Democrats should begin to prepare for the 2026 midterms. Before we get started, we need to understand what broke in 2024. 

1.Democrats didn’t get out the vote. 

In 2020, there were 155 million voters; Joe Biden defeated Trump by four percentage points, 81 million votes to 74 million. In 2024, there were 145 million voters; Donald Trump defeated Kamala Harris by two + percentage points, 74 million votes to 71 million votes. 

Between 2020 and 2024, Trump’s absolute vote total remained constant at 74 million. However, the Democratic candidate’s total diminished by 10 million votes (a loss of 6 percent of 155 million.) These voters didn’t disappear, they made a choice. 

2.It’s the Economy, Stupid.  

A) In the 2024 presidential election, why did the presidential Democratic vote diminish by 10 million? The prevailing explanation is that was a result of the post-pandemic economy. This same pattern happened in all the western democracies after the pandemic: about six percent of voters abandoned the ruling party and voted elsewhere in the next election. 

Pollsters theorize that because of the economic malaise produced by the pandemic, western-world voters were angry. Therefore, they penalized the ruling party – on the average of six percent. For example, in England, voters moved from the Conservative Party to Labor. 

In the United States, angry Democrats penalized the Party by not voting for Kamala Harris. Other Americans chose to show displeasure by not voting for any major Presidential candidate. For example, RINOs did not leave the Republican Party; they chose to not vote for Trump or Harris. 

In 2024, 10 million votes were not cast for President. This means that Trump supporters are in the minority; the true size of the Trump opposition is 81 million. 

B) In the US there hasn’t been an actual economic recession, but for many voters it feels like there has been one. Polls consistently show; a strong majority “… feel like the US is going in the wrong direction.” (61.3 percent according to the last Real Clear Politics poll.) 

gRobert Reich writes, “On [11/5], according to exit polls, Americans voted mainly on the economy — and their votes reflected their class and level of education. While the economy has improved over the last two years according to standard economic measures, most Americans without college degrees — that’s the majority — have not felt it. Most of the geconomy’s gains have gone to the top… This has caused many Americans to feel frustrated and angry. Trump gave voice to that anger. Harris did not.” 

gOf course, racism and sexism were factors in the election. I’m arguing that the dominate factor was the economy. 

3.Trump can’t fix it. 

In this dark hour, there are several positives to consider. Trump voters are the minority. Trump may govern as if he has a “mandate,” but the reality is different. 

ggTrump talks about many issues, but for 2024 voters the number one issue was the economy. Trump has two years to fix the economy. He has 24 months to respond to the economic malaise that led to his election victory. 

Trump won’t be able to fix the economy because 1) he, personally, has no idea what to do. And 2) the Republican Party’s economic philosophy does not provide the answer. Republicans believe in” trickle-down” economics; they believe that if they give tax cuts to billionaires then “a rising tide will lift all boats.” Trickle-down economics won’t fix the current economic malaise. 

Going forward: whenever Trump/Republicans do something outrageous, the opposition should say, “What’s this got to do with fixing the economy?” 

By the 2026 midterms, voters will blame Trump for the bad economy. The missing 10 million voters will return to the Democratic opposition, which will have a clear majority. 

4.in 2026, Voters will repudiate Republicans. 

g Trump was elected by a minority of the electorate and given a chance to fix the economy. He won’t be able to accomplish this, Instead, Trump will bring chaos to American society. 

Democrats have a clear path to victory in the 2026 midterms: Develop a plan for a just economy. Reach out to disaffected voters. Mobilize. 

The 2026 midterm themes are clear: Fix the economy. Stop the chaos. Vote Democratic. 

Gee whiz! We’re barely two weeks past Election Day, and the Democrats have already formed their circular firing squad. In order, clockwise, we have the dreary Conor Lamb on the right, about at one o’clock. On the left, up there at 11 and counting, we find Alexandria Ocasio-Cortez, the darling of the left. They’ve both laid claim to the soul of the Democratic party, newly on offer after Joe Biden took back the presidency and six assorted congresspersons lost their seats to Republicans.

As usual, the newsies are eager to turn the circle into a football game: two teams facing each other and fighting to reach the goal on the other side with some combination of cleverness and brute force. A nice demonstration of how this works can often be found in the New York Times, which disgraced itself in 2016 by pumping up a foolish and pointless discussion of Hillary Clinton’s email server into a game-changer in the last week or two of the campaign. Yes, it probably was clickbait, but look what mischief they wrought. 

The current Game of the Week can be viewed as a matched pair of interviews by Astead W. Herndon in recent issues of the NYT: 

Conor Lamb, House Moderate, on Biden’s Win, ‘the Squad’ and the Future of the Democratic Party 

and Alexandria Ocasio-Cortez on Biden’s Win, House Losses, and What’s Next for the Left; 

I’m not going to summarize these two pieces because I find them equally boring. They’re not unique either—you can find similar enunciations of false dichotomies in many online venues frequented by the chattering class.  

Maybe it’s my advanced age, but I see fewer and fewer ideological differences in the never-Trump set, especially the self-styled Democrats, just more and more differences in what can reasonably be called marketing strategies. 

