Trumpcare, Mental Health, and the Goldwater Rule

Content Note: Ableism, Healthcare, Politics, Trump, Mental Health

Senator Susan Collins, a white woman with short red hair wearing a dark blazer, white blouse, and pearls, stands in front of an American flag background. Keyword: Goldwater Rule

Image Description: Senator Susan Collins, a white woman with short red hair wearing a dark blazer, white blouse, and pearls, stands in front of an American flag background.

Back to politics today for  a moment…because there’s something I want to say, and because I’m struggling with something about Donald Trump and the Goldwater Rule.

First, I feel like I need to give credit where it’s due. Although I have Republican friends that I cherish in spite of our differences in opinion, regular readers know that as a group I’m hard on them. I’ve called them out, sometimes by  name (some have told me unfairly.) I don’t believe that I’ve been off-base.

But I also believe in giving credit where it’s due. So, to Senator Susan Collins of Maine and Senator Lisa Murkowski of Alaska, who’ve stood firm in this round of Obamacare repeal deliberations that what’s been included in the proposed repeal scenarios are not good for their constituents, despite bullying from Donald Trump, thank you. Thank you on behalf of my disabled American friends, and the children, families and elderly people of America that not only depend on Medicaid to keep them happy and healthy, but depend on it to keep them alive. Thank you for insisting that America be a country where everyone is taken care of. Your integrity and courage give me hope.

Senator Lisa Murkowski of Alaska, a white woman with short blonde hair wearing a red blazer, a write blouse, and a pendant on a chain, stands in front of some trees. Keyword: Goldwater Rule

Image Description:  Senator Lisa Murkowski of Alaska, a white woman with short blonde hair wearing a red blazer, a write blouse, and a pendant on a chain, stands in front of some trees.

Thank you also to John McCain, a man with whom I’ve definitely had my disagreements, who came to Washington in spite of his cancer diagnosis, right after brain surgery, speaking eloquently about bipartisanship and the need to work together to craft a plan for healthcare, pushing himself through the week and into the early hours of the morning last Friday night to cast the vote that brought down Trumpcare. Sir, I salute you.

Senator John McCain, a white male in his 70s with white hair wearing a navy blazer and blue dress shirt. stands against an American flag background Keyword: Goldwater Rule
MESA, AZ – June 4: Senator John McCain (R – AZ) appears at a town hall meeting on June 4, 2010 in Mesa, Arizona.

Image Description: Senator John McCain, a white male in his 70s with white hair wearing a navy blazer and blue dress shirt. stands against an American flag background.

I won’t ever forget what the three of you have done for my American friends.

And to the rest of GOP who are struggling with the idea of single-payer as an idea for health care in the US…on one level, I get it.

Didn’t think I’d say that, did you? Well, I’m nothing if not practical. Single-payer isn’t a perfect system. Not by a long shot. Are there wait times? There can be, for non-emergency issues especially. Is it bureaucracy-heavy? Not any more than the bureaucracy created by the American system having to deal with many insurance plans, I’d argue, but I could be wrong. But even though I waited a couple of months for the functional MRI that the AVM Clinic at Toronto Western Hospital needed to decide how to best treat my AVM, I didn’t have to worry about whether my family could afford to have one of the best neurosurgeons in North America specializing in AVM treatment rooting around in my head for 14 hours.

Take our system and make *your* single-payer system better. Show us up. In fact (if it’ll get you moving on this), I’ll bet that you can’t do it. Go ahead and prove me wrong.

Please! 🙂

***

Now…why I’m struggling.

Donald Trump, Mental Health, and the Goldwater Rule

Last week, two friends who work in the mental health field, for whom I have a great deal of respect, said that despite their concerns about the Goldwater Rule, they firmly believe Donald Trump has a mental health condition and needs evaluation to determine whether he’s psychologically healthy enough to continue on as President. The American Psychoanalytic Association officially said recently that members shouldn’t feel restricted by the the Goldwater Rule when discussing Trump.

This is a tough one for me. I don’t like Trump at all, simply because I don’t tend to like people that are lying, arrogant bullies.  But I’ve fought hard against the idea that he’s unfit for office because he’s “crazy” because:

  • Even the most qualified mental health diagnostician would need time and access to Trump to make an accurate diagnosis
  • If the policy is that a clean bill of mental health is required to be the President, then Presidents as far back as Lincoln have been in violation
  • It’s ableist. There’s no reason that a President with a well-managed mental health condition should be treated any differently, in terms of perception of ability to govern, than a President with any other sort of well-managed condition.

And I think that ultimately I still believe that the Goldwater Rule should apply to the position of the President, provided that some other safeguards are put in place (because we do know that Presidents have had mental health conditions, and even degenerative brain conditions, that went largely unnoticed while they were in office):

  • Any President (not just Donald Trump) gets his or her mental health evaluated by an independent mental health practitioner on a regular basis. (I don’t know if this happens, or how often.) The Presidency is an extremely high-stress job, and it’s not unreasonable to periodically check at the very least whether that stress is having an adverse affect on the President’s well-being.
  • Concerns about the President’s mental health are treated like concerns about the President’s physical health – they are quickly, and thoroughly evaluated and, if necessary, treated. The President takes time off work if necessary, but the assumption is that he or she will be able to return to work, and that it will happen as soon as possible. The public is entitled to no more information than it would be if the President had a physical issue.

In other words: If the White House properly monitored the President for mental health conditions and ensured that if there were any conditions that were affecting the President so much that they interfered with his or her ability to govern that the President took time off (if necessary) and received the treatment and education needed to ensure that the condition was well-managed and no longer an issue…then I’d continue to stand on the Goldwater Rule and say, “It isn’t up to people who’ve never spoken to President to make a diagnosis. It’s up to the White House.”

But I don’t have that confidence in this White House. They can’t even make Donald Trump stop using his phone. They’re not going to convince him to let someone do even a simple mental health evaluation, or start treatment if that was deemed necessary – and Donald Trump is not a man that would step down. Not for the good of his health. Not even, I don’t think, for the good of his country.

So, I Struggle…

I’ve struggled as I’ve watched mental health diagnosticians openly break the Goldwater Rule since Trump’s election with their pronouncements in the media that he’s got any number of mental health conditions.

I struggle now, wondering if they were right to break the Goldwater Rule the way they did.

I don’t think that a mental health condition should automatically disqualify anyone from any job – I know too many people with well-managed mental health conditions that are in high-stress positions and that do an excellent job. But, like my friend said:

Whether someone agrees or disagrees with the content of his inflammatory statements, that is not the issue. This is not a matter of attributing mental illness because of disagreement with his views/statements. If you go back and view interviews with him from decades ago, he’s still the same big jerk, but his behavior has changed.”

It’s one thing to be a seventy-year-old civilian man with no insight into behaviour change and perhaps the need for help, and with apparently no one around you who will call you on that blind spot. It’s quite another thing when you’re the most powerful man in the world.

I think I know now where I land on this. If the White House won’t take action when there are indicators that the President needs treatment for a mental health condition, other people with experience and knowledge in the field of mental health need to be allowed to speak without fear of what it could cost them. It’s ableism to say, “People with a mental health condition can’t be President,” but it’s not ableism to expect Presidents that do have mental health conditions to work with their staff and medical team to manage those conditions so that their ability to govern isn’t affected.

To be clear:  Mental health professionals who are worried that Donald Trump isn’t competent to lead need the freedom to speak about it. Someone has to.

 

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