Biden's And Trump's Shortcomings Aside, Why Still Bernie? Part I

I have every intention of writing in Bernie's name in November. Why? He's the best man to be president. I don't vote against people; I vote for people. Bernie and his platform were right for 2016 and he and his platform are right for 2020. Watch the video above and maybe you will decide to write him in too.

Last week, HarrisX did a Medicare-for-All poll for The Hill. They found that 69% of registered voters support Medicare-for-All. That breaks down to 88% of Democrats, 68% of independent voters and 46% of Republicans. Gabriela Schulte wrote that "Progressive lawmakers have been pointing to the coronavirus crisis to make a case for the need for Medicare for All as millions of Americans are kicked off their employee-based health insurance due to the economic fallout of the pandemic. 'Crises are moments of opportunity for policy change,' Robert Griffin, Research Director of the Democracy Fund Voter Study Group, told Hill.TV... President and CEO of the Roosevelt Institute, Felicia Wong, believes support for Medicare for All will only grow amid the coronavirus crisis. 'These progressive policies have been popular for a long time. I think COVID-19 will make them more popular as it becomes clear just how fragile our American political economy really is,' Wong told Hill.TV."

Yesterday, Pramila Jayapal (D-WA)-- with 33 co-sponsors-- proposed the Medicare Crisis Program Act, which is meant to ensure that everyone has guaranteed access to health care during the COVID-19 pandemic, including the millions of Americans who have been thrown out of work and off their employer-related health insurance. The legislation would expand Medicare and Medicaid eligibility during the crisis, cap out-of-pocket costs for Medicare enrollees, and eliminate co-pays, coinsurance or deductibles for COVID-19 testing and related care. Pramila's office explained that "More than 26 million Americans have filed for unemployment in the last five weeks, and as a result many have lost their income and seen their health coverage disappear in the middle of a public health emergency. As COVID-19 continues to wreak havoc on our economy, it is estimated that up to 35 million Americans will lose their health coverage-- joining the roughly 30 million who were previously uninsured. By dramatically expanding the number of Americans eligible for Medicare and Medicaid-- two effective and efficient health insurance programs-- the Medicare Crisis Program Act would guarantee Americans have health care when it is needed the most."

In a written statement, Pramila noted that "Our nation’s for-profit, employment-based health care system did not make sense before COVID-19 struck, and it is proving dangerous and deadly during the crisis. Millions of Americans are losing their job and their health insurance at precisely the moment when we need everyone to be able to access care and treatment for illness. The Medicare Crisis Program Act would guarantee health care for millions of people struggling with the health and economic realities of the COVID-19 pandemic and protect Americans from outrageous out-of-pocket costs."

Her chief co-sponsor is Joe Kennedy (D-MA) and other members of Congress who have signed on are Earl Blumenauer (F-OR), Yvette Clarke (D-NY), Steve Cohen (D-TN), Debbie Dingell (D-MI), Mike Doyle (D-PA), Eliot Engel (D-NY), Adriano Espaillat (D-NY), Tulsi Gabbard (D-HI), Alcee Hastings (D-FL), Jahana Hayes (D-CT), Sheila Jackson Lee (D-TX), Ro Khanna (D-CA), Barbara Lee (D-CA), Alan Lowenthal (D-CA), James McGovern (D-MA), Grace Meng (D-NY), Grace Napolitano (D-CA), Joe Neguse (D-CO), Eleanor Holmes Norton (D-DC), Alexandria Ocasio-Cortez (D-NY), Ilhan Omar (D-MN), Chellie Pingree (D-ME), Ayanna Pressley (D-MA), Jamie Raskin (D-MD), Jan Schakowsky (D-IL), Darren Soto (D-FL), Mark Takano (D-CA), Rashida Tlaib (D-MI), Nydia Velázquez (D-NY), Juan Vargas (D-CA) and Peter Welch (D-VT). Not one Republican or Blue Dog is behind the bill.

