Most of Donald Trump’s success in politics has stemmed from his reputation as a savvy dealmaker. But in his 11 years on the national political scene, that has been exposed as a fiction — a persona invented by Tony Schwartz, the ghostwriter for the president’s bestselling book “The Art of The Deal,” who followed him around for 18 months and realized in the process that no one would want to read a book about the real Trump.
After Trump announced his run for president in 2015, Schwartz told the New Yorker’s Jane Mayer he felt deep remorse for creating this erroneous image of Trump, saying if he wrote the book today, he would call it “The Sociopath.” He said, “I genuinely believe that if Trump wins and gets the nuclear codes, there is an excellent possibility it will lead to the end of civilization.”
His words were startling, to say the least, but Schwartz’s description of the president’s true personality was revelatory. The man who touted himself as the world’s greatest dealmaker was a pathologically dishonest hype artist with the attention span of a four-year-old, described by Schwartz as having “a stunning level of superficial knowledge and plain ignorance” who seemed “driven entirely by a need for public attention.” His alleged negotiation prowess was actually nonexistent, as the multiple failures of his businesses should have made clear.
In Trump’s first administration, it became obvious that his idea of dealmaking consisted of willingly succumbing to flattery by malevolent actors and ineffectually bellowing at allies. Professional diplomatic and national security advisers managed to steer him away from most disasters, although he commonly embarrassed the nation on the world stage by displaying his ignorance and fondness for sucking up to adversaries.
Trump’s second term is a whole other story.
The president has confused his “Art of the Deal” with the art of diplomacy, and they are most definitely not the same thing. Even if he were actually talented at the former, which he is not, it would have no bearing on the latter, and the consequences of that are turning out to be substantial and damaging. By this point, it’s a cliché that Trump is “transactional,” which many (if not most) people understand to mean he is negotiating on behalf of the American people, bringing riches and security to the nation. In reality, Trump’s often self-serving deals are gravely harming the national interest.
Credibility is everything for a country like the United States, and now, without it, we are unleashing powerful forces that will be very hard to control.
Diplomacy isn’t just signing a particular agreement between two countries. That may be the culmination of negotiations or just the beginning, but it isn’t actually the goal, especially for a superpower. The aim is to manage relations between countries over the long term to maintain stability and predictability; it’s not a “winner take all” proposition. Credibility is everything for a country like the United States, and now, without it, we are unleashing powerful forces that will be very hard to control.
Trump is a pathological liar. Schwartz discovered that from the very beginning. He was attached to Trump at the hip for many months, listening in on every phone call, observing his conversations and racking his brain to figure out how to present the man as a lovable rogue rather than the damaged personality he really is. The whole world has seen this up close for the past decade.
At first, allies depended upon the professional diplomatic and national security apparatus to continue to run things in spite of Trump’s erratic behavior and belligerence. They understood early on he loved pomp and circumstance, and that he was easily flattered by obsequious compliments, so they played along, giving him the pageantry of over-the-top state visits and paying homage to him at his properties and the White House. But for the most part, they were just trying to wait out the term, expecting that the American people would realize the error of their ways and revert to being a serious nation.
This time around is different. A recent report in the Washington Post by Steve Hendrix and Anthony Faiola revealed that the world is no longer taking the U.S. seriously, leaving the government with no credibility. As a result, international relations are unstable and dangerous.
When Trump regained office the second time, the world quaked at his swagger, backed up by a bizarre tariff regime that seemed to be put together by Mad Libs. The markets dropped, recriminations flowed, and it looked as if Trump had finally been completely unleashed. To some extent, he had been. He and his close circle had decided to do whatever they wanted and see what they could get away with. But it soon became evident there wasn’t really any strategy or even any particular goals, despite the apparent participation of people like Elon Musk and the authors of Project 2025. In the end, it was all about Trump’s whims, which changed from minute to minute.
The short attention span Schwartz described is now even more pronounced. The president’s obsession with building monuments to himself notwithstanding, he flits from subject to subject, bellowing threats to all who oppose him and rewarding his cronies with ever more obvious modes of corruption.
The world has decided to stop paying attention. “[M]ost consequently,” Hendrix and Faiola wrote, “Iran refuses to bend under American bombs and reopen the Strait of Hormuz, and Russian President Vladimir Putin persists in his war in Ukraine. Europe met Trump’s recently renewed demands for Greenland with a collective sigh, and trading partners have shrugged off the latest tariffs.”
Over the years, world leaders have had varying reactions to American presidents of both parties. But the country’s leaders have never been disregarded.
Jeremy Shapiro, director of the U.S. program at the European Council on Foreign Relations, told the Post he was surprised at how long Trump’s bluffs and bellicosity had worked, crediting it to the “awesome power and deep, long-stored-up diplomatic capital of the United States” that Trump has “finally started to blow through.”
The president’s threats are now seen as empty, and his so-called deals aren’t worth the paper they’re printed on. This was most recently on display in mid-July when he made a big, splashy announcement of a nuclear deal with Saudi Arabia. Within a day, Trump added a poison-pill requirement by way of a Truth Social post that left the Saudis reeling. His threats to annihilate Iran are now falling on deaf ears because he’s all over the place, usually lying about the progress of diplomatic talks, showing that he’s full of bluster and bombast but lacks a strategy to win and ideas about how to get out.
America’s political dynamics have us all just trying to hold on until he’s out of office so we can try to rebuild from the rubble. But the loss of credibility, the exposure of the nation’s weaknesses and the people’s willingness to put such a man in charge will not be easily repaired. The long-term damage to our international reputation, coupled with the weakness we are demonstrating in any number of areas, will leave us vulnerable for a long time to come.
In a call last week, Blanche, who is serving as both acting attorney general and deputy attorney general and has previously served as Trump’s personal lawyer, suggested that under his leadership, the department would prioritize restrictions on medication abortion.
“If states have said we are going to protect the unborn and we’re going to protect every life from the moment of conception, we’re putting practices and policies in place so that other states and other organizations can’t attack that,” Blanche said on a call organized by the White House Faith Office and posted online in full by Intercessors for America, a Christian organization. The call’s contents were first reported by Politico.
The remarks are only the latest to suggest that if confirmed, Blanche might take a more aggressive approach than his predecessor. In a July hearing before the Senate Judiciary Committee, Blanche said that if confirmed, he would commit to reviewing how the federal government interprets the Comstock Act, an anti-obscenity law from the 1800s that abortion opponents believe could be interpreted to prohibit the mailing of any drug used to terminate a pregnancy.
Anti-abortion activists have been pressing the administration to revive the Comstock Act since the beginning of President Donald Trump’s second term; Trump has declined to do so.
When asked about the possibility of enforcing the law to ban mailing of abortion medications, the Department of Justice confirmed that its Office of Legal Counsel, which advises the president and attorney general, “is undertaking a thorough review” of policies and procedures related to abortion.
Blanche requires one more vote to secure support from a majority of the Senate. Two Senate Republicans — Lisa Murkowski of Alaska and Bill Cassidy of Louisiana — have not yet indicated whether they would vote to confirm him. Susan Collins, a Maine Republican up for re-election, said Tuesday she would not vote to confirm Blanche, citing his abortion-related remarks as a key factor.
The confirmation fight comes months before a midterm election in which Republicans — already facing an uphill battle to control both chambers of Congress — have largely avoided talking about abortion. Though reproductive rights dominated the 2024 election, polling suggests that the issue has taken a backseat, with voters primarily concerned about the cost of living.
Still, national restrictions on abortion remain unpopular.
Abortion pill restrictions have emerged as a top priority for the anti-abortion movement. Even as bans have proliferated across the country, medical professionals in protective states have continued to prescribe and mail them to people living under abortion bans. This telehealth practice is medically safe and has enabled thousands of people to circumvent their states’ laws and end their pregnancies.
Anti-abortion activists have called on the federal government to intervene, arguing that the existence of this telehealth model has undercut states’ abilities to enforce bans. But so far, the Trump administration has taken no action to block telehealth abortion, despite pressure from top anti-abortion groups.
Blanche’s remarks suggest that could be changing, though it’s unclear when or how that shift might take place.
In the White House Faith Office call, he did not reveal what approach the administration might take to limit the availability of abortion medication, or when any switch might take effect — only saying that “victory will be soon and victory will be permanent.”
Abortion opponents have pressed for the Food and Drug Administration to reverse its decision approving mifepristone, one of two drugs used in most abortions, to be dispensed without an in-person visit. The FDA is currently reviewing mifepristone’s approval, despite a vast body of medical research showing the drug’s safety and effectiveness, including by telehealth.
They have also pressed for the Department of Justice to revive the Comstock Act to bar the mailing not only of mifepristone, but also misoprostol, an ulcer medication that is prescribed off-label as part of the abortion medication regimen. Under the Biden administration, the Justice Department argued that the Comstock Act could not be enforced to enforce a blanket ban on the mailing of mifepristone or misoprostol.
Democrats have argued that Blanche’s remarks are disqualifying.
“He wants to strip Americans of their right to choose and strip states of their right to govern,” Sen. Richard Blumenthal, a Democrat from Connecticut, said Tuesday during a meeting of the Senate’s Judiciary Committee.
Sen. Patty Murray, a Democrat from Washington, posted on the social media platform X that “Senators who vote for Blanche are voting for an Attorney General who will attack abortion rights in EVERY state.”
Abortion opponents are concurrently pursuing restrictions on mifepristone through the courts, notably in a case filed by Louisiana, in which the state has argued for the government to reverse its decision approving mifepristone for telehealth. That case is set to be heard by the 5th U.S. Circuit Court of Appeals in September.
BRUSSELS — EU Migration Commissioner Magnus Brunner warned on Thursday the bloc is vulnerable to unauthorized migration if control of its external borders depends on the goodwill of neighboring countries.
Brunner’s remarks came at an extraordinary meeting of the European Parliament’s civil liberties committee, a week after a major migration surge from Morocco into the Spanish exclave of Ceuta, which has reignited debate over how the EU should secure its frontiers.
“What we have seen in Ceuta during the past few days was … a test of our resilience and also of the security of our external borders,” Brunner said.
“We must cooperate with our neighbors, of course. But as long as control depends on the goodwill of one neighboring state, we remain … vulnerable,” he added.
Brunner described last week’s events in Ceuta, when around 72,000 migrants forced their way into the Spanish exclave, as “solid proof that we need a strong and effective tool — and different tools — to combat smuggling.”
Ceuta Mayor-President Juan Jesús Vivas, who also attended the meeting, saidthat around 100 people died during the mass border crossing, and that between 3,000 and 5,000 remained in the exclave.
Brunner said the EU should use all available leverage to secure the cooperation of countries bordering the bloc.
“It’s about further strengthening the work with partners … [We need to] step up our migration diplomacy by reinforcing comprehensive partnerships to stem this illegal migration, secure effective returns and create the right opportunities for people at home,” he said.
Brunner said cooperation with non-EU countries was essential “because the goal there is to make sure such events never happen again.”
The conservative Austrian commissioner’s party colleague Integration Minister Claudia Bauer warned on Thursday in a written statement that “another attempted mass crossing” in Ceuta could happen on Aug. 15, quoting Spanish media.
“In light of reports of another attempted mass crossing, Spain must immediately and significantly reinforce border protection in its African enclaves and ensure that this time it will hold,” she said.
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Malta leads fight against EU bid to tax Big Gambling
The tiny Mediterranean island is clashing against the European Parliament and former football legend to oppose the levy.
By GREGORIO SORGI in Paceville, Malta
Photo–Illustration by Natália Delgado/POLITICO
Brussels is bracing for an unusual fight between the EU’s smallest country and a British ex-footballing legend.
Peter Shilton, the England goalkeeper who conceded the “Hand of God” goal from Diego Armando Maradona in 1986, has started a new life as an anti-gambling advocate after overcoming a decades-long addiction.
Despite being a diehard Brexit supporter, he’s become the poster boy of the European Parliament’s push to tax online betting in a bid to raise some much-needed funds to finance the bloc’s next €2 trillion budget.
But the campaign has run into strong opposition from Malta. The tiny island in the Mediterranean Sea, with a population of just over half a million people, is home to a burgeoning betting sector. It says that higher taxes will cripple its gambling industry, boost illegal operators and drive firms outside the bloc.
But Shilton, who lost more than £1 million in betting on horse racing over 45 years and now runs his own gambling addiction charity, dismisses the arguments by Malta and the gambling lobbies as “window dressing.” He’s in favor of higher taxes as he wants to shrink advertising revenue that is used to lure in new gamblers.
“Deep down they’re after everybody’s money. Simple as that,” he told POLITICO during a visit to Brussels in June.
Former England goalkeeper Peter Shilton lost more than £1 million in betting on horse racing over 45 years and now runs his own gambling addiction charity. | David Cannon/Allsport/Getty Images
The topic has split the EU’s 27 governments, pitting gambling-heavy Southern European countries against their more supportive Western European peers, led by France. Capitals are already fighting even though the Commission hasn’t yet issued a formal proposal for the possible tax, which would ultimately need to be unanimously approved by governments.
It’s one of numerous budget battle lines being drawn, with Ireland — which is steering the talks as chair of the rotating Council presidency — set to restart negotiations to facilitate an overall deal on the EU budget before the end of the year.
That’s no mean feat given Dublin’s task to mesh competing spending priorities into a single budget — financing everything from farmers’ subsidies to foreign aid — that is acceptable for each of the EU’s 27 governments.
National capitals will have to unanimously approve new EU-wide taxes — known as own resources — to pay for soaring defense spending and post-Covid debt repayments if they want to avoid drastically increasing national contributions to Brussels.
Supporters of the gambling levy point to the fact that it would rake in over €13 billion throughout the next budget cycle and — for some, more importantly — address a serious public health issue. An estimated 80 million adults globally have experienced a gambling addiction, according to experts.
“We look on it [gambling] as an illness. It’s something that’s inborn in you and that can be ignited,” Shilton said.
Malta’s game plan
Malta has invested heavily in the gambling industry — including lotteries, betting and casinos increasingly operating online — which now accounts for around 12 percent of its gross domestic product.
These firms have relocated to Malta because of its light-touch licensing regime, business-friendly tax regime and balmy weather.
The country is “as dependent on the online gambling industry as Germany is on cars,” said an EU diplomat, granted anonymity to speak freely.
While gambling firms need local authorization to operate in most other European countries, securing the Maltese license is crucial to access banking services and gain a foothold in the EU market.
Malta-based firms dominated the German and Austrian online gambling markets before national regulators cracked down. This has prompted the Maltese government to refuse to recognize some court rulings and sanctions issued by other EU countries against its gambling firms.
Betting lobbies say they oppose higher gambling rates on the grounds that they will fuel appetite for the illegal market. | Photo illustration by Graeme Robertson/Getty Images
Given its influence, it is hardly surprising that the gambling industry has found a friendly ear among Malta’s politicians in Brussels.
The Maltese president of the European Parliament, Roberta Metsola, last year gave the opening speech at an international gambling conference in Rome that also featured Italian Foreign Affairs Minister Antonio Tajani.
“I’m more than a little proud that it started in my island home of Malta,” she said, referring to SiGMA, a Maltese events company that focuses on online gambling founded by Eman Pulis, a university friend of Metsola.
