Street art by Farid Rueda
Street art by Farid Rueda
THURSDAY, FEB 23, 2017 05:00 AM PST
On Wednesday NBC News released a poll reporting that 66 percent of Americans surveyed were worried that the United States will become involved in another war. One might think that’s surprising since President Donald Trump has famously been portrayed as an old-school isolationist, an image mostly based upon his lies about not supporting the Iraq War and his adoption of the pre-World War II isolationist slogan “America First.”
As I laid out for Salon a few weeks ago, that assumption is wrong. Trump is anything but an isolationist. He’s not much on alliances, preferring to strong-arm other nations into supporting the U.S. “for their own good.” But if they are willing to cough up some protection money, he might agree to fulfill our treaty obligations. His adoption of the phrase “America First” reflects his belief that the U.S. must be No. 1, not that it should withdraw from the world.
In other words, while Trump has no interest in perpetuating the global security system under which the world has lived since the dawn of the nuclear age, that’s not because he believes it hasn’t worked. He doesn’t know what it does, how it came to be or why it exists. He simply believes other countries are failing to pay proper respect and he is aiming to make sure they understand that America isn’t just great again; it’s the greatest.
This has nothing to do with American exceptionalism. Trump is happy to admit that American pretenses to moral leadership are hypocritical, and he’s openly contemptuous of anyone who believes that the U.S. should try harder to live up to its ideals. If you want to understand what Trump believes, “to the victor goes the spoils” pretty much covers it. He means it in terms of his family, which continues to merge the presidency into its company brand all over the world, and he means it in terms of the United States, believing that this is the richest and most powerful nation on Earth and we can take whatever we want.
One of his goals is to “defeat ISIS.” And when he says defeat, he means to do whatever it takes to ensure it does not exist anymore. That does seem like a nice idea. After all, ISIS is an antediluvian, authoritarian death cult and the world would be better off without it. The question, of course, has always been how to accomplish such a thing.
Thoughtful people rationally understand that “defeating” radical extremism of any kind isn’t a matter of killing all the people. Indeed, the more extremists you kill, the more extremists you tend to create. But while Trump simply sees the world by playground rules, his consigliere Steve Bannon sees the threat of ISIS as a preordained apocalyptic confrontation between Western countries and the Muslim world. In a notorious speech he gave at the Vatican in 2014, Bannon put it this way:
We’re at the very beginning stages of a very brutal and bloody conflict . . . to fight for our beliefs against this new barbarity that’s starting, that will completely eradicate everything that we’ve been bequeathed over the last 2,000, 2,500 years.
He has called Trump his “blunt instrument” to bring about this global conflagration. Bannon is now a member of the National Security Council and is said to be running a parallel national security agency called the Strategic Initiatives Group, which he has stacked with kooks who share his views. He is a powerful influence.
Trump has promised to take the gloves off, and I think we all know exactly what he meant by that. He said it many times during the campaign: He favors torture. And he reiterated it just last month in his interview with ABC’s David Muir saying, “When ISIS is doing things that nobody has ever heard of since medieval times, would I feel strongly about waterboarding? As far as I’m concerned, we have to fight fire with fire.”
And Trump went on to grudgingly promise that he would listen to the secretary of defense and hold back on torture if that was his recommendation. But Trump also claimed that he’s talked to people at the highest levels of the intelligence community who told him that torture works like a charm. So we will have to see if the president is really able to restrain himself. (His CIA chief, Mike Pompeo, has been all for it in the past. Maybe they’ll simply decide to leave Defense Secretary Jim Mattis out of the loop.)
But what about Trump’s promises to “bomb the shit out of ’em” and “take the oil?” What about Bannon’s desire to bring on WorldWar III? Will that really happen? It might, and sooner than we think.
The New York Times reported on Wednesday:
More American troops may be needed in Syria to speed the campaign against the Islamic State, the top United States commander for the Middle East said on Wednesday.
“I am very concerned about maintaining momentum,” Gen. Joseph L. Votel, the head of the United States Central Command, told reporters accompanying him on a trip to the region.
