Some New Pieces of the Healthcare Puzzle

The failure of the House to bring Ryancare/AHCA to vote last week has succeeded at inspiring a barrage of insightful essays about this very complex issue. My synthesis of these insights is forthcoming. Here are some of the new pieces of the healthcare puzzle for now.

The existing ACA has two big components: the expansion of Medicaid and the private insurance exchanges. Only the latter is broadly exposed to “hastening an implosion” by Secretary Tom Price or Trump’s Executive orders. The Federal government currently props up the Health Insurance providers when a state market is not lucrative enough to offer insurance. Those subsidies could be discontinued, forcing insurers to raise premiums, increase deductibles or pullout of the exchange entirely. 

The health insurance offered to “hard working Americans” is mostly a bunch of junk policies. The premiums and deductibles are repellant. The policies include the cancellation if the policyholder starts filling big claims for illnesses that were not preexisting. The voters’ pushback against the “health insurance mandate” in the ACA could be more about those junk policies than against contributing to the common good by being insured like everyone else.  They want freedom of choice, not freedom from health insurance. 

Health insurance companies have been more profitable than ever since the ACA was enacted. They are getting out of the business of aggregating the health costs risk and simply providing administrative services for big employers who have become self-insured. The biggest consumer of conventional health insurance policies are those citizens on Medicaid who use Federal money to buy policies. 

A majority of voters now want single payer, Medicare for all, insurance. They are benefiting from the ACA and do not want it taken away. They want it improved, simplified or expanded. The government can no longer be trusted to formulate and pass a complex piece of legislation. The 17% approval rating of AHCA provided how clueless Congress is about considering diverse constituencies. They appear far better suited to make enemies of the State Governors, seniors, disadvantaged citizens, physicians, private healthcare providers and more. The Republicans are expected to take a hit in the midterm elections next year, whether they were in favor of or opposed to the AHCA. 

Lots of the voters for Trump could have just as easily voted for Bernie Sanders. These voters are not located on the political spectrum where political issues spawn loyalties. These voters want change from the do-nothing government that answers to special interests and hostile campaign funding sources. They want a return to “consent by the governed” as if we are living in a democracy, not an aristocracy or oligarchy. 

The adversarial tactics of the Freedom Caucus appear to be more focused on Republican lawmakers than on the AHCA itself. They suspected the late night “closed door sessions” to formulate the AHCA was only Paul Ryan meeting with health insurance company lobbyists. The loyalists to Speaker Ryan need to be exposed, humiliated and discredited. The Freedom Caucus’s blocking the passage of the “undemocratic” bill worked superbly toward their objective.

Trump’s approach to negotiating the passage of the AHCA indicates that he doesn’t really care what is in the healthcare legislation. All he wants is a win. He leaves it up to the legislators to resolve their differences, just like he left the architectural and engineering plans up to those professionals in his real estate deals. He expected that the Republicans had been preparing blueprints over the seven years they were raised a stink about “repeal and replace Obamacare”. He discovered he was working with a bunch of loudmouth amateurs in Congress. #sad! He has not discovered who else is a loudmouth amateur in power just yet.

Trump’s only “skin in the game” is for a personal win. This could be making him increasingly amenable to working with Democrats on upgrading the AHA. He also has clearly demonstrated that he is pragmatic, not ideological. He’s inclined to do what works to gain popularity with some interest group, though not the same one all the time. Pragmatism does not make for consistency, but it does make him susceptible to bait that promises approval and adulation. Democrats have been dealt a hand to be played strategically, not politically. 

All this is shaping up into a wonderful opportunity for universal health coverage in the near future. I will explore how that could unfold in my next post. 

Trump and the Freedom Caucus

Speaker Paul Ryan could ever realize on healthcare issues. John Martin, National Political Reporter for the NY Times, planted that idea in my mind this week on MSNBC with Chris Jansing. Martin suggested that Trump and the Freedom Caucus appeal to a similar base of voters. The idea continued to ruminate in my mind and evolved into what follows.

President Trump is famously fluid in the stances he takes on issues. He thinks like a Product Marketing wiz— as I explored yesterday. He appears to rely on one simple criteria for choosing his positions: “whatever sells”. The Freedom Caucus and all its brethren (Tea Party, Libertarians, Nationalists, etc) are the opposite of fluid. Their stances appear rigid, demanding and intolerant of compromise. Compatibility with Trump is unlikely given the unyielding criteria that the Freedom Caucus applies to political stances. Here are a few of the likely sticking points I foresee:

• Trump says he wants universal coverage and the Freedom Caucus wants access to care unrestricted by bureaucratic regulations which interfere with free market competition.
• Trumps says he wants to protect Medicare and Medicaid from revisions and the Freedom Caucus wants to eliminate subsidies that increase taxes and provide disincentives for hard work.
• Trump wants to maintain a Federal healthcare program and the Freedom Caucus wants the States to ensure more competition which will bring soaring costs under market control.

