To Make Men Free

There’s that old Sam Cooke song – “don’t know much about history, don’t know much biology, don’t know much about a science book, don’t know much about the French I took” – and so on. The guy is saying he’s kind of dense, and that’s okay, because he loves the girl and that’s all that matters. His hapless ignorance, that he knows he’ll never be able to overcome, and may not really want to overcome, is supposed to be charming. That’s the hook. Lou Adler and Herb Alpert actually wrote the song, but Cooke revised the lyrics to add the stuff about school, and of course there’s a reason so many others have recorded versions of that song since its 1960 release. That song speaks to our American culture. If this guy could “win” the girl’s love, in spite of his ignorance about most everything, what a wonderful, wonderful world this would be. Ignorance about most everything doesn’t matter, or it shouldn’t matter. Some things are more important – love, and “winning” in general.

That’s the American dream – see Richard Hofstadter and Anti-Intellectualism in American Life – published three years after Cooke’s hit song, but probably not a response to it. This sort of thing had been going on since the United States organized itself. An American may not know much about history, and not know much biology, and not know much science in general, but that’s okay. Even a general understanding of any of those things will do. The rest is for nerds – the losers. Winners can fake it, and then, what a wonderful world this will be.

That may explain Donald Trump’s recent historical musings. Steve Bannon has been telling Donald Trump that Donald Trump is just like Andrew Jackson, for years. Trump came to believe that. Jackson was a very tough person. Trump is a very tough person. Jackson had a big heart – except for the Trail of Tears thing that Trump seems to have never heard of. Donald Trump also has a big heart – except for the immigration thing tearing families apart and a refusal to accept refugees, even children. And no one knew how to make deals back then and work things out – which is true if the Missouri Compromise and all the rest is “fake history” of course.

That’s why Trump insisted that Jackson, had he lived, as the consummate alpha-male ball-buster, someone who speaks and embodies the ethos of domination – a “swashbuckler” just like Trump – would have slapped people around and bent them to his will, and cut the deal. There would have been no Civil War. Jackson was, like Trump, a master dealmaker. Lincoln must have been a fool and wimp, although Trump didn’t mention that obvious corollary.

There was a brief flurry of outrage about this – Trump knew nothing about history, or about Andrew Jackson, a slaveholder who died fifteen years before the Civil War – and then everyone shrugged and moved on. Trump was that charming guy in the Sam Cooke song – a little dense, but idealistic, and harmless. This was no big deal.

Historians may disagree. Heather Cox Richardson is professor of American history at Boston College and wrote the book on these guys – To Make Men Free: A History of the Republican Party – and she now offers this:

There is more to Trump’s question than ignorance, and it lies in the idea that the root causes of the war could somehow have been “worked out.” His view of government as a broker of bargains, rather than an expression of democratic will, is nothing new. In fact, it’s been a common feature of oligarchic politics for nearly all of American history. In the light of the oligarchs of the past, Trump’s insistence that some deal could have prevented the Civil War has plenty in common with the anti-democratic wheeling and dealing of big bankers and slaveholders, and their fate bodes ill for the Trump administration.

“Why could that one not have been worked out?” sounds a lot like banking mogul J.P. Morgan’s comment to President Theodore Roosevelt in 1902, when Morgan found out that the government was about to slap his giant railroad conglomerate with an antitrust suit. “If we have done anything wrong,” the astonished Morgan said to Roosevelt, “send your man to my man and they can fix it up.”

Sometimes it’s useful to know a bit of history:

In Morgan’s day, government officials built or changed the nation’s laws to suit industrialists. It was an arrangement that made sense to both the lawmakers and the businessmen who benefited from it. They were all wealthy, educated and well connected. They figured they were rich because they were better than most men (and all women). They thought they had a deeper knowledge of the world than regular workers, and a much better idea of how to keep the country moving forward. Progress, they thought, could only be achieved if laws favored them, because they were the nation’s best-suited leaders. Anything that shared money or power with their inferiors would weaken their ability to run the country effectively. Thus, Roosevelt’s suggestion that Morgan wielded too much power in a democracy left Morgan incredulous.

Nothing much has changed since then. Many voted for Trump because they really did believe that he had a deeper knowledge of the world than regular workers, and any and all politicians. He was a billionaire. He must know things no one else knows, and maybe he does know something about Andrew Jackson that no one else knows.