Example: all of them, the Lambs, the AOCs and almost all in between agree that Americans need some kind of government-guaranteed health care. Exactly what form this should take is endlessly discussable, but we can be darn sure that if we ever get it, it will NOT look exactly like any of the proposals now offered by any of the arguing camps. Today’s trendy branding slogans (Single Payer, Medicare for All, etc.etc.etc.) will NOT be attached to the bills that finally succeed. 

Example: Just about any Democratic candidate or officeholder if asked will affirm that Black Lives do indeed Matter. Any or all will agree that in many cases police have made mistakes, sometimes fatal, in their dealings with Black and Brown people, and sometimes even with others.  

But here’s the slogan mistake: Defund the Police. “Defund” is a terrible invented branding word, not ordinary language and therefore subject to misinterpretation.. No, it’s not all about how much police are paid, it’s that what they do badly should be done differently by someone else, regardless of where the money comes from.  

Other top issues: Democrats, probably with no exceptions, tend to agree that science is true, that the CDC should be restored, that we need to defeat Covid, and that national leadership is the way to do it. 

An apparently disputable topic, more apparent than real: Climate Change and how to fix it. Most Dems agree that Climate Change needs action, but how to do it is the question. The hierarchy is something like this: Coal is bad but miners need jobs, natural gas is better and also provides jobs, electric is better still if produced sustainably while employing many, and we must eventually get to Net Zero or even Net Negative. The only hiccup is in states like Pennsylvania which produce natural gas through fracking, but we all know, even Conor Lamb, that we’ll need to phase out petrochemical production eventually. 

And who would ever argue that the same kind of marketing works for both Conor and AOC? Their circumstances are wildly different. He squeaked into a basically Republican district in 2018 on the heels of an incumbent’s sex scandal, and barely held his own this November. He ran as effectively Repub-lite, which is how he won—no surprise there. Contrary to what AOC implied, his loss has very little to do with his use of Facebook and other social media or lack thereof. He’s in a Republican district, for heaven’s sake. 

She, on the other hand, won a primary, not a general election. Primaries are usually easier to win because they have a lower turnout. AOC lives in a solidly Democratic district in which the primary is everything, and she was able to sneak up on the incumbent. Also, she’s a lot younger, smarter, better looking and more charming than her predecessor. 

There’s that apparent difference between a Conor Lamb and an Alexandria Ocasio-Cortez on the issue of climate change, but here, again, it’s really about branding. Her brand name for her stance is The Green New Deal, which plays well in the mostly-Dem context of her district but falls flat in his area, which probably didn’t support the original New Deal, though it’s not as flat as Defund the Police. Fracking’s the only substantive difference between the two (I suspect)--supporting fracking is worth approximately bupkes on AOC’s home turf.  

So what about that “S” word? Socialism, OMG? But I bet it’s not a hot issue in rural PA.  

It’s a no-go, perhaps, but that’s not why Lamb had a close call. In Miami, maybe, but not in the Pittsburg exurbs. 

AOC does brand herself as a Democratic Socialist (oddly the U.S. term for what would be a Social Democrat in Rest of World). Her mentor Bernie Sanders is another one of them, a spiritual descendant of those passionate theory arguments in the CCNY cafeteria in the 1930s. That’s a label which doesn’t frighten many people voting in the Democratic primary in the Bronx in the 21^st century. Youthful energy always sells well: “It’s time for a change” always works. 

And I’m sorry, but I don’t think presence on Facebook counts for much in that district either. But AOC might be correct in her belief that congressional candidates everywhere would have benefited from her help with the kind of technology she espoused in her postmortem Times interview. 

There’s one place where her critique of the internet savvy of the D-triple-C resonated with my political experience. 

I tried, really did, to volunteer for a project this year which was supposed to make it possible for lawyers to give telephone support to people threatened with voter suppression. It was sponsored by the DCCC, and it used three of the worst-designed software programs I’ve ever tried. I gave up on it when a friend reminded me of the catastrophic app which destroyed the Iowa Democratic Caucuses last winter. Are they buying apps from their brother-in-law or what? Not worth the trouble. 

Understand that I’m not against technology per se—I used a computerized database in Ann Arbor in the mid 1960s when most campaigns were still on index cards. After that I worked in a software company for 16 years. 

That’s how I know that pushing high-tech doodads which don’t work does more harm than good. If you’re going to do it, do it right. I suspect that the six Democrats who lost seats in previously Republican districts which they took in 2018 had more problems than not spending $200K on Facebook. 

Much depends on what happens in Georgia in January. If the good guys win by some miracle, they should move as fast as possible to get something substantial done, including fixing what’s wrong with the Supreme Court. If they lose, the next 18 months should be devoted to creating an exemplary program, long on rhetoric but short on specifics, which will appeal to a majority of likely voters despite doctrinal disputes. Then in the last 6 months they should work like hell to make sure that everyone hears about it. 

2022 is upon us already, though many things will change by then. What we have ahead of us should be neither a circular firing squad nor a football game. Campaigns for the Senate and House should be run (and covered) like a marathon, remembering, of course, in the year of the pandemic, that “the race is not to the swift…but but time and chance happeneth to.. all.” Democrats in the next two years must keep their eyes on the prize, roll with the punches, and move on.  

