Tag Archives: Trump Administration

Dishonesty And Healthcare

As the blizzard of political television ads becomes ever more annoying–and less informative–one thing about them has become very interesting. Even Republicans who have previously made it clear that they don’t want government involved in healthcare are airing advertisements touting support for Medicare and willingness to protect pre-existing conditions.

I’ve been particularly struck by the U Turn in Indiana’s Fifth District, where a radically-reactionary, pro-Trump Republican noted for opposing “socialism” (which she has defined to include pretty much anything done by government) has begun running commercials supportive of Medicare and coverage of pre-existing conditions. Evidently, her polling has overcome her previously expressed belief that government should have no role in health care.

She’s not alone.

When the Affordable Care Act (aka Obamacare) passed, several Republicans went on record with their concern that its trajectory would mirror that of Medicare and Medicaid: despite initial resistance, the public would come to expect/demand/approve of the program. Survey research has confirmed those fears, which is why GOP officeholders continue to pretend that they will protect access to healthcare at the same time as they are feverishly working to eviscerate it.

The Brookings Institution recently published a report detailing six ways Trump has sabotaged the ACA.The report began by stressing that its authors did not use the term “sabotage” lightly.

For analytic purposes, the term “sabotage,” should not be used lightly. Presidents upon taking office typically have priorities that trigger executive actions strengthening some programs while weakening others. The losing programs often face resource reductions, pressure to deemphasize certain goals, directives to alter their administrative approaches, and other measures that can undermine their effectiveness. In doing so, a president often pays lip service to the program, claiming it has been “modernized” or otherwise improved. In contrast, Webster’s defines “sabotage” as efforts to foster “destruction and obstruction” and to “cause the failure of something.” In the context of the administrative presidency, it reflects a commitment to program emasculation and termination through executive action. As such, it sharply departs from the constitutional requirement that the president “take care that the laws be faithfully executed.”

There were six actions detailed in the report.

1) The administration dramatically reduced outreach about, and opportunities for enrollment in, the ACA’s insurance exchanges. The administration sharply reduced support for advertising and exchange navigators and reduced the annual enrollment period to about half the number of days. 

2) Together with Congressional Republicans, it reneged on commitments to private insurance companies. Those insurers had been offered various subsidies that reduced the risks of participating in the exchanges. The GOP failed to honor those commitments.

3) The administration has constructed what the report calls “off-ramps to cheaper, lower-quality insurance.” One goal of the ACA was to improve the quality of health insurance by specifying essential benefits, guaranteeing coverage of those with preexisting conditions at reasonable rates, and prohibiting insurers from imposing certain spending caps. The Trump administration expanded access to coverage that was cheaper because it didn’t meet these standards and that siphoned off the healthier enrollees whose participation is needed to make the ACA work.

4) It allowed–indeed, promoted– a variety of state waivers that decreased ACA enrollments and undermined its regulatory structure.

5) It discouraged legal “aliens” from enrolling in Medicaid. In a particularly evil move, Homeland Security promulgated a “public charge” rule authorizing officials to treat Medicaid enrollment as a negative factor when reviewing the requests of legal non-citizens to extend their stays or change their status (e.g., from temporary to permanent resident).

6) And then there’s the existential threat. The Trump Administration brought the lawsuit that is now pending at the Supreme Court, attacking the constitutionality of the ACA. If that suit is successful–despite a legal argument that has been widely characterized as ridiculous, despite its endorsement by an appellate court composed of Trump-appointed judges– millions of Americans will lose access to health care.

As a student once reminded me, the United States doesn’t have a health-care system; we have a health-care industry. As a result, millions of Americans remain underinsured or completely uninsured, other millions are bankrupted each year by medical costs, and our health outcomes are among the absolute worst in the developed world. 

Deeply dishonest political rhetoric to the contrary, the current Republican Party wants to keep it that way.

Distraction

Note: Apologies for the extra and misleading email yesterday. The blog referenced (to which the link would not work) will post on the 16th. (I sometimes work ahead–and in those cases, obviously don’t know what I’m doing…)

_______________________–

I know that many of you who read this blog also subscribe to Heather Cox Richardson’s  Letters from an American. That almost-daily letter is particularly valuable for those who are trying to just keep up with the daily outrages and indignities coming from the White House, since she tends to focus on updating readers to the fire hose of improprieties that exhaust so many of us.

The other day provided an example: from continued fallout over Trump’s “suckers and losers” insult to America’s soldiers, to documentation of his continuing buildup and corruption of the Military-Industrial Complex, to not-so-surprising revelations in Michael Cohen’s new book, to the absolutely unprecedented, legally-appalling effort of Bill Barr’s version of a Justice Department to assume Trump’s defense against Jean Carroll’s defamation suit, it was just another day in TrumpLand.