Betting lobbies say they oppose higher gambling rates on the grounds that they will fuel appetite for the illegal market, away from the grasp of EU rules.
“A higher tax would lead to worse odds for the customers … and it is relevant because access to the illegal markets in Europe is, obviously, one click away,” said secretary general of the European Gaming and Betting Association, Maarten Haijer.
Nicola Matteucci, an economist at the Università Politecnica delle Marche in Italy who has undertaken extensive research on the gambling sector, argued there is a “point where prices exceed a certain level and the demand [for gambling] diminishes. But it’s not as immediate as suggested by the industry.”
Matteucci said that most gamblers will be undeterred by slightly higher taxes and worse odds as they are not fully rational consumers.
Anti-gambling groups reason instead that higher taxes will reduce the sector’s spending on commercials, preventing would-be punters from getting sucked in to gambling in the first place.
“Higher taxes will therefore mean less gambling advertising overall and many people would regard that as a public benefit,” said Derek Webb, the founder of the Campaign for Fairer Gambling advocacy group.
Club Med joins Malta
Malta has joined forces with fellow Mediterranean countries — Italy, Portugal and Spain — to challenge the mooted tax which was first proposed by the Parliament’s socialist lawmaker Victor Negrescu, said four diplomats with knowledge of the discussions.
According to the European Commission’s estimates, seen by POLITICO, a 3 percent tax on the net turnover of the online gambling sector would generate an estimated €1.9 billion per year.
With its big online gambling market, Spain is expected to be among the biggest financial losers, should the tax go ahead. It is estimated to be on the hook for €414 million per year, almost a quarter of the total amount. That compares to a projected bill of €165 million per year for Malta— a disproportionality high amount for such a small country.
Portugal is also reluctant to back the levy. It fears that higher taxes would eat into revenue brought in by state-run betting and lotteries that is currently channeled to the charity Santa Casa da Misericórdia de Lisboa‘s healthcare and youth support programs, said a Portuguese official.
Meanwhile, given the relatively low uptake of online gambling, Italy’s misgivings have surprised anti-betting advocates. Rome is expected to pay a mere 7 percent of the proposed new levy — a significantly lower proportion than its regular EU budget contributions.
However, Prime Minister Giorgia Meloni’s Brothers of Italy party has previously been receptive to the gambling industry. Last year its MPs passed a resolution encouraging the reversal of a ban on professional football clubs advertising gambling firms.
As homeownership slips further out of reach in America, more people are spending more of their lives as renters. Millennials and Gen Zs are less likely to own homes than older generations did at the same age, and the median age of a first-time homebuyer recently reached an all-time high of 40, up from 28 in 1991.
That need not be a bad thing. Renting offers many benefits — flexibility, far lower upfront costs, never having to figure out what a “sacrificial anode rod” is — and homeownership is overrated as a savings vehicle.
But being a renter in America (as roughly one in three people here are) can also be a very undignified experience. In most states, your landlord can kick you out when your lease ends for no reason at all, even if you haven’t done anything wrong. Many tenants live in fear of receiving their next lease renewal, not knowing if they’ll be displaced by the next rent hike.
Some progressive policymakers, buoyed by the growing influence of democratic socialism and a resurgent tenant movement, are reviving an old, highly controversial answer to renters’ lack of security: simply ban steep rent increases through rent control.
In June, New York City, under Mayor Zohran Mamdani, froze rents on rent-stabilized apartments, which make up about 40 percent of the city’s rental housing stock. Rent control laws have been passed or tightened in recent years in places from Washington state to Los Angeles to Montgomery County, Maryland, and tenant advocates this year have pushed similar measures in Massachusetts, Washington, DC, Providence, Rhode Island, and Redwood City, California.
Decoding rent control jargon
• Rent control: The broad umbrella term for laws limiting how much landlords can charge or raise rents on covered homes. It can refer to anything from a total freeze to a relatively loose cap on the size of annual increases.
• Rent stabilization: A form of rent control that permits rents to rise but limits the size of annual increases, often according to inflation or a percentage set by a government board. It usually implies a less rigid system than a permanent price freeze.
• Rent freeze: A temporary prohibition on rent increases for apartments covered by rent control, like the policy adopted in NYC this summer.
• Vacancy decontrol: A rule allowing landlords to increase an apartment’s rent to its market rate after a tenant moves out. Limits on annual increases then resume once a new tenant moves in.
Rent control’s advocates argue that the policy not only moderates prices, but also offers tenants stability and a firmer claim to their homes. It helps put “the landlord-tenant dynamic on different and more equal footing,” as Siraj Sindhu, executive director of Reclaim Rhode Island, which backed a Providence rent-stabilization ordinance that passed the city council before being vetoed by the mayor, told me.
Those are really important goals. I’m a lifelong renter, having literally never lived in an owner-occupied home, and I hate that I can’t predict what my housing costs will be less than a year from now. But is rent control the best way to achieve stability?
Housing economists have long hated rent control; the Swedish economist Assar Lindbeck famously called it “the most efficient technique presently known to destroy a city — except for bombing.” Decades of research have found that it can have many unintended negative consequences, including depressing housing construction by making it financially impractical to build new rentals. And as we know from today’s crippling housing shortage, nothing is worse for long-term affordability than a scarcity of homes. More recent research, however, suggests that better-designed rent control laws can protect some tenants without having catastrophic consequences for housing supply.
That rent control keeps coming back as a centerpiece of our housing politics reflects just how impoverished our policy ideas are for providing renters what they lack most: predictable costs and secure tenure. The US has an elaborate policy infrastructure to privilege and subsidize homeownership, while treating renting as an afterthought, like a condition of poverty or at best a waystation on the path to buying a house. That makes ever less sense in a country where millions of people will rent for life, whether by choice or necessity.
The truth about rent control is somewhere between both extremes. It can, in some cases, certainly be worthwhile. But it remains a highly limited tool, and others can furnish some of the same benefits without fueling the very affordability crisis that they’re meant to address.
Why economists (mostly) oppose rent control
Rent control polls favorably, and it’s not hard to imagine why — voters despise high prices. Capping rents might intuitively seem fair and costless: The tenant is protected from ridiculously high prices, the landlord profits a bit less, and society as a whole is no worse off. Who could object to that?
In fact, though, many economists vehemently oppose rent control precisely because it isn’t cost-free — it merely moves costs onto others and makes them less visible.
In uber-expensive cities like New York and Boston, rents are so high because demand to live there far outstrips the supply of homes. In a healthy housing market, high prices signal to developers to build more homes, which then brings prices down and, just as importantly, grows the city’s population and economy by providing homes to people who want to move there. We’ve recently seen this happen in Austin, Texas: The city experienced a rapid run-up in rents during Covid, and builders responded (after the city eased some of its building restrictions) with a flood of new apartments. Rents have since fallen well below pre-Covid levels in real dollars. By contrast, policies that cap rents would diminish the incentive to build rental homes at a time when the US needs many more of them.
Meanwhile, if rent caps fail to keep pace with landlords’ rising costs, owners may neglect maintenance or even pull apartments from the rental market if they no longer pencil out. One widely cited economics paper documented this dynamic in San Francisco, where the majority of rental housing is rent-controlled and annual rent increases are capped well below inflation. The city’s 1994 expansion of its rent control law, the researchers found, shrank the supply of rental housing among newly covered properties by 15 percent, largely because landlords converted rentals into owner-occupied units. The expansion made tenants 10 to 20 percent more likely to remain in their homes, but at the cost of making San Francisco’s rental housing scarcer and raising the rents of non-rent-controlled apartments.
Rent control programs are generally not means-tested, meaning that tenants in eligible apartments receive it regardless of their incomes. So a higher-income tenant who happened to secure a regulated apartment can remain indefinitely at a steep discount, while a lower-income newcomer is left to compete for market-rate units, which are exorbitantly priced in part because of rent control.
As a result, rent control laws bear part of the blame for why San Francisco and New York City are so unaffordable, Arpit Gupta, a housing economist at New York University, told me. Trying to suppress rents in cities like these is like trying to hold the lid down on a boiling pot — the pressure inevitably spills over somewhere else. Gupta, who sits on the New York City Rent Guidelines Board, which sets maximum increases for the city’s rent-stabilized apartments, cast the lone “no” vote on the rent-freeze measure this summer.
The freeze creates “a severe risk of financial distress” for many buildings, he told me. It could prompt landlords to leave apartments vacant after a tenant moves out if the cost to rehabilitate it cannot be recouped through the legally permitted rent. The number of vacant rent-stabilized apartments in the city has already been rising, and Gupta has argued that New York state’s 2019 overhaul of its rent-regulation laws, which further constrained landlords’ revenues, may be partly to blame.
Many leftists don’t like arguments like these because they’re uncomfortable with the idea that housing must be kept financially worthwhile for private owners. I sympathize with that instinct — housing is a human need, and it feels wrong for its availability to depend on profitability. But it doesn’t do us much good to ignore the structure of the economy we actually live in, where housing is overwhelmingly provided by the private market.
Housing markets can be very good at providing for people’s needs, if we allow them to workbetter by legalizing more housing construction and pair it with targeted rental subsidies to people with low incomes.
How rent control got smarter
One of the clearest ways to understand rent control comes from Shane Phillips, a housing researcher at UCLA. It should be viewed not as a long-term affordability strategy, he has argued, but as a targeted stability tactic. For affordability, there’s no substitute for building enough homes. But in already broken, unaffordable markets, like many of America’s superstar cities, rent control can be a stopgap that lets some residents remain in their homes. It’s reasonable to expect that people’s homes shouldn’t be treated as crude commodities that they can be priced out of at any moment. The question is how to balance security for existing residents against the structural harms rent control can cause to the overall market.
Not all rent control policies are created equal. Old forms of it appeared in places from ancient Rome to imperial China to the Jewish ghettoes of Early Modern Europe. When describing modern rent control, however, researchers distinguish among a few different types. “First-generation” rent controls arose largely as emergency measures across Europe during World War I, becoming very widespread in the US during World War II. These typically froze each unit’s rent at a fixed dollar amount, with few avenues for adjustment as costs rose; over time, they tended to push homes out of the rental market and discourage maintenance, reducing both the quantity and quality of rental housing.
By the 1970s-80s, a “second generation” of rent control laws, often called “rent stabilization,” was adopted in New York, Boston, Washington, DC, municipalities across New Jersey, and numerous California cities. These introduced some important innovations: They allow modest annual rent increases, set by a formula or regulatory board and often pegged to the rate of inflation. They exempt new-construction buildings from price controls, which reduces the disincentive for developers to build new apartments.
They also often include “vacancy decontrol,” which allows landlords to reset an apartment’s rent to its current market rate after a tenant moves out (after that, the unit remains subject to the annual rent increase caps). Vacancy decontrol is especially important for preserving rental housing supply, experts told me. But it also creates an incentive for owners to try to push tenants out so they can raise the rent. To combat this, most rent-control programs include “just-cause” eviction protections, meaning that landlords cannot arbitrarily evict tenants or refuse to renew their leases; they must cite a serious lease violation (or another legally recognized reason, such as removing the unit from the rental market).
Second-generation systems remain in place in major US cities, including New York, San Francisco, and Los Angeles. They tend not to distort housing markets as severely as first-generation laws, but they can still, as seen in the evidence from San Francisco, meaningfully damage housing supply. And Gupta has warned that New York City’s system has been regressing back toward first-generation rent control, with the recent rent freeze and the removal of vacancy decontrol under New York state’s 2019 Housing Stability and Tenant Protection Act.
Meanwhile, the recent revival of interest in rent control has produced some laws whose design may magnify the policy’s worst impacts. Montgomery County, Maryland, which includes some of Washington, DC’s most expensive suburbs, implemented a rent-control law in 2024 that lacks vacancy decontrol, while St. Paul, Minnesota, voters approved a 2021 ballot measure that initially lacked both vacancy decontrol and an exemption for new construction. Both places subsequently saw sharp declines in apartment construction, though the timing alone does not prove rent control was the sole cause. (St. Paul has since added partial vacancy decontrol and a permanent new-construction exemption.)
In a recent working paper, a pair of UCLA economists identified a “third generation” of rent control that is less restrictive than second-generation laws. California passed a statewide rent stabilization law in 2019, for example, that set a high ceiling on allowable annual rent increases: 5 percent plus inflation, or 10 percent, whichever is lower. It exempts new buildings for their first 15 years, and includes vacancy decontrol and just-cause eviction. Oregon passed a similar law the same year, as did Washington state in 2025. Using data from San Diego, the new paper found no discernible loss in housing supply there under California’s law. The implication is pretty intuitive: “The laxer the policy, the fewer the negative consequences,” as Phillips put it.
The flipside, of course, is that the least restrictive laws also do the least to protect tenants — a 10 percent cap mostly just amounts to an anti-gouging measure, and landlords rarely raise rents by that much anyway. Still, double-digit rent increases do happen. And even a loose cap can offer renters peace of mind and insurance against a life-upending rent hike.
We need a broader renter stability agenda
Some current proposals may soon play out the tradeoffs of rent control. This November, residents of Redwood City, located between San Francisco and San Jose, will vote on a ballot measure that would cap rent increases at 60 percent of inflation, with a maximum increase of 5 percent.
Clara Jaeckel, a renter in the city and an organizer with the campaign, told me that the proposed law would allow landlords to petition for higher increases if it’s necessary to cover operating costs. It’s “designed to strike a fair balance between letting landlords have a fair return on their investment and keeping things affordable for renters,” she said. Under California law, the city would still be required to include vacancy decontrol and exempt housing built after 1995. “We believe building new housing goes hand-in-hand with rent control — so we want both of those things,” Jaeckel said.
Limiting rent increases so far below inflation, which is similar to San Francisco’s rent cap, has the potential to meaningfully reduce the quantity and quality of rental housing. But it’s also possible that its negative impacts remain muted. Gupta and Phillips both told me that vacancy decontrol substantially limits the harms of rent control, regardless of the exact percentage rent increase permitted, and the proposed Redwood City rent cap would apply to a smaller share of its rental housing than San Francisco’s law does.
Voters and policymakers might decide that this tradeoff with housing supply is worth it if it can allow longtime residents to stay in their homes. The Bay Area has become so unaffordable that such laws right now represent one of the few ways that communities in the region can maintain some measure of class diversity.
But it’s worth considering how to deliver the same stability and affordability without rent control, which for too long has been the fallback that expensive cities and towns reach for after allowing their housing markets to become dysfunctional. It can ultimately only offer tenants a cramped kind of security, trapping them in homes that may no longer suit their needs because leaving would mean surrendering their only affordable option.
A better stability agenda for renters would give them genuine choices in where to live, and how long to stay. In places with broken housing markets, that means, first and most importantly, repealing exclusionary zoning laws and other barriers to building enough homes. That’s the foundation of affordability for everyone, but especially for renters, whose housing costs rise unpredictably with the market rather than remaining relatively fixed by a long-term mortgage. Renters with low incomes, meanwhile, need help affording housing even in a balanced market, and that ought to be provided far more consistently (Section 8 vouchers and other federal rental-assistance programs currently only reach a fraction of people who qualify).
