Jonathan Cohn
Appearances
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
We will feel the impact in 20 years when we don't have a cure for something we might have because that scientist, you know, is going to go into some other field, you know, that skill set.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
And one thing I just, I keep coming back to as I think about this is, I mean, if you sort of listen to Mosker, you'll listen to like Russ Vought, you know, or any of these people who are sort of on this, you know, crusade. And there's just this implicit difference.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
denigration right of these like researchers and you know as if these were like you know people you know you know kind of exploiting the public till for their own good middle managers in the hr department who aren't doing any work you know who are whatever like working eight working bankers hours like yeah sure and that's just not that's not the fucking scientists at hhs it's not it's not the scientist at hs or the university i mean almost by definition
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
If you have the skill set of that scientific level and you're at a university or you're at HHS, you know, employed by HHS, you can make a lot more money in the private sector. You're not there to get rich. You're there because you care about this as an intellectual project, as something good for humanity. And look, I mean, I know a lot of people are certainly well paid. They're not suffering.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
I live in a university town. I'm married to a professor. So, I mean, just to be, you know, I know this world and it isn't, These are not people in poverty or anything, but you could be making a lot more money out there. The fact that you've decided to be in a research or in the government says that you actually care about this.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
This denigration of these people is something that just – we saw this also, I think. I was thinking about – I've written about this too. You've talked about this, I know, with the people working at USAID, people working on PEPFAR. You know, if you have the skill set, you know, medical or administrative that you can make a lot of money in the private sector. And instead, what are you doing?
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
You're working on getting drugs, you know, life saving drugs to people with malaria or HIV. These are the people we're denigrating. I mean, what are we doing here? I mean, what kind of value system is that?
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
Yeah, I mean, it's kind of amazing. It was tepid.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
Right, right. Well, I don't want to sound paranoid, but have you noticed that we haven't actually heard him say that? It's a great point. These are statements.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
I'll be curious about the backstory here. You know, it turns out how those came to be and what he, you know. actually wanted it to say, whatever, I'm sure that will come out at some point, or maybe I'll find out, you know, he is promoting this as we're, you know, this great health agenda, right? I mean, that's his whole thing, make America healthy again.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
And the gist of the agency is to emphasize his idea of what makes people healthy, you know, which is no vaccines and, and, and, There's some parts of it that I think lots of people think, oh, let's get rid of artificial food dyes. Let's encourage healthier eating. Sure. I mean, that sounds great. But HHS does a lot of stuff to make people healthier, to keep people healthy.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
And all those departments are getting gutted. We see that at the CDC. He keeps talking about we want to do things for chronic health. We had all kinds of people working on HHS, whether through government insurance programs or direct provision of services that are trying to work on chronic disease and make people better, and they're all losing their jobs.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
This idea that he's this sort of crusader for health, I think even if you put aside what he thinks and some of the, there's just, you know, the scientifically nonsensical views he has.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
I mean, even if you accept that that's a sort of reasonable, you know, kind of agenda, which I think most scientists would, you know, he's actually dramatically diminishing the staff of people whose job it is, is to make people healthier. So that, how is that going to make people healthier? I just don't, I don't, I don't see it as nonsensical. And, you know, my sense is, you know, that,
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
I can't tell how engaged... I mean, I've talked to people. It's hard to know how engaged he really is. This is not like a master administrator we're talking here, someone who really knows how to manipulate the sort of bureaucracy. So it's hard to...
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
Yeah. No, he's getting his people in and getting the people he doesn't like out. I mean, the amount of expertise they've sent out the door is just stunning. You know, the sort of best known at this point, I think, is Peter Marks, who was the top vaccine safety official, you know, who tried to be, you know, according to Marks, you know, really tried to be effective. accommodating.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
You know, Marx said, you know, look, if you want to really look into this autism vaccine link that, you know, we've debunked repeatedly, sure, you know, I'll help you do that. And I think Marx probably thought, okay, we'll debunk it again. And according to Marx, that wasn't good enough.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
You know, he, you know, reading between the lines, I think he thought Kennedy wanted to stack the inquiry against vaccines and Marx was like, no, but you know, you're losing all this, this institutional expertise. And then that gets back to what we were talking about earlier, which is you know, institutional expertise in something like this is so important.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
You know, someone told me that it's going to seem like a sort of random and silly thing, but there was an official at NIH whose job it was, was like the sort of most knowledgeable person, like, More or less on the planet on how to run a clinical trial, just the mechanics of how to do it, how to do it safely and what protocols and all that. And that person's gone now.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
And, you know, that's not like super sexy, right? It's not the person who's, you know, doing the cutting edge, you know, cancer therapy. Seems pretty important though. Right. Right. And, you know, that person's gone. And like, you know, at every level now, it's going to be harder. People, you know, in dealing with an IHSV, that much slower, that much harder, that much more prone to failure.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
And these are the kinds of things that set us behind. And I think I just, this is the part of this that just blows my mind. Maybe I'm naive, but... Even if you don't agree, you know, whatever, you know, sort of the sort of, you know, MAGA view of the world, you know, it is supposed to be about making America great. And if you thought about like one day, what is America actually great at right now?
