(Article originally published here on January 22, 2017)
[I originally published this article on January 22, the day of President Trumps' inauguration. It seemed like wishful thinking then, maybe even satire...but now I wonder even more. Trump has gone out of his way to appoint the worst possible heads of departments imaginable, people who have spent their lives opposing the very departments they now lead. He has signed the most terrible legislation - when he could - and executive orders imaginable, stripping human rights, enabling polluters, and rolling back civil rights years, even decades.
He has made the U.S. a laughing stock, or at least a feared country with such uncertain objectives that even our allies are going ahead on the environment, workers' rights and economics without us.
At every turn, the president out-extremes even the extremist elements of his newly-adopted party (there were many years when he was a Democrat, then saying if he ran for president he would do it as a Republican because they are so much easier to fool).
So, is Donald Trump trying to lose? Is he trying to exhaust his true but unacknowledged opposition by letting them "hang by their own petard?" Is he really not 5 steps, but 10, maybe 20 steps ahead of all of us? How long until the following scenario, seemingly inconceivable when I wrote this, becomes all that's left as an option for healthcare...and for a president who will sign anything his beleaguered party puts in front of him?
What if newly inaugurated President Trump is actually smarter than everyone? What if, as he has said, he "has a really good brain?" Then his promises that seem so over-reaching and even-simple-minded, might actually be part of a long-range endgame that only he knows how to achieve.
Isn't it strange, after all, that he has appointed so many people to lead agencies that those people have spent their careers opposing, even trying to shut down?
I realize that there is a management technique that says "appoint the strongest critic to the department you want seriously reformed" but this is carrying that to extremes....or is it? Maybe Trump is practicing some sort of management Jujitsu, turning an opponent's strength against himself.
Taking health-care as an example, where his nominee, Tom Price, has suggested everything from repealing the Affordable Care Act to eliminating Medicare and Medicaid as we know it, perhaps replacing those with vouchers or block grants to states, respectively, as House leader Paul Ryan wants to do.
Trump has promised "Health Insurance for everyone" as recently as January 15th in an interview with the NY Times.
But, as usual, his promises are dramatically short on specifics, although he has said "I don't want single-payer."
However, there's a management technique, surely known to Donald Trump, who has managed 10s of thousands of people, wherein you go along with someone's idea that you actually oppose. Then, over time, while agreeing with them all the way, you watch them back themselves into a corner, until the proposal you secretly want, becomes the inevitable option.
It could go something like this (substitute Paul Ryan with Top Price, or any number of top level healthcare policy makers):
Donald Trump (DT) (in Oval Office, discussing latest healthcare proposal): Hello Paul, how are you today?
Paul Ryan (PR): Fine, Sir, and you?
DT: Great, just like the country is going to be! I'm very excited to see what you have today to replace the terrible Obamacare with.
PR: (clears throat): Well, Sir, that's what I wanted to talk to you about. As you know, we've been in deep discussion with the House healthcare committee and Secretary Price, but we're having a tough time coming up with a plan everyone can accept, especially one that will cover nearly everyone...
DT: Yes, I want to cover everyone with insurance.
PR: Well, Sir, nothing can really do that that is affordable...I mean (laughs nervously), I mean nothing short of Single Payer...
DT: Oh no, no one wants that...
PR: Well, the Democrats do, of course, at least if we scrap the ACA, they keep tossing that out there, so they don't have to take reform seriously perhaps.
DT: Terrible idea. Just terrible. So...what's your plan so far?
PR: Well, some form of insurance across state lines...and of course, enhanced health savings accounts as you've suggested...but this won't cover everyone...
DT: (sensing that Ryan has nothing substantial to offer): We do have to cover everyone. I made a promise. I have every confidence in you, Paul. Oh, and let's do it soon. After all, we've already basically gutted Obamacare or let it wither and die...and it certainly deserves to do so! It's a terrible plan! Simply terrible, terrible, terrible plan.
PR: Uh, yes Sir. We all agree on that, but we were hoping to repeal it and force the Democrats to help us negotiate a better plan once people have too few coverage options left...
DT: I don't like that. It's too complicated, and too far out there. It could take years. We can't take years. I promised the ACA would be replaced simultaneously.
PR: Yes Sir, but...
DT: I have every confidence in you, Paul. Come back in a week with what you've got.
This goes on for not just a week, but a few weeks, and Ryan and Price and the Republicans are no further along than they were. Two months later, President Trump is pressing the case more urgently to Ryan:
DT: Paul, you mentioned in our last meeting some sort of guaranteed healthcare for everyone below a certain income level, right?
PR: Well, yes Sir, but there is no way to pay for it with private insurance...
DT: (perking up). Oh, you mean there's a way to do it but not with private insurance?
PR: Well, it would have to be some sort of...(makes a face of disgust) Public Option...
DT: Oh, no one wants that...
PR: Well, the Democrats do but...
DT: They're a bunch of losers...just losers, terrible losers. Terrible, terrible losers.
PR: Yes Sir, but...
DT: (suddenly inspired): I know, what if we call it Trumpcare!
PR: Excuse me Sir? Call what Trumpcare?
DT: This single payer option. We won't call it that. It's not that. Because we aren't calling it that. We're calling it Trumpcare.
PR: Well, it would still cost a lot of money, hundred of billions a year...
DT: But not a tax, it's not a tax on the wealthy to pay for the mandate. It's not a tax on them. Make sure you let them know that. Because it's not that. It's an increase in Medicare, in payroll deductions. It's a deductions increase, let's say. Not a tax. No new taxes.
PR: It's still a tax, Sir.
DT: (mulling it over): Yes, you're right. We'll just have to fund it out of borrowing...but just for now.
PR: Excuse me, Sir? Fund what?
DT: Trumpcare! Focus, Paul!
PR: But that'll blow a hole in the budget...
DT: Only temporarily. Jobs are coming back to America. They're coming back. Our GDP is going higher. We'll fund it now, but Trumpcare will be paid for later. Just like the Wall will be paid for by Mexico. Yes, let me know the figures, Paul. Come back in a week.
Well, Trump could pull this off much better than me writing about it, but this is one way to get towards where he claims he wants to go. OK, I don't really believe it either, but then I may not have "a really good brain" like our president.