On the off-chance that you missed that last offense, here’s a brief background: Carroll is one of the many women who have accused Trump of sexual assault. She alleged that he raped her some 20 years ago, and when he responded in true Trumpian fashion that he’d never even met her (as usual, there are contemporaneous photographs to the contrary) and she “wasn’t his type,” she sued him for defamation.The courts have thus far refused to dismiss or halt that lawsuit.

Now, lawyers with the Department of Justice (presumably with straight faces) are arguing that Trump was acting in his official capacity as president when he denied knowing her and thus should be defended by the DOJ, which is funded by taxpayer dollars. As Richardson reported,

CNN legal analyst Elie Honig called this “a wild stretch by DOJ…. I can’t remotely conceive how DOJ can argue with a straight face that it is somehow within the official duties of the President to deny a claim that he committed sexual assault years before he took office.” He continued: “This is very much consistent with Barr’s well-established pattern of distorting fact and law to protect Trump and his allies.”

(I am at a loss to understand Barr, who–unlike Trump– is not stupid. My operating theories since he began acting like the President’s consiglieri vacillate between mental illness and blackmail, since he clearly knows that history will not be kind…)

All this is, in a fashion, beside the point. 

Much has been made of Trump’s ability to distract—to point to the “shiny object” (squirrel!!), to create a new outrage in order to distract attention and media from his most recent crimes and misdemeanors. It’s true that the media turns its attention to the most recent example of norm-and-rule breaking, but what makes this constant misbehavior a really effective distraction is simply the “fire hose” rate of discoveries of the administration’s corruption and incompetence.

It becomes impossible to keep up–and it exhausts those of us who continue to try.

The sheer volume of the misbehavior prevents the sort of continued, in-depth reporting of  a single incident of unethical or criminal behavior–the sort of ongoing media attention that would be paid to such incidents occurring in past administrations. Think of the amount and duration of reporting on Clinton’s dalliance with Monica Lewinsky, or the Watergate break-in. Substantial research has shown that it takes numerous repetitions of news items before they “sink in” and become common knowledge.

Historians will undoubtedly have a field day with the literally hundreds of examples of this administration’s criminal, unethical and deeply disturbing behaviors, but the rapidity with which these incidents come to our attention and then vanish means that they barely have time to make an impression on the significant number of citizens who do not follow political issues closely.

There’s an analogy here to that old joke to the effect that, if you have run over someone with your car and maimed them, you’d do well to back up and finish them off.  A few corrupt transactions will attract sustained attention, but the daily trashing of laws and norms will simply wear us out. 

Why Competence Matters….

I’m so tired of writing about the Coronavirus pandemic, and I’m sure most of you are equally sick of reading about it–or receiving updates to the monumentally-long list of ways the Trump administration continues to commit malpractice–or worse.

But the hits keep coming…

You know we are in uncharted territory when a Republican governor admits that he is hiding protective gear and testing supplies from the federal government.

Not only is the administration not helping states navigate this pandemic, it is appropriating critically needed supplies and according to multiple reports, doling them out in ways that favor political allies and punish states seen as insufficiently enamored of “dear leader.”

Now, a report from the Inspector General of the Department of Health and Human Services has again highlighted the multiple failures of the administration. (There’s a reason Trump is constantly firing or otherwise neutering Inspectors General…) Update: Yesterday, Trump–reportedly furious– fired the IG who submitted this report.

NBC News reports that the HHS IG found that hospitals across the United States are lacking supplies as basic as thermometers, even as they’re being undercut by their own federal government in trying to acquire new supplies.

 “Vendors have told us that they need to send whatever they have to the national stockpile,” said Ruthanne Sudderth, senior vice president for the Michigan Health & Hospital Association.

Additionally, the report found that supplies delivered to states by the federal government were either inadequate or defective.

“One hospital received two shipments from the Federal Emergency Management Agency with protective gear that had expired in 2010,” NBC News writes. “Another hospital system received 1,000 masks from federal and state governments, even though it expected a much larger delivery, and ‘500 of the masks were for children and therefore unusable for adult staff,’ the report said.”

Professionals have characterized these and other failures listed in the report as “unprecedented.” (One hospital administrator reported sending his staff to auto part shops,  home supply stores, beauty salons and art supply stores in an effort to find gloves and masks.)

Hospital administrators around the country also complain that conflicting guidance from federal, state and local governments is causing confusion.