When I have sought to empathize with the Freedom Caucus, I have found it helpful to imagine these members of Congress as trial attorneys in private practice who argue for the plaintiffs in criminal cases. They assume the defendants are guilty of the crimes before the trial. The public defender for the criminal clients appears to be a chronic loser who cannot win. There is no incentive to win in the pay from a government job. There’s no chance to win when protecting a guilty party. There’s nobody with the education and talent for prosecution who would work for the government. There are no extra resources available to the public defender that could create an advantage in the minds of the jury or a judge. 

These trial attorneys need to win at all cost. They assume they are right and everyone else is wrong. It makes no sense to settle out of court or utilize mediation when a total conviction is easily obtained. They go after the win like a shark feasting on chum. They do not see their own shortcomings, obsessions or predictability. All they see is too many public sector losers who spend tax dollars to lose every time. The winners in these courtroom confrontations are subsidizing incompetent losers by paying the taxes that pay for public defenders. 

Adding President Trump to this scenario brings in a new character unlike the public defenders. These unexpected attorneys can flank attack the trial lawyers focused entirely on winning. The fixated lawyers don’t anticipate the surprise witness, new evidence or contradictory testimony. They fall prey to more a fluid winner who can come at them from many different angles.  The shark becomes confused by the strange behavior of the chum. The defense is defying the sacrosanct expectations and failing to put up lame arguments to be easily shot down.

In this way, it does appear President Trump could force some concessions out of the Freedom Caucus, but not get their willing cooperation. Because they share a common base of voters, Trump could be between the voters and the Freedom Causus. He could challenge the older voters to question their loyalty to the Freedom Caucus MOC’s who were about to mess with their current, trusted healthcare. The Caucus would probably experience getting taken advantage of or pressured into submission — just like those “public sector losers” they despise. This, of course, would spawn lots of resentment toward Trump and even inspire some retaliatory moves in the future. It’s doubtful Trump would risk those consequences in the process of getting this deal to come together. 

Marketing Trumped Politics in 2016

Donald J. Trump did not win the 2016 Presidential election by knowing how to play the game of politics better than seasoned politicians. He changed the game to marketing where he is good enough to “sell snow to an Eskimo”. Here’s a look through the lens of business marketing at how Donald J. Trump won the 2016 Presidential election.

Political Rallies

In the world of product marketing, there are no political rallies. There are focus groups and lots of them. They usually consist of small groups in windowless rooms with lots of electronics to collect immediate feedback from the participants. Thinking outside the box, a political rally could function as a focus group without changing its size or location. Rather than getting individual feedback from participants, simply listening for the variations in the roar of the crowd could provide insights into what was selling. I suspect Trump did this. He’d dish out a rabble rousing remark and pause to see how big a reaction he’d get. He’d try another inflammatory comment and compare reactions. Over many rallies in many states, he learned what to say to define his brand and to excite those who were eagerly buying what he was selling.

Political Advertising

Conventional wisdom expects a large percentage of campaign spending to be spent on TV advertising. It’s an opportunity to expose a more human side of the candidate and to portray opponents in a negative light. Product marketing sees most political TV ads as push tactics which usually generates lots of pushback. Pull tactics generate word-of-mouth advertising which is comes from a familiar, trusted source. Trump did almost no TV advertising for many months in the run-up to the General Election. Yet he was generating huge amounts of buzz. He created demand for his brand without hard selling it. He got people talking among themselves while provoking the the print journalists and TV talk shows to fuss about his brand of politics.

Political Debates

Neither commercial or industrial products get into big debates on a stage full of other candidates. If a new product stands out from the crowd, it gets press coverage and product reviews online and in magazines. With enough exposure, the product becomes a “household name”. Trump figured out the way to standout in that crowd of Republican candidates was to be as controversial as possible. He defied convention at every event. As he said: “There’s no such thing as bad publicity — all publicity is good publicity”. He stole the spotlight daily for months. 

Political Polling

Conventional campaigning runs on getting a bump in poll numbers after an event, TV appearance or the party’s national convention. Pollsters survey voters by asking for them to rank issues from most important to least important. Product marketing does not track fluctuations in customer opinions, preferences and reactions. Marketing campaigns follow sales numbers by territory. Trump said he didn’t trust the polling numbers to show the momentum he was building or the emotions he was arousing. He was counting votes he could rely on, not movement on issues. 

Political Demographics

During a political campaign, maps get repeatedly drawn and revised. They show the changing number of red and blue states, the size of urban and rural regions, or the breakdown of voting by district from a previous election. The very diverse population gets mapped into homogenous territories. Product marketing positions a brand among other products in its market space of product attributes - not a geographic space of districts. Trump positioned himself in the market for the presidency as a Washington outsider who could bring about changes that insiders could never accomplish. He found unmet demand for change that neither batch of campaign promises had fulfilled. He not only voiced his distinctiveness, he walked the talk. He embodied be the change that could bring change to Washington. He acted unconventionally and differentiated himself from conventional candidates by his antics.

