An Open Letter to Donald Trump About Health Care – The New York Times

 

 

In today’s New York Times, David Leonhardt wrote an Op-Ed consisting of an Open Letter to Donald Trump which I consider a model for how to press for action in a manner consistent with the ideas of TrumpLemonade.

He began by pointing out that in the past Trump had advocated for Universal Healthcare. He writes to Trump in the context of some of the appointments Trump has put forward of people who have views favoring a contraction of healthcare and thus antithetical to the view that Trump once expressed.  Leonhardt could have criticized Trump for “flip-flopping” or could have called him a hypocrite.  But doing so would have been counterproductive. So, in his letter, Leonhardt writes as follows:

I am writing to you now because I am concerned that Republicans in Congress do not share your goal and are not giving you good advice on this issue. I’m worried that they are not acting in the best interests of your presidency or the country. I encourage you to be skeptical of them.

Consider Leonhardt’s tactics.  He communicates that it is the congressional Republicans who are the source of the problem rather than Trump himself.


TACTIC-01: LET TRUMP FEEL THAT IT IS NOT HIS FAULT.  THAT IS A STANCE THAT TRUMP USUALLY TAKES, SHIFTING THE BLAME FOR HIS ACTIONS TO SOMEONE ELSE.  USING THIS TACTIC MAKES TRUMP FEEL YOU ARE WITH HIM AND NOT AGAINST HIM.  HE WANTS EVERYONE TO AGREE WITH HIM.  IT DOES NOT COST LEONHARDT ANYTHING TO GIVE THIS TO TRUMP.


 

Leonhardt reminds Trump that he (Leonhardt) is cognizant of Trump’s goal (Universal healthcare) and warns Trump to be careful of the congressional republicans who do not share Trump’s goal.


TACTIC-02: EXPRESS CONCERN FOR TRUMP’S BEST INTERESTS.  LEONHARDT  IS COMMUNICATING THE FOLLOWING MESSAGE: “I AM NOT JUST COMPLAINING ABOUT YOUR ACTIONS.  I AM OFFERING YOU HELPFUL ADVICE.


Leonhardt encourages Trump to use his ability to recognize the difference between good and bad advice.

He then continues:

It is entirely possible for you to sign a conservative health care bill that lives up to your belief in universal coverage. It’s a bill that you could celebrate as a replacement of Obamacare. But it would be quite different from the bills that congressional Republicans are pushing.

Leonhardt frames Trump’s goal as consistent with his commitment to a conservative position while at the same time remaining consistent with his value of universal health coverage.  Whether Leonhardt really believes that Trump holds any particular values is not the issue.  As a tactic, Leonhard’s flattery of Trump for supposedly holding a belief that is important to him is a good choice – one that has a better chance of moving Trump where Leonhardt wants him to move than criticizing Trump for his actions.


TACTIC-03: USE FLATTERY WITH TRUMP.  TRUMP LOVES TO BE FLATTERED.  BUT TIE THAT FLATTERY TO A MATTER THAT CAN BE CONSIDERED SUBSTANTIAL: HOLDING A BELIEF THAT GUIDES HIS ACTIONS. THE BELIEF THAT IS MENTIONED IS RELATED TO A GOAL SHARED BY LEONHARDT AND SUPPOSEDLY BY TRUMP AS WELL.


Leonhardt also frames the action he wants Trump to take as one that would allow Trump to “celebrate” an accomplishment that fulfills one of his campaign promises (replacing Obamacare.)

Leonhardt goes on to describe how congressional Republicans want to engage in bait and switch tactics so that they can repeal Obamacare and delay indefinitely implementing a new program that will replace it. Leonhardt says that

When they claim that their bills will not take health insurance away from millions of people, they’re engaging in magical thinking. They are trying to fool the media, voters and you.

Again, Leonhardt uses implied flattery.  (TACTIC-03). When he includes Trump in the collection of entities that the Republicans are trying to fool, he wants Trump to think “well maybe they can fool the media and the voters but they can’t fool me!”  After all, Trump has told us “I have, like, a very smart brain.”  A brain too smart to be fooled by the people who might be able to fool all those others who aren’t “as smart as I am.”

Leonhardt continues:

But they do not have a realistic plan, despite years of talk. Nor, to be blunt, does your choice for secretary of health and human services, who is one of those congressional Republicans.


TACTIC-04  COMMUNICATE THAT YOU ARE LAYING YOUR CARDS ON THE TABLE.  BY USING THE PHRASE “TO BE BLUNT” LEONHARDT IS SAYING THAT HE IS NOT JUST GOING TO FLATTER TRUMP BUT WHEN THE TIME IS APPROPRIATE, HE IS GOING TO CRITICIZE HIM AS WELL.  SO DESPITE HAVING SAID FLATTERING THINGS PREVIOUSLY, LEONHARDT IS NOW SAYING THE “HARSH TRUTH” (I.E. YOU MADE A POOR CHOICE FOR SECRETARY OF HEALTH AND HUMAN SERVICES.) IF YOU ONLY SAY FLATTERING THINGS YOU WILL NOT BE TAKEN SERIOUSLY.  YOU WILL BE A “YES MAN” RATHER THAN A PERSON WHO CAN “SPEAK TRUTH TO POWER”.


And a repeal is likely to undermine insurance markets long before its effective date.

Next, Leonhardt appeals to Trump’s self-image as a savvy businessman.

Mr. President-elect, you are a businessman. You understand that savvy executives don’t simply live in the present. They look to the future. They’re fond of quoting Wayne Gretzky: “Skate to where the puck is going, not where it has been.

