By Jerri-Lynn Scofield, who has worked as a securities lawyer and a derivatives trader. She now spends most of her time in Asia and is currently researching a book about textile artisans. She also writes regularly about legal, political economy, and regulatory topics for various consulting clients and publications, as well as scribbles occasional travel pieces for The National.
Anne Case and Angus Deaton published a new paper last week, Mortality and morbidity in the 21st century,a follow-up to their groundbreaking 2015 paper on the mortality and morbidity consequences of the increasing immiseration of the American white working class.
Naked Capitalism has covered this issue extensively (see here, here, here, here, and here.) As Lambert noted in last Thursday’s Water Cooler, we’ll undoubtedly have much more to say on this topic in future days. Readers have already chimed in extensively with their thoughts on the latest paper in the comment threads and I encourage them to do so for this post as well.
Despair and US Politics
In their work, Case and Deaton document the stunning decline in health and rise in mortality, among white, working class Americans with low levels of education in this century. These changes are unprecedented in recent times in advanced industrial countries (although they were previously seen following the collapse of the Soviet Union). My aim in this post this post is not to discuss their work in great detail. What I do want to consider are connections between the problems that Case and Deaton document and the current state of US politics– as well as some possible Trump administration responses.
First off, let me start with Case and Deaton’s summary of what caused these morbidity and mortality patterns:
We propose a preliminary but plausible story in which cumulative disadvantage over life, in the labor market, in marriage and child outcomes, and in health, is triggered by progressively worsening labor market opportunities at the time of entry for whites with low levels of education. This account, which fits much of the data, has the profoundly negative implication that policies, even ones that successfully improve earnings and jobs, or redistribute income, will take many years to reverse the mortality and morbidity increase, and that those in midlife now are likely to do much worse in old age than those currently older than 65. This is in contrast to an account in which resources affect health contemporaneously, so that those in midlife now can expect to do better in old age as they receive Social Security and Medicare. None of this implies that there are no policy levers to be pulled; preventing the over-prescription of opioids is an obvious target that would clearly be helpful.
What created those “progressively worsening labor market opportunities” that exacerbated this “cumulative disadvantage over life”? Well, I have an answer for that. How about those neoliberal policies that immiserated the working class and were enacted over the decades since I cast my first presidential vote in 1980? These include anti-union policies, trade liberalization, “starve the beast” budget policies, deregulation, the rightward lurch of the courts, and policies that promoted elite impunity not only for misdemeanors, but for outright crimes (and have encouraged those who can to misdirect or outright steal whatever isn’t tied down). (I am aware that some of these trends predate 1980– e.g. airline deregulation and I do want to mention in passing Jonathan Cobb and Richard Sennett’s excellent Hidden Injuries of Class— which I last read in graduate school– which suggest the indignities that the working class has suffered are not new.)
Reversing these policies– as regular readers are well aware– is a far from trivial project. And although vitally necessary, even if we lived in a world in which we could simply all clap our hands and instantaneously eliminate the scourge of neoliberalism, that action would, unfortunately, fail in itself to reverse the morbidity and mortality patterns Case and Deaton document.
Policy Failures Will Not Damage Trump’s Popularity With His Base
Unfortunately, however, the world in which we live in does not operate according to J.M. Barrie’s rules, and, thus, Tinkerbell must die. As the last several days have demonstrated, the Trump administration has a lot to learn about getting Congress to enact its announced policy goals– e.g., eliminating Obamacare (although I am of course aware that this health care system is an abomination, and despite that, allow for the possibility that the Trump administration may not, indeed, have wanted to kill it at this time).
Yet so far, the chaos surrounding Trump has yet to damage him with his base, as recent news coverage demonstrates (e.g., Angry over U.S. healthcare fail, Trump voters spare him blame and Donald Trump voters: We like the president’s lies).
Now, why is that? While Hillary Clinton’s infamously dismissed the views of a big chunk of the electorate as “deplorables”– a soundbite I’m sure she wishes she could take back– Trump is in tune with what plays to his base. So, what does this imply for the future– (especially with respect to health care deficiencies suggested by the most recent Case-Deaton paper)?
Donald Trump: Hedgehog or Fox?
For the answer, dear readers, allow me to revert again to graduate school. The starting point for what I wish to discuss is Isaiah Berlin’s famous essay, The Hedgehog and the Fox, which begins with an aphorism from the ancient Greek poet Archilochus: “The fox knows many things, but the hedgehog knows one big thing.”