Doctors Justin Lowenthal and Meenakshi Bewtra, co-chairs of the COVID-19 response taskforce and members of the national board of directors of Doctors for America, issued a statement on the proposed legislation yesterday: "Doctors for America and its 20,000 members nationwide have been on the frontlines of this pandemic and we commend Representatives Jayapal and Kennedy for including critical health and life-saving measures that aim to ensure increased availability and equitable distribution of PPE and other medical equipment for all frontline workers. We also know firsthand that COVID-19 has not merely caused-- but rather, exposed-- the deep and critical problems that our patients face in affordability, equity, and accessibility of their health care. We applaud this proposal for ensuring coverage, affordability, and access to health care for all of our patients during the COVID crisis, while illustrating one of several viable approaches for moving toward universal health care in the future. This crisis shows us that, as a nation, we are all in this together: We should all have access to PPE when caring for and serving others, and we should all have insurance coverage that does not disappear when you need it nor depend on your employment status during a pandemic."

I have no idea who Dr. William Haseltine favors for president. It's probably not Trump, though, as you might guess from the Fox News interview below. Haseltine is a scientist, biotech entrepreneur, author and current chair and president of the global health think tank ACCESS Health International. He is also the chair of the U.S.-China Health Summit and was in Wuhan last November just before the outbreak there emerged. This is an OpEd about healthcare for all in The Hill yesterday.

Each day a new story of crowded hospital corridors and exhausted health care workers appears in our newspapers. But another story, equally tragic, is unfolding in the privacy of our homes. Countless Americans with chronic conditions and other serious illnesses languish in isolation without access to care. While hospitals have of course remained open for urgent care, patients with less critical needs have been relegated almost entirely to virtual visits.

Many without illness are able to cope, but countless families have been permanently broken by the hospital closures. Take, for example, the blood cancer patient in Philadelphia who was desperately in need of chemotherapy. Unfortunately, blood supplies had been rationed for COVID-19 patients and the patient couldn’t get enough transfusions to allow his chemotherapy to begin. His clinic visits were cancelled, his condition worsened and by the middle of April, he had passed away, a death expedited by COVID-19.

Stories like this are just the tip of the iceberg. Doctors across the country have been reporting concerning trends among patients, with many delaying much-needed care because of concerns about contracting COVID-19 during an emergency room visit. A survey of nine major hospitals published earlier this month in the Journal of the American College of Cardiology found that the number of patients presenting with severe heart attacks had dropped by nearly 40 percent since March. Vaccinations and well-child visits have seen a similar deterioration, with millions of children now at greater risk of infection of other preventable diseases due to the stark decline.

All of this reinforces the undeniable fact that the first facilities to reopen in our communities must be our hospitals. The Centers for Medicare & Medicaid Services (CMS) recently released guidance for reopening health care facilities for non-emergent cases, but the advice included is vague at best. While it has recommendations for testing and screening of both patients and providers, it gives no concrete advice on how often to screen each group or what to do if a health care provider tests positive.

Guidance from state departments of health is equally inadequate and, in some cases, downright dangerous. Some in the hardest hit areas suggest that health care professionals can return to work after testing positive for COVID-19, assuming they have been symptom free for just three days and seven days have passed since their symptoms first developed. This despite the fact that studies have shown that some people may be infectious for up to ten days after obvious symptoms have resolved.

In the absence of more careful guidance, many medical centers have developed their own more stringent guidelines. In addition to designing their own strategies to protect health care workers, hospitals are also crafting their own plans to protect patients. Some hospital systems have created broad networks of ambulatory care centers that operate as outpatient facilities. Many hospital administrators think their best bet may be to funnel patients suspected of COVID-19 to the hospitals while maintaining a steady supply of high-quality services for non COVID-19 patients through the ambulatory care centers. This would keep hospital beds free for the worst COVID-19 patients and still provide high-quality care to other patients in need.

All of this extra effort will require additional resources, something that is becoming a pivotal challenge for all hospitals. Ever since facilities were forced to cancel these procedures to ramp up COVID-19 care, they have been hemorrhaging cash in extraordinary amounts. In New York State alone, one of the Buffalo region’s smallest hospitals has said it is losing roughly $1 million each month. In New York City, some of the major medical centers are losing as much as $450 million.

The only way these hospitals can survive is with an immediate infusion of money. True, there are some large hospitals with generous endowment funds that may be able to make it through the crisis without outside support. But smaller hospitals in rural communities and many safety net hospitals in larger cities are running out of cash already. We cannot charge patients more for the care they are receiving. A recent poll suggests that one in seven Americans avoid seeking care because of the financial burden and potential cost.

The onus is on our government to step in and support our hospitals as they reopen fully. It is quite simply a matter of life and death, not convenience or economic recovery.