Richardson doubts that:

Fifty years before Morgan told Roosevelt that their men could “fix it up” between the government and industry, Southern slaveholders also thought that they could fix things up between themselves and their friends in the White House, Congress and Supreme Court. Like the later industrialists, slave owners pointed to their extraordinary wealth as proof that they had figured out the best social system in the world. Most people were stupid, South Carolina Sen. James Henry Hammond explained, good only for menial labor. The work of those drudges supported the educated, well-connected wealthy men of society, the ones who led “progress, civilization, and refinement.” And, like Morgan after them, slave owners argued that the government must work for them. It must protect their slave system not only in the South, but also in new Western territories, and even in the free North – even if the vast majority of Americans disagreed.

And that leads to an obvious corollary:

Trump’s administration looks a great deal like those of the 1850s and the 1890s, with business and government so intertwined that they cannot be disentangled. It makes sense that he would think it should have been easy for the nation’s elite leaders to “work out” the tensions that caused the Civil War: Easy solutions arranged by strong, elite leaders have been Trump’s go-to solution all along, on health care, taxes, immigration, the Islamic State, even the Arab-Israeli conflict. So why not the Civil War?

Why not? History has other ideas:

Morgan and slave owners miscalculated. They were so blinded by their worldview that they did not reckon with the possibility that it might be wrong – that they were not superior nor especially well-suited to govern, but rather particularly skilled at gaming their way into outsized wealth. And the rest of society was not full of dimwits who were happy to serve their betters. In fact, when they saw an elite cabal taking power, regular Americans in both eras came together to take a stand. They demanded that the government treat everyone equally, rather than working only for the very rich. Once Americans began to articulate that core principle of democracy, they put into office leaders who took the government back for the people.

In 1902, Roosevelt declined Morgan’s offer. “We don’t want to fix it up,” his attorney general explained. “We want to stop it.”

Roosevelt’s stand against a government stacked in favor of industrialists launched the Progressive Era, in which the government stopped protecting big business and instead promoted equality of opportunity for all.

And then there’s that other matter:

Fifty years before, the fight to reclaim democracy was bloodier. In 1861, the nation descended into four years of war that cost the equivalent of more than $5 billion dollars and left more than 600,000 people dead or wounded. And maybe Trump doesn’t realize it, but they did it for a reason – because Americans thought it was important to guarantee, as President Abraham Lincoln said, “that government of the people, by the people, for the people, shall not perish from the earth.”

Sometimes the people rise up. Extraordinary wealth does not prove that those with that wealth have figured out the best social system in the world, or now the best healthcare system. Send your man to my man and they can fix it up? That’s our government now:

House Republican leaders planned to hold a showdown vote Thursday on their bill to repeal and replace large portions of the Affordable Care Act after adding $8 billion to the measure to help cover insurance costs for people with pre-existing conditions.

“We have enough votes,” Representative Kevin McCarthy of California, the House majority leader, said Wednesday night. “It’ll pass.”

A breakthrough came earlier Wednesday thanks to an amendment proposed by Representative Fred Upton of Michigan, with the support of Representative Billy Long of Missouri, to add the money to the bill. The two Republican lawmakers had come out against the health care legislation, warning that it did not do enough to protect the sick, but they threw their support behind it on Wednesday.

Eight billion dollars fixed the problem, or it didn’t:

The measure faces a wall of opposition from health care providers, disease advocates and retirees, and has been derided by many Senate Republicans, who are all but certain to reject vast portions of it should it clear the House…

The liberal health advocacy group Families USA said another $8 billion would do little to improve the “high-risk pools” that could be set up by states to provide coverage to people with pre-existing medical conditions who could not find affordable insurance in the open market.

The American Medical Association and 10 organizations representing patients, including the American Heart Association and the advocacy arm of the American Cancer Society, reiterated their opposition to the House Republican bill on Wednesday, as did the retirees’ lobby AARP.

“None of the legislative tweaks under consideration changes the serious harm to patients and the health care delivery system” that the bill would cause, said Dr. Andrew W. Gurman, the president of the American Medical Association. The latest changes, he said, “tinker at the edges without remedying the fundamental failing of the bill – that millions of Americans will lose their health insurance as a direct result of this proposal.”

