HOW TRUMP WON - WHAT’S NEXT?

 

There is one general point to make before launching into How Trump Won and What's Next, namely, he did not win a grand mandate nor did the “Republicans” who eked out victories in Congress. In addition the Democrats made gains in several areas particularly in the down ballot State races. Vice President Harris, a relatively unknown woman, lost three Midwestern States by 230,000 votes, (0.012 percent of 19 million votes), that had she won she would have been President. The reality of the narrowness of Trump’s victory hangs over the future of American politics particularly since there is a MAGA civil war . (Blog: “Can Trump Pull This Off”.)  

Just one other fact Kamala Harris on the trail was faultless but she was hamstrung by two factors - Biden hanging on for dear life and her inherited campaign staff hid her like they closeted him.  

HOW DID TRUMP DO IT?

How did Trump with all his character flaws, penchant for not telling the truth, switching  policies mid sentence, being a grifter deluxe, a convicted felon, inspirer of an insurrection and an approval rate of 41percent, win?  

How was he able to be the binary choice of a tiny yet crucial number of suburban white women, (you just grab them by the pussy), some youth, (no way is he going to forgive student loans), enough black men, (just shoot them in the legs), Hispanic men, (they are sending us their drug dealers, murderers and rapists) and Union Workers, (to Elon, “when they say they’re going to strike you just fire them”)? 

 How did this epitome of a spoiled brat of a mega rich privileged family with failed grandiose schemes where his daddy bailed him out, who trashed the very demographics he needed, become the avatar of the underdog? 

Thus Instead of just focussing only on why a barely known black Indian woman, a first generation immigrant, lost, although her demographic was implicitly a large part of MAGA'S negative narrative, the question is how Trump regained that tiny 2016 vote and got 90 million voters to stay at home.

There are a multiplicity of reasons why Trump won in 2016 and again in 2024 which Jay H. Ell will detail but he believes a central answer lies in what the Canadian Author Marshall McLuhan punted in the 1960’s and then in his book, “The Medium is the Message”. 

McLuhan argued that how a message was delivered had a significant impact on how it was perceived, more so than the content itself. He has been proved right throughout the ages as revolutions in the medium have facilitated cataclysmic events. Examples include the printing press - 30 years religious wars with a third of Europeans dying; the radio - Hitler, Churchill and Roosevelt - WW11;  television - Kennedy and Nixon, Watergate and the era up to 1990. The new medium of the World Wide Web, (www), certainly has more than done its bit.

THE WORLD PRIOR TO COVID 

The fact that Donald Trump was elected President in 2016 was indicative that profound change had already filtered into the political landscape of the world. The United Kingdom had absurdly voted for Brexit and Viktor Orban was ensconcing himself in Hungary just for starters

Populism was the new ism. A dictionary definition of the phenomenon includes the appeal to ordinary people who feel they are being ignored by the elites and their institutions. Before the www they were hardly heard of, disorganized let alone a major force globally creating an agenda - mainly just their opinions and feelings and not fact. No one defined the new ism more than Donald Trump.

Trump trashed objectivity although he had no idea that there were philosophers that had articulated his schtick of anti science, anti experience and anti values or morality. Michel Foucault argued that “The elites controlled the masses by claiming that they had the monopoly on facts and science on the basis of objective facts”. Kelly Anne Conway argued “We have our own truth”. Trump claimed he knew more than the generals.

Trump laid the blame for the outsourced industries, the failure of the rural populations to move forward, the non College degree youth stuck in a rut, the loneliness and the drug addicted outcasts on the liberal elitist experts and scientists, their institutions mostly their universities and their control of the established media. The “Dark State” of unelected  bureaucrats carried out the agenda. He was a victim. He even claimed that black men should connect with him as he like them was being being unfairly targeted. 

But there were other factors that caused insecurity, discontent and anxiety. The growth of women power as illustrated in the “Me Too” movement. Their emancipation in the education process resulting in more women college graduates then men. Misogyny played a large role, The growth industry of the marginalized, LGBT  groups, Black Lives Matter and no body worrying about the poor whites who “were last in line”. 

