EXCERPT FROM CHAPTER 4 Trump seeks to impose deep and drastic cuts on the budgets of 19 agencies designed to help the poor, students, public education, academic research, and the arts. Whatever savings result from these cuts will be used to expand the machineries of war, militarization, and detention. The culture of cruelty is on full display here as millions would suffer from the lack of loans, federal aid, and basic resources. The winners would be the Departments of Defense, Homeland Security, the private prison industry, and the institutions and personnel needed to expand the police state. What Trump has provided in his 2018 federal budget proposal is a blueprint for eliminating the remnants of the welfare state, while transforming American society into a "war-obsessed, survival-of-the fittest dystopia." Trump's neoliberal austerity policies and priorities are crystal clear not only in the savage, $4.1 trillion in draconian cuts he makes to so many vital social programs that benefit the poor, particularly children, but also in the $5 trillion tax benefits for the ultra-rich and big corporations. War is a central category for understanding Trump's budget proposals in two related ways. First, a metaphysics of war functions as an organizing principle for waging an assault against vulnerable populations while expanding the power of the police and punishing state. Second, the ongoing production of the machinery of destruction and death provides enormous profits for the wealthiest individuals and corporations driving the arms, defense, and border security industries. In the first instance, war as an organizing principle of society is particularly evident in the Trump administration's savage cuts to programs that give hope and a small measure of security to the 14.5 million children who live in poverty, lack healthcare, endure homelessness, and live with disabilities. Marian Wright Edelman makes this point clear in arguing that Trump's "immoral budget declares war on America's children, our most vulnerable group" and points to some of the more egregious policy cuts in the 2018 budget, which: Slashes $610 billion over ten years from Medicaid which nearly 37 million children rely on for a heathy start in life and which pays for nearly half of all births and ensures coverage for 40 percent of our children with special health care needs....Rips $5.7 billion from CHIP (Children's Health Insurance Program), which covers nearly 9 million children in working families ineligible for Medicaid....Snatches food out of the mouths and stomachs of hungry children by slicing $193 billion over ten years from the Supplemental Nutrition Assistance Program (SNAP), which some still call food stamps. SNP feed nearly 46 million people including nearly 20 million children....Whacks $72 billion over ten years from the Supplemental Security Income Program (SSI) which more than 8 million children and adults with the most severe disabilities depend on to keep going. In the second instance, war as a revenue producing program is a high priority for the Trump administration and is evident in Trump's proposed budget which allocates initially $2.6 billion to work on the wall planned for the Mexican border while also increasing the military budget by $54 billion. As Edelman observes, President Trump's 2018 Budget includes an estimated $5 trillion tax package for the wealthiest individuals and corporations [and] increases base defense spending $54 billion in 2018 alone (and $489 billion over ten years). That's $147,945,205 a day, $6,164,384 an hour and $102,739 a minute. The U.S. military budget is already the largest military budget in the world. We spend more on the military than the next eight countries combined (China, Russia, Saudi Arabia, India, France, United Kingdom, Japan, and Germany). [Moreover, the 2018 budget] spends $2.6 billion new dollars on border security including $1.6 billion for a down payment on the President's proposed obscene wall at the Mexican border estimated to cost $10 to $20 billion before completion and after false campaign promises that the Mexican government would pay. Under Trump, it has also become clear that an increasingly militarized United States is now on a war footing internationally. It is no longer overstating the case - given the provocations unfolding on the world stage - to say that Trump poses a growing threat to the planet itself. On the home front, the war on poor youth of class and color is being expanded. For example, under the Trump presidency, Americans have witnessed the rapid mobilization of a domestic war against undocumented immigrants, Muslims, people of color, young people, the elderly, public education, science, and democracy. The moral obscenity and reactionary politics that inform Trump's budget were summed up by Bernie Sanders: "At a time of massive income and wealth inequality, when 43 million Americans are living in poverty and half of older Americans have no retirement savings, we should not slash programs that senior citizens, children, and working people rely on in order to provide a massive increase in spending to the military industrial complex. Trump's priorities are exactly the opposite of where we should be heading as a nation." As more and more people find themselves living in a society in which the