The Pro-Death Administration

One of the outcomes of Trump’s “culture war” approach to the pandemic during his first administration was the documented excess death rate of the MAGA partisans who refused to wear masks or get vaccinated. Although I’m unaware of research into the survival rates of the even more hard-core cult members who imbibed bleach and/or Hydroxychloroquine per Trump’s suggestions, I assume those outcomes were similarly unfortunate.

This time around, Trump is doubling down on his “angel of death” approach. 

Thanks to his “Big Beautiful Bill,”  health care costs are poised to go through the roof. As a recent essay in the New York Times put it, health spending in the United States since 1975 “has pushed down wages, fueled inequality and left families drowning in unaffordable medical bills.” The essay’s author, who teaches public health and economics at Yale, says the administration is making it worse, and that  rising health care spending is killing the American dream.

The imminent sharp rise in health insurance premiums has been front page news for several months, but unaffordable costs are just one of the health threats faced by the vast majority of Americans who cannot pay exorbitant costs out of pocket. The installation of Mr. Brain Worm as Secretary of Health and Human Services has turned America’s public health agencies over to cranks who elevate conspiracy theories over vetted medical science.

Lincoln Square recently enumerated the threats. For example, as we’ve just seen, the CDC just voted to end universal Hepatitis B vaccine recommendations for newborns, despite the fact that the mandate has demonstrably saved lives.

Now, under Trump guidance, only infants of mothers who test positive (or whose status is unknown) receive the recommendation. Everyone else? Optional. Delayed. A ‘maybe’ if the parents decide to go that route in two months.

And here’s the thing RFK Jr. and the Trump regime aren’t talking about:

Medicare and Medicaid only cover vaccines that are recommended by federal bodies like the CDC. If you cut the recommendation, you cut the coverage. And when you cut the coverage, vaccinations become a commodity. The wealthy will pay out of pocket to protect their kids. The poor will hope and wait – and hope doesn’t prevent liver cancer.

As the article points out, this most recent assault is part of a pattern that has emerged during Trump’s second term. Health protections have been shifted from a public good to a private luxury, and preventative care is being turned into something you buy, not a human right. The wealthy get immunized; the poor get sick.

The Trump administration has raised healthcare costs, reduced Medicaid access, and increased premiums and deductibles. Working individuals can’t keep up with the costs–and fewer Americans are working. 

Americans have now watched 1.1 million jobs vanish in 2025 – the most since 2020 – with Amazon alone cutting as many as 30,000 corporate positions. Not part-time workers, but white-collar analysts, engineers, and project managers who were told they would be insulated from the automation. And rather than sounding the alarms, the Trump regime has been covering for their billionaire buddies. Jobs reports? Non-existent, because the truth is politically inconvenient when corporations are firing workers in droves during the holidays.

And in a country where healthcare is tied to employment – where those who lose work fall back on Medicaid, and Medicaid only covers vaccines recommended by the CDC – the consequences compound quickly. If parents can’t access affordable healthcare, can’t find work, can’t afford fresh food, and can’t protect their children from preventable disease, then the future looks less like a safety net and more like a prison shiv. A slow attrition of the working class. A world where the wealthy live longer, healthier lives while everyone else is riddled with disease, hungry, and desperate.

For much of my adult life, I have marveled at the idiocy of America’s approach to healthcare. We pay far more–and get far less–than other first world countries, countries that long ago recognized that healthcare is a human right, and incidentally, that national coverage offers efficiencies leading to very substantial cost savings.

Trump and his MAGA GOP are rolling back Medicare, Medicaid and the Affordable Care Act–America’s incremental “baby steps” toward more universal coverage–and substituting magical thinking for medical science. They are also ensuring that only the rich will be able to protect their health and that of their children.

As the linked article asks, “Is this the collateral damage of incompetence, or the blueprint of a ruling class preparing for a future where most of us just aren’t needed?”

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Misinformation As A “Wicked Problem”

I continue to be a “when” person, not an “if” person. What I mean by that is that I become more convinced every day that America will emerge from the disaster that is Trump and MAGA, and that the pertinent questions we will face have to do with how we will repair things when that day comes and we have to repair not just the damage done by the mad would-be king, but the structural flaws that enabled his unfit occupancy in the Oval Office.

Political scientists, sociologists, lawyers, law professors and a wide variety of experts in other fields are already offering their perspectives on how to address the Supreme Court’s corruption, protect Americans’ voting rights, jettison (or at least alter) the filibuster, and neuter the Electoral College– proposals intended to fix the structural weaknesses that have become all too obvious.

