August 22, 2025
Dear Interested Readers,
The President’s Exceptional Intrusiveness
If you are like me, you may open an online newspaper each morning with some trepidation. You are apprehensive. The central question you are exploring is whether things have gotten worse in some sudden and dramatic way. If they have not gotten worse, is there evidence of a new trend that could indicate how close we might be to disaster on the foreign or domestic front?
You might have noticed that my letters often are a mosaic of other people’s ideas, which I have recently read and then share with you after riffing on the ideas the articles explore. I am trading on the opinions of publications or authors who articulate my fears and concerns. They say with better prose what I am thinking. They also frequently point out nuances and connections of which I was not aware, but feel burdened to pass on to you. I assume that if you were exposed to the same information, we might find some way to unite our concerns and together make a difference, or at least we might share the same anxieties for issues that we can’t change alone at this time.
I frequently read the “Guest Essay” in the Opinion section of the New York Times written by Thomas Edson. I don’t remember ever directly passing on to you what he has written. Ironically, I find his pieces to be very long and constructed as a series of quotations from other people. Being somewhat self-aware, I think our writing methodologies share some similarities. What I don’t like about my own words, I see in his. Mr. Edsall writes about politics. He only occasionally mentions healthcare, and then what he writes is probably best recognized as connected to the Political Determinants of Health. Again, I see my connection to Edsall’s writing because more and more I am writing about politics and healthcare.
I ascribe to the opinion that the Political Determinants of Health are fundamental to the Structural Determinants of Health, and that those concepts are foundational to understanding how to reform the Social Determinants of Health. By that logic, almost all current political issues and the president’s confusing and inconsistent performance across the broad scope of all of his attitudes and actions impact healthcare. This makes what Mr. Edsall passes along from others very interesting to me.
Thomas Edsall is 84 today! I wish him well. He was born in Cambridge, Massachusetts, on August 22, 1941. Even though he does not usually write about healthcare, his grandfather was Dr. David Linn Edsall, who served as Dean of the Harvard Medical School from 1918 to 1935. Edsall was educated at Brown and Boston University. He wrote about politics for the Washington Post for many years and was the Joseph Pulitzer II and Edith Pulitzer Moore Professor of Public Affairs Journalism at the Columbia University Graduate School of Journalism from 2006 to 2014, where he is now an adjunct faculty member. His column has been in the New York Times since 2011.
His piece on Tuesday was entitled “The Mind-Boggling Intrusiveness of Donald J. Trump.” For a New York Times column, it is long–over 2700 words. My tendency to wordiness makes the average length of my letters even longer. Wordiness happens when you are quoting others and annotating their work with your words, stimulated by their thoughts. In this column, he includes comments and quotes from a dozen authorities, most of whom are academics. A couple of his quotes come from individuals who work at libertarian or conservative think tanks like the The Cato Institute.
Edsall frequently notes that he is referencing an email that he has received from the person he is quoting. Perhaps, he sends out a “request for opinion” on a specific topic and then uses the best answers that come back as the substance of his article. If that is true, his request this week must have been: What is your opinion as to whether Trump’s policies and actions are “intrusive,” and if so, please discuss and compare to some previous president.
He records the thoughts of an impressive collection of people willing to express their opinions. The fact that he can ask such a question and get responses must mean that there is still a bit of free speech left for the advocates of Project 2025 to yet remove. The twelve experts he quotes in their order of appearance in his essay are:
- Rogers Smith, a political scientist at the University of Pennsylvania
- Sean Wilentz, a historian at Princeton
- Bruce Miroff, a political scientist at SUNY-Albany
- Terri Bimes, a political scientist at Berkeley
- Jeremi Suri, a historian at the University of Texas-Austin
- Clark Packard and Alfredo Carrillo Obregon, both Cato researchers
- Veronique de Rugy, a senior research fellow at George Mason University’s Mercatus Center
- Ryan Young, senior economist for the conservative Competitive Enterprise Institute
- Jack Rakove, professor of history and American studies at Stanford
- Matt Dallek, a political historian at George Washington University
- George C. Edwards III, a professor emeritus at Texas A&M and a fellow at Oxford
The opinion piece begins:
The Trump administration ranks among the most intrusive in American history, driving the tentacles of the federal government deep into the nation’s economy, culture and legal system.
Economically, the administration is dictating corporate behavior through tariffs, subsidies and the punishment of disfavored industries and companies, while rewarding allies with tax breaks and deregulation. And that’s all before the government takes its cut.