quality of life is measured through market-based metrics such as cost-benefit analysis, it becomes difficult for the public to acknowledge or even to understand the cost in human misery and everyday hardship that an increasing number of people will have to endure in the age of Trump. The celebration of human misery and policies that produce it are on full display in the health care reforms proposed by Trump administration in 2017. It is to this issue that I want to turn to in some detail. Health Care as Domestic Terrorism The health care reform bills proposed by Republicans in the House and Senate have generated heated discussions across a vast ideological and political spectrum. On the right, Senators such as Rand Paul and Ted Cruz have endorsed a new level of cruelty-one that has a long history among the radical right--by arguing that the current Senate bill does not cut enough social services and provisions for the poor, children, the elderly, and other vulnerable groups and needs to be even more friendly to corporate interests by providing massive tax cuts for the wealthiest Americans. Among right wing pundits, the message is similar. For instance, Fox News commentator, Lisa Kennedy Montgomery, in a discussion about the Senate bill, stated without apparent irony that rising public concerns over the suffering, misery and death that would result from this policy bordered on "hysteria" since "we are all going to die anyway." Montgomery's ignorance about the relationship between access to health care and lower mortality rates is about more than wilful stupidity, it is about a culture of cruelty that is buttressed by a moral coma. On the other side of the ideological and political divide, liberals such as Robert Reich have rightly stated that the bill is not only cruel and inhumane, it is essentially a tax reform bill for the 1% and a boondoggle that benefits the vampire-like insurance companies. In the latest senate version, tax reductions for the rich have been modified, but that seems inconsequential given the political and economic benefits the rich gain from the bill. Others, such as Laila Lalami of The Nation, have reasoned that what we are witnessing with such policies is another example of political contempt for the poorest and most vulnerable on the part of right-wing politicians and pundits. These arguments are only partly right and do not go far enough in their criticisms of the new political dynamics and mode of authoritarianism that have overtaken the United States. Put more bluntly, they suffer from limited political horizons. What we do know about the proposed Republican Party federal budget and health care policies, in whatever form, is that they will lay waste to crucial elements of the social contract while causing huge amounts of suffering and misery. The notion that the government has a responsibility to care for its citizens and that society should be organized around the principles of mutual respect, care, and compassion has been under attack since the 1970s with the advent of a savage neoliberalism. The latest measure of such an attack is evident in the Senate bill which will lead to massive reductions in Medicare spending. Medicare covers 20% of all Americans or 15 million people, 49 percent of all births, 60 percent of all children with disabilities, and 64 percent of all nursing home residents, many of whom will be left homeless without this support. Under this bill, it has been estimated that close to 22 million people will lose their health insurance coverage, accompanied by massive cuts proposed to food-stamp programs that benefit at least 43 million people. The Senate health care bill allows insurance companies to charge more money from the most vulnerable. It cuts maternity care and phases out coverage for emergency services. Moreover, as Lalami points out, the first senate proposal "includes nearly $1 trillion in tax cuts, about half of which will flow to those who make more than $1 million per year." The latter figure is significant when measured against the fact that Medicaid would see a $772 billion cut in the next ten years. It gets worse. The Senate bill will drastically decrease social services and health care in rural America and one clear consequence will be rising mortality rates. In addition, Dr. Steffie Woolhandler, co-author of a recent article in the Annals of Internal Medicine, has estimated that if health insurance is taken away from 22 million people, "it raises ... death rates by between 3 and 29 percent. And the math on that is that if you take health insurance away from 22 million people, about 29,000 of them will die every year, annually, as a result." An earlier study by the American Journal of Public Health was more ominous and estimated that "nearly 45,000 annual deaths are associated with lack of health insurance." It seems reasonable to argue that the Republicans' focused attempt to reduce healthcare coverage is not only an act of domestic terrorism, but also a right-wing plot no less ideological or terroristic than was that of Timothy McVeigh. In fact, far more will suffer and perish according to the these studies. In short, an American Nightmare. Excerpted from American Nightmare: The Challenge of U. S. Authoritarianism by Henry A. 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