Category Archives: Public Policy and Governance

Suicide By MAGA

Most of us have read about “suicide by cop”–a (hopefully rare) situation where someone desiring death purposely provokes a standoff with police. I don’t think MAGA cult members are that intentional, but I do think the result will be the same. The pandemic was a precursor: data shows that the MAGA science-deniers who refused to be vaccinated against COVID died in far greater numbers than more sane Americans.

Who coined that phrase “you ain’t seen nothin’ yet.”?

The Trump administration has already taken a meat-ax to medical research, derailing promising research into cures for cancer and Alzheimer’s and other deadly diseases. Those cuts will hurt all of us–Red and Blue alike. But as Paul Krugman recently pointed out, the administration’s radical changes in social spending, immigration policy and tariffs won’t simply hurt tens of millions of Americans — they will land disproportionately on Red, rural Americans.

The first thing you need to understand is that while rural Americans like to think of themselves as self-reliant, the fact is that poorer, more rural states are in effect heavily subsidized by richer states like Massachusetts and New Jersey.

This reality makes it inevitable that the standard conservative fiscal agenda — tax cuts for the rich, benefit cuts for the poor and middle class — hurts the heartland more than it hurts major metropolitan areas. But MAGA’s Reverse Robin Hoodism goes far beyond the standard conservative agenda, in ways that will be especially devastating to rural areas and small towns.

I’ve previously posted about Trump’s horrendous “Big Beautiful Bill” that will rob the poor to further enrich the wealthy. The bill contains savage cuts to Medicaid and food stamps, programs that will hurt all poor folks; but will disproportionately devastate Trump-supporting rural areas.

Krugman notes that Medicaid is a far more important program than most Americans realize.

Almost 40 percent of children are covered by Medicaid, with some of the highest percentages in deep red states like Alabama and Mississippi. Medicaid pays for 42 percent of births in America. And more to my point, Medicaid covers a higher fraction of the population in rural than in urban counties. So deep cuts in the program will hit Trump-supporting regions especially hard.

Ditto the impact of the drastic cuts to food stamps.

Many people–even those who are opposed to the “Big Beautiful Bill”– fail to recognize its very foreseeable impact on rural hospitals.  Hospitals in areas with low population density and a high percentage of patients who cannot pay for care struggle to stay open even now. Without Medicaid reimbursements at current levels, most will close. 

Most of us also fail to understand the role that Medicaid and Medicare spending play in supporting what Krugman calls “rural and left-behind local economies.”

For example, the economy of West Virginia no longer rests on coal mining, which employs very few people these days. It would be more accurate to say that the foundation of West Virginia’s economy is federal spending on Medicare and Medicaid. That is, in deep red West Virginia, Medicare and Medicaid are directly and indirectly a major source of income.

We are already seeing the impact of Trump’s immigration vendetta on the nation’s farmers.  Our agriculture relies heavily on hired workers, and some two thirds of those workers are immigrants–most of whom are undocumented. Farmers are already seeing the results of the threat: even workers who are legal residents or native-born citizens feel unsafe from the ICE goons who very clearly think all Brown people are illegal immigrants–so we see growing reports of workers decamping out of fear of arrest and deportation.

And then there’s the trade war.

In case you haven’t noticed, Trump hasn’t yet delivered a single one of the 90 trade deals he promised to negotiate by July 8. China has already retaliated, and others will follow. And U.S. agriculture is highly dependent on exports…

While many are now realizing that Trump’s policies will produce social and economic disaster, relatively few understand that the disaster will fall disproportionately on rural Trump voters. But of course it will. For the purveyor of Trump bibles and Trump meme coins, screwing the little guy has always been his personal style of grift. It remains to be seen if rural Trump supporters will awaken from their naivete.

Krugman is kinder than I am. I have given up any illusion that Trump voters are merely naive or uninformed. I’m pretty sure that MAGA voters are so wedded to their racism and grievance that they will support their own suicide if that’s what it takes to “own the libs.” 

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Law Versus Power

There’s a tendency to confuse the rule of law with obedience to the rules of a regime.

