Our Weekly Discontents, 1/18/2021

We’ll write you a Sick Note.

Hello, Discontents readers! I am your new friend, Libby Watson, the author of Sick Note and the latest addition to the Discontents lineup. Sick Note is a newsletter about America's awful healthcare system. Each week, I interview someone about their experience with American healthcare; last week, for example, I interviewed a DC woman whose poor-quality housing, riddled with mold and mice, made her sick. Tomorrow I'll be running an interview with an emergency room nurse about how our healthcare system fails to care for people before it's an emergency. I also send out weekly roundups of healthcare news and pictures of my small, chatty cat, Digby.

Before I let you get to reading about what the rest of the gang is up to, let's talk about the big story this week, and the reason why my city is heaving with troops right now: On Wednesday, Joe Biden will be sworn in as president. Trump will leave, probably directly to one of his golf clubs, where he will eat a sweaty beef sandwich. Colors will be brighter, songbirds will sing louder and sweeter, and so on. But then, in the coming months, the question that dominated so much of the 2020 Democratic primaries must be answered: What are we going to do about this country's cruel joke of a healthcare system? There have been many articles about the sorts of things Biden can do with a rickety Senate majority held together by Joe Manchin's nasty palms, outlining a range of options—tweaking the ACA, trying to reverse some of Trump's last-minute Medicaid sabotages, even passing a public option. But to fully understand what Joe Biden can do, you can look at what Donald Trump couldn't do. 

Trump is going to leave office without ever having revealed a plan to reform healthcare in America. Just like it was always Infrastructure Week, the Trump plan to fix healthcare was always just around the corner, coming very soon and verrry nicely, you're going to be very surprised by how much we're going to do.

Towards the end, Trump issued a whole executive order about healthcare that merely said he would protect pre-existing conditions, which is a lie and wouldn’t be a healthcare plan if it were true. That was it, the whole thing. A couple of times, he did a thing that was designed to look like part of a healthcare plan, but was actually not even that, as if he said he was going to buy you a new car but then just held up a steering wheel made of macaroni. His $200 prescription drug cards for seniors never happened, for example.

This whole charade started after the Republicans’ failed 2017 attempt to repeal and not-really-replace the ACA, which was an epic fail for them. It simply reminded everyone that yes, this party does want you to die without healthcare. Even then, when they came extremely close to unraveling the progress made in the last 10 years, the bill didn't really have anything to replace what had existed: It was repeal the ACA, [file not found], and then... What? You're still here? Stop coughing, you're fine! 

Republican politicians never hated all of the ACA. I don't think they hate the billions in subsidies to insurance companies; insurance companies sure love those. They managed to repeal the individual mandate, which everyone except Democratic wonks hated too, and everything was obviously fine, so sure, whatever.  What Republican politicians really, truly hated about the ACA, other than the expansion of Medicaid, is that it forces insurance plans to "cover" (after your deductible, plus your coinsurance, also sometimes they’ll just say no and you have to have enough time and energy to appeal) certain things. Plans have to cover "going to the hospital." They have to cover "medicine." They have to cover "giving birth to a baby." Forcing HEALTH INSURANCE companies to cover HEALTHCARE—disgusting. Instead, they want to let Aetna sell you an insurance plan for $Everything-In-Your-Bank-Account that covers hospital visits, but only on Tuesdays. We'll cover you having a baby but only if you call it Gerald. This is why Trump made it easier for scammy insurance companies to sell you junk plans that cover almost nothing. And it's why so many Republican states, in conjunction with the Trump administration, tried to overturn the law's mandate that insurance companies cover people with pre-existing conditions. They wanted insurance companies to be able to randomly drop anyone who was unprofitable.

All of this is deeply unpopular. Republicans had to spend a lot of energy running away from the fact that they were trying to undermine pre-existing condition coverage, while simultaneously continuing to do that. They had this weapon that was powerful and useful to them in 2010, but over time, became impossible to wield effectively, until it started to bonk them on the head too. Voters liked Medicaid expansion, even in red states. There weren’t many specific parts about the ACA that they didn't like at all, in fact.

