In today's Washington Post Jonathan Greenberg writes about how Donald Trump lied his way onto the Forbes' 400 list of the wealthiest Americans back in the early 1980s. It's an amazing story, which illustrates just how insecure, desperate and pathological Trump truly is. It reminds us that, then as now, he possessed no shame whatsoever and would stop at nothing to portray himself as wealthy and powerful, going so far as to disguise his voice and to pretend to be another person in order to appear as something he was not. 

While most people are sharing and reacting to that story based on the bald-faced lies Trump told and the audacious things he did in order to make Forbes' list, the story tells a larger and, in my mind, more significant story. It's a story about journalism and American values and about how a certain failure and bankruptcy in both of those things led us to where we are today.

Malcolm Forbes came up with the idea of the Forbes 400 in 1982. The idea was to personalize wealth after decades in which faceless corporate conglomerates dominated the story of American business. Given the circles in which Malcolm Forbes traveled, his personal extravagance and his obvious love of fame and celebrity, it's not surprising that there was more going on here than the mere reporting about powerful business figures.

The Forbes 400 was about elevating and celebrating the wealthy -- many of whom were not, actually, business figures but, rather, heirs -- simply because they were wealthy. It was a gossipy, clickbaity listicle for the pre-Internet age. We all know what MegaCorp Consolidated owns and what it does, but who is its biggest shareholder? How is he special? What makes him tick? More importantly, what does he own? What does he wear, eat, drink, drive and fly? The Forbes 400 constituted an implicit argument for the social value of wealth for its own sake. An argument which kicked off or, at the very least, worked in tandem with the greed-is-good, "Lifestyles of the Rich and Famous" social and cultural forces ascendent in 1980s America. 

It was this culture which gave us Donald Trump. Donald Trump became president because he was famous. He became famous because he was portrayed as rich. He was portrayed as rich because, in the early 1980s, there was a big cultural push -- much larger than Donald Trump -- to celebrate the rich simply for their status of being rich. If that culture did not exist, there would have been no Forbes 400 for Trump to lie to get on to and if there was no Forbes 400, and the culture which surrounded it, it's an open question whether anyone outside of the New York real estate world would've ever heard about Donald Trump. Donald Trump did not lie his way to the presidency on his own. He had a lot of help. 

The elevation of the rich for their own sake in the 1980s was not new, of course. Back in the Gilded Age the robber barons were larger-than-life figures, permeating the culture far beyond the business pages. In the Great Depression the names of the wealthy could be found in song lyrics and constituted instantly recognizable references in movies, on stage and on the radio. This elevation of the rich likewise did not stop with the death of Malcolm Forbes and the end of the go-go 1980s. To see how this celebrity-style reporting on the rich and powerful still works, one only need look at the often uncritical coverage of figures like Elon Musk, Jeff Bezos, Mark Zuckerberg and, more broadly, the culture of Silicon Valley as something separate, apart and, somehow, more noble and visionary than the mere businessmen and women that they are. 

All of which is to say that, however much fun it is to point and laugh at the prospect of a 36-year-old Donald Trump pretending to be something he wasn't, that's not really the big takeaway from today's piece in the Washington Post. We know Trump is a pathological liar and those of us who paid attention to him before he got into politics have known this for years.

The more important questions raised by that article are how and why Trump was given the platform from which to tell his lies in the first place? Who will be the next to take advantage of America's sick and misguided fascination with wealth for its own sake to ascend to a position for which he is clearly unqualified? Finally, when will the media, which utterly failed to push back against the idea that greed is good in the 1980s and has continued to fail in this regard each and every time that ethos has been repackaged for a new era, begin to ask itself why the wealthy are celebrated and considered newsworthy in and of themselves?   

Once when I was a little boy, a lightbulb burned out in a lamp in our house. As my dad changed the lightbulb I asked him why they don't make lightbulbs that last forever. He said, "if they did that, the people who make lightbulbs wouldn't make any money."

