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Former Vice President Joe Biden

Health care policy has been a major issue for a long time. It played a big role in Barack Obama's 2008 election victory, his entire presidency and the 2010 GOP takeover of the House of Representatives. Repealing Obamacare was a Republican priority before and after Donald Trump became president. The debate on "Medicare for All" dominated the 2020 Democratic primaries.

Now, in the middle of the nation's worst pandemic in 100 years, you would think health care policy would be the object of obsession among politicians and voters. Instead, the issue has gone missing.


Congress is absorbed with economic stimulus and help for the unemployed. The Trump administration's favorite topic is law and order. Racial justice is paramount among Democrats right now.

But the topic may finally get some attention. "His aides are touting a speech in which Trump will lay out his health care vision," Politico reported Sunday. "White House counselor to the president Kellyanne Conway has been calling Trump 'the health care president.'"

Seriously? In June 2019, he said he would "produce phenomenal health care" with a plan he would be announcing "in two months, maybe less." We're still waiting for it.

Laying out his health care vision three-and-a-half years into his presidency would only highlight how little the issue concerned him. It's as if George W. Bush had waited until 2005 to respond to the 9/11 attacks.

Not that Trump has any coherent idea of how to address the problems in our health care system. His one firm idea was to undo what his predecessor did.

By his own standards, he's a failure. Candidate Trump decried the ACA as a "total disaster" and said in October 2016, "Repealing Obamacare and stopping Hillary's health care takeover is one of the single most important reasons that we must win on November 8." But he couldn't get a Republican-controlled Congress to get rid of the ACA. With some minor changes, it's alive and functioning.

Nor has the administration made any serious effort to construct an alternative that would expand coverage, reduce costs or fill the many holes in our health care system — needs that suddenly grew more urgent with the arrival of COVID-19. The United States still has the dubious distinction of being the only major industrialized nation that does not guarantee universal health care.

In a pandemic, the gaps in coverage are particularly worrisome, because patients who go without treatment — or work while ill for fear of losing their insurance — make it easier for the virus to spread. Lack of access for one person may mean death for another.

Our current system somehow yields both excessive costs and disappointing results. Despite spending far more than 11 other wealthy countries examined in a 2017 report by the Commonwealth Fund, the U.S. ranked last in performance.

The consequences are serious. "Poor access to primary care has contributed to inadequate prevention and management of chronic diseases, delayed diagnoses, incomplete adherence to treatments, wasteful overuse of drugs and technologies, and coordination and safety problems," the report concluded. None of those failings has abated under the pressure of the pandemic.

Joe Biden, fortunately, has not let himself be stampeded into supporting Bernie Sanders' extravagant "Medicare for All," a favorite of progressives. This week, the Democratic Party's platform committee rejected any single-payer system.

They may have heeded the lesson of the ACA experience: Americans dislike the health care status quo but distrust any major change. Incremental reforms are a more practical strategy than an ambitious overhaul.

Such changes can also make a difference in people's well-being. In 2008, 14.7 percent of Americans had no health insurance coverage, but by 2017, the figure was down to 7.9 percent, thanks in large part to the ACA. Obamacare represented a centrist approach that combined a conservative reliance on private insurance and markets with a liberal emphasis on providing crucial help to low-income Americans.

Trump has not offered a serious alternative because he and his party have never been come up with one. The most conservative states showed their priorities by refusing to expand Medicaid, not by creating better options. The result is that they have far higher numbers of uninsured people than other states.

Between the callous preferences of conservatives and the extravagant dreams of progressives lies the practical path to improvement represented by the ACA. Biden's plans, faithful to that approach, may be too dull to attract much attention. But they're not imaginary; they're not scary; and they're not futile.

Steve Chapman blogs at http://www.chicagotribune.com/news/opinion/chapman. Follow him on Twitter @SteveChapman13 or at https://www.facebook.com/stevechapman13. To find out more about Steve Chapman and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate website at www.creators.com.

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Former President Donald Trump, left, and former White House counsel Pat Cipollone

On Wednesday evening the House Select Committee investigating the Trump coup plot issued a subpoena to former White House counsel Pat Cipollone, following blockbuster testimony from former White House aide Cassidy Hutchinson, who said the lawyer had warned of potential criminal activity by former President Donald Trump and his aides.

The committee summons to Cipollone followed long negotiations over his possible appearance and increasing pressure on him to come forward as Hutchinson did. Committee members expect the former counsel’s testimony to advance their investigation, owing to his knowledge of the former president's actions before, during and after the January 6, 2021 attack on the U.S. Capitol.

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Mark Meadows

Donald Trump’s White House Chief of Staff Mark Meadows wanted a presidential pardon. He had facilitated key stages of Trump’s attempted 2020 coup, linking the insurrectionists to the highest reaches of the White House and Congress.

But ultimately, Meadows failed to deliver what Trump most wanted, which was convincing others in government to overturn the 2020 election. And then his subordinates, White House security staff, thwarted Trump’s plan to march with a mob into the Capitol.

