While the world is shocked, Americans are not — here's why…

The Lancet is arguably the most respected medical journal in the world. Founded in 1823, its reputation is impeccable and it only publishes science that's peer-reviewed and scientifically sound. Which is why their indictment of the last four years of Republican rule under Trump, McConnell, and McCarthy is particularly shocking.

"Trump exploited low and middle-income white people's anger over their deteriorating life prospects," the Lancet's Commission on Public Policy and Health in the Trump Era wrote, "to mobilize racial animus and xenophobia and enlist their support for policies that benefit high-income people and corporations and threaten health."

Published on February 10th, this British commission's shocking report lays out for the world's public health community exactly how monstrous, cruel and depraved Trump and his GOP cronies behaved in the face of a worldwide public health crisis. They actually called out GOP fealty to the corporate elite and billionaire class.

"His signature legislative achievement," the Lancet commission wrote, "a trillion-dollar tax cut for corporations and high-income individuals, opened a budget hole that he used to justify cutting food subsidies and health care."

We shouldn't be surprised that the world's top medical journal is pointing out how disastrous Trump's presidency was for the American people. It's simply the logical extension of conservative policies on pretty much everything for the past 90 years.

Republicans simply don't believe it's part of the job of government to provide for the "general welfare" of the American people; instead, government — in their minds — should only run the police and the military, while maintaining a stable currency and court system so business can function.

Republicans, for example, don't believe government should help the elderly avoid poverty. A safe retirement should only go to those who set aside money during their working years, they say, and Social Security should be run by private insurance companies, as President George W. Bush told us in 2005. Republicans have tried to cripple, privatize or destroy Social Security year after year ever since the 1930s when it was created.

Similarly, the GOP argues that government shouldn't pay for health care anywhere, anytime because, they say, that should come out of people's own pockets. If we want protection from serious illness or accidents, they say, we can buy private insurance. Republicans have tried to cripple, privatize or destroy Medicare and Medicaid since the 1960s when these programs were created.

As The Lancet commission pointed out, "Although [Trump's] effort to repeal the Affordable Care Act failed, he weakened its coverage and increased the number of uninsured people by 2•3 million, even before the mass dislocation of the COVID-19 pandemic, and has accelerated the privatisation of government health programmes."

Public health is a multi-dimensional undertaking, The Lancet commission points out, and Trump even packed the courts to sabotage it in America.

"He chose judges for US courts," they wrote, "who are dismissive of affirmative action and reproductive, labour, civil, and voting rights; ordered the mass detention of immigrants in hazardous conditions; and promulgated regulations that reduce access to abortion and contraception in the USA and globally."

Regardless of how the rest of the developed world works to keep their citizens safe and well, the GOP throws in exclusively with big corporations and rightwing billionaires.

Republicans lecture us that government's job isn't to protect citizens from being poisoned by industrial pollution or protect our rivers, lakes, oceans or air; these are all the jobs of private industry. Since 1920 when Republican Warren Harding successfully ran for president on the platform of "Less government in business and more business in government," GOP politicians have championed deregulation and privatization as the solution to almost all problems.

As The Lancet commission noted: "Trump's hostility to environmental regulations has already worsened pollution — resulting in more than 22,000 extra [American] deaths in 2019 alone — hastened global warming, and despoiled national monuments and lands sacred to Native people."

Back in 2000, when Mike Pence was running for Congress, published an op-ed explaining how Republicans think about public health. About 340,000 Americans died that year from smoking-related illness, but, Pence wrote, "Despite the hysteria from the political class and the media, smoking doesn't kill."

Instead, much like Trump saying that most people who get COVID-19 don't die from it and that lots of Americans die from the flu, Pence added, "In fact, 2 out of every three smokers does not die from a smoking related illness and 9 out of ten smokers do not contract lung cancer."

Instead, Pence said we should be wary of, "Government big enough to protect us from our own stubborn wills."

After all, Pence pointed out, "[A] government of such plenary power, once conceived will hardly stop at tobacco. Surely the scourge of fatty foods and their attendant cost to the health care economy bears some consideration. How about the role of caffeine in fomenting greater stress in the lives of working Americans? Don't get me started about the dangers of sports utility vehicles!"

Which should remind us that Republicans even fought against seat belt laws and other car safety regulations, as well as nutrition labeling on children's cereals and baby food, and country-of-origin labeling on any foods. And, as The Lancet points out, they continue to block action on climate change, which is killing Americans from coast to coast via floods, hurricanes, wildfires, tornadoes and heatstroke.

If Mike Pence was just fine with hundreds of thousands of Americans dying from an entirely preventable tobacco addiction, why would he fret about a half-million dying from the Covid virus?

As The Lancet commission points out in this new analysis, "Disdain for science and cuts to global health programmes and public health agencies have impeded the response to the COVID-19 pandemic, causing tens of thousands of unnecessary deaths, and imperil advances against HIV and other diseases."

