President Trump’s Bad Medicine
President Donald Trump won his first term while I was in Houston with my brother Harry seeking medical care. Patients and family members at the lunch tables at MD Anderson and women lunching at the local arts museums talked in hushed tones about their fears for the futures of their health coverage and care under Trump’s leadership. I did not know there was such a terror in Texas for those expressing what I, being from deep blue California, thought of as mainstream thinking and policies. My brother Harry knew a great deal about Trump as he had lived in both NYC and Palm Beach and thought him an utterly unprincipled self-promoter. Trump had been rejected in the old money worlds of NY real estate and Palm Beach society, but had set about creating his own world and his own circle centering on Mar a Lago, new wealth, and created his own improbable but successful path to the Presidency.
As President, he sought constantly to repeal the Affordable Care Act and undo nearly all the health policy advances for America’s uninsured – an issue that I had worked on for over 40 years. Thank you, Senator John McCain for your courageous “no” vote and Senators Collins and Murkowski. Trump’s only significant legislative success in his first term was the big reduction in tax rates for the wealthy and for the large corporations.
He did change the Republican Party and made it more xenophobic and isolationist than it had been since the late 30’s, the era of the America Firsters who were unwilling to confront the NAZI’s and/or were in sympathy with Hitler in the lead up to WW II. He signaled to all that it was ok to be racist, misogynist, lying, cheating, not paying taxes, hate-filled, anti-immigrant, and it was even ok to try to overthrow the government to keep him in power.
He focused on building a wall on the Mexican border to keep out immigrants. This was a fool’s errand, and he wasted lots of money and political time trying to ram through a superlatively stupid idea. I was more upset about his anti-immigrant rhetoric and actions than anything else because ITUP had had so many wonderful individuals with immigrant backgrounds working there, and I was so impressed by, and learned so much from all of them.
Trump did not create this maelstrom that seeks to swallow and destroy all that is best about this country. He has haphazardly woven together strands from many infamous predecessors, dating back to the Know Nothings of the 1850’s, the Confederacy and its adherents in the 1860’s, the robber barons of the 1880’s and 90’s, the KKK, the white supremacists, the eugenicists, the home grown NAZI’s, fascists and their sympathizers of the 1930’s, and the McCarthyites and John Birchers of the 1950’s. Lately, they have been joined by the Billionaire Boys Club of tech-titans intent on feathering their own already very comfortable nests at Trump’s sumptuous dining table.
The question for all of us is why do people find this appealing and vote for him and his allies? In particular, why do working class voters not reject this effort to roll back their rights and benefits in favor of the billionaires associated with Trump and benefitting from his corruption and misguided policies? Having spent my life and professional career supporting the policies he seeks to destroy, I should have seen this coming and should have had some good answers. I didn’t; I don’t, but I’ll try.
Working class wages have been stagnant or even declining since the late 70’s while upper class incomes have soared. https://www.epi.org/publication/charting-wage-stagnation/ The bouts of inflation hit lower- and middle-income families the worst. https://www.dallasfed.org/research/economics/2023/0110 Immigration is a huge boon to the economy but hurts the wages and economic prospects of low wage and low skilled US citizens. https://www.urban.org/sites/default/files/publication/31186/1001162-immigration-and-economic-mobility.pdf While the US economy has been surging, the quality of American life has been deteriorating quite badly. https://www.nytimes.com/2025/02/04/briefing/the-us-economy-is-racing-ahead-almost-everything-else-is-falling-behind.html And the life expectancies of the white working class have been cratering – “deaths of despair”. https://pmc.ncbi.nlm.nih.gov/articles/PMC8221228/#:~:text=It%20is%20believed%20these%20causes,Case%20and%20Deaton%20(2017). The US economy has been shedding better-paying manufacturing jobs and shifting towards lower-wage service sector jobs for many decades. https://www.jec.senate.gov/public/_cache/files/94bf8985-1e87-438b-9a3a-e3334489dd30/background-on-issues-in-us-manufacturing-and-supply-chains-final.pdf
We got involved in long, senseless and ultimately futile wars in the Middle East, then failed to support the VA, and the VA failed to do its job in addressing the complex needs of those returning with terrible wounds to the body, spirit and psyche. https://www.minnpost.com/politics-policy/2013/08/back-home-government-failing-its-returning-veterans-many-levels/
Trump captured working class voters by saying he would bring back the US manufacturing excellence and US economic supremacy and increase worker’s take home pay and reduce their cost of living. His two major hobbyhorses to achieve these laudable goals are tariffs and immigration, and he is wrong on both issues and taking the nation in the wrong direction.
We need to enact a sound immigration policy because our workforce is aging, our proportion of workers to retirees is inadequate to support our social safety net for seniors; US birthrates are low and declining (https://www.ajmc.com/view/us-birthrate-reaches-historic-low-new-cdc-data-reveal), and the dynamism of new immigrants benefits the whole society (https://www.forbes.com/sites/stuartanderson/2023/02/23/immigrants-make-economies-more-dynamic-increase-employment-growth/. No progress in Congress has been made on this issue since the mid 80’s under then President Ronald Reagan. At a time when we have worker shortages and badly need more young workers for the health of our economy, Trump is trying to deport this young hard-working, often low paid workforce and deter them (about 11 million) from remaining in the country.