Culturally, Trump is seeking to redefine the boundaries of public discourse: pressuring universities, elevating grievance politics and reshaping federal agencies to reflect ideological loyalty rather than expertise or experience.
Within the legal system, the administration is aggressively reshaping the federal judiciary, asserting executive power over independent institutions and using the Justice Department for political ends.
In another opinion piece written by the traditionally conservative and evangelical Constitutional lawyer, David French, who is now also a New York Times opinion columnist we read in his column this week entitled “One Sentence in the Constitution Is Causing America Huge Problems” that Trump is taking advantage, “like no other president in history,” of serious ambiguity in Article II of the Constitution. French contends that Trump is walking through a loophole that has concerned some authorities going back to 1789 that allows him to subjugate Congress and the Supreme Court and enforce the laws he wants while ignoring the laws he doesn’t like or care about. If that is an accurate assessment, Edsall’s next point is consistent with that interpretation and underlines what we see and hear about on the evening news and read in our liberal media. Edsall continues:
Taken together, these interventions reveal a presidency determined to expand executive reach into virtually every sphere of national life.
“No peacetime president has remotely approached the Trump administration’s campaign to control the conduct of all the major institutions that comprise American civil society as well as its governments,” Rogers Smith, a political scientist at the University of Pennsylvania, wrote to me by email.
As those of us in healthcare know, this assertion of unbridled executive power has already resulted in damage to the NIH, the CDC, the FDA, the development of mRNA vaccines, public health in general, and has the potential to lead to the denial of access for many to the benefits of Medicaid and the ACA marketplaces. Also at risk is the undermining of academic freedom, and many of the foundational efforts to improve the Social Determinants of Health through public education, housing benefits, and food programs. Other publicly funded programs are at risk, including fuel assistance and SNAP ( today’s iteration of food stamps), which augments access to nutritious meals for millions of children and their families.
Edsall moves on to the second voice that makes his arguments for him:
For Sean Wilentz, a historian at Princeton, the word “intrusive” fails to capture the full scope of Trump’s agenda. Writing by email, Wilentz argued that Trump has intimidated major institutions of civil society, including universities, major law firms, and the corporate media, to bend them to his will. He has deployed the military for political purposes. He has militarized ICE and turned it into nation’s largest law enforcement force, accountable only to himself and Stephen Miller, thus laying the basis for a police state.
He and his attorney general have hounded federal judges who oppose the Trump agenda to the point where those judges and their families rightly fear for their lives. His appointees to the Supreme Court, in concert with Chief Justice Roberts, are completing the gutting of the 14th Amendment and (as crucially supplemented by the 1965 Voting Rights Act) the 15th Amendment, thereby destroying crucial legal legacies of the Civil War and the abolition of slavery.
I would add that Trump is also busy attempting to rewrite history with the erasure of 246 years (1619-1865) of our national history of condoning slavery, plus decades of Jim Crow oppression that did not end until 1965, by attacking the Smithsonian Museums and renaming military bases for Confederate generals. As Edsall continues to quote Wilentz, we read:
…Most recently, he has commanded a rewriting of American history as a providential story culminating in his own divinely inspired rule. Approaching the 250th anniversary of the American Revolution, he is grasping for a monarchy that the Revolution repudiated, in the name of a plutocratic and theocratic order that the Revolution rejected.
At one level, Trump’s policies are the embodiment of what have been core Republican principles since Ronald Reagan, as foreshadowed by the ultraright big business opposition to the New Deal: slash taxes on the wealthy, bash the poor, dissolve the social safety net and deregulate, deregulate, deregulate…Trump, Wilentz argued, is intruding like a wartime president when there’s no war. The only checks on his brazen lawlessness would be the Congress and the Supreme Court. But the first is supine and the second has thus far sustained Trump on 90 percent of the cases where lower courts have tried to restrain him. And if permitted, his assumption of war powers without a war will enable his authoritarian regime.
Professor Wilentz is just the sort of liberal academic that gets the president’s goat and is a reason that our universities are in his line of fire. Edsall moves on to the opinion of another professor:
Bruce Miroff, a political scientist at SUNY-Albany, expanded on Trump’s autocratic approach to government in an email:
Trump himself has an authoritarian mind-set that ignores a checks and balances system that has frustrated some earlier chief executives. But he also has an advantage in the capitulation of the other two branches out of fear, but also out of hope that only under him can a long sought conservative agenda finally roll back the liberal welfare state.
