Yes, You Should Be Concerned About Trump's Age

"After 9/11, the United States spent $8 trillion on counterterrorism. It is currently spending zero to dementia-proof the second Trump administration."

Maybe you haven’t noticed, but Joe Biden is very old. In fact, when Biden entered office, there was a 20.5% chance that a man his age would die over the next four years, according to the Social Security Administration’s actuarial life table. If Biden had won re-election, there would have been a 31.7% chance that a man his age would have died by the end of his second term.

Donald Trump is also very old. When he first took office in 2017, there was a 10.4% chance that a man his age would die over the next four years. Today there is a 22.6% chance that a man Trump’s age will die by the end of the next presidential term.

(If you’re wondering, the chance of death for a 60-year-old woman — Kamala Harris’s age — is 3.9% over the next four years and 8.6% over the next eight.)

If you’re a Republican, you might take solace in the fact that, if the Supreme Court consisted of nine generic people of the same sex, age, and ideology as the real justices, there would be a 54.4% chance that at least one of them would die during the next presidential term, and a 14.4% chance that at least one liberal would die.

The Grim Spreadsheet O’ Death

Of course, you should take this all with a grain of salt (and if you care about your own mortality, make it potassium salt). SSA data fail to capture the relevant factors in any individual case. We know, for example, that Trump does not smoke or drink alcohol, and he has access to the best medical care in the world. We also know that he is obese, thinks exercise depletes the body of its “finite amount of energy,” and doesn’t eat vegetables. For what it’s worth, a year ago longevity researchers concluded based on a review of the candidates’ medical records that:

Biden was projected in 2020 to have over a 95 percent chance of surviving a first term in office (about 13 percent better survival than for an average man his age). Today his chances of surviving through a second term in office are close to 75 percent (about 10 percent better survival than for an average man his age). Similar, although slightly less favorable survival prospects are present for Trump.

So, just a little bit more optimistic for Biden and more pessimistic for Trump than what I have above.

You might think that this isn’t much to be worried about. If Trump has a 77.4% chance of surviving for the next four years, that means he probably won’t die in office.

But the thing about events with a 77.4% chance of happening is that they only happen 77.4% of the time. FiveThirtyEight gave Hillary Clinton a 70% chance of winning the 2016 election. If 20 to 30% events never happened, we wouldn’t be in this situation in the first place.

For a high-impact event like the death of a U.S. president, a 22.6% chance of something going wrong is astonishingly high. When a Twitter hoax in 2013 claimed that President Obama had been injured in an explosion at the White House, the S&P 500 lost $136.5 billion in value within minutes. After the 1981 assassination attempt against Ronald Reagan, the White House was left in pandemonium. Secretary of State Alexander Haig, who was fourth in the line of succession, frantically told reporters, “I am in control here,” and sparked off a near-constitutional crisis.

Of course, these examples are qualitatively different from a president’s death due to natural causes, since they involve acts of violence and security failures that are uniquely costly. But it’s not clear that if the president deteriorated mentally and physically while in office, up to the point of death, the country would be any better prepared for it than it is for an assassination attempt or a terrorist attack.

The Biden White House apparently developed ad hoc protocols for governing the country under a president with diminished mental faculties, but even then, they weren’t very good at it. The president’s infirmity no doubt contributed to his failure to get anything done besides stoke conflict with China, pass a few industrial policy bills, and send round after round of military aid to Ukraine and Israel (and most of that was Jake Sullivan’s domain, anyway). When he actually had to interact with Congressional leaders and foreign officials, they thought he was senile. Fifty million Americans heard him say on live television that he “beat Medicare.” And that was just the beginning of the decline, not the end!

When you seriously game out what it would look like for a president to govern from the death bed, you run into a lot of problems that the Biden team thankfully didn’t have to troubleshoot.

Say that you have a president with dementia or end-of-life delirium and paranoid delusions who orders the military to launch a nuclear strike. He’ll probably forget about it within a few minutes, but for a semi-lucid moment that’s the official order, and it never gets retracted.

It might seem obvious to you that if you were part of the nuclear chain of command, you shouldn’t follow through on the order. But the president’s authority over the nuclear arsenal is unambiguous and legally unlimited. And every single person who’s selected to receive and execute the nuclear launch orders is chosen specifically because they’re good at following commands.

There are three escape clauses — voluntary resignation, impeachment, and the 25th Amendment — but when the president is a narcissist, and his staff deliberately hide his condition, and his movement is a cult, you can’t be sure that any of those is actually going to work. If there’s even a remote chance that they don’t, the country is in serious trouble.

If the president did launch a nuclear attack — say, a single B-61 Mod 7 warhead detonated over Pyongyang — it would kill, at minimum, some 870,000 people and probably start a nuclear war. If there’s a 22.6% chance that Trump dies in office, and a 25% chance that his death involves mental decline or delirium, and a 25% chance that this causes him to try to do something at least as crazy as launch a single nuclear weapon, and a 25% chance that he’s not removed from office before he succeeds, the expected-value cost of Trump becoming demented in office is at least 3,000 lives, or the equivalent of one 9/11-scale terrorist attack.

After 9/11, the United States spent $8 trillion on counterterrorism. It is currently spending zero to dementia-proof the second Trump administration.

Sober risk management would mean doing something to make sure the safeguards work — if that’s even possible — or, at the very least, making sure that everything is set up for a smooth transition to President Vance and there isn’t a constitutional crisis when Elon Musk inevitably tries to decide Trump’s successor via Twitter poll.

But there doesn’t seem to be any momentum on the side of those in the administration who don’t think that Weekend at Bernie’s is an instruction manual (if any such people actually exist). In fact, the central organizing principle of the second Trump administration seems to be that everything must be structured around Trump himself. You could plausibly make a case for having a government like this under some other leader, but it’s obviously a recipe for disaster when the president is 78 years old and thinks Diet Coke is good for you.

I don’t mean to sound like a shitlib here — I hope I trashed Biden enough above that nobody could mistake me for one — but the mere fact that Trump is as old and narcissistic as he is ought to disqualify him from office. Our rules and institutions just aren’t designed to be run by someone who’s not long for this mortal coil.

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