 

After Insisting "No Quid Pro Quo," Texas House Speaker Dennis Bonnen Finally Announced He's Retiring

Lt Gov. Dan Patrick, Gov. Greg Abbott, Speaker Dennis Bonnen

You probably read the Dennis Bonnen, the Speaker of Texas' House of Representatives, announced yesterday that not running for reelection to the state legislature. The 47 year old Rep, first elected in 1996, is embroiled in an internal GOP scandal between the two factions in the state party. Bonnen is a pretty typical mainstream Republican-- racist, homophobic and conservative without being a bona fide Nazi. The other faction are the Nazis, although the members he was targeting were moderates. He had just been elected Speaker, unanimously, in January.

He represents coastal HD-25 south and west of Houston, between Galveston and Corpus Christi, neither of which is in the district. The main cities are Freeport, Angleton, Lake Jackson and Bay City and the district is primarily a large chunk of Brazoria County with all of Matagorda County. Half the district is in the 14th congressional district (Randy Weber, R+12) and the other half is in the 27th congressional district (Michael Cloud, R+13). This isn't the part of Texas that is changing and becoming more moderate; Trump won the district with around 60%. HD-25 is 54.6% white.

“After much prayer, consultation, and thoughtful consideration with my family, it is clear that I can no longer seek re-election as State Representative of District 25, and subsequently, as Speaker of the House,” Bonnen said in a statement, which included a list of 43 House Republicans-- a majority of the House GOP Caucus-- that the speaker said "have made clear that it is in the best interest of both myself and the House to move on." (Bonnen's own brother, Greg Bonnen of Friendswood, was among those on the list.)

Bonnen’s political future was first called into question in late July, when hardline conservative activist Michael Quinn Sullivan, who heads the group Empower Texans, revealed that Sullivan, Bonnen and one of the speaker’s top allies had met at the Texas Capitol the month before. At that meeting, Sullivan alleged, Bonnen and state Rep. Dustin Burrows, R-Lubbock, suggested Empower Texans go after a list of 10 House Republicans and told Sullivan his group could have media access to the lower chamber in 2021. Bonnen also disparaged multiple Democrats, calling one “vile” and another “a piece of shit," and said his goal for the next legislative session is to make it the worst "in the history of the legislature for cities and counties."





A majority of members were at first unsure of what to think about the allegations, given that Sullivan was a longtime critic of House leadership and that their new speaker had overseen a legislative session that was hailed largely as a success. The allegation that Bonnen had planned to politically target members from his own party also seemed to contrast what he had announced on the last day of the session: If an incumbent targeted another colleague, regardless of party, there would be consequences.

But that uncertainty disappeared for a lot of members last week, when Sullivan released his secret recording of that June 12 meeting that largely confirmed his allegations against the speaker. Bonnen, in response, said he did nothing criminally wrong-- a nod to the current criminal investigation into the matter by the Texas Rangers-- and insisted the 150-member “House can finally move on.”

Since then, a growing number of Republicans-- and Democrats, too-- have called on the speaker to resign, arguing that the damage done by Bonnen is beyond repair. After the House GOP Caucus met Friday and released a statement condemning both Bonnen and Burrows for their remarks, the speaker’s biggest blow politically came Monday night, when five of the chamber’s most influential Republicans announced they could no longer support Bonnen for the post

By Tuesday morning, over 30 House Republicans had either called for the speaker’s resignation or had pulled support for the speaker.

After the speaker's announcement Tuesday, Sullivan tweeted that it Bonnen "could have behaved ethical"-- but "instead chose lies, deceit, dishonor, and ruin."

"He has gone from 3rd constitutional officer in Texas to a cautionary tale," Sullivan said.

Bonnen's decision not to seek reelection means his seat in House District 25 will be open for the first time in over two decades. One Republican, emergency room nurse Rhonda Seth, was already running for the seat before Tuesday, aiming to take out Bonnen. The district in southeast Texas is solidly Republican.

With Bonnen's exit, members will be jockeying among one another to become the next speaker. That election officially won't happen until the next time the Legislature convenes, which is scheduled to happen in January 2021. In the meantime, if Bonnen remains in place until then, he can carry out typical interim duties, which include assigning issues for committees to study ahead of the next legislative session.

The race to replace Bonnen is coming ahead of a competitive election cycle for Republicans, who, after losing a dozen House seats to Democrats in 2018, are gearing up to hold onto their majority in the lower chamber. If Democrats were to flip nine seats and hold onto the dozen they picked up, they could be the party in power in the House and, consequentially, elect a member from their caucus to lead the lower chamber.

