Thursday, October 31, 2019


New York Times Confirms: It's Trump Versus the Deep State

Even the Gray Lady admits the president is up against a powerful bureaucracy that wants him sunk

The New York Times on Thursday published a remarkable piece that essentially acknowledged the existence of an American “deep state” and its implacable hostility to Donald Trump. The Times writers (fully five on the byline: Peter Baker, Lara Jakes, Julian E. Barnes, Sharon LaFraniere, and Edward Wong) certainly don’t decry the existence of this deep state, as so many conservatives and Trump supporters do. Nor do they refrain from the kinds of value-charged digs and asides against Trump that have illuminated the paper’s consistent bias against the president from the beginning.

But they do portray the current impeachment drama as the likely denouement of a struggle between the outsider Trump and the insider administrative forces of government. In so doing, they implicitly give support to those who have argued that American foreign policy has become the almost exclusive domain of unelected bureaucrats impervious to the views of elected officials—even presidents—who may harbor outlooks different from their own.

This is a big deal because, even in today’s highly charged political environment, with a sitting president under constant guerrilla attack, few have been willing to acknowledge any such deep state phenomenon. When in the spring of 2018, The National Interest asked 12 presumed experts—historians, writers, former government officials, and think tank mavens—to weigh in on whether there was in fact such a thing as a deep state, eight said no, two waffled with a “sort of” response, and only two said yes. Former Colorado senator Gary Hart made fun of the whole concept, warning of “sly devils meeting in the furnace room after hours, passing out assignments for subverting the current administration.”

But now the Times’ Baker et al weigh in with an analysis saying that, yes, Trump has been battling something that some see as a deep state, and the deep state is winning. The headline: “Trump’s War on the ‘Deep State’ Turns Against Him.” There’s an explanatory subhed that reads: “The impeachment inquiry is in some ways the culmination of a battle between the president and the government institutions he distrusted and disparaged.”

As the Times reporters put it in the story text, “The House impeachment inquiry into Mr.Trump’s efforts to force Ukraine to investigate Democrats is the climax of a 33-month scorched-earth struggle between a president with no record of public service and the government he inherited but never trusted.” Leaving aside the requisite rapier thrust at the president (“with no record of public service”), this is a pretty good summation of the Trump presidency—the story of entrenched government bureaucrats and a president who sought to curb their power. Or, put another way, the story of a president who sought to rein in the deep state and a deep state that sought to destroy his presidency.

Baker and his colleagues clearly think the president is on the ropes. They quote Virginia’s Democratic Representative Gerald Connolly as saying the nation is headed toward a kind of “karmic justice,” with the House impeachment inquiry now giving opportunity to once-anonymous officials to “speak out, speak up, testify about and against.”

Connolly and the Times reporters are probably right. The House seems headed inexorably toward impeachment. The president’s struggle against the deep state appears now to be a lost cause. To prevail, he needed to marshal far more public support for his agenda—including curtailment of the deep state—than he proved capable of doing. He is a beleaguered president and is likely to remain so throughout the remainder of his term.

The reporters note that Trump sought from the beginning to minimize the role of career officials. He gave more ambassadorships to political appointees—”the highest rate in history,” say the reporters (without noting that Franklin Roosevelt, John Kennedy, Lyndon Johnson, and Ronald Reagan weren’t far behind). The result, they write, has been “an exodus from public service.” They quote a “nonpartisan organization” saying the Trump administration lost nearly 1,200 senior career service employees in its first 18 months—roughly 40 percent more than during President Barack Obama’s first year and a half in office.

The reporters reveal a letter from 36 former foreign service officers to Secretary of State Mike Pompeo complaining that he had “failed to protect civil servants from political retaliation” and citing the removal of U.S. ambassador to Ukraine Marie Yovanovitch. Another letter signed by more than 270 former employees of the U.S. Agency for International Development expressed anger at the treatment of public servants and the president’s “cavalier (and quite possibly corrupt) approach to making foreign policy.”