Now that Trump is the POTUS, he is out of his element. His practiced marketing tactics look deceitful, controlling and incompetent under the glare of our expectations for presidential leadership. Bad publicity is really bad now, no longer good for brand visibility, word of mouth advertising or pull strategies like it was during the campaign. Being a Washington outsider looks like a disadvantage when trying to significant changes in how a polarized Congress functions. He was a game changer during the election. Now his game is getting changed. 

Trump-speak and Fake News

“I hate to tell you this folks, but that is fake news, totally fake news.”

“Let me tell you, those reporters putting out fake news are bad people.”

“Trust me, they’re telling lies, they’re liars, total liars. What can I say?”

These are not actual quotes of Donald J. Trump. These are examples of Trump-speak, an unusual vernacular that arose in American English following the Obama years . Form a zero with your right hand while you say these trumpisms with pursed lips in order to get the full effect.

In a previous post, I explained how any attacks on others are best understood as telling remarks. It would only occur to people to say these things if they were dishing out fake news themselves, secretly thinking of themselves as bad people and knowing subconsciously how they have been telling lies often. 

Here’s what Donald J. Trump is not saying that would ordinarily be said by a leader of the free world:

• “It’s become apparent to me that I am not giving the press enough information to publish an accurate appraisal of our situation.”
• “I’ve done a bad job of clearing up some misunderstandings that have arisen following something I said last week.”
• “I may have provoked you to think that I was misleading you or covering up the truth by saying so little about this so far.”

In these statements, the leader is making “I” statements. The leader is taking full responsibility for errors that appeared in press coverage. The leader is conveying a desire to work with the press to clear up confusion, correct misinterpretations and report accurately on the leader’s intentions, activities and accomplishments. These statements noticeably avoid finger pointing, blaming, labeling and self-aggrandizement. The press is shown respect because the leader has enough self respect to see the press as worthy of respect. The press would respect this leader in return, seeing that admiration was earned and well deserved. 

Another remarkable feature of trumpisms is the frequent prefacing of remarks with references to the big deal involved with informing us:  Let me tell you, I have to tell you, Listen to this, I hate to tell you this but, Trust me I know, I must tell you, etc. When these prefaces get used, we often get called “folks”. He is sending us signals when he phrases his announcements this way. They are also telling remarks. 

Back when restaurant waiters and waitresses started addressing my entire table as “guys”, I was taken aback by that turn of phrase. I’ve now grown accustomed to the greeting. Now, I am equally startled to be addressed as “folks”. For it to be coming from such a powerful source of mixed messages, I presume the use of “folks” is more telling than incidental. Here are four possibilities for what is being implied, conveyed in the subtext or meant to be read between the lines:

1. “I’m being gracious enough to be folksy with you, even though I am far superior to you and forced to condescend to address you at your low level”.
2. “I’m a folk-hero to all the working folks in America who pay exorbitant taxes with their hard earned money and I don’t want you to forget that when you get exposed to all the fake news about me”.
3. “I’m being polite to all you good folks while I’m working a rip-off scheme that treats you as a real sucker”.
4. “Folk you folkers! If you won’t believe me, you don’t buy what I’m selling or you can’t fall for the incredible deal I’m offering you, go folk yourselves”.

I read a blog post by George Lakoff a couple months ago (A Minority President: Why the Polls Failed, And What the Majority Can Do). It got me thinking how marketing savvy may be what’s animating Donald J.Trump’s speech. His real estate deals and Celebrity Apprentice TV show would have given him countless opportunities to hone his craft. Now I have to tell you, all the prefaces that occur in Trump-speak have the feel of a marketing outlook on life. I hate to tell you this, but they are not causal phrases to be taken lightly. Listen to this, they orchestrate some subliminal manipulation to get buy-in, customer loyalty or cross selling to other offerings. What can I say? I’m going to translate these prefaces to say what I now think they mean:

• Let me sell you this bill of goods 
• I have to sell you on my amazing abilities
• Listen to my fake news you are going to fall for
• I hate to sell you this but I have no choice with others pulling my strings
• Trust me, I know what I’m talking about when I put my spin on this empty promise
• I must sell you this now before you suspect that I’m lying

In short, if you have misgivings about these frequent prefaces in Trump-speak, trust how it doesn’t feel right to you. Suspect, as I have here, that he is signaling us about a hidden dimension to his unusual vernacular. Piece two and two together. Do not take him at his word or take him literally. Read between the lines of his verbal antics.

Telling Remarks

When we make a telling remark, we know what we said but not what we’re telling people. We’re sending signals unconsciously. Others can read us but we cannot read ourselves. We do not get taken at our word because we are contradicting ourselves in ways that do not register on our outlook.