Other policies can offer the long-term stability that rent control provides, too. “The ultimate issue that a lot of [rent control] interventions are trying to target is the challenge of being a renter and being faced with these cost shocks year after year,” Gupta said. Most American residential leases are one year long, but policy could encourage longer terms, which are common in some peer countries like Germany and Japan, and, Gupta noted, widespread in US commercial leases.
Another step is to give tenants a presumptive right to remain in their homes — in the vast majority of states, landlords can refuse to renew a lease without any cause because the law simply defers to their private property rights. That is a bigger deal than it might sound like: If you’re a renter in one of the 40-odd states that don’t have a right to renewal, and you have, say, loud young children who irritate one of your neighbors, you can be forced out when your lease ends without any recourse. I’ve seen this happen firsthand as a renter in Wisconsin, and it’s one of many ways that cities can be hostile to families. Protection from arbitrary eviction would benefit renters regardless of whether their units are rent-controlled.
These sorts of policies also need to be balanced with reliable processes for removing tenants who seriously damage property, endanger their neighbors, or repeatedly violate their leases. “Sometimes landlords are taken advantage of. Sometimes they are lied to,” Phillips said. It’s rare to find a jurisdiction in the US that’s both “very concerned about tenants and very concerned about landlords,” he said. Instead, US housing policy tends to oscillate between either extreme, but protecting the rights and interests of both need not be mutually exclusive.
America will remain stuck with a housing shortage for the foreseeable future, which not only makes housing unaffordable in our highest-demand cities and suburbs, but also gives landlords a structural advantage over renters because they’re shielded from competition. Until that changes, a limited form of rent control can redistribute some of that power back to renters. That may be a bargain worth making, but, Phillips said, cities should make it knowingly: with a clear idea of which renters they intend to protect, and who will bear the cost.
A field organizer places signs on the podium before the pro-choice Kansas for Constitutional Freedom primary election watch party in Overland Park, Kansas, August 2, 2022. | Dave Kaup/AFP via Getty Images
Editor’s note, Aug. 5, 6:20 am ET: Kansas voters rejected a proposed amendment to change how state supreme court justices are selected. This piece below was originally published on August 4.
Four years after the Dobbs decision, abortion battles have largely taken a backseat in national news to other policy fights this cycle. Leaders in the anti-abortion movement say they’re disillusioned with President Donald Trump’s unwillingness to push for further restrictions. The federal battle over access to abortion medication seems to be settled — for now. Public awareness of that fight is limited, and even at the state level, a couple years have passed since the high-pitched but successful state-level efforts to protect abortion access in red states.
Yet a little-known battle has been playing out in Kansas, where a ballot measure to change the way state supreme court justices are selected serves as a reminder that these fights over abortion are still active, even if they take the form of creative procedural and administrative efforts.
If it succeeds, opponents say, it would open the floodgates for similar efforts in other states to politicize the remaining independent state courts (13 other states use a method similar to Kansas) and provide a road map to undoing abortion protections in other states that have safeguarded them.
On Tuesday, Kansans are deciding whether to change the way judges on the state’s highest court are selected. Up until now, judges were selected through a nonpartisan merit-based system: When a spot opens on the bench, a nine-member commission submits a list to the governor, who then selects a replacement.
The referendum would replace this system with direct, partisan elections of judges, like any other politician. Proponents say it’s a democratic move, a way to better express the will of voters over “unelected” bureaucrats. Yet critics say it’s first and foremost about restricting abortion rights — which both the court and voters have rejected.
How Kansas became an abortion rights flashpoint
In 2019, the state supreme court recognized the right to abortion in the state constitution; three years later, after Dobbs, voters rejected a Republican-championed proposal to overturn that ruling, choosing to preserve abortion rights by a 59-41 margin in a deeply red state.
It was after that failed vote in 2022 that then-state attorney general Republican candidate Kris Kobach outlined a new strategy for undoing these protections: changing the way the supreme court is selected, electing anti-abortion candidates, and “slowly and quietly” overturning the 2019 decision and 2022 vote.
“If you look at the various proposals, one of the proposals that is crystal clear is allowing people to popularly elect justices to the supreme court, which is the most common system among all of the states in the country,” Kobach said in 2022.
He’s a bit more careful talking about this in 2026: “There is a real desire to bring back some accountability to the judiciary,” he told the New York Times this week. “It’s not just about abortion.”
Tuesday’s results would have huge ramifications, critics said, given that nonelected state courts have been a final bulwark against Republican supermajorities and governors in red states. Kansas has been an island for abortion access for women in the South and central US since the Dobbs decision.
The victory in 2022 also inspired abortion rights advocates to try to use ballot measures to enshrine these protections in about a dozen other states, which successfully overturned abortion bans in Missouri and Ohio. State courts in Utah and Wyoming, meanwhile, blocked bans.
The next frontier in the abortion wars
These independent checks on power have been under attack for years, Michael Milov-Cordoba, a court expert and counsel in the Brennan Center for Justice’s judiciary program, told me.
“State legislators across the country are increasingly trying to undermine those courts. … That retaliation takes a few different forms, but changing how judges are selected is top of the list,” Milov-Cordoba said. “And what we’ve seen is that in many states where courts stand up for abortion rights and strike down abortion restrictions, efforts to change state judiciaries have followed.”
He noted the complete reworking of the Utah supreme court in the last year, including by expanding and packing it. Similar retooling of the state supreme court happened in Iowa in 2022. Montana is likely the next battleground, where Republican legislators are exploring various avenues to strip or limit the state supreme court’s powers. That in turn has led the ACLU to get involved to boost a constitutional amendment this year that would preserve the nonpartisan status of judicial elections.
And in recent years, state supreme court elections have been inundated with spending and attention from both in- and out-of-state backers. Last year’s Wisconsin judicial election, for example, became the most expensive race of its kind in US history, with more than $100 million spent — just two years after a contest for a different seat on the state supreme court had set its own record at more than $50 million spent.
“If these courts become partisan, then they will be just like any other election fight — subject to being bought and sold by billionaire political funders,” Deirdre Schifeling, the chief political and advocacy officer at the ACLU, told me. “They become a race to the bottom … and [Republicans] are finding backdoor ways to seize power to push their ideological agenda.”
Already, Kansas has seen heavy spending: More than $12 million have been spent from both sides, including about $5 million from the ACLU, Schifeling told me.
”Everyone’s focused on the Michigan Senate race, other kind of big-ticket, sexy elections,” Schifeling said. “Well, this is just as important and much more under the radar. Without a balanced court, we are going to lose rights and liberties across the board in a state like Kansas.”
Road injuries remain the leading cause of death for everyone between the ages of 5 and 29 — ahead of malaria, ahead of war and homicide, ahead of every disease we spend more time worrying about. | Sharon Steinmann/Houston Chronicle via Getty Images
Let me start with the most local of local stories: the intersection down the street from my apartment in Brooklyn, New York, where Columbia Street meets Summit Street.
Since my family moved into the neighborhood in 2023, I’ve hated this intersection. It has no stop signs, no crosswalks, no signal. Crossing on foot with my son has meant grabbing his hand and hoping any oncoming cars would slow down, which, given that this is New York City, is maybe a 50/50 proposition at best. Everyone knew a stop sign or signal was needed, but the city did nothing.
That finally began to change late last year, after a 10-year-old girl was struck and injured by a car just two blocks north of the intersection. The neighborhood organized, packed a public meeting, and eventually walked a city official down the block so he could stand in the intersection and see what they saw every day. Which is how I woke up on July 17 to see four stop signs and freshly painted crosswalks at the intersection I hated so much.
My very local story is part of a much bigger one. Cars kill about 1.16 million people a year worldwide — more than the population of San Jose, California erased every year. Road injuries remain the leading cause of death for everyone between the ages of 5 and 29 — ahead of malaria, ahead of war and homicide, ahead of every disease we spend more time worrying about.
For most of the 20th century, that was simply the price of moving around faster. Being in a car was the most dangerous thing most of us did on any given day, and we seemed to have no choice but to accept the consequences.
But, it turns out, we don’t. According to new data released last month, between 2011 and 2025, the rate at which the world’s roads killed people, measured against population, fell 21 percent, even as more than a billion motor vehicles were added to the world’s roads. It’s still far too high, and the death rate actually increased in Africa, as more vehicles are added to often substandard roads. But in epidemiological terms: Globally, exposure went up while deaths went down. What ultimately changed was an argument about whose fault it really is when a car crashes.
Detroit’s answer to all this was that Americans were bad drivers. A doctor named William Haddon Jr. thought the industry was looking at the wrong thing. Haddon trained as a physician and came to car crashes as an epidemiologist. He saw them as systems failures and understood that cars had to be designed to protect drivers against themselves.
Haddon wasn’t working alone. In April 1959, a Labor Department official named Daniel Patrick Moynihan published “Epidemic on the Highways,” making a version of the same argument: The problem was how cars were built, not who was driving them. In 1965, the consumer advocate Ralph Nader — whom Moynihan had hired the year before to help write the government’s highway safety report — published Unsafe at Any Speed, a catalog of everything automakers already knew they should fix and had decided not to.
But while America has largely aimed to make crashes survivable, other countries decided that wasn’t ambitious enough. In October 1997, the Swedish parliament adopted a national policy called Vision Zero, built on the premise that nobody should be killed or seriously injured on the roads — and that, when someone is, ultimate responsibility belongs to the people who designed the system, rather than solely to the person who made the mistake. Sweden began adding median barriers to rural highways in 1998, and a national revision of speed limits rolled out in 2008-’09. Since Vision Zero’s adoption, Swedish road deaths have fallen about 61 percent, from 541 in 1997 to 213 in 2024 — about two deaths per 100,000 people, the lowest rate in the EU.
Four stop signs on a Brooklyn corner are what that idea looks like at its smallest possible scale.
The people we left outside the car
But, in our effort to make our cars safer, we neglected to do the same for everyone else on the street. Between 2009 and 2023, US pedestrian deaths rose 80 percent, even as other categories of traffic deaths increased just 13 percent. By 2022, pedestrian deaths had climbed to a 40-year high — back to 1981 levels.
One major contributor is as simple as geometry. The Insurance Institute for Highway Safety (IIHS) found that vehicles with hoods above 40 inches are about 45 percent more likely to kill the pedestrian they hit than vehicles with hoods of 30 inches or less and a sloped profile. A low, sloped hood catches an adult at the legs and rolls the body up onto it. A tall flat one catches the torso and drives the body down and under. Light trucks — which have gone from under a fifth of new vehicle sales in 1975 to more than four-fifths today — accounted for 54 percent of US pedestrian deaths with a known vehicle type in 2023.
I’m glad there are stop signs at Summit and Columbia now, but it was a good outcome produced by a bad process — one that required a child being hit by a car to get started. There are more dangerous intersections in this country than there are communities with the voice and the stamina to demand fixes. A real Vision Zero wouldn’t wait for the crash; it would identify which intersections could kill someone and fix those first.
For now, though, I’m simply happy that, in my local corner of the world, the streets got just a little bit safer.
New York is also an outlier. As my colleague Marina Bolotnikova wrote earlier this year, Vision Zero hasn’t worked nearly as well elsewhere in the country, largely because the American public is less accepting of road designs that inconvenience drivers.
Since the US probably won’t adopt Sweden’s approach, a more realistic hope might be autonomous vehicles. This month, the Insurance Institute compared about 50 million driverless Waymo miles across four cities with human driving in the same places and found that, per mile, the robotaxis were involved in 68 percent fewer crashes of the kind a human driver would typically report to police. Waymo’s own tally across more than 220 million driverless miles claimed 93 percent fewer injury-causing crashes involving pedestrians — which is to say the technology is best at precisely the thing American road design has been worst at.
If Haddon fundamental insight was that systems have to be built to counter the inevitable errors when a human drives a two-ton hunk of metal and glass at 60 mph, then maybe it makes sense that the ultimate system response is to remove the human altogether. For now, though, I’m simply happy that, in my local corner of the world, the streets got just a little bit safer.
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Acting Attorney General Todd Blanche attends a Cabinet meeting at Camp David, the presidential retreat, on July 31, 2026. | Anna Moneymaker/Getty Images
For a brief moment late last week, it looked like acting Attorney General Todd Blanche’s bid to get the word “acting” removed from his job title was in serious trouble. But that moment appears to have passed, as two key Republican senators just signaled that they will vote to move his nomination forward.
Sens. John Cornyn (R-TX) and Thom Tillis (R-NC) halted Blanche’s nomination because of concerns about a $1.8 billion slush fund that Blanche helped create as the Justice Department’s acting leader, as well as some objections to a collusive deal between President Donald Trump and the IRS that could have shut down tax investigations into Trump, his family, and his businesses. Both senators announced on Monday that they will no longer block the nomination.
Though these two senators, both of whom are retiring in January, did extract some minor concessions from the Department of Justice in return for their votes, they objected to only a small fraction of Blanche’s efforts to transform the DOJ’s lawyers into Trump’s personal advocates and enforcers. The fact that Blanche is likely to be confirmed, despite his sycophancy toward Trump, suggests that any meaningful guardrails on a weaponized Justice Department have ceased to exist.
Cornyn and Tillis both currently serve on the Senate Judiciary Committee. That committee, where Republicans currently have a two-vote majority, was originally scheduled to vote on Blanche’s nomination Thursday — but that vote would have failed if Cornyn and Tillis rejected the nominee. And, now, it’s likely to go ahead.
Cornyn and Tillis’s objections to Blanche were quite narrow in scope. They demanded a written order from Blanche “terminating the anti-weaponization fund,” a reference to the $1.8 billion slush fundthat could be paid out to Trump’s allies, including participants in the January 6 attack on the US Capitol. Blanche originally established this fund in a May 18 order. On Sunday night, he tweeted out a new document terminating his May 18 order.
For the most part, however, the two senators did not object to Blanche’s broader efforts to weaponize the Justice Department against people who’ve displeased Trump, including the use of law enforcement to cow Trump’s critics. As both deputy attorney general and as acting attorney general, Blanche oversaw several highly dubious prosecutions brought against Trump’s perceived enemies and prominent Democrats.
A video introduced in federal court, for example, indicated that Blanche personally instructed law enforcement officers to arrest Newark’s Democratic Mayor Ras Baraka — an arrest that led a federal magistrate judge to scold the DOJ for “using the immense power of the government to pursue weak cases or to make examples without sufficient cause.” Under Blanche’s oversight, the DOJ’s also brought flimsy charges against individuals like former FBI Director James Comey and New York state Attorney General Letitia James, who investigated Trump for potential wrongdoing.(One minor exception: Tillis did previously pressure Blanche to drop an investigation into former Federal Reserve chair Jerome Powell.)
So, while Cornyn and Tillis successfully pushed Blanche to make some small concessions in order to secure their votes in the Judiciary Committee, neither senator appeared interested in a confrontation over Trump and Blanche’s broader efforts to transform the DOJ into a revenge-seeking agency. And now, it appears likely that Blanche will be confirmed — and that those efforts will continue.
What did Blanche actually agree to do in order to get Cornyn and Tillis’s votes?
