There’s a lot for Democrats not to like about President Trump’s nominee to be the Secretary of Health and Human Services. Chief among then, I suppose, is that Alex Azar clerked for Antonin Scalia and served on Kenneth Starr’s investigative team. But I also wonder how much Trump’s own supporters should like this pick.

After all, Mr. Azar was until recently the president of Lilly USA, the biggest affiliate of Eli Lilly, a giant pharmaceutical corporation. And I don’t recall candidate Trump telling his adoring hordes that the answer to our health care woes is to put Big Pharma in charge.

This is something I’ve noticed quite a lot with Trump. There’s a basic disconnect between his rhetoric and his promises on the one hand, and the kind of people he’s put in charge of key areas of our economy. It seems like a transparent fraud, and while it might not be met by immediate resistance from his base, there’s no sense that he’s actually working toward building a new kind of politics or a new kind of Republican Party based on concrete economic populism.

Everything seems restricted to grievance and prejudice, and that doesn’t strike me as something that is going to win enduring allegiance, especially if there is an effort to transfer it to new candidates.

It’s not quite that there can’t be Trumpism without Trump—as people have been debating in recent days—it’s more that Trumpism doesn’t actually exist.

Maybe Trump likes Mr. Azar because he’s been an outspoken opponent of Obamacare, or maybe he chose him because he knew the Washington Post would call him “a pragmatic pick” since he is at least qualified and acceptable to Senate Republicans. But it isn’t the kind of pick you make if you’re serious about taking the side of your working class base against the rapacious pharmaceutical industry.

It shows how fake Trump’s populism really is, and in this sense it’s no different than his picks of Steve Mnuchin and Gary Cohn to head up his economic team.

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