Category Archives: Public Policy and Governance

The War On Medical Knowledge

This administration is waging a war on all sorts of research, scholarship and expertise.

MAGA Republicanism has long been an enemy of that hated “elitist” devotion to knowledge and empiricism (remember Scott Walker’s attacks on the University of Wisconsin and the “Wisconsin Idea”? He wanted to change the description of the University’s purpose from “basic to every purpose of the (University of Wisconsin) system is the search for truth” to “meet[ing] the state’s workforce needs.” )

If there remains any doubt about MAGA’s animus toward scholarship and the search for truth, one need only look at Trump’s all-out attacks on Universities and the judiciary. The universities’ commitment to empirical fact and the courts’ commitment to “fact-based” analysis are incompatible with the madman’s desire to impose his own prejudices on the American public.

Perhaps the clearest–and most horrifying– example of Trump’s assault on knowledge and expertise has been his enthusiastic facilitation of RFK Jr.’s assault on medical research, including but not limited to cancer research.

As The Washington Post recently reported,

A federal judge might have paused President Donald Trump’s attempt to slash about $4 billion for biomedical research funding through the National Institutes of Health, but the uncertainty created by the administration is already taking an immense toll on science.

Many schools and institutions have preemptively implemented cost-cutting measures in anticipation of losing funding down the line. This will, of course, curtail all sorts of crucial research happening now on disease treatments and preventions. But it will also have reverberations for years to come — potentially affecting an entire generation of future scientists.
 
The NIH has announced cancellation of its prestigious internship program–a program that gave more than 1,000 college students the opportunity to work at the agency each summer–and the National Science Foundation has downsized its research program for undergraduates. Countless doctors and medical scientists owe their careers to these programs.
 
 
Johns Hopkins University said Thursday it had begun laying off more than 2,000 workers across the globe after the institution lost $800 million in federal grants cut by the Trump administration.

As the administration has slashed funding for the U.S. Agency for International Development (USAID), perhaps no institution of higher education has been hit harder than Johns Hopkins. Among the programs targeted were a $50 million project to treat HIV while experimenting with machine learning in India and a $200 million grant to treat one of the world’s most deadly diseases in thousands of children.
 
Several other media outlets have reported on Trump Administration’s cuts to cancer and Alzheimer’s research funding, including the termination of a $5 million grant to the Herbert Irving Comprehensive Cancer Center at Columbia University. DOGE has listed that amount among DOGE’s “savings.” The vicious cuts to medical research have included pediatric cancer research funding.
 
 
The Trump administration’s effort to reshape the federal government through Elon Musk and his Department of Government Efficiency (DOGE) is raising fears among public health experts, researchers and advocacy groups of a massive brain drain and dire impacts to public health. 
 
Termination letters hit the inboxes of thousands of workers across health agencies in just the past week as the administration took a sledgehammer to the federal government.  

The employees worked on projects including studying infectious diseases, medical device safety, food safety, lowering health costs and improving maternal health outcomes. All of them are now out of a job.  

“The federal government has a huge footprint. [These layoffs] will interrupt all fields of research. Every phase of our scientific endeavor has been interrupted, including that research that is essential for our national security,” said Georges Benjamin, executive director of the American Public Health Association.  

MAGA’s Christian Nationalists evidently want to take us back to the days when “good Christians” like Cotton Mather understood diseases like smallpox to be evidence of God’s displeasure….

To believe the Trump/Musk assault is on “fraud and waste” would require us to re-define those terms. “Waste” in Musk jargon is defined as any program with which he disagrees. The fact that Congress chose to establish a program or pursue a goal is entirely beside the point, as is that pesky Constitutional provision vesting Congress–not DOGE– with exclusive authority over fiscal matters.

If there is one thing that distinguishes MAGA and its White Christian Nationalists from the rest of us, it is a seething resentment of those who differ, and especially those they consider “elitists”–defined not as people with money, (they  worship oligarchs, no matter how obviously ignorant) but people with knowledge and expertise. 

They’re thrilled with Trump’s destruction of our government, and they evidently don’t worry that they’ll get cancer…or measles.