“It could be that we take on a larger burden ourselves,” he added. “That’s an option.”
Despite his unfounded reputation for isolationism, it’s obvious that Trump is itching for a war. Responding to a debate question about whether he would follow a military commander’s advice to put troops on the ground, Trump said, “We really have no choice; we have to knock out ISIS. We have to knock the hell out of them.” When asked how many troops he thought might be needed, he replied that the number he had heard was 20,000 to 30,000.
Nobody thought much of Trump’s bluster at the time. But now he’s in the White House with an apocalyptic crackpot whispering in his ear and generals on the ground talking about taking on “a larger burden.” Whether his administration’s military advisers, Defense Secretary Mattis and his newly installed national security adviser, Gen. H.R. McMaster, are as eager for this battle remains to be seen. But it appears that the two-thirds of Americans who are worried that we’ll be dragged into another war are anxious for good reason.
The US media and political establishment has responded with virtually universal praise to Donald Trump’s choice of Lt. Gen. H. R. McMaster to replace the fired ex-general Michael Flynn as his national security adviser.
Observing the response from both Democrats and Republicans, as well as the corporate media, one might conclude that a memo had gone out from CIA headquarters on the language to be used in describing McMaster. He is a “scholar,” an “experienced commander,” an “iconoclast,” even an “intellectual.” The received wisdom is that this mixture of Thucydides and Clausewitz will provide “reasoned and sound judgment” to guide the foreign policy of the Trump administration.
Democratic Senator Sheldon Whitehouse gushed that McMaster is a “card-carrying grownup,” while Democratic New York Representative Steve Israel proclaimed him a “brilliant, reasoned leader.” Former Obama administration official and Clinton advisor Jared Cohen called him a “brilliant strategist and thinker.”
On the part of the media, the New York Times, which functions as a de facto organ of the Democratic Party, set the tone with its editorial on Wednesday. Its response was particularly noteworthy given the newspaper’s leading role in the anti-Russian campaign waged by the intelligence agencies.
The editorial’s headline appealed directly to Trump and his top White House aides: “Now, Let General McMaster Do His Job.” It declared the latest Trump general to be “an enlightened choice.” It went on to advise, “If Mr. Trump empowers him and defers to his judgment, General McMaster could be an important moderating force in an administration packed with radicals and amateurs.”
The editorial praised McMaster as a “student of history,” “one of the military’s most gifted scholars and strategists,” and “one of the best American commanders” in the Iraq War. According to the Times, McMaster’s book on Vietnam War decision-making in Washington, Dereliction of Duty, “lays out the consequences of abetting misguided presidents with ill-conceived policies.”
The Times piles on the flattery in an op-ed column by Jonathan Stevenson, a former Obama national security aide, who describes McMaster as “a compelling choice: a scholar-warrior in the mold of Secretary of Defense Jim Mattis, with the bonus of looking every inch the part,” and “a proven cavalry officer and a formidable defense intellectual,” who demonstrated in Iraq “exemplary application of counterinsurgency doctrine.”
The immediate issue driving the praise for McMaster is the hope that his foreign policy views, which adhere to the conventional anti-Russian consensus of the bulk of the military-intelligence apparatus, will prevail within the councils of the Trump administration, particularly when General Mattis at the Pentagon and General John Kelly at the Department of Homeland Security weigh in as well.
More generally, the exercise in collective deification is an expression of the disintegration of American democracy and the extraordinary power of the military over all official institutions in the United States.
The growing influence of current and former generals, who occupy four top positions in the Trump national security hierarchy—secretary of defense, secretary of homeland security, national security adviser and National Security Council chief of staff—is no cause for concern to the media pundits and newspaper columnists, who appear to have forgotten the core democratic principle of civilian control of the military.
Especially noteworthy in the praise of McMaster—who will remain on active duty as national security adviser—is the reference to the lessons he drew in his analysis of the Vietnam War. McMaster’s book denounced the Joint Chiefs of Staff for failing to demand that President Lyndon Johnson commit the resources required to “win” the war up-front: as many as 700,000 troops, no restrictions on ground operations in South Vietnam, and unrestricted targeting of North Vietnam for bomb attacks, including MiG fighter bases and ports where Soviet and Chinese military personnel would likely have been killed.
