WHAT’S THE MATTER WITH TRUMP

America and the world have observed Trump’s behavior and decision making for a year. Do not expect any change during the three years remaining in his term.

Sufficient time has passed to permit an astute observer to make summary observations about the patterns in his behavior.

Trump does not read.  Rather, he gathers information orally and principally from TV talk shows. When he departs for a golfing weekend, neither does he carry a briefcase of reports nor assemble a panel of experts to address current and prospective issues.

In two ways, Trump seems to have the personality of a teenager.  First, he is extremely thin-skinned. Rather than hold his own counsel and roll with the punches, Trump invariably lashes out ridiculing the source’s personality, physical attributes or affiliations.

Second, Trump is a know-it-all. Whether it is the snowfall along the east coast, the personality of another world leader, Putin’s motivation or any other matter, Trump has an opinion.  Whether his opinion is informed is a completely separate question.  Usually not, because like a teenager, Trump has an uninformed opinion about everything.

These are only a few of many examples that question Trump’s stability.

So, what is the evolving observation about Trump’s behavior?  Trump has some type of personality disorder, mental disorder or both.

For two exhaustive survey article see:

https://www.theatlantic.com/health/archive/2018/01/trump-cog-decline/548759/

https://www.vox.com/science-and-health/2018/1/5/16770060/trump-mental-health-psychiatrist-25th-amendment

IT IS TIME

After 11 months as acting as president, Trump’s method of operation is clear.

He makes outrageous and unfounded claims about persons and events via Twitter.

He attacks persons who disagree with him with false assertions via Twitter.

In both cases Trump’s purpose is to divert attention from his questionable acts.

So, it is time to question Trump’s personality disorder and mental state or both.

TRUMP’S MO

It is clear months after Trump’s inauguration that his personality demands that he be the center of attention.  The evidence includes his Tweets that attack:

  1.  Any person offering any suggestion that differs from Trump’s opinion is a candidate for an attack.  The attacks are personal and usually mock or ridicule the person’s age, physical appearance, political affiliation, heritage, associates or qualifications.
  2. Any news organization, non-profit, political or advocacy group that offers contrasting evidence is immediately labeled ‘fake news.’

It is not difficult to see how Trump’s attacks on individuals and organizations result in the feeding his ego.  The sequence begins with an individual or organization stating an obvious error in Trump’s assertion.  The size of the inaugural crowd is an example.

Trump Tweets an attack, usually something nonsense and irrelevant to the individual’s or an organization’s original statement but mocking some characteristic of the person or claiming the facts are ‘fake.’

Then Trump issues re-Tweets or is asked a question in a news conference.

And around-and-around we go with Trump the center of the circle.

Readers know or have known individuals who thrive at being the center of attention.  Most readers respond to acquaintances with Trump-like personalities by dismissing their claims of self-righteous importance as nonsense.

Trump’s Current Ploy

Beginning mid-week Trump began beating the war drums against North Korea by repeating ‘locked and loaded’ and other catch phrases. His ultra-right wing supporters roared their approval and clapped their hands saying ‘Oh boy, another war’.

Yesterday he expanded the possibilities by announcing he is (or may be) considering military action against Venezuela.  What could possibly be in Venezuela that is in America’s national interest except a few barrels of heavy crude petroleum.

Trump’s ploy is to direct the public’s attention away from his failures in Congress and the investigations of his involvement with Russia in last November’s presidential election.

The Affordable Care Act (Again)

Now that the U.S. Senate has failed to repeal and replace the ACA (at least for the time being), today (29 July) Trump has threatened to stop subsidy payments to states and remove coverage for congressional employees.

It is helpful to review the underlying structure of the ACA as an insurance scheme and some of the consequences of Congressional proposals.

The Issue:

Health insurance works by pooling risk across consumers. If people only purchase insurance when they are sick –or when they know they are likely to need medical care in the near future– that results in higher premiums.  The Affordable Care Act, more commonly known as “Obamacare”, used a combination of carrots and sticks to entice healthy individuals to buy insurance: it offered subsidies to purchase insurance but also imposed the individual mandate which requires people to pay a tax penalty if they do not get insurance. The current Republican proposal to “repeal and replace” the Affordable Care Act eliminates the individual mandate and provides less generous subsidies to consumers who buy coverage on the individual market.