In most of these areas, we’ll undoubtedly argue about the approaches and details, but fixes are possible.

There is, however, one truly enormous problem that has no simple answer. As I have repeatedly noted on this platform, we live today in an absolute ocean of mis- and dis-information. There are literally thousands of internet sites created to tell us untruths that we want to believe, technologies that were created to mislead, cable and streaming channels in the business of reinforcing our preferred biases–even psuedo-education organizations that exist solely to propagandize our children. There is no simple remedy, no policy prescription that can “fix” the Wild West of our “information” environment–and virtually any effort to shut down propaganda will run afoul of the First Amendment and its essential Free Speech guarantees.

The widespread availability of misinformation is what academics call a “wicked problem.” Wicked problems have a number of characteristics that make them difficult to manage and– practically speaking– impossible to actually solve. They can’t be fully defined because their components are constantly changing; there’s no one “right” solution– possible solutions aren’t true or false, but rather good or bad, and what’s good for one aspect of the problem might exacerbate another part (in other words, the interconnections mean that solving one part of the problem can easily aggravate other parts); and there’s no clear point at which you can say the problem is solved.

Misinformation is a whole set of wicked problems– on steroids.

As a Brookings Institution publication put it some time back, 

Disinformation and other online problems are not conventional problems that can be solved individually with traditional regulation. Instead, they are a web of interrelated “wicked” problems — problems that are highly complex, interdependent, and unstable — and can only be mitigated, managed, or minimized, not solved.

The Brookings paper recommended development of what it called “an architecture” that would “promote collaboration and build trust among stakeholders.” It noted the availability of several models that currently promote collaboration among a number of  stakeholders, including the Global Internet Forum to Counter Terrorism (GIFCT) and the Information Sharing and Analysis Centers (ISACs). These and similar successful organizations have learned how to adapt and innovate, and have focused on trust-building and information-sharing.

Any effective effort to counter misinformation and propaganda will need to go beyond the creation of other, similar organizations. If and when we re-institute a rational government and are gifted with a working Congress, there will be a role for (hopefully thoughtful) regulation. And of course, long term, the most effective mechanism must be education. Students need to be taught to recognize the difference between credible and non-credible sources, shown how to spot the markers of conspiracy theories and propaganda, and given tools to distinguish between deep fakes and actual photography.

The crux of the problem, of course, is that all-too-human desire to justify one’s particular beliefs and biases–the allure of “information” that confirms what that individual wants to believe. We all share that impulse, and its existence is what makes the manipulation of data and the creation of “alternative” facts so attractive. It’s also what feeds “othering,” bigotries and self-righteousness.

The persistence of that very human desire is what makes misinformation–also known as propaganda–such a wicked problem.

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About That MRI…

I know it is dangerous to get one’s “news” from Facebook and/or other social media platforms, but I was sufficiently intrigued by a post I came across to do some due diligence–to research its accuracy and check it out. The post in question noted that a drug named Leqembi is used to treat early symptoms of Alzheimers, that it is administered via infusion (often through the back of the hand), and that its use requires monitoring via regular MRIs.

The post ends with “why am I mentioning this? No reason,” a tongue in cheek disavowal of the obvious purpose of sharing the information. As most readers of this post will immediately recognize, the information–if accurate–is a likely explanation of the bruises on the back of Trump’s hand and the recent MRI he has been unable to explain. It is certainly consistent with the mental deterioration everyone outside the MAGA cult has observed.

The results of my (admittedly unscientific) research suggest that the post accurately describes the nature and purpose of Leqembi–  generic name lecanemab. It is described as a drug that “targets amyloid-beta (a protein) in the brain,” and it was developed because medical experts believe that amyloid-beta plaques (otherwise known as clumps in the brain) play a key role in the development of Alzheimer’s disease.

Leqembi binds to these proteins and helps to clear them, slowing the progression of the disease. It isn’t a cure; rather, it’s
considered a “disease-modifying” therapy.

The Alzheimer’s Association describes it as follows: 

Lecanemab (Leqembi®) is an antibody intravenous (IV) infusion therapy that targets and removes beta-amyloid from the brain. It has received traditional approval from the U.S. Food and Drug Administration (FDA) to treat early Alzheimer’s disease, including people living with mild cognitive impairment (MCI) or mild dementia due to Alzheimer’s disease who have confirmation of elevated beta-amyloid in the brain. Leqembi lowers beta-amyloid in the brain and reduces cognitive and functional decline in people living with early Alzheimer’s.

Leqembi is administered by intravenous (IV) infusion every two weeks, and regular MRI scans are required.