Senator Chuck Schumer of New York, the Democratic leader, also criticized the latest version of the legislation. “The proposed Upton amendment is like administering cough medicine to someone with stage-four cancer,” he said in a statement. “This Republican amendment leaves Americans with pre-existing conditions as vulnerable as they were before under this bill.”

In this case, the general idea wouldn’t do:

The Affordable Care Act generally requires insurers to accept all applicants and prohibits them from charging higher premiums because of a person’s medical condition. Conservatives argue that this and other requirements of the 2010 health law drive up insurance costs.

At the insistence of conservative lawmakers, House Republican leaders agreed to let states apply for waivers allowing insurers to charge higher rates based on a person’s “health status.”

The original version of the Republican repeal bill would have established a $100 billion fund that states could use to help people pay for health care and insurance from 2018 to 2026. House leaders added $15 billion last month to help insurers pay claims for their sickest customers. Mr. Upton’s proposal would provide $8 billion over five years on top of that.

How far that $8 billion would go in providing coverage for people with pre-existing conditions is not clear. Mr. Upton’s proposal does not specify who would be eligible, how much of their costs would be covered or how much they would be expected to contribute in premiums.

It’s nothing:

The House Democratic leader, Nancy Pelosi of California, said the money was a pittance compared with the likely need. “It’s a joke,” she said. “It’s a very sad, deadly joke.”

The latest amendments to the bill amount to “a hoax on pre-existing conditions,” Ms. Pelosi said. “If Republicans have their way, Americans with pre-existing conditions will be pushed off their insurance and segregated into high-risk pools where they face soaring cost, worse coverage and restricted care.”

Josh Marshall frames that this way:

Trumpcare 1.0 went down in flames in part because of the CBO score showing that 24 million people would lose their health care coverage and that most of the protections provided by Obamacare would be scrapped.

You’re not hearing it a lot – or perhaps I’m just missing hearing it as clearly as I thought I would or should. But the new version of Trumpcare is actually worse than the old one. There’s every reason to think the number of people who lose coverage will be at least 24 million people and perhaps more.

There’s a reason for that:

Critically, this version, in a bow to the House Freedom Caucus, guts the so-called essential benefits requirement under Obamacare. That’s the part that makes ‘coverage’ more than a word.

This version isn’t a bit more generous, as some of the coverage might seem to suggest. It’s considerably worse. The same 24 more million Americans are on the chopping block. Indeed, according to a Brookings study, the change in essential benefits could remove protections from people who get employer-based coverage.

If you were worried about the fate of those 24 million, worry more about this.

As Richardson put it, the rest of society may not be full of dimwits happy to serve their betters – by getting nothing much now, even if their betters say they’re being offered “freedom” or whatever.

Paul Waldman puts that this way:

After the first version of the AHCA failed because it was opposed by both moderate Republicans and the ultra-right Freedom Caucus, lawmakers tried to make the bill more cruel, in the hopes that the extreme conservatives would find it pleasing enough to vote for. One of the changes they came up with was to allow states to essentially gut the ACA’s provision requiring insurance companies to cover people with preexisting conditions. Depending on what you include, that’s somewhere between one quarter and one half of all non-elderly Americans.

The preexisting conditions question is quickly becoming the axis around which this debate is revolving, which is understandable, given the large portion of the population whose fates are at stake. Republicans insist that their bill actually protects all those tens of millions of Americans, but make no mistake: if you’re one of them and this bill passes, your life will become hugely more complicated, potentially more costly and possibly in danger if you’re unlucky.

And that means there are four possible outcomes here:

This version of the AHCA dies in the House. While many Republican House members haven’t said where they stand, the number of explicit GOP “No” votes has been hovering around 20 in the past couple of days, with many others leaning against it or undecided; if they lose 23, the bill fails. I think this is the most likely scenario, but that’s just a gut feeling. The politics of this debate are just dreadful for Republican members, who are already terrified that 2018 will be a “wave” election that sweeps them out of office, and they’re acutely aware of the anger that has built up against their bill and how broadly unpopular it is. That may provide enough of an incentive for those last few to bail on it, especially if it looks as though it can’t succeed. There’s no great political outcome on offer, but it’s better to vote against something that failed than to vote for it. At least then you can claim you had something better in mind.

There’s that, and then there’s this:

They pass a bill in the House, which then dies in the Senate. Although Republicans are trying to push this latest bill through the House before the Congressional Budget Office gives it a score, this is in many ways the same bill that the CBO said would result in 24 million Americans losing their health coverage. If it loses a mere three Republican votes in the Senate (where they have a 52-48 advantage), it’s over. In some ways, this is the best political scenario for Democrats: The ACA remains intact, but they get to savage GOP members of the House for voting for something so dreadful.