Meadows’ role has become clearer with each January 6 hearing. Earlier hearings traced how his attempted Justice Department takeover failed. The fake Electoral College slates that Meadows had pushed were not accepted by Congress. The calls by Trump to state officials that he had orchestrated to “find votes” did not work. Nor could Meadows convince Vice-President Mike Pence to ignore the official Electoral College results and count pro-Trump forgeries.

And as January 6 approached and the insurrection began, new and riveting details emerged about Meadow’s pivotal role at the eye of this storm, according to testimony on Tuesday by his top White House aide, Cassidy Hutchinson.

Meadows had been repeatedly told that threats of violence were real. Yet he repeatedly ignored calls from the Secret Service, Capitol police, White House lawyers and military chiefs to protect the Capitol, Hutchinson told the committee under oath. And then Meadows, or, at least White House staff under him, failed Trump a final time – although in a surprising way.

After Trump told supporters at a January 6 rally that he would walk with them to the Capitol, Meadows’ staff, which oversaw Trump’s transportation, refused to drive him there. Trump was furious. He grabbed at the limousine’s steering wheel. He assaulted the Secret Service deputy, who was in the car, and had told Trump that it was not safe to go, Hutchinson testified.

“He said, ‘I’m the f-ing president. Take me up to the Capitol now,’” she said, describing what was told to her a short while later by those in the limousine. And Trump blamed Meadows.

“Later in the day, it had been relayed to me via Mark that the president wasn’t happy that Bobby [Engel, the driver] didn’t pull it off for him, and that Mark didn’t work hard enough to get the movement on the books [Trump’s schedule].”

Hutchinson’s testimony was the latest revelations to emerge from hearings that have traced in great detail how Trump and his allies plotted and intended to overturn the election. Her eye-witness account provided an unprecedented view of a raging president.

Hutchinson’s testimony was compared to John Dean, the star witness of the Watergate hearings a half-century ago that led to the resignation of President Richard Nixon for his aides’ efforts to spy on and smear Democrats during the 1972 presidential campaign.

“She IS the John Dean of the hearings,” tweeted the Brooking Institution’s Norman Eisen, who has written legal analyses on prosecuting Trump. “Trump fighting with his security, throwing plates at the wall, but above all the WH knowing that violence was coming on 1/6. The plates & the fighting are not crimes, but they will color the prosecution devastatingly.”

Meadows’ presence has hovered over the coup plot and insurrection. Though he has refused to testify before the January 6 committee, his pivotal role increasingly has come into view.

Under oath, Hutchinson described links between Meadows and communication channels to the armed mob that had assembled. She was backstage at the Trump’s midday January 6 rally and described Trump’s anger that the crowd was not big enough. The Secret Service told him that many people were armed and did not want to go through security and give up their weapons.

Trump, she recounted, said “something to the effect of, ‘I don’t f-ing care that they have weapons. They’re not here to hurt me. Take the mags [metal detectors] away. Let the people in. They can march to the Capitol from here.

As the day progressed and the Capitol was breached, Hutchison described the scene at the White House from her cubicle outside the Oval Office. She repeatedly went into Meadows’ office, where he had isolated himself. When Secret Service officials urged her to get Meadows to urge Trump to tell his supporters to stand down and leave, he sat listless.

“He [Meadows] needs to snap out of it,” she said that she told others who pressed her to get Meadows to act. Later, she heard Meadows repeatedly tell other White House officials that Trump “doesn’t think they [insurrectionists] are doing anything wrong.” Trump said Pence deserved to be hung as a traitor, she said.

Immediately after January 6, Hutchinson said that Trump’s cabinet discussed invoking the 25th Amendment to remove a sitting president but did not do so. She also said that Meadows sought a pardon for his January 6-related actions.

Today, Meadows is championing many of the same election falsehoods that he pushed for Trump as a senior partner at the Conservative Partnership Institute (CPI), a right-wing think tank whose 2021 annual report boasts of “changing the way conservatives fight.”

His colleagues include Cleta Mitchell, a lawyer who pushed for Trump to use every means to overturn the election and leads CPI’s “election integrity network,” and other Republicans who have been attacking elections as illegitimate where their candidates lose.

Hutchinson’s testimony may impede Meadows’ future political role, as it exposes him to possible criminal prosecution. But the election-denying movement that he nurtured has not gone away. CPI said it is targeting elections in national battleground states for 2022’s midterms, including Arizona, Georgia, Florida, Michigan, and Pennsylvania.

Trump did not give Meadows a pardon. But in July 2021, Trump’s “Save America” PAC gave CPI $1 million.

Steven Rosenfeld is the editor and chief correspondent of Voting Booth, a project of the Independent Media Institute. He has reported for National Public Radio, Marketplace, and Christian Science Monitor Radio, as well as a wide range of progressive publications including Salon, AlterNet, The American Prospect, and many others.

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