Nemesis

Donald Trump has met his nemesis – and it is not another country. It is the market: that faceless tangle of independent decision-makers constantly making decisions every minute.

When Trump began insulting and threatening to fire Fed chair Jerome Powell a few days ago, the market reacted strongly. The US dollar plunged. The yields on US Treasuries spiked. The New York stock market took yet another deep dive. The major financial institutions forecast an impending recession. Global confidence in the immediate future of the US economy cratered.

The Fed chair is well regarded by the market. If he is taken out, the US economy would be unhinged. Monetary decisions will be politicized. The US, the most heavily indebted economy, could default. The bottom will be pulled from under all the charts.

In two days, Trump folded. He claimed he never had any intention of firing the Fed chair. That is a lie. Until the markets severely penalized him for his idiocy, he imagined he could control monetary policy himself along with the cabal of knuckleheads he keeps around him.

After his own Treasury Secretary publicly remarked that high tariff rates between the US and China would be unsustainable, effectively embargoing trade between the world’s two largest economies, Trump seemed like he was sounding the bugle for retreat on his makeshift trade policy against China.

In remarks before reporters early this week, Trump said his 145 percent tariff against all Chinese goods “is very high and it won’t be that high… It’ll come down substantially. But it won’t be zero.”

There is no rational method for understanding Trump’s thinking about global trade. Therefore, there is no rational way to predict what he will do next. The market hates uncertainty. Trump is the embodiment of uncertainty.

The “reciprocal” tariffs he announced for all nations earlier this month caused the financial markets to lose about $10 trillion in capitalization. That will be hard to recreate anytime soon. Because of all the losses incurred by the financial markets, international institutions have downgraded growth prospects for this year and the next. Trump’s trade policy is clearly a path to more wealth destruction penalizing everyone.

Trump finally signaling he might finally embrace economic sanity and withdraw his punitive tariffs will be welcomed by the market. Some degree of recovery might be seen in the coming days. But this will not restore the wealth that had been destroyed. Trump has made himself a curse on all humanity.

With Trump still at the White House, confidence in the US economy cannot be restored. Everyone will fear his next clown act. This fear is reflected in the diversion of trade and investment from the US to other economies that are better managed.

Even if Trump drops all his idiotic policies today, the damage has been done.

Disperse benefits

The Universal Healthcare Act may have to be drastically amended. The promise of accessible health care for all Filipinos remains illusory.

Much has been written about how PhilHealth, the main agency delivering health care coverage for all Filipinos, utterly failed in fulfilling its mandate. This is due to inefficiencies in its operation as well as possible corruption.

There is an even more basic flaw that needs closer examination. PhilHealth benefits tend to be concentrated in the major urban areas and large hospitals. These benefits fail to trickle down to remote communities and basic health care systems. This is the reason universal health care is not felt at the grassroots.

Compounding the problem, local governments tasked with managing health services in their communities often lack the personnel, facilities and equipment to deliver reliable health care. The mechanisms for delivering PhilHealth benefits through this channel remain spotty.

Former Senate president Tito Sotto, one of the co-authors of the Universal Health Care Act, shows awareness of the need to evolve the mechanisms for better dispersal of benefits to the communities. The issue goes beyond technical execution. There are deep structural issues, including uneven budgetary allocations tending to favor highly urbanized areas.

Although our educational system produces a strong cadre of doctors and nurses, many of our graduates choose to work abroad. Many medical facilities suffer from lack of qualified personnel.

Speaking before the staff of the Vicente Sotto Memorial Medical Center (VSMMC), the former Senate president spoke of the need to build modern medical facilities nationwide. The regional hospitals, in turn, should provide training for provincial medical personnel to address the growing shortage of talent.

He urgently told the staff of VSMMC to go beyond hospital care and contribute to improvement of public health. This might include providing health care to victims of drug abuse, making our approach to the drug problem more caring and more exclusive.

The provincial hospitals need to be reimagined not only as facilities for intensive treatment of patients afflicted with serious medical concerns but also as hubs for telemedicine, using modern communications technology to widen the reach of health care. The provincial hospitals could provide the model for efficient and decentralized public health services.

The concentration of medical facilities in the highly urbanized areas is not an easy problem to solve. It calls for adjustments in budgeting, reorientation of our medical education and a stronger role played by the local government units.

Needless to say, we need legislators committed to focus on public health as an evolving challenge.