His thesis is a variant of the criticism leveled against the methods of “limited war” in Iraq and Afghanistan in favor of an all-out approach, summed up by the slogan, “Go big, or go home.”
That such methods would have constituted a massive war crime in Vietnam, even greater than the one actually perpetrated by the tactics of gradual escalation—millions of Vietnamese dead, more than 50,000 American soldiers killed, Vietnam, Laos and Cambodia laid waste—does not interest McMaster’s fan club in the slightest.
Even more reactionary is McMaster’s argument that the main defect of the Vietnam War was the failure of the generals to assert themselves more forcefully against the civilian leadership. Their “dereliction of duty” consisted of allowing themselves to be overruled by a president who, in McMaster’s view, was more interested in winning the war on poverty than the war in Southeast Asia.
More recently, McMaster has been engaged in a military project to study the conflict in Ukraine and the lessons to be drawn by US military planners preparing for war in Eastern Europe against the Russian army and air force.
The response to the selection of McMaster underscores the fact that the conflict that has raged within the political establishment since Trump’s inauguration has nothing to do with the concerns motivating millions of people opposed to Trump’s authoritarianism and right-wing policies. As far as Trump’s establishment critics are concerned, the more power the military and intelligence agencies have over the instruments of state, the better.
In terms of policies, if the desires of those promoting the “moderate” McMaster are fulfilled, there will be a vast escalation of US militarism in relation to Russia, a nuclear-armed power. As for Trump’s other “moderate” generals, Department of Homeland Security head John Kelly is overseeing the assault on immigrant workers and has signed a memo calling for the mobilization of hundreds of thousands of national guardsmen to enforce it. Secretary of Defense Mattis, a war criminal responsible for the destruction of Fallujah, is overseeing a massive expansion of the military in preparation for world war.
All of this demonstrates, as the WSWS has stressed, that Trump is not an interloper into an otherwise healthy democratic society. His administration is the outcome of twenty-five years of unending war and decades of social counterrevolution. The American financial aristocracy stands atop a deeply diseased social order and relies ever more directly on the instruments of war and state repression to maintain its domination.
There is no popular support for further military adventures in the Middle East, let alone the cataclysmic prospect of war with China or Russia, both nuclear-armed powers. The drive to maintain the dominant world position of American imperialism by means of ever more bloody military aggression abroad is inseparably linked to a frontal assault on the social conditions and democratic rights of the working class at home.
BLU in Colonia, Germania
WEDNESDAY, FEB 22, 2017 05:00 AM PST
As you know, our administration inherited many problems across government and across the economy. To be honest, I inherited a mess. It’s a mess. At home and abroad, a mess. Jobs are pouring out of the country; you see what’s going on with all of the companies leaving our country, going to Mexico and other places, low pay, low wages, mass instability overseas, no matter where you look. The Middle East is a disaster. North Korea — we’ll take care of it, folks; we’re going to take care of it all. I just want to let you know, I inherited a mess.
— Donald Trump, Feb. 17
These words of the president are not quite as evocative as his doomsday inaugural “American carnage” address, but it may be more effective in the long run. Donald Trump is ignorant in most ways a president should be smart, but he does have an unerring instinct for hype.
One of his favorite tall tales is the miraculous “comeback” story. You’ve heard him endlessly recount the tedious details of his Great Campaign in which nobody said he could get the nomination and yet he defied the odds and vanquished 16 men, Carly Fiorina and one crooked Hillary, ultimately winning a historic landslide of epic proportions. No, it wasn’t historic and it wasn’t epic and it wasn’t a landslide, but that’s part of the myth Trump has created for himself: He only wins big.
The point is that he’s making himself out to be a hero who can defy tremendous odds to fight back and win. That’s why he insists that he inherited a terrible mess that will take a heroic effort to turn around, and he’s the only guy who can do it.