I didn't think too hard about that answer at the time, but I thought about it right after I read this story from Tae Kim at CNBC, about something a Goldman Sachs analyst wrote in a report to biotech company executives last week. 

The report, entitled "The Genome Revolution," asks, "is curing patients a sustainable business model?" The answer is no, at least not in the long run: 

"People would love a lightbulb that lasts forever," the report basically says, "and it would be great for society. But you would make less money if you made one of those." Except, instead of lightbulbs, it's cures for hepatitis of diabetes or what have you. The report goes on to outline ways these companies could make more money if they focus on chronic therapies rather then cures, not because it's better for the world, but because it's better for the bottom line.  

The report hit the news the other day and since then I've seen a good amount of outrage about it on Twitter. It seems perverse to many that an analyst from an investment bank would tell biotech company executives that curing diseases is not as good for "sustained cash flow" as treating a recurring stream of customers who never are cured but always need expensive medical products.

Such outrage is misplaced. Or at least not sufficiently placed. We should not merely or even primarily be outraged at the Goldman Sachs analyst. What he said is completely true. That doesn't get him off the hook, of course, as "I was just doing what I was asked to do" is not, last I checked, a "get out of morality free" card, but that's not the end of the discussion. What's outrageous is that we willingly accept a medical system in which what he wrote in that report can be completely true. One in which "cash flow" rather than "tremendous value for patients and society" is the priority and in which those two things are at odds. 

The medical establishment -- including providers, the pharmaceutical industry and biotech firms -- has long been caught in a fundamental dilemma between the need to cure and treat the sick and the pursuit of market-based wealth. These actors have improved and extended the life for millions of people through their products and services, yet the need to make entrepreneurial decisions is frequently at odds with the advancement of public health, particularly the health of the poor.  Striking a balance between those allegedly equal imperatives is why biotech firms do things like hire Goldman Sachs analysts to tell them what to do. Well, that and putting the hard, moral and ethical calculations inherent in this dilemma in someone else's hands. 

Motives aside, the lines of debate on this tend to break down between (a) pro-market actors arguing that, if not for the profit motive, biotech firms and pharmaceutical companies would not research and develop lifesaving cures and drugs; and (b) those who find profiting off of the lives and health of others to be immoral on the other. The former group tends to believe in the market like the devout believe in a god, believing that it will provide all that we need if we merely have sufficient faith. The latter group is often naive about what, exactly, motivates human beings to do anything.

The market is not just, of course. It creates "winners" and for there to be "winners" there must be "losers." In the context of people's lives and health, the existence of "losers" is obscene. Likewise, most people are not inherently altruistic. Depending on people to simply do the right thing, however noble, is misguided. 

Typically at this point in the discussion someone will bring up Jonas Salk, who famously eschewed patenting the polio vaccine despite the fact he could have made billions of dollars if he had. When asked why he did this, Salk famously said that "the people" owned the patent and asked, rhetorically, "would you patent the sun?” Salk truly believed that, by the way. He considered his work to be a "moral commitment" -- his words -- and devoted the rest of his life to trying to make the world a better and healthier place when he could've spent it sitting on boards, hitting the lecture circuit and raking in boatloads of cash. I tend to think he's the exception, not the rule, when it comes to this sort of thinking.

Either way, it did not require someone as altruistic as Salk was for the polio vaccine to be developed. Salk's research, after all, was not free. It was funded by donations from The National Foundation for Infantile Paralysis -- the March of Dimes -- which represented a massive mobilization of the public, spurred on strongly by FDR and the federal government. Rather than R&D losses willingly taken in the hopes of future profits to help recoup those costs, the polio vaccine was financed on the front end by hundreds of millions of donations. As I said, Salk truly was an altruist, but it's also the case that if he had patented the vaccine, he'd be double-dipping in a sense. The public, in large part, had already paid for it, the work was done and then society benefitted, massively. 