This is why Trump could never come up with a healthcare plan. There is almost nothing that is to the right of the ACA that would be popular with the American public, because the ACA is already very conservative. It's basically RomneyCare, for Christ's sake! The Heritage Foundation invented a lot of it! It is already not a plan to cover everyone, which is why it never got close to doing that. Quietly undermining parts of the ACA is all Trump could manage to do. Yet all Joe Biden really seems keen on doing is tweaks and add-ons to the original, conservative idea of the ACA, like expanding premium subsidies; he even promised during the campaign to bring back the individual mandate (the only bit voters really did hate).

The scam the Republicans ran the past couple years was claiming they were repealing the ACA, while also saying they were actually preserving all the good bits. They had to try and undermine as much as they could without actually unraveling the whole thing. The effect is that things were kept mostly the same. The scam Joe Biden is going to run is telling you he's fixing healthcare—while keeping it mostly the same. Neither party has the strength or will blow this whole thing up, whether it’s to totally destroy it or replace it with something actually good. It’s the ACA’s world, and we’re just dying in it.

So look forward to Wednesday and the Biden administration, where things will be Better—doesn’t matter how much better, just better, even if it feels very much the same to you. In fact, people will tell you that the things Joe Biden does are actually very significant, in a stern tone that is meant to tell you not to wish for more. Sometime in 2022, a chart will emerge from some center-left think tank showing that the number of insured people aged between 33 and 37 increased by 3.4 percent, and they will say, “see, Bernie bros, this is that progress you said would never happen—or do you not want 3.5 percent more people to have insurance???” Expanding ACA subsidies so that your premium can only be 8.5 percent of your pre-tax income instead of 9.83 percent—a real thing in Joe Biden's plan, you lucky devils—that's going to be recast as very significant, simply because it's in the other direction from what Trump wanted to do. It doesn't matter how far in that direction it goes. “Thank God we had Progress,” you’ll say, as your mother dies of preventable heart disease that went undiscovered because there were no primary care providers with appointments available before the heat death of the universe—at least we still have the ACA.

Welcome to Hell World

Luke O’Neil

Last week I wrote about how the Trump administration’s sick lust for executing people kicked into high gear this year including three at the last minute. In the past six months alone the Trump administration has executed fourteen people. In the century prior the federal government only killed thirty seven.

I also sent out to paid subscribers this piece on the fallout of the riots or insurrection or failed coup attempt or whatever you want to call it and in particular how it almost instantly devolved into the same tired conversation about freedom of speech and tech censorship we’ve been having every day for the past couple years.

Trump not being able to post lies to 100 million people every single day is a net good for the world. The entire network of worms who worship him not being able to organize and gas each other up as easily as they have been for years is a net good. These seem like easy distinctions to make to me in the same way that saying rallying and protesting and occupying government buildings for the cause of good is good and doing it for the cause of bad is bad.

A Lonely Impulse of Delight

Connor Wroe Southard

Last week, my never-ending quest for non-shitty narrative art led me to Giri/Haji, a very well-made joint British-Japanese production about yakuza, cops, Cockney gangsters, sex workers… that kind of thing. It’s very much worth checking out, and it’s on Netflix.

I concluded that the show’s main failing was a fixation on Having Something to Say. I firmly believe that made-up stories don’t need to say much of anything, at least not in these that a piece of commentary writing or a speech by an authority figure (lol) is supposed to say something. Immersing us in a convincing story in which we care what happens to the characters is plenty—and that’s not the only way to do it, either, but it’s a better guiding principle than My Transnationally Produced Television Show Must Be Profound. No, please no. Just have it look cool and have the drama be passable.

I suspect I’ll be expounding on this theme a lot. I don’t like it when my television tries to tell me things. Especially now, when everyone else is all over my social media trying to tell me things about the news. Enough of that—let’s make up some stories. Sign up and join me on my neo-curmudgeonly journey.