From the early dismantling of the “deep state” to the current takeover of law enforcement in D.C. and Trump’s threat to institute a makeover of the Smithsonian that will stifle any exhibits that don’t use happy talk on even the darkest moments in American history, Trump has forged ahead to shut down anything he dislikes and replace it with his own imagination.
That is a very succinct statement of our current state of affairs under the thumb of a wannabe autocrat. Edsall, perhaps to be fair, then moves on to discuss two other respected presidents, Lincoln and FDR, who were accused in their days of overstepping the boundaries of the Constitution. He writes:
There are experts in presidential studies who contend that other presidents have been more aggressive and activist than Trump.
“Measured in terms of sheer scale and scope,” Terri Bimes, a political scientist at Berkeley, wrote by email, “Franklin Roosevelt’s interventions during the New Deal and World War II eclipsed anything attempted by Donald Trump.”
…There are, however, major differences between the Roosevelt and the Trump administrations, including Roosevelt’s willingness to respect court decisions and his willingness to seek congressional approval for his policies.
Roosevelt, Bimes wrote, commanded huge congressional majorities, yet still encountered formidable pushback. The Supreme Court struck down key New Deal programs. Congress blocked or diluted others. Even at the height of his presidency after winning a major landslide election in 1936, his court-packing plan failed, his first attempt at executive reorganization was voted down, and his bid to purge conservative Democrats failed.
By contrast, Trump’s actions have met with far less resistance. Operating largely through executive orders, administrative reinterpretations, and emergency declarations, he has pursued an agenda aimed less at constructing a new administrative order than at dismantling existing institutions, a process requiring little cooperation from Congress.
In short, Roosevelt’s most ambitious projects were checked by resilient institutions; Trump’s have advanced in part because those institutions are weaker.
Now we move on to the comparison of Trump to Lincoln, who faced real dangers to the health of the nation and not the concocted ones that Trump offers to justify his expansion of powers as described in the Second Article and normalized by most of our previous presidents, including Regean. Edsall continues:
Jeremi Suri, a historian at the University of Texas-Austin, pointed to Abraham Lincoln as an activist president in his determination to prevent the South from seceding, to restore the union and ultimately to end slavery.
Lincoln, Suri wrote by email, was more intrusive than Trump has been so far. Lincoln was the first president to use conscription, requiring Union residents (many recent immigrants) to serve in uniform. He remade the Supreme Court, creating a new bench dominated by Republicans. He limited civil liberties on a number of occasions.
Lincoln used a war order to end constitutionally protected slavery in Confederate-held territories. Lincoln then brought more than 100,000 of those former slaves into the Union Army, gave them guns and sent them to fight their former masters.
That comparison does not, however, diminish the import and adverse consequences of Trump’s invasive policies, Suri wrote:
What makes Trump so different and threatening is how he does things — he is acting unilaterally and on personal whim, largely ignoring separation of powers. He is pushing the boundaries from president to dictator.
We also learn that Trump is not like Lyndon Johnson who operated somewhat like FDR, always playing politics close to the line of what was ethical, but accepting the independence and restraints of the courts and Congress.
… F.D.R. and L.B.J. were aggressive, but they worked through Congress and the courts. Trump is willing to work around them. That is what puts him beyond the pale for a historian.
Republicans in Congress have remained both prostrate and complicit in the face of Trump’s assaults on traditional party beliefs even as some of the administration’s policies have alarmed conservative and libertarian proponents of free markets.
I have possibly been unfair to libertarians because I lump them with the sort of conservatives at the Heritage Foundation who were active in the development of Project 2025, which Trump denied he knew anything about during the election, but seems to be following as his road map now. In bold letters on its website, the libertarian Cato Institute declares:
Our mission is to keep the principles, ideas, and moral case for liberty alive for future generations, while moving public policy in the direction of individual liberty, limited government, free markets, and peace.
That is not my agenda, but I can respect the words and assume that it does not mean they plan to violate traditional political norms and the Constitution as they seek policies that are aligned with that vision. Edsell now quotes two of the institute’s intellectuals:
The libertarian Cato Institute faulted Trump’s recent deal with Nvidia and Advanced Micro Devices allowing the companies to export chips used for artificial intelligence to China in return for the payment of 15 percent of revenues from the sales to the government.