We are speaking about telling remarks whenever we say:

• There’s the pot calling the kettle black
• Birds of a feather flock together
• It takes one to know one
• Look in the mirror when you point your finger at someone
• It’s your own damn fault when you find fault in others
• When you point your finger at someone, you’re pointing three fingers back at yourself

Our most telling remarks attack other people. When we are pointing fingers, we are saying a lot more about ourselves than what we’re pointing out about others. When we’re finding fault with others, we don’t realize how clearly we blame ourselves in worse ways. When we cannot imagine how to be respectful, grateful or considerate of others, we are obviously showing the world how damaged we feel behind our pretentious display of overbearing confidence. 

When we are captivated by the flaws we see in others, we are repulsed by similar shortcomings we keep hidden in ourselves. We take offense to others when we are offended by something about ourselves. We are fussing at the spec in our brother’s eye when we are not seeing what interferes with our clear vision. We cannot know why we are spellbound by other people’s flaws until we stop rejecting similar facets of ourselves. We will continue to fuss and fume until we get to know ourselves behind the masks we show the world.

Spoiled brats make telling remarks that are the most obvious and easy to read. They are not good at hiding what they don’t want others to see. They are extremely obvious about what they are not saying with their words. They tip their hand for us to see what cards they are playing. They pull back the curtain for us to see what they are really saying beneath their superficial bravado. 

Spoiled brats have had it too good in life and that is too bad for them. They barely disguise how they feel sorry for themselves and inferior to those who didn’t have it so good. They feel driven to defy social convention which usually dictates “putting on your best face in public”. They wear their worst face in public and keep their goodness out of sight. The act out their frustrations with being privileged. They take secret pleasure in being so bad, surprising and defiant. They say all this with their vicious telling remarks, accusations and blame games. 

In the worlds of business, sports and theater, spoiled brats are called “prima donnas”. They are conceited and extremely selfish. Their minds are closed to constructive feedback or helpful advice. They cannot listen to reason, take more responsibility for their effect on others or change their closed minds. They are convinced they are the best in spite of all the evidence they are only good for themselves. They need to be right at all cost and see everyone else as wrong, bad, stupid or incompetent. Their telling remarks reveal how weak they seem to themselves, how inferior they feel and how troubled they are by their profound insecurities. They obviously come on too strongly to compensate for not feeling strong enough. They blatantly trouble others and barely disguise how troubled they really are. 

The political arena has always been sanctuary for spoiled brats and prima donnas. Political discourse is usually as noisy as bird sanctuaries during mating season. Each partisan politician dishes out one or two telling remarks at every opportunity. Pointing fingers is all in a day's work. Attacking others is the norm. Being the loudest pays well. Sounding hypocritical is inevitable while all the commonalty with the opposition is inconceivable. 

A collaborative, bipartisan politician is a rare specie in the noisy arena. Sounding inclusive, reasonable and insightful does not play well in the breaking news stories of ongoing investigations and shocking revelations. Focusing on policy changes instead of political harangues does not quack like all the other ducks on the pond. Acting collaborative and diplomatic with the opposition does not excite campaign rallies, entice the party faithful or motivate the campaign donors.

At first glance, all this evidence shoots down the possibility of draining the swamp. The dysfunctional discourse and deadlocked deliberations appear to be robust and resilient. However, the emergence of a vibrant democracy looks both feasible and likely to me. There’s more going on here than the culture of telling remarks which bodes well for the transformation I foresee. As I will explore in my next post, there is no real opposition, only posturing. Those in power are playing a losing game while winning elections. They clearly are their own worst enemies. They can only succeed at falling down as the swamp morphs into a meadow. 

Self-sabotaging Leadership Failures

When a leader, governing body, enterprise or nation is showing symptoms of self-destruction, the wise give this natural process of decay room to take effect. Fools ignore the signs of self-sabotage and either try to prop up the falling edifice or continue to fuss at it vociferously. There is really no need to do battle with anything that has become it’s own worst enemy. I suspect this may be why:

• Mathew 5:39 states “but I say unto you, resist not him that is evil: but whosoever smiteth thee on thy right cheek, turn to him the other also”
• Mohandas Gandhi encouraged nonresistance to effect change
• Sun Tzu, in The Art of War describes how emptiness can defeat fullness, but only the emptiness that cannot be described succeeds at this

I’ve seen this pattern of self-sabotage unfold in several business enterprises and academic settings. I’m currently seeing signs of this same astonishing demise in the antics of the Trump Administration, Congress and their political parties’ organizations. Here’s a glimpse at a trio of the dynamics.

Web of deceit

When leaders lack self respect, their psychic void gets filled by insecurities, neediness and desperation. None of this is admirable, so these leaders put on a show of bravado. However, they cannot earn respect from others with so little self respect, so they opt for collusion with lieutenants who are also equally needy, insecure and desperate. Loyalty gets defined as acting to maintain a web of deceit that bolsters their equally shaky confidence. To their way of thinking, only traitors would expose the hidden insecurities, ignorance or incompetence of the leadership team. Loyalists tell each other what they want to hear and avoid pushing any hot buttons. The inner circle is not alarmed when their leader shoots down those troublesome messengers who are bringing truth to power. All this ensures that no self-respecting outsider will show these leaders respect or fall for their contrived web of deceit. The tide eventually shifts so the team at the top loses all credibility and buy-in to their leadership. Meanwhile, outsiders set an example of self respect, a healthy distance from the mandatory collusion and a steadfast commitment to the truth. They become trusted, informal leaders who ease the transition of power and envision an inclusive resolution of the turmoil. 