Before starting treatment, there’s a baseline brain MRI, and during treatment, regular MRIs monitor for abnormal changes in the brain like swelling or bleeding, something that can occur when amyloid is being cleared. The manufacturer advises that additional MRIs be given before the 5th, 7th, and 14th infusions, and additional MRIs may be required if certain symptoms arise–symptoms that include confusion, visual changes, dizziness, edema, and gait problems.

There’s a reason doctors and psychiatrists consider it unethical to diagnose from a distance–absent an actual, in-person medical or psychological examination, there is no way to explain behaviors or symptoms with any certainty. In Trump’s case, his refusal to disclose accurate medical information (or for that matter, accurate financial information, i.e. tax returns) understandably gives rise to speculation that may or may not prove accurate. We should acknowledge that, but it is also obvious that the description of Leqembi–the reasons for prescribing it, the method of its administration, the need for MRIs, and the enumeration of the side effects–are consistent with what anyone looking at this walking (limping?) disaster of an egomaniac can see.

In a sane world, a situation where doctors are treating a president for a condition that clearly and negatively affects decision-making would immediately trigger invocation of the 25th Amendment. In our world, where a delusional president and would-be King surrounded by sycophants, grifters and assorted incompetents, a diagnosis of Alzheimers is just one more reason to dissemble, to cover up, to pretend that “Dear Leader” is hale and hearty.

The King isn’t naked, he’s wearing beautiful clothes.

This is unlikely to end well….

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The Aftermath

Those of us outside the MAGA cult see Trump’s steady deterioration. Granted, he’s always been mentally ill, intellectually deficient,  massively ignorant, and a purveyor of ugly rhetoric, but his daily descent–both mental and physical– from even that very low bar is impossible to miss.

So what happens when he’s gone? What happens when the cult loses its Jim Jones?

In an essay in Lincoln Square, Rick Wilson revisits the aftermaths of other strongman regimes, and makes several predictions. (My favorite: an aside suggesting the inevitability of his grave becoming “the largest public all-gender restroom in history.”) Snark aside, Wilson notes that the public discussion has yet to address the chaos and bloodshed that so frequently comes after the collapse of systems built around a single man. As he warns, that’s when a supposedly unified movement turns into a feeding frenzy among the sycophants who have been rewarded not for competence but for “fealty, loyalty, public and private obeisance.”

Autocrats are very good at seizing power and holding it. They are very bad at leaving it behind without blowing something up on the way out. Political scientists have long argued that personality cult regimes are especially fragile at succession because the leader spends his life eliminating rivals rather than training successors.

Wilson points to a long succession of cult figures, beginning with Nero and extending through Mussolini, Stalin and Mao. The more a system is in thrall to one man,” the less prepared it is for the day that man disappears. “The court that spent years flattering him is suddenly full of men who see an empty chair they crave beyond words and reason.”

Franco’s Spain. Romania’s Ceausescus. Libya’s Ghaddafi. Dozens of cases exist in the modern era, including, of course, the Austrian Guy. Some age out. Some lose wars.

In each case, the same thing happened. The autocrat spent his life telling the country that he alone embodied the nation. He hollowed out institutions, punished independent power centers, and promoted flatterers over equals. When he left the stage, he did not leave behind a constitutional order; he left behind a mob of ambitious men in the same room.

If you zoom out, scholarship on personality cults and personalist regimes boils it down to a few core truths, and in the age where Trump is dying before our eyes, we’d better get ready to watch them play out…and exploit the chaos to slap autocracy back into its hole.

Wilson tells us that the more central the person has become, the more dangerous the aftermath. He describes three possibilities: the movement may fracture into rival factions (in which case, he predicts a Vance/Cruz/Rubio/DeSantis knife fight); the cult converts into a dynasty (Donald Jr. is already ramping up–as Wilson says, “you don’t think the Trumps are giving up all this money, do you?”); or the movement is forced into a larger “transition” because it’s too weak to carry on without its human idol.

Donald Trump has spent almost a decade turning the Republican Party from a political party into a cult. The party platform literally dissolved into “whatever Trump says.” Candidates run on loyalty to him more than any coherent ideology. The conservative media ecosystem revolves around his moods, his grudges, and his need for constant adoration. If that is not a proto-cult, it is a full-dress rehearsal.

Wilson says the sycophants who aspire to follow Trump come in three factions: the zealots who picture Trump as some kind of quasi-religious figure, and who won’t move past him will be the core of Don Jr’s 2028 campaign. Then there are the courtiers– the family, money men, and figures like JD Vance who’ve been cultivating their ties to billionaires and Silicon Valley reactionaries, who claim to be the only people who can keep the base and the money together. Finally, there are post-Trump aspirants like Marjorie Taylor Greene and Ted Cruz.