The country he describes is very familiar: Its economy is terrible, millions of people are going bankrupt and losing their jobs, their homes and their health care. People who have saved money for decades have seen their retirement funds shrink to nothing in the stock market crash, while Wall Street masters of the universe collect millions and tell everyone financial institutions are simply “too big to fail.” Major industries are on the verge of collapse. Banks are closing all over the country.
Tens of thousands of troops are still stationed overseas in a war that seems to never end. Terrorist bombings are happening all over the world and nobody knows when the next one is going to hit close to home. Even the natural disasters are catastrophic, taking out whole American cities and seeming to portend more of the same as the climate changes and nobody knows what to do about it. The future seems bleak indeed.
We all know that country. It was America in 2009. It was the mess our last president inherited, not this one. (If you need a little refresher course on how bad the employment situation was during the Great Recession, you can read all about it in a recap from the Bureau of Labor Statistics.) It was the worst economic recession in the lifetime of anyone younger than age 70 and it came on the heels of a period of tremendous fear and anxiety after 9/11 and the debacle of the Iraq war.
Now that was a real mess.
To be sure, the recovery has been a long, uneven slog and many people are still reeling. There are long-term economic trends that have hit some communities very hard for decades and the Great Recession exacerbated their suffering. And much of the gains have gone to the upper 1 percent.
But millions more people have jobs, homes and health care today than they did eight years ago. That is just a fact. The idea that Donald Trump is facing an emergency of that magnitude, even among many of the white working-class folks who remain underemployed and financially insecure is ridiculous. We were on the verge of another global Great Depression. Now we’re not.
As I pointed out before the election in September, whoever won was going to have the economic wind at his or her back, which is a lucky thing for any president. I quoted economist Jared Bernstein who wrote in The Washington Post that “poverty fell sharply, middle-class incomes rose steeply, and more people had health coverage” in 2015, which meant that many of those who had been left behind by the recovery were starting to see the benefits. But there is often an emotional hangover after a deep economic crisis that takes some time to dissipate; even when things have improved, people still feel anxious for some time afterwards.
One suspects Trump understood from the beginning that the economy was rebounding. But in order to take advantage of his reputation as a wealthy businessman, he needed to pump up those feelings of anxiety so that he could take credit for the upturn once in office. The dystopian hellscape that he describes today will quickly give way to “Morning in America” for his followers. And he doesn’t have to do anything.
This is lucky for him since Trump doesn’t have a clue about what a president has to do in a real crisis and doesn’t have the temperament or skills to do it anyway. As Jonathan Cohn wrote in this piece for The Huffington Post on Tuesday, as much as Trump and his minions insist that his first month in office has been historically successful, it’s been nothing more than endless gaffes, scandals and flashy edicts that are far less substantial than the sweeping and complicated legislation that President Barack Obama ushered through Congress in the corresponding period.
Cohn related Trump’s attitude toward the hard work of creating policy:
During the presidential campaign, Trump mocked Hillary Clinton for her wonkishness: “She’s got people that sit in cubicles writing policy all day,” he said during one interview. “It’s just a waste of paper.” At one point, Trump’s own policy advisers quit because nobody was paying them or taking them seriously.
That’s appalling. But unless Trump’s GOP colleagues in the Congress muck up things badly by repealing the Affordable Care Act or making such drastic cuts that employment falters, he doesn’t really have to do much. He can just tweet about saving some manufacturing jobs that CEOs are happy to pretend he personally negotiated, and his followers will be happy to give him credit for “saving” an economy that was already on the upswing.
Photo Credit: Shutterstock.com
When senators Bernie Sanders and Ted Cruz debated the merits of the Affordable Care Act of 2010, aka Obamacare, on February 7, Sanders had a dire prediction: “We are moving into an era where millions of people who develop terrible illnesses will not be able to get insurance, and God only knows how many of them will die.” The Vermont senator, who favors a single payer or “Medicare for all” system, was right to be concerned. It remains to be seen when or how Republicans in the U.S. Senate and the House of Representatives will repeal the ACA; Sen. Rand Paul has been complaining that repeal is taking much too long and that fellow Republicans don’t appear to be in a hurry to repeal it. But the Urban Institute estimates that if and when Republicans do repeal the ACA, “The number of uninsured people would rise from 28.9 million to 58.7 million in 2019, an increase of 29.8 million people”—and Sanders has predicted that “36,000 people will die yearly as a result.”