Leonhardt reminds Trump that Leonhardt agrees that Trump is a savvy businessman and as a savvy businessman Trump understands how insurance markets work and why insurance executives will make decisions based on the future.


TACTIC-05 REMIND TRUMP OF ASPECTS OF HIS SELF-IMAGE THAT ARE IMPORTANT TO HIM. LEONHARDT USES SEVERAL ASPECTS OF TRUMP’S SELF-IMAGE THAT TRUMP, IN HIS PUBLIC STATEMENTS, HAS COMMUNICATED ARE IMPORTANT TO HIM.  TRUMP HAS FREQUENTLY MENTIONED THAT HE IS A SAVVY BUSINESSMAN WHO KNOWS HOW TO MAKE DEALS.  TRUMP HAS ALSO INDICATED THAT HE ENJOYS BEING SURROUNDED BY SPORTS LEGENDS (THINK BOBBY KNIGHT AND TOM BRADY). SO NOW LEONHARDT BRINGS UP LEGENDARY HOCKEY PLAYER GRETZKY WHO HAS PROMULGATED A STRATEGY THAT GRETZKY USED TO BE SUCH A START PLAYER.  CLEARLY TRUMP WILL NOT WANT TO ESCHEW SUCH A WINNING STRATEGY.


Leonhardt is prodding Trump to avoid looking foolish when things don’t pan out in the future.  And to top it off, he uses an appeal to example of a sports legend, Wayne Gretzky who is smart enough to be aware of the insurance executives’ strategy.  Surely Trump who wants to be admitted to the fraternity of sports stars will want to avoid making a mistake that a savvy athlete would avoid.

Then, Leonhardt suggests that congressional Republicans are using Trump for their own ends.

As you know, the Republican leaders in Congress have never been your biggest fans. I think it’s fair to say that they care more about being able to brag that they got rid of Obamacare than about your political standing. The bills they are considering threaten your standing.

If Trump could be persuaded that this is the case, he would want to avoid being a chump  (TACTIC-05) a trait that is inconsistent with his self-image (i.e. someone who has been taken advantage of).  Allowing Republicans to take advantage of him would mean that they got the better deal – anathema to the ultimate dealmaker!

Next he offers Trump some advice.

But you have alternatives.

The crucial first step is to avoid repealing the insurance expansion without simultaneously replacing it. The new Congress comes to Washington next week, and its members should know where you stand from the beginning. It won’t work to promise millions of people health insurance on spec.

If you avoid this trap, you can then push both parties toward a different version of universal health coverage.


TACTIC-06 ADVOCATE A BIPARTISAN SOLUTION. USE A GOAL THAT BOTH PARTIES COULD SHARE. OF COURSE, ARRIVING AT A COMPROMISE ACCEPTABLE TO EACH SIDE WOULD REQUIRE SKILLFUL NEGOTIATION AND MEDIATION.  BUT THAT IS WHAT TRUMP BELIEVES IS AN IMPORTANT COMPONENT OF HIS SKILLSET. AND IF HE WERE TO SUCCEED IN FINDING AN AREA OF BIPARTISAN AGREEMENT, HE COULD USE THAT AS A PRECEDENT FOR BUILDING OTHER FUTURE AGREEMENTS.


Leonhardt is communicating that he is trying to be helpful to Trump and wants Trump to succeed. He points out features of the plan that Trump might like.

That deal could give states more flexibility to meet the top-line coverage goals. It could rely more heavily on subsidies to bring healthy people into the market — and ultimately scrap the mandate. It could permit insurers to charge young people less (and older people more). It could create incentives for personal responsibility, allowing higher prices for people who have voluntarily gone without insurance.

Leonhardt communicates that he is willing to give Trump advice even though some of what he is advising goes against the things that Leonhardt would like to see (TACTIC-04).

I will be honest that I do not favor some of these ideas and worry that they would cause hardships. But I was not elected president, and you were. And all of these ideas are within the realm of serious debate about our healthcare system.


 TACTIC-07 COMMUNICATE THAT YOU TOO HAVE “SKIN IN THE GAME”. LEONHARDT NOTES THAT WHAT HE WANTS TRUMP TO DO IS NOT COMPLETELY TO HIS LIKING AND THAT THE CONSTITUENCY HE IS FIGHTING FOR WILL LOSE SOME THINGS IF TRUMP FOLLOWS LEONHARDT’S ADVICE.  


Leonhardt is communicating that despite not wanting to see Trump elected, he accepts the outcome and feels compelled to work to make Lemonade from Trump’s lemons.


 TACTIC-08  ACCEPT THE OUTCOME OF THE ELECTION.  LEONHARDT IS CLEAR THAT TRUMP’S ELECTION IS NOT THE OUTCOME HE WANTED BUT DESPITE THAT, HE ACCEPTS THE OUTCOME. IF YOU CONSTANTLY CHALLENGE THE OUTCOME OF THE ELECTION IT IS AN INVITATION TO HEIGHTEN THE COMPETITIVENESS OF THE RELATIONSHIP BETWEEN GROUPS.


 Leonhardt’s letter is a good example of an alternative to simply resisting and opposing anything Trump and the Republicans propose.  It is consistent with ideas of trying to initiate a cooperative process between social groups who strongly hold differing positions.  Maybe it can work and maybe it can’t.  But it is worth a try.

Source: A Letter to Donald Trump About Health Care – The New York Times

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