Winning a losing game

When leaders are consumed by winning at all cost, almost everyone they are leading looks like losers. They justify becoming authoritarian or totalitarian bullies because the losers need to be told what to think and do. The players of the losing game are doing whatever works. The rules no longer apply. There is no right and wrong. It pays to be ruthless to win small victories.  Every negotiation appears adversarial to everyone labeled a "loser". The leaders’ tactics escalate the context of suspicion and mistrust.  Opponents prepare equally adversarial maneuvers to retaliate against the attacks and expose the vulnerabilities of these leaders. Unbeknownst to any of the adversaries, they are all playing a losing game where no one can win. It’s like a nuclear war with second strike capability on both sides. The only outcome is MAD: Mutually Assured Destruction. Before any meltdown, the pendulum swings back and forth, making news headlines, and taking turns at winning senseless victories. Adversarial conflicts are struggles of attrition designed to wear down the opponents, to deplete their reserves, to lower their morale and to weaken their conviction. It’s very fair. Both sides get wasted. Live by the sword, die by the sword. 

The silent treatment

When leaders get worried that they are not getting respect because they are not leading, they start making gratuitous changes. They may throw money at problems that need more than a quick fix, turn up the heat on subordinates who already hold themselves to higher standards, or light fires under those who are already fired up to get better results. The leadership appears to be deaf, dumb and blind. It’s a mystery how the top can be so clueless when one’s colleagues and direct reports are fully aware of the dedication, determination and diligence brought to the job every day.  It becomes obvious down below that it has become pointless to manage up or keep the leaders in the loop. The leaders deserve zero respect. The top leaders are then driving blind. They are steering with only their rear view mirror to guide them. The bend in the road becomes the end of the road for the leaders because they fail to make the turn. Nobody down below who could warn them had said a word about the change, danger or opportunity. The leaders were getting the silent treatment. The leaders had lost all respect following their debacle of misguided leadership maneuvers. 

When these patterns occur in settings employing professionals (architects, engineers, lawyers, physicians, computer techs, college professors, etc) the brightest and best fly the coop, crippling the workflow. When it occurs at the scale of a nation, the national press becomes a far more trusted source than the self-sabotaging leadership. Grassroots efforts flourish and discourse outside the bastion of power reaches a fever pitch. There is an inevitable change in national priorities, alliances and agendas as the disheartened and disoriented seek to get their bearings amidst such a high level leadership failure. 

How Trump is Our Perfect Monster

A century ago, the ranchers bordering Yellowstone National Park were up in arms over grey wolves killing their livestock. If they could have built a wall around Yellowstone to keep the wolves out, they would have. They killed those horrific monsters off to extinction instead. As far as they could tell, their livestock and bottom line both were better off. They assumed the wolves would not be missed inside Yellowstone Park.

If this was a story like George Orwell’s Animal Farm, the grizzly bears, coyotes, otters, beavers, hawks, and ravens would have ganged up and killed off the ranchers. The ranchers’ diagnosis of their wolf problem was so short-sighted it only benefited the elk inside the park. 

This is a different kind of allegory. Democracies are ecosystems of highly interdependent interest groups cooperating in ways that serve both selfish and mutual interests. None of the constituents of a democracy are “horrific monsters” but a few function as “perfect monsters”. Acting on their own short-sighted interests yields widespread and long term benefits for the entire ecosystem. 

One century later, we now understand how wolves function as “perfect monsters” in the Yellowstone ecosystem. Their absence yielded horrific consequences. In hindsight, the ranchers were the “horrific monsters”. Their pointing a finger (and their rifles) at the wolves missed how they were being what they were seeing. They should have pointed some fingers back at themselves and questioned their flawed reasoning that put all the blame on the wolves. 

When the wolves were exterminated, the elk were free to forage by river. They over-harvested the willow, aspen and berry bushes that grow by the water’s edge. The beavers no longer had food to eat or construction materials for dams. With no dams, the groundwater did not get recharged. Many of the fish and amphibians that thrive in and around ponds died off. The grizzly bears population declined. They missed the berries they fed upon to prepare for winter hibernation. The river banks became barren and eroded into the river when it rained or the snow melted. The water became very muddy, killing off the fish that otters thrive on. The absence of trees on the riverbanks meant many varieties of birds lost their perches, their tree bark teeming with nutritious insects and their lightweight twigs for building nests. The hawks and ravens were dying from starvation when the supply of fresh wolf-kills dwindled to nothing. The ecosystem could not have been more out of balance, but also more poised to equilibrate. 