 
 
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What The Fire Hose Obscures…

Perhaps the most disconcerting aspect of what has aptly been called the “firehose” of unconstitutional, illegal and profoundly stupid actions being taken by Trump and DOGE is the public’s corresponding inability to understand it all–to keep track of the assaults on the multiple responsibilities of government, and to recognize the immensity of the harms being done.

It’s all too easy to focus on the pettiness and bigotries–the erasures of the contributions of Blacks and women from official websites, the withdrawal of Secret Service protections from those on Trump’s extensive “enemies” list, the threats to law firms that represent people on that list…etc. etc. But while we are appalled by the lack of backbone being demonstrated by many of those targets (and all of the Republicans in Congress), we are missing less reported actions that are wreaking incalculable harms.

Last Sunday, the New York Times reported on one of those actions.

In a climate-controlled bunker in an unremarkable building in rural Aberdeen, Idaho, there are shelves upon shelves of meticulously labeled boxes of seed. This vault is home to many of the United States’ more than 62,000 genetically unique lines of wheat, collected over the past 127 years from around the world.

Though dormant, these seeds are alive. But unless they are continually cared for and periodically replanted, the lines will die, along with the millenniums of evolutionary history that they embody.

Since its establishment in 1898, the United States Department of Agriculture’s National Plant Germplasm System and the scientists who support it have systematically gathered and maintained the agricultural plant species that undergird our food system in vast collections such as the one in Aberdeen. The collections represent a towering achievement of foresight that food security depends on the availability of diverse plant genetic resources.

In mid-February, Trump administration officials at what has been labeled the Department of Government Efficiency fired some of the highly trained people who do this work. A court order has reinstated them, but it’s unclear when they will be allowed to resume their work. In the meantime, uncertainty around additional staffing and budget cuts, as well as the future of the collections themselves, reigns.

As the article notes, America’s food system relies on our ability to respond to the next plant disease or other emergent threat, and this little-known agency is essential to our preparedness. Across 22 stations maintained nationwide, 300 scientists maintain more than 600,000 genetic lines of more than 200 crop species.

The collections of some crops, like wheat, are in the form of seeds. But others, like apples (2,664 lines), must be maintained as living plants in the open field. The scientists who care for them must follow strict requirements for sustaining genetic purity so they can provide healthy viable seeds or plants to the tens of thousands of researchers and others who request them each year.

The article compares this activity to a survivalist cache. It represents a safeguard against all future challenges to growing the food we need. (You’d think a man with 13 children might care about the future of those children, if not the rest of the human race, but apparently not.)

Moving fast and breaking things may work in some sectors. But the disruptions underway threaten irreversible losses of crop genetic diversity. Such losses directly undermine the United States’ ability to ensure continued food security and dietary diversity amid challenges to our agricultural systems.

The word “irreversible” is chilling–and therein lies the challenge we face.

It isn’t just the fact that Americans have installed a collection of clowns and buffoons–in both the Oval Office and Congress– who lack any ability to govern, or even understand the purpose of government.  It isn’t their ham-handed efforts to erase evidence of diversity–much of which will be countered by  Internet sources. It isn’t even the mean-spiritedness of their attacks on disfavored “Others” (as one participant at a Town Hall put it, “what kind of people are only happy when they are hurting someone else?”). It’s the immense and irreversible damage that is being done, and the fact that the assaults are so widespread that we can’t keep track of them.

We can recover from the economic damage being done, although not without considerable pain as prices increase, tourism vanishes, and working Americans have fewer jobs and less disposable income. We will mourn the unnecessary deaths from vaccine misinformation, termination of medical research and drastic cuts to Medicaid, but the nation will survive those losses.

It’s the irreversible damage being done–to our international alliances, to food safety, to America’s promise of liberty and civi equality, and to who knows what else–that will forever mark this horrible juncture in our national story.

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Red State Blues

I don’t know indiana State Representative Chis Campbell, and I had to look up her district (26) but everyone in Indiana ought to understand the contents of her recent newsletter, detailing the losses that Indiana will sustain as a result of the carnage being wreaked by the Trump/Musk administration.