It's unclear what role-- if any-- Bonnen will play in 2020 in helping to hold onto the GOP seats. In July before Sullivan's allegations surfaced, Bonnen announced he had infused a new political action committee with $3 million to support House Republicans running for reelection. Since the speaker became engulfed with the drama though, some members have privately wondered whether Bonnen would be a help or hindrance to their fundraising efforts heading into the election cycle.

Democrats, for their part, cast Tuesday's news as a "a victory for transparency and accountability."

"Texans are tired of politicians, like Republican Speaker Bonnen, who use backroom deals, cover-ups and outright lies to pursue power over everything," said state party chair Gilberto Hinojosa in a statement. "Now more than ever, it is clear that only the election of Texas Democrats will return of ethics and good governance to our great state.”

Will Bernie Run In 2020?

Progressive Democrats by Nancy Ohanian

I went to the first convention of the burgeoning alternative music business way back in the late '70s. All of us at indie labels, indie radio, indie publications, etc, got to meet in person for the first time and share our passion nd ideas about a music scene that was starting too take root in the popular culture. It was small and focused and fun. Now, I really hate going to conventions. At Warner Bros we did them annually, often twice a year-- one for the domestic company and one for the international company-- and I revelled that upon retiring I would never have to go to one again. All those germs... all that drunken behavior... all that bullshit and pointless travel. So I never went to any for the netroots movement that I really knew I should have gone to. But last night I got home from Berniepalooza. I had a good time and it was small enough to not be overwhelming-- maybe 250 people-- and to not be obsessed with mass inebriation and mass germ attacks. And I got to meet people in person who I've been conspiring with for over a decade on progressive politics. One woman whose work I admire tremendously told me she's in her 40's and said she's been wanting to meet me in person for years so that she could thank me for something that happened to her when she was 17 years old at a Morrissey concert at Madison Square Garden. She had charged the stage and was being escorted out of the building by the police when I walked over and gave her a backstage pass so she could get back in. She's been grateful all these years.

The event itself was good. Meeting all those people was enough for me but some of the presentations were inspiring and elucidating. Some weren't. But my mood kept going up and down based on whether or not I felt I was getting signals that Bernie is running or not. Blue America was the first PAC to start raising money for his 2016 campaign--even before he announced back then-- and we're doing it again this cycle too (just tap the thermometer on the right). But I was positive he was running a few months ago and Berniepalooza left me unsure. I asked Jeff Weaver every time I saw him and he said "maybe" every time. He and his staff are working as though Bernie is 100% in but when you talk to them they say that what Bernie says in public-- he's 50% decided basically-- is exactly what he says in private: he's 50% decided. So one day I felt all the signals added up to 49% and I would get depressed and the next day it was 51% and I would be all elated. Look, I'm not going to last forever; I'm not young anymore and the sense of immortality I had when I was climbing Mt. Everest or horseback riding in the Afghanistan's trackless Hindu Kush is long gone. I just want to see one great president before I die. Don't we all get one? There's no rule that says we do, is there? I just want to see one-- not someone who's somewhat good and relatively great, like Obama, but one who's historically great and who moves the country forward, like FDR. That's not Amy Klobuchar or Michael Bloomberg or Kirsten Gillibrand. That's Bernie.

But, as it turns out, I didn't even have to venture up into the frozen tundra to "find out" the good news. The Associated Press' Steve Peoples had the scoop all along. Sanders, his headline blared, eyes 'bigger' 2020 bid despite some warning signs. Dateline Burlington. "An insurgent underdog no more," he wrote, "Vermont Sen. Bernie Sanders is laying the groundwork to launch a bigger presidential campaign than his first, as advisers predict he would open the 2020 Democratic presidential primary season as a political powerhouse." Whew. And then...

"A final decision has not been made, but those closest to the 77-year-old self-described democratic socialist suggest that neither age nor interest from a glut of progressive presidential prospects would dissuade him from undertaking a second shot at the presidency. And as Sanders’ brain trust gathered for a retreat in Vermont over the weekend, some spoke openly about a 2020 White House bid as if it was almost a foregone conclusion.

“This time, he starts off as a front-runner, or one of the front-runners,” Sanders’ 2016 campaign manager Jeff Weaver told The Associated Press, highlighting the senator’s proven ability to generate massive fundraising through small-dollar donations and his ready-made network of staff and volunteers.