Sanders is not exaggerating about the potential death toll; if anything, he is being optimistic. In 2009, a pre-ACA Harvard Medical School/Cambridge Health Alliance study found that almost 45,000 Americans were dying annually due to lack of health insurance. Shortcomings and all, the ACA—according to Gallup—has reduced the number of uninsured Americans aged 18-64 from 18% in 2013 to 11.9% in late 2015. And that includes millions of Americans with pre-existing conditions such as diabetes, heart disease and asthma. The ACA has not only made it illegal for insurance companies to exclude people due to pre-existing conditions, but it has also emphasized preventive care and screenings, which can prevent chronic conditions from developing or at least treat them after a diagnosis. Without those protections, it stands to reason that diabetes, heart disease, cancer and other potentially life-threatening illnesses will be on the rise.
Here are several diseases that are likely to increase or have much worse outcomes if Republicans succeed in abolishing Obamacare and render millions of Americans uninsured.
According to the American Diabetes Association, 30 million Americans suffer from diabetes, while another 86 million have prediabetes. For those 116 million Americans, access to health care is crucial; diabetes, if not managed and controlled, can lead to everything from amputations to heart disease, stroke and blindness. And when prediabetes is managed, patients have a much better chance of avoiding full-blown diabetes. Bearing those things in mind, the American Diabetes Association sent members of Congress a letter in December warning them how dire the consequences could be for Americans with diabetes or prediabetes if the ACA is repealed without a suitable replacement.
“The ACA,” the American Diabetes Association told Congress in the letter, “ended fundamental inequities in access to adequate and affordable health insurance that separated Americans with diabetes from the tools they needed in the fight against the horrific and costly complications of diabetes, including blindness, amputation, kidney failure, heart disease, stroke and death. Repealing the ACA will create huge access barriers for millions of Americans, especially if no fully defined replacement is put in place immediately to meet the health care needs of individuals with chronic health conditions like diabetes.”
In 2016, medical researchers Rebecca Myerson and Neda Laiteerapong examined the ACA’s possible effects on diagnosis and treatment of Type 2 diabetes. The physicians found that 23% of American adults, aged 18-64, with diabetes lacked health insurance in 2009/2010, but said it was “likely that a significant fraction became insured in the subsequent years due to ACA provisions.”
Jennifer Kates, director of HIV policy for the Kaiser Family Foundation, has described the ACA as a “watershed moment” for Americans living with HIV, and the Centers for Disease Control called it “one of the most important pieces of legislation in the fight against HIV/AIDS in our history.” Kaiser research has indicated that 200,000 HIV-positive Americans may have gained coverage through the ACA, and according to the AIDS Foundation of Chicago, the ACA brought insurance to 12,000 HIV-positive Illinois residents.
With HIV treatment, one of the goals is avoiding full-blown AIDS. In a recent article for The Advocate, Carl Schmid, deputy executive director of the AIDS Institute, warned that ACA repeal could be devastating for Americans living with HIV and that access to treatment can be a matter of survival.
“If Congress repeals the ACA without simultaneously replacing it with programs that ensure comprehensive health coverage for the same, if not more, individuals, the private insurance market will become unstable—and people with HIV and others would lose access to the care and treatment that they rely on to remain healthy,” Schmid said. “People with HIV, who depend on a daily drug regimen, cannot risk losing access to their health coverage—not even for a single day… We cannot afford to go backwards by eliminating or destabilizing the health care that the ACA provides.”
In January, Gregory Cooper and his colleagues at University Hospitals’ Cleveland Medical Center in Ohio released a study that compared access to cancer screenings before and after the ACA, which they found was making it easier to obtain mammograms but needed to do more to encourage colonoscopies. Cooper, reflecting on GOP plans to repeal the ACA, stressed that the U.S. needs more cancer screening, not less, saying, “If you take away people’s health insurance and they’re going to pay out of pocket for health care, are they going to get a mammogram, or are they going to buy food? People are going to do what gives them the best benefit in the short term, which is food and shelter.”