Earlier this year, Trump, the Trump Organization, and Trump’s two oldest sons sued the IRS, claiming that it failed to prevent a contractor from leaking some of Trump’s tax documents. The president originally demanded a $10 billion payout from the federal government, and the lawsuit triggered widespread concerns about a conflict of interest, because Trump was both the plaintiff and the chief executive of the government he sued.
On May 18, a little over a month after Blanche became the federal government’s top lawyer, Trump (and the other plaintiffs) entered into a “settlement agreement” that did not include a $10 billion payday for Trump but that did include several provisions favorable to Trump, his family, and his companies.
Among other things, the settlement announced the creation of the “anti-weaponization fund,” which would distribute moneyto an unknown group of people who claim they were unfairly targeted by previous administrations based on decisions by five individuals appointed by Blanche. It also included a provision claiming that the IRS (and potentially other federal agencies) is “FOREVER BARRED” from pursuing any claims that “have been or could have been asserted by Plaintiffs” — open-ended language which sparked fears that a wide range of potential investigations into Trump, his family, or his companies could be shut down forever.
So, Blanche walked back the specific order that he signed to establish the $1.8 billion slush fund, but he did not repudiate the part of the settlement that immunizes Trump, his two oldest sons, and the Trump Organization from many tax investigations. According to Tillis, the DOJ merely said that this part of the settlement does not apply to parties (including federal agencies) that were not parties to Trump’s original lawsuit.
Though this deal appeared to have been enough to secure Cornyn and Tillis’s votes, and most likely to ensure Blanche’s confirmation in a Republican Senate, it is unlikely to placate Democrats. As Sen. Adam Schiff (D-CA) tweeted Tuesday morning, Blanche’s new order “doesn’t prevent payouts to violent insurrectionists in the future,” and it “leaves in place a tax-immunity deal that could help Trump skip taxes on the $2.3 billion he made last year.”
And the question of whether the DOJ may bring politically motivated charges against figures like Baraka, Comey, or James appeared to not even be part of the deal struck between Blanche, Cornyn, and Tillis.
One reason why the two senators exacted such meager concessions may be because they didn’t have a very strong hand to play against Trump. Because Blanche is currently the Senate-confirmed deputy attorney general, he can remain head of the Justice Department, in an acting role, for as long as Trump is president. Indeed, when negotiations between Blanche and the two senators appeared to hit an impasse late last week, Trump threatened to “keep Todd as Acting A.G., and push hard to get the Anti-Weaponization Bill” if Cornyn and Tillis wouldn’t support Blanche.
But that doesn’t change the fact that Blanche’s concessions are thin gruel. His statement on the slush fund merely confirms that “there is no Fund” right now. And, under the terms of the apparent deal reached with Cornyn and Tillis, Trump, his sons, and his primary business still gain broad immunity from a wide range of tax investigations.
So, while Cornyn and Tillis may have given Trump and Blanche a brief scare, they never put up much real resistance to Trump’s nominee.
Mayor Zohran Mamdani holds up bananas labeled with a 30 percent off sticker during an announcement on municipal grocery stores at a Campaign for Hunger community food distribution center in Brooklyn, New York, on July 27, 2026. | Adam Gray/Bloomberg via Getty Images
New Yorkers will soon enjoy a 30 percent discount on their meat, seafood, milk, and bread — so long as they shop at a city-owned store.
Mayor Zohran Mamdani touted such bargains this week at a press conference detailing his plans to launch five public grocery stores, in a bid to lower New Yorkers’ food costs. Under the proposal, the city would own each supermarket and dictate its pricing and labor practices, while private grocery companies would handle the day-to-day operations.
Key takeaways
• Mamdani plans to open five city-owned grocery stores offering steep discounts on staple foods. • Public stores can help where private grocers are absent, but that is not the main problem in New York City. • The stores are unlikely to sell food more efficiently than large private retailers. • The same public money could reach more low-income New Yorkers through direct food assistance.
While stimulating, these grand philosophical arguments have often overshadowed more banal but pressing questions: Would public grocery stores do more to advance Mamdani’s stated goals than other things the city could do with the same money? Has New York’s mayor discovered a way to sell groceries more efficiently than Costco does — or an approach to nutritional relief more effective than simply giving poor people more cash and food?
The answer to both of these questions appears to be “no.” And that should concern more than just New Yorkers. Mamdani’s vision is already inspiring imitators, with San Francisco and Boston both exploring their own public grocery store proposals. And in national discourse, the mayor’s policy is widely understood as an experiment — one testing a bold new theory of how governments can make food more affordable.
Unfortunately, although public grocers have merit in some circumstances, the theory underlying Mamdani’s specific plan is not merely unproven but incoherent.
Grocery socialism makes more sense for small-town Republicans
Public grocery stores have historically aimed to solve a problem that New York City does not have — a total absence of private supermarkets.
In 2018, the small town of Baldwin, Florida lost its only grocer. With only 1,600 residents — and a median income of $44,271 — the community no longer generated enough business to be worth the local IGA’s while. And no other national chain rushed in to fill the gap.
So, the municipality opened its own grocery store, the Baldwin Market.
This attracted national media attention. And not without reason. A deeply conservative small-town trying its hand at socialism was a fun story. And it turned out that Baldwin wasn’t an aberration: Other agingrural communities in red America had turned to government grocers once private supermarkets had left them in the lurch.
Progressive policy thinkers took inspiration from these examples. In the ensuing years, proposals for using public grocery stores to combat urban food deserts — impoverished neighborhoods without convenient and affordable supermarkets — began to circulate. The merits of such plans can be debated. But their logic was straightforward: Where the market fails to provide residents with healthy food options, the government should step in.
When post-COVID inflation sowed outrage over food prices, however, some on the left reconceived the purpose of public supermarkets: In their telling, such stores weren’t merely a means of eliminating food deserts, but also a way to make groceries more affordable.
Mamdani’s plan is principally animated by the latter goal. With more than 1,100 grocery stores and 10,000 bodegas, most of New York City is well-provisioned by private food vendors. And although parts of the municipality are under-served, the mayor is not actually concentrating his stores in such areas; his planned East Harlem location lies just blocks from an Aldi, Costco, and many other grocers.
In a report detailing its policy, the mayor’s office makes clear that its primary aim is to drive down New Yorkers’ food bills. Yet there’s little reason to think that public grocery stores are a cost-effective way to do that.
New York City probably won’t provide groceries more efficiently than Costco
Without question, a government store can make groceries more affordable for its own customers: All it has to do is charge below-market prices.
And yet, if that store manages this feat by operating at a loss, then its shoppers’ savings will come at the broader city’s expense.
That might not be too troubling, if one pictures rich taxpayers footing the bill. But for a city like New York — which faces a structural budget deficit — revenue is a scarce resource. A tax dollar spent on public grocery stores is one that can’t be spent on nutritional assistance for low-income people. And all else equal, the latter will do more to enhance affordability: If you have a limited pool of food subsidies — and want to minimize the number of New Yorkers who can’t afford groceries — then you should spend your funds on the poor, not on whoever happens to show up at your city-owned store.
Thus, for Mamdani’s supermarkets to be cost-effective, they can’t just subsidize low prices with taxpayer money. Rather, they need to deliver groceries more efficiently than private retailers do.
Public ownership can unlock efficiencies in certain contexts. For example, America’s private health insurance system generates massive administrative redundancies. By one estimate, if the US replaced its sprawling insurance industry with a single government payer, it could cut our health system’s annual administrative costs by $500 billion. In other words, a Medicare For All program could theoretically provide more healthcare-per-dollar than the current system does, by eliminating excess bureaucracy.
But there are no comparable inefficiencies in the grocery sector. True, a government retailer could generate some savings by declining to take a profit. But margins in the industry are slim; the average profit rate among food retailers was just 2.1 percent in 2025. Therefore, Mamdani’s stores can’t finance 30 percent discounts merely by dispensing with shareholder returns.
Meanwhile, the city actually wants its stores to be less cost-efficient than private grocers in some respects. According to its policy brief, the government grocers will pay their workers higher wages than most retailers and may also favor “local and regional suppliers,” rather than automatically contracting with whichever food producers offer the best rate.
The city suggests that its stores will have some cost advantages: Unlike private competitors, they will pay no rent or property taxes on their facilities. But these are merely additional subsidies, not actual efficiencies: By providing free real estate to its grocers, the city is forgoing revenue that it could otherwise collect and spend on nutritional assistance or other public goods.
It is not yet clear how much money the city is prepared to lose each year on these stores. If Mamdani’s celebrity — and heavily advertised bargains — lure large masses of people to his markets, their steeply discounted goods will quickly sell out. In that circumstance, to avoid long stretches with empty shelves, or some complex rationing system, the city would need to rapidly restock money-losing items, compounding the stores’ operating losses.
In theory, there is one way that government stores could benefit consumers throughout a city without being especially efficient enterprises in themselves: They could force other retailers to cut prices by accepting lower profits or discovering new efficiencies. But with grocery margins already thin, squeezing private markets further could lead to closures, thereby reducing shoppers’ options. Further, Mamdani himself insists that his stores will go out of their way to avoid harming private competitors (which, in New York, consist primarily of the sorts of small businesses that Mamdani has promised to help).
In any case, five stores won’t substantially impact pricing citywide. And so long as each government grocer operates at a loss, scaling up the program will only deepen its costs — and thus, the tradeoff between funding public supermarkets and anti-hunger programs.
Aldi for all
At present, Mamdani’s grocery store experiment looks fairly cheap. The city estimates the stores will require $70 million in capital costs. As already noted, it’s unclear precisely how large each store’s annual operating budget will be. But even if each supermarket loses many millions each year, it still won’t make that big a difference, in the context of the city’s $125 billion budget.
Still, the opportunity costs of Mamdani’s policy are real. New York City currently plans to spend $3.1 million next year on a program called Get The Good Stuff (GTGS), which essentially gives SNAP recipients up to $10 off each time they purchase fruits and vegetables from 25 participating grocery stores. With the money slated for its public supermarkets, New York could dramatically expand the program, while also investing more money into its food banks. Alternatively, the city could modestly increase cash transfers to its lowest-income residents.
To be sure, none of that would offer much benefit to middle-class shoppers. And the mayor is quite reasonably concerned with increasing grocery affordability for the typical New Yorker. But the city can advance that aim — while actually increasing its revenue — by easing zoning and permitting rules that currently make it difficult for large, low-cost retailers like Costco and Walmart to operate in many parts of the city. Happily, to Mamdani’s great credit, his administration’s paper on public grocery stores does briefly mention the need for permitting reforms.
Maybe public grocery stores are an end in themselves
All this said, there may still be a reasonable case for Mamdani’s stores or others like them. For example, a city’s residents might come to see such retailers as a kind of attraction, public amenity, or community space, akin to a park or library.
Further, public grocers could theoretically increase the public’s faith in the government. While the grocers are unlikely to be efficient in reality, they may appear to be. After all, their low prices will be far more visible to consumers than their operating costs. If Americans come to associate the public sector with cheap, ostensibly well-run supermarkets — rather than dreary DMV lines — that could aid the left’s broader efforts to expand the government’s remit. (Although, if the public grocers end up being characterized by overcrowding and empty shelves, the policy could further erode Americans’ confidence in the public sector.)
As a means of maximizing affordability, however, Mamdani’s program makes little sense. It will mostly just transfer income from the city’s broad population to the small subset of New Yorkers who happen to live near — or work at — one of its five stores.
Where private markets fail to provide any grocery options, public stores may be the best way for municipalities to meet their residents’ nutritional needs. But in other contexts, governments can make a bigger difference by simply putting more money in poor people’s pockets.
In cities where space is tight, underused golf courses are, in theory, ideal canvases for new housing. | Patrick T. Fallon/AFP
Maybe it was never a great idea to build so many golf courses in the desert. But in the 1990s, when Tiger Woods mania was at its peak, Las Vegas went on a fairway construction spree, dotting the city with dozens of pristine, water-gobbling green oases, most woven around upscale master-planned suburbs.
One of those new fairways was the privately owned Badlands Golf Club, whose name now evokes huffs of frustration and wistful what-ifs from Las Vegans in the know. Opened in 1995 about 15 miles west of the Strip, the luxury course once wound its way around some of the city’s most opulent mansions and gated communities.
Key takeaways
An old golf course in Las Vegas is about to be transformed into the largest affordable housing complex in Nevada’s history.
If all 16,000 golf courses in America were turned into such housing, we’d have 22 million more affordable homes.
NIMBY urges can make such projects difficult, but the housing crisis makes it important to consider them.
By the time Woods crashed his car into a fire hydrant in 2009, the golf industry was in a crisis of its own. Many Americans had lost their appetite for the sport, which began hemorrhaging millions of players during the Great Recession and Woods’s fall from grace. Thousands of golf courses built during boom times shut down as a result — Badlands Golf Club among them.
Meanwhile, Las Vegas, like many American cities, needed more homes to help alleviate its brutally high housing costs. These days, Nevada needs 120,000 additional affordable homes, but it is running out of places to build them, in part because about 85 percent of the state is federally owned, meaning there’s little room left for its cities to grow or sprawl. Shuttered golf courses — which often had the advantage of being tied into existing urban infrastructure, unlike more undeveloped land — presented ideal spots for relatively low-cost development.
Not everyone was happy about the idea. To the ire of its affluent neighbors, the precious real estate of the Badlands Golf Club was slated for a new housing development in 2015. What came next was one of the worst land disputes in Nevada history, a decade-long legal tussle waged by the city of Las Vegas at the behest of wealthy locals. Las Vegas was forced to fork over $286 million to a developer last year — one of the largest such settlements in history, and more than the city’s entire annual municipal culture and recreation budget — for illegally denying applications and permits to build atop the Badlands, which by then sat empty, an abandonedeyesore. Eleven years after the fiasco started, a new developer finally began clearing the site for a new luxury housing complex earlier this year, while Las Vegas has had to enact hiring freezes and delay municipal projects to pay off its hefty bill.
In cities where space is tight, underused golf courses are, in theory, ideal canvases for new housing. These huge, repurposed tracts of land can fit thousands of new units — ideally, affordable ones — alongside other amenities like parks or basketball courts smack in the middle of some of the country’s most desirable and well-connected neighborhoods. This makes such developments much cheaper to build than creating a new suburb with all new roads and power lines from scratch.
Not every attempt to turn golf courses into housing lands is destined for financial calamity. Just last year, the city of Las Vegas approved a plan to convert a separate golf course, the city-owned Desert Pines Golf Club, into a 1,500-unit housing complex, the largest affordable housing project in Nevada history and a public-private partnership between the city, the Nevada State Infrastructure Bank, a private developer, and nonprofit partners. The project is a rare win for these kinds of developments, and may offer a blueprint for how they can be accomplished in the future. But even there, the challenges are still real.
“Everyone wants more housing at a regional level. Everyone acknowledges that we need more housing,” said Nicholas Irwin, research director at the Lied Center for Real Estate at the University of Nevada, Las Vegas. “But no one wants it near them, and that’s the tricky part.”
How to turn a golf course into housing
Desert Pines Golf Club opened in the heart of East Las Vegas in 1996, a lush, manicured 18-hole course, peppered with over 4,000 imported pine trees. Like nearly one in five fairways nationwide, Desert Pines was municipally owned, its pricey water needs subsidized by Vegas taxpayers.