Within that confusion lies one of the multiple, dangerous threats posed by our current administration–a threat that became manifestly clear when Trump pardoned the January 6th insurrectionists. Autocrats can devise rules; the rule of law, however, is defined as a durable system characterized by four universal principles: accountability, just law, open government, and accessible and impartial justice.

Those elements are entirely foreign to MAGA and Trump. (Let’s face it–Trump wouldn’t even be able to define those terms…)

The chaos of the Trump administration, and the breadth of its attacks on democratic governance, have operated to distract public attention from its ongoing assault on the rule of law, and its persistent substitution of rules benefitting plutocrats and autocrats for laws benefiting society.

A recent issue of the American Prospect addressed that under-appreciated assault.

A functioning economy depends on a basic principle: cheaters shouldn’t win. But Donald Trump has tossed aside that principle, and that has real consequences. When the rules disappear, the worst actors thrive and everyone else pays the price.

In our new print issue, we examine how the collapse of financial enforcement and consumer protection is opening the floodgates to a golden age of scams. Under Trump, the referees have left the field. Civil penalties go unenforced. White-collar fraudsters are rewarded with pardons. Entire arms of the government designed to prevent theft, abuse, and discrimination are being dismantled.

It’s an intentional choice to let exploitation run wild. If there’s a way to game the system, someone’s doing it—and now they’re doing it with the government’s blessing.

The issue documented a variety of scams that have gained new security against government enforcement. One article reported on the multiple ways in which the gutting of the CFPB–the Consumer Financial Protection Bureau–has facilitated a wide variety of rackets and frauds. Another article delved into the failures of the Department of Education under Trump to protect student loan recipients from predatory lenders.

An article titled “Three Coin Monte” described what the magazine calls “the greatest and most brazen tale of corruption in history”– Trump’s crypto project. That article outlined “how Trump is using his ‘shitcoin’ to monetize the presidency and create new avenues for influence peddling.”

There’s also an explanation of a scam involving merchant cash advances. These are transactions in which tycoons sell what are effectively payday loans to small businesses and ruin their livelihoods. (We are told that one of those “tycoons” was on Trump’s pardon list in 2020; he’s back in jail, for now.)

These investigative articles are just a few examples of what happens when government fails in what has always been considered a foundational task: to prevent some citizens from taking advantage of others, to prevent the strong (or unscrupulous) from harming the weak and/or naive.

Donald Trump’s government has corrupted the very concept of law. The evidence is overwhelming: the gutting of the Department of Justice, the indiscriminate labeling of immigrants as “criminals” as justification for masked ICE agents’ thuggish behaviors, the appalling arrests of elected lawmakers on transparently false premises, orders from the administration to the EPA directing the agency not to enforce environmental rules against fossil fuel companies, the Trump family’s failure to even try to mask its monetization of the Presidency…the list goes on.

When the rule of law is replaced with rules favoring the predatory, when people in positions of authority sneer at the very notion of ethics and ethical behavior, when elected members of Congress fail to exercise their constitutional oversight responsibilities, ordinary citizens lose respect for the very concept of law. Corrupt regimes encourage lawbreaking by people who wouldn’t otherwise be scofflaws. Cynicism explodes. The trust on which societies rely evaporates.

The central goal of Project 2025 was to replace the rule of law with rules allowing selected people to exercise unrestrained and arbitrary power–power to give their sycophants and fellow-travelers free reign to plunder, but–more fundamentally– to facilitate the remaking of America into the Lily-White “Christian” nation of Project 2025’s fantasies.

In Henry VI, Shakespeare wrote “First you kill all the lawyers.” The authors of Project 2025 understood why that’s wrong. First you kill the rule of law.

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Discarding Medical Ethics

There really is no way to ignore the White supremacist and patriarchal roots of MAGA and the Trump administration. The behavior of ICE in conflating Brown skin with “illegal” status is one aspect; the bigoted nature of so many Trump’s insane Executive Orders is another. A recent federal court decision–handed down by a judge appointed by Ronald Reagan–expressed astonishment at the obvious discriminatory motive behind the administration’s NIH cuts. Etc.