Now, Donald Trump is famously shy on details– and thus is not by any stretch of the imagination, a fox. But he does know one big thing: he understands, that the white working class has been screwed. Though they undoubtedly wouldn’t put it in such vulgar terms, in their work, Case and Deaton spell out the recent mortality and morbidity consequences of this insight.
Allow me to speculate wildly, since given what came down last week, health care is on my mind. Suppose someone convinces Trump that one big thing that could alleviate the suffering of the working class– white and otherwise– would be for the US to adopt a better health care system such as single payer. I believe a hedgehog such as Trump could make this leap– if he grasped that the costs of the status quo fall disproportionately on his base and that these individuals would benefit from such a policy change (as incidentally would many others).
What follows? Is Trump merely a cynical opportunist who has successfully ridden the waves of (white) working class discontent to get where he is? Or is there more there there and is he capable of assembling a skulk of effective foxes who can push a single payer agenda– or indeed– any plausible health care alternative?
Without mentioning hedgehogs or foxes, however, Maureen Dowd on Sunday spelled out some obvious flaws with my thought experiment. Addressing last week’s health care failure, she said:
You mused that a good role model would be Ronald Reagan. As you saw it, Reagan was a big, good-looking guy with a famous pompadour; he had also been a Democrat and an entertainer. But Reagan had one key quality that you don’t have: He knew what he didn’t know.
You both resembled Macy’s Thanksgiving Day balloons, floating above the nitty-gritty and focusing on a few big thoughts. But President Reagan was confident enough to accept that he needed experts below, deftly maneuvering the strings.
You’re just careering around on your own, crashing into buildings and losing altitude, growling at the cameras and spewing nasty conspiracy theories, instead of offering a sunny smile, bipartisanship, optimism and professionalism.
I’m not sure that I agree with all MoDo says here. In particular, I think that getting sucked down the standard DC bipartisan rabbit hole is probably a dead-end for Trump, given the circumstances (crazypants Republicans, ineffectual and unimaginative Democrats). And further, I think Trump’s base not only regards itself as far worse off than its counterparts in the Reagan era would have done– and is indeed correct in doing so, at least as far as their health is concerned, as the latest Case-Deaton study suggests. So I’m not sure Trump’s outright contempt for Washington does not indeed play better to his base than did Reagan’s bromides.
But the bottom line is that the pain is real, and his base won’t be satisfied with rhetoric forever (nor, for that matter, will anyone else). So Trump needs to find a cunning little skulk of foxes, and soon, to press some effective policies, if he hopes to achieve anything other than broadcasting inane twitter blasts, and spouting press conference bluster. Will he do so? I’m not sure he’s capable of such vulpine behavior. If he’s indeed not, he’ll undoubtedly be yet the latest in the ongoing series of ineffectual Presidents who have failed to slow– let alone arrest, the slow steady decline of working class America.
29 comments
Comments are closed.
Your Donny-Boy needs some ideas that he can implement quickly – aka quick wins, runs on the board. We are now in April and, at least here faraway, he looks bogged down by inertia.
He chose ACA as a target to remove – yet there appears to have been no coherent thought about what would replace it. It was the wrong target, particularly as he is reliant on the legislature, one that doesn’t really want to reverse or change course.
He needs to look at what he is authorised to achieve unilaterally.
An imperfect example, as a lot of money was wasted (the tender process was gamed and the taxpayer paid more than twice what it should have for the buildings erected), was the School Buildings project implemented by the Labor government after the GFC. This was a quick injection of public funds to benefit every community in Australia and it got people working and money circulating in an economy which was in danger of recession.
Getting even a few people working would increase his popular support and strengthen his power base to attack real reform like the Un-ACA
Trump brings a combination of an extremely self-centered personality and a rapacious economic worldview to the presidency that has no dimension of public service. He wanted a quick win to cement himself as “the closer”. This healthcare repeal fiasco typifies his theatre sans substance career and how his business methods don’t work in the presidency. Therefore he gave no thought to what to put in Obamacare’s place because he’s never considered anything he’s done as a public service. He’s incapable of serving the public; he will pursue his interests, which are -allowing for his mercurial nature- those of the 1%. (I think Obama and Clinton had the same orientation to serve the 1%, but they were much more sophisticated about it.)