Then there was the fear of immigrants both legal and illegal. They were taking American jobs, consuming entitlement money, “poisoning the blood”, committing murder and thus changing what America was. “Make America Great Again” was code for “Keep America White”. But most important the discontents now had a www. medium to unite and crystallize their grievances and yearn for a savior who was made to order - Trump.

THE WORLD CIRCA 2024  - THE TRUMP RE ELECTION

The world in the first quarter of the 21 first century had recovered from a pandemic the likes of which had not been experienced for over a hundred years. The fact that it resulted in over 7 million deaths, was soon forgotten. Rather what was perceived was the anger at the restrictions placed on citizens in an attempt by the scientists to control the contagion. Forgotten was the bizarre manner in which Trump lied about the danger, suggested bleach as a cure, congratulated China then smeared them by tweeting continuously that it was “The China Virus" . Fitting into the narrative was good old RFK Jnr who argued that the vaccination was dangerous. 

The post Covid scapegoat for the devastation, inflation and loneliness was the most respected infectious disease expert Dr. Fauci who today is listed by the Trump nominated FBI Director Kash Patel, as one of the “Deep State” that should be prosecuted by the incoming Administration.The attack on institutions including the Centers For Disease Control, which was plastered billions of times, one way or another on the world wide web, was another factor that a slither of voters that preferred Biden in 2020 switched back to Trump

SO IT’S THE MEDIUM NOT THE MESSAGE - STUPID!

Of course there are counter narratives far more convincing than Trump’s charge. Biden addressed the manufacturing and jobs issue in a revolutionary fashion with the money going where it was needed most - the red states. The crime rate is down and statistically lower among immigrants. Currently there is the lowest unemployment rate on record with best economy in the world. Biden deported a record number of “illegals” and offered a bipartisan border deal which Trump rejected and told the world why - to leave the issue open so he can run on it. Biden dealt with the international crises unbelievably competently.  But he kept all to himself not even talking to the conventional media. 

In 2020 the campaigns were run from the bunkers. It was the height of Covid and Trump’s Covid laissez - affaire approach was still fresh in every one’s minds. In 2024 the environment changed. Biden now needed to be out front. He bombed when he finally appeared in a debate and belatedly pulled out of the race. 

Harris inherited Biden’s yesterday’s campaign staff. It all looked so marvelous, an incredible ground game, paid staff, more money, hundreds of volunteers, but Harris had hardly name or policy recognition. She was kept hidden lest she make a mistake.  When they exposed her she was convincing. Any rate they only did so in the conventional media which was moribund.

 Harris attracted large crowds delivered short sharp effective speeches and phrases such as “… a very unserious man … whose consequences could be brutally serious”. But how big were Harris’s audiences - tens of thousands at rallies, 15 million at the Convention and twenty million at that debate where Trump claimed that the legal Haitian immigrants, “were eating the dogs and the cats and the swans”.

 

Trump used all media, especially the revolutionary media from podcasts and the social media sites. What he said on the traditional didn’t impact his base. He had other the new www. medium just to win over the crucial few who had the binary choice between himself and the sheltered Harris. 

Social media needs short sharp phrases. Who wants to read screeds? First of all Trump had his own Twitter account which had nearly a 100 million followers. Then he had Elon who has 200 million. But it was the podcast bros that were the real movers and shakers. They were the most effective communicators to large audiences on the democratized medium. It is a so much easier to sit and watch for three hours then read Harris’s detailed policies. 

Joe Rogan the podcaster has 178 million followers. Harris refused to go and sit for three hours in tune with keeping her from sight. Maybe her antiquated campaign, which only inhabited Cable News was terrified that she would make mistakes. Trump made plenty. It didn’t matter. He cared enough to sit there for hours, there and every where else on the modern media. Harris was picture perfect for her followers and who knows had she been giving daily interviews maybe she would have reached a few hundred thousand more of the hundreds of millions which was all she needed in the MidWest. They said Trump wasn’t trying to increase his base. No he wasn’t he just wanted to reassure the demographics that voted for him in 2016 should rather vote for him than an unknown idiot.