Now, the administration is encouraging the VA to be “selective” in providing medical care to veterans. According to a recent report from The Guardian,

Doctors at Department of Veterans Affairs (VA) hospitals nationwide could refuse to treat unmarried veterans and Democrats under new hospital guidelines imposed following an executive order by Donald Trump.

The new rules, obtained by the Guardian, also apply to psychologists, dentists and a host of other occupations. They have already gone into effect in at least some VA medical centers.

Medical staff are still required to treat veterans regardless of race, color, religion and sex, and all veterans remain entitled to treatment. But individual workers are now free to decline to care for patients based on personal characteristics not explicitly prohibited by federal law.

Language requiring healthcare professionals to care for veterans regardless of their politics and marital status has been explicitly eliminated.

I sent this article to my cousin, a long-time cardiologist whose medical knowledge I sometime share on this site; he responded that this “goes against all the rules that guide the medical profession, not to mention against the guiding principles of this entire nation! It’s simply additional confirmation of Trump’s insanity, not that we needed it! “

According to the report, this permission of discrimination isn’t limited to patient care. “Doctors and other medical staff can also be barred from working at VA hospitals based on their marital status, political party affiliation or union activity.” The changes even apply to chiropractors, nurse practitioners, optometrists, podiatrists, licensed clinical social workers and speech therapists.

The administration claims that these changes were intended to support the president’s executive order titled “Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government”. That executive order purported to eliminate existing government protections from transgender people, and since it was issued, the VA has stopped  providing most gender-affirming care.

The administration has also forbidden a long list of words, including “gender affirming” and “transgender”, from clinical settings.

The article quoted a former VA administrator who said the changes would allow doctors to refuse to treat veterans based on the reason they were seeking care, including allegations of rape and sexual assault. Refusal could also be based upon current or past political party affiliation or political activity, and on personal behaviors like alcohol or marijuana use.

Most Americans fail to recognize just how extensive the VA is. The Department of Veterans Affairs operates the nation’s largest integrated hospital system; it has more than 170 hospitals and more than 1,000 clinics, employs 26,000 doctors and serves 9 million patients annually. It is hardly an exaggeration to say that rule changes of this sort are likely to have profound consequences.

In an emailed response to questions, the VA press secretary, Peter Kasperowicz, did not dispute that the new rules allowed doctors to refuse to treat veteran patients based on their beliefs or that physicians could be dismissed based on their marital status or political affiliation.

Dr. Arthur Caplan, a prominent medical ethics expert, called the new rules “extremely disturbing and unethical.”

The changes are part of a larger attack on the independence of medicine and science by the Trump administration, Caplan said, which has included restrictions and cuts at the National Institutes of Health and the Centers for Disease Control and Prevention, where the secretary of the Department of Health and Human Services, Robert F Kennedy Jr, last week fired every member of a key panel that advises the government on vaccines. The Guardian has earlier reported on a VA edict forbidding agency researchers from publishing in scientific journals without clearance from the agency’s political appointees.

Just one more drop in the ocean of ignorance and “othering” that characterizes MAGA and Trumpism. From the “very fine” people Trump insisted were among the bigoted rioters at Charlottesville, to his description of (majority Black) “shithole countries,” to his efforts to bar entry into America from Muslim countries, to his constant manifestations of racism, misogyny, and anti-Semitism, Trump has represented and ingratiated himself with the White “Christian” supremacists who form the base of his support.

America’s divisions aren’t political. They’re moral and ethical. And MAGA is on the wrong side of that divide.

 
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Listing The Obscenities

On Tuesday evening, I participated in a Zoom hosted by Indivisible of Central Indiana. It was focused on Trump’s “Big Beautiful Bill,” and if you can stand yet another enumeration of that insult to Americans, I’m posting my comments below.

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As Heather Cox Richardson has said, the Republicans’ “One Big, Beautiful Bill” is MAGA’s attempt to replace the government we’ve had since the 1930s with one that reflects the goals of Project 2025.

It is also an effort to rob the poor to further enrich the wealthy.

The Bill is 1000+ pages, but in this brief presentation I want to highlight the major elements—and alert you to the fact that, despite the fact that it is billed as a “budget,” it has numerous, damaging non-fiscal provisions which should be ruled non-germane in the Senate, but may not be.

