Project 2025 And Health Care

As we all know, the United States is the only first-world country without a national health-care program. While the approaches differ, most advanced countries consider access to healthcare a human right–not a consumer product. Here in the US, efforts to extend that access–Medicare, Medicaid, and more recently the Affordable Care Act–have been met with hysterical claims that such programs are “socialism” and incompatible with freedom.

I’m not the first person to note that these critics don’t seem nearly as upset by programs that can accurately be labeled “socialism for the rich.” Increasingly, American economic policy, with its generous tax advantages and outright subsidies, seems to be socialism for the rich and brutal capitalism for the poor. But a dissertation on that topic is for another day.

The scolds who resent any effort to make health insurance more affordable or accessible are among those who have produced the Heritage Foundation’s Project 2025, so we shouldn’t be surprised by the Project’s health care proposals. Neither should we con ourselves into believing that Project 2025 isn’t an outline that Trump will follow if elected–there is ample evidence to the contrary.

So–what health policies would another Trump Administration pursue?

A doctor writing in Time Magazine has recently explained why voters need to understand that agenda–especially when it comes to healthcare– and take it seriously.

Sponsored by the right-wing think tank, the Heritage Foundation, the Project 2025 policy agenda was written by more than 400 conservative experts and published in a book titled Mandate for Leadership: The Conservative Promise. While Trump has publicly disavowed the initiative, he has endorsed (and even tried to implement) many of its core proposals, several of which were penned by his former staffers.

The Biden Administration’s Inflation Reduction Act (IRA) has made life-saving drugs like insulin more affordable. Project 2025 calls for its repeal.

The Inflation Reduction Act (IRA)—signed into law by President Biden two years ago—capped insulin costs at $35 per month for people on Medicare. The data show that this cap increased the number of insulin prescriptions that were filled, ensuring more patients with diabetes got what they needed to stay healthy. The IRA will also cap annual out-of-pocket spending on prescription drugs (not just insulin) for seniors starting next year. And despite aggressive lobbying and legal challenges from drugmakers, the law empowered Medicare to negotiate prices with Big Pharma for the first time in history, achieving significant discounts and saving billions. These are just a few of the many reasons more than 500 health professionals recently signed an open letter to protect the IRA.

Other provisions of Project 2025 would reduce access to Medicaid. Currently, more than 70 million low-income Americans rely on Medicaid for health care. The Project proposes lifetime caps on benefits and the addition of work requirements as a condition for coverage, among other onerous changes.

Unsurprisingly, Project 2025 would not only restrict abortion at the national level, it would also eliminate no-cost coverage for some contraception. (Those Right-wingers really want women to breed….) Of course, once children have been produced, concern for their welfare vanishes.

Project 2025 takes particular aim at the well-being of children. The authors seek to prevent public health agencies from requiring vaccination in school children, which could cause more outbreaks of preventable diseases like measles. They also propose invalidating state laws intended to stem gun violence, a leading cause of death for children in the U.S. Project 2025 would even eliminate Head Start, a critical program for early childhood development, especially in low-income and rural communities.

As the doctor writes, implementation of even a few of these proposed policies would set back decades of progress in medicine and public health.

The Harris/Walz ticket has used the slogan “We Won’t Go Back.” The usual interpretation of that phrase is that it refers to women’s reproductive liberty, but it actually–and accurately– describes what is really at stake in November’s election. MAGA is a movement entirely focused on taking America back–back to a time when women were property, Black and Brown people second-class citizens, LGBTQ+ people closeted, and adequate medical care a consumer good available only to those who could afford it.

I don’t know when opposition to vaccination and common-sense public health measures became part of the ideology of the Right. I don’t know why MAGA folks think the working poor aren’t entitled to health care. I don’t understand their evident belief that government should cater to White Christian males to the exclusion of other citizens.

But I do know they’re stuck in a past that I don’t want to return to. When people say this election poses an existential choice, they aren’t engaging in hyperbole.

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Let’s Talk About Economic Performance