Deep-Red Indiana, where citizens love to hate the federal government, is the state third-most reliant on federal funding. We are behind only Louisiana and Mississippi (a statistic that gives credence to the frequent accusation that Indiana’s terrible legislature wants to turn Indiana into the Mississippi of the north).

According to Representative Campbell, nearly 44% of Indiana’s budget comes from federal agencies and grants.

So what are a few of the biggest impacts Trump’s plans will have on Hoosiers? Rep. Campbell lists them.

First, there’s the projected impact of Trump’s insane tariffs. The Conversation calculates that Indiana will be the third most impacted by those tariffs, losing $4.82 billion (a 1.12% decrease in our GDP), primarily in the auto, manufacturing, and agriculture industries. “The auto industry, one of Indiana’s biggest economic sectors, is expected to lose $28.2 billion because of these tariffs.”  It is projected that a Hoosier family of four will spend an extra $2,836 each year, “equivalent to half a year’s worth of utility payments.”

If Trump is successful in ridding us of the much-maligned Department of Education, Indiana will lose $1.8 billion we now get for K-12 and higher education.

The Division of Family Resources (DFR), which primarily funds schools with a high number of low-income students or students in need of special education, receives a little under $2 billion from the federal government. Indianapolis Public Schools (IPS) receives approximately $670,000 in Title III funding. These dollars help students who are learning English as a second language, and they benefit approximately 6,400 students in the IPS system. Additionally, students with disabilities rely on the DOE to enforce the right to an individualized education plan.

Then there’s Medicaid.

Congressional Republicans have proposed $880 billion in federal cuts, which would be impossible to achieve without cutting Medicaid or Medicare. Since roughly 70% of Indiana’s funding for Medicaid comes from the national government, Indiana could be in a serious bind. It’s estimated that close to 484,000 Hoosiers would lose their health care coverage if these federal cuts are passed and Indiana fails to cover the costs.

As Representative Campbell notes, the assault on healthcare isn’t confined to Medicaid. Cuts to the NIH–the National Institutes of Health–will dramatically affect Indiana University and Purdue University, both of which rely heavily on federal funding to conduct on-campus medical research.

Cuts to HUD will worsen Indiana’s challenging housing market. We are already one of the most difficult states in which to rent  (Fort Wayne is ranked the third least renter-friendly city in the U.S.). And since HUD enforces fair housing laws, Trump’s cuts to the agency will join his other efforts to revive Jim Crow.

If Trump was capable of rational decision-making, he would re-think his wildly unconstitutional Executive Orders and his support for Musk’s equally unconstitutional chain-saw “efficiencies,” because the data shows that the mayhem is hitting Red states like Indiana far harder than it is affecting Blue states.

It is unlikely that Trump understands that differential impact, or recognizes the European Union’s very deliberate effort to target its responses to his tariffs to the states inhabited by his supporters.  As the linked article from Fortune reports:

The EU measures will cover goods from the United States worth some 26 billion euros ($28 billion), and not just steel and aluminum products, but also textiles, home appliances and agricultural goods. Motorcycles, bourbon, peanut butter and jeans will be hit, as they were during President Donald Trump’s first term.

The EU duties aim for pressure points in the U.S. while minimizing additional damage to Europe. The tariffs — taxes on imports — primarily target Republican-held states, hitting soybeans in House speaker Mike Johnson’s Louisiana, but also beef and poultry in Kansas and Nebraska. Produce in Alabama, Georgia and Virginia is also on the list.

Unfortunately those of us in Red states who aren’t members of the MAGA cult will suffer along with everyone else. And of course, residents of Blue states won’t escape the effects of the combined madness (Trump, Musk) and cowardice (Republicans in Congress).

As the consequences become increasingly impossible to ignore, the resistance will grow. It is already gathering speed: over 11,000 people turned out to hear Bernie Sanders and AOC in bright-Red Greeley, Colorado, and an amazing 34,000 turned out in Denver.

