The Man on the Ledge

There’s always that man on the ledge, and the good man, the hero, who goes out there and talks him down from that ledge. Empathy – understanding – reason – the careful application of guilt about all the people who would be devastated if the guy jumps to his death – stalling for time – it all works, at least in the movies. The jumper doesn’t jump. No one is going to die this day. That’s because good men will keep foolish men – who don’t think anything through – from doing foolish things. And of course it’s a metaphor. This isn’t about suicide. The world is full of fools out there on the ledge, about to do something really stupid. They might start a war or something. Someone has to talk them down. These fools are dangerous.

This happens with Donald Trump all the time. His first summit with that Kim fellow from North Korea produced fine words that one week later meant nothing at all. The second summit blew up –Trump walked out after one day. No deal was possible, and now North Korea is ramping up to test new missiles that could hit Washington and New York, and ramping up production of nuclear warheads. This is back to where things were when Trump took office.

It’s time for new sanctions, or the old sanctions, reapplied, but Trump is that man on the ledge:

Last week, President Trump announced in a cryptic tweet that he was canceling major sanctions against North Korea. This led to several hours of confusion, because the Treasury Department had just announced sanctions against two Chinese shipping companies that were accused of facilitating trade with North Korea. Canceling sanctions the day after they were announced seemed like an unprecedented step. After several hours of confusion, the administration announced that Trump had not been referring to those sanctions – but instead had canceled new, as-yet unannounced North Korea sanctions that were in the pipeline.

And that was bullshit:

Today, Bloomberg News reports that this explanation may have been false. Bloomberg reporters say they have been told by five unnamed sources familiar with the matter that there were no new North Korea sanctions planned and that Trump was indeed referring to the sanctions against the two Chinese shipping companies doing business with North Korea. He was eventually persuaded to change his mind, however. According to Bloomberg, the purported explanation was no more than a “cover story” intended to conceal the erratic policy process in the White House and Trump’s eventual change of mind.

Someone talked him down, perhaps offering empathy – yes, Trump likes Kim and admires his strength – the man gets things done and no one gives Kim shit. They do and they die, so they don’t – as with Putin too. Trump admires them both. He seems to envy them. When he grows up he wants to be them. So he won’t impose sanctions on his young hero, the impressive Kim. But someone said to him, this time, this was going too far. You really don’t want to look like a Kim fanboy right now – so come in off that ledge. Don’t jump. Tell the world how much you love and admire the guy, but don’t jump.

He didn’t jump. They generated a cover story for him – he was really saying something else about something else. No one was supposed to know how he was about to do something absurd. He was going to jump. They stopped him.

And sometimes “they” just cannot do that:

The Trump administration’s surprising move to invalidate Obamacare on Monday came despite the opposition of two key cabinet secretaries: Health and Human Services Secretary Alex Azar and Attorney General Bill Barr.

Driving the dramatic action were the administration’s domestic policy chief, Joe Grogan, and the acting director of the Office of Management and Budget, Russ Vought, according to three sources with direct knowledge of the decision. Both are close allies of White House acting chief of staff Mick Mulvaney, who helped to engineer the move.

But Monday’s terse, two-sentence letter from the Department of Justice to a federal appeals court, which reversed the administration’s previous partial opposition to a lawsuit challenging the 2010 health care law, took many Republicans aback – in part because they see it as bringing high political risk for a party that has failed to unite behind an Obamacare alternative and which lost House seats in the 2018 midterms when Democrats made health care a focus of their attacks.

But it was time to jump off the ledge anyway:

The new challenge to Obamacare follows a heated internal administration debate that began late last year and continued through yesterday’s announcement. Azar argued against backing a lawsuit seeking the full repeal of the health care law at a White House meeting in late December, citing the lack of a Republican alternative, according to two sources briefed on internal discussions, while Mulvaney said that taking a bold stance would force Congress into repealing and replacing the law.

Mulvaney jumped off the ledge for Donald Trump. Strip health insurance from over twenty million Americans and make it ten times more expensive for everyone else and Congress will have to act. They have to come up with an utterly comprehensive and far better and bulletproof brilliant alternative to Obamacare in ten days – they’d have no choice – but even the new attorney general didn’t see that:

Barr also opposed the decision, and now finds himself in the uncomfortable position of running the department that leads the new charge against Obamacare. His opposition was based in part on skepticism among conservative lawyers about the wisdom of seeking to overturn the law, officially known as the Affordable Care Act. The Supreme Court in 2012 upheld the constitutionality of Obamacare’s individual mandate, which the current lawsuit is once again challenging.

The attorney general, who was confirmed only a month ago, was overruled by the White House.

