Trump and healthcare

Many left-lib­er­als are cur­rently cel­eb­rat­ing the col­lapse of the Re­pub­lic­ans’ pro­posed health­care bill, which would have “re­pealed and re­placed” Obama­care. There is good reas­on to cel­eb­rate, of course: the AHCA would have likely been even more dis­astrous than the ACA has proved to be. But some pun­dits seem to think that this, along with the on­go­ing Rus­sia in­vest­ig­a­tion, will be enough to sink Trump’s pres­id­ency. Fi­nally, they say, after months of scan­dal and dip­lo­mat­ic faux pas, the or­ange men­ace will be laid to rest. Re­id Kane Kot­las spells out why this isn’t ne­ces­sar­ily the case:

Don­ald Trump did not lose; he got ex­actly what he wanted. He let the Re­pub­lic­an es­tab­lish­ment dis­cred­it them­selves. Re­peal­ing Obama­care was not Trump’s is­sue; it’s been a Tea Party hobby­horse since the bill first passed in 2010. They couldn’t even re­peal it with a sol­id Re­pub­lic­an Con­gress, which just demon­strates the depth of di­vi­sion with­in the party. Con­gres­sion­al GOP lead­er­ship now look bad in the eyes of their own sup­port­ers, which strengthens Trump’s lead­er­ship role in the party.

Trump is only in of­fice be­cause he’s been ex­ploit­ing and ex­acer­bat­ing that di­vi­sion since he first an­nounced his can­did­acy. Mean­while, as the ACA gets worse and worse, it just re­flects neg­at­ively on the Demo­crats who passed it in the first place. So Trump won. If you don’t get that, you don’t get polit­ics.

All this should be fairly ob­vi­ous to any­one not caught up in the 24-hour news cycle, with its con­stant bar­rage of bull­shit re­port­age. What happened with health­care is that Trump handed the House Re­pub­lic­ans an un­ex­ploded gren­ade with the pin already re­moved. He let them in­de­cis­ively juggle it around be­fore blow­ing them­selves up. Now if Trump wants to move in an­oth­er dir­ec­tion, even a drastic­ally dif­fer­ent dir­ec­tion — something like, say, uni­ver­sal single-pay­er health­care or medi­care for all — he can hon­estly say to Paul Ry­an and the rest of the GOP, “You had your chance.”

Corey Robin, humbled in his polit­ic­al pre­dic­tions ever since Trump won the elec­tion, hoped “that the rage of the GOP would over­whelm its reas­on.” Trump did him one bet­ter: he banked on it, while trolling the Pro-Life Free­dom Caucus with mid­night ul­ti­mata pos­ted on Twit­ter. In all like­li­hood, Trump prob­ably wouldn’t mind if the Re­pub­lic­ans got mauled in the midterm elec­tions. Es­pe­cially some of the Tea Party hol­d­overs, be­cause he’d be bet­ter able to pass ac­tu­al health­care re­form and in­fra­struc­ture spend­ing with Dems man­ning the le­gis­lat­ive branch.

For the mo­ment, however, his only vis­ible in­tern­al op­pos­i­tion has been totally un­der­cut. Some have gone so far as to sug­gest that it’s not even use­ful to think of Trump and his in­ner circle as Re­pub­lic­ans. Rather, they rep­res­ent a het­ero­gen­eous fac­tion with­in a party they’re seek­ing to des­troy and re­cre­ate. After all, Trump was re­gistered as a Demo­crat between 2001 and 2008, and stated for the re­cord that he was “very pro-choice” in a live in­ter­view from Oc­to­ber 1999. His Re­pub­lic­an op­pon­ents dur­ing the primar­ies wer­en’t wrong when they ac­cused him of re­peatedly prais­ing the Scot­tish and Ca­na­dian mod­els of so­cial­ized health­care.

Oth­ers ob­ject it is more use­ful to think about Trump in terms of the con­stel­la­tion of so­cial forces which elec­ted him and the known-quant­ity con­ser­vat­ives and bil­lion­aires he’s since ap­poin­ted to his cab­in­et. Michael Kinnucan, for example, correctly points out that

Trump was elec­ted by es­sen­tially the ex­act co­ali­tion that voted for Rom­ney, a co­ali­tion solidly united around re­peal­ing Obama­care, plus 1% of dis­af­fected folks. He lob­bied very hard to pass AHCA be­cause he’s a Re­pub­lic­an who (to the lim­ited ex­tent that he cares about policy) strongly be­lieves in tax cuts and doesn’t care about health­care bey­ond something-something-mar­kets, and be­cause his power to pass laws de­pends solely on a Re­pub­lic­an ma­jor­ity com­mit­ted to gut­ting Medi­caid. But sure, maybe now he’ll pivot to single-pay­er!