With its rolling green hills, Desert Pines was, by far, the largest contiguous green space in the mostly working-class neighborhood that surrounds it. But while golfers flocked to the course, many local residents barely even knew it was there or likely assumed it was out of their price range, said Ángeles Ramos, a local organizer with the immigrant advocacy group Make the Road Nevada. “Only the wealthy wanted it for their own purposes,” she told me in Spanish, but “what we want, what we urgently need, is more affordable housing.”
There was a time when “we could just build anywhere and everywhere because the valley was underdeveloped,” Irwin said, but “now, we’re buttoned up against it. We are incredibly dense, because we’ve basically filled up the land we have.” Much of Nevada is undevelopable because the federal government has set it aside for other purposes like recreation, which explains the state’s bevy of tourist attractions like Lake Tahoe or Red Rock Canyon. But it also leaves the city with little space to build.
If all 16,000 golf courses in America turned all of their land — about 2.3 million acres — into housing with the same density as Desert Pines, it would be enough space to build 22 million homes. If you applied that approach to only those courses that are, like Desert Pines was, municipally owned, then you could still build 4.3 million affordable homes, which would make an enormous dent in the nation’s current shortage of about 7.2 million affordable homes.
That’s not to say that every golf course in every land-constrained city ought to be bulldozed to make way for new apartment buildings. Golfing, for the record, has made a bit of a comeback lately, much like its most famous star. And even if fairways were still closing at the rate they were a few years ago, there’s no way that they could solve Nevada’s housing gap alone, much less overcome the shortage nationwide. But they can still help close the gap.
Ramos, who is among the local leaders organizing community meetings around the Desert Pines redevelopment, believes it could be transformative for the community over time. She says that in her neighborhood it’s become a luxury for many families just to live alone with their spouse and kids, rather than doubling up in cramped apartments, pooling together money each month to keep up with rising costs.
When the Desert Pines redevelopment opens about a decade from now, it will include not just 1,500 housing units, but also a soccer pitch, walking trails, and a job training center. In East Las Vegas, the temperature often feels more than five degrees hotter than it does in the Badlands’ affluent suburbs, where residents enjoy over nine times as much parkland per person.
“This project brings a lot of hope,” said Ramos, who’s especially excited about the prospect of more accessible, kid-friendly green spaces. “We’re all human. We need equity, respect, and to live with dignity, and that’s why we urgently need trees too.”
As it turns out, you can do a lot with an old fairway. Even with all of those bells and whistles, the new development will still likely use less water than the golf course did. And, because the plot of land is already enmeshed within the community of East Las Vegas — close to existing sewer, water, and electricity lines — it will be much cheaper to build there than it would be to try doing so on the outskirts of the city, said Antonio Bermúdez, vice president of McCormack Baron Salazar, the developer working with the city and state government on the proposal.
“What I’ve seen so far in the state of Nevada is that the political will is there,” he said, though the question is, “how do we make this happen not just in Nevada and the city of Las Vegas, but everywhere else where affordable housing is needed.”
Not in my golfyard!
If the Badlands has become a brutal fable of bad governance and highly charged NIMBYism, then Desert Pines may prove to be the model of a golf course-to-housing project gone right.
It also enjoyed the privilege of being located in a welcoming neighborhood, filled with renters who could personally benefit from the project. By contrast, many other golf courses were instead built as a luxury perk embedded in master-planned communities, meaning they’re surrounded by homeowners who fear that losing a recreational amenity — especially if it’s replaced by less upscale housing — could affect their property value.
“Everyone wants more housing at a regional level. Everyone acknowledges that we need more housing. But no one wants it near them, and that’s the tricky part.”
Nicholas Irwin, research director, Lied Center for Real Estate
Just across the street from the Badlands is another golf course, Angel Park Golf Club, built on federal land granted to the city of Las Vegas. If the city ever tried to build an affordable housing complex like the one it’s planning in Desert Pines, it would almost certainly fail given the outrage with which the surrounding community reacted to a proposal for other high-end housing in their backyard.
Victoria Seaman, a former Las Vegas City council member, was elected in 2019 to represent the district that includes the Badlands, mid-lawsuit. Even the “big, beautiful two-acre lots” the developer originally envisioned for the site, she said, were not good enough for Queensbridge, an ultra-luxury gated community abutting the course that acted as a powerful lobbying bloc during the decade-long process, influencing the city’s illegal decision to block the original property owner from breaking ground.
The city of Las Vegas is still paying off the total $286 million settlement it made over its obstruction of the Badlands project, in part through funding cuts to projects like the Desert Pines redevelopment in East Las Vegas.
“These were expensive homes with beautiful planning,” Seaman said of the project planned for the former golf course, and yet somehow, “these very big donors in Queensbridge convinced the entire [homeowners association] that the developer would ruin the neighborhood.”
The fight over fairways is really a fight over who gets to live where
The Badlands example is particularly dramatic, but it also gets at the challenges faced by similar projects across the country. Even a decade after many fairways fell into decline, there are few other examples quite like Desert Pines, and certainly none as large. While dozens of cities — including Denver, New York, and Virginia Beach — have made overtures to turn golf courses into housing in recent years, almost all such projects have been met with upheaval and fierce resistance from locals.
To some extent, that’s understandable. In Sparks, Nevada, hundreds of local residents have flooded community meetings in recent months to oppose a proposal to raze the Red Hawk Golf and Resort and build over 700 new homes in its place. “Promises were made to this community,” Tom Ciesynski, one of those homeowners, told me, “these lots, these very nice homes, were sold with premiums added for those that were sitting on the golf course.” Now, he says, the fairway’s owner is trying to build “tract homes that just don’t fit the character” of a neighborhood that has come to see the Red Hawk as its centerpiece, where Ciesynski regularly goes to golf, and where his wife takes her yoga and pilates classes.
He understands that Sparks, like most of Nevada, faces a housing crunch. “Most people aren’t opposed to all new development, but there’s a right way to do it and a wrong way to do it,” he said, and there are other places within a “stone’s throw of where we live” where he thinks the developers ought to go and build instead.
He arguably has a point. Recreation spaces are important for livable cities, too, and it’s not fair that homeowners who were promised one thing when they bought their properties are now facing a new reality.
And yet, the most troubling trade-off is not the one that leaves a homeowner golf course-less but the one that leaves families in East Las Vegas unable to afford homes at all. It may be tempting to only build affordable housing in places that won’t put up a fight, which in practice, means avoiding most golf courses, especially those in wealthy neighborhoods that want to preserve the kind of exclusivity that many fairways were built to project in the first place. But cities can no longer afford that indulgence — and in any case, they shouldn’t be digging in their heels to protect it.
When people talk about a new development not fitting the character of a neighborhood, “what they’re describing is an amorphous feeling,” said Irwin of the University of Las Vegas, “and if you make policies based on feelings and vibes, you get bad policy.”
Secretary of State Marco Rubio at an ASEAN meeting in the Philippines on July 23, 2026. | Ezra Acayan/Getty Images
The International Criminal Court is in the trenches right now.
Last week, its chief prosecutor, Karim Khan, was voted out of his position. In a first-of-its-kind vote, 82 member states decided that he engaged in misconduct and a serious breach of duty. The vote comes after he was accused of sexual misconduct by a female colleague at the ICC, which Khan has denied.
It’s a mess, and it’s hitting the ICC at an inopportune time. On top of this internal turmoil, US Secretary of State Marco Rubio recently launched an all-out attack on the court.
In a Wall Street Journal op-ed earlier this month, Rubio wrote that the Trump administration’s goal is to “dismantle the ICC—brick by brick, if necessary,” citing the possibility that the court could “target” American citizens, such as Border Patrol agents or US soldiers.
The US is not a member of the ICC, and has a history of wariness about the organization.
Beth Van Schaack previously served as the US ambassador-at-large for global criminal justice, a role that led her to work directly with the International Criminal Court. She spoke with Today, Explained co-host Noel King about the decades-long tumultuous relationship between the US and the ICC. And they discuss whether, if the ICC is now weaker than ever, the Trump administration can actually break it for good.
Below is an excerpt of their conversation, edited for length and clarity. There’s much more in the full podcast, so listen to Today, Explained wherever you get podcasts, including Apple Podcasts, Pandora, and Spotify.
If the International Criminal Court is charged with dealing with people who have allegedly done very bad things and then trying them, why is the United States not a member?
The United States signed the treaty in the waning days of the Clinton administration, but never submitted it for ratification to the Senate. And one of the concerns is that the final treaty allows for jurisdiction over individuals who may commit crimes on the territory of state parties. And the United States has always been concerned about that principle because we have troop commitments.
Supporters of the court have always said the United States and its personnel are vulnerable regardless of whether you join. If US personnel are committing crimes on the territory of state parties, which we saw in Afghanistan, the response is to do those cases domestically and there’ll be no occasion for the International Criminal Court to consider those matters.
There’ve been peaks and valleys in the relationship between the ICC and the United States. So we’re in a frankly pretty deep valley right now with this new campaign that Secretary Rubio announced.
But back in the Bush administration, there was also very acute concern and it stemmed from this Afghanistan investigation. The Bush administration and Congress both put in place measures that they thought would be protective of US servicemembers. So that was one valley.
Now what’s interesting is in the second term of the Bush administration, many of these measures were dismantled because the Bush administration realized that the court was doing important work in some areas where it also cared about justice — in particular, Darfur.
Then, the Obama administration announced a reset in its relationship with the court, and that’s where I entered the picture. The Obama administration directed various executive agencies to look for ways to support the court where the work that it was doing was consistent with US policy.
Then, we had the first Trump administration, which reversed course almost immediately and eventually imposed sanctions on senior figures, including the prosecutor herself and one of her key aides.
Then, we get to the Biden-Harris administration. They pulled down those sanctions and again launched a reset of the relationship. At that point, there were a number of situations where the court was working, including following the brutal war of aggression by Russia against Ukraine.
Here we saw a remarkable rise of bipartisan support for the work of the court. You had senior Republican figures in Congress supporting the court. The late Sen. Lindsey Graham (R-SC) led a resolution that was supporting justice in Ukraine. Secretary Rubio, then Sen. Rubio, joined that resolution. There was new legislation passed that made it easier for the United States to support the work of the court.
Of course, with the second Trump administration, we have reversed course again, and in particular with Rubio’s announcement.
Well, let’s talk about the reversal. Secretary of State Marco Rubio is at one point on board with the ICC, and then recently he vows to dismantle it. What happened here?
It’s not clear what the precipitating event is, to be honest. There is no existential threat at present. Obviously, there’s always the concern that this is some kind of a distraction because matters are not going well in Iran and with respect to the economy — that this is something to pull eyeballs away from those matters onto something that he can look tough in. Is this just kind of red meat for anti-multilateralism or is there something that is not made public that is happening?
Is there anything actually that Marco Rubio or anyone else in the United States at the highest level could do to the International Criminal Court to put an end to it?
The International Criminal Court is part of a larger system of the rules-based order that we’ve been trying to build since World War II. Almost all of our friends and allies are members of this court and they care deeply about its success. They are committed to seeing a system of international criminal justice. So, no is the answer. The United States alone cannot dismantle this court.
Now, it can injure the court and it has already done so. There are already eight ICC judges, including judges who hail from some of our closest allies — France, for example — who have been subjected to brutal sanctions. They can’t use credit cards that pass through New York. They can’t make reservations online because of financial sanctions. They can’t travel to the United States because of travel bans, et cetera. The chief prosecutor and two of his two deputies have been sanctioned. Non-governmental organizations that are involved in human rights in Palestine have been sanctioned and a UN figure has been sanctioned. Those measures are already in place.
What his most recent campaign seems to announce is some diplomatic move to try and convince states to leave the court or to cease their cooperation with the court. And we have seen in recent days a couple of states announcing that they were withdrawing. These are mostly states within Africa, but also Venezuela, subject to investigation by the prosecutor’s office. The United States can certainly injure the court, but there’s no way that we could dismantle the court.
Most Americans don’t spend a lot of time thinking about the International Criminal Court, but they may know it because lately, it has gotten a lot of attention that the court has issued an arrest warrant for [Israeli Prime Minister] Benjamin Netanyahu. New York City Mayor Zohran Mamdani has said he would like to see Netanyahu arrested if he comes to New York.
Mamdani has said he does not have that power. He cannot order the NYPD to do it, but he would like for it to happen. What are the chances that Benjamin Netanyahu comes to the United States and is arrested?
Pretty close to zero, if not actually zero. This is a matter of federal law and international law. And the Headquarters Agreement between the United States and the United Nations, which placed the headquarters of the UN in New York, basically gives certain privileges and immunities to individuals who are coming to New York to attend official functions.
New Yorkers are a feisty bunch. So when word is out that Benjamin Netanyahu is in New York, can you imagine the protests that would happen? Can you imagine the embarrassment that he might experience when he’s supposed to be giving his remarks at the General Assembly High-level Week where all the heads of states convene to deal with transnational issues and his motorcade is ensnarled in protests protected by the First Amendment, calling for his arrest for various international crimes? If I were his lawyer, I would say, “There’s no chance you’re going to get arrested.” But honestly, it could be a miserable visit, given all of the strong support for accountability in this matter in the United States.
This is a lot of drama for a body that for a long time seems to have avoided a ton of very public drama. So who gets hurt in all of this? Is it the court? Is it the US and its reputation? Where do you think this leads?
Unfortunately, I think everyone comes out not looking great here. The court needs to put in place measures to be able to receive those complaints by witnesses, whistleblowers, victims themselves, process them quickly, but also fairly to all parties involved. The United States looks terrible as well, launching a campaign like this against an international organization whose mandate it is to deliver justice for the worst crimes known to humankind.
Here in the U.S., we’re looking at the Iran War in terms of whether the U.S. should have started it in the first place, how it’s affecting oil prices, how it’s going to affect the midterms and a bunch of other things. But there’s another way to look at it, which is that Iran is putting on a global performance of standing head to head with the full might of the U.S. military and pulling it off. By their actions, we can see pretty clearly that the Iranian government does not fear Donald Trump. They’re not acting scared. If anything, they’re upping the rate of their provocations, as the state of war and effective stalemate transitions to a new normal of sorts.
It is fair to say that this is not actually the full might of the U.S. military in a theoretical sense. The president could order the U.S. military to mount a full scale ground invasion of Iran, occupy the country, dismantle the state’s system of command, control and repression. Those things are very likely possible, albeit at vast cost. But the real test of a military is not what it can do in some theoretical sense, the precise armaments it has and so forth but what the country which controls that military is able and/or willing to do in a specific economic, geopolitical, and political context. And the U.S. is clearly not willing to do those things. So in a practical sense — not the abstract power and capabilities of the U.S. military but the country’s ability to do those things — this is the full force of the U.S. military.
If you want to be informed on exactly how AI is being used in your medical care, you have every right to ask your doctor, experts say. | Malte Mueller/Getty Images
AI is the hottest thing in medical care right now — but many of us feel trepidation about it. Just one illustrative public survey sample: An October 2025 KFF poll found just 8 percent of Americans reported feeling a “great deal” of trust in AI managing their appointments or analyzing their health records, and only 32 percent said they would trust an online health tool that uses AI to access their medical records to provide personalized health information.