President Trump claims that he is proud of all he has accomplished on behalf of African Americans. In fact, he boasts that he has done more for the American community than any president with the exception of Abraham Lincoln. If his boast is accurate in our race conscious society , isn’t it surprising that the overwhelming number of whites voted for him.

Let’s take a brief look at his actual record, He claimed that his policies kept black unemployment low and he improved household income. Obviously, these are important achievements. However both these claims are inaccurate. Actually, joblessness for African Americans actually increased slightly to 16.8 percent. Also, their median household income had declined. 

But Trump’s shortcomings were not only in the numbers. Unquestionably, Trump is a racist. His criticism of four women in Congress who had argued with Pelosi was outrageous. . He told them to “go back” to the countries they came from rather than “loudly and viciously telling the people of the United States how to run the government.” Which country did these women come from? Three out of four were born in the United States. 

Trump’s characterization of minorities has been ugly. He referred to Mexicans as rapists and addicts. He was opposed to admitting residents from Haiti and African American countries, which he referred to as “shithole” nations. He claimed that all Haitians who travel to the United States from Haiti have Aids. 

Particularly troubling,Trump passed a significant “tough on crime” criminal justice measure which has resulted in a phenomenal increase in the federal prison population. His callousness in dealing with crime is suggested by his comment “When the looting starts the shooting starts”. 

Did you know that Trump opposed the slogan “Black Lives Matter. Why? Although his capacity to hate is well known, he nevertheless had the audacity to complain that the slogan was a symbol of hate. 

About the substantial vote that Trump received from white voters,he successfully abolished Obama’s policy on affirmative action, No longer are universities required to consider race or income as a factor in selecting students. The result of adopting race blind admissions has been a reduction of minority and low income students and a substantial increase in white students from less than half to more than 50 percent.. 

Trump is attempting to pick up votes wherever he can. He won over 70 million votes. In fact, he won 12 percent of the black male vote. For progressives, it is immensely important to understand why this right wing and racist candidate was able to win the support of so many voters.

UC Berkeley staff is making the rounds of Berkeley’s City Council and commissions presenting its Long Range Development Plan (LRDP). After its presentations, UCB staff have gotten a lot of critical comments, for example, being accused of attempting to devour Berkeley and turn it into another Irvine, CA, with its ghastly array of glass-box high rises. UCB’s Project #1 was skewered, a proposal to build a multi-story housing and commercial block on Oxford Street between University Avenue and Berkeley Way, which would unnecessarily destroy three historic buildings and displace residents of 1921 Walnut Street – a rent-controlled building with many longtime tenants. 

UCB plans a public-private partnership for the project, teaming up with the Prometheus Real Estate Group. Remember them? Spending many millions, they were the fourth largest contributor fighting the passage of the rent control initiative, Proposition 21. 

Seemingly UCB will bend over for any predatory corporation to deal with its budget deficit created by its ill-fated investment in a new (now empty) football stadium with luxury boxes that never produced a profit and the added deficit created by the COVID crisis. In its scramble for cash, UCB is monetizing land it’s purchased in Berkeley outside the campus boundaries. 

This is not new behavior for UCB. To wit, the “BP Building” was built by UCB one block over on Oxford and Hearst. Joining up with a predatory, gross-polluting oil company seemingly did not present an ethical dilemma for Cal administrators. 

Why not go for a trifecta? One block away from Project #1 is University Hall at Oxford and University, certainly in need of replacement or seismic upgrade. UCB could probably court the Sackler family who assuredly is in need of some image-burnishing. It would be perfect – a predatory pharmaceutical corporation, Purdue Pharma, the bank roller of another new building. 

These three blocks represent a local version of the corporate excesses of the current, and soon to exit kicking and screaming, federal executive branch. UC Berkeley could help keep the greed game alive of the several real estate moguls in high places that made billions on the mortgage crisis. Trumpism could live on symbolically here in Berkeley. However, renaming at least that stretch of Oxford Street to “Greed Street” would be an appropriate reminder of what is the true drift of the University’s “public-private partnerships.” 

People's Park Historic District Advocacy Group has an alternative that would bring the city, the university, and the South Campus community together to preserve and improve the park as both an important historical site and an important neighborhood open space. People's Park, which is Project #2 of UCB’s LRDP, is a historical landmark and thus under city policy should be protected from development. For details, go to peoplesparkhxdist.org.

During one of the so-called debates staged by the Democratic Party National Committee last fall another candidate asked Bernie Saunders -- in a tone implying the absurdity of the idea -- how he expected to fund a universal national health care system which was projected to cost half a trillion dollars over ten years. In a real debate Saunders would have had time to ask why the United States, though among the wealthiest nations, is the only "developed" country in the world that (supposedly) cannot afford universal health care -- while its cizizens pay twice as much per capita as other developed nations' for a private for-profit health care system which delivers third world public health rates. As John Kenneth Galbraith wrote in 1981, "no one should assume that American election campaigns are conducted in a context that allows candidates any inconvenient freedom of speech." But while America infants and mothers die in childbirth at levels worse than Turkey's or Cuba's or over 30 other countries, because America "can't afford" to do better, earlier this year, a few months after those "debates," Congress, without substantive discussion and in a matter of hours, voted six trillion dollars to buoy up Wall Street after its latest and largest funny-money bubble collapse thus adding over a half trillion dollars to the wealth of a few dozen billionaires in a few weeks. 