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
Biomedical research. Like we are the world leader in, Why? I mean, there's nothing ideological about biomedical research. Like, why would you want to undercut that? I mean, it doesn't even make, I don't even understand it from the MAGA point of view. I mean, I do. I understand where it's coming from, but it just seems so obviously self-destructive.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
Yeah, yeah. So, I mean, you know, look, they're writing this tax bill. They need to find money to offset the amount of money that you lose in the taxes. We think they do. Who knows? Maybe they will, they won't, you know, whatever. But they're looking for savings. And, of course, they don't like government. You know, a lot of our conservatives who, you know, have very, you know, principle.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
They don't think government should be in the business of health. You know, they want to minimize government's role in health care. And, of course, we have this program, Medicaid. It gives coverage to more than 70 million mostly low-income people.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
Mostly, it's working-age people and children in terms of numbers of people in the program, although most of the money in the program is actually a very big chunk goes to people who are either elderly or or people with disabilities. Medicaid is the single biggest financier of nursing home care in this country. So they need to find the money. There's a couple different ways to do it.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
The biggest gun they could sort of fire at Medicaid would be to really kind of make a radical change in its financing The federal government provides the majority of the money. States make up the rest. You could cut back on what the federal government is contributing in any number of ways in a very significant way that would leave states on the hook for much more.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
And most states would not be able to afford it. So they'd have to cut back. This is the kind of change they talked about. They've talked about this for decades when they're trying to repeal Obamacare. It's part of the Obamacare repeal legislation. It's the toughest to do politically because it puts states on the hooks, including a lot of red states.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
And, you know, it's gotten some attention in this round, although, you know, we've heard a lot. You know, it doesn't seem to be the number one item on anyone's list because it looks like a benefit company. Right. It looks like you're cutting Medicaid. And politically, that is dangerous at this point, even, you know, especially, you know, including many red states. So that is one possibility.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
Very real. But at this point doesn't look like the most likely. There's sort of a second category, which I do think is much more likely, which is they will, you know, looking at work requirements, work requirements, ideas that you have to demonstrate that you're employed or have a good reason why you're not in order to get Medicaid benefits. It polls well.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
Well, you know, it depends on how they do it with any of these things. You can sort of dial it up or dial it down. But, you know, the general rule is if you're getting a lot of money out of it. That's a pretty good tell that you're not just, you know, getting people who, you know, this isn't just about getting lazy people or encouraging people to work. I mean, we've done versions of this before.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
And what ends up, you know, most people on Medicaid are working. And if they're not, you know, it's because they're a caregiver, they have a disability, they're in school. So you're dealing with a small number of people who don't, you know, qualify for the program if you have a kind of work requirement. But what happens in practice is it's quite difficult always to sort of verify your work status.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
gets done you're dealing with a population low income maybe not doesn't have great education hard to navigate the system and every time this has been tried the same thing happens you end up tons of people who qualify for medicaid have satisfied the work requirements and need it don't get it they get kicked off the rolls they get caught in this sort of bureaucratic hell when you spend so much money on the administration that you're not even you know that that eats into the savings
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
I read that somewhere. It's efficiency. And, you know, there is a third category of what they call waste and abuse, which is a sort of broad category, which, you know, like there are some financing games. States play all kinds of financing games, you know, with the system as they all do. Of course. And there's certainly a case for sort of, you know,
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
Here in the world of healthcare, the assumption was Medicaid was weak politically. It wasn't like Medicare. Everyone pays into Medicare, everyone gets Medicare. We've seen in the last 10 years that's actually not true because Medicaid is so woven into our system at this point. Nursing home care, which I was mentioning earlier.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
But also, you know, hospital system is sort of, you know, the economy of hospitals markets depend on it. It's really important, especially in rural areas. And then that gets to the sort of politics of this is cutting Medicaid hurts a lot of red states, a lot of red districts. It's been interesting. All of us have been watching this have noticed.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
On the Republican side, as this is sort of starting to get some conversation, you've heard skepticism from the usual suspects. Lisa Murkowski, famously a defender of Medicaid, in part because in Alaska, the native Alaskan population has been the main beneficiary of expansions of Medicaid. There's a big reason she voted against Obama repeal back in 2017.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