That’s because this was no time for reality:

“The Republican Party will soon be known as the party of health care,” Trump told reporters in brief remarks during a visit with Senate Republicans on Capitol Hill Tuesday. “You watch.” Over lunch, the president tasked Republican lawmakers to come up with a new health care plan.

He jumped, or he was pushed by this guy:

As a congressman from South Carolina, Mulvaney was a founding member of the Tea Party Caucus on Capitol Hill and one of the Republican Party’s most vocal opponents of the Affordable Care Act. He was one of about two dozen right-wing lawmakers who backed a government shutdown in 2013 in an attempt to push the Obama administration to scale back the law. As director of the Office of Management and Budget, he submitted budget proposals that proposed the repeal of Obamacare – a demand renewed in the White House’s 2020 proposal authored by Vought, Mulvaney’s one-time deputy.

And now he got his way. His president will jump off the ledge with him, as a gift to the Democrats:

A surprise move by the Trump administration aimed at striking down the Affordable Care Act thrust the partisan battle over health care into the middle of the 2020 campaign on Tuesday, handing Democrats a potential political gift on an issue that damaged Republicans badly in last year’s midterm elections.

In a new court filing, the Justice Department argued that the ACA, also known as Obamacare, should be thrown out in its entirety, including provisions protecting millions of Americans with preexisting health conditions and allowing young adults to stay on their parents’ health-care plans.

President Trump praised the move during a lunch with Senate Republicans, and suggested the GOP should embrace a new congressional battle over health-care policy ahead of the 2020 elections.

Trump says make this an issue in the 2020 election, make it the ONE BIG ISSUE in that election, and the Democrats are saying please do, pretty please, because they’re ready for this:

Democrats immediately seized on the administration’s filing, calling it the latest attempt by Republicans to strip health insurance from Americans. House Speaker Nancy Pelosi (D-Calif.) on Tuesday also unveiled Democratic plans for further bolstering the ACA.

“Trump and his administration are trying to take health care away from tens of millions of Americans – again,” Sen. Kamala D. Harris (D-Calif.) said on Twitter, one of several tweets by presidential candidates hitting Trump on health care. “We must fight back again with everything we’ve got. And in 2020, we need to elect a president who will make health care a right.”

That sells, and luckily, Trump can’t help himself:

As recently as November, after Democrats won control of the House of Representatives in an election dominated by the health-care issue, Republican congressional leaders had suggested they planned to move on from their years-long efforts to repeal Obamacare.

But Trump suggested he wants to revisit the issue, after two unsuccessful efforts in 2017 to undo former president Barack Obama’s signature legislative achievement. Trump has long fumed over those failures, and as recently as last week was attacking the late senator John McCain (R-Ariz.) for his pivotal role in quashing the effort.

It may be that Trump is so angry with John McCain that this is personal. He’ll show John McCain who’s boss and who’s the real hero here – him, not John McCain – and McCain will now have to hang his head in shame and admit that Donald Trump is the far better man. Trump will get rid of all of Obamacare, every bit of it, and show John McCain a thing or two.

How will McCain react? Trump can’t wait. John McCain can. He’s dead. And Obamacare is alive. And now Trump has finally found a way for the Democrats to finally get organized:

By resurfacing old battles about stripping away popular elements of the current health-care system, Trump is likely to embolden and unite Democrats who seek to make health care a top issue in 2020, said Amy Walter, national editor of the Cook Political Report. Democrats who have been divided in recent months over proposed Medicare-for-all legislation can now coalesce around the idea of protecting the ACA’s most popular provisions, she said.

Trump provided the Democrats with a clear mission that ends all their internal squabbling:

While many Democratic presidential candidates have embraced health-care proposals that go beyond the Affordable Care Act to offer universal coverage, defending the law against Republican efforts to dismantle it has proven to be a potent rallying cry and an effective unifying tool.

Sen. Bernie Sanders (I-Vt.) has frequently emphasized his support for Medicare-for-all in his presidential campaign, but Tuesday he sought to defend Obamacare from the Trump administration.

“Our goal is to pass Medicare-for-all and make health care a right,” he wrote on Twitter. “Today our job is to defend the Affordable Care Act from relentless attacks by the Trump administration.”

Paul Waldman asks a simple question:

Why would the administration do something that is both so substantively horrifying and so politically bonkers?

They should have known better, and some did know better:

This lawsuit was brought by a collection of Republican states, which filed it in a particular district in Texas precisely so it would be heard by Judge Reed O’Connor, who has a well-earned reputation as a partisan Republican. Yet when he did what they wanted and ruled that the entire ACA should be wiped from the books, even many conservatives were aghast (see here or here), as they realized what the fallout would be if their long-standing effort to destroy the ACA were to actually succeed.