In 1917, commenting on the fact that one tenth of Americans owned nine tenths of the country's wealth (just as today), Thorstein Veblen pointed out that the only way to preserve such a system is to insure the ignorance of its victims -- its prey. A key method for insuring this result is the collaboration of "both" political parties with what Veblen's generation called the "kept press" to prevent such proposals from appearing on the national agenda or being substantively considered in Congress. 

Germany had national health care in 1883, England in 1911, Canada in 1972, but this matter has been entertained by Congress barely three times in these 140 years -- and blocked every time. In 1934 FDR's New Deal legislative program swept aside the proposal as "impractical." In the late 1940s the AMA and other interested parties blocked President Truman's initiative for national health care, hiring the public relations firm Whitaker & Baxter which coined the ostensibly opprobrious phrase "socialized medicine"to help the successful campaign to defeat it. During President Obama's administration, when an overwhelming consensus of Americans (67%) favored a single-payer system (as we still do), the administration and both parties in Congress collaborated in delivering, instead, a system designed to perpetuate and reinforce the predatory investor-profit system. 

In accord with Veblen's dictum, these fundamental facts -- and indeed the entire history of how America has come to be the only "developed" country in the world without universal health care -- are kept little known. So too are the consequences for America's public health yielded by this 100-year blockade -- notwithstanding the present pandemic's tendency to expose them. This essay aims to alter this meticulously contrived ignorance, principally by reviewing and summarzing two watershed investigations of the facts. 

In 2009 two British epidemiologists, Richard Wilkinson and Kate Pickett, published The Spirit Level, a study correlating and comparing statistical measures of public health and social well-being with the distribution of wealth among 23 developed nations and each of all fifty of our United States. Their work summarizes and coordinates hundreds of different studies of specific factors by thousands of investigators -- epidemiologists, demographers, sociologists, economists -- rates of physical health (infant mortality, maternal death in childbirth, life expectancy, major disease prevalence and mortality, etc.), mental health, obesity, teenage pregnancy, educational access and performance, comparative stability of community life, social trust and distrust and malaise, drug abuse, violence and crime, imprisonment and severity of policing and punishment, and social and economic mobility. Their investigation conclusively demonstrates that, across the board, rates of public health and social well-being correlate closely and strongly, cross-culturally and pervasively with the distribution of wealth. Their conclusions have been attacked, misreported, twisted and obfuscated, but their factual basis is plain, firmly evidenced and irrefutable. The more equitable the distribution of wealth, the better is a society's public health and social welfare as a whole. The more unequal the distribution, the worse for the society as a whole. 

Remarkably, this holds true whether societies are, on average, at large, comparatively rich or poor. It is not the absolute level of average income or of average wealth that matters, but the degree of equity or inequity in its distribution across the population. America's average income is high compared to some of these 23 nations but our social conditions, along with our distribution of wealth, consistently rank at the bottom or near it. Often, in fact, our conditions of health and social well-being are worse than countries that fall well below the 23 examined in their study. The much lower average income in Cuba is, by comparison, far more equitably distributed, and Cuba's statistics significantly surpass America's. Cuban infants and childbearing mothers have markedly better chances of survival than American infants and mothers, and so on. And conversely, the more nearly egalitarian a society's distribution of income and wealth, the more its social conditions improve -- across the board. The same trend shows in comparisons among our fifty states. 

Another remarkable feature revealed by Wilkinson and Pickett's analysis is that the consequences of maldistribution of wealth for public health and social well-being tend to impact the entire population, individual income notwithstanding. In most respects these consequences are not proportionately worse for the poorer members of a society alone, they are worse across the entire spectrum of the population, except possibly for tiny wealthy elites (which are difficult to assess statistically, in any case) who can insulate themselves from some of these consequences -- with "concierge" health care, gated "communities," chauffeurs and bodyguards, etc. Otherwise, for all but these very few -- and in many ways for them also -- maldistribution of wealth negatively impacts society as a whole individually across all strata of economic status. 

In both these respects, Wilkinson and Pickett's study suggests that societies behave, physiologically, psychologically, and socially, as integral organisms. In these dimensions, we are all in it together and we all suffer together or thrive together. We may persuade ourselves that we are doing better than some -- and the steeper the pyramid the easier this illusion comes, for some -- but cross-cultural comparison reveals the reality. All levels of a society do better or worse depending on its overall degree of economic equity. Consistently, across the entire span of the 23 most "developed" nations and by every measure, America's economy produces and perpetuates the least equitable distribution of wealth and the sorriest conditions of public health and social welfare. This is a systemic problem of very long standing. 

In the words of our Constitution's Preamble an essential goal of our government is declared to be to "promote the general welfare." Wilkinson and Pickett's investigation shows that in this crucial respect, which bears on all our lives and livelihoods, our children's and grandchildren's, on our communities and on the future of our country, we are coming up seriously short. It utterly demolishes the assiduously fostered myth of the international superiority of the American standard of living. America's tiny elite does very well indeed; Americans at large do not. We have the most billionaires, and third world health rates, the world's largest prison population, and the first world's shoddiest social welfare support system. 

