If there’s a president who leads with his heart, it’s Donald Trump. That is, when he’s not leading with another, lower, part of his anatomy. When Trump leads with his heart, however, it yields some of his best directions, because at heart, the president doesn’t like to see Americans suffering. Such as it is with the opioid emergency.
On Monday, he announced “We’re going to be doing it in the next week.” Of course, nothing even close to a plan exists, only lots of meetings and competing ideas–some of which were proposed by Tom Price, who isn’t around any more.
In August, Trump promised to declare an opioid emergency on the recommendation of a commission he personally chose, headed by Chris Christie. Then politics intervened and nothing happened while the cost and details were hashed out.
Members of Trump’s Domestic Policy Council, budget director Mick Mulvaney and former HHS Secretary Tom Price opposed the plan for months because of the multi-billion-dollar price tag, legal issues and questions about how it would be implemented, according to White House officials. Price argued that the government could respond efficiently without taking such a step.
As with many of Trump’s blurts, reaction to this news was “Believe it when we see it.”
But here’s the thing. It’s needed. The opioid problem is terrible, and it’s affecting millions of lives–the addicted, their families, coworkers, and the medical community.
The problem is that Trump lacks the staff needed to implement any emergency announcement. As the old saw states, “personnel is policy.” And Trump is without an HHS secretary, a drug czar (Rep. Tom Marino withdrew after pushing a disastrous bill in Congress to weaken DEA’s authority to investigate bulk opioid shipments), a DHS secretary and a DEA chief.
Who will act on the emergency?
There are a few options:
Trump could declare a public health emergency. This would be really weak sauce. According to POLITICO, there’s only $57,000 (that’s thousand) available to put towards that effort. It’s laughable.
He could use the Stafford Act to help the half dozen states that have declared their own emergencies, and speed nalaxone–which reverses opioid overdose–to affected areas. But that’s dependent on the states.
The best solution, of course, is to repeal Obamacare and move on with sensible health care programs that don’t incentivize drug producers to flood the market with dangerous drugs. But that is Congress’ fight, and unlikely to yield any result.
“There are no silver bullets,” said Jay Butler, Alaska’s chief medical officer and president of the Association of State and Territorial Health Officials, a group of public health officials. “We can’t get distracted on unicorn hunts thinking there’s one solution to solving the complex issue of the opioid crisis. It’s not a problem that will be quickly or easily resolved.”
The president is doing a good thing leading with his heart. Unfortunately, the heart alone rarely solves problems that require teamwork, leadership and effort. The emergency isn’t the opioid problem, it’s now a problem for Trump’s staff to solve with precious few resources.