But many clinicians and healthcare administrators see AI as a powerful new tool that offers myriad opportunities to streamline and improve treatment. A 2026 survey found that more than 80 percent of US doctors use AI professionally — doubling the share from 2023. Physicians are excited by AI’s potential to keep more accurate notes of interactions with patients, to act as a second pair of eyes for human doctors, and to monitor people at risk of deteriorating and ending up in a dangerous situation.
The disconnect between what people and their providers want from AI could create more distrust, at a time when faith in the healthcare system and the medical profession have slid. Patients today want to feel empowered and in control. How can that be possible when these seemingly godlike machines are becoming more and more entrenched in our hospitals and doctors offices?
The answer comes in four words: “human in the loop.” It’s the principle upon which the ethical integration of AI depends and it could help to bridge the gap between lay people and the professionals on AI in medicine. In surveys, people are much more comfortable with the idea of their doctor using AI as an assistant than with AI acting on its own. And most clinicians want to use AI in that way, as a second opinion or passive monitor, not as a replacement for their judgment. There are real fears among the healthcare workforce about that possibility: A group of NYC nurses who were recently laid off claim it’s because their labor was going to be replaced by AI. “Human in the loop” appears to be a point of agreement between doctors and patients at this pivotal moment.
“Doctors…and nurses and staff always have been interested in primarily making the best decision for the people under their care — and these tools can help with that,” Alison Callahan, a research scientist at Stanford University who works on AI programs used in the university’s health system, told me. “The interest in making sure those tools are accurate is high.”
But what does “human in the loop” really mean in practice? How can you know when and how your doctor is using AI? And what is the best way to talk to your provider about the sudden influx of artificial intelligence in healthcare before a robot starts taking appointment notes or analyzing your MRI? I called some leading experts to find out.
How AI is currently being used in medicine
Patients and providers alike are incorporating AI into healthcare. Individuals are using commercial AI chatbots to ask about their symptoms or the health metrics tracked by their Apple Watch, while large academic medical centers are developing sophisticated programs and protocols to try to improve medical care at the population level.
It starts with ChatGPT, Claude, etc. — the large language models that are available to the public. People are increasingly turning to them to try to understand what’s going on with their own bodies. Individual physicians are also consulting with large language models to answer questions or get up-to-date on the latest research as they figure out how to best care for their patients.
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Then there are ways in which hospitals and doctors offices are adopting AI at the institutional level. Many facilities are using AI as a way to take, collate, and summarize notes on a patient; in theory, it’s a more organized way to keep track of the informal interactions and observations that doctors have when checking on their own patients. Hospitals are also using AI to handle some administrative tasks, like scheduling follow-up appointments; some health systems have even started to use AI to help patients get ready for appointments — to send reminders about colonoscopy prep, for example.
And finally, you have maybe the most ambitious use of AI by health systems right now: as a diagnostic and risk prediction tool. In these cases, AI might offer a second opinion when, for example, a doctor is triaging a patient in the emergency room. It might help the ER staff figure out how to prioritize patients. Or these programs could monitor people either during a hospital stay or out in the real world (by drawing data from the person’s wearable) and make predictions about who may be at higher risk of complications and require further care. AI could recommend that somebody would benefit from seeing certain specialists or receiving a specific medicine or lab test, and generally offer proactive advice about the patient’s medical care.
But at this point, AI adoption is still “highly localized,” said Jennifer Goldsack, CEO of the Digital Medicine Society, a nonprofit that works with healthcare providers, drug makers, and government agencies on how to incorporate new tech (including AI) into clinical care. It depends on the individual doctor or health system. A lot of them are setting up their own programs and their own protocols for how to use these tools.
That is a big reason why it is so important for patients to be proactive about understanding how AI is being used for their health care. You can’t make assumptions; the only way you’re going to know for sure is to ask.
The questions you should ask your doctor about AI
By and large, experts say, patients should feel confident: Doctors and nurses want to keep a human in the loop, even as they integrate AI into their workflows.
“It will be a doctor who is going to be reading that summary or a nurse who is going to be reading that summary and then taking an action to order a lab or put a recommendation in for a follow-up appointment,” Callahan said. “There is high interest in making sure that that is the right decision for that person. That hasn’t changed.”
Still, many patients say they’d be more comfortable with AI use if their doctor fully explained it in advance. And health systems may have their own priorities that push their facilities toward more rapid AI adoption and delegating more tasks to these AI tools, as seen in the recent NYC nurse layoffs.
So if you want to be informed on exactly where this technology is present and have the ability to consent to its use, you have every right to ask your doctor, experts say.
“AI is new, but the trust that serves as the foundation of the physician-patient relationship is not,” Timothy Keyes, a machine learning scientist at Stanford Health Care, told me over email. “To that end, I think that conversations about medical AI use should be open, honest, and transparent — just like any other conversations about shared decision-making in the clinical environment should be.”
For some things, your doctor should be asking you proactively if you consent to AI use — note-taking, for example. At my most recent primary care appointment, my doctor asked me if it’d be okay for him to use AI to take and summarize notes from our conversation; Goldstack told me she’d experienced the same at recent physician visits. (This is probably the most common AI use that you will encounter, and Keyes said it’s worth considering giving your consent: “There is growing evidence that they reduce physician burnout and save them at least a bit of time each day writing notes.”)
There are also a number of direct questions that you can ask:
Will AI be used in my care and how?
How is my data being protected?
Can I opt out of any AI services that I do not feel comfortable with? (Keyes noted that patients should be allowed to opt out of any care, AI-related or not; if opting out is not an option, ask how a human provider will be involved.)
How is the health system or clinic making sure that any AI system they use is working as intended?
And the transparency goes both ways. If you’re asking a question because you consulted ChatGPT before your appointment, tell your doctor. If you’ve talked with a chatbot because of mental health struggles, tell your doctor. And at the same time, feel free to ask your physician how you yourself could actually use AI in a responsible and productive way to improve your health.
“This opens up the opportunity for both the physician and the patient to be humans-in-the-loop,” Keyes said, “in different parts of the loop, with different perspectives, using an AI system to better understand the bigger picture.”
In a way, the novelty of AI and its rapid adoption is an opportunity for all of us to be nosier and more inquisitive patients. What all of these questions really come down to, Callahan said, is how your doctor is making decisions about your health care. That is relevant to all of us, no matter how AI is involved or even if there is no AI being used at all.
Callahan said she always has a list of questions for her doctor when they recommend a course of treatment: “What are the factors in my health that are informing this recommendation that you have? Would you be making this recommendation for other patients who are similar to me? What can you tell me about the outcomes that I might expect to experience if I say yes to this?”
“I actually think if they can point to the part of your health that is connected to the decision, whether or not an AI tool helped to make that connection is secondary to their ability to communicate effectively to me about it, and help me to feel engaged in making a decision about my own care,” she said.
AI is changing medicine quickly, for both patients and their doctors. The best way to stay ahead is to talk about it.
An immigration court sign is seen as federal agents patrol the halls of the Ted Weiss Federal Building in New York City on May 12, 2026. | Michael M. Santiago/Getty Images
This story appeared in The Logoff, a daily newsletter that helps you stay informed about the Trump administration without letting political news take over your life. Subscribe here.
Welcome to The Logoff: The Trump administration is further limiting due process for asylum-seekers in the US.
What’s happening? On Tuesday, the administration issued a rule changing how some asylum requests are handled. Under the new policy, immigrants in more than 444,000 asylum cases could be denied the chance to speak with an asylum officer and claim asylum, which requires them to have experienced persecution, or the threat of persecution, in their home country because of their race, religion, nationality, political opinions, or another characteristic.
Instead, those immigrants would be redirected to immigration judges — who could order their deportation without any additional process.
The change, according to the administration, is intended to help clear a substantial backlog in the US asylum system, which has 1.4 million cases currently pending. But it fits a pattern by the Trump administration of dramatically curtailing access to asylum in the US.
What’s the context? Under the second Trump administration, many previous immigration judges have been forced out or fired from their roles. Their replacements, as Bloomberg reported earlier this year, are minimally trained and instructed to deny most asylum claims outright.
What’s the big picture? The Trump administration also has a long record of sending immigrants back into dangerous situations in their home countries, or even to countries to which they have no connection.
And those deportations are poised to get worse: In June, the Court also cleared the way for Trump to end temporary protected status for immigrants from Haiti and Syria, without consideration of procedural rules. Now, Immigration and Customs Enforcement is reportedly preparing to target hundreds of thousands of Haitians living in the US for deportation, even though the island nation is dealing with serious and widespread gang violence.
With less than 100 days until the 2026 midterm elections, don’t miss my colleague Astead Herndon’s new newsletter, The Midterms, Actually. Every week, Astead breaks down the big ideas and key people behind the political shifts shaping the 2026 elections. You can subscribe here.
And with that, it’s time to log off…
Want to spend less time on social media? Here’s some excellent advice from my colleague Constance Grady, available here with a gift link.
Thanks for reading, have a great evening, and we’ll see you back here tomorrow!
It’s tough to find any semblance of a silver lining in the humiliating implosion of Donald Trump’s foreign policy over the last year, especially after a week that has brought us another escalation of the war no one supports, a recycled trade war with Canada, an out-of-nowhere nuclear deal with a country that should never have access to nuclear weapons, and yet more threats against a small nation that poses no threat to the United States.
But here’s the upside, just maybe: The tiny and perverse cadre of “anti-anti-Trump leftists” has been decisively silenced. If you find that phrase baffling, consider yourself fortunate. You evidently haven’t wasted any of your one wild and precious life arguing with renegade Marxists about whether the Trump-Putin alliance, in world-historical terms, was “objectively” superior to neoliberal internationalism on the Clinton-Obama model.
If this is a safe space, I will admit here that at one time I was around one-third vulnerable to such arguments. I don’t mean the part about Trump being a force for progressive change in any sense, even if entirely by accident, since that was obviously and hilariously wrong, not to mention based on the same “enemy of my enemy” pretzel logic that produced the disastrous Nazi-Soviet pact of 1939. But on the level of a sophomore-seminar intellectual exercise, I could understand why self-appointed contrarians like Julian Assange and Glenn Greenwald saw Trump as a disruptive force who might upend the softcore imperialism of the previous three or four decades, which had led to the “forever wars” in Iraq and Afghanistan and the global hegemony of corporate capital.
You didn’t have to be an unregenerate Leninist or an online troll or a Pat Buchanan-style paleoconservative (or all three at once!) to be momentarily seduced by Trump’s “America First” nonsense. Disgruntled Americans of all varieties voted for Trump by the millions, based in large part on his populist, isolationist rhetoric. Maureen Dowd’s notorious “Donald the Dove, Hillary the Hawk” column from 2016 should be inscribed above the gates of one of the lower circles of hell as a permanent warning to know-it-all media commentators.
It was, of course, immensely helpful to Trump’s agenda of fabrications, exaggerations and outright lies that we experienced the failings of mainstream U.S. foreign policy all over again during the strange interregnum of Joe Biden’s presidency, with its pious invocation of a “rules-based order” — where the rules are set by America, of course — and its theological commitment to a now-entirely-imaginary “two-state solution” in the Middle East. Several things can be said in retrospect about Biden’s fateful embrace of Benjamin Netanyahu on the Tel Aviv tarmac after the Oct. 7 attacks: It was an authentic and heartfelt gesture, it was a grievous political error and it paved the way for a humanitarian catastrophe now widely perceived as genocidal.
(GPO/ Handout/Anadolu via Getty Images) Joe Biden is welcomed by Benjamin Netanyahu at Ben Gurion Airport, Oct. 18, 2023.
Trump’s return to power has, at the very least, finally confounded all the doofuses who ever took anything he said at face value, and has also dispensed with the contradictory or two-faced rhetoric of the Biden years. There’s no more talk of universal human rights or the spread of democracy. The fundamental logic of Trumpian policy is cynicism all the way down: We don’t care about any of those things and we never did. To paraphrase Stephen Miller, surely the most instrumental figure in the Trump White House, the only thing that matters is power.
Maybe we should be grateful for the epic and reckless corruption of this administration, since Miller’s ambitious schemes to reshape America and the world as a white-supremacist wonderland are consistently undercut by the enormous levels of graft surrounding him. (Miller strikes me as a true believer whose corruption is moral rather than financial, one of many traits he appears to share with Joseph Goebbels.)
As the Trump administration veers unsteadily into its lame-duck phase and a likely midterm wipeout, its quest for a legacy achievement becomes increasingly pathetic, not to mention increasingly dangerous. Trump’s dance of death with the Iranian regime might have a comical aspect if the lives of many thousands of people and the future of the global order were not at stake. By goading the president into restarting the war for the third time (by my count), the new roster of hardline leaders in Tehran, at least for now, have strengthened both their domestic control and their international reputation. It’s difficult to imagine, in fact, how Trump and his ludicrous cast of advisers could possibly have screwed this up worse than they did. (D.C. rumors suggest that high-testosterone “Secretary of War” Pete Hegseth will ultimately be compelled to walk the plank over this fiasco.)
Maybe we should be grateful for the epic corruption of this administration, since Stephen Miller’s ambitious schemes to reshape America and the world as a white-supremacist wonderland are consistently undercut by the enormous levels of graft around him.
Meanwhile, the search for something that can be pitched to last-ditch MAGA loyalists as a victory, no matter how petty and insignificant, continues. Trump has never given up on his dream of seizing or annexing Greenland, but it was always more like an extortion scheme or a real estate scam than a military threat. Roughly the same applies to his improvised plan to rebuild Gaza as a Trumpified new Riviera, which took even Netanyahu by surprise and was never likely to escape the uncanny valley of AI fantasy.
I’m inclined to feel similar about this week’s reports that Seb Gorka, an unhinged far-right free radical with some sort of roving-ninja role in the Trump White House, is urging a military assault against Islamist militia groups in Mali, a West African nation with complicated internal dynamics and no relationship whatever to U.S. national security. Again, this might be amusing if real human lives weren’t at stake, and if billions in taxpayer dollars appropriated by Congress for aid to impoverished countries like Mali weren’t being diverted to right-wing nationalists, white supremacists and anti-LGBTQ groups instead of humanitarian and healthcare NGOs. (Read this ProPublica report for more on that.)
Things have truly gotten dark if we’re looking to JD Vance and Marco Rubio as the proverbial adults in the room, managing the worst impulses of their increasingly disinhibited and incapacitated boss. I don’t know which of those two geniuses signed off on the reported nuclear deal with Saudi Arabia, which may fall apart, goddess willing, under the weight of its impromptu idiocy and the fact that literally no one thinks it’s a good idea. Mohammed bin Salman, that kingdom’s journalist-murdering leader, is roughly the last person in the world who should have access to nuclear materials. If this deal goes through, it could rank among the very worst of Trump’s foreign policy blunders. Of course there’s still time for more.
Last week, the Food and Drug Administration (FDA) approved a small pill called enlicitide. It is a tablet you swallow once a day on an empty stomach with a sip of black coffee, water, or tea. But it does something that until now took a needle and a specialist’s prescription: It lowers the most dangerous kind of cholesterol by nearly 60 percent, about as much as the strongest injectable drugs on the market.