A look at America's health care system reveals some of the reasons why this situation exists and persists. As befits the second largest sector of America's economy, the prices Americans pay its investor-owned health care "industry" top the world at $10,209 per capita in 2018. "We are number one." Health care costs Germans (at number 5) 56% of what we pay, costs the French 48% (#11), and costs Italians 35% (#20). But America's public health rates fall far below all these countries and many more. In 2017 we were #55 in infant mortality, #47 in maternal death in childbirth, #43 in life expectancy, and so on. 

Bismarck created Germany's public health system in 1883. "Both Germany and Great Britain adopted comprehensive programs of social-insurance legislation, the former as early as the 1880's, and the latter in a series of laws culminating in the National Insurance Act of 1911. By 1914, Western Europe generally had accepted the principle of social-welfare legislation with programs that included workmen's compensation for industrial accidents, health and unemployment insurance, and old-age pensions. Much of Europe thus seemed to be moving toward greater social and economic as well as political democracy." In the 1880s and after, American scholars returning from study and research at Germany's world-leading universities began to circulate these ideas here, but they did not get far. Why America did not and still has not followed Europe's (and Canada's) clearly successful examples, and what the metropolitan elite's system of monopoly corporate finance has created instead, and how, is the subject of Christy Ford Chapin's scholarly investigation, Ensuring America's Health: The Public Creation of the Corporate Health Care System (Cambridge, 2015). This densely documented study reveals a century of determined profusely funded expert connivance on the part of medical associations, trade groups, medical schools, lobbyists and legislators, corporations and corporate law firms, insurance corporations, finance and financiers, with finance, and the investor elite it serves, coming out on top. 

In the first decades of the twentieth century Americans relied for health care, insofar as they could, on medical practitioners in private practice and, increasingly, on local physician groups operating multi-specialty clinics which contracted with dues-paying community groups -- small businesses, fraternal organizations, mutual aid societies, church groups, neighborhood clubs, union locals, and local individuals -- to provide yearly medical attention as required. Being small and local kept their administrative costs to a minimum and their reputation among their patients, local doctors and hospitals provided effectively direct oversight of their performance. 

The 1920s witnessed the financial consolidation and monopolization of numerous hitherto local American public-service businesses -- public utilities, transit systems, grocery stores, department stores, drug stores, bakeries, breweries, etc. Chapin documents the American Medical Association's efforts, beginning during these years, to establish that medical care would be provided strictly through individual practitioners on a fee-for-service basis. Local group-plan clinics were hindered and suppressed by gaining control over hospital admissions boards and refusing them access, and over state licensing and medical school admissions to limit the number of practicing and new doctors. (As a lasting consequence, one third of America's physicians today are foreign born and educated.) During the 30s and 40s, as community clinics succumbed to the assault and public demand for insurance rose accordingly, the AMA compelled insurance companies willing to offer policies to adopt their fee-for-service model rather than the clinic plan. Under the clinic plan, members' dues effectively created small local mutual insurance groups, each with its local funding pool, without entailing the costs of nationwide centralized administrative bureaucracies and staff, large-scale regimes of financial control, cartelization and monopoly, and such like "overhead." 

In 1933 President Franklin Roosevelt's original New Deal legislative program side-tracked public health insurance proposals as "impractical." In 1938, however, facing dicey Congressional elections while sunk in the second trough of America's Great Depression (the world's longest, it lasted 12 years), the second Roosevelt Administration found it expedient for the Department of Justice to file an antitrust suit against the AMA over its suppression of physician group clinics -- but the case disappeared into the fog of war. In 1939 the California Medical Association fought an expansively funded battle to defeat a proposal for state health insurance. Lack of widely available effective health care, along with degraded social conditions and malnutrition, took their toll. Second World War Selective Service induction examinations classified 30% of draftees as "unfit for military service." During President Truman's second term the AMA and other interested parties defeated his national health care initiative, continuing their opposition through the 50s and beyond, while their critics "publicized the AMA's receipt of $10 million in research funds from the tobacco industry" to help thwart the spectre of socialized medicine. 

With national and state public health care blocked, public demand for insurance continued to build and "AMA leaders found their most reliable political collaborators among commercial insurers" who were prepared to cooperate with their fee-for-service model and who proceeded to restructure health care as a money-making business subordinate to corporate control. As with life insurance, for elite interests a major attraction of the private insurance model is that it serves to funnel nationwide premiums to "the Northeast" and place them under centralized control for the use of consolidated finance, financiers, investors and speculators. The medical system's corporate investor overseers have consistently placed their pecuniary interests above those of public health, patient service and even physicians' medical concerns, and devoted vast sums in politics and media, overtly and covertly, to sabotage initiatives for change and to enforce their for-profit agenda. "Socialism" was their war-cry from the start and "universal health care" their bête noire. It is well known that health care without predatory corporate investor profits is a communist menace. 

