Making Things Greater

Making Things Greater


Leonard Zwelling

Even in Manhattan, I saw the MAGA hats starting to sprout. We must be getting close to 2020 and another election season. It also must mean that Mr. Trump’s announcement that kicked-off his re-election bid has been heard by his followers and they are breaking out the old gear. But in his announcement, Mr. Trump said the slogan this time around is Keep America Great. I guess we should be seeing KAG hats soon. But is KAG really what he is after or is it making America greater? It’s hard to make something great even greater.

I am not sure what the evidence is that America has been made great under the leadership of Mr. Trump. It has most certainly been made different, but was in pretty good economic shape when he took over. But to his credit, Mr. Trump has not interfered with the economy and Wall Street and Main Street have both benefitted, although the former more than the latter.

Civil discourse is harder to come by and Congress is even more inept than it had been under Mr. Obama. It can get nothing done.

In domestic matters, the seminal accomplishment of the Trump Administration has been a tax cut for the wealthy that caused me and many others to pay more taxes and even did away with the individual mandate portion of ObamaCare that could, in turn, lead to the abolition of the whole ACA depending on court rulings as to the separability of the facets of the law. If one part is no longer operative (the mandate), is it all unconstitutional?

Trump has accomplished little else besides rolling back regulatory frameworks and inheriting a booming economy that he has not made worse. Wall Street is happy. Conservatives are happy with Trump’s Supreme Court appointments. Whether the American people are happy will be known in November of next year.

Nonetheless, like Bill Clinton before him, Trump stayed out of war (or at least new wars) and did not interfere with the economy. That is worthy of credit and Mr. Trump gets high marks for both even as the manner in which we interact with one another has grown coarser.

Mr. Trump also owns the Republican Party. In fact, he’s their daddy. None of the erstwhile leaders of the Republican congressional delegation will even peep in opposition to him. To be honest, they’re his bitches.

On the international front, the jury is still out on whether the Trump plan, if there is one, will make America great in the eyes of the world. Thus far, not so much. Trump has cozied up to dictators, blasted our European allies, and given mixed signals as to how aggressive he is really willing to be when Iran or North Korea gets belligerent. His “tariffs as weapon one” strategy may work against both Iran and China, but in the case of the former if they cause a shooting war, the tariffs may be a high price to pay. In the case of the latter, China may be big enough to wait us out, but we shall see. I do give Trump credit for calling China what it really is, a predatory nation willing to do anything to dominate economically including pressing its citizens into involuntary servitude in the name of stealing intellectual property, although I don’t think the high value property is in the labs of major academic institutions. But, it may be and the FBI is supposedly on the case. Supposedly. The attack on individual Chinese faculty members at American universities has confused everyone and sown fear everywhere.

In short, I think an objective view of Mr. Trump’s first thirty or so months is remarkable in that there have been no major catastrophes despite what probably does amount to collusion during the 2016 election and obstruction thereafter. He’s just lucky Congress is so unskilled and frightened of him that it can’t get anyone to even testify.

It will be up to Mr. Trump to outline what his plans for a second term are and how he will accomplish them. He’s not much for planning nor for getting good people to work for him. My guess is that if he does manage to get re-elected, nothing much will happen, but remember, I’m usually wrong.

How about making MD Anderson greater? How is that going?

Fortunately, after the DePinho years, there is nowhere to go but up and I think that is occurring, but I still do not have a clear picture of the strategy of the new MD Anderson administration when it comes to how it will advance the core values of discovery, caring and integrity beyond making sure everyone says good morning to everyone else and treats patients like family. I am not sure that’s such a good idea given how some families interact, but it’s a nice thought.

Dr. Pisters needs to advance specific ideas about the future of clinical care, basic science, education and prevention at Anderson, especially in Houston. That’s what making MD Anderson greater will look like. I’m still waiting.

In Peggy Noonan’s WSJ column on Saturday, June 22, she points out her sister and uncle were immediately taken by Donald Trump after he announced his run for the White House in 2015. He was the no BS candidate and that appealed to a lot of people. It still does.

But Noonan also points out how unready the current White House is for a catastrophe for two reasons, the president’s lack of experience and the paucity of others with experience around him.

These are things that Dr. Pisters should consider as well. The recent twin catastrophes of firing Asian faculty and warning letters from CMS suggest that the inevitable knock on the door at 1515 Holcombe has come.

The fallout was swift, but manageable. The long term effects of the twin crises remain to be seen.

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