Trump and today's Republican Party are simply carrying on a long tradition of conservatives and libertarians, arguing there's no role for government in helping or protecting the American people (unless they're billionaires).

As the late billionaire David Koch put into his platform when he ran for vice president in 1980 on the Libertarian ticket, "We advocate the complete separation of education and State. Government schools lead to the indoctrination of children and interfere with the free choice of individuals. Government ownership, operation, regulation, and subsidy of schools and colleges should be ended."

Reflecting conservative philosophy dating back to the 1920s, Koch even called for "the abolition of the governmental Postal Service," "the abolition of the Environmental Protection Agency," and "the abolition of the Food and Drug Administration."

After the Republican Great Depression struck in 1929 and about a third of Americans lost their jobs, homeless exploded, and hunger stalked the land, Republican President Herbert Hoover's treasury secretary, Andrew Mellon, famously argued that saving the economy and American workers was the duty of the private sector, not government.

Instead of helping out working people, Mellon's advice was just to let everything crash, and the very, very rich (like himself) would eventually pick up the pieces and start over.

"Liquidate labor, liquidate stocks, liquidate the farmers, liquidate real estate," Republican Treasury Secretary Mellon said. "Purge the rottenness out of the system. High costs of living and high living will come down… enterprising people will pick up the wrecks from less competent people."

Republicans simply don't believe that protecting the people of America is a legitimate function of government. And they're strengthened and disciplined in that belief by the billions of dollars industry and hard-right billionaires shower on them at every level of elected politics.

We're literally the only developed country in the world where this bizarre belief is held by about half the nation's politicians. We're the only developed nation where healthcare is a mere privilege rather than a right.

The story of how Florida Republicans let a young mother of three die illustrates how cruel this system is.

In 2014, Charlene Dill was working several part-time jobs (house cleaning and babysitting) and had just added a gig selling vacuum cleaners, just barely getting by while parenting 3 young children.

As her best friend, Kathleen Voss Woolrich wrote at the time and later told me in a phone interview, "She paid her property taxes and took care of her little trailer, which she owned, and got all three of her kids to school and daycare. She was a very responsible person."

As Woolrich noted, after feeling pain in her chest, "She went to the emergency room in 2012 and was told she had heart issues and needed monitoring and medication. But the Florida Republican Party and Governor Rick Scott had turned down $51 billion federal dollars for [Obamacare's 2009] Medicaid expansion, so she had to work extra to pay for the meds and the ER was her doctor's office."

On March 21st, Charlene was going to get together with Woolrich and her daughter, who'd essentially grown up with Dill's kids, but first she had to earn a few more dollars to pay for her heart medication, which she'd been cutting back on because of its cost.

The Affordable Care Act would have paid for Charlene's doctor's visits and medications, but then-Governor Rick Scott was particularly incensed by that prospect and had refused to expand Florida's Medicaid system under Obamacare.

So, after spending a day cleaning houses, Charlene headed out to a lead in Kissimmee, a small town near her trailer near Orlando, where a family had indicated an interest in buying a Rainbow Vacuum Cleaner.

In the middle of a sales pitch her heart stopped, and, in the early evening of March 21, 2014, she fell over, unconscious. The family she was visiting called an ambulance and Charlene was taken to the Poinciana medical center, but she was already dead at age 32.

"I am burying my best friend because of [Governor] Rick Scott and the policies of the Republican Party," Kathleen Voss Woolrich wrote. "She is one of the 7 people who will die each day because the Florida House of Representatives Republicans and the Tea Party decided that we are not worth living. We are not worth healthcare. We are not worth Medicaid expansion."

Woolrich added, "I'll never have her back. I'll never see my friend again. I'll never have another day with her because of the [Florida] Republican House of Representatives."

(Ironically, Scott's hospital company, that he sold just before becoming governor, paid a $1.7 billion fine after being convicted of the largest Medicare fraud in the history of our country, all on his watch. He walked away with nearly $100 million that he used to leverage himself into the Governor's office and then the US Senate.)

Charlene's then-Congressman Alan Grayson, wrote for The Tampa Bay Tribune, "This young mother didn't have to die." Charlene Dill, a hardworking, loving single mother of three young children, was just 32 years old.


Charlene Dill, photo courtesy of Kathleen Voss Woolrich

Charlene died because multimillionaire Republican and then-Florida Governor (now US Senator) Rick Scott — and the entire US Republican Party — didn't believe government should provide healthcare to the working poor.

So let's stop being "amazed" that Trump, Pence and their GOP allies refused to mandate or even federally facilitate widespread testing and contact tracing as we headed toward half-million dead Americans.

We shouldn't have been surprised when Trump blocked the Postal Service from delivering masks to every American, and McConnell refused to even consider debating legislation to pick up the medical or burial costs of people infected because of Trump's lack of action.

The world is shocked by the callous way Republicans govern when given a chance, and The Lancet gives credible voice to this horror.

But to Americans this was nothing new; it's what Republicans always do.

-Thom

Originally posted on thomhartmann.medium.com.