America's health care industry is "organized for profit" in the first place and yields "high costs and fragmented care." "In comparison with alternative arrangements, the insurance company model has delivered medical services less efficiently and more expensively" and drives up "costs by separating the delivery of care from the financing of care." The way "it has structured patient and service provider incentives" is the primary means by which its costs have been inflated -- to the increase of administrative compensation and investor profits. Wilkinson and Pickett's study shows the long term and present-day results for Americans' health compared with other nations. 

Once some form of Medicare legislation became inevitable (1965), insurance companies and others worked to limit its coverage to seniors and minimize the level of support it would offer so as to create a market for "supplementary" private insurance. "Influential Social Security expert [federal bureaucrat] Wilbur Cohen advised fellow reformers [sic] that partnering with insurance companies would create a [sic] politically palatable program." "The final bill guaranteed that for service providers, Medicare would be a government-funded version of the existing insurance company model ... with a program that increases demand for physician services while allowing doctors to charge generous fees. There was no mechanism for restraining costs." 

Nevertheless, "doctors increasingly lost autonomy to practice as they saw fit and witnessed a growing share of system revenues diverted to administration costs and third-party organizations" [sic]. During the 50s, general practitioners still made house calls and a practice comprising four doctors might typically employ one secretary for appointments and correspondence. As the insurance system took hold the need for office staff increased dramatically while physician-patient interactions were increasingly constricted and regimented. "In contrast, insurance companies emerged from the Medicare fight with augmented political and economic power." And, best of all, Medicare would be funded by a charge levied on seniors' Social Security benefits, themselves funded in the first place by a poor tax which exempts elite income sources (dividends, interest, capital gains, etc., as well as their "earned income" above a low ceiling). Meanwhile in 1953, once the first Republican administration after the New Deal took office, business's "equal contribution" to Social Security was made tax deductable. 

The Affordable Care Act of 2010 (which has proven to offer most people nothing of the sort) left the foundations, premises and practices of this system in place and increased opportunities for investor profits by reinforcing industry monopoly markets. In Canada, whose national public health system has shamed America for many decades, insulin costs one tenth what it does across the border. Here, under the regime of America's for-private-profit system, with congressional legislation safeguarding pharmaceutical corporation patent and market monopolies and liability-exposure, "a study shows that of the 100 biggest pharmaceutical corporations two-thirds spent at least twice as much on marketing as on research and development, with 43 spending five times as much, and 27 ten times or more." "Marketing" expenses not infrequently include perks, junkets, honoraria and other euphemized kickbacks for prescribers. 

Pursuing a similar agenda at a higher level on behalf of the same investor interests, in 2018 "analysts" at New York finance bank Goldman Sachs advised their pharmaceutical corporation clients that research leading to life-long therapies for diseases promises a brighter future for profits and dividends than does discovering cures. Goldman Sachs described such therapies as offering a more "sustainable" strategy -- a "chronic" strategy, you might say. And in March 2020 Wall Street investment bankers took the golden opportunity presented by the crisis onset of the corona-virus pandemic to "press health care companies" to raise their prices -- thus also raising the question whether there is a degree of flagrant abuse, parasitic greed and flaunting predation that Americans will ever effectively determine is not sustainable. Meanwhile, America's suicide rate has increased by one third since 2000. As it bears on social conditions, this amounts to a very bad review. And it does not include additional millions of deaths by the slow suicide of despairing alcoholism and opiate addiction (in recent decades a promising new growth market for American pharmaceutical corporations and a real boon for their investors). 

The local community clinics of the early twentieth century sprang from and embodied the same spirit of collective mutual aid that was key to the American progressive-populist tradition's vision of a cooperative commonwealth -- the spirit that created such frontier practices as barn-raisings. Many clinics had their origins in association with populist-progressive community organizations. But in placing community health before profit and eschewing the guild monopoly methods that suppressed their clinics, these doctors also participated in the oldest traditions of the healing arts. 

Physicians practiced as priests of Asclepius and Apollo in ancient Greece. In Egypt their god was Imhotep. Typically, pre-modern cultures consider healers in the guise of wise men and women, a little uncanny, unworldly (shaman, wizard, mage or witch), as adepts of an arcane craft, akin to magic, working close to the hidden inner springs of life, affected with its spiritual mystery and so owing a natural reverence and allegiance to the art of medicine, a devotion which necessarily takes precedence over the worldly preoccupations of the marketplace and pecuniary calculation. "The temple is holy because it is not for sale." In this view, the human body is holy also (and it is not for sale) and the healer and his art partake of this sacral dimension. He may ask a fee, even a large one from an affluent patient and, equally, he may treat the poor gratis or, on country rounds, accept a dozen eggs, a hare or a honeycomb, or find a sack of potatoes on his porch come harvest time. More than a few American doctors today maintain this tradition as best they can, on the margins, against the current, insofar as the health care industry does not prevent them. Many find it a losing battle. 

In contrast with all other developed nations today, what is peculiarly American (if it really is "American") is the health care industry's programmatic and all-pervading intrusion of organized greed into the precincts of this ancient and sacred art and its essentially priestly functions, through the systemic connivance of finance, corporate law, politics, media and the academy. Self-described "health care" corporations buy up and close hospitals the same way J.P. Morgan bought and shut down blast furnaces and steel mills to consolidate the monopoly of U.S. Steel. It's called "creative destruction" in the jargon of Wall Street vulture fund investors. 