Before getting to the truly horrifying fiscal mischief, let me share with you some of the most egregious non-fiscal provisions:

  • A measure to cripple the courts by prohibiting any funding from being used to carry out court orders holding executive branch officials in contempt. Passage of this measure would enable Trump and his officials to defy court orders at will.
  • The addition of billions to various parts of Trump’s deportation efforts, ramping up those efforts to the tune of an additional trillion dollars That includes $45 billion for construction of immigration jails (more than 13 times ICE’s current detention budget.) In addition, it would allow the indefinite detention of immigrant children and would charge families $3,500 to reunite with a child who arrived alone at the border. Asylum seekers will be charged an “application fee” of at least $1,000.
  • The administration would be given authority to label nonprofits as “terrorist-supporting organizations,” and terminate their tax status- an open invitation to suppress the free speech and activism of climate and civil liberties organizations, among others of which Trump and MAGA disapprove.
  • The bill would eliminate the National Weather Service, making local weather reports far less accurate.
  • One provision would allow the administration to sell off national parks.
  • A particularly ugly provision repeals the $200 excise tax on the sale of gun silencers, which have no lawful purpose other than concealing shootings.

Other bits of “fine print” more directly support the major goal of the bill, which is, as I’ve noted, to protect the extremely wealthy against efforts to get them to pay their fair share of taxes–basically, the bill exempts rich people from paying their dues to the country that made their accumulation of wealth possible. (For example, the bill would basically eliminate an Estate Tax that is already massively favorable to the top 1%.)

The “guts” of the bill are the fiscal provisions. Basically, the bill is an effort to fund the extension of Trump’s tax cuts for the rich by eliminating health care for the poor and middle class.

The Congressional Budget office estimates that as many as 16 million people would lose health insurance under the House-passed version of the bill. The annual cuts to Medicaid would average over 70 billion dollars a year—the same amount millionaires and billionaires would gain in tax cuts. The media has focused on those Medicaid cuts, but a number of analysts have explained that measures that have been minimized as “technical revisions” would essentially repeal Obamacare.

Not only would millions of individuals lose their health insurance, the consequences of these cuts would close many, if not most, rural hospitals and would have a dramatically negative impact on local economies, ironically mostly in Red states like Indiana. Economists have estimated that depressed local spending under the House bill would force the loss of 850,000 jobs. (Health care is the largest employer of any sector of the economy; it employs 18 million workers.)

Republicans who claim that they’re just adding “work requirements” to Medicaid are lying—the budget cuts 715 billion from Medicaid and 335 billion from Obamacare (the Affordable Care Act). And prior experience in the states has demonstrated that work requirements do nothing but erect paperwork barriers that throw eligible people off Medicaid; as we’ve learned from those previous efforts, Medicaid recipients who are able to work are already working—most Medicaid recipients are disabled, elderly or children.

There’s much more. The bill weakens the Child Tax Credit, by lowering the eligibility income threshold, so millions of children will suddenly become ineligible. It expands school vouchers–continuing the GOP effort to destroy public education and shift tax dollars to religious institutions, in violation of the First Amendment. It includes a variety of “Stealth Cuts’ to the Affordable Care Act that will increase out-of-pocket costs and make insurance more expensive for those people who are fortunate enough to retain it.

As if the assault on poor folks wasn’t mean-spirited enough, the bill also has deep cuts to SNAP. The House-passed version would cut nearly $300 billion from SNAP, the Supplemental Nutrition Assistance Program, according to Congressional Budget Office (CBO) estimates. That would be by far the largest cut to SNAP in history, and it would mean that millions of low-income families would lose some or all of the food assistance they need to afford groceries and feed their children.

SNAP has been the nation’s most effective anti-hunger program, and the bill cuts it by roughly 30 percent. These extreme cuts are actually deeper than the $230 billion in cuts the original budget resolution called for because the bill adds tens of billions of dollars in new spending for farm programs, and pays for those dollars by taking more food assistance away from people with low incomes.