The tone of the Times piece seems to suggest these expressions and actions constitute a kind of indictment of Trump. But a more objective appraisal would be that it is merely the outward manifestation of that “33-month scorched-earth struggle” the Times was talking about. Does a president have a right to fire an ambassador? How serious an offense is it when he appoints political figures to ambassadorships at a rate slightly higher than some previous presidents? If foreign policy careerists decide to leave the government because they don’t like the president’s effort to rein in foreign policy careerists, is that a black mark on the president—or merely the natural result of a fundamental intragovernmental struggle?

But the Times reporters give the game away more explicitly in cataloguing a list of instances where those careerists sought to undermine the president because they found his policy decisions contemptible. “While many career employees have left,” writes the Times, “some of those who stayed have resisted some of Mr. Trump’s initiatives.” When the president canceled large war games with South Korea, the military held them anyway—only on a smaller scale and without fanfare. Diplomats negotiated an agreement before a NATO summit to foreclose any Trump action based on a different outlook. When the White House ordered foreign aid frozen this year, agency officials quietly worked with Congress to get it restored. State Department officials enlisted congressional allies to hinder Trump’s efforts to initiate weapons sales to Saudi Arabia and other nations.

Further, as the Times writes, “When transcripts of [Trump’s] telephone calls with the leaders of Mexico and Australia were leaked, it convinced him that he could not trust the career staff and so records of subsequent call were stashed away in a classified database.” And that was very early in his presidency, about the time Trump also learned there was a nasty dossier out there that was designed to provide grist for anyone interested in undermining or destroying his presidency.

And of course, now governmental officials are lining up before the House impeachment panel to slam the president over his effort to get Ukraine to investigate his Democratic rival Joe Biden and Biden’s son, Hunter, and his apparently related decision to hold up $391 million in security aid to Ukraine. As I have written in this space previously, this outlandish action by Trump constituted a profound lapse in judgment that was a kind of dare for opposition Democrats to fire off the impeachment cannon. And fire it off they have. “Now,” writes the Times, “[Trump] faces the counteroffensive.”

But that doesn’t take away from the central point of the Times story—that Trump and the deep state have been in mortal combat since the beginning of his administration. And the stakes are huge.

Trump wanted to restore at least somewhat cordial relations with Russia, whereas the deep state considered that the height of folly.

Trump wanted to get out of Afghanistan, whereas the deep state totally opposed such a move.

Trump viewed America’s role in Syria as focused on defeating ISIS, whereas the deep state wanted to continue favoring the overthrow of Syrian President Bashar al-Assad.

Trump was wary of letting events in Ukraine draw America into a direct confrontation with Russia, whereas the deep state wants to wrest Ukraine out of Russia’s sphere of influence even if it means opening tensions with the Bear.

Trump wanted to bring China to account for its widespread abuse of normal trading practices, whereas the deep state clung to “free trade’’ even in the face of such abuse.

These are big issues facing America. And the question hovering over the country as the impeachment drama proceeds is: are these matters open to debate in America? Or will the deep state suppress any such debate? And can a president—any president—pursue the Trump policy options without being subjected to the powerful yet subtle machinations of a wily bureaucracy bent on preserving its status and outlook?

SOURCE 

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Why Not Try Free Market Health Care?

John C. Goodman

I’m often asked if the free market can work in health care. My quick answer is: that’s the only thing that does work.

Show me a health care sector where there is no Medicare, no Blue Cross and no employer and I bet that’s a market that works very well.

Lasik surgery is one example. Patients get a package price and they know what they are going to pay in advance. There are no “surprise medical bills.” As my colleague Devon Herrick has shown, there is price and quality competition here – unlike other health care markets.

Competition works. Over the past decade, the real price of Lasik surgery fell 25%, despite a huge increase in the number of procedures and all manner of technological change – the type of change we are told leads to cost increases everywhere else in medicine.

A similar story can be told about cosmetic surgery – another sector where the third-party payers have no role to play.