Reduced subsidies together with the elimination of the individual mandate are likely to result in a smaller share of healthy people participating in the individual insurance market.

The Facts:

  • The individual mandate, one of the most contentious and unpopular aspects of the Affordable Care Act, imposes a tax penalty on people who do not obtain health coverage through any source (unless they meet certain exemptions). Although it was politically unpopular, the mandate was considered necessary for the market to work. Popular ACA provisions that prevent insurers from excluding pre-existing conditions and restrict their ability to charge sick people higher premiums make it more likely that unhealthy people get coverage. Mandate penalties were phased in over three years starting in 2014 to encourage healthier consumers to purchase coverage. The average household penalty was estimated to be $969 for tax year 2016 among those who were uninsured in early 2015 and eligible to enroll in the marketplace. There is some evidence that having a mandate encourages healthy people to participate in health insurance markets.
  • Since the majority of the U.S. population receives coverage either through employer-sponsored health insurance (about 50 percent) or through Medicaid, Medicare, or other public programs (about 35 percent), the people most impacted by the mandate are those who buy insurance through the individual market. As of 2015, about 7 percent of the U.S. population received insurance coverage through the individual market and 9 percent — about 29 million people — were uninsured.
  • The American Health Care Act proposed by House Republicans would eliminate the individual mandate, adding instead a “continuous coverage” provision that would impose a 30 percent surcharge on monthly premiums for a year to those who let their coverage lapse. In practice it is unclear whether this provision offers enough of a stick to keep healthier individuals enrolled. While the penalties could be higher for some groups, the prospect of facing higher premiums could make people who lose coverage wait until they get sick to purchase insurance (see here for estimates).
  • Insurance subsidies under the Republican proposal are on average less generous than the existing ones, according to estimates from the Kaiser Family Foundation. While the Affordable Care Act bases subsidies on income and limits them to people who are below 400 percent of the poverty level, the Republican proposal bases subsidies on age. As a result, subsidies are less generous for most consumers under the Republican plan.

What this Means:

If the Republican sponsored American Health Care Act becomes law, the combination of reduced subsidies and the elimination of the individual mandate are likely to result in a smaller share of healthy individuals participating in the individual market. A relatively sicker pool of insured people would raise insurance premiums and higher prices would lead to reduced coverage. The Congressional Budget Office estimates that premiums will be 15 to 20 percent higher than under the current law. A Brookings report has warned that a recurring cycle of increasing premiums leading more healthy people to opt out of insurance could lead to a downward spiral in which rising premiums lead to an increasingly sicker pool of insured patients and eventually to a collapse of the individual market.

The underlying strategy of Republican efforts to replace certain elements of the ACA is to reduce federal expenditures so that the funds not spent on ACA can be used to reduce the taxes paid by high income earners.

P.S. The second attempt to ‘repeal and replace’ the ACA failed to move to a Senate vote on 27 September.  A third attempt is likely to emerge sometime in the future.

In the meantime, construction of the ‘Wall’ is underway. Remember that East Germany constructed a wall to keep its citizens from escaping to the West. The purpose of Trump’s wall is prevent Hispanics from escaping to America. How silly can it be to think that a physical barrier, i.e., the ‘Wall’ will prevent the ingenuity of people from figuring out a way the barrier – slow down perhaps, but not prevent.

 

Source: Econfacts.org and author’s analysis

Yesterday (12 October), Trump signed an executive order removing federal subsidies for low income persons receiving health insurance via ACA, permitting insurance companies to offer policies with extremely limited coverage across state lines.

Trump’s actions are a direct attack on the ACA and whose purpose is to destroy America’s health insurance market.

Trump’s purpose is to tear down/destroy rather than improve/enhance the Nation’s health insurance market.

Trump’s actions in the health insurance market follows along with his initiatives with respect to NATO, climate change, Iran, North Korea, immigration, and the Wall.

Snippet added 13 October 2017

 

 

Widely Shared Concerns/Fears of the American People

– The threat of jihadist terror on a mass scale
– The growing danger of nuclear weapons in the hands of radical regimes
– The possibility of debilitating cyberwarfare
– The economic and political challenge posed by a rising China
– The impact of globalization on American jobs

When people think that their leaders do not share their fears, or are incapable of acting on them, then popular fear turns to rage.

Trump’s campaign sensed voter’s fears. His campaign focused almost exclusively on highlighting these fears.