“This miry Slough is such a place as cannot be mended; it is the descent whither the scum and filth that attends conviction for sin doth continually run, and therefore is it called the Slough of Despond: for still as the sinner is awakened about his lost condition, there ariseth in his soul many fears, and doubts, and discouraging apprehensions, which all of them get together, and settle in this place; and this is the reason of the badness of this ground.”
That’s the famous Slough of Despond from John Bunyan’s 1678 The Pilgrim’s Progress – the swamp of despair – a place of fears and doubts and discouraging apprehensions. Bunyan’s hero – “Christian” – gets stuck there for quite a bit on his way to the Celestial City. All seems lost. That calls for dispassionate logical analysis of the situation. That doesn’t help. Realism leads to more despair – but this is a Christian allegory. Forget realism. Forget logic. “Faith” is the only way out of the Slough of Despond.
No one reads Bunyan anymore. Allegory is no more than elaborate scolding – but with Bunyan there are cool characters along the way. There’s “Obstinate” – one of the two residents of the City of Destruction – and “Pliable” – the other of the two, who goes with Christian until both of them fall into the Slough of Despond. There’s also “Giant Despair” – the savage owner of Doubting Castle – and “Old Honest” – a pilgrim from the frozen town of Stupidity – and “The Flatterer” – a deceiver dressed as an angel. There’s no Donald Trump – this was 339 years ago – but he’s both “Old Honest” from the frozen town of Stupidity and “The Flatterer” these days. Allegory is stupid stuff, but sometimes it’s useful.
That’s a way to frame what E. J. Dionne discusses here:
When a policy that helps some corporate sector can be repackaged to make it look like a pro-worker move, President Trump will always hide his real purpose behind a phalanx of workers. Thus did he surround himself with coal miners on Tuesday when he signed a shamefully shortsighted executive order nullifying President Barack Obama’s climate-change efforts.
“Come on, fellas,” Trump said. “You know what this is? You know what it says, right? You’re going back to work.”
That’s “Old Honest” from the frozen town of Stupidity and “The Flatterer” – the deceiver dressed as an angel – in operation. It’s nonsense:
Actually, Trump’s promise to the “fellas” is no more believable than any of his other promises. As Clifford Krauss and Diane Cardwell reported in the New York Times, the biggest challenges to coal come from market forces – cheap natural gas and the increasing competitiveness of wind and solar power, for example. So don’t count on those jobs.
And workers and consumers are nowhere to be seen or heard when it comes to the rest of Trump’s corporate priorities. The president, for example, is expected to sign a bill passed on a party-line House vote this week that eliminates Obama-era online privacy protections. This is good for Verizon, AT&T, Comcast and other providers that, as The Post’s Brian Fung noted, “will be able to monitor their customers’ behavior online and, without their permission, use their personal and financial information to sell highly targeted ads.” Not exactly empowering to the ordinary American.
Trump already signaled his indifference to the lives of his working-class supporters by backing the failed House Republican health-care bill. It would have deprived 24 million Americans of health insurance. And the administration’s next big priority is corporate tax cuts, not an issue high on voters’ wish lists in Erie, Pa., or Bay County, Mich.
Then again, not many proletarians hang around at the Trump resorts and golf courses where our commander in chief has already spent nearly a third of his time in office.
Someone’s going to end up in the Slough of Despond. Someone did:
Almost entirely lost in the Trumpian world of high-profile scandals and tweets is a great national tragedy involving what Princeton economists Anne Case and Angus Deaton called “deaths of despair” among white Americans with a high school degree or less.
In a paper released last week by the Brookings Institution (with which I am associated), they show that the rising death rates among less well-off whites ages 45 to 54 contrast sharply with the falling death rates among comparably placed citizens in Europe.
“Mortality declines from the two biggest killers in middle age – cancer and heart disease – were offset by marked increases in drug overdoses, suicides and alcohol-related liver mortality,” they write.
It seems that fears and doubts and discouraging apprehensions lead to drug overdoses and suicides and alcohol-related liver mortality. That happens when all seems lost. That’s what Dionne sees:
We are living in a society where the long-standing injustices of racial discrimination against African Americans and Latinos are compounded by the injuries of class. These afflict all lower-income groups, but they are currently hitting white Americans particularly hard.