If that sounds less innovative than some of the medical advances I sometimes cover here — there’s no AI or gene editing involved — you’re missing the story. Enlicitide is just the latest example of how medicine has been quietly making progress against the deadliest thing in the modern world.
But today, our enemy is on the retreat. In the US, the age-adjusted death rate from cardiovascular disease has fallen about three-quarters since 1950. In plain terms: A 60-year-old today is roughly four times less likely to die of heart disease this year than a 60-year-old was when Harry Truman was president. As I wrote last year, deaths specifically from heart attacks are down 89 percent since 1970.
That progress comes down to a single number. Low-density lipoprotein, or LDL, aka the “bad” cholesterol your doctor always wants you to lower. Until recently, a high LDL score was all but inescapable, something you could nudge lower with a better diet and willpower but struggle to really fix. What has changed is that we can now lower LDL for nearly anyone who needs it — further, more easily, and earlier in life than before.
A lifesaving genetic mutation
It’s a story that goes back 20 years. In the early 2000s, two geneticists at University of Texas Southwestern, Helen Hobbs and Jonathan Cohen, wanted to solve a medical mystery: Why did some individuals have striking low cholesterol levels? They combed the Dallas Heart Study for an answer. They found a handful — many of them Black Americans — carrying a broken copy of a gene called PCSK9. Their bodies cleared LDL from the blood with unusual efficiency, and the payoff was staggering: carriers of the strongest variant had about 28 percent lower LDL and roughly 88 percent lower risk of heart disease than people who did not carry the mutation.
That finding proved lowering LDL prevents heart attacks, and it handed drugmakers a target: copy that gene. Every PCSK9 drug since — including the new enlicitide — imitates a mutation a few people in Dallas were simply born with.
Millions of Americans still take the old cholesterol-lowering workhorses, statins, and they’ve proven highly effective at reducing heart disease for most people. But not everyone: Some people can’t tolerate the muscle aches; others take them faithfully and still don’t get their LDL low enough. Enlicitide is built for exactly those people: a pill as cholesterol-lowering as an injection but without the needle, and a drug that spares them the statin muscle aches.
Closing the loop
If the pill is today, gene editing is tomorrow — and it may be the answer to a problem no pill can reliably solve: getting people to keep taking their medicine.
About half of patients on statins quit them within a year, and a daily pill, however potent, only helps the people who actually take it. So that demands a fix you can’t forget. A company called Verve Therapeutics, now owned by Eli Lilly, has been testing a treatment that makes a single-letter edit to the PCSK9 gene in the liver — one infusion, in theory for life. In its first human trial, published over the spring in the New England Journal of Medicine, a single dose cut LDL by as much as 62 percent, and held it there for more than a year. Instead of a pill mimicking the effects of the genetic mutation that protected those people in Dallas, gene editing just switches off the gene.
As important as it is, cholesterol isn’t the whole story when it comes to heart disease. There’s smoking, which declined from about 40 percent of US adults in the 1960s to under 15 percent today, sparing countless arteries. High blood pressure — the silent condition that killed President Franklin D. Roosevelt at 63 in 1945, when doctors had few effective ways to treat it — can now be caught early and treated with cheap generic pills.
And then there are the GLP-1s. More than one in 10 US adults say they are currently on an anti-obesity drug, and whatever else you may think of them, they’ll make a significant dent in heart disease. In one major trial semaglutide cut cardiovascular events by 20 percent.
The war continues
Still, the war on heart disease won’t be easy to win.
Just because a pill like enlicitide has been proven to lower a lab value does not mean it’s yet proven to lower deaths. They should — the injectable versions of these drugs cut heart attacks and strokes by about 20 percent in long trials. But enlicitide’s own outcomes study won’t conclude for years.
Precisely because the condition itself so widespread, treatments for heart disease will only be effective if they are equally widespread.
Heart disease is shifting, too. The same research showing heart-attack deaths down 89 percent found deaths from other heart conditions — heart failure, arrhythmias, hypertensive disease — up 81 percent since 1970, though because heart attacks were killing several times as many people, overall heart-disease deaths have still dropped by about two-thirds since 1970. Some of that shift is perversely the result of success: people who might have died of an initial heart attack now live long enough for the heart to wear out in other ways. And some of this is the reverse of progress: As smoking and cholesterol fell, obesity climbed to about 40 percent of US adults, pulling diabetes and high blood pressure with it.
And then there’s perhaps the biggest problem in medicine: access. A 60 percent drop in cholesterol helps only the people who can actually get the drug. Half of patients abandon cheap statins within a year. Enlicitide arrives at about $300 a month with uncertain insurance coverage. The gene edit, whenever it becomes available, will certainly cost far more, and at first will reach only the sickest.
More than 60 percent of US adults are projected to have some form of heart disease over the course of their life. Precisely because the condition itself so widespread, treatments for heart disease will only be effective if they are equally widespread.
Which brings us back to that unassuming little pill. It’s just a tablet, doing what a generation of scientists spent their careers trying to do: turning one of the deadliest numbers in medicine into one you can change. It’s the kind of progress that’s too easy to miss — until it saves your life.
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Abdul El-Sayed, US Democratic Senate candidate from Michigan, speaks during a campaign event in Detroit, on July 18, 2026. | Nic Antaya/Bloomberg via Getty Images
Abdul El-Sayed is among America’s most prominent proponents of Medicare-for-all.
The frontrunner in Michigan’s Democratic Senate primary literally wrote the book on that policy (or at least, a book on it). In El-Sayed’s view, Medicare should cover “all necessary healthcare” for every American — without co-pays, premiums, or deductibles — and be “accepted everywhere.”
Key takeaways
• American healthcare is expensive largely because our hospitals, doctors, and drugmakers charge unusually high prices.
• American physicians earn about twice as much as Canadian doctors and four times as much as Swedish ones.
• To make Medicare-for-all affordable, we need to push down many doctors’ salaries, which is politically difficult.
• Expanding the supply of doctors — by funding more residencies and easing barriers for foreign-trained physicians — would lower costs and make universal coverage more feasible.
Alas, despite his many years of advocacy, El-Sayed has seemingly failed to persuade his wife of that last point: According to a recent report from the Washington Free Beacon, El-Sayed’s partner, the psychiatrist Sarah Jukaku, does not accept Medicare as a form of payment at her private practice.
This bit of gossip is of little importance, in and of itself. The Free Beacon’s story does nothing to refute the case for El-Sayed’s candidacy or his healthcare plan (his wife’s business is, well, her business). As hit pieces go, it’s weak tea.
Nevertheless, the tension between El-Sayed’s healthcare proposals and his wife’s business practices is real. And it is illustrative of a major challenge facing anyone who wishes to reform our nation’s misbegotten healthcare system: To meet the medical needs of all Americans, reformers will need to defy the interests of most doctors — and in many cases reduce their compensation.
And that won’t be easy. Few people feel a deep fondness for insurance companies. But El-Sayed is far from the only American who loves a physician.
The biggest obstacle to Medicare-for-all
To understand why Medicare-for-all would be bad news for many doctors — and how the Free Beacon’s story illustrates that point — we must first dwell on one fundamental fact about America’s healthcare system: It’s a rip-off.
The US spends about twice as much per person on medical goods and services as other wealthy countries. And yet, all that money does not actually buy us much more care. Compared to our peers abroad, Americans are less likely to see a doctor, secure a long hospital stay, or access a timely appointment for medical treatment. On the other hand, we do have the privilege of paying radically higher healthcare prices.
To take just one telling example: In the United States, a coronary bypass surgery will typically cost more than $89,000; in Australia, it costs just $17,741.
Such exorbitant prices are the chief obstacle to any version of universal healthcare. Even with one-third of working-age Americans uninsured or underinsured — and thus, consuming too little medical care — the bill for America’s health sector ran to $5.7 trillion in 2025.
In El-Sayed’s vision, Americans would consume vastly more medical services than they do today: The uninsured would suddenly have access to every doctor in the country, while everyone else would see their co-pays and deductibles drop to zero, encouraging them to schedule far more doctors’ visits.
This would be a costly proposition in any country. At America’s current healthcare prices, it would be prohibitively expensive. There is simply no way to realize anything approaching the left’s healthcare ambitions without slashing the amount of money that Americans pay per medical service.
Doctors will pay a price for universal healthcare
Medicare-for-all advocates are aware of this fact. And they’re typically eager to talk about one source of America’s high healthcare prices: The inefficiencies of our private health insurance model.
In America’s byzantine system, each insurer needs its own teams of auditors, claims reviewers, and myriad other specialists, while every major healthcare provider needs a horde of administrators to navigate the idiosyncratic rules of all these different insurance companies. Americans pay dearly for this bureaucratic bloat. By one estimate, our system’s administrative costs are $500 billion higher than they would be if the insurance industry was consolidated into a single public insurer.
And yet, as large as that figure may seem, it still represents a fraction of America’s excess healthcare costs. The primary cause of our nation’s exorbitant medical prices is simpler than administrative redundancies: our healthcare providers charge exceptionally high rates.
Hospitals are the biggest culprits on this front. But physicians are also part of the problem.
According to a 2026 study from economists at the University of Chicago, Stanford, and the US Census Bureau, American physicians earn about twice as much as Canadian ones — and four times as much as Swedish doctors.
Critically, this does not merely reflect America’s greater wealth or wage inequality. It is true that educated professionals of all kinds — financial analysts, lawyers, software engineers, etc. — earn more in the US than they do in other rich countries. But American doctors don’t just earn unusually high absolute incomes — they also occupy an atypically rarified place within their own country’s class hierarchy. About 42 percent of American specialty physicians are in the top 1 percent of their nation’s income earners. Among Canadian specialists, that figure is just 27 percent; for Swedish ones, it is 7 percent.
The main driver of these disparities is straightforward: America imposes fewer price controls on its healthcare sector than other nations do.
And this is where Jukaku’s practice reenters the picture.
The public parts of America’s insurance system — Medicare and Medicaid — pay rates that are only modestly above international norms. It is when American doctors bill private insurers — or the rich consumers of boutique medicine — that they really make bank.
As a result, top clinicians like Jukaku often decline to take Medicare. If you’ve got affluent patients beating down your door, accepting Uncle Sam’s rates just doesn’t pay.
Unless the government forces doctors and hospitals to swallow steep pay cuts, however, Medicare-for-all won’t pencil out. According to a widely cited 2018 analysis by the economist Charles Blahous, if a single-payer system kept provider payments constant, national health spending would rise by $3.25 trillion over a decade, even with administrative savings taken into account. By contrast, if all providers were forced to accept Medicare’s rates, health spending would actually fall by $2.05 trillion over the same period.
Soaking physicians is tough politics
Thus, there is a clear conflict between progressives’ healthcare ambitions and medical providers’ material interests.
Yet the left is often reluctant to acknowledge this reality. El-Sayed tends to portray insurers as the sole economic beneficiaries — and political defenders — of America’s inequitable healthcare system. The fact that hospitals and doctors also profit off the status quo’s dysfunctions does not feature prominently in his rhetoric. To the contrary, El-Sayed suggested in 2020 that doctors like his wife are actually underpaid, even though American psychiatrists earn far higher salaries than their counterparts abroad.
To be fair, progressives aren’t alone in eliding providers’ culpability. Virtually all Democratic politicians do the same. And not without reason. Politically speaking, it is one thing to denounce the greed of private insurers — the faceless bureaucracies standing between Americans and their desired treatments. It’s quite another to call for reducing the wages of doctors, men and women who perform laudatory work and enjoy widespread admiration.
Precisely for this reason, however, reformers must grapple with healthcare providers’ investment in the current system. The American Medical Association (AMA), the lobby representing our nation’s physicians, was instrumental in killing past attempts to move toward single-payer. And at least some segments of the medical profession would surely mobilize against any contemporary Medicare-for-all bill that imposed substantial cost controls on the healthcare sector. What’s more, in doing so, they would be able to draw on a resource the private insurance industry lacks — the public’s trust.
How to make healthcare less expensive right now
There is no easy answer to the problems all this presents. But part of the solution is to chip away at providers’ payment rates where progressives already have the power to do so. This would not only help drive down costs for existing healthcare in the short term, an urgent priority all its own, but also would smooth the path to universal coverage in the long run.
That project can take many forms. One would be state-level payment regulations. In Maryland, hospitals receive the same rates, no matter whether their patients pay with Medicare, private insurance, or cash. And their budgets are also fixed, so that they aren’t able to milk fees out of unnecessary care. Rhode Island, meanwhile, caps the growth of its hospital reimbursement rates at the pace of overall inflation. Other states could follow their lead.
But policymakers should also address the supply constraints that undergird American doctors’ high salaries. US physicians’ ability to command high pay doesn’t just reflect America’s weak cost controls but also a persistent shortage of working doctors. The US has roughly 2.7 physicians for every 1,000 of its residents; the average among comparable countries is 3.9, according to a Kaiser Family Foundation analysis.
In this context, forcing down doctors’ pay might seem perilous. After all, doing so would reduce young people’s incentive to pursue a medical career, potentially deepening the shortage.
In reality, however, there is no dearth of qualified people who want to practice medicine in the US. We just don’t let many of them do so.
This is partly because American policymakers consciously sought to restrict the number of doctors in the country, beginning in the 1980s. As Robert Orr of the Niskanen Center explains, the US government issued a report in 1981 warning of an imminent “physician surplus” and recommending “immediate action to curtail both the domestic training of physicians as well as the admittance of those trained outside of the country.”
The report’s argument rested on false premises; it failed to anticipate that Americans’ demand for healthcare would rise sharply as they grew wealthier. Nonetheless, its recommendations were largely implemented: Federal support for medical-school scholarships was pared back while funding for residencies has been capped since 1997.
At the same time, policymakers maintained high barriers to the immigration of fully-trained foreign doctors: Even physicians with years of experience, and credentials in nations with high medical standards, are typically required to complete a multi-year residency before being able to practice in the US.
Ending the federal freeze on residency funding will require congressional action. But states can immediately make it easier for foreign doctors to practice within their borders. In fact, Tennessee established a pathway for such physicians to ply their trade in the state, without having to repeat a residency, in 2023. And many states subsequently enacted similar reforms.
Removing the bottlenecks on America’s doctor supply won’t eliminate the political hurdles to Medicare-for-all. But it would put downward pressure on doctors’ salaries, reduce the risks of capping physician pay, and make the left’s vision of healthcare abundance more feasible. After all, you can’t actually eliminate the care rationing that so many Americans resent by extending insurance coverage or enacting price controls alone. No matter how we pay for our medical services, we can only deliver as much care as our health sector’s resources allow.
Don’t hate the doctor, love the sick
In saying all this, I don’t mean to convey disdain for the medical profession. Like El-Sayed, some of my best friends are doctors! In fact, my mother, father, brother, and sister-in-law are all physicians. And they all have contributed far more to American society than I ever will. My brother spends his workdays providing lifesaving treatments to cancer patients; I often spend mine sitting at a desk in my pajamas, arguing about politics on the internet.