In their Aug. 13, 2025, article, “The Nvidia/AMD-Trump Deal: Legal Questions, Crony Capitalism and National Security for Sale,” Clark Packard and Alfredo Carrillo Obregon, both Cato researchers, wrote:
The president’s unprecedented deal with Nvidia and AMD raises serious legal questions, further entrenches Washington’s crony capitalist favor factory, and gives at least the appearance of putting national security up for bid. Whatever the future of this arrangement, it sets yet another dangerous precedent of the executive branch abusing its national security authorities to influence or dictate the actions of private entities.
After that succinct quote, Edsall continues his analysis by moving on to yet another respected academic with libertarian leanings:
Similarly, Veronique de Rugy, a senior research fellow at George Mason University’s Mercatus Center, which supports entrepreneurial scholars and market-oriented thinking, warned in an Aug. 11 essay, “To Aid Economy, Trump Must Restore Faith in Institutions,” that “if the president continues to treat disagreement as disloyalty — especially from vital, independent agencies such as the Bureau of Labor Statistics and the Congressional Budget Office — then Trump’s second term could leave a dark mark on the country.”
She is stating the obvious. When there can be no debate or tolerated disagreement, we have moved from a democracy to some form of authoritarian rule. It is not a surprise that many of the authorities that Edsall quotes are commenting on events of the past few days and weeks. I sense a crescendo of oppression that will generate a tsunami of change that will injure our healthcare systems and efforts to move toward something like the Triple Aim of just health equity for decades to come. Edsall’s next expert is also a “conservative intellectual,” which is not an oxymoron.
In February, Ryan Young, senior economist for the conservative Competitive Enterprise Institute, published a broadside attacking a key element of Trump’s economic policy, “Trump’s Unilateral Tariffs: Time for Congress to Do Its Job.”
“Why,” Young wrote, does Donald Trump like tariffs so much? It’s clearly not on the merits. When he talks about trade deficits, or raising revenue, or being treated badly by another country, all he’s doing is rationalizing a conclusion he reached long ago. While Trump is unlikely to ever admit he is wrong about tariffs, the rest of us can learn from his mistakes. This includes Congress, which needs to take back the taxing authority it should never have delegated away in the first place…
Edsall likes Young’s commentary on the stupidity of the tariffs that Trump is using to traumatize the world, and especially those Americans living paycheck to paycheck. Remember, he said that the tariffs may hurt for a little while. I wonder how much pain the billionaire class will experience. Young’s quote is long, and I will spare you the rest because many of you could write it.
After reviewing tariffs, Edsall goes in another direction to build his case that Trump’s policies are “mind-bogglingly obtrusive,” and are not being well received by a growing majority that does not have the tools to control him as long as Congress and the Court are silent. He peaks his own mind for a moment when he writes:
In terms of public support, Trump began his second term with positive job approval numbers, 50.5 percent favorable to 44.3 percent unfavorable, according to RealClearPolitics. The numbers turned negative in late March, and in the most recent aggregated count, Trump had a disapproval rating of 51.2 percent and an approval rating of 45.8 percent.
Trump’s deviousness, his disregard for the truth and his all-consuming narcissism are exceptional, even among politicians and even among the kind of men and women who seek the presidency.
Having applied those superlatives to the president who loves to refer to himself with self-granted accolades like “I am also a war hero,” Edsall is back to quoting others:
“Any attempt to compare Donald Trump to any other president is a pointless exercise,” Jack Rakove, professor of history and American studies at Stanford, argued in an email:
His overt acts, craven ambition, delusional beliefs, erratic behaviors, perpetual dishonesty, and mental capacities lie so many norms of deviation apart from all his presidential counterparts that he has to be taken as a unique case.
Simply asking whether “any peacetime president has been as intrusive as Donald Trump” virtually answers the question in itself. Of course not — it would have been literally inconceivable.
Trump has claimed the oxygen of attention of the world in such a way as to give no one else, except maybe Putin and Netanyahu, any chance to get enough air to speak or effectively rebut his policies or actions, which they will not do.
Trump, Rakove argued, has adopted a strategy of making false claims to justify casting “himself as a wartime or emergency president.”
The flow of immigrants across the border, Rakove wrote, may create social problems aplenty, but that does not turn them into the form of “invasion” to which the Constitution refers. You cannot place cities in a state of emergency warranting unprecedented action by federal agencies and the National Guard when their crime and especially their homicide rates are falling.
So what? The truth no longer has an audience. Believe it or not, Edsall has not run out of pen-pal-authorities whose words he wants us to consider. He continues.