Amino, Inc., researching 129 insurance companies, has offered some estimates on possible out-of-pocket costs for cancer screening in a post-ACA environment; in Alaska, for example, the costs could be almost $500 for a routine mammogram or $2,565 for a colonoscopy. And as Cooper pointed out, Americans will put off or avoid potentially life-saving tests when they become cost-prohibitive.
4. Blood Pressure and Hypertension
In 2015, researchers at George Washington University School of Public Health released a study on the effect the ACA was having on hypertension, a major factor in heart disease and stroke. The researchers reported that 78 million Americans suffer from hypertension and that “lack of insurance coverage is a critical barrier to better treatment of hypertension,” and they predicted that if ACA expansion continued, it “would lead to a 5.1% increase in the treatment rate among hypertensive patients.”
5. High Cholesterol
In 2015, the Harvard T.H. Chan School of Public Health published a study that linked the ACA with better outcomes for three conditions: diabetes, high cholesterol and high blood pressure. The study found that uninsured people suffering from any of those conditions were much less likely to find out they had a problem, whereas insured people had a 14% greater chance of finding out if they had diabetes or high cholesterol and a 9% greater chance of finding out they had high blood pressure. And for those who those who were diagnosed, the Chan School found, being insured greatly improved one’s chances of controlling blood sugar, total cholesterol or systolic blood pressure.
Joshua Saloman, a senior author of the study, said, “These effects constitute a major positive outcome from the ACA. Our study suggests that insurance expansion is likely to have a large and meaningful effect on diagnosis and management of some of the most chronic illnesses affecting the U.S. population.”
But instead of insurance expansion, Republicans could significantly reduce coverage. Even John Kasich, right-wing governor of Ohio and one of the many Republicans who lost to Donald Trump in the 2016 GOP presidential primary, sounded a lot like a Democrat when he said that while there is “room for improvement” with the ACA, he was worried about what would happen to “these people who have very high cholesterol” if it is repealed without a solid replacement.
Before the ACA, the term “pre-existing condition” as defined by health insurance companies was far-reaching; anything from multiple scleroses to kidney disease to anemia was grounds for rejecting an application for coverage. For people with asthma, obtaining health insurance was difficult or impossible. 17.7 million adults, according to the Centers for Disease Control, suffer from asthma in the U.S., and when asthma is not treated or controlled, it can become life-threatening (in 2014, CDC attributed more than 3600 deaths annually in the U.S. to asthma).
In 2013, a Harvard Medical School study cited lack of health insurance as the main reason asthma care for young adults deteriorated when they turned 18; emergency room visits became more frequent, and medications often became cost-prohibitive. But with the ACA’s implementation, young asthmatics could stay on their parents’ health plans until 26—and asthmatics, regardless of age, could not legally be refused coverage because of their condition. With full ACA repeal, however, it could once again become legal for insurance companies to deny coverage to asthmatics. And even partial ACA repeal could make asthma care cost-prohibitive.
While ACA repeal is likely, it remains to be seen what, if anything, Republicans would replace it with. Rep. Steve King has made it clear he couldn’t care less if the ACA is repealed without a replacement. However, Rep. Tom Price, President Trump’s nominee for secretary of the U.S. Health and Human Services Department, has proposed replacing it with a plan that would eliminate Medicaid expansion, thus making coverage more expensive for Americans with preexisting conditions. And President Trump has promised that after the ACA, Americans can look forward to more comprehensive coverage at much lower prices. But it’s an empty promise because he has yet to offer any specifics.
In other words, Republican plans for an ACA alternative range from terrible to woefully inadequate to nonexistent. To make matters worse, Rep. Paul Ryan is still pushing for Medicare privatization, meaning that Americans who suffer from ACA repeal could be facing additional hardships if they live to see 65. With Republicans going out of their way to make access to health care difficult or impossible for millions of Americans, the future looks grim for anyone suffering from cancer, HIV, hypertension or other potentially deadly illness.
Street art by Farid Rueda.