One of the recurring questions on presidential polls asks respondents for their perceptions of economic performance.
Although Kamala has bested Trump in a couple of recent polls, it has really rankled me that so few Americans have recognized and/or appreciated either the damage Trump did to the economy or the Biden administration’s incredibly successful management of it–management that financial markets and economists acknowledge was masterful, and brought the U.S. out of the pandemic downturn faster (and better) than any other country.
Knowledgable observers compare Biden’s performance to that of FDR. He will go down in history as one of America’s most consequential Presidents. In my humble opinion, the lack of popular recognition of his performance is attributable to his relative lack of oratorical skills–if Biden had the oratorical gifts of an Obama, perhaps a general public fixated on celebrity, salesmanship and hype (and too lazy to consult evidence and data) would have appreciated the extent of his administration’s accomplishments.
The Democratic convention got underway Monday, and in his speech, Biden justifiably reminded listeners of his “greatest hits.” In a column about the convention and the speech, Jennifer Rubin focused on Biden’s economic and foreign policy performance, noting the historic pieces of legislation Biden managed to pass even when the House of Representatives was in the hands of a partisan–and looney– GOP: measures on infrastructure, microchip manufacturing, and green energy investment. Cost controls on insulin and a variety of prescription drugs for Medicare patients. A massive operation to immunize Americans against the coronavirus, despite what Rubin called–accurately– “irrational and destructive” Republican opposition. That operation saved thousands of lives in addition to allowing the U.S. economy to recover. 

These domestic successes accompanied equally impressive foreign policy accomplishments: “repairing and expanding NATO, arming Ukraine, reestablishing the United States’ credibility on the international stage, new and reinvigorated alliances to check China’s power).”

Kamala Harris has been part of the Biden administration, and can be expected to continue the policy approaches that have been so successful. There will be some “tweaks,” but she has administration “bragging rights.” She is running on four years of demonstrated, excellent performance.

So, you might ask, what are Donald Trump’s “bragging rights?” My sister recently listed them, and seeing them all in one list was–shall we say–edifying:

First President in history to serve a full term and increase the deficit every year he was in office.

First President in history to maintain a debt to GDP ratio over 100% for his entire term

Highest annual budget deficit.

Most added to the national debt in a single term.
Most new unemployment claims.
Largest single day point drop in the history of the Dow.
First President in almost a century to lose jobs in his first term.
Longest government shutdown in history (and he did that while his own party controlled both chambers of Congress).
In addition to that dismal economic performance, Trump was also the first President to lose the popular vote twice, the first to maintain a net negative approval rating for his entire term, first to be impeached twice (with bipartisan support for his conviction after both impeachments) and, as we know, the President with the most indictments, guilty pleas, and criminal convictions of members of an administration.
The first to be a convicted felon.
The only people who cheered Trump’s economic policies were the super-rich, who benefitted from his tax cuts–cuts that placed the tax burden squarely on the middle class, and further enriched the wealthiest Americans.
You know what to do. VOTE BLUE.
Listen to the nuns….
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History Is Rhyming…

Note: yesterday’s “extra” post was an accident. Sorry for the assault on your inboxes!

Like many readers of this blog, I subscribe to Heather Cox Richardson’s daily “Letters from an American.” Having come through an education system notoriously light on comprehensive history, I find her daily expositions of America’s past very enlightening–especially when I learn about the details of past events that bear an uncanny resemblance to our current quandaries.

A recent Letter made me think of the quip attributed to Mark Twain, to the effect that while history doesn’t necessarily repeat itself, it frequently rhymes.

Richardson was comparing our current divisions with those that triggered the founding of the Republican Party–and the Civil War. The GOP, ironically, was formed to fight slavery and uphold the premise of the Declaration that “all men are created equal.” In the years since the Civil War, we’ve seen the parties change places–the Democrats have become the party defending human equality, while today’s GOP looks very much like the combination of racists and plutocrats that characterized the old Democratic Party.

What really struck me was the sense that we’ve returned to that age-old fight. The parties may have switched sides, but the nature of the battle remains depressingly familiar.

After providing details of the events leading up to the demise of the Whigs and the formation of a new Republican Party–a party formed to combat the notion that some humans are superior to and entitled to rule over others by virtue of their skin color– Richardson compared that era to our own.

When voters elected Lincoln president, the fledgling Republican Party turned away from a government that catered to an oligarchy trying to overturn democracy and instead reinvented the American government to create a new, active government that guaranteed to poorer men the right to be treated equally before the law, the right to a say in their government, and access to resources that had previously been monopolized by the wealthy.

The present looks much like that earlier moment when people of all different political backgrounds came together to defend the principles of the United States. In today’s moment, when someone like J.D. Vance backer billionaire Peter Thiel says, “Democracy, whatever that means, is exhausted,” and the Republicans’ Project 2025 calls for replacing democracy with Christian nationalism, it makes sense for all people who care about our history and our democratic heritage to pull together.

Richardson noted that there are some in the GOP who recognize the threat posed by a MAGA party that looks a lot like the Confederacy.  She quoted Olivia Troye, who served in the Trump White House, and who is now working with Republicans for Harris. Troye has called upon Mike Pence to endorse Harris, and is quoted as saying that

“[W]hat is happening here with the Republican Party… is dangerous and extreme. And I think we need to get back to the values of…observing the rule of law, of standing with our international allies and actually providing true leadership to the world, which is something that Kamala Harris has exhibited during the Biden Administration.”