A report on the situation from NBC News  met with a response directly out of that “alternate reality” Trump inhabits.

President Donald Trump on Saturday said hospital administrators speaking to his administration were “thrilled” about their situation.

“Many hospital administrators that we’ve been in touch with, even in the really hotspots — you know what they are — are communicating directly with us that their level of supplies are meeting essential needs. And at the current time, they’re really thrilled to be where they are,” Trump told reporters.

All of the other failures reported pale in comparison to the shortage of testing supplies. The inability to test sufficient numbers of people and to get the results of those tests promptly delays the day the nation can reopen, and further strains an already inadequate system.

Diagnostic testing kits to identify patients or staff members with the virus were also in short supply, according to the inspector general. Hospitals said they were struggling with “a severe shortage of test kits,” limiting their ability to monitor the health of patients and staff members, the report said. There were also problems with incomplete testing kits missing nasal swabs or reagents to detect the virus.

“Across the industry millions are needed and we only have hundreds,” a hospital administrator was quoted as saying.

The shortage of testing kits was aggravated by delays in testing results, straining hospital resources and bed capacity as doctors waited for the results, the report said. One hospital reported test results’ taking as long as eight days, it said.

Hospitals said that presumptive patients waiting for test results took up bed capacity needed for other patients, according to the report, and that staff members were forced to use personal protective equipment, or PPE, as a precaution because of the slow pace of test results, wasting precious resources.

The armed idiots storming state capitols to demand an end to measures that are saving lives should be storming the White House and demanding competent governance.

But of course, that would require another possession that is apparently in short supply, at least in their ranks: cognitive capacity.

 

Visualizing Trump Country

Several readers have sent me an infographic from The American Prospect, titled “Mapping Corruption.” It’s stunning–not because we didn’t know, or at least assume, what has been going on, but because being faced with a comprehensive overview is just overwhelming.

The introductory text invites exploration of the details–agency by agency.

The Trump administration has brought its brand of corruption and self-dealing to every agency in the federal government, and it’s hard for anyone to keep on top of it all. We’ve mapped it out for you. Click on any agency building below, and unlock an extensive dossier of the activities happening inside.

For each agency, there is a list, detailing the corrupt activities undertaken by that agency by Trump’s administration, and even more telling, a description of the particular “best” person Trump has placed in charge of that part of our government.

We have heard a fair amount about several of them–Betsy DeVos and her campaign to destroy public education, Bill Barr who has shamed the Department of Justice–but there are several lesser-known figures who are equally slimy. Take Sonny Perdue, at the Department of Agriculture–the first agency in the alphabetical list.

As governor of Georgia, after issuing an order prohibiting gifts worth more than $25 to state employees, Perdue accepted sports tickets, airplane flights, and other gratuities valued at over $25,000.

He signed a tax bill with a last-minute tweak that saved him $100,000 on an already-completed land sale. One of the legislators backing that bill had worked part time for Perdue on his personal legal business.

As a founder or part-owner of more than a dozen agribusiness companies, Perdue collected $278,000 in federal farm subsidies between 1996 and 2004.

In his campaigns for political office, Perdue received large contributions from the likes of Monsanto and Coca-Cola.

In a 2014 article, Perdue dismissed efforts by “some on the left or in the mainstream media” to connect extreme weather events to climate change. “Liberals,” he wrote, “have lost all credibility when it comes to climate science because their arguments have become so ridiculous and so obviously disconnected from reality.”

Under “Quick and Dirty”–the abbreviated portion of the agriculture section–we see that Perdue appointed former agribusiness executives and lobbyists, and what the report says is an “unusual number” of Trump campaign workers without obvious qualifications, to the Department’s management. Those officials have authorized sharply higher line speeds for slaughterhouses; they’ve cut back on USDA meat-safety inspections; and they’ve allowed some large operations do handle their own inspections–with low-wage workers.

The department has also proposed denying food stamps to three million people who currently rely on them, and has rolled back a number of environmental, health and safety regulations.

The Trump administration may oppose welfare for those lazy bums on food stamps, but in the longer, more detailed portion of the report, we learn about the handout recipients of whom they approve:

Perdue’s Agriculture Department has distributed more than $28 billion in emergency relief to farmers injured by the administration’s trade war with China. This program has been massively tilted toward multinational agribusiness companies. More than $62 million, for example, has gone to the world’s largest meat processor, JBS, owned by a pair of billionaire brothers who have served prison time for bribing hundreds of government officials in their native country of Brazil.