A well-functioning political system and bold leaders would bring us together to build a more just and socially healthy country across the board. But we find ourselves in the Trump Era, where distraction, delusion and division define public life.
There’s not much hope here:
If moral imperatives won’t inspire our politicians, perhaps political interest could lead them to take the costs of class inequality to heart. The 2016 Cooperative Congressional Election Study released at the beginning of the month suggested that Trump’s victories (particularly in the swing Midwestern states and Pennsylvania) were driven by white voters without a college degree who either didn’t vote in 2012 or had supported Obama.
My reading of this survey and other post-election analyses so far is that while Trump’s core supporters were largely moved by issues related to race, culture, religion and immigration, the decisive swing voters were motivated by economic anxiety.
Trump has no coherent approach to lifting up working-class Americans. But Democrats need to do more than just embarrass him about the tilt of his policies toward the best-off. They need to put serious thought and energy into pushing a comprehensive program to relieve economic insecurity across racial lines.
They tried. Six years ago Obama gave a big speech about this:
Inequality also distorts our democracy. It gives an outsized voice to the few who can afford high-priced lobbyists and unlimited campaign contributions, and runs the risk of selling out our democracy to the highest bidder. And it leaves everyone else rightly suspicious that the system in Washington is rigged against them – that our elected representatives aren’t looking out for the interests of most Americans.
More fundamentally, this kind of gaping inequality gives lie to the promise at the very heart of America…
It was a fine speech. Inequality actually was the biggest threat to America around – and that did no good. Bernie Sanders has been saying the same thing for years – and offering specific policy proposals – but Hillary Clinton got the nomination. She said the same sort of thing, but she didn’t like any of those policy proposals – don’t do too much too fast – and she lost to Donald Trump, the man with the vacuous and rather dim third trophy wife, who ran his campaign from his Manhattan penthouse, atop his personal skyscraper, with the gold-plated toilets and gold-plated everything else – but he was “honest” of course. “Folks, you’re getting screwed.” And he was the flatterer – the angel who told the forgotten, in despair, that they were far better people than all those fat-cats and experts and science people and Hollywood assholes put together.
That worked, and then he forgot them all. He filled his cabinet with Goldman Sachs folks, and a few generals, and an alt-right firebrand, and a pretty daughter with a fashion business, and her husband, a young real estate tycoon with no government or diplomatic experience at all. Then Paul Ryan rolled him on the Obamacare replacement. Twenty-four millions Americans would have lost health coverage. Trump was fine with that. He didn’t even know what was in the bill. He just wanted a win. “Old Honest” from the frozen town of Stupidity and “The Flatterer” didn’t win that one, but he tried – and moved on. Obama had been wiretapping his phones all along. The polls are fake news. The press is the enemy of the people. There’s nothing to that Russia business. And Saturday Night Live sucks.
Dionne can offer only this:
It would be a national service for at least some politicians to point out that in Washington’s angry noise, the voices being drowned out are those of Americans whose despair should be commanding our attention.
Good luck with that. Rich Lowry, the editor of National Review, sees a structural problem here:
No officeholder in Washington seems to understand President Donald Trump’s populism or have a cogent theory of how to effect it in practice, including the president himself.
House Speaker Paul Ryan isn’t a populist and doesn’t want to be a populist. He has spent his adult life committed to a traditional limited-government agenda. He crafted his own platform during the campaign, the so-called Better Way agenda, to differentiate congressional Republicans from Trump.
Trump, for his part, has lacked the knowledge, focus or interest to translate his populism into legislative form. He deferred to others on legislative priorities and strategies at the outset of his administration, and his abiding passion in the health-care debate was, by all accounts, simply getting to a signing ceremony.
In light of all this, the product of the Ryan-Trump partnership on health care was a bill bizarrely at odds with a national election Republicans had just won on the strength of working-class voters.
This was never going to work:
Maybe Ryan doesn’t “get” the new political reality created by Trump’s victory, as the president’s boosters like to say. But what excuse does the president himself have for evidently not “getting” it either?