Wilson’s conclusion? “When Trump finally fails to answer the bell, either politically or biologically, do not expect a solemn passing of the torch. Expect the Roman script with better lighting and worse hair.” There will be competing Right wing factions fighting for the same base, scapegoating and accusing each other of treachery (a la Mao’s “Gang of Four”). And he predicts “historical rewrites that would make a Soviet propagandist blush.”

Bottom line: MAGA won’t disappear when Trump does.

The energy that once ran vertically, from base to Leader, will start to run horizontally, between camps and claimants. That is where movements get creative, and reckless, and violent.

You really need to click through and read the whole essay.

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An Immoral Slum Of An Administration

I’ve posted several times about the misuse of political labels and the unfortunate effects of that language misuse. It is especially misleading to call MAGA and Trump “conservative.” They are the antithesis of genuine conservatism, and the ranks of the Never Trumpers are filled with pundits and political figures who are conservative, just not neo-Nazis.

If you need any confirmation of that assertion, read this recent column by George Will.

I almost never find myself in agreement with Will. I not only disagree with a majority of his policy prescriptions, I’m put off by the arrogance and pomposity of much of his writing. That said, when a Republican administration has lost George Will, they’ve lost any connection to intellectually respectable conservatism.

Will doesn’t pull any punches. His first sentence is: ” Secretary Pete Hegseth seems to be a war criminal. Without a war. An interesting achievement.” And he proceeds from there. After repeating the facts that have emerged, he writes that “the killing of the survivors by this moral slum of an administration should nauseate Americans. A nation incapable of shame is dangerous, not least to itself. As the recent “peace plan” for Ukraine demonstrated.”

Will then turns to the “peace” proposal that Trump demanded Ukraine accept, noting Rubio’s initial confession that the proposal had been delivered to an American official by Russia–and that he told members of the Senate that the proposal didn’t represent America’s peace plan. Mere hours later, he reversed himself, taking to social media to assert that the United States had “authored” the plan.

Two weeks ago, the chief of staff of the French army said: “We have the know-how, and we have the economic and demographic strength to dissuade the regime in Moscow. What we are lacking … is the spirit which accepts that we will have to suffer if we are to protect what we are. If our country wavers because it is not ready to lose its children … or to suffer economically because the priority has to be military production, then we are indeed at risk.”

Putin has surely savored the French recoil from these words. And he has noticed that, concerning Ukraine and the attacks on boats near Venezuela, the Trump administration cannot keep its stories straight. This probably is for reasons Sir Walter Scott understood: “Oh, what a tangled web we weave,/ when first we practise to deceive!” Americans are the deceived.

If there was any doubt of the accuracy of Will’s analysis, publication of the 2025 National Security Strategy (NSS) should confirm it. As Heather Cox Richardson has written, it represents a dramatic retreat from the foreign policy goals the U.S. has embraced since World War II.

After a brief introduction touting what it claims are the administration’s great successes, the document begins by announcing the U.S. will back away from the global engagements that underpin the rules-based international order that the World War II Allies put in place after that war to prevent another world war. The authors of the document claim that the system of institutions like the United Nations, alliances like the North Atlantic Treaty Organization, and free trade between nations that established a series of rules for foreign engagement and a web of shared interests around the globe has been bad for the U.S. because it undermined “the character of our nation.”

And the document makes it very clear what this administration believes is the true “character of our nation.”

Their vision of “our country’s inherent greatness and decency,” requires “the restoration and reinvigoration of American spiritual and cultural health,” “an America that cherishes its past glories and its heroes, and that looks forward to a new golden age,” and “growing numbers of strong, traditional families that raise healthy children.”

Observers referred to the document as National Security Council Report (NSC) 88 and noted that it could have been written in just 14 words. White supremacists use 88 to refer to Adolf Hitler and “fourteen words” to refer to a popular white supremacist slogan…

The document is a White supremacist manifesto. It rejects immigration, denounces “the disastrous ‘climate change’ and ‘Net Zero’ ideologies” that it claims have harmed Europe, threatened the United States, and operated to subsidize our adversaries. It further distances the U.S. from NATO.

The upshot is that the document “reorients the U.S. away from traditional European allies toward Russia.” It characterizes Europe’s current course as one leading to “civilizational erasure” and calls for reassertion of “Western identity,” (by which it clearly means White.)

It may be the most shameful document produced by this “Immoral slum” of an administration.

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