.

Then she and Bina took Jenesis traveling.

"She was about 10 or 11, she was on oxygen, and we thought her life was about over," Rothblatt said. "We thought, 'Let's just show her what we can of the world.' "

They toured, seeing the Great Wall of China, and when they came back, Rothblatt was stunned to find several doctors had answered her requests.

She was impressed with James Crow, a just-retired research scientist who had done work on the condition, and got him to come on board. They eventually developed a key drug, Remodulin, that helped keep blood pathways open in the lungs, though it is delivered by injection or a pump. They developed Tyvaso, which is inhaled; and finally, Orenitram, a pill.

The medications can cost north of $100,000 per year, but as treatments improved, so did the number of patients able to benefit from them. Today, more than 30,000 patients are treated with these or similar drugs each year.

"All of these are people just would not be alive without these medicines," Rothblatt said at a recent conference.

Jenesis's condition slowly improved. But she tired of the illness and the sheltered lifestyle it imposed. "I still wanted to be able to go out and do the things other kids my age were: sleepovers, roller coasters, staying up past 7 p.m."

So she rebelled. "I drank, I skipped class, I wouldn't take my medication."

But then, as the pages on the calendar turned, she matured, studied audio engineering, then biochemistry. U.T. didn't provide the only medication she took, but it was at the forefront of the field.

Today, she takes three pills per day (one made by U.T.) and feels lazy if she takes an elevator up a floor rather than hoofing it. She just moved to L.A., still working for the company, but a little glad to get out of the home office.

"Because it was founded in my honor, there's really no way I could be disassociated from it, whether I worked there or not," she says. "On one hand, it's very humbling. It's so special. It's kind of cool. But, sometimes, you'd like to be a little more anonymous."


Martine and Bina Rothblatt at U.T. headquarters. A couple so close their children call them "Marbina." (André Chung/For The Washington Post)

One of the first things you notice about Rothblatt is that she has a very offhand manner. Second, she's almost comically upbeat. She effusively praises subordinates in meetings, compliments the waiter at lunch on the tea and praises Bina in all things — even if it's her habit of rearranging furniture, unbidden, even if it's the sitting room of a doctor's office. "She's got a natural sense of feng shui!"

Rothblatt is 6-foot-2, rangy, an athletic lope to her stride. She sometimes wears custom-made women's suits ("women's clothes don't really fit me, men's clothes don't really fit me"), but mostly she knocks around in dark slacks and a pullover.

On this particular recent evening, she has her hair flat-ironed, is wearing dark slacks, a turtleneck and a leather jacket. If she told you she was a yoga instructor, you'd totally go for it.

She, Bina and I were chatting in a sitting area on the sixth floor of U.T. headquarters. The cubed tables change colors every few seconds. It was after closing hours, and when a stray employee walked past, Rothblatt halts the conversation to call out, "Thanks for working late!"

It grew late. As we were leaving, she pointed out the window, across the street. The lights were still on at the lab. "They're sending our first lung to be transplanted tonight in Toronto," she said. "See the ambulance?"

The transplant was completed at 1 a.m. Eight hours later, she e-mailed me pictures, replete with time stamps.

"Last night one fewer person died on the transplant list," she wrote, exultant. "I feel confident that we'll at minimum double # of transplants by end of 20teens."

Roll your eyes? Sure, go ahead.

Then go back up, near the beginning of this story, and, when betting against the future, reread the handicapping of Ray Kurzweil, generally regarded as one of the planet's great minds, about the track record of Martine Rothblatt.

Neely Tucker is a Washington Post Magazinestaff writer.

E-mail us at wpmagazine@washpost.com.