What about conventional procedures – like knee and hip replacements? Can the market work there? Where patients pay with their own money, it already is working. Canadian patients routinely come to the United States for these procedures (in order to avoid lengthy waits for surgery in their own country). They get package prices and they pay about the same amount that Medicare pays. That’s about one-half to one fourth of what employer plans typically pay.

By the way, there is nothing the Canadians are doing that you can’t do. There are three requirements: (1) you must be willing to travel, (2) you must pay in advance and (3) you can’t have an insurance company step in after the fact and argue about whether the entire procedure was really necessary.

MediBid is a company that puts patients and doctors together for all manner of procedures. It has created an online competitive market. Patients submit data and their need for a procedure. Providers bid on price. Patients can also check out quality information about the providers.

Then there is the international market for medical tourism. You can shave one-third off the cost of surgical procedures and maybe more by traveling to Health City Cayman Islands. The center posts quality information online (infection rates, readmission rates and mortality rates) and I suspect that their numbers easily beat comparable figures at the hospital nearest you.

It’s also worth noting that most of the cost-saving innovations in health care have emerged outside the third-party payer system – initially catering to people paying with their own money, even if the third-party payers eventually came around.

Walk-in clinics emerged for patients who bought primary care with their own health care dollars.

Firms like Teladoc began providing phone and email doctor consultations – completely outside the third-party payer system.
If the idea of letting employees participate in a free medical marketplace seems too radical for some employers, I have a more modest suggestion. Liberate primary care.

That is, put two or three thousand dollars in an account for the employee every year and let the employee be completely responsible for all primary care, all diagnostics tests and maybe even all generic drugs.

Who is ready to serve these employees? Walmart, for one. Beginning this month, Sam's Club is offering customers packages of healthcare services, including discounted dental care, free prescription drugs, and telephone health consultations in Michigan, Pennsylvania and North Carolina.

Also, Walmart has opened its first Health Center in Dallas Georgia, following its business model of “everyday low prices.” A dental cleaning costs $25, a doctor’s visit $40. A test for a urinary-tract infection is $10; a pap smear $50; a vitamin B-12 injection $18; and a flu shot $39.84.

Then there is concierge care. At one time only available to the very rich, a model of what is now called “direct primary care” has been developed by Atlas MD in Wichita and is rapidly spreading across the country.

The cost is $50 a month for an adult and $10 for a child. For that the family gets 24/7 access to a physician (including by phone and email), who provides all the services people traditionally expect from a family doctor. The family also gets access to generic drugs for prices lower than what Medicaid pays.

Ameriflex is a Dallas-based company that helps employers set up a platform for employees to connect with direct primary care doctors – bypassing insurance companies altogether.

A market for primary care is fast developing. Employers are foolish if they don’t take advantage of it.

SOURCE 

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IN BRIEF

"SWINDLING FUTURITY ON A LARGE SCALE": Senate rejects Rand Paul's latest effort to cut spending (The Hill)

FOR THE RECORD: Confiscating the wealth of all billionaires wouldn't pay for three average years of Medicare for All (Washington Examiner)

DEFAMATION SUIT REOPENED: Judge reopens Covington Catholic High student's defamation suit against The Washington Post (Fox News)

TPS EXTENDED: U.S. to extend temporary protections for El Salvadorans for at least another year (CNN)

BREXIT: Britain set for an early election

INNOVATION, NOT REGULATION: MIT engineers develop a new way to remove carbon dioxide from the air (MIT News)

POLICY: Why millions are still uninsured despite government intervention (The Daily Signal)

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For more blog postings from me, see  TONGUE-TIED, EDUCATION WATCH INTERNATIONAL, GREENIE WATCHPOLITICAL CORRECTNESS WATCH, AUSTRALIAN POLITICS, and Paralipomena (Occasionally updated), A Coral reef compendium and an IQ compendium. (Both updated as news items come in).  GUN WATCH is now mainly put together by Dean Weingarten. I also put up occasional updates on my Personal blog and each day I gather together my most substantial current writings on THE PSYCHOLOGIST.

Email me  here (Hotmail address). My Home Pages are here (Academic) or  here  (Personal).  My annual picture page is here

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