(As an aside, I’d be shocked if Pence had the spine to endorse Harris…I’m pretty sure that his one moment of integrity in refusing to go along with Trump’s coup exhausted his ability to do the right thing. I hope I’m wrong, but I think his four years of utter, embarrassing sycophancy are more consistent with his character than that one example of moral courage…)

Richardson’s comparison of that pre-civil war era with our own is apt. There are differences, of course, but the choices Americans face today certainly “rhyme” with the choices that confronted Americans then. Once again, We the People are facing a frontal challenge to the most basic premises of our founding documents–premises that we have admittedly never quite lived up to, but that we have (mostly) continued to pursue.

There’s a lot wrong with American society today, but most of it is fixable–if we elect public servants who are honorable and who–in the words of Olivia Troye–are committed to the rule of law, to standing with our international allies, and capable of providing what has been called servant leadership.

Richardson reminds us that we’ve been here before, and the good guys prevailed. If we want to preserve the country they saved–if we want to turn back the White Supremacists and plutocrats of today’s GOP–we’ll vote Blue in sufficient numbers to drive the lesson home. A Blue wave would–ideally– lead to the disintegration of MAGA and a return of the GOP to normalcy.

Or perhaps, as with the Whigs, the creation of a new, saner political party.

I can live with either result.

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The Difference Between Red And Blue

Sensible people who follow politics have abandoned what was–in more civil times–reasonable advice. We used to be urged to vote for individual candidates rather than voting a straight ticket based on party. When there was considerable overlap between Republicans and Democrats, and voters could anticipate bipartisan support for policies, voting for the person made some sense.

It no longer does. 

Republican candidates today come in two flavors, and only two flavors: rabid MAGA White Supremacists and spineless suck-ups. Even if  GOP candidate A seems less than enthusiastic about Christian Nationalism, there is zero likelihood that Candidate A will depart from the party line. Any vote for any Republican is a vote for MAGA, full stop.

Permit me to share two relevant examples.

At the very top of the GOP ticket we have Trump and his Vice-Presidential candidate, JD Vance. That Vice-Presidential choice is consequential, because Trump is old, and–in addition to his more and more obvious senility–clearly unhealthy. If he is elected, Vance, who has only a few months of experience in government, would likely become President.

And what do we know about him, other than his opposition to abortion for any reason and his disdain for childless cat ladies? Well, Talking Points Memo recently shared his cozy connection to Neo-Nazis.

Vance has had a six-figure stake in Rumble, an online video platform. The company has played host to Russian propaganda and to far-right personalities like Stew Peters and Tim Pool. It has also featured even more extreme content, including explicitly neo-Nazi images and themes like this song touting the “Reich” and calling for Jews to be placed in ovens from a “dissident rapper” with a dedicated page on the site. The site features a plethora of channels and videos dedicated to the concept of “white genocide,” which is a core belief for white supremacists. It also hosts channels for explicitly white supremacist organizations including VDare and Patriot Front, which has led masked demonstrations around the country. 

Nice guy. Not. (And that lack of niceness–that weirdness— becomes especially obvious when contrasted with uber-nice coach Tim Walz.)

Here in Indiana, we have Micah Beckwith, self-identified Christian Nationalist, on a ticket with MAGA Mike Braun, fellow theocrat Jim Banks and far-right sleaze Todd Rokita.  The entire ticket is terrifying, but–credit where “credit” is due–Beckwith is willing to put his bigotries front and center. On his website, he has posted a diatribe attacking both the LGBTQ+ community and those faux Christians who counsel acceptance of their gay neighbors.

The entire essay, titled HOMOSEXUALITY, MARRIAGE, AND SEXUAL IDENTITY, is breathtaking in its arrogance. 

A reaffirmation of biblical teachings has become all the more urgent because writers sympathetic to the LGBT (Lesbian/Gay/Bisexual/Transgender) communities have advanced revisionist interpretations of relevant biblical texts that are based upon biased exegesis and mistranslation. In effect, they seek to set aside almost two thousand years of Christian biblical interpretation and ethical teachings. We believe these efforts are reflective of the conditions described in 2 Timothy 4:3, “For the time will come when people will not put up with sound doctrine. Instead, to suit their own desires, they will gather around them a great number of teachers to say what their itching ears want to hear.” 