Weaver added: “It’ll be a much bigger campaign if he runs again, in terms of the size of the operation.”

Amid the enthusiasm-- and there was plenty in Burlington as the Sanders Institute convened his celebrity supporters, former campaign staff and progressive policy leaders-- there were also signs of cracks in Sanders’ political base. His loyalists are sizing up a prospective 2020 Democratic field likely to feature a collection of ambitious liberal leaders-- and not the establishment-minded Hillary Clinton.

Instead, a new generation of outspoken Democrats such as Massachusetts Sen. Elizabeth Warren, New Jersey Sen. Cory Booker and California Sen. Kamala Harris are expected to seek the Democratic nomination. All three have embraced Sanders’ call for “Medicare for All” and a $15 minimum wage, among other policy priorities he helped bring into the Democratic mainstream in the Trump era.

Let me stop here for a minute. Elizabeth Warren-- yes. She's the real deal; a real progressive. Tried and true-- PROVEN. Filled with great ideas, if-- maybe-- not the easiest to elect. But Kamala and Cory. You know a progressive by their actions, not by their electoral positioning strategies. Maybe Cory and Kamala will turn out to be progressives. They could start being progressives for a few years, obliterating past mistakes and in a decade, maybe less, run for president as progressives. I'm open to it. But in 2020? Are you kidding? I'm glad they've learned to parrot Bernie and that they've decided to vote well. It means something that they both have ProgressivePunch "A"s and that for the current session Kamala scores 99.61 and Cory scores 97.29, sandwiching Bernie's 98.82. It means "something," but not enough. Slow down kids, you both have a lot to prove before you'll win my vote. And you can do it-- by doing it, not claiming you will do it. People reported that a "high-profile Sanders supporter who was in attendance, Cornel West, described the Vermont senator as 'the most consistently progressive one out there,' suggesting that some would-be 2020 candidates have adopted Sanders’ words, but maintained ties to Wall Street and 'militarism.'" BINGO!

Perhaps the most important member of Sanders’ network, wife Jane O’Meara Sanders, said Democrats may be embracing Sanders’ “bold progressive ideas” on health care and the economy in some cases, but there’s need to go further on issues like climate change, affordable housing and student debt.

Whether her husband will lead the debate as a presidential candidate in 2020, she said, remains unclear. O’Meara Sanders noted that one question above all others would guide their decision: “Who can beat Donald Trump?”

“That has to be the primary goal. To win. We think you win by a very strong progressive commitment,” she told AP. When asked if Sanders could win in 2020, she said “every single poll” showed that Sanders would have beaten Republican nominee Donald Trump two years ago.

...“It’s not about us,” O’Meara Sanders added. “It’s about what’s right for the country.”

Despite signs pointing to a 2020 run, Sanders has given himself a clear escape hatch.

Weaver, like Sanders himself in a recent interview, suggested that the senator would step aside if he believes another candidate has a better shot at denying Trump a second term. There are no clear indications from Sanders or those closest to him, however, that he currently has that belief.

“I know they haven’t announced, but it sort of seems like that’s what’s happening,” said John Cusack, another actor invited to the weekend summit. Asked about his preference for 2020, he called Sanders “the only real progressive candidate out there.”

“All of the sudden, what was once fringe politics is now mainstream. Don’t get me wrong, it’s great that (Texas congressman) Beto O’Rourke and all these young candidates are running on the People’s Summit and progressive movement platform, but let’s not forget who broke us through.”

“If he runs again, I’ll be on board,” Cusack said.

A word about Beto, since Cusack brought him up. Beto's a friend who I like a lot. Blue America backed him when he first ran for Congress and endorsed him against against Ted Cruz. And Beto is as progressive as they come on 3 issues: immigration, campaign finance reform and marijuana. Other than that... Beto never joined the Progressive Caucus. He joined the New Dems. His record in Congress was, at best, middling. It's great that he took on Cruz and did so well... and, perhaps (I think so) grew as a politician. But hie's no Bernie Sanders. He's been in Congress for 6 years. Go ahead and name an accomplishment or an initiative. His ProgressivePunch voting record, I'm sorry to say is an overall "F." Sorry to shatter any hallucinations. His lifetime crucial vote score-- 78.99. And this cycle... 67.65, pretty terrible, especially for someone representing a deep blue district (PVI D+17) where Obama won twice and where TRump's share of the 2016 general election vote was a miserable 27.2%.

