For the Trump skeptics, the full-blown resisters, and everyone who prefers to see government remotely good, the downfall of Tom Price was a moment of true catharsis.



Donald Trump’s loathsome health and human services secretary was driven from office on Friday after a series of stunning Politico reports detailed how he racked up at least $400,000 in travel bills for charter flights. The extravagance was too much even for Trump, who in his past life as a failed developer wasted plenty of taxpayer money, and Price was told he had to go.



Before sobering reality sets in – nothing has really changed about Trumplandia – let’s remember all the ways Price represented the worst of the worst about Trump’s storming of Washington.



Tom Price resigns as health secretary over private flights and Trump criticism Read more

A former rightwing congressman from Georgia and an orthopedic surgeon, Price spent most of his House tenure trying to destroy Obamacare and replace it with something far more draconian.



As health and human services secretary, his dream fully realized, Price set about trying to undermine American healthcare as much as humanly possible without achieving a repeal of Obamacare. Price stopped trying to encourage people to sign up for insurance, ensuring costs would rise for everyone else. He obliterated Obamacare’s advertising budget.



Price backed a Trump budget that slashes funding for health and human services, the National Institutes of Health, and the Centers for Disease Control and Prevention. His vision of healthcare was rather simple: get any trace of the government out of there, any protections that might be offered for the poorest and sickest. Let the free market take care of the rest.



Now Trump will cast about for a worthy successor. Price, a multimillionaire, will feel shame for a few days and then go back to cashing out in the private sector, maybe as a healthcare lobbyist trying to wrangle goodies from his old colleagues. The waterline of the swamp will rise.



Health secretary Tom Price apologizes for taking private flights for work Read more

The real question, once the celebration dies down from liberals and various journalists heartened by the power of the press to get their scalp, is how anything will change in Trump’s Washington.



Will a new HHS secretary bring some common sense to the role and realize stabilizing the healthcare markets is their chief job? Will he or she attempt to be anything resembling an administrator? Probably not.



Despite the conventional wisdom that Trump is a gun-slinging independent beholden to no party, he is fully indoctrinated in far-right, slash-and-burn thinking. He is a president for nihilist billionaires and Milton Friedman apostles. He will lurch to the left, but his grounding will stay true. We know that from his tax plan, which promises to give relief to the rich and no one else.



In another time now lost to history, both parties paid allegiance to the idea of governing. Democrats, in the post Franklin D Roosevelt-era, were the party of large, activist government, but Republicans understood that dismantling what they inherited made no sense.



Richard Nixon preserved the gains of Lyndon Johnson’s civil rights and Great Society legislation. Medicare and Medicaid remained.



Under a moderate Republican president – almost no moderates actually ran for president in 2016, and it’s increasingly unclear such a creature even exists – Barack Obama’s Affordable Care Act would be understood for what it is: not socialism, but a mixture of government intervention and market-driven policies dreamed up by the rightwing Heritage Foundation and later pioneered by a Republican governor, Mitt Romney.



It is nothing approximating single-payer healthcare. It’s a start – but it’s also plenty flawed.



Many marketplaces are succeeding, but others are failing, in part because the Trump White House is encouraging their failure. The next best thing to repealing Obamacare, for the Republican party, is to let it rot without serious reform.



Federal subsidies must be increased and a public option should be introduced to compete with private insurers. The long-term goal, championed by Bernie Sanders, should be Medicare-for-all, universal healthcare, though we’re not there yet.



Price’s successor probably won’t think about any of these things. He or she will serve at the altar of Trump, after all. The only requirement? Destroy what you can. Let everyone else suffer.