In other words, if mainstream theologians disagree with those who wrote this, well, they’re clearly wrong! Only fundamentalists like Beckwith understand what God demands…The essay asserts that “there is abundant evidence that homosexual behavior, along with illicit heterosexual behavior, is immoral and comes under the judgment of God,” and it continues with several lengthy sections explaining why all gay people are disgusting sinners.

Beckwith has made clear his firm conviction that not only are his religious beliefs the only correct ones, they are beliefs that government must impose on the rest of us. During his brief “service” on a Hamilton County library board, he demanded that books portraying gay people be excluded from the collection, and that other materials in conflict with his rather peculiar notions of godliness be censored. Beckwith rejects the First Amendment’s Separation of Church and State.

Vance and Beckwith are entirely representative of today’s GOP. 

The disclosure of Project 2025–produced by multiple Trump allies and lauded by Vance–opened a window into the GOP’s  obsessions and hatreds. Forget e pluribus unum. Forget the Bill of Rights. These are people who firmly believe that American law should privilege their retrograde beliefs–and that anyone who isn’t a straight White “Christian” male should be excluded from the equal protection of the laws. 

In November, voters will choose between the America envisioned by the Founders (Blue) and the theocratic fantasies of MAGA as exemplified by JD Vance and Micah Beckwith (Red).  

Vote Blue.

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What Is Merit?

You’ve got to give Trump “credit” for one thing: he publicly expresses all the most vile racist tropes embraced by the MAGA movement. His attack on Kamala Harris as a “DEI” candidate is on a par with his constant assertions that people of color are either criminals or bums (or “not the finest” people…). Too bad America doesn’t get more immigration from Norway…

One of the most persistent accusations that bigots like Trump level at efforts aimed at erasing the structural effects of decades of discrimination is that such efforts necessarily disregard merit–that attempts to diversify a workforce or a student body inevitably result in a less-effective workforce or a “dumbed down” classroom.

The problem with that accusation is that it rests on a deeply-held conviction that merit is something that “those people” obviously lack, rather than on an accurate understanding of what constitutes merit and how we measure it.

Persuasion recently featured an interview between Yascha Mounk and Simon Fanshawe on just that topic. Fanshawe does a good deal of diversity work rooted in the philosophies of John Stuart Mill and other Enlightenment figures, and Mounk asked him how his approach differs from other diversity efforts. Fanshowe responded that “diversity inclusion” is about trying to understand what people’s different experiences bring to joint enterprises.

What organizations or businesses really have is a bunch of strangers brought together to achieve a common objective, whether it’s making pizzas or teaching a course at university or putting a man or woman on the moon. And my proposition to them is that it’s through their differences, what they each differently bring to that task and its different components—that’s why diversity matters. And one further thing that I would say is that there’s a key difference when we think about this notion of diversity. We think about the deficits. In other words, you can look at data and you could look at where the imbalances are between different groups of people. But there’s another element of this which is the diversity dividend, and that’s what happens when you start to combine the differences. Diversity is absolutely a talent strategy if you’d like to achieve common objectives.

When Mounk questioned him about the widespread notion that diversity efforts necessarily downplay merit-based hiring, Fanshawe’s response was, in my opinion, exactly right.

What I would say is that you need to think about what you mean by merit. In other words, what do you value and what people are able to bring it into organizations? Typically what you have is that merit is largely based on a technical notion, on a professional skill notion. They will bring that technical skill. But the truth of it is there’s a kind of skill threshold when you’re trying to fill a job or create a team. But then the question is, what else is that person bringing? And I’m not suggesting, ever, that people should be recruited because of who they are. I’m saying that, actually, it’s not who they are that matters. It’s what they bring through who they are…

 So what I would say is that if we start to think of merit as being that combination of skill and then also the knowledge of that and the experience you bring through who you are and your personality, then what you start to do is to combine a number of things with other people. So it’s important to recognise that the members of certain groups and certain members of those groups experience disadvantage. But it’s not a uniform experience. It’s not an all-day experience. I often say that the thing about prejudice for lesbians and gays is we might experience discrimination every day, but we don’t any longer experience it all day.

Let’s reevaluate merit, because what you often have in jobs is that people have an assumption about the merit that’s required for the job. They then recruit to that assumption and that assumption is never challenged. And in effect what it can do is cut out people who actually have got enormous amounts of talent they could bring to that job but they’re just not perceived as being suitable for it.

That last paragraph really speaks to the issue of prejudice. Not prejudice for or against certain groups of people, but the “pre-judging” that so often occurs in formulating job descriptions. What are the skills this job really requires? If that skill list is too narrow, the business or organization will overlook applicants who would be enormous assets.

Of course, the MAGA cult doesn’t consider such possibilities.

Like Trump, they define “merit” as White skin, a penis, and a “Christian” label.

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