Once again, what's wrong with these people?

This morning we begin to get reports of the shitshow MAGA and RFK Jr are making of the American health complex. It's bad. It will be a few days before the newsmedia suss out the full catastrophe.

But this morning we get The Bulwark's new healthcare writer Jonathan Cohn taking up what those of us who live in the reality-based universe frequently find ourselves reverting to these day: why are these lunatics tearing down the country we have known? What motivates them? I found this summary helpful:

THE WRECKAGE FROM TUESDAY’S CUTS ONCE MORE raised the question of why, instead of undertaking a more carefully calibrated set of staff reductions, the Trump administration cut so crudely and destructively.

Most likely, multiple motives are at work, coming from different parts of the Trump coalition. For ideologues like Russ Vought, the Project 2025 participant who now leads the Office of Management and Budget, this is a chance to cut the federal government down to their preferred size—and to wipe out all the supposedly left-wing activists they believe have burrowed into the bureaucracy.

For Elon Musk and the DOGE team, quite possibly, there’s an element of techno-arrogance at work. And for Trump himself, the cuts would seem to fit in neatly with his agenda of attacking the “deep state” he believes thwarted him during his first term.

That leaves Kennedy, the secretary, who if so inclined could have pushed back on these reductions or at least demanded they proceed in a more deliberate way. There are no signs that happened. Instead, the one hallmark of Kennedy’s tenure so far has been a disregard—some would say disdain—for the department’s veterans and the way they do things.

You can see it in the expertise that the Trump administration cavalierly dispatched on Tuesday. You can see it, also, in how RFK Jr. is dealing with real-world challenges the department currently faces.

Right now the United States is confronting two serious threats that fall under HHS jurisdiction: the measles outbreak that started in Texas and has now spread to three other states, and the strands of avian flu decimating poultry flocks. ...

Photo from 2009. Will these Unitarian Universalists have to come back to the fray?

Jonathan Cohn is long time student of our health care morass who was one of my go-tos during the Obamacare passage wars.  Definitely someone worth following as MAGA tries to unravel decades of health accomplishments.