Even in Red Indiana, Town Halls are packed with Americans who aren’t going down without a fight. And as the cuts to Social Security staffs make access difficult-to-impossible, those crowds are exploding.

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The Gang That Can’t Shoot Straight

When I read the astonishing news, the first thing that came to mind was a 1971 film titled “The Gang That Couldn’t Shoot Straight.” There’s a reason I frequently refer to Trump’s idiot appointees as clowns or Keystone Cops. 

But of course, it isn’t funny.

By now, you’ve undoubtedly read the media reports about a security breach so ludicrous that it could be the subject of a comic film: intelligence officers used a commercial messaging app (Signal) to discuss and coordinate a military strike against Houthi rebels. In the process, they accidentally included Atlantic editor Jeffrey Goldberg in those discussions. (Initially, Goldberg– understandably– thought the messages were part of a hoax. Only after the strike occurred as discussed did he realize the texts he’d received were genuine.)

Robert Hubbell (and many others) noted that the recklessness wasn’t simply stupid; it was criminal. As Hubbell pointed out, a government employee of lower rank who committed the same offense would be behind bars “awaiting trial without the benefit of bail. See, e.g., 18 U.S.C. § 793(f) (“Whoever . . . .through gross negligence permits [national defense information] to be . . . delivered to anyone in violation of his trust” shall be fined or imprisoned for up to ten years.”

Huffpost quoted Mayor Pete’s reaction, including the expletive:

Former Transportation Secretary Pete Buttigieg is calling out President Donald Trump and his cabinet after an “epic fuckup” accidentally gave a journalist access to a group chat detailing a planned airstrike in Yemen.
“It is getting clearer by the day that the people in charge of the American government cannot keep the American people safe,” Buttigieg said in a video posted on social media.

In the New York Times, David French addressed the breach, saying that Hegseth should resign, having “blown his credibility as a military leader.”

I’m a former Army JAG officer (an Army lawyer). I’ve helped investigate numerous allegations of classified information spillages, and I’ve never even heard of anything this egregious — a secretary of defense intentionally using a civilian messaging app to share sensitive war plans without even apparently noticing a journalist was in the chat.

There is not an officer alive whose career would survive a security breach like that. It would normally result in instant consequences (relief from command, for example) followed by a comprehensive investigation and, potentially, criminal charges.

Federal law makes it a crime when a person — through gross negligence — removes information “relating to the national defense” from “its proper place of custody or delivered to anyone in violation of his trust, or to be lost, stolen, abstracted or destroyed.”

As French and several others have commented, the incident is an example of public officials using a commercial messaging app so that they could avoid accountability by circumventing the “security infrastructure that protects defense secrets and preserves the official records of communications and decision-making by senior government officers.”

The very use of the app broke several laws. French quotes one: Department of Defense Policy Regarding Use of Unclassified Mobile Applications. Paragraph 10 in Attachment Two of that document states:

Unmanaged ‘messaging apps,’ including any app with a chat feature, regardless of the primary function, are NOT authorized to access, transmit, process non-public DoD information. This includes but is not limited . . . iMessage, WhatsApps, [and] Signal.

The use of a commercial messaging app (presumably on personal cell phones!) endangered US national security. That, in itself, was an appalling and entirely illegal lapse. But as French goes on to argue, the reckless disclosure to Jeffrey Goldberg elevates the offense to a level requiring impeachment and removal from office.

And then, of course, there’s our Madman-in-Chief’s response to this gobsmacking breach of security:

One additional unsettling aspect of the affair is that Trump claimed to know nothing about the inadvertent disclosure to Jeffrey Goldberg—even after a representative of the National Security Advisor admitted that the texts received by Goldberg were authentic. Trump is either clueless, lying, or both. There is no combination of those possibilities that reflects favorably on Trump.

