Pubdate: Fri, 11 Aug 2017
Source: Asbury Park Press (NJ)
Copyright: 2017 Asbury Park Press


Taking a break from his provocative tweets on North Korea, President
Trump on Thursday declared the opioid addiction epidemic a national
emergency, heeding Gov. Chris Christie's suggestion as part of
Christie's work with a special presidential commission on opioid abuse.

It was a welcome step by Trump, albeit a bit unexpected; as recently
as Tuesday, Health and Human Services Secretary Tom Price said Trump
would not make the emergency declaration because it was unnecessary.
But as is so often the case with Trump, even sensible policy is
layered with impulsiveness, hypocrisy and a general sense of

The Christie-led commission offered recommendations that, not
surprisingly, mirror many of the things for which Christie has
advocated in New Jersey, including expanded treatment options,
prescription restraints and wider access to the overdose antidote
Narcan. There seems little reason to question the points of emphasis,
although there have been a few rough patches along the way, including
a mandate to limit initial opioid painkiller prescriptions to five
days that most physicians opposed.

Trump has praised the commission's work -- but on Tuesday talked of
tougher law enforcement and border walls, the kind of punitive
response largely at odds with commission views and Trump's own
campaign pledges of a more humanitarian approach to the crisis. There
was no initial discussion of following through on a national emergency
declaration. That's when Price seemingly felt obliged to downplay the

So who knows why Trump went ahead with the emergency order on
Thursday. Was it an off-the-cuff answer to a reporter's question that
he decided on a whim? Did Christie convince him? Did he give it any
thought at all?

We're thankful he made the decision. The emergency declaration may not
mean much in practical terms, but it does open up some doors for
targeted funding and waivers for relevant Medicaid regulations, for
instance. It also, importantly, highlights the scope and urgency of
the crisis. Overdose deaths are skyrocketing across the nation, and
New Jersey is a particular hot spot.

But we can't help wondering just how this apparently aggressive effort
to combat opioid abuse fits with the broader GOP notion of gutting
health care across the board -- including the Medicaid program, which
provides much of the assistance for opioid addiction. Is government
really going to zero in on this one particular public-health crisis
while creating countless others?

The GOP's stated goal for health care reform is to reduce premiums --
but for whom? The well-heeled who already have quality health
insurance? Of course premiums will drop for some people if insurers
don't have to cover much of anything. Those who need more coverage,
however, will face steeper costs -- if they can get any coverage at
all. Republicans want to cut taxes on the wealthy; that's a given for
most any of their policy efforts. Beyond that, most seem to care
little about the damage they'll create with their vision of an
Obamacare replacement, although some with a conscience have managed to
curtail the effort to date.

Trump, meanwhile, appears to have no interest at all in the details of
repealing and replacing Obamacare. His campaign pledges about
protecting certain services have long ago been tossed aside and
forgotten. He scolds congressional leaders and tweets out directives
to "get the job done" as if all that matters is striking any deal at
all that will allow him to claim victory and move on. Trump's idea of
leadership on this issue amounts to a coach's pep talk with no
strategical ideas in support.

But yet he's going to fix the opioid crisis, which he said with
typically blustery Trumpian language had reached a level "the likes of
which we've never seen?" But why should we trust that there will be
any meaningful action beyond this? We certainly can't expect much
inspiration from the White House.

Trump's supporters like to rationalize the president's whims by
talking about learning curves and differing presidential styles.
Trump, however, is loath admit any weaknesses. A leader who refuses to
acknowledge he has a lot to learn is dangerous. The health care
blundering is bad enough. But we certainly can't afford him stumbling
his way through diplomatic efforts with a volatile North Korean
dictatorship beating its nuclear drums.

Trump himself is our true national emergency.
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MAP posted-by: Matt