Well, another senator who's been quite outspoken of all is Josh Hawley. and not exactly a flaming liberal, but Hawley, Missouri is one of those states where they had a voter referendum. Voters overwhelmingly approved an expansion of Medicaid so that it now covers everybody with incomes up to or just above the poverty line.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
And the way my understanding is a little fuzzy, but my understanding is the way it's worded in Missouri is that that that amendment is that if the federal government somehow pulls back on that money, that amendment is still in force. They still have to provide that Medicaid coverage. So Missouri is going to have to find the money for it. It's a big ticket item.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
You know, they have to raise taxes, cut education. They don't want to do that. So Hawley has been quite vocal. He doesn't want to cut Medicaid benefits. He said work requirements may be interesting. So I think that's something to watch. And, you know, in the House, I mean, there's a lot of, you know, you can look down the list.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
I mean, of the vulnerable Republicans, there's at least 20 in districts where they've expanded Medicaid. And, you know, for most House members, right. The single biggest employer in their district typically is the hospital system at this point. Hospitals. So they're going to hear about it.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
Yeah, yeah. So, I mean, my background is as somebody who writes about policy, which my whole life I always felt I had to apologize for in the world of political journals. I'm like, it's a little boring. It's a little wonky, you know. But it turns out that, you know, policy is another word for what the government does that affects people.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
and you know affects their lives you know are they going to get health care you know are they going to get deported you know run down the list and so um you know the newsletter the idea is me twice a week and the idea is to look at the way i think of it is it's why policy matters how policy matters so there will be a mix of you know explaining when these debates are going on you know you hear that they're cutting funds at the national institutes of health or that there's a tariff coming
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
Or, you know, that they're going to, you know, they're talking about new, you know, rolling back environmental regulations. Well, you know, I hope if I did my job right, number one, I'll be able to tell you what's actually happening, what that means and why.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
But then I'll also be able to tell you what that means for you, the viewers, for everyday Americans, how this is actually going to play out in the country. And so a kind of mix of those two, a mix of kind of behind the scenes in Washington, but Also, what's happening out in the rest of the country. And, you know, they'll take advantage of the fact that I don't live in Washington.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
Actually, I'm in the Midwest. And so, you know, I kind of use that as my journalistic backyard and, you know, write about what's happening here, fly to other parts of the country and give you kind of a picture. So, you know, you can understand what this all means.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
Yeah, yeah. So, I mean, obviously, you know, this is Michigan, home of the auto industry. And, you know, if anyone who's lived here for a while knows, I mean, it's really, even now, I mean, the auto industry is not as big as it used to be, but it is just so integrated into the economy here. And it's not just the big three, right?
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
It's not just GM and Ford and Stellantis, which we used to call Chrysler before it was bought by this foreign conglomerate. You know, I mean, you know, those are the big plants you drive around Michigan any length of time, you know, on the highway. At some point you're going to pass, you know, the GM plant. You're going to see all the trucks lined up outside. And that's obviously a big part of it.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
But then there's this whole ecosystem, this whole economy around of these suppliers, you
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
medium-sized small and it just reaches into every community and of course they you know have a broader impact in terms you know so you know the people working in the factory they got to eat so they go to the diner although we call them coney islands not diners but you know go to the coney island we do i know it's a whole thing you say that like a sentence we go to the coney island no no no no no i'm saying you know that's what they call them the coney island so you see i we are we are getting into like some sort of you know revelations about me which is although i've lived here for 20 years like i've
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
I actually am from the East Coast, and I still have those traces. So you have this ecosystem of all these parts suppliers, and it just ripples through these communities. And when it comes to the tariffs, there isn't like, we talk about Detroit, but The Detroit auto industry is really more like the Detroit-Windsor auto industry.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
You may have heard this before, but it's not uncommon for a part that goes into an F-150, if you sort of trace it, it will actually cross the border multiple times. And there's just there's this constant back and forth traffic.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
And so the more you're putting tariffs on, you know, the more you're raising the price of these cars and these trucks, even if they're assembled here in the U.S., you're still paying for all the sort of parts that are coming into them. Now, there are overlapping agreements in the Trump administration.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