When the wolves were re-introduced into Yellowstone, the river water cleared up. The groundwater got recharged. A wide variety of birds returned. The riverbanks became lush with aspen, willow and berry bushes. Eight beaver dams appeared on the Yellowstone River. The otter population staged a comeback as the fish were multiplying because the aquatic plants had revived. The coyotes, hawks and ravens found enough wolf-kills to scavenge and prosper. The return of berries increased the grisly bear population. The number of elk came down to a sustainable level, in part by their foraging far from the riverbanks for safety. 

The wolves did not build a water treatment plant or restock the river with fish. They did not plant the willow, aspen and berry bushes on the riverbank. They did not re-introduce beavers, otters, ravens, hawks or other bird populations. All the wolves did was prey upon the oversupply of elk. Everything else fell into place. How perfect!

The wolves started what ecologists call a “trophic cascade”. Wolves can have these wide-ranging effects because they are one of the keystone species that impact so many other species. Beavers are another keystone specie. They destroy hundreds of young trees along a riverbank. Their short-sighted destruction benefits aquatic plants, fish, otters, beaver offspring, grisly bears, birds, water quality and ground water levels. What perfect monsters!

Democracies need short-sighted perfect monsters, just like other ecosystems. Voters can become disenchanted, disengaged or despondent. Communication flows can get blocked or distorted. Deliberations can become stagnant, stalemated or toxic. Representative bodies can lose essential components like creativity, statesmanship, diplomacy and bipartisan strategies. Leaders can become politically motivated instead of policy driven. The cost of political campaigns can skyrocket. Candidates for elected offices can become scarce. Commercial agendas can infect democratic processes where the electorate no longer respects politicians or trusts their campaign promises. Investigations of suspicious activities can overtake the formulation of new legislation, policy improvements and budgetary reformulations. Journalistic priorities can get turned upside down where small issues become enormous and critical issues become insignificant. 

The Trump Administration has been profoundly destructive to complacency, apathy and disengagement at every conceivable level from citizens who did not vote to the legislators who only blocked legislation. Nothing can be taken for granted for now. Business as usual has been taken off the table. Everything is in jeopardy of getting changed somehow if people don’t speak up, show up and act up. 

The US democratic ecosystem is currently brimming with vitality. Investigative journalists have a new mandate to uncover as many hidden truths as possible before we get blindsided by them. Press outlets are experiencing a surge of new subscribers, readers and viewers. Legislators seeking reelection are under new pressures to look beyond the interests of lobbyists and campaign funding sources to the voters who put them in office. Committees in the US Senate have become energized to do a thorough job of vetting the cabinet positions nominees and investigating Russian interference with our last election.  Political parties have new priorities to emphasize their ground games and listen more closely to varied interest groups at the grassroots level. Citizens have started taking the classes, getting the signatures and running for elected office in their districts. Voters in town hall gatherings have new reasons to clarify the issues they’re focused on and to dismiss the label of “sore losers”. Voters marching in the streets have new motivation to protect consumers, minorities, refugees, educators, small investors, seniors, healthcare providers and the natural environment from the onslaught of cabinet appointments and executive orders aimed at dismantling those protections. 

There’s no way these widespread improvements in our democracy could have happened by only preaching the importance of civic engagement, begging people to get involved or threatening citizens if they did take more initiative. Senator Bernie Sanders’s presidential bid got people thinking about getting more involved. It took President Trump’s predatory behaviors to seal the deal. All these signs of revitalization could only happen with the arrival of a perfect monster. All these fixes for the broken system are simply falling into place thanks to the Trump Administration’s destructive effect on complacency. How perfect!

Presidential Paranoia

Donald J. Trump is obviously living with some significant psychological disabilities. It’s too easy to criticize people with disabilities, as he as sadly demonstrated to us. He’s appears to be incapable of empathy or moral leadership. It’s our job to add those ingredients to the mix in the conversations about him and his Presidency. If we follow his example and give him a taste of his own medicine, we are fighting fire with fire and taking the low road.  That can only backfire on us and add fuel to his raging fire. 

In this essay, I’ll show you how to empathize with one of his disabilities and provide some moral leadership in conversations where you can take the high road. I realize this may be a very big ask if he offends you, upsets you or infuriates you with his conduct and verbiage. I also realize this may be too much to ask if you share in his psychological condition or milder versions of it.

It appears to me that Donald J. Trump suffers from an anxiety disorder that uses “paranoid delusions” to cope with unwanted circumstances. He relies on these fantasies often. For him they are a solution to several hidden problems that are not going away in his psyche. For starters, here are a few examples of the paranoid delusions he has found comforting:

• Barrack Obama is not an American citizen
• Crowds in New Jersey cheered when the twin towers fell on 9/11
• Mexico will pay for the wall along the southern border
• The murder rate and unemployment rate are climbing
• Millions of undocumented immigrants gave Hillary the bigger popular vote illegally  
• My electoral college victory was the largest since Ronald Reagan
• Photos were altered to make my inauguration crowds look smaller than they were
• George Soros paid all the marchers (in 670 US cities and 70 countries) the day after my inauguration
• There are many more terrorist incidents occurring than those covered by the press
• Paid protesters were disrupting all the Town Hall gatherings during the Congressional Recess
• Lots of bad people are crossing the borders every day that we don’t have a travel ban in place and a wall to stop them
• President Obama is a bad person who ordered a wiretap on the lines in Trump Tower just before my election victory

It may be hard to imagine how he could be comforted by telling himself these delusions. They are not comforting for most people in this country and around the world. However, some members of his base and the Alt Right movement share his anxiety disorder and take comfort in the reorientation these delusions provide. Earning others’ respect or building more trust are not on the menu. It does not matter to them if these claims have no basis in fact. Desperate times internally call for these desperate delusions. 