Some de­gree of skep­ti­cism with re­spect to the above nar­rat­ive is thus war­ran­ted, to be sure. Lib­er­als seem to os­cil­late between the view that Trump is an in­com­pet­ent buf­foon and the view that he’s an evil geni­us. Ac­cord­ing to the former view, the ex­ec­ut­ive fias­coes of the first sixty days are a func­tion of his in­ex­per­i­ence and lack of prop­er qual­i­fic­a­tions, while ac­cord­ing to the lat­ter these are just an elab­or­ate ruse in­ten­ded to at­tract or dis­tract me­dia at­ten­tion while more ne­far­i­ous meas­ures are put in place. Just a way of keep­ing our eyes off the ball.

The real­ity, I sus­pect, is far more banal: Trump and his as­so­ciates com­mit a blun­der or vi­ol­ate the usu­al pres­id­en­tial etiquette. Me­dia out­lets and seasoned com­ment­at­ors like clock­work over­re­act with ex­pres­sions of shock or dis­be­lief. He then re­sponds by fur­ther rub­bing it in their face, which un­doubtedly forms part of Trump’s ap­peal — i.e., his total dis­reg­ard (even out­right con­tempt) for time-honored con­ven­tion. Quite a lot of this is im­pro­visa­tion­al or ad hoc, so I’m not com­pletely sure that this was a de­lib­er­ate move on the part of Trump. But it’s happened sev­er­al times now.

Per­haps it was de­lib­er­ate on the part of Steve Ban­non, however. Ban­non’s said since the be­gin­ning that he wants to “des­troy” Ry­an, and that the Tea Party darlings of yes­teryear like Ted Cruz and Rand Paul are “the en­emy.” Of course, Ban­non is known for his hy­per­bole and omin­ous state­ments about “de­con­struct­ing the ad­min­is­trat­ive state.” So murky au­gur­ies help with his mys­tique. I mean, this is a man who called him­self a “Len­in­ist” to Re­agan­ites and ex­pressed open sym­pathy for the dev­il while he made a play for the evan­gel­ic­al vote. “Dark­ness is good,” Ban­non told Hol­ly­wood Re­port­er, “Dick Cheney, Darth Vader, Satan: that’s power.”

Nev­er­the­less, I would cau­tion against un­der­es­tim­at­ing Trump’s polit­ic­al acu­men, not to men­tion the in­tel­li­gence of his closest ad­visors. This guy ut­terly dom­in­ated the Re­pub­lic­an primar­ies des­pite run­ning no cam­paign, while fa­cing sev­er­al ca­reer politi­cians at times united in op­pos­i­tion to him. He then pro­ceeded to win the gen­er­al elec­tion against someone who had dec­ades of polit­ic­al ex­per­i­ence, the com­plete back­ing of Wall Street, and a former pres­id­ent for a hus­band. Not to men­tion the fact that she out­spent him on ad­vert­ising by the price of roughly three F-35s.

And he did all of this des­pite hav­ing no ex­per­i­ence in of­fice, fa­cing count­less scan­dals — ran­ging from “he made fun of a dis­abled guy” to “he brags about grabbing pussy” to “he may be a child mo­lester” — and re­ceiv­ing luke­warm sup­port (if not out­right hos­til­ity) from the most in­flu­en­tial mem­bers of his own party. I’m not say­ing that either Trump or Ban­non is some sort of diabol­ic­al mas­ter­mind, but neither one of them is an idi­ot. Both know how to spot an op­por­tun­ity and ex­ploit it, and how to ma­nip­u­late people. Stop look­ing for some sil­ver bul­let that will ma­gic­ally take down Trump.

Your en­ergy would be bet­ter spent try­ing to build a real polit­ic­al op­pos­i­tion in­de­pend­ent of, and im­plac­ably op­posed to, both ma­jor parties. Noth­ing short of so­cial­ism.

2 thoughts on “Trump and healthcare

  1. As it happens, the actor who played the Little Man in Twin Peaks is a very vocal Trump supporter (after voting for Bernie in the primaries, oddly enough) so very apropos.

    Where is the Kinnucan quote from (link just goes to his archive at Current Affairs). I think he’s closest to the mark.

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