His energies were taken up trying to placate the conservative House Freedom Caucus. The supposed affinity between Trump and the Freedom Caucus is one of the great ideological misunderstandings of our time. Just because Trump and the conservative caucus are both “anti-establishment” doesn’t mean they have anything else in common…
A President Trump acting more in keeping with his free-floating reflex to take care of people – as expressed in speeches and interviews – would have pushed the health bill to the left. But Trump so far hasn’t followed the logic of his own politics in dealing with Congress.
The logic of Trump’s own politics, assuming there is some logic there, would mean that the “forgotten” – those in a place of fears and doubts and discouraging apprehensions, in Bunyan’s fanciful swamp – would be forgotten no longer. That’s unlikely, but Lowry holds out hope:
The range of possible outcomes of the Trump presidency is still wide. Unexpectedly, one of them is that his most die-hard populist supporters will eventually be able to say that Trumpism, like socialism, hasn’t failed, it’s just never been tried.
The forgotten will remain forgotten, but maybe not, as Politico reports this:
As a candidate, Donald Trump promised rural towns and states hit hard by opioid addiction that he’d solve the epidemic ravaging their communities. “We will give people struggling with addiction access to the help they need,” Trump vowed in October.
Trump won many of those communities – often overwhelmingly. But as president, he’s proposing deep cuts to research and treatment in favor of funding a border wall to stop drug traffic, while hinting at bringing back policies like criminalization of drug misuse – and announcing Wednesday yet another big presidential commission to study the problem.
Yes, he will not forget these people. He just won’t fund anything for them. He needs the money for his wall. He’ll just put more addicts in jail, and create a commission, which seems absurd:
Public health advocates say those plans, at best, duplicate those of the Obama White House and at worst could set back efforts to tackle a problem that contributes to more than 47,000 deaths per year. Many experts advocate treatment and support services over jail for drug abusers, saying they reduce the risk of a person committing another crime.
The emerging Trump strategy, including failed plans to repeal Obamacare protections that enabled millions to get substance abuse treatment, “doesn’t bode well for the public health approach, such as it is,” said Leo Beletsky, a law professor at Northeastern University who specializes in health and drug policy. He points to Republican rhetoric about criminalizing the crisis, as well as proposed funding cuts to research and treatment.
“This new shift will certainly make the situation much worse,” Beletsky added.
Yes, the failed bill did contain provisions to repeal Obamacare protections that enabled millions to get substance abuse treatment – it’s not the government’s business to be involved in such things – so now we get this:
Trump will sign an executive order Wednesday creating a high-level opioids commission led by New Jersey Gov. Chris Christie, who has spoken about the need to prioritize treatment for opioid addiction. It includes Attorney General Jeff Sessions, who has suggested more of a crime-and-punishment approach.
For all the good that will do:
Public health experts question the value of the commission. It was just last November when Surgeon General Vivek Murthy released his office’s first-ever report on opioids and addiction, which included tools and recommendations collected from more than a year of research. The CDC also released prescribing guidelines after thorough study.
“These people don’t need another damn commission,” said a former Obama administration official who worked to address the opioid crisis and asked not to be named. “We know what we need to do. It’s not rocket science.”
Maybe it is. Team Trump is heading in other directions:
The White House on Tuesday also shuffled the leadership at the Office of Drug Control Policy, replacing acting head Kemp Chester – a compromise pick between the outgoing Obama and incoming Trump administrations – with acting head Rich Baum, a former Hill GOP staffer who’s been critical of legalizing marijuana and wants to tackle drug cartels abroad.
Baum specializes in what’s called the “supply side” of drug policy – cracking down on the flow of illegal drugs – as opposed to “the demand side,” or treating the end user. Baum is close to GOP policy experts who worked to enact the “war on drugs” tactics under previous Republican presidents, several sources told POLITICO.