And despite the GOP’s purported concerns about budget deficits, the bill blows up the budget deficit. According to the Congressional Budget Office, the bill will increase borrowing by a total of $2.4 trillion by 2034, because the $1.3 trillion in cuts to Medicaid, food stamps, and other programs don’t even come close to canceling out $3.7 trillion in tax cuts for the rich. Just the tax cuts going to the richest 5 percent outstrip the cuts to Medicaid and food stamps by 300 billion. If you add in interest costs, the total debt the bill creates exceeds $3 trillion.

This is just a horrible bill, and it needs to be defeated.

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Journalism In The Age Of Trump

History confirms the existence of what we might call “fringe folks” in every society–people who, for whatever reason, have embraced conspiracy theories and/or rejected credible evidence of reality. The question for our age is: how did we get to a point where these deluded and arguably dangerous individuals have assumed authority? What has enabled a certified nutcase like RFK, Jr. to hold sway over the health of Americans, or a man seemingly devoid of contact with either knowledge or reality to become President of the United States?

As regular readers of this blog know, I attribute much of this state of affairs to our current information environment–a fragmented environment that allows Individuals to “curate” their preferred realities. (I used to tell the students in my Media and Public Affairs classes that if they really believed aliens had landed in Roswell, I could find them five internet sites with pictures of the aliens…)

I think it is fair to say that one of the reasons for the proliferation of alternate media sources, including widespread propaganda outlets, has been the inadequacy of mainstream, “legacy” journalism. There’s a reason that so many of the most professional journalists have abandoned their positions with those legacy outlets and decamped to places like Substack–a reason why so many of us depend upon the daily reports from reputable scholars like Heather Cox Richardson and Paul Krugman, and look askance at news reporting that continues to “sanewash” and normalize behaviors that are objectively insane and abnormal.

A recent example: my husband and I were watching an NBC national news report on the shocking assault by administration goons on California Senator Alex Padilla, when he tried to ask a question of Secretary Kristi Noem. The report repeated Noem’s assertion that the Senator had failed to identify himself. It didn’t call that assertion a lie, despite the fact that widely available video of the incident showed that Padilla had done so. 

Shouldn’t we be able to rely on journalists to highlight lies being told by Trump’s collection of clowns and ideologues? Why has it been so difficult for legacy media to call a lie a lie?

Recently, a reader shared with me an article from the Columbia Journalism Review, exploring that question. It began,

Perhaps the most basic task of journalism is to distinguish truth from falsity. To identify the facts, and to present those facts to a readership eager for information. Journalists may once have believed that their responsibility stopped there—but in today’s media environment, it’s become clear that delivering facts to the public is not so straightforward. Distinguishing true from false, which often entails calling attention to false information, risks amplifying and even legitimizing that information. There is no better contemporary example of this problem than the media coverage of Donald Trump.

Trump’s brazen dishonesty in his public comments is without political precedent in this country. During his first term, the Washington Post’s fact-checking database clocked 30,573 untruths. That rate shows no sign of slowing during his second term, and now he seems to be combating accusations of lying by simply manipulating who is allowed in the press pool.

Granted, as the article notes, journalistic norms weren’t created for a President like Trump. The belief that “both sides” of a situation should be covered ignores the reality that both sides often don’t deserve equal weight. (It also ignores the fact that many issues have more than two sides, but that’s a different problem..)

The article argues that legacy journalists need to find new ways to talk about false information–for example, not describing a tweet or statement as “racially charged,” but as racist; calling a lie a lie, not a “misleading statement.”

The Columbia Journalism Review is a respected journal, and I was happy to see that it was taking on what has proved to be a hugely consequential problem, although its discussion is arguably too little and too late. Thousands–probably millions–of citizens now get their information (or misinformation/lies) from non-legacy sources, from the Internet’s wild west of sources peddling everything from informed analyses to ideological claptrap.

Journalists used to be gatekeepers, deciding what news was needed to keep the citizenry informed. There were certainly problems with that role, but I would argue that the information world we inhabit today–where each of us must be our own gatekeeper–is no improvement. Quite the contrary.

I wonder: If mainstream journalists had been doing their jobs these past couple of decades, would we now have a federal government composed of racist cranks and misfits and conspiracy theorists? I doubt it.

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