So Trump, the best salesman in the world intuitively mastered the new media and Jay H. El firmly believes like Marshall McLuhan that it is the medium not the message that matters and that is why he won while Harris was stuck in the old paradigm.

WHAT’S NEXT ?

Trump has claimed the narrative before he has even been installed as President, flooding the zone. He has lost on every single issue that he has foist on his Party. From supporting the wrong Senate Leader, asking for non consented recess appointments, to having his request for not having to have a debt ceiling ultimately leading to 170 House Republicans and nearly every Republican Senator defying him. He poured political capitol into a disgraceful Attorney General candidate, Matt Gaetz, and is hoping to place hopelessly unqualified candidates in his cabinet. Just like the revealing of Gaetz’s ethics report the public hearings may well expose his shocking judgement. 

Then there is the legal immigration issue where Musk and Ramaswany are at war with the full blown MAGA. Ramaswany called Americans mediocrity and Musk maintained if America don’t import talent they will lose. What do those two know they both come from “shit holes”? Apparently a lot since Trump is backing them! Bannon and the real MAGA base are going ballistic.

Trump is going for broke on disgraceful Pete Hegseth for Defense. That is the crucial battle, if he wins that he controls the military.  The good news is that the Republicans have demanded an FBI report. Trump may still declare a National Emergency ostensibly about illegal immigration but he still needs Congress money for his grandiose plans and of course the military. He will probably produce a dark shocker at inauguration and it is going to be ugly. But remember, Mexico didn’t pay for the wall and Obamacare is still around. 

AT THE END OF THE DAY

Wish that the genuine lunatics would run this asylum. Hope Kamala Harris finds some fake electors.  Will Greenland be a blue state or a red state?

First task is to elect a MAGA Speaker which is going to be  a challenge. 

TRUMP, TEXAS AND WOMEN'S HEALTH

 

In this age of the insanity of Trump, health care, for the wrong reason - the violent death of a health care executive - has once again become the focus of attention. A 2024 Gallup showed only 28 percent of those surveyed showed strong approval of their health care coverage. 

The current health care system is dysfunctional.  America, the richest country in the world, spends 20 precent of its Gross Domestic Product on health care, that is close to 5 trillion dollars a year, around about 14,000 dollars per person. That cost is double the average of the other rich countries with the worst outcome measures such as longevity, maternal and fetal mortality. 

That doesn’t mean that America doesn’t deliver the most sophisticated and revolutionary management of disease. However the latter comes at a massive cost financially, and in the geographic distribution of where health care is available. Healthcare is not acknowledged as a right but rather a commodity to be bought and sold in the free market.

Jay H. Ell will not attempt to address the whole health care subject but will focus on one state, Texas, and one aspect of health care - women’s health and the factors that influence it. 

The women’s health care situation in Texas was bad enough before Roe v Wade, which enshrined the right for women to control their bodies, was overturned on June 2022 and Is so much worse in December 2024. Now all the "red" States are exponentially worsening what is on its way to a full blown crisis in health care. None of this could have happened without the first Presidency of Donald Trump.

(There is one fact that has been neglected and cannot be overestimated in the current abortion debate, namely that abortion care cannot be differentiated from miscarriage care and the comprehensive ongoing care of women in general).

MATERNAL DEATH RATE IN AMERICA AND TEXAS

The maternal death rate in America is 32.9 per a 100,00 live births which is far higher than the world’s other rich countries where it is between 2 and 3. In America, California has the lowest mortality 4 per 100,000 and Arkansas at 43. 5 the highest. In fact it is most of the “red” states that are in the worst half with Texas at 28.1 percent.

