 | | President Donald Trump tossing masks into a crowd at a rally in Sanford, Fla., in October.Jonathan Ernst/Reuters |
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Former President Donald Trump stands accused of inciting a riot that left at least five people dead and more than 100 police officers injured. |
But according to a new report from The Lancet, a respected medical journal, that's just the tip of the iceberg when it comes to the harm that Trump did to public health during his time in office. |
Released today, the 49-page report ticks off the health effects of Trump's policies on everything from the environment to taxes to Covid-19. And the results aren't pretty. |
Soon after Trump took office in 2017, The Lancet established the Commission on Public Policy and Health in the Trump Era to study the health impact of his decisions in the White House. Over the past four years, the commission analyzed his policies as they took shape while seeking to place them in a broader historical context. |
They found that Trump's mismanagement of the coronavirus pandemic caused tens of thousands of deaths that might have been avoided if the country's response had been more effectively coordinated. |
"I think the huge number of deaths from Covid, compared to the other G7 wealthy nations, was striking," said Steffie Woolhandler, a co-chairman of the committee and a distinguished professor at Hunter College in New York. |
But even before the pandemic, the report found, Trump's attempts to dismantle the Affordable Care Act had increased the number of uninsured Americans by two million to three million people. |
His trillion-dollar tax cuts primarily benefited high-income Americans, while stripping the federal government of resources that it had used to pay for social-welfare programs. |
"Even prior to the pandemic," said Woolhandler, a physician, "the United States' policies had so thoroughly failed to provide the conditions to protect health that 461,000 people who died in 2018 would have survived if our death rate were the same as other healthy nations." |
Yet she noted that many of the United States' public health problems predated not only the pandemic, but also the Trump administration. In many cases, the authors wrote, the health decline under Trump was only a continuation of a broader trend — one that seems to have begun in the early 1980s. |
"In 1980, life expectancy in the United States was the same as in all our developed nation counterparts — Germany, France, Japan," said Kevin Grumbach, a member of the commission and a professor at the University of California, San Francisco. "Every year since 1980, the U.S. started falling farther and farther behind these other nations. So now we are three or four years behind the average life expectancy of these other nations." |
Grumbach, who is also a physician, said that over the same period, the cost of health care had risen far more quickly in the United States than in other nations — a trend that Trump contributed to. The report found that his administration increased the privatization of government health programs like Medicare, most likely leading to a rise in costs for consumers. |
The report also concluded that by loosening scores of regulations, Trump caused environmental harm that led to the deaths of over 22,000 people in 2019 alone. That was significantly more than had died for similar reasons in 2016. |
"That was very surprising, because it's one area the United States has been improving on in recent decades," Woolhandler said. "And Trump very quickly managed to reverse the progress." |
Biden's economic plans put American manufacturing at the center. |
As President Biden seeks to push through a $1.9 trillion coronavirus relief package, his economic team already has its eyes set on more distant horizons. |
As Noam Scheiber reports in a new 7,500-word feature for The Times Magazine, Biden and his economic advisers are hoping for nothing short of a total transformation of the United States economy, turning the page on an era in which business interests and free trade were often given more weight than the interests of middle-class and working-class Americans. |
Noam and I connected today, and he answered a few questions about what he learned while reporting. |
Hi Noam. You mention in the story that Biden's economic plans include an embrace of protectionist trade policies, which will shelter American manufacturing from foreign competition. How much does this represent a shift from the approaches of recent presidents, including Democrats like Barack Obama and Bill Clinton? And how realistic does it seem? |
Yes, it's not quite protectionist in the most obvious sense of the term — with tariffs or overt trade restrictions of the sort that Trump put in place. But the White House very much intends to subsidize new industries in a way that advantages domestic production over imports, which is something that countries like China have done a lot of in recent decades and we've typically shied away from. |
Clinton of course signed an agreement to permanently normalize our trade relationship with China, which a lot of economists now believe resulted in devastating losses to the U.S. manufacturing sector. Obama negotiated and aggressively promoted the Trans-Pacific Partnership, which would have liberalized trade with 12 other countries. So this is a shift, one that's at odds with the language of some of Biden's own advisers before entering the administration. Most prominent among them is Treasury Secretary Janet Yellen, long a self-proclaimed free trader. |
How are labor leaders feeling about Biden's plans? Do they feel as if they have a real seat at the table? |
Yes, organized labor has been very pleased with Biden so far. The campaign consulted closely with industrial unions like the United Automobile Workers and the United Steelworkers, as well as service-sector unions like the Service Employees International Union. S.E.I.U. was thrilled by Biden's $775-billion-plus proposal to raise the pay of care workers like home health aides and improve access to care for families who rely on them. |
You write that the United States has recently seen a widespread embrace of so-called economic nationalism across the political spectrum. Why do you think that is? |
It's a handful of things. The loss of manufacturing jobs thanks to the so-called China shock — a flood of Chinese imports undercutting domestic manufacturing — during the first decade of this century played a key role. Employment in manufacturing had hovered near 18 million from 1965 to 2000. Then we lost over three million manufacturing jobs from 2001 to 2007. That was promptly followed by the Great Recession in 2007-9, and then by a grindingly slow recovery. The combination of those things was a pretty good recipe for populism and economic nationalism. |
Then there's another factor, which is that over the past two decades it has become increasingly clear that China is itself practicing a very aggressive form of economic nationalism. For years the Chinese government suppressed the value of its currency to make the country's exports cheaper, which undercut American goods. |
China also massively subsidizes a variety of industries to help its producers achieve global dominance. Both Democrats like Biden and Republicans like Senators Marco Rubio, Mitt Romney and Tom Cotton have become alarmed at China's industrial ambitions. |
Biden often says that all of this industrial activity will go hand-in-hand with building a green economy. Is it really possible to invest tons of resources in manufacturing and not harm the environment? |
It should be doable if Biden is able to simultaneously meet his goals for the power generation industry — he wants to make power generation carbon-free by 2035, which means relying a lot more on wind and solar energy. The bigger tension on the left is between job creation and environmental goals. To meet those emissions goals, we're going to have to increase the amount of solar and wind power we generate each year roughly threefold. That means we've got to start building a lot more solar and wind farms pretty much immediately. |
But we don't manufacture nearly enough solar panels and wind turbines, or their components, domestically to meet that demand. We're going to have to import a lot of that equipment, meaning workers in countries like Malaysia, Vietnam, Korea and Denmark are going to be doing a lot of that manufacturing, not Americans. That said, there's a lot of work to be done installing this equipment, and making and pouring concrete and steel for new plants. But the jobs picture is a little more complicated than either Biden or supporters of Green New Deal policies make it out to be. |
The impeachment prosecution rests. |
The Democratic impeachment managers rested their case today, arguing that Trump could "do this again" if he is not convicted and appealing to Republican senators' senses of patriotism and decency. |
"Senators, America, we need to exercise our common sense about what happened," said Representative Jamie Raskin of Maryland, the lead manager, reading from Thomas Paine. "Exercise your common sense about what just took place in our country." |
The outcome remains all but predetermined, as Nicholas Fandos and Aishvarya Kavi report in our live briefing, with most Republican senators appearing inclined to stand by Trump. But a few steps remain. Senators will have a chance to question the prosecution and the defense, and the managers may force a debate and vote on whether to call witnesses. |
A verdict could arrive by the end of the holiday weekend. |
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