We don’t need to know the exact nature of their internal events to empathize with their use of delusions. It’s enough to realize how paranoid delusions could make sense to some troubled states of mind. Here are four sudden changes in mental state that can take comfort in paranoid delusions.

1. If the bottom suddenly dropped out of your self confidence, you might be feeling like an insignificant nobody. You would suddenly experience being very vulnerable to any remarks that exposed your inferiority and worthlessness. You could be feeling very fragile and extremely wary of getting shattered again. You might even start believing this setback keeps happening to you because you deserve it and you can never escape it even if you tried.  
2. If your mood was suddenly overwhelmed by an onrush of hatred, intolerance and disgust, you would be feeling out of control. You might be wondering what got into you and what brought that on. You would be finding that it was difficult or even impossible to get back to your previous mood. You might imagine that you had flipped your lid without a way to get a grip on emotions. You could easily be thinking the only way to get some relief would be an outburst, eruption or explosion of your inner turmoil
3. If your outlook suddenly become apprehensive, you might become very suspicious, vigilant and even vindictive. You could not be sure about anything that was hidden, covered-up or said in secret. Trusted confidents might suddenly become suspected as saboteurs of your reputation and endeavors. Conspiracies against you would suddenly seem more likely. You could be feel glad you suddenly got spooked to snap you out of your over-confident outlook. 
4. If your memories suddenly dwelled on your troubled past, you might start replaying your past. What happened to you seems so easy to obsess upon and impossible to forget. You would be repeatedly scanning for clues you missed and comments you misinterpreted at the time. You could experience being possessed by your recollections and obsessed with them never happening to you again. You could be feeling like an idiot to have been suckered into that situation or feeling singled out to have gotten victimized that way.  

Any of these changes in mental state produces excessive anxiety. The imagination scrambles to make sense of the staggering agitation. No rational explanations, reasoned arguments or practical advice puts the mind at ease. It takes something extreme to match the mood. Paranoid delusions work really well when the mind get this troubled.  

Moral leadership for these people reduces their anxiety without colluding with their delusions. It helps them to know they are not alone while they are feeling singled out and persecuted. It helps to remind them of other situations where they have been undoubtably confident, resourceful and valuable to others. It helps them to notice the shift in their mood while you’re giving them a listen, a show of respect and a word of encouragement. This high road is easy to take once you have a more empathy for their mental states and a better read of their resulting situation.  

Drain the Swamp

Ecosystems routinely convert marshes into fertile meadows. This occurs by decaying the accumulating aquatic plants and trees, aided by bacteria-rich brackish water. Windblown top soil helps with replacing the decaying stench with luxurious soil, wildflowers and softwood forests. Ecosystems do not drain swamps or build water treatment plants. Changes occur by natural processes. 

Pondering how wetlands become meadows has me thinking how the quagmire of politics in Washington could occur naturally. How could President Trump keep his promise of “draining the swamp” without taking action to get that done. What if Donald J. could function as an anti-hero who’s finale was anti-climatic? What if the key to “draining the swamp” was failed negotiations? What if he followed the lead of the “do-nothing” Congress and did nothing to drain the swamp? What if he rendered conventional “make it happen” presidential leadership irrelevant? What if we’ve elected the right guy for the job of morphing gridlocked Washington into a new political landscape teeming with vibrancy and diversity?

Congressional consensus building and policy formation have ground to a halt. The sides mistrust each other so much that they cannot compromise or find some middle ground. Their objectives appear to be diametrically opposed. Nothing the Executive Branch does has broken the deadlock. The RNC and DNC have not changed the kinds of candidates running for seats in Congress. All this compares to the brackish water in the swamp analogy.

The aquatic plants going to rot in a marsh are the contentious issues remaining unresolved in both houses of Congress: national debt, entitlement programs, immigration reform, healthcare policy, tax reforms, etc. The aquatic plants are rooted in muck that equates with the kinds of thinking in use which perpetuate the unresolvable contentiousness. In this analogy, those plants won’t start growing again, they will disintegrate in support of a new landscape. 

The fertile ground of the resulting meadow equates with a newer style of leadership that goes by many names: facilitative, consultative, participative, democratic or servant leadership. Subordinates are no longer under the leader’s authority or obligated to report up the command chain. These leaders have everyone’s back. They lead from behind and support other’s initiatives. They listen to and learn from everyone’s concerns. They facilitate solutions that span across different teams, departments or levels. These leaders take a coach approach to getting others to produce results, to enhance their capabilities and to collaborate with others. 