In the last year of Washington's first administration, John and Abigail Adams paid a worried visit to Manhattan where their New Yorker son-in-law was up to his neck brokering land deals amid "a wave of business failures." In the aftermath of a "rage of speculation" punctuated by Wall Street's first post-independence credit bubble collapse, "terrible is the distress," Abigail wrote her sister, "from the failure of many of the richest people." John called the city's money-mad demonic spirit "Mammon." A century later, during the hard years between the Crash of 1893 and the Panic of 1907, amid the wreckage of the People's Party watching the climactic enthronement of metropolitan elite corporate finance in consolidated dominion over America's economy and government, populist-progressive activists revived this personification or avatar of all-mastering, all-consuming fanatical greed. Perhaps they got the word from their colleagues in the Social Gospel movement, who got it from Jesus. Confronting Wall Street's established temple of the Almighty Dollar, triumphant uber alles, they employed "Mammon," as Adams does, to voice and to bear witness to the sense, the belief that there are values properly governing human affairs which are not reducible to pecuniary terms, principles which from the beginning -- "we hold these truths to be self evident" -- inform the core of American ideas about liberty and democracy, society and government. As Lincoln put it, "Liberty before property; the man before the dollar." 

REFERENCES 

Richard Wilkinson & Kate Pickett, The Spirit Level: Why Greater Equality Makes Societies Stronger (New York, Bloomsbury Press, 2009). 

Christy Ford Chapin, Ensuring America's Health: The Public Creation of the Corporate Health Care System (Cambridge University Press, 2015). Unless otherwise indicated quotations are from Chapin. 

These sources are quoted ad hoc: 

John Kenneth Galbraith, A Life In Our Times (Boston, Houghhton Mifflin, 1981) p. 297 quoted. 

Thorstein Veblen, An Inquiry into the Nature of Peace and the Terms of its Perpetuation (New York, Huebsch, 1917) p. 151 & 293 quoted. 

Arthur A. Ekirch, Jr., Progressivism In America: A Study of the Era from Theodore Roosevlt to Wooodrow Wilson (New York, New Viewpoints, 1974) quoted on history of European social welfare legislation. 

On the New Deal's shaping of congressional initivatives see John Flynn, The Roosevelt Myth, (New York, Devin-Adair, 1948), a detailed eye-witness account by a major progressive activist of the era. 

Future Supreme Court Justice Charls Evans Hughes chaired the 1905 New York State Armstrong Committee's investigation of the character and use of consolidations of insurance funds in the hands of financiers. 

Emily Rauhala, "As price of insulin soars ..," Washington Post June 14, 2019 -- www.washingtonpost.com. 

"RN Report: Pharma Giants Spend Far More on Marketing, Sales Than They Do on Research and Development," www/nationalnursesunited.org (October 21, 2016), reporting a study by the Institute for Health and Socio-Economic Policy. 

Amy Martyn, "Goldman Sachs warns biotech clients that curing patients may not be 'sustainable" Consumer Affairs (April 13, 2018) www.consumeraffairs/com/news. 

Lee Fang, "Banks Pressure Health Care Firms," The Intercept, March 19, 2020 www.theintercept.com/2020/03/19/. 

Chuck Collins, Omar Ocampo, Sophia Paslaski, "Billionaire Bonanza 2020" at inequlaity.org (April 23, 2020) 

John and Abigail Adams are quoted from Page Smith, John Adams (New York, Doubleday, 1962). 

Lincoln's maxim is quoted from Ray Ginger, The Bending Cross: A Biography of Eugene Victor Debs (Rutgers University Press, 1949; rpr. Russell & Russell, 1969). 

President Trump mocked environmental activist, Greta Thunberg, the Swedish environmental activist and told her to “chill out” when she denounced governments for their lack of action on the threats of climate change. Greta offered President Trump the same advice when he was roundly defeated in the Presidential election. 

Late night comedian, Bill Maher deserves credit for warning his viewers many months ago that DJT would not concede defeat but would rant and rave claiming election fraud. 

Trump’s niece Mary Trump and elder sister, Maryanne warned the general public that their uncle/brother was untrustworthy, and a pathological liar. Many Republicans have quietly congratulated Biden on his victory behind closed doors but are reluctant to go public lest they alienate the mercurial “godfather” and his ardent mask-less supporters. It is time Republicans stop coddling their fallen leader and allow the country to move forward. Perhaps Mary Trump could offer her uncle a free therapy session to help repair his wounded ego. The post-election activities of Biden and Trump reveal a stark difference in character. While the president elect has been busy forming a task to tackle the myriad of challenges which will soon confront him, the president neglect is out golfing. 

Finally, it is puzzling why the Republicans are happy to accept the Senate and the House results, but not the presidential race? Are they not on the same ballot?

We've had more than a week to consider the election results and several things jump out:

1.It was a big win: The Biden-Harris campaign brought out a huge vote. 538's Nate Silver estimates: "Extrapolating out from current vote totals, I project Biden winning the popular vote by 4.3 percentage points and getting 81.8 million votes to President Trump’s 74.9 million, with a turnout of around 160 million." To put this in perspective, no previous candidate has ever garnered more than 70 million votes. (Biden's win was the largest popular vote margin since Barack Obama defeated John McCain in 2009.)