A couple of other items from the list:

Perdue undid a set of newly adopted rules meant to keep agribusiness giants from engaging in price-fixing and other forms of collusion at the expense of farmers or consumers. He effectively eliminated the unit (known as GIPSA) responsible for enforcing the anti-fraud regulations that remained, making it part of an office dedicated to marketing and public relations.

The Agriculture Department went to bat for Dow Chemical in pressing China to accept its genetically modified, herbicide-resistant corn seeds. With that victory secured, Dow spun off its agriculture business into a new subsidiary, Corteva, which is now the top corn seed producer in the Asia-Pacific region.

The department reinterpreted the Clean Water Act to let farmers use previously forbidden chemical pesticides and fertilizers at the risk of contaminating local waterways.

The infographic has similar lists for every agency of the federal government. Click through and see for yourselves. And weep….

 

Speaking Of Paradigm Shift…

I’ve posted before about my theory that we (i.e. all humans) are in a period of paradigm shift–defined as a time when cultures’ previous world-views are undergoing profound change. The result of that shift is that people who see the world through previous lenses and those who have adopted new ways of understanding reality cannot communicate.

Just one example: People who see the world as it is and as it is emerging understand that humans are globally interdependent; folks wedded to an older paradigm cling tightly to nationalism, exclusion and slogans like “America First.”

Remarks made by the pastor who conducts Trump’s weekly bible study (and boy, would I like to be a fly on the wall in one of those!) are an excellent illustration of the wide gap–the abyss, really–between old and new realities.

According to the Intercept

The minister who hosts a weekly bible study session for President Trump’s Cabinet has an opinion about the origins of the coronavirus. According to Ralph Drollinger, it’s just another form of God’s wrath in response to an increasingly progressive nation.

“Relative to the coronavirus pandemic crisis, this is not God’s abandonment wrath nor His cataclysmic wrath, rather it is sowing and reaping wrath,” Drollinger wrote in a series of posts. “A biblically astute evaluation of the situation strongly suggests that America and other countries of the world are reaping what China has sown due to their leaders’ recklessness and lack of candor and transparency.”

Drollinger didn’t leave it at that; he also blamed the “religion of environmentalism” and people who express a “proclivity toward lesbianism and homosexuality,” and claimed that such persons have  infiltrated “high positions in our government, our educational system, our media and our entertainment industry” and “are largely responsible for God’s consequential wrath on our nation.”

Granted, Drollinger’s worldview–like that of Mike Pence–is hardly representative of today’s  American society. (Trump, as best I can tell, doesn’t have a worldview;  he has only a Trumpview.) Drollinger, Pence, DeVos and most others in the administration–along with the cult that supports them– are extreme examples of the eras when humans explained everything they didn’t understand or couldn’t control as “God’s will.”

America’s mainstream has been inching toward a very different approach, one that respects science, empirical evidence and human agency. It recognizes that there is still much that we don’t know, much that we cannot answer or control (see: pandemics), but has confidence that with additional study and information, humans will eventually be able to answer the unanswered questions and control more of our common destiny.

The current Coronavirus pandemic may speed up the shift from reflexive attribution of everything we fail to understand to this or that deity, and toward adoption of a very different cultural and intellectual framework.

I thought about that possibility when I read a New Yorker article about Estonia, of all places. Estonia is evidently coping with the pandemic admirably.

Estonia may be the nation best prepared for the consequences of the pandemic, both economically and socially. As my colleague Nathan Heller has written, its economy is bound to tech, its government is digital, and most services in the country either are or can be provided electronically—in fact, it’s nearly impossible to overstate the extent of Estonian digitization. People vote online and use digital prescriptions; a single piece of I.D. securely stores each Estonian’s personal information, including health, tax, and police records; one can even establish residency and begin paying taxes in the country digitally—effectively immigrating online. Estonians say that only three kinds of interaction with the state require a person’s physical presence: marriage, the transfer of property, and divorce. In some cases, births had to be registered in person, but this requirement has been suspended because of the coronavirus pandemic. Ninety-nine per cent of households have broadband Internet connections, and the education system is a world leader in developing and using electronic technologies. In other words, the prospect of having to work, study, and shop online may not require the sort of readjustment in Estonia as many people face elsewhere.

I don’t mean to suggest that digitizing society is a “new worldview.” it isn’t. But it is evidence of a society that accepts change and educates for it. And acceptance of and adaptation to change definitely is a very different approach to life than that adopted by people like the Reverend and other Trump supporters, characterized by resentment of change, blaming bad fortune on the  “other,” and insisting that bigotry is “God’s will.”

Transitions are always bumpy, but the sooner Americans abandon the Trumper’s paradigm, the better.