Not entirely true. Trump did famously get Wollman Rink re-opened after “the city had spent six years and $12 million trying to produce ice.“
I think that Donald Trump knows the problem, he talked about it incessantly, but he is unable to identify the solution, because in so doing, he would have to identify himself and those like him as the problem.
Very few people gave the integrity and lack of ego to identify themselves as a part of the problem, particularly when it also requires them to recognize that their life’s work is essentially parasitic.
Our entire political system is financed by and operated by a class of people whose wealth comes from skimming, renting, and exploiting the lower classes.
These parasites won’t stop until they have killed the host. The white working class of the flyover states is too small to merit any changes at the political level.
Trump doesn’t have anything to do with the health care industry, so its failures don’t reflect on him. Hence I don’t see how you can say his ego is a problem with respect to this issue.
However, there’s no way Trump can do this.
1. Whatever deal he cut with the Republicans when he won the nomination. He moved way to the right, for instance clearly embracing pro-life when before he was pro-choice. Recall he needed the cooperation of the party to get his hands on some of the campaign apparatus, and he particularly needed that since he had underinvested in that. It appears from his conduct with the ACHA that it wasn’t just signing Republican bills, but also whipping for them when necessary.
2. He had, or felt the need, to reward early backers like Jeff Sessions. So his team includes quite a few extremists and oddballs. And since he”s not a detail guy and his knowledge base is thin, if they sound credible, they can sway him.
3. The folks that joined his team later are billionaires and orthodox Republicans who believe all that conservative think tank twattle. So they would push hard against single payer if that idea ever were to get to or occur to Trump.
I think that is perceptive, Yves. DT thought he could get the job without any strings, be his own man. Now that he’s there, he now sees just how little he can actually get done unilaterally.
Ultimately, I think the US health, insurance and pharma industries are unreformable as they currently stand. Even if a bill were to be introduced for ‘single payer’ they would all just argue about the money, and all the ‘losers’ from reform would bleat, and nothing will happen.
All going on as people die before they should and increasing numbers live in poverty
The GOP estab underestimated the strength of Trump’s appeal to voters. ( I give the GOP credit for running a more democratic primary than the Dems.)
Trump underestimated the strength of the Blob.
Trump cancelled TPP and TPIP by executive order. Win for workers.
The Blob got rid of Flynn who was set to clean house at the CIA and FBI. The Blob is also getting lots of MIC spending. Wins for the Blob.
ACHA vote is a wash since its repeal would have been a GOP win that would cost GOP seats in the midterm. A win would be a Pyrrhic victory.
This sort of contest – the Blob v. the President – hasn’t been seen in DC for decades, imo.
Now, if he can’t go whole hog for single payer, can he compromise with bernie on dropping medicare eligibility to 55?
That would bring in some dems and some moderate repubs like state governors with budget issues.
It would also shore up obamacare’s exchanges by taking out the expensive people from the risk pool.
Is there a reason bernie is floating these trial balloons?
If the 2018 elections turf out some Republicans, particularly the Freedom Caucus whack jobs, and some progressive Democrats get in, the dynamic could change a lot more than the vote shift would suggest. But that’s an awfully big set of ifs.
Trump understands how to please his voter base; e.g., by opening up the coal mines and giving Kentucky miners their jobs back (in spite of the environmental degradation that will occur again), he will have their votes in the future. If he does something similar in other areas, he will not have to worry about pandering to anyone else but his loyal base.
Jerri-Lynn, you refer to “Maureen Down.” Did you mean “Maureen Dowd”?
BTW — out of context at least, I don’t know who she’s referring to with the pronoun “You.”
The quoted column by Maureen Dowd was written as a (one-sided) conversation with Donald Trump, the “you” in question. It was linked from NC within the last 2-3 days.
Fixed it– thanks!
Donald Trump was elected because he identified the problems of Middle America including dying early. The question is how to solve them. The health care system and higher education evolved into financial extraction schemes because with the manufacturing base gone there are no easy alternatives. Solutions are ending crony capitalism, a debt jubilee, peace and the single payer healthcare scheme. This would turn the world turned upside down and has powerful corporate foes including maybe Donald Trump. The alt right solution is to destroy government and its regulations; in effect, returning to our tribal roots. That isn’t working too well in the Yemen or Somalia. But, rage and despair are always shortsighted. They always end up aimed at those close at hand.