Biden flipped the 2016 results and garnered 306 electoral votes. This included the key Democratic objective of carrying the mid-West "blue Wall" states (Michigan, Pennsylvania, and Wisconsin) along with Arizona and Georgia..

Trump joined the infamous "one-term" President club, alongside Herbert Hoover, Jimmy Carter, and George H.W. Bush. 

2. Trump got a lot of votes: Biden brought out his voters. But so did Trump. In 2020, Trump got 12 million more votes than he did in 2016. This turned the tide in several states. For example, in 2016, Trump won Texas with 4.6 million votes; in 2020, Biden got 5.2 million Texas votes, but Trump prevailed because he increased his vote total to 5.8 million. 

How did Trump increase his vote count? Two explanations: First, in the last two weeks of the competition, Trump developed a compelling message."Biden wants to shut down the economy, I want to open it up." New York Times exit polls indicated that a significant percentage of Trump voters decided to vote for him in the last couple of weeks. The most important issue for Trump voters was the economy. Exit polls indicated that Trump supporters strongly supported this position: "Rebuilding the economy now, even if it hurts efforts to contain the coronavirus." (Versus the position that Dems supported: "Containing the coronavirus now, even if it hurts the economy.') 

The second explanation: Republicans registered and mobilized 3 million new voters. In 2016, the vote breakdown by Party was 36 percent Democratic, 33 percent Republican, and 31 percent Independent. In 2020, the breakdown by Party was 37 percent Democratic, 35 percent Republican, and 28 percent Independent. Republicans increased their voters by two percentage points and increased their voting loyalty by 5 percent (88 percent voted for Trump in 2016 versus 93 percent in 2020.) 

The fact of 3 million newly registered Republican voters accounts for some of the election poll errors. That is, the Trump voters who didn't show up in the polls weren't "shy" they were too new to show up in the polling data bases. (In addition, pollsters probably underestimated the enthusiasm of Trump likely voters.) In the New York Times (https://www.nytimes.com/2020/11/12/us/politics/election-polls-trump-biden.html?referringSource=articleShare ) David Leonhardt suggests another reason for the poll errors: "The most likely explanation remains an unwillingness among some Republican voters to answer surveys. This problem may have become more acute during Mr. Trump’s presidency, because he frequently told his supporters not to trust the media." 

3. The Coronavirus pandemic was a wedge issue. Out here on the Left Coast, we thought that Trump's mishandling of the pandemic would finish him off -- lead to a 'blue wave." It didn't turn out that way; "Machiavelli Trump" managed to use the pandemic to further his objectives: first, he ignored the health issues and mounted a ferocious voter registration and get-out-the-vote effort. (Democrats, sensibly, didn't do this -- for example, in most states, Dems didn't go door-to-door as they usually do.) On election day, massive numbers of Trump supporters showed up, in person, at polling locations. Democrats saved the day by virtual canvassing and generating 80 million votes, many of which were mail-in ballots. 

The second way that Trump responded to the pandemic was to promote a false coronavirus narrative. During the last two weeks of the campaign, Trump's core message was: "The Coronavirus pandemic is not serious enough to justify shutting down the economy." Of course, Trump had contracted COVID-19, been hospitalized, and recovered. Trump flew around the U.S. with the message, "The Coronavirus is no big deal; see, I've recovered." (Trump's implied message was that he was a real man, who confronted the Coronavirus without a mask; in contrast, Biden was a wimp.) 

Trump's closing theme held his base. The most important issue for Trump voters was the economy (57 percent); in contrast, the most important issue for Biden voters was 'Racial inequality" followed closely by "the coronavirus pandemic." Not surprisingly, Trump voters believed that Trump "would better handle the coronavirus pandemic" compared to Biden. 

Most Trump voters believed the "U.S. efforts to contain the coronavirus pandemic" were going "very well" or "somewhat well." (Biden voters believed the opposite.) Most Trump voters reported that the pandemic had caused them "a moderate financial hardship" or "no financial hardship at all." (Again, Biden voters reported the opposite.) Most Trump voters consider wearing a mask "a personal choice" rather than a "public health responsibility." 

Regarding the coronavirus pandemic: there's a chasm between Trump voters and Biden supporters. This will likely have lasting consequences. 

Trump's closing message -- "The Coronavirus pandemic is not serious enough to justify shutting down the economy" -- was criminally irresponsible. Trump flew around the country and hosted "super spreader" events. He mobilized his base at the price of their health and safety. Trump's actions yielded short term results -- his base turned out -- but, in the long term, this will hurt the economy and the nation. We are adding 135,000 new Coronavirus cases per day and are on track to add 5 million new cases by the end of 2020. 

Trump waged a "scorched earth" campaign. He placed his own interests above those of the American people, but his supporters did not see this. 

Bottom line: Considering the circumstances, the Biden-Harris campaign did a remarkable job getting their voters to turn out. Donald Trump plumbed new depths of immorality. It's very sobering to consider that more than 70 million Americans voted for Trump. 

Joe Biden has pledged to be President for all Americans, regardless of who they voted for. Godspeed, Joe.