Sometimes it says, well, we might exempt this or we might not, but it's just all this instability. And you already are seeing the impacts. There are announcements of plants idling, canceling plans to build new factories. You're already seeing this ripple through here. So that's what's going on here in Michigan. In terms of my newsletter, I actually – it was a story that kind of came to me from –
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
somewhat randomly from someone I'd interviewed for a story like two years ago on a totally different subject. And he called me up and he actually, he works for a, one of these boutique, you know, game companies that makes like strategy role-playing games.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
I mean, honestly, I know a little bit more maybe, but I was not a Dungeons and Dragons kind of kid or whatever. I was checkers or go outside, play football, whatever. Again, no insult intended. Anyway, this guy called me, who I know, and he's like, you know, he's like, I thought you might be interested to know our company is like, we are like facing an existential crisis.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
Because of course, you know, you think about what's in a game. It's board, you know, the board and the sort of cards and then the pieces. Well, that's all manufactured in China. or Vietnam, depending on the company. They're talking about raising their costs 50%, 100% now. They can't do that.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
This particular company, like a lot of companies in this space, the joy of being a reporter is the things you learn about that you never knew before. I didn't realize this, but for these very sophisticated games, they're expensive. We're not talking like you know, $20 for the Monopoly set, right? This is like 100, $150 game.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
What they do is they sort of put out a call early that we are thinking of making this game and it's got some kind of whatever fantasy narrative to it. And people kick in money for a Kickstarter and they raise the money that way. And it's about a two year cycle from sort of conception of the idea up through when you sell the game.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
And, you know, they price it out and people pay in and then when the game is ready, they get it. Well, they've now sold a bunch of games based on their cost projections from two years ago. And this is a successful company. So he was explaining to me the process of how they price. And he's like, look, we try to take into account the unthinkable. What if postage goes way up?
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
104. On China now. Yeah. Yeah. And he's like, What do we do with this? I mean, you know, they've sold the product. They now owe it to people. It's going to come over. It's going to cost them twice as much. I mean, they're going to lose money on it. I mean, they are going to lose money on every single unit if this tariff stays in place.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
So I thought that was a kind of interesting way to kind of get at a kind of inside, you know, what is it? How do tariffs actually work at the sort of business firm level? And, you know, I mean, this is like a small business, you know, it's eight employees and, you know, they're, you know, it's not talking to them. This is not, you know, making, you know, sort of impersonal making of widgets.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
Yeah. Yeah. I mean, they had no idea and they still can't plan. Right. Because he's all over the place. I mean, within the span of a day, you're getting 10 different messages from 10 different members of the administration. I mean, it's a it's a bad idea executed badly.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
They can't plan. And I actually did talk to like the trade group for, you know, the toy companies and the small gamers. And that's what they said. I said, look, I mean, isn't the whole idea here to kind of bring this production together? Back to the U.S., can you do this? He's like, we can't plan on that. He's like, we have no idea what this is going to look like in a month or five years.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
Yeah. Yeah. I mean, there's so many. I'll just mention two that come to mind that, you know, we've talked about. One is this sort of stunning gutting of future research and innovation and science. And it's at all levels. I mean, there's the immediate freeze and canceling of so many things.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
ongoing studies and grants into things like Alzheimer's and cancer, things people really care about and should care about. Again, as with the tariffs, in the most clumsy way possible, right? I mean, it's not just that they're canceling, they're sort of taking away the funding through the National Institutes of Health of all these medical studies. This is very random.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
You know, when they hit Columbia University with all these funds, I mean, the list of ongoing projects that just lost their money. I mean, it was everything from people studying in a ways to sort of, you know, combat, you know, osteoarthritis. Right. To, you know, I guess a cancer or Alzheimer's.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
You know, this was in the name of, you know, in theory, punishing, you know, Columbia for not cracking down on anti-Semitism. Right. And whether you take that seriously or not, I mean, you know, whatever. But like, even if that was the goal, what does that have to do with a cancer study? I mean, why would you defund a cancer study? And that makes no sense at all.
The Bulwark Podcast
S2 Ep1016: Jonathan Cohn and Mark Lilla: Lobotomizing America
So, I mean, you have that sort of immediate effect, but then I think it's just the sort of longer term effect, which is there. And, you know, there are so... Many scientists, young scientists who are now not going to go into the field, right? They're not going to get started. And, you know, this is a classic case of sort of, you know, the impact is we won't feel this tomorrow, right?