I will not pretend to have all of the answers about how to best structure our medical and public health system. I appreciate that innovators require incentives and funding to innovate and that depending on altruism to solve society's problems is unrealistic. I do not believe, however, that Goldman Sachs analysts are privy to the only means by which innovators can innovate and I do not believe that the market is as omnipotent as Goldman Sachs analysts believe, especially when it comes to public health, where the ultimate rewards are not and should not be financial ones. 

Don't believe people when they tell you that taking the profit motive away from science that science will cease to exist. Don't believe them when they tell you that the market will provide optimal outcomes. We have plenty of counterexamples to both of these spurious assertions and we can do better than we are doing to deliver the goods which benefit humanity.

It is being reported this morning that Speaker of the House Paul Ryan is not going to run for reelection. I am not surprised in the least.

The modern, allegedly mainstream GOP has never had any interest in leading or governing. Guys like Paul Ryan and the hundreds of cut-rate Reaganites he leads sought power to enrich their wealthy friends and benefactors with ruinous fiscal policy and are now getting out before being held accountable, after which they will no doubt enrich themselves with lobbying or media gigs.

The tell: they never once ran on their actual agenda. Since the day after the 2009 inauguration they ran against ridiculous caricatures of Barack Obama and Nancy Pelosi and then ran against an even more ridiculous caricature of Hillary Clinton and whatever other liberal boogeymen they could conjure. Now that they have a record of being the party in power, they're quitting rather than face the wrath of voters. 

Go back and study the campaigns of guys like Ryan and other GOP leaders and try to find examples of them promising to do what they actually did this past year or so. Find the speeches and ads in which they promised to slash taxes for the wealthy, deprive people of health care, threaten popular social services and eviscerate health, safety and environmental regulations while exploding the deficit and national debt in the manner in which they've done. Maybe you'll find some red meat along those lines to small audiences of party loyalists and donors, but I submit that you will find no examples of guys like Paul Ryan offering details of what would become the American Health Care Act they tried to ram through last year or the tax plan they did, in fact, ram through. You will find ZERO mention of what their 2017-18 legislative agenda has actually done to the budget. Indeed, they ran hard against Democrats on exactly those grounds. 

There's a reason for that, of course. Outside of conservative think tanks, Wall Street investment banks and a narrow class of ultra-wealthy people, there is no constituency in this country for slashing the taxes of millionaires, eviscerating the regulatory framework of our nation and taking services away from the poor and middle class. None. People don't want it. There's ample proof of this.

• The proof is in the polling data;
• The proof is in the fact that most GOP candidates hide the realities of their legislative agenda from voters, talking instead in terms of platitudes or, more often, simply lying about their true intentions;
• The proof is in the fact that, to the extent they ever are pinned down on something, they simply lie about the results their policies will bring, such as the disproven idea that cutting taxes for corporations and for the rich will result in trickle down benefits for the poor and middle class;
• The proof is in the 2016 presidential election results. Donald Trump ran against a bunch of Paul Ryan types in the Republican primary -- guys who actually implemented such an agenda on the state level, which led to fiscal and civic ruin -- and cleaned their clocks. He didn't whup 'em because he's charming -- Trump is repugnant -- he whupped 'em because his message was about rebuilding and investing in America and in aiding the middle and lower classes, not the rich. Now, as the last year has shown, Trump obviously does not believe that message himself -- once in office he became beholden to the Paul Ryans and Mitch McConnells of the world -- but that's what Trump ran on and that's what voters responded to. It's understandable that they did. 

Americans do not want to giveaways to the wealthy, they want investments in the country and in its people. They know that government is often inefficient and wasteful, but they do not consider it their mortal enemy and do not want representatives who have no ideas apart from starving it and the people it serves. 

That's exactly what Paul Ryan did as Speaker. And now he's quitting before being held accountable for it. That's no accident. It's by design.