And what would that fallout be? Never in our history has the health-care system undergone an upheaval such as what the Trump administration and other Republicans are seeking. It would be an absolute catastrophe for tens of millions of Americans.

Someone didn’t think this through:

The expansion of Medicaid would be rolled back, snatching coverage away from millions of Americans. So would the subsidies that millions more receive to afford coverage. Protections for preexisting conditions? Gone. Insurers would once again be able to deny you coverage if you’ve ever been sick or had an accident. Young people allowed to stay on their parents’ plans until age 26? Not anymore. Women could once again be charged more for insurance than men. Yearly and lifetime caps on coverage would come back, as would the Medicare prescription drug “donut hole.” Rural hospitals would be starved of funding and would close.

That covers just a portion of what the ACA does. There are dozens of other provisions that in the years since the law was passed have profoundly altered the shape of the American health care system. To just chuck it out the window would be an instant cataclysm. As the ordinarily measured Nicholas Bagley puts it, “The notion that you could gut the entire ACA and not wreak havoc on the lives of millions of people is insane.”

And it’s immoral and stupid too:

As a recent Urban Institute analysis concluded, eliminating the ACA would cause 19.9 million Americans to lose their health coverage. The Kaiser Family Foundation estimates that 52 million Americans, or more than a quarter of all non-elderly adults, have a preexisting condition that could shut them out of health coverage were the ACA not in place.

Especially after health care was the most important issue of the 2018 election, in which Republicans desperately tried (and failed) to convince voters that they’d protect people with preexisting conditions, it’s difficult to find words to adequately describe how politically stupid it is for the administration to take this position.

Waldman, however, sees how this might have been predicted:

When he ran for president, Trump made lots of noises that suggested he was something of a moderate, at least on a few issues. He’d claim that he’d protect Medicare and Social Security, and even promised that he’d provide “insurance for everybody.” But no one really took those statements seriously, because it was obvious that outside of trade and immigration, Trump has no particular beliefs about any issues, much less a coherent ideology that guides him.

But instead of producing moderation, Trump’s ideological blurriness led to a more conservative set of administration policies. His own beliefs provide no borders within which his aides are required to work. And since he is so corrupt and personally despicable, many of the more sensible Republican policy wonks who would have staffed a different Republican administration chose to stay away, leaving the administration to be filled either by people who shared Trump’s penchant for self-dealing or by extremist ideologues who correctly surmised that a president who didn’t care about policy would give them free rein to indulge their wildest fantasies.

Now add in the fact that unlike other Republican presidents, Trump sees no political advantage in expanding his support. He firmly believes that his political survival depends only on keeping his most ardent supporters satisfied with what he’s doing while also keeping them agitated and angry at his opponents. So there is never a moment when Trump will say, “Hold on, that’s going too far —- moderate and independent voters will be angry if we do that.”

So this had to happen:

When you combine these two factors – Trump’s indifference to policy, and his desire to play to his base and only his base – the result is an administration that is in many ways more conservative than any in modern history.

For them, the thought of taking away health coverage from tens of millions of Americans and removing vital protections from tens of millions more isn’t an unfortunate consequence of their effort to destroy the Affordable Care Act; it’s the whole point. That’s what victory looks like to them – unless, of course, someone stops them. Don’t be surprised if that someone is Chief Justice John G. Roberts Jr., who is smart enough to know when the Republican Party needs to be saved from itself.

 But even if Roberts winds up joining with the liberals on the Supreme Court to rule against the administration and send this abomination of a lawsuit where it belongs, the Democrats just had much of their 2020 campaign written for them.

That’s a gift, and Karen Tumulty adds this:

Trump may be going through this as a theoretical exercise merely to please his base. After all, the Supreme Court has already ruled twice that the key parts of the ACA are constitutional.

But it may also be that Trump believes that the hardball tactic will somehow bring Democrats to the negotiating table. If that is the case, he is making the same miscalculation he did when he shut down the government on the assumption that it would give him leverage to get the money he wanted to build his border wall.

No one would argue that the ACA has worked perfectly. And many Democrats are at risk of running too far in the other direction as they tout Medicare-for-all, a government-run system that would replace private health insurance.

But they are delighted to change the subject from the Mueller investigation. In the House, Democrats introduced legislation Tuesday that aims to provide additional tax credits and subsidies for families struggling to buy coverage in the ACA marketplace and strengthen protection for people with preexisting conditions.

Speaker Nancy Pelosi (D-Calif.) told her members during a closed caucus: “This is a path to everything else.”

As it happens, Tuesday was Pelosi’s birthday. And Trump just handed her the best gift she could have hoped for.

That was not his intention. None of this was, but no one talked him down from that ledge, where he seems to have lived his whole life. That’s exciting, and now the excitement is killing us – now it’s actually killing us.

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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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