Our trade imbalances have long persisted in manufacturing (but not services or farming), and they are troubling, but they are due more to the decline in US manufacturing competitiveness in particular industries like clothing or shoes, our aging and inefficient infrastructure which needs updating, and our higher relative wages, than they are to other nation’s dumping practices or their tariffs. We have appropriate and effective remedies for dumping; they are not broad scale tariffs on our allies and important trade partners, which simply fuels inflation, hurting American consumers and disrupts entire industries (like automobiles) built from components from around the world. https://enforcement.trade.gov/intro/index.html
The President believes that he can impose tariffs without a vote of Congress (I’m not so sure); tariffs are basically a sales tax on the price of imported goods that consumers pay. We had our founding revolution based on a tax on imported tea – remember no taxation without representation and the Boston Tea Party. Tariffs are not going to help build new factories in the US (it takes a lot of money and a long time to build a new factory), they will increase the costs of consumer goods in the US and spike inflation for consumer’s everyday purchases. Targeted tariffs to protect our emerging industries like solar and electric vehicles do make sense. Tariffs to build a wall around the US economy make no sense whatsoever and will suffocate us all.
Trump believes that his prescriptions of protectionism and isolationism will rebuild America’s factories. He supports the old and waning economy of oil, coal, gas, steel, and gas guzzling cars that fostered and accelerated global warming. I grew up in the region that later became the rust belt, and when I go home, the shuttered factories of Cincinnati depress me immensely; I’m sure that part of my distress is the shuttering of Baldwin Piano’s factory which was so much a part of my upbringing and our family history. But the city and its economy have moved on and changed, and now it’s evolving for the better. https://www.pbs.org/newshour/show/community-colleges-gear-up-to-train-workers-for-americas-proposed-manufacturing-future
Hard as it is to imagine, President Trump and I have actually a few things in common. Trump and I both grew up in the era of John Kennedy and Martin Luther King, of the Great Society and the Vietnam War, of civil rights and peace movements, of idealism and the nuclear arms race and fears of Armageddon, of the space race and the residues of McCarthyism, of the environmental movement, and the corruption of Watergate. We learned totally different lessons and completely opposing values from that era.
His dad and his company were prosecuted for their segregated housing practices. He now seeks to tear down civil rights protections and the important programs and progress from the Great Society era. He learned the corruption and bullying tactics he now deploys at the hands of deep masters like Roy Cohn. My dad and the company he worked for were involved in building factories in the Deep South and bringing good paying jobs and an integrated workforce into new factories in Arkansas and Mississippi. They were also a part of the exodus of manufacturing from the North to Southern states due to the wage differentials and lack of unions in the South. That exodus has since shifted manufacturing sites and jobs from the US to Asia and Mexico, and it fueled the male working class decline and debacle in which we all now find ourselves.
Trump spent his professional life catering to the wealthy in country clubs, golf courses, luxury hotels and housing developments and creating the aura of wealth around himself. It is not surprising than that his highest priorities are tax cuts to put even more wealth into the hands of the super wealthy; they are his lucrative clients. You often become the hat you wear at your work.
I spent most of my professional life as a lawyer and advocate for low-income families, for low wage workers, for kids, for immigrants and for the working poor. That has unquestionably colored my views about the economy, taxes and government. I recognize that the struggle to improve the plight of working America requires both mass mobilization and convincing enough of those with power and money to adopt the necessary corrective policies, and that this often can be a long term, collaborative, confrontational, and continuous process with inevitable ups and downs. We are right now entering into the deep abyss, that could in turn I hope provoke a monster backlash. If we do emerge, as a nation, we will have to move effectively and efficiently when opportunities arise and permit rapid change. LBJ and FDR did that for the nation; they had the deep experience and vision to do that for our country. Obama did this in part with the Affordable Care Act and Dodd-Frank, which Trump and allies seek to reverse.
Trump’s economic mindset and worldviews seem stuck in the economy of the 50’s, when he grew up. He blames everyone else around the globe for the decline of the US iron, steel, coal industries, and its many industrial spin offs. This vision clearly has a lot of superficial appeal to hurting blue collar voters and distressed factory owners from the regions of the industrial rust belt. His prescriptions to fix our economic imbalances, however, are not only bad, but dangerous. We live and operate in a global economy; we cannot stick our heads in the sand like ostriches and pretend otherwise.
Trump’s vision is bad for the future of the planet and for the future of our nation. His agenda will accelerate global warming, isolate us from our allies, and take us down the wrong path for developing the new US economy. Try selling overpriced or poorer-quality cars, trucks, appliances, or other manufactured goods to customers in a highly competitive world that has moved on from America’s post WW II industrial dominance. You have to be able to sell a quality product that is competitively priced; you have to constantly innovate to stay ahead of your competitors. Global fair market competition compels and allows us as a nation to do so. Tariffs and isolationism do not.
You don’t win in the global economy by destroying science and scientific inquiry, by muzzling academic debate and attacking the great institutions of higher learning. You shoot yourself and the whole nation in the foot at the same time other nations are producing more well-trained scientists and engineers than ever.
Trump in his own fashion is pushing the same misguided and insular isolationism that caused the decline and eventual collapse of the Soviet Union and the Eastern Bloc countries. The same insular attitudes, in concert with the US embargo, help keep the Cuban economy in the deep freeze of the 50’s. The same insular attitudes are at play in Venezuela. We in the US, as powerful and rich as we now are, still have to compete on a level playing field with China, with Europe, and with the strong Asian economies, not pull up the drawbridges at the water’s edge and our northern and southern borders. We have to offer fair wages and a good and growing standard of living to our workforces. And we need to put a stop to the lavish executive compensation packages that have lost touch with any semblance of reality. See for one particularly egregious example, Elon Musk’s $56 billion compensation package approved by his hand-picked Board of Directors. https://www.investopedia.com/elon-musks-multi-billion-dollar-pay-package-8757243