How Senile Is Trump?

In the clip above, David Parkman makes the case that Trump, the oldest person to ever occupy the White House, may be suffering from Alzheimer's disease-- like his neo-Nazi father-- or some other form of dementia. Last week Sharon Begley posted a piece at STAT headlined Experts Say Trump's Deteriorating Speech Could Be Sign of Early Dementia. "STAT," she wrote, "asked experts to compare Trump's speech from decades ago to that in 2017. All noticed deterioration, which may signal changes in Trump's brain health." This is also the only plausible reason I can think of for why Trump has made himself so dependent on Ivanka and Kushner-in-law, who are hardly brain surgeons but are family members who he can count on to abide by the Code of Omertà.

It was the kind of utterance that makes professional transcribers question their career choice:

" … there is no collusion between certainly myself and my campaign, but I can always speak for myself-- and the Russians, zero."

When President Trump offered that response to a question at a press conference last week, it was the latest example of his tortured syntax, mid-thought changes of subject, and apparent trouble formulating complete sentences, let alone a coherent paragraph, in unscripted speech.

He was not always so linguistically challenged.

STAT reviewed decades of Trump's on-air interviews and compared them to Q&A sessions since his inauguration. The differences are striking and unmistakable.

Research has shown that changes in speaking style can result from cognitive decline. STAT therefore asked experts in neurolinguistics and cognitive assessment, as well as psychologists and psychiatrists, to compare Trump's speech from decades ago to that in 2017; they all agreed there had been a deterioration, and some said it could reflect changes in the health of Trump's brain.

In interviews Trump gave in the 1980s and 1990s (with Tom Brokaw, David Letterman, Oprah Winfrey, Charlie Rose, and others), he spoke articulately, used sophisticated vocabulary, inserted dependent clauses into his sentences without losing his train of thought, and strung together sentences into a polished paragraph, which-- and this is no mean feat-- would have scanned just fine in print. This was so even when reporters asked tough questions about, for instance, his divorce, his brush with bankruptcy, and why he doesn't build housing for working-class Americans.

Trump fluently peppered his answers with words and phrases such as "subsided," "inclination," "discredited," "sparring session," and "a certain innate intelligence." He tossed off well-turned sentences such as, "It could have been a contentious route," and, "These are the only casinos in the United States that are so rated." He even offered thoughtful, articulate aphorisms: "If you get into what's missing, you don't appreciate what you have," and, "Adversity is a very funny thing."

Now, Trump's vocabulary is simpler. He repeats himself over and over, and lurches from one subject to an unrelated one, as in this answer during an interview with the Associated Press last month:

"People want the border wall. My base definitely wants the border wall, my base really wants it-- you've been to many of the rallies. OK, the thing they want more than anything is the wall. My base, which is a big base; I think my base is 45 percent. You know, it's funny. The Democrats, they have a big advantage in the Electoral College. Big, big, big advantage. … The Electoral College is very difficult for a Republican to win, and I will tell you, the people want to see it. They want to see the wall."

For decades, studies have found that deterioration in the fluency, complexity, and vocabulary level of spontaneous speech can indicate slipping brain function due to normal aging or neurodegenerative disease. STAT and the experts therefore considered only unscripted utterances, not planned speeches and statements, since only the former tap the neural networks that offer a window into brain function.

The experts noted clear changes from Trump's unscripted answers 30 years ago to those in 2017, in some cases stark enough to raise questions about his brain health. They noted, however, that the same sort of linguistic decline can also reflect stress, frustration, anger, or just plain fatigue.

Ben Michaelis, a psychologist in New York City, performed cognitive assessments at the behest of the New York Supreme Court and criminal courts and taught the technique at a hospital and university. "There are clearly some changes in Trump as a speaker" since the 1980s, said Michaelis, who does not support Trump, including a "clear reduction in linguistic sophistication over time," with "simpler word choices and sentence structure. … In fairness to Trump, he's 70, so some decline in his cognitive functioning over time would be expected."



Some sentences, or partial sentences, would, if written, make a second-grade teacher despair. "We'll do some questions, unless you have enough questions," Trump told a February press conference. And last week, he told NBC's Lester Holt, "When I did this now I said, I probably, maybe will confuse people, maybe I'll expand that, you know, lengthen the time because it should be over with, in my opinion, should have been over with a long time ago."