Along parallel lines, Matt Dallek, a political historian at George Washington University, wrote by email:
What distinguishes Trump from his predecessors is the aggressive, holistic nature of his intrusions. As with so many other aspects of his second term, Trump stands alone…
…Trump stands apart from his predecessors, Dallek wrote, because he has been so eager to push past laws, norms, and constitutional guardrails to force institutions and individuals to cater to his vision of American greatness. His intrusive acts have been more aggressive, covering more areas of domestic life, than anything seen in the modern presidency.
The president likes to be referenced in superlative terms. Would he be pleased with the accolade of “His intrusive acts have been more aggressive, covering more areas of domestic life, than anything seen in the modern presidency.”
I am exhausted from Edsall’s exhausting review to support his contention of something most of us already believed: Trump is the most intrusive president in our history, and he is not done yet. His last expert has roots in both Texas, which is its own special problem for the rest of us, and Oxford.
George C. Edwards III, a professor emeritus at Texas A&M and a fellow at Oxford, contended that “President Trump is unique”:
No peacetime president has been as intrusive in intervening in the economy, including extracting funds from corporations (Nvidia), requiring domestic investments, strongarming the selection of C.E.O.s, picking winners (fossil fuel companies, steel manufacturers) and losers (wind farms, EV vehicles) in the economy, and using tariffs — to raise revenue, to reduce trade imbalances, and to coerce both U.S. companies and other nations.
And no other peacetime president has so blatantly sought the territory of a sovereign nation. No president has been as hostile to environmental protection, financial regulation, and efforts to advance civil rights.
Professor Edwards has neglected to mention healthcare, but he did mention the environment and civil rights, which gets him a few points with me. Edsall continues:
What makes Trump one of a kind, Edwards wrote, are his efforts to influence so many other spheres of American life. No president has reached so far into the governing of universities, been so active in determining Kennedy Center honors, and been so eager to employ the symbolic politics of naming everything from athletic teams to mountains and oceans.
What may be most significant of all, in Edwards’s view, is the president’s undermining the structural and moral underpinnings of the government. Unilaterally dismantling the administrative state by destroying expertise that took generations to build in areas ranging from investigating and prosecuting crime and protecting the public against environmental hazards to predicting the weather and curing cancer can cause long-term, structural harm to American society.
As he continued, Edwards remembered that Trump is undermining the efforts to defeat cancer. He finishes with a flurry and the expertise of a scholar who has written or edited 28 books and approximately 100 articles and essays. I doubt the president has read any of them or even knows who he is, but Professor Edwards has clearly analyzed the president. According to Professor Edwards:
For Trump, the rule of law is not a principle of democratic government; it is a speed bump on the road to exercising unilateral authority. In his own mind, he is on a path to the ultimate in gold-plated power.
I bolded that last line because one of the small indignities I must bear each time I see a news clip from the Oval Office is how much gold and tasteless gilding the president has added to one of the most historic rooms in America. Can you imagine Truman or JFK sitting in that ostentatious and tasteless opulence? The room itself, now obnoxiously gold-plated, is a metaphor of what we have endured so far and what we may yet endure. It is possible that I will not have the opportunity to report on any significant progress toward the Triple Aim, improvement in the Social Determinants of Health, or greater health equity before I write my last Friday letter and give up the ghost. My guess is that, being a fellow octagenarian, Mr. Edsall might have had the same thought.
Is Fall Here Early?
I took the picture that is today’s header on Wednesday. It was a cloudy, overcast day that felt like fall. The overnight low was in the forties, and the high for the day was 61. The day began with a much-needed drizzle until noon, which was followed by a damp feel to the air that made me question how the temperature could really be sixty. I donned my wetsuit for my swim and was still chilly as I did my laps.
The positive for the day was that the conditions were perfect for my walk. My recent daily exercise routine has been a two-mile walk with my very light Canadian crutches, followed by a quarter-mile swim and a hot shower outdoors. I admit that on Tuesday, it was so chilly that I substituted a bike ride for the swim. My othopedic issues and peripheral neuropathy cramp my walking style, but thankfully, I am whole on a bike or in the water.
My walks are yielding further evidence that fall is coming. Some trees that don’t look too healthy, like the elderly Japanese maple in my front yard, have a few leaves that are turning color early. The roads I walk are garnished with ferns and wildflowers. The goldenrod is out in its late summer abundance, and the ferns are beginning to turn brown. It is easy to see that changes are on the way. If you look closely at the foreground in the picture, which is today’s header, you can see some tired ferns that are transitioning from green to brown.
I hope that you are getting ready to enjoy the last hurrah of summer, or if you prefer, an early hello to fall.
Be well,
Gene