Air Gordon pt. 2

Jeremy Gordon

After a few months off the grid, I put together some thoughts on Kyrie Irving’s recent revolt, Substack’s rise-and-grind culture, watching Tenet (a movie about the past and the future) in the present, rewatching Lost (a show from the past, about the past) in the present, and the latest Avalanches record (an album from the present that fuses music from the past and present to gesture at something about the future). Namaste and thank you for reading.

The Insurgents

Jordan Uhl & Rob Rousseau

This week we spoke to three-time returning guest Vanessa A. Bee, editor at Current Affairs, to talk about Trump’s impeachment, the aftermath of the incident at the US Capitol, the possibility of further nationalistic violence in America and much more.

We also congratulate the incoming Biden Administration on keeping their promise of delivering $1400 Covid relief checks — that thing we all very clearly remember them mentioning repeatedly in the run up to the election and the Georgia runoffs. It’s just nice to see them get off to a good start right out of the gate, you know?

Wars of Future Past

Kelsey D. Atherton

“Green Zone” is a Pentagon jargon made real. It’s a euphemism for safety and security within a tightly patrolled perimeter, a term whose very use masks the violence that calls it into being. There are no Green Zones in peacetime.

Following the assault on the Capitol, the National Security State responded the only way it knows how: with disproportionate force, as though that will make up for a past failure to take a treaty seriously. The Capitol Hill Green Zone borrows its terminology from the occupation of Baghdad, when the military secured a small territory of American government and luxury in the middle of the violence inflicted on the country. DC’s Green Zone, called into being to prevent future assassination attempts against Congress or the President-elect, has taken the easily transversibile, vibrant heart of a city, and turned it into checkpoints where waitresses need special papers to get to work. (All this in the middle of the pandemic, too).

Yet for all the direct comparisons made to the hostility of US experience in Iraq, this is an occupation of Americans by Americans, speaking the same language, in theory supporting the same government, and with far fewer incentives to shoot to kill on sight. I’ll have more to say on this at Wars of Future Past later this week, but for now let me leave you with this: the Green Zone is only the latest in a long series of antidemocratic lockdowns on the people of Washington. That the Green Zone as enforced maps also exactly to the proposed boundaries of what would remain a federal district should the rest of DC get statehood is only a further argument in favor of statehood.

Perspectives: Past, Present, and Future

Patrick Wyman

What the fuck just happened? That’s the basic question I tried to answer in one of my two posts last week, arguing that the Capitol Riot was a huge and very serious event that’s going to reverberate through American (and probably global, too) politics and society for quite some time.

The people who fomented and participated in the insurrection - which was only a hair’s breadth away from being much, much worse than it was - aren’t going away. We’ll see them giving speeches in or running for Congress, showing up at rallies, protests, and riots, and taking potshots with ARs or blowing things up. It’s the beginning, not the end, and we’d be fools to think we can predict precisely where it’ll lead.

On an entirely different note, I also wrote about some of the prehistoric complex societies of the Americas, the earliest temple- and mound-builders of the American southeast and the Pacific coastline of South America. It’s interesting stuff, I promise.

The Flashpoint

Eoin Higgins

We're nearly two weeks removed from the Capitol riot, Joe Biden's about to be inaugurated and is already breaking promises or adjusting language, depending on who you talk to, and the GOP is trying to "turn the page" on a political disaster—an effort Democrats could inexplicably help them with. 

There was a security threat this morning in DC as smoke rose from nearby the Capitol but no fear: it was just the belongings of someone living outside going up in flames. Nothing to see here, ignore the complete lack of subtlety. 

So things are getting back to normal. Yay.

This week at The Flashpoint, I talked about the entitlement and privilege on display by the Capitol mob, calling it evocative of Dave Chappelle's comedy routine about his white friend Chip, who cruises through life without a care in the world for how police behave, telling a cop, "I'm sorry officer, I didn't know I couldn't do that" after drag racing drunk and being let off.

That "I didn't know I couldn't do that" energy pervaded the mob that attacked the Capitol and their reactions since being caught—and while it's an amusing comparison, the reality of what the rioters were trying to do is far from funny. 

More at the link, along with a quick review of what I've been up to.