Other sentences are missing words. Again, from the AP: "If they don't treat fairly, I am terminating NAFTA," and, "I don't support or unsupport"-- leaving out a "me" in the first and an "it" (or more specific noun) in the second. Other sentences simply don't track: "From the time I took office til now, you know, it's a very exact thing. It's not like generalities."

There are numerous contrasting examples from decades ago, including this - with sophisticated grammar and syntax, and a coherent paragraph-length chain of thought-- from a 1992 Charlie Rose interview: "Ross Perot, he made some monumental mistakes. Had he not dropped out of the election, had he not made the gaffes about the watch dogs and the guard dogs, if he didn't have three or four bad days-- and they were real bad days-- he could have conceivably won this crazy election."

The change in linguistic facility could be strategic; maybe Trump thinks his supporters like to hear him speak simply and with more passion than proper syntax. "He may be using it as a strategy to appeal to certain types of people," said Michaelis. But linguistic decline is also obvious in two interviews with David Letterman, in 1988 and 2013, presumably with much the same kind of audience. In the first, Trump threw around words such as "aesthetically" and "precarious," and used long, complex sentences. In the second, he used simpler speech patterns, few polysyllabic words, and noticeably more fillers such as "uh" and "I mean."

The reason linguistic and cognitive decline often go hand in hand, studies show, is that fluency reflects the performance of the brain's prefrontal cortex, the seat of higher-order cognitive functions such as working memory, judgment, understanding, and planning, as well as the temporal lobe, which searches for and retrieves the right words from memory. Neurologists therefore use tests of verbal fluency, and especially how it has changed over time, to assess cognitive status.

Those tests ask, for instance, how many words beginning with W a patient can list, and how many breeds of dogs he can name, rather than have patients speak spontaneously. The latter "is too hard to score," said neuropsychologist Sterling Johnson, of the University of Wisconsin, who studies brain function in Alzheimer's disease. "But everyday speech is definitely a way of measuring cognitive decline. If people are noticing [a change in Trump's language agility], that's meaningful."

Although neither Johnson nor other experts STAT consulted said the apparent loss of linguistic fluency was unambiguous evidence of mental decline, most thought something was going on.

John Montgomery, a psychologist in New York City and adjunct professor at New York University, said "it's hard to say definitively without rigorous testing" of Trump's speaking patterns, "but I think it's pretty safe to say that Trump has had significant cognitive decline over the years."

No one observing Trump from afar, though, can tell whether that's "an indication of dementia, of normal cognitive decline that many people experience as they age, or whether it's due to other factors" such as stress and emotional upheaval, said Montgomery, who is not a Trump supporter.

Even a Trump supporter saw and heard striking differences between interviews from the 1980s and 1990s and those of 2017, however. "I can see what people are responding to," said Dr. Robert Pyles, a psychiatrist in suburban Boston. He heard "a difference in tone and pace. … What I did not detect was any gaps in mentation or meaning. I don't see any clear evidence of neurological or cognitive dysfunction."

Johnson cautioned that language can deteriorate for other reasons. "His language difficulties could be due to the immense pressure he's under, or to annoyance that things aren't going right and that there are all these scandals," he said. "It could also be due to a neurodegenerative disease or the normal cognitive decline that comes with aging." Trump will be 71 next month.

Northwestern University psychology professor Dan McAdams, a critic of Trump who has inferred his psychological makeup from his public behavior, said any cognitive decline in the president might reflect normal aging and not dementia. "Research shows that virtually nobody is as sharp at age 70 as they were at age 40," he said. "A wide range of cognitive functions, including verbal fluency, begin to decline long before we hit retirement age. So, no surprise here."

Researchers have used neurolinguistics analysis of past presidents to detect, retrospectively, early Alzheimer's disease. In a famous 2015 study, scientists at Arizona State University evaluated how Presidents Ronald Reagan and George H.W. Bush spoke at their news conferences. Reagan's speech was riddled with indefinite nouns (something, anything), "low imageability" verbs (have, go, get), incomplete sentences, limited vocabulary, simple grammar, and fillers (well, basically, um, ah, so)-- all characteristic of cognitive problems. That suggested Reagan's brain was slipping just a few years into his 1981-1989 tenure; that decline continued. He was diagnosed with Alzheimer's disease in 1994. Bush showed no linguistic deterioration; he remained mentally sharp throughout his 1989-1993 tenure and beyond.