The best hope is to try to keep government functioning until social democracy is restored. If not, a civil war will rip the Coastal enclaves and Mestizo Cartel areas away from the Heartland.
Trump will not embrace single-payer ever because his billionaire cronies are profiting like crazy from business as usual. For-profit health insurance paid for mainly by employers is a relatively recent institution. When I was a kid, your daddy paid, or the doctor took an IOU and became part-time bill collector – that led to Blue Cross.
Health insurance today is a scam – a costly one, but not one likely to die under Trumpism.
Is Trump EVEN driving the bus? Or are his advisers? Seems to me there is a good case to be made for the latter. And if so all the analyzing Trump in the world (does he really care about the white working class? Is he a con-man? etc. etc.) doesn’t amount to much more than an amusing distraction.
Donald Trump’s game plan is to create an environment for his oldest daughter, Ivanka Trump, to make a successful bid for the Presidency in 2020 or 2024. He will need single payer health care to accomplish this.
Let us wait a while to see what he can negotiate?
IMO, Trump is The Wizard Gandalf, in alliance with the Elves, Hobbits, Dwarves (Deplorables) – up against the The Dark Lord Sauron (Soros), and his Powerful allies, Saruman (Big Democrats), Melkor (Big Republicans) and the assorted Silicon Valley Orcs and Wall Street Nazgul…..The Witch King of Angmar (Deep State).
Cometh the hour, cometh the man… Be patient. This is a Titanic Battle we are witnessing, not a skirmish. The Globalists are howling for blood
… that sounds crazy, if not beyond fantasy.
Trump is not a genius, he’s not even smart, he’s essentially lucky that 77,000 disgruntled voters in 3 states tipped the electoral balance. Not that that isn’t of consequence, it is. And the world is being set back to the Middle Ages.
The biggest import of the last election is that the US political system presented voters with awful choices; and like Russian Roulette, they pulled the trigger: the chamber was charged!
Cross posted at Lambert’s piece on Rich.
I have been puzzling over the question of who is trump’s base ever since he won. I have the answer: it’s not rural America (only 17% of the electorate and reliably Repub voters), and it’s not white workers in the rust belt, tho in four states they did push him over. No, his true base is college educated whites, young and old, in the suburbs and some cities (outside of east/west coast and those w/out major universities), they are predominantly well off – make 70K and over. They vote reliably Republican and did so again. the numbers back this up.
This article from the New Republic, https://newrepublic.com/article/138754/blame-trumps-victory-college-educated-whites-not-working-class, points out that of the above 62% of white men (the category is not broken down by education) and the 52% of white women who voted Trump, among college-educated whites, only 39 percent of men and 51 percent of women voted for Clinton. I’m guessing they voted Trump because they ALWAYS vote Republican and would never vote Clinton.
So the question becomes: why the rage among neoliberal pundits and the Dem party toward the white working class? Is it because Clinton tried hard to pull the college educated whites to the Dems, and failed, and they don’t want to alienate them for the future? Or do they truly think the working class – of all colors since they took blacks and latinos for granted – are truly deplorable? Or is it both? I’m going with both.
I suggest more research needs to be done on this. The argument that the white working class should get what it deserves for electing Trump is not only cruel and grotesque but is a blatant lie. It needs to be blasted out of the water.
Coming from an auto manufacturing town in Michigan I can tell you that $70,000 was chump change for these UAW employees. They could easily, with a bit of overtime, bring in well over $100,000 a year. And many, many of them retired very well off and still live here. They were never white collar workers, but they earned more money than many white collar workers can even dream of these days.
And they voted for Trump.
Understood. You’re talking about the Labor Aristocracy of skilled union – mostly white – that was bought off after WWII and was given great wages and good benefits. The union leadership was bought too and was complicit in maintaining “orderly” strikes, while investing the pension funds in Las Vegas real estate, etc. The black union workers came along later, were the last hired, first laid off, and couldn’t move to the suburbs as they were locked out of FHA loans and their neighborhoods were red listed. They were kept in their bantustans so to speak.