Physicians deserve to be well-paid for their strenuous labor. But if we want healthcare in America to be universally affordable and widely accessible, we will need to pay many of them a bit less.
What caused the ongoing outbreak of cyclospora, the diarrhea-causing parasite currently spreading across the United States? Michigan officials have been saying for weeks that they believed the outbreak may be linked to bagged salad or salad kits. What we were waiting to learn was the specific brands and specific products in question.
And late last week, it looked like we finally had the answer — but then things quickly got cloudy.
On July 16, the Washington Post reported, citing anonymous sources, that the outbreak had been linked to shredded iceberg lettuce supplied to Taco Bell by Taylor Farms. A day later, Taylor Farms said it was withdrawing products from US stores and restaurants based on information from the FDA.
But then on July 19, per NBC News, the FDA said that there had been a false positive for cyclospora when testing a sample of Taylor Farms iceberg lettuce; Taylor Farms said in its own statement that the FDA had “apologized” for the mix-up. The next day, the company and the federal government were stuck in a semantic argument: Per NOTUS, the FDA insisted it did not “officially apologize” to Taylor Farms but “explain[ed] factually the issues” with the false positive.
So where does that leave us right now? Officials still believe that Taylor Farms iceberg lettuce was the source of the Michigan outbreak. But whether those are the only products driving the outbreak remains unclear, with almost every state now reporting at least one cyclospora case in 2026. And on Thursday afternoon, the FDA announced that it was tracking a second outbreak linked to other unspecific products, though details were otherwise scarce.
Any outbreak of food-borne illness requires careful public communication. Officials need to tell people how to avoid contaminated food without scaring them away from eating fresh fruits and vegetables altogether.
But instead, many Americans have been left wondering what, exactly, they’re supposed to do. As one frustrated Reddit user put it: “So is the damn lettuce bad or not????” (If you need some advice on what foods are safe and what foods to be cautious about, we have a story for you.)
It may sound like a funny question, but it’s a profoundly serious one. The problem isn’t just that people are confused about their lettuce. The Trump administration’s handling of the cyclospora outbreak — from its conflicting public messages to accusations of political favoritism — has left many Americans even more confused about whether they can trust anything they’re hearing from the government. That’s a dangerous place to be during any public health emergency.
The cyclospora outbreak has become a communications nightmare
We are approaching 10,000 cyclosporiasis cases across the US this year: Michigan alone has recorded 7,664 as of this morning, Ohio has seen more than 1,200, and more than 40 states have now reportedat least one case in 2026. The country usually sees a few hundred cases at most in a given year. Cyclosporiasis, the disease caused by the cyclospora parasite, leads to what public health experts describe as “watery” and “frequently explosive” diarrhea. While it isn’t typically life-threatening, it can cause serious complications: 160 people have been hospitalized in Michigan since the outbreak began.
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And so for those of us who very much hope to eat fresh produce but do not want diarrhea, there’s a bit of urgency to figure out where the cyclospora is coming from. Food-borne illness investigations are already inherently difficult because of how globalized our food supply has become: Produce can travel all over the country and the world before it comes to your grocery shelf, and the process of government health workers interviewing the people who get sick and cross-checking to identify the shared foods that they might have in common is laborious.
Once investigators find a source, the information has to be shared clearly and responsibly. That is where the Trump administration has tripped up this week.
Trump — and Health Secretary Robert F. Kennedy Jr. in particular — came into office criticizing the public health establishment. They accused officials of misleading the public about the novel coronavirus and the vaccines developed to fight it, while failing to convey the nuances of the pandemic. But now, as they grapple with the incomplete picture of the cyclospora emergency, they are making many of the same mistakes.
“They’re very similar problems, even if on the outside, they don’t look quite the same,” said Michael Mackert, director of the Center for Health Communication at the University of Texas at Austin. “The underlying commonality is very much that we are dealing with imperfect information all the time.”
In any outbreak, some uncertainty is to be expected. Investigators have struggled to identify the source of earlier cyclosporiasis outbreaks too. And the FDA maintains that the likely source of the outbreak is Taylor Farms iceberg lettuce, based on the information they have gathered from sick patients and other sources, no matter the false positive result that has sparked so much confusion.
“The epidemiological evidence is so strong that the lack of a positive test is almost meaningless,” said Francisco Diez-Gonzalez, director of the Center for Food Safety at the University of Georgia.
But the mistake that the Trump administration made was in sharing preliminary results and then having to issue a seemingly contradictory statement shortly afterward.
“FDA should have waited for confirmation of the presumptive results before going public,” Diez-Gonzalez said.
The larger stakes of the Trump administration’s poor communication
Investigations like these are hard enough — but when you add in the public health funding cuts of the past 18 months and the casual and widespread corruption characteristic of the Trump administration, trust in the government’s public health apparatus has sunk even lower.
It’s created just the conditions for conspiracies to bloom. “Unfortunately our FDA is compromised,” wrote one top commenter on Reddit. “I would not trust what comes out of it during this administration.”
Several news outlets and influential social media accounts noted that Taylor Farms had donated $1 million to Trump’s MAGA super PAC and, in the middle of the controversy, received a private White House meeting. According to the New York Times, Taylor Farm officials used that meeting to dispute the findings that their products were responsible for the outbreak — and shortly thereafter, the FDA made its “false positive” announcement.
The administration insists that their decision-making is being guided by science, but even the appearance of impropriety has become a common theme in the press coverage. The broader uncertainty and distrust may help to explain why it’s not only Taco Bell and Taylor Farms taking a hit right now: According to Market Watch, Chipotle and the fast-casual salad chain Chopt have also seen a decline in traffic in recent weeks.
Public health requires public confidence. Perceived influence from special interests is a problem, even if the interactions didn’t alter the FDA or CDC’s actions.
Kennedy, who helms our government’s health department, should understand this well: His Make America Healthy Again movement made restoring public trust a central part of its message while accusing the existing public health establishment as being in league with special interests.
The cyclospora outbreak has revealed how difficult that is to do in practice.
In trying to communicate nuanced information during an active outbreak — while consulting interested parties like Taylor Farms itself — the administration has instead fueled doubts about the credibility of its messaging
Even before cyclospora turned eating salad into a leap of faith, Trump had a poor track record: His administration has slashed CDC staff, brought on vaccine skeptics to set vaccine policy, and clashed with the scientific establishment on a number of high-profile issues, like the time Trump held a televised press conference to argue a disproven theory that Tylenol can cause autism.
“Unfortunately, this is another example of a missed opportunity to establish credible and trusted communications to prepare the public to understand the real risks from the pathogen and confidence in the food safety and information from the FDA,” Scott Ratzan, editor-in-chief of the Journal of Health Communication: International Perspectives, told me. “Faith in our institutions continues to erode. We could do better.”
We are lucky cyclospora is not a deadly disease. Next time, the stakes for these miscues could be much higher.
Acting Attorney General Todd Blanche appears at his confirmation hearing in front of the Senate Judiciary Committee on Capitol Hill July 15, 2026 in Washington, DC. | Win McNamee/Getty Images
There was an unintentionally revealing moment in acting Attorney General Todd Blanche’s confirmation hearing last week. After Sen. John Kennedy (R-LA) asked Blanche whether he and President Donald Trump are friends, the leader of the United States Department of Justice replied, “I’m his lawyer,” before correcting himself and saying he “was his lawyer.”
Blanche previously defended Trump in three criminal cases brought while the president was out of office, but he is emphatically not supposed to be Trump’s lawyer right now. As acting attorney general — Blanche currently leads the DOJ because the attorney general’s job is vacant and Blanche is the Senate-confirmed deputy attorney general (DAG) — Blanche’s client is the United States, not the person who happens to occupy the White House.
But it’s easy to see why he misspoke: Blanche has largely acted as Trump’s hammer since he was confirmed as the DOJ’s No. 2 official, overseeing numerous prosecutions of Trump’s perceived enemies. Now Trump wants to promote him to the DOJ’s top job — a sign of Trump’s confidence in his former criminal defense lawyer turned personal enforcer.
And he’s put at least five of those criminal defense lawyers in top federal jobs.
Trump’s decision to turn much of his criminal legal team into powerful government officials matters for two big reasons. The first is that two members of that team, Blanche and Solicitor General John Sauer, are leaders within the Justice Department. Next to the military, there is no more fearsome government institution than the DOJ, which has the power to arrest people and try them for federal crimes.
The DOJ is supposed to exercise this authority with restraint — and often with restraints imposed by the Constitution itself — but Blanche has used the Justice Department’s power against Trump’s political enemies who appear to have committed no crime and removed constraints on Trump and his Justice Department, all while Sauer has worked consistently to convince the Supreme Court to remove other constraints on Trump.
Meanwhile, three of Trump’s former criminal lawyers,Emil Bove, Justin Smith, and Matthew Schwartz, now have lifetime appointments as US Court of Appeals judges, placing them one rung on the judicial ladder down from the Supreme Court. The judiciary, of course, is the branch of government that is supposed to prevent the president from breaking the law, so every Trump loyalist appointed to this branch weakens the remaining legal constraints on Trump and his administration.
Trump, of course, isn’t the only president to place close confidants in the Justice Department or the federal bench. President John F. Kennedy famously named his brother attorney general. President Lyndon B. Johnson appointed Abe Fortas, who represented him in a 1948 election dispute, to the Supreme Court in 1965.
But Trump’s decision to place someone willing to pursue his personal vendettas in charge of the Justice Department is, at the very least, a break with post-Watergate norms established to prevent the DOJ from becoming a political weapon. And Fortas, who resigned in disgrace after fewer than four years on the bench, is more of a cautionary tale than a model of good governance.
Although the current Supreme Court is dominated by conservative Republicans, some of these justices do break with Trump on questions that divide the Republican Party — such as whether Trump should unilaterally impose high tariffs on many nations. But if Trump gets to turn his personal cronies into justices, that could change quickly. A judiciary controlled by MAGA loyalists means that all remaining checks on Trump’s authority could end.Many of his former-lawyers-turned-appointees are already working to make an unchecked Trump administration a reality.
How are Trump’s former personal lawyers already reshaping American legal norms?
But Blanche, Bove, and Sauer have all displayed ruthless cunning in their efforts to advance Trump and his causes.
Blanche has been DAG since March 2025, a role that oversees the federal government’s criminal prosecutions and its 93 regional US attorneys’ offices. He’s led the entire Justice Department since April, after former Attorney General Pam Bondi — another of Trump’s former personal lawyers — left office.
So Blanche oversaw several dubious federal prosecutions targeting people Trump perceives as enemies, including criminal proceedings targeting former FBI Director James Comey and current New York Attorney General Letitia James. There’s also evidence that Blanche has played an unusually direct role in the Justice Department’s decision to bring meritless charges against prominent Democrats.
In May 2025, for example, Newark Mayor Ras Baraka, a Democrat, showed up at an ICE detention facility in his New Jersey city and asked to tour it. He was briefly let inside the gate, where he was confronted by about a dozen law enforcement officers and asked to leave, which he did.
But then one of these officers received a phone call. A video, later submitted to a federal court, shows the officer turning to his colleagues after the call and announcing, “We are arresting the mayor right now, per the deputy attorney general of the United States.” That deputy attorney general, of course, was Blanche.(In a September court filing, DOJ confirmed that officers arrested Baraka “after consulting with the Deputy Attorney General.”)
Yet, despite Blanche’s apparent decision to personally order Baraka’s arrest, the DAG forgot to check whether Baraka had actually done something that could support criminal charges. The mayor was only charged with misdemeanor trespassing, and those charges were dismissed two weeks later. At the court hearing formally dropping these charges, a federal magistrate judge admonished prosecutors for “using the immense power of the government to pursue weak cases or to make examples without sufficient cause.”
Blanche also unsuccessfully attempted to establishTrump’s $1.776 billion “anti-weaponization fund,” which would have been used to distribute money to Trump’s allies — including, potentially, Trump supporters who participated in the January 6 attack on the US Capitol.Although the fund appears dead after it received bipartisan pushback in Congress, a DOJ press release announcing the fund said it was “established” by the attorney general, a role performed by Blanche, and that the fund would be administered by five people chosen by Blanche.
Before Trump took office, Bove was Blanche’s law partner. Shortly before Bove joined the bench, he briefly served as principal associate deputy attorney general — essentially the DAG’s top deputy, which meant that Bove was Blanche’s right-hand man. In that role, he was often described as Trump’s “enforcer.”
Bove spent only about half a year as Blanche’s lieutenant, but he managed to spark a mini-revolt in one of the Justice Department’s most prestigious offices during his short tenure. After Bove ordered the DOJ to dismiss corruption charges against then-New York City Mayor Eric Adams “without prejudice,” a maneuver that would allow the charges to be reinstated if Adams did not cooperate with the Trump administration’s immigration crackdown, seven federal prosecutors resigned rather than comply with Bove’s order.
One was Danielle Sassoon, a former law clerk to Justice Antonin Scalia, a conservative icon. Another, Hagan Scotten, wrote in his resignation letter to Bove that “I expect you will eventually find someone who is enough of a fool, or enough of a coward, to file your motion. But it was never going to be me.” Scotten clerked for Republican Chief Justice John Roberts and for future Republican Justice Brett Kavanaugh.
Meanwhile, a whistleblower complaint by another former DOJ lawyer claims that Bove said, in a meeting about a court decision halting some deportations, “that D.O.J. would need to consider telling the courts ‘fuck you’ and ignore any such order.”
Trump appointed Bove to theUS Court of Appeals for the Third Circuit last September. Federal appeals courts typically spend months deciding cases, so his tenure on the Third Circuit has thus far been less eventful than his time at the DOJ. But there are early signs that he remains loyal to Trump even after moving into an independent branch of government. Bove attended a Trump rally in December, a highly unusual move for judges who are supposed to remain nonpartisan. And the background image on his iPhone is reportedly an image of a defiant Trump raising a fist, or at least it was months after he joined the bench.
Despite these losses, Sauer has an impressive winning record before the Supreme Court, largely because the Court is controlled by six Republicans who are highly sympathetic to Trump and his agenda. This is, after all, the same Court that said that Trump may use the powers of the presidency to commit crimes, after Sauer argued as much.
Sauer has been particularly effective in persuading the Republican justices to block lower court rulings against Trump on the Court’s “shadow docket,” a once rarely used mix of emergency motions and other matters that became a routine part of Supreme Court litigation during Trump’s first term.
So Trump has taken several of his personal lawyers and transformed them into some of the most well-credentialed — and in some cases, the most powerful — figures in the legal profession. Thus far, the evidence suggests that these individuals remain loyal to Trump, even when they move into jobs that are supposed to be nonpartisan. Three of them already have lifetime appointments.
Any nation governed by the rule of law must have government officials who will obey whatever constraints the law imposes — whether they be federal agency leaders who follow the law out of a sense of duty, or judges who rein in executive branch leaders who refuse to do so. Institutions like the Department of Justice also depend on informal norms, many of which are a response to similar abuses of power during the Nixon administration, that have long constrained federal prosecutors.
But Trump’s DOJ is often actively hostile to these norms, and the growing legal power of Trump’s personal lawyers is just the latest example. Their steady reshaping of the judiciary clears the way for a federal government that is not constrained by anything.
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