The Bullies are Coming for Our Lunch Money

I was in physical therapy the other day (hamstring, no big deal), when I realized that the vibrant facility I was in, part of a large orthopedic surgery practice, is one of those thousands of healthcare-related businesses that were made possible by the Affordable Care Act.

It brought to mind the ongoing fragility — the sheer precariousness — of these businesses, as the bullies ride into town. Obamacare is surely in their sights.

We’ve always assumed Trump and his rubber-stamp Congress were still determined to repeal the ACA, but it occurred to me that with Elon Musk and his cyber-vandals screwing around with government computers, repeal is hardly necessary. All they need to do is cut off the funding, which, they would have you believe, is a matter of a few lines of code.

If Musk can actually pull that off — and make it stick — it would quickly kill off PT centers like the one now stretching my hamstring, and wreak havoc on the ecosystem of surgery centers, specialty practices, urgent care facilities, and the entire range of twenty-first-century health services we’ve learned to take for granted.

It would also put heavy pressure on an already-strained hospital system, and would create vast “healthcare deserts” all through the country, especially in red states. Taken to extremes — which we have to assume — it would make healthcare in general far more difficult for most people to access affordably. Which is to say my hamstring would go untreated, many would die prematurely, and many more would suffer before dying prematurely.

I then mused about how many of the people in this PT center — providers and patients alike — grasp any of this. I wonder how many of them voted for Trump, and how many understand that their livelihoods are now hanging by a few lines of code.

If Musk’s bullies were to cripple a major government disbursement system — Medicare, Medicaid, Social Security, Obamacare — everyone in the room with me would be affected. The therapists would lose their jobs. The patients would lose access both to their therapies and the means to pay for them. Healthcare companies of every stripe would lose their income streams. Investors would lose their shirts.

That’s a lot of losing for one tiny piece of the healthcare system. And it would all be due to the wanton destruction of a multi-trillion-dollar government that, for better or worse, much of the world depends on. These are bullies who want everyone’s lunch money.

I won’t get into Musk’s motives for such an extraordinary demolition of such vital institutions. I can’t begin to understand what goes on in a brain so megalomanic. He’s a Bond villain come to life, apparently following some apocalyptic vision of a massive cultural reset, in which he gets to rule the world. Or maybe — in an eerie evocation of Orwell’s Eurasia and Eastasia — he divvies it up with Putin and Xi.

But it’s hard to see his long game, and I suspect it’s because he doesn’t really have one. His whole strategy seems to be smash-and-grab, mostly smash, and it’s clear that he and his rogue coders are as clueless about the workings of government as the eighty million Americans who voted us into this mess.

It makes you wonder what the plan is, because Musk’s nominal boss, Donald Trump, doesn’t do plans. And Trump seems to have only the vaguest idea what the Musk gang is doing.

Trump has never had any interest in governing, only grifting. But now his brain appears to have deteriorated to where his main interests are revenge and tariffs.

He ran for a second term for one reason only, to stay out of prison. Having succeeded in this he feels, in his uniquely narcissistic way, that the country now owes him for treating him so unfairly. The only way we can possibly repay him is to let him stay president forever. Yes, it’s a drag that he has to do some actual governing, but he’ll bravely put up with it as long it doesn’t cut into his golf game.

As this new administration inflicts itself on an unsuspecting world, Trump seems little more than a figurehead. Even his rants on Truth Social seem composed by his handlers, who have mastered his all-caps, bomb-throwing style.

Which is not to say he’s any less dangerous, just less predictable. There are obsequious courtiers at his side, ready to hand him that next Sharpie for that next executive order, which he might or might not sign, depending on his mood.

These are the shockingly mediocre people whose only purpose is to carry out Trump’s slightest whim. And Trump’s whims are off the charts in terms of the damage they can do. His tariff obsession alone is already making inflation great again, and it’s just getting underway.

The tariffs are most likely a shakedown, and a potentially lucrative one. First, Trump puts whole industries under threat of death by tariff, then he offers those same industries “exemptions,” an offer they can’t refuse. “Nice industry you got there, shame if it got hit by a tariff.”

Most of them will pay up, one way or another. Money will be part of it, probably under the table. But the real currency will be political loyalty. You couldn’t find a better recipe for runaway inflation, widespread unemployment, institutionalized corruption, and pain everywhere you look.

And even as the tariff grift gets into gear, Trump shows he can still baffle the rubes with bullshit, even in his diminished state. He constantly throws up shiny objects, like making Gaza a resort, annexing Greenland, renaming the Gulf of Mexico, or making Canada a state. He’ll say anything to distract, anything to keep you watching one hand while the other picks your pocket.

But the actual thieves, the bullies kicking up to the Boss, fall into at least three mutually hostile factions — call them the Muskies, the Project 2025ers, and the MAGA True Believers.

All three are running rampant, breaking laws with what they assume is impunity. They’re all vying for Trump’s extremely limited attention, and looking to slit each other’s throats at the earliest opportunity.

So here we are, looking for answers, grasping for any encouraging signs. We’re not used to the idea of resisting our own government. It puts us in an upside-down mindset, where we’re actually rooting for widespread incompetence, for vandals who don’t know what to break, and for countries who stand up to us, just as they might to a playground bully.

Hang on to your lunch money.