Discourse Blog

So Trump got impeached again! Wow.

With a matter of hours left in his presidency, there aren’t really any complicated arguments or feelings to have about Impeachment 2: it’s just extremely funny. Paul Blest had a good essay last week on why the Democrats should take that victory and finally, finally start playing the kind of hardball the Republicans have been for years. But we’ve been let down time and time again, like by the new confusion over exactly how much we’re getting in stimulus checks: first it was $600 and then a new $2000, now it’s maybe just a total of $2000. Who can say. Certainly not the people in charge of the country!

We spent most of the week focusing on the relaunch of our new subscription tiers and premium newsletter, which you can preview here. We’re calling it WHAT NOW?, and it’s going to have a pretty significant amount of exclusive content you won’t get on the blog: interviews, mailbag Q&As, news roundups, et cetera. What we’re NOT going to have, we promise, is fucking Ben Shapiro guest writing any of our posts, which Politico did this week for their new edition of Playbook. That apparently touched a nerve for Katherine Krueger, because she went off for a while and came back with this blistering essay on the right wing’s favorite little squeaky worm. So all in all, a pretty good week for Discourse Blog, a ruinous week for our haters and enemies. Here’s to more of the same provide the right wing doesn’t overthrow the government on Wednesday. We’ll have a livestream on Inauguration night, so come tune in at www.twitch.tv/discourseblog. See ya there.


I can’t think of a single endeavor I approach with a level single-mindedness and absolute determination that could come close to rivaling the Trump administration’s obsession with immigration policy. Last Friday, when we published our latest edition of BORDER/LINES, Trump had less than a week left in office. Yet somehow, in the days leading up to Biden’s inauguration, the immigration news won’t stop coming. 

One of the administration’s final acts was to reshuffle leadership at the Department of Homeland Security as part of a likely ill-fated attempt to stop legal challenges to policies implemented under the tenure of acting DHS Secretary Chad Wolf, who—in addition to having a name that sounds fake and totally made up—wasn’t legally appointed to his position. Meanwhile, a federal judge blocked the administration’s “death to asylum rule,” which would have all but ended asylum in the U.S., partly because, well, Wolf implemented it despite having been serving illegally. Amid all that, former DOJ officials who were responsible for the 2018 family separation scheme are now trying to distance themselves from the policy, and from Trump more broadly. Rats, sinking ship, etc.

Foreign Exchanges

Derek Davison

We’re approaching a presidential transition, or at least I think we are. Normally when the White House changes parties, the transition period is marked by a lot of high-minded and mostly feigned comity and collaboration. This time around it’s marked by the image of National Guard troops sleeping on the floor of the US Capitol in case pro-Trump rioters try to seize the building again. Vive la différence, I guess.

This transition is also being marked, on the foreign policy front, by a Trump administration that’s trying to cram four years of accomplishment into two months while doing as much as possible to hamstring Joe Biden’s plans once he takes office. And so the past several days have seen the administration lift 40+ year old rules governing US diplomatic contacts with Taiwan (putting Biden in an immediate spat with the Chinese government), return Cuba to the State Department’s list of terrorism sponsors (both as a political gesture—hi, Florida!—and to undermine Biden’s plans for Latin America, and impose ever more sanctions on Iran and China. On a more constructive note, if you want the United States to reduce its global military footprint, the administration did hit its January 15 deadline to reduce the US troop presence in Afghanistan and Iraq to 2500 personnel in each country.

In my opinion the most dangerous recent move the administration has made along these lines was its decision earlier this month to designate Yemen’s Houthi rebels a “foreign terrorist organization.” That there’s little justification for this designation is bad enough, but the effects of punishing international contact with the Houthis could be catastrophic, impacting everything from peace talks to the delivery of critical humanitarian aid to northern Yemen to the United Nations’ efforts to prevent an environmental catastrophe in the Red Sea. All to achieve…well, nothing really, apart from a final kiss to Saudi Arabia and one last “fuck you” to Iran. A fitting end for an administration run by a sociopath, but not a great one for the Yemeni people.