The burgeoning wildflowers and fast growing trees resemble the flourishing of initiative, better judgment, individual talents, collaborative creativity, unique contributions and shared commitments. Everyone is setup to succeed, made to feel like owners and treasured for their unique contributions. Imagine both houses of Congress blossoming like this.

This delightful transformation often occurs following the widespread failures of autocratic leadership and adversarial negotiations. The resulting lack of initiative and the absence of everyone’s better judgment helps to bring about the demise of the old order. It’s much like a brackish swamp caving in on itself and disintegrating under its own weight. 

The pending failures of Congressional and Presidential leadership are easy to anticipate. So much of the political landscape also fits a model of adversarial negotiations. All the stagnation then fits into the frame of failed negotiations. (I’ll explore this in several future posts) The fallout from both failures is a perfect end to the swamp and the start of the fertile meadow. 

Why So Many Leaks to the Press?

The Trump Administration initially asked for government insiders to leak news to the press. The Administration then insisted that the leaks continue unabated and preferably increase in volume.  Those in a position to leak news to the press got the message loud and clear. However the Trump Administration has no recollection of asking for a single leak. They didn’t ask with words. Actions speak much louder than words, especially when the speaker cannot be trusted to speak honestly. The actions of the Trump Administration could not have been more clear. Leaks were called for in a big way to preserve our democracy, the free press and access to factual truths. 

The Trump Administration appears to be assuming that words speak louder than actions. The White House staff continually endeavors to manage their press coverage and change their story as if their words are somehow powerful. President Trump and his advisors are walking a different talk from what they are saying. They are sending mixed messages. The press and public both sort out this confusion through the lens of “actions speak louder than words”. “Follow their feet, not their flapping lips” is a effective guide for remaining oriented amidst this barrage of confusing messages. It’s immediately clear what the Administration is really saying in contrast to their contradictory verbiage. 

It’s very easy to ask for leaks without asking directly. The Trump Administration appears to be following the playbook verbatim. Here are some pointers for getting leaks to happen wily nilly:

1. Let it become widely known that factual information will not be forthcoming, in part by coverups and in part by spewing erroneous speculations routinely.
2. Discourage further investigations into questionable evidence by frequent suggestions that “there is nothing there to find” 
3. Make obvious efforts to dismiss critics, block deeper inquiries and favor propagandists who replicate your pronouncements without question. 
4. Become defensive and vindictive anytime outsiders reveal truths which target your exaggerated claims of progress, success or intended results. 
5. Express your admiration for any high profile despot who poisons his critics, imposes state control on broadcasters and invades sovereign countries without compunction.
6. Shoot all messengers who expose your shortcomings, ignorance or incompetence by banning their attendance at briefings, gagging their interagency communications or silencing them to their faces.
7. Frame all your opponents, who are attempting to weaken your bargaining position, by labeling them as losers and discrediting their professional credentials. 
8. Overplay your hand whenever getting the upper hand so you appear to be a bully who is fixated on winning regardless of the cost.  
9. Use misdirection and confusion techniques so often as to appear really confused, instead of successfully deflecting accusations with a firm grip on reality
10. Rely on hyperbole, fantasy and paranoia to get the public to feel at ease, to put in a kind word for you and to put their trust back in your leadership. 
11. Routinely shift the blame away from yourself, indulge in frequent “character assassinations” and avoid taking any responsibility for any mistakes, errors or falsehoods. 
12. Threaten to prosecute all those leaking information to the press as if they are a bigger threat to national security than anyone following this playbook to the letter. 

Taking these actions speaks much more loudly than mere words. They send very clear signals that anyone following these dozen pointers:

• Cannot tell the truth, appreciate the truth or seek out the truth
• Cannot stop themselves from interfering with the truth getting uncovered
• Cannot believe the truth is true, accurate and verified
• Cannot trust where the truth is coming from, how its being used or what it’s implying
• Cannot handle the truth itself at first glance or upon further reflection
• Cannot cope with the truth being revealed by others unless it attacks others
• Cannot expect the truth to contribute to their goals, progress or corrective actions

With so much missing from forthright discourse, leaks become essential, even irreplaceable. There are so many gaps in explanations, motivations and plans, the only available way to fill the gaps is leaks. Leaks seem like the right thing to do when the only alternatives are wallowing in ignorance, falling into paranoia or jumping to false conclusions. 

With truth taken off the table at the highest level, truth naturally flows under the table where the leaks can be shared anonymously. The FBI, CIA and NSA move to the forefront of trusted voices. Journalists become like spies who cannot reveal their sources and methods. Journalists and governmental investigators become far more trusted than the White House to reveal the real stories of who was there, what was said, when did it occur, and what then happened as a result. The leaked information seems extremely valuable when truth becomes such a scarce commodity.