It’s “just say no” and go after the Mexicans, all over again, and that won’t work this time either:
“Our hope is they would take a public health approach to addressing this epidemic,” said Laura Hanen, chief of government affairs at the National Association of County and City Health Officials. She pointed out that while there have been inroads to clamp down on over-prescribing of prescription opioids there’s been a corresponding uptick in heroin and fentanyl. “You squeeze one end of the balloon and the air goes to the other end. … If we’re only going to use a supply side approach I doubt it’ll be very effective.”
Drug-policy experts also worry about Sessions’ punitive view of drug abuse and his skepticism about treatment, which he believes seldom works. “We can wish that we could just turn away and reduce law enforcement,” he said in a speech last year. “But I do believe that we’re going to have to enhance prosecutions. There just is no other solution.”
Expect more despair, much of it from inside jail cells, but Trump has his priorities:
The White House issued a budget request recently that would siphon billions of dollars from NIH research and CDC public health work this year while steering about $2 billion toward construction of Trump’s border wall with Mexico.
The president has promoted the wall as a linchpin of his strategy to fight the opioid epidemic. “A wall will not only keep out dangerous cartels and criminals, but it will also keep out the drugs and heroin poisoning our youth,” Trump said in October in New Hampshire – a state hard-hit by the opioid crisis.
“We must focus on prevention and law enforcement,” Trump said at a Wednesday event showcasing the effort. “That is why I have issued previous executive actions to strengthen law enforcement and dismantle criminal cartels. Drug cartels have spread their deadly industry across the nation and the availability of cheap narcotics – and by cheap, some of it comes in cheaper than candy – has devastated our communities.”
That’s why he’ll slash the budget of the National Institute for Health and the Centers for Disease Control. That makes sense to him, but he may stand alone:
Trump’s own homeland security czar said that the border wall “in and of itself will not do the job” and drug-policy experts warned cartels would be motivated to find a way around it. In any case, it may be a non-starter this year; Congress will rebuff the request, Sen. Roy Blunt (R-Mo.), a senior appropriator, signaled on Tuesday.
Democrats on the Hill also blasted Trump for a plan that they say prioritizes optics like a border wall and a political commission over investing more dollars in caring for people who are addicted to opioids, recovering or are at risk. They also said that the ill-fated American Health Care Act – the House Republican plan to strike down Obamacare – would have dealt a critical blow to coverage for millions of substance misusers.
“I’d take President Trump’s proposed efforts on opioids more seriously if he hadn’t spent the last two months trying to derail the historic steps forward on substance abuse treatment through the Affordable Care Act – and if his budget didn’t also include a 20 percent cut to mental health services, which are so important in the fight against this epidemic,” Sen. Patty Murray (D-Wash.) said in a statement.
“I was pleased to see then-candidate Trump recognize this issue on the campaign trail,” Sen. Maggie Hassan (D-N.H.) told POLITICO. “But I am concerned that rather than show a commitment to increasing resources to boost treatment capacity, President Trump has so far pushed policies that would harm our efforts to combat the crisis.”
It seems that Trump’s populism was bullshit all along:
Several advocates pointed out that the failed House Republican bill to repeal Obamacare would have significantly hindered access to addiction treatment. The legislation was not only projected to lower coverage but also would have eliminated essential health benefit guarantees – including mental health – for millions of Americans covered through various ACA-related programs.
The bill would have slashed Medicaid expansion, which experts have concluded helped nearly 1.3 million low-income Americans gain access to substance-use treatment.
Trump’s budget proposal for next year keeps the $500 million allotted to states through the 21st Century Cures Act to fight opioid addiction and proposes $175 million more to fight drug trafficking. But it would cut funding by 14 percent for the Coast Guard, whose maritime interdiction efforts are necessary at a moment when cocaine production and trafficking is at an all-time high.
Drug policy experts across the federal government say they weren’t consulted on the executive order to create the opioids commission.
“The first time I learned about this was when I saw it in the press” on Sunday night, one said.
The guy who is both “Old Honest” from the frozen town of Stupidity and “The Flatterer” – the deceiver dressed as an angel – was at it again. And the Pilgrim remains in the Slough of Despond – full of fears and doubts and discouraging apprehensions. We’re all there now. America: the Slough of Despond – we needed a new tag line. That’ll do.