As far as women’s health care is concerned Texas has been rated 50th out of 50 states by "The Commonwealth Fund”.

The Gender Equity Policy Institute noted that maternal death rate increased in Texas by 56 percent between 2019 - 2022. This compares with 11 percent nationally which also is indicative of sub par health care delivery. This is prior to the anti abortion legislation.There has been an increase in mortality in 2023 and 2024.

 According to the Austin Community Foundation 80 percent of the maternal deaths in Texas were preventable. There is a racial disparity with African American women three times as likely to die then white women to have a pregnancy related death. 

So what has Trump done to exacerbate the crisis in American and Texas maternal care to reach rock bottom?

PRESIDENT TRUMP

It is fair to state that sans President Elect Trump the constitutional right to an abortion until viability of the fetus, 23 weeks, would not have been overturned in June 2022. The 45th President's position has evolved over the years. From a lifetime supporter of a woman’s right to choose, in his 2016 campaign overturning this provision was the central plank. In addition he responded to Chris Mathews of MSNBC that women that seek an abortion and doctors that assist them should be “Punished”. 

Trump promised to deliver Supreme Court judges that would do his bidding although they appeared unaware of this certainty at their ratification processes in the Senate. It is history that Trump's awareness of their judicial philosophy was vindicated. In litigation before the Supreme Court, which didn’t even ask for a complete revocation of the 50 year old precedent's Constitutional right to "privacy'"with regard to a women's right to control her reproductive decisions. The confidence in American Federal Courts where the Supreme Court garners the overwhelming amount of public exposure is according to Gallup, at its lowest point in memory 35 percent - on a par with the judiciary of Syria. 

Trump changed his position in 2024 from an absolute abortion ban to declaring that “what everyone wanted - each state to decide”. He claimed further that he was, “the protector of women’s rights whether they liked it or not”. Nevertheless Trump nominated an anti abortion hardliner, Ed Martin to his staff. He believes that there are no, nada, nil exceptions for an abortion including saving a woman’s life or for a 10 year old pregnant as a result of incest. 

What followed the revocation of the woman's freedom of choice in the “ Red” states, including Texas?

TEXAS LAW ON ABORTION POST JUNE 2022

Texas had passed “trigger” abortion legislation in 2021 in the event of Roe v. Wade being reversed. So on June 2022, Chapter 170A came into effect. The latter banned abortions “outright” then stated “except in certain circumstances”. This phraseology created chaos as the “circumstances” were to save a woman’s life. This judgement call has resulted in patients bleeding to death in car parks, hanging around till they were so close to death that the doctors’ were able legally to do an abortion.

 There were several court challenges to Chapter 170A where the Attorney General of Texas, Ken Paxton has zealously pursued the law. The Texas courts to date have backed him. There are women that have come forward to explain their horrific experiences. Most that can afford it leave the state for care. Some have received the medication mifesterone, which can induce an abortion, by mail. Paxton has taken the unprecedented action of suing a New York doctor who prescribes the medications to Texas patients. A common medical practice since telemedicine has been practiced for years, especially important for under doctored areas. New York like 7 other  States have laws to protect their doctors from any civil or criminal prosecution for their telemedical activities.

The sanctions for doctors performing an abortion In Texas are civil and criminal. Both can result in loss of their medical license and a 100,000 dollar fine. Criminally the practitioner can be jailed for 99 years. This has had a devastating impact on the providers of women’s health care which are detailed below.

 But first who are these providers and what treatments do they carry out? 

WHO ARE THE PROVIDERS OF WOMEN’S HEALTH CARE AND WHAT ARE THEIR AREAS OF CARE?

By and large women’s health, especially reproductively related, is managed by obstetrician/gynecologists,(Oby/Gyn). Their responsibilities includes pregnancies, where one in five end in a miscarriage, problems relating to pregnancy such as pre eclampsia which can cause fetal and maternal mortality and those who have co morbidities such as diabetes. 