The cabinet officials recruited by Trump and obediently confirmed by Senate Republicans are an embarrassing collection of know-nothings, incompetents and conspiracy theorists, leavened with a sprinkling of Russian assets. (Designations that are not mutually exclusive…)

If we needed any additional proof that the administration’s anti-DEI, anti-“elitist,” anti-woke, anti-education assaults are efforts to ensure continuation of the historic dominance of mediocre (and worse) White men over more competent women and minorities–efforts to turn back the clock to a time before individual merit mattered more than a preferred gender or skin color– the pathetic performance of these individuals should be dispositive.

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Unintended Consequences?

One of the dangers of even thoughtful policymaking is the possibility of unintended consequences; as I used to tell my students, even the best-intended legislative efforts can create unforeseen “spinoffs” that range from unfortunate to truly damaging. That’s why careful attention to policy details, consultation with people having expertise on the subject, and thorough review of available evidence are all so important.

So what happens when people in positions of authority are incapable of thoughtful policymaking and dismissive of evidence and expertise? We are about to face the consequences of policymaking by ignorant egomaniacs, and Paul Krugman has identified some of the most obvious.

Krugman notes that the new PM of Canada has ordered a review of that country’s plan to buy a substantial number of U.S.-made F-35 fighter jets, joining European nations that are similarly reconsidering their dependence on U.S. weapons.

This turn away from military dependence on the U.S. is understandable. America is no longer a reliable ally to the world’s democracies; indeed, between Trump’s turn toward Putin and his talk of annexing Canada and Greenland, we don’t look like an ally at all. Rumors that U.S. jets have a “kill switch” that would allow Trump to disable them at will are probably false, but sophisticated military equipment requires a lot of technical support, so you don’t want to buy it from a country you don’t trust.

He then considered several other emerging responses to the chaos being caused by our mad kings, pointing out that a nation “that can’t be trusted to honor agreements or follow the rule of law has to have monetary as well as political and diplomatic consequences.”

Several of those monetary consequences will be very damaging. Krugman says he’s been exploring the available data, and “U.S. exposure to foreign revulsion looks quite large.”

Military hardware isn’t the only export likely to suffer from our new rogue nation status. Our trade deficit in goods is partly offset by a surplus in services trade, but several of our major service exports will definitely be hurt by America’s turn to the dark side.

One of these is education. Many foreigners come to America to study, attracted by the quality of our colleges and universities. In 2023, the most recent year for which data are available, they spent more than $50 billion. But if you were a foreigner considering study in the U.S. next year, wouldn’t you be worried that you might find yourself arrested and deported for expressing what the current administration considers anti-American views? I would. So we can expect a hit to higher education, which, although we rarely think of it this way, is a major U.S. export.

Personal travel — basically tourism — was even bigger, more than $100 billion. But you can be sure that we’ll be seeing a lot fewer Canadians this year and next. And it won’t just be Canadians reconsidering their plans.

Media is already reporting cratering European tourism.

Krugman admits that he’s much more worried about Trump’s threat to our democracy than his bad economic policies. He also notes that– even in purely economic terms–the self-inflicted damage from tariffs and deportations is likely to outweigh the costs caused by other countries’ loss of trust in the United States. That said, those costs are real.

One way to think about this is to say that Trump is doing to America what Elon Musk is doing to Tesla, destroying a valuable brand through erratic behavior and repulsive ideology. Did I mention that Tesla sales in Europe appear to be cratering?

True, there are differences between a private business and a nation-state. I don’t think people visiting Tesla showrooms are subject to random arrest, or that Musk will kill your car if you say something he doesn’t like (although to be honest I’m not entirely sure on either count, especially since Musk seems to be running much of the government.) On the other hand, Tesla depends a lot more on buyer goodwill than the United States as a whole does.

Still, Trump’s belief that America holds all the cards, that the rest of the world needs access to our markets but we don’t need them, is all wrong. We are rapidly losing the world’s trust, and part of the cost will be financial.

I think it’s unlikely that either of our mad megalomaniacs considers the probable or improbable consequences of their actions. The hard core of MAGA cultists will refuse to acknowledge even the outcomes that negatively affect them (and the data suggests that Red states will likely bear the brunt).

We can only hope that a sufficient number of “softer” Trump supporters will realize that the costs of voting their racism have become too high.

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