That’s likely, but then there’s this:

The bill passes in the House, gets radically changed by the Senate, and then fails when it comes back to the House. Members of the House leadership have been trying to persuade moderate Republicans to vote for this bill on the basis that once the Senate gets a hold of it, their version will be less horrifying, and then the two houses could pass something more like what the Senate produces. Which is possible – but the problem is that if the Senate moderates the bill, it could lose the support of the Freedom Caucus members who are now supporting the current version precisely because of the widespread suffering it would cause. “They better not change it one iota,” said Freedom Caucus member David Brat, visions of millions of people being kicked off Medicaid no doubt dancing in his eyes. “If they change it, you’re not going to have 218 [votes].” It’s impossible to know how many votes such a bill would lose in the House until we know what it contains, but the general presumption has been that nothing conservative enough to pass the House could pass the Senate, and nothing liberal enough to pass the Senate could pass the House.

Americans would then be safe, but then there’s this, even if it’s unlikely:

The bill passes in the House, and the Senate passes a version, and then the two houses work out a compromise in the conference committee that majorities of both houses can support. This is the ultimate path to victory, but it depends on a lot. Among other things, Republicans in the Senate would have to craft a bill that meets the requirements of “reconciliation,” which mandates that only provisions with a direct effect on the budget are allowed. Otherwise, the bill would be subject to a filibuster, and be doomed. That means certain provisions that are policy changes without direct budgetary effects – such as allowing insurers in one state to sell plans in the other 49 states, something most Republicans want – couldn’t be included. They could pass some reconciliation-ready provisions without undoing the whole ACA, such as undoing its expansion of Medicaid or slashing the subsidies people now get to help afford insurance. But it’s clear that they’d rather rip the bandage off all at once.

This makes the current situation impossible:

On one side is keeping the promise they made to their base to repeal the ACA. On the other side is the political danger any version of the AHCA will present to them.

And that danger is almost incalculably high. While the details of the bill may change, we know for certain that it will be spectacularly unpopular. There’s just no way around that. It will boot tens of millions off their insurance. It will endanger coverage for tens of millions more. And while there will be some winners – mostly young, healthy, well-off people who will wind up paying less for their insurance – their numbers will be dwarfed by the losers. When people have to once again go through the onerous process of documenting every pill they’ve taken and ache they’ve had checked out when they apply for coverage – which you don’t have to do now, but you will if Republicans get their way – they’re going to be seriously ticked off.

The news media will be filled with horror stories of people who have lost their coverage, and in some cases their lives, because of what Republicans did. If the bill passes, it will result in an outpouring of rage, particularly on the left but among all kinds of voters, outrage that will vastly increase the chances of a Democratic wave in 2018 and even 2020.

There’s no good outcome here:

Republicans certainly want to pass something, if only to show that they kept their promise and they can get things done. But if that something looks as though it could mean the end of their careers, don’t be surprised if enough of them shake their heads and step back from the precipice at some point or other during this process.

Here, losing is winning, and in the background Sam Cooke, or Donald Trump, is singing – “don’t know much about history, don’t know much biology, don’t know much about a science book, don’t know much about the French I took” – or one damned thing about healthcare policy.

Is he charming? He’s a little dense, but idealistic – but he’s not harmless, and this is a big deal. Send your man to my man and they can fix it up? Trump really should read some history.


About Alan

The editor is a former systems manager for a large California-based HMO, and a former senior systems manager for Northrop, Hughes-Raytheon, Computer Sciences Corporation, Perot Systems and other such organizations. One position was managing the financial and payroll systems for a large hospital chain. And somewhere in there was a two-year stint in Canada running the systems shop at a General Motors locomotive factory - in London, Ontario. That explains Canadian matters scattered through these pages. Otherwise, think large-scale HR, payroll, financial and manufacturing systems. A résumé is available if you wish. The editor has a graduate degree in Eighteenth-Century British Literature from Duke University where he was a National Woodrow Wilson Fellow, and taught English and music in upstate New York in the seventies, and then in the early eighties moved to California and left teaching. The editor currently resides in Hollywood California, a block north of the Sunset Strip.
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