One of the many indications for a medical termination of a pregnancy is when there are serious abnormalities to the fetus which make continuing the pregnancy a risk to the mother and/or her future ability to fall pregnant again. There are several others relating to the pregnancy itself including heavy bleeding, complications whether they be mental, physical or social and of course major morbidities and death.   

It is not surprising that on the Texas governmental website that they suggested seeking an attorney to help them interpret the law!

 So what is the response of the practitioners to the Texas law?

IMPACT ON WORK FORCE OF TEXAS ABORTION LAW 

Texas like most states is suffering from decreasing care generally in rural areas. The specialty of Oby/Gyn is very hard hit. In Texas 47 percent of the counties are “maternity deserts”

.

Fifty - five percent of Texas’s Oby/Gyns are over 55 years of age. Twenty - one percent of all those practicing today are contemplating or planning to leave the State while 13 percent have decided to retire earlier. At worst it cuts the existing workforce by 34 percent.

The obvious answer is to replace some of those leaving. However in 2024 the applicant rate to the Residency training programs was 16 percent down.  This can only get worse as the programs arrange for out of state rotations from 4 - 6 weeks for abortion care which is mandated by the professional body of Oby/Gyns. If it is not provided the residency won't be accredited.  

The trainees have to by definition confront the chaos raging in Texas now. Their teachers have to be among the 76 percent of Oby/Gyns who believe that as a result of the Texas legislation they are unable to practice evidenced based care. The situation is exacerbated by the fact that 60 percent of the Oby/Gyns fear legal consequences as a result of their care of patients. Not surprisingly the residents are stating that this situation will impact on their decision as to where they will practice when they complete their training. 

Dr. Anitra Beasley of the Baylor College of Medicine maintained that the out of state rotation was depriving the trainees of the comprehensive longitudinal management of patients that they need. She is worried about the quality of applicants that the programs are going to get if they don’t care that they are not receiving training that allows for longitudinal care of their patients. 

THE EFFICIENCY OF HEALTH CARE GENERALLY

The number across the country that are insured has increased under the Affordable Care Act however the deductibles and co pays are still far too high. According to the retirees organization, the AARP, over 5 million patients were sent for collection in 2023. Health care costs are still the commonest reason for declaring bankruptcy. 

There are also legions of complaints that private insurance companies are denying care. The Kaiser Foundation reported that  58 percent of patients had problems with claims.  

 Not only are the Health Care administrators paid obscene amounts so are hospital administrators sometimes with bonuses of 10’s of millions per year.

 Despite the argument that the commercial agencies are more efficient their administrative costs are between 20 to 30 percent of their expenditure while Medicare, a government run program, similar costs represent 1.3 percent. 

According to the Health Justice Monitor with regard to the of  percentage of administration and clerical health care personnel per insurance entity the Government's Veterans Administration, (VA), insurance had the lowest 22.5 percent versus 29.5 for the others. If the VA's staffing policy was followed there would be 900,000 less non medical personnel needed in the health care industry.

AT THE END OF THE DAY

Texas like the rest of America is facing a crisis in delivering health care. The shortage of doctors in the discipline of Obstetrics/Gynecology is one aspect not to mention their distorted geographic distribution, and the high cost of care is another.

There is a prediction that abortion restrictions are just the beginning of the control of reproductive rights. Project 25 details further draconian legislation or Executive orders on contraception and IVF.

The upshot of the abortion restriction laws in Texas like in other “red” states is going to exacerbate the dysfunctional health care delivery system in the United States where a grand overhaul is needed.

Perhaps Elon Musk and Vivek Ramaswany would be better served not to pretend that there is a need to cut spending from government insurance programs. If it is efficiency they are after they should start first with the private health care systems. 

Trump by nominating Robert Kennedy Jnr as head of Health and Emmet Oz as tzar of Medicare and Medicaid, is confirmation of his lack of care of Americans’ health. 

What is the political impact going to be of all this when 70 percent of Americans broadly support the framework of Roe v Wade.?