As there was no genuine left party at the time, and what there was was under fierce attack by McCarthy and the union leadership, it was quite “natural” for the white workers to see their interests aligned with their capitalist masters. Whether they voted Dem or Repub didn’t matter. The big shift to the Repubs came in mid-60s due to culture wars around the Vietnam War and Civil Rights movement. While trade unions could still be progressive – some more than others – you would have to have lost your touch with reality not to believe that vast swaths of white workers would just abandon their patriotism and their racism and not feel threatened by the tumult. Again, with no leadership and plenty of misleadershp this should come as no surprise.
So its no surprise that many of them voted for Reagan, Bush 1 and Bush 2 and Trump. When you’ve developed a world view there is culture bias that is part and parcel. Hence the Trump voters who love Trump tho they know he lies.
None of this changes the fact that it was NOT THESE WORKERS who elected Trump nor does it excuse HRC from actively despising these voters and distancing herself from them so she could capture the more educated (but equally racist if not more so) Repubs in the suburbs.
I have been puzzling over the question of who is trump’s base ever since he won. I think I have the answer: it’s not rural America (only 17% of the electorate and reliably Repub voters), and it’s not white workers in the rust belt, tho in four states they did push him over. No, his true base is college educated whites, young and old, in the suburbs and some cities (outside of east/west coast and those w/out major universities), they are predominantly well off – make 70K and over. They vote reliably Republican and did so again. the numbers back this up.
This article from the New Republic, https://newrepublic.com/article/138754/blame-trumps-victory-college-educated-whites-not-working-class, points out that of the above 62% of white men (the category is not broken down by education) and the 52% of white women who voted Trump, among college-educated whites, only 39 percent of men and 51 percent of women voted for Clinton. I’m guessing they voted Trump because they ALWAYS vote Republican and would never vote Clinton.
So the question becomes: why the rage among neoliberal pundits and the Dem party toward the white working class? Is it because Clinton tried hard to pull the college educated whites to the Dems, and failed, and they don’t want to alienate them for the future? Or do they truly think the working class – of all colors since they took blacks and latinos for granted – are truly deplorable? Or is it both? I’m going with both.
I suggest more research needs to be done on this. The argument that the white working class should get what it deserves for electing Trump is not only cruel and grotesque but is a blatant lie. It needs to be blasted out of the water.
If that is true get ready for a spike in whites with a college degree. The great recession was the first time that whites with a college degree did just as bad entering the labor market than those without. Which I can personally attest to as well.
http://citeseerx.ist.psu.edu/viewdoc/summary?doi=10.1.1.393.1225
From that paper
If it’s true that Trump’s supporters are just as trumped up as ever, and love his lies so much, what’s up with the rapidly plummeting approval numbers? 36% approval rating? Seems like some people really aren’t too happy with him.
As for Obamacare, Trump very well may have decided long ago to nudge it along to a natural demise (all while lying for all that he’s worth that he would repeal it and replace it with something better, but, hey, for lie lovers, this was a good one). But I think people who wake up in a year to two to find that their insurance company is bankrupt, or that they’ve been kicked off of Medicaid aren’t as likely to blame Democrats who have been utterly taken out of power as they are the people currently in charge, who, again, promised to fix it.
Pacific Standard published a pretty extensive critique of the Case-Deaton paper: “The death of the white working class has been greatly exaggerated” (or at least, a critique of the media coverage of the paper).
Does anyone know what Emmanuel Todd, the French demographer who predicted the Soviet Union’s collapse based on similar statistics, thinks about Case-Deaton’s work?
I agree that the effect is real, but I’m not sure I buy with the “dying from despair” argument. In the Soviet Union, you saw almost an identical pattern, but with two big differences: (a) people still had better absolute hopes for their life outcomes than their parents (i.e., they didn’t expect to starve for years the way their parents did, and the way they themselves had as children) and (b) it was men who took the brunt of the mortality and morbidity hits, despite always having the most work opportunities. What did increase by the end of the 1980s was certain types of inequality. I don’t think that’s a despair issue so much as it is despair adjacent.
Moreover, our society’s demand for simple explanation may be missing the actual explanation, which, I suspect, is a little bit more complex. My working hypothesis is that people are dying from their attempts to self-medicate for immune and endocrine disorders ultimately caused by environmental contaminants because physicians’ class biases prevent them from accurately diagnosing and treating their poorer patients.
https://en.wikipedia.org/wiki/The_Rhetoric_of_Reaction
Jerri-Lynn, for your reference per post on Rhetoric.