US Politics

Arlie Russell Hochschild’s Strangers in their own Land, which explored the motivations and resentments of working-class conservatives in Louisiana, was named one of six books to help understand Donald Trump’s win by the New York Times when he was first elected president, in 2016. (Another was Hillbilly Elegy, by now vice president JD Vance, published just a few months earlier.)

Since then, Californian progressive sociologist Hochschild has been struggling to understand the appeal of Donald Trump: particularly to white, working-class men, once a strong Democratic constituency. No writer has worked harder to grasp the gut-level appeal that saw Trump win two elections – and in the process, convert the Republican Party into his personal fiefdom.

Review: Stolen Pride: Loss, Shame and the Rise of the Right – Arlie Russell Hochschild (The New Press)

The puzzle is greatest when one contrasts the current billionaire cabinet with the fact much of Trump’s support comes from people who are objectively worse off under his policies – including tariffs. Last week, Oxfam America called them “an attack on the global working class” that will harm working-class families in the United States and “inflame inequality”.

Much of Trump’s support comes from working-class people objectively worse off under his policies – including tariffs.
Michael Arellano/AAP

In Strangers in their own Land, Hochschild called this “the Great Paradox”. Stolen Pride returns to many of that book’s questions, but in a different era – and a US that seems more fragmented, and far angrier than it was in 2016.

Hochschild explores the world of Pikeville, Kentucky, a poor, overwhelmingly white, Trump-supporting city in the heart of Appalachia: in the “whitest and second-poorest congressional district in the country, a region that had rapidly shifted from the Democratic Party to the Republican Party”.

The American dream’s broken promise

One of Hochschild’s subjects is James Browning, a recovering drug user whose hands are tattooed and covered in rings. “There you have it” he says, “I have a shame hand and a pride hand.” This sums up the basic argument of Stolen Pride.

Arlie Russell Hochschild.
Mark Leong/New Press

“Pride and shame,” she writes, “signal the juncture between the identity we hold out to the world, and how the world responds to our identity.” The men she speaks to desperately need a sense of pride, but too often find their failures are the cause of deep shame. The American Dream, after all, teaches them every individual can make it, inherently implying failure is due to individual weakness.

Many of the men she speaks to have experienced unemployment, domestic breakups, jail, alcoholism and drug abuse. (She even manages to speak to one current jail inmate.) Kentucky has one of the highest rates of opioid addiction in the United States – and despite Trump’s attacks on Mexico and Canada, the doctor-prescribed drugs some were addicted to appear to be domestically manufactured.

So many of the men Hochschild interviewed talk of the balance between shame and pride, I began to wonder if they were prompted. On reflection, I suspect this represents Hochschild’s careful selection from a series of very extensive interviews, conducted over roughly six years.

Her emphasis is almost entirely on the men in Pikeville, though a majority of white women also voted for Trump. I would love to see Hochschild explore this further. That so many women can support a convicted sexual predator in a country obsessed with sexual behaviour is one of the mysteries of contemporary American politics.

Hochschild interviewed residents of Pikeville, Kentucky, a poor, overwhelmingly white, Trump-supporting city in the heart of Appalachia.
Howder Family/Flickr, CC BY-NC

By 2021, many Americans – and most Republicans – believed Trump’s claims that he had really won the 2020 election. They saw the rioters at the Capitol on January 6 as heroes defending American democracy. In Trump’s claim the election was stolen, many of those Hochschild interviews saw parallels to what they believed had been stolen from them, by economic and cultural upheavals.

Importantly, many of her respondents saw Trump as a bully — but a bully who stood up for them, against what they perceived as urban liberal elites. When Hillary Clinton spoke of his supporters as “a basket of deplorables”, she reinforced the grievances of people consistently looked down on as “hillbillies” and “rednecks” by people they identified as Democratic elites.

Many saw themselves in Trump’s stolen election, which mirrored what they felt had been stolen from them.
Ross D Franklin/AAP

How ‘deep stories’ inform politics

For Hochschild, there are underlying emotional narratives, which she calls “deep stories”, that inform our political positions.

In Strangers in their Own Land, these were identified as a sense of being overtaken by groups, usually educated women and Black people, who benefited from programs of affirmative action. The second Trump administration’s crusade against “DEI” is playing directly to these grievances. In Stolen Pride, this feeling is strengthened by the sense liberal elites are undermining both traditional values and the ability for individuals to succeed.

Eastern Kentucky is coal country, and Clinton’s ill-worded election-trail claim she would “put a lot of coal miners and coal companies out of business” was a major factor in swinging voters towards Trump. For men who took pride in their work, the collapse of the coal industry produced a sense of shame: strengthened by a strong belief individuals are to blame for their own misfortunes.

Pikeville was also the site of a neo-Nazi march in April 2017, the forerunner of the tragic Unite the Right march in Charlottesville later that year, which resulted in one death and multiple injuries.

Much of the book skilfully explores the preparations for and reactions to the Pikeville march, which seemingly passed without incident. Some 100 white nationalists turned up and were outnumbered by counter protesters, As Hochschild writes, “Very few Pikeville locals were involved on either side”.

Much of the book explores the 2017 Pikeville forereunner to the tragic Unite the Right march in Charlottesville, later that year.
Tasos Katopodis/AAP

Perhaps the most fascinating figure in Hochschild’s book, and evidence of her skill in persuading the most unlikely people to open up in interviews, is Matthew Heimbach, who led the 2017 Pikesville march, identified as a proud Nazi and co-founded the now-defunct neo-Nazi party, Traditionalist Worker Party.

He also co-planned the Charlottesville march, where he railed against “white genocide” and was sued (with other members of the TWP) for his role in it on behalf of Charlottesville victims. He was found guilty on charges of civil conspiracy in 2021.

“Some years later”, he reveals some of his core beliefs are shaken, especially his attitude toward Black Americans, whom he recognises as often sharing the same sense of dispossession that had fuelled his own anger. “I love Russia and I love Putin,” he told Hochschild, “so I looked into moving there.” As Hochschild remarks: “It seemed that Adolf Hitler was to be replaced in his pantheon by Vladimir Putin.”

Transcending the gulf?

Pikesville is also the home of America’s most famous family feud, between the Hatfields and the McCoys. The feud, which lasted many decades from the late 19th century, “began as a dispute over a stolen pig” and “ended as the longest and fiercest clan fight in the nation”. It has been the basis for a dozen movies, virtually all unmemorable. In 2017, a member of the reconciled clans said if they could settle their differences, “there has to be a way for Americans to get back together as one”.

In the last section of the book, Hochschild looks for ways to transcend the apparent gulf that separates blue and red America. Reading the book after Trump’s return to power, this felt sadly inadequate. Yes, as she points out, most voters are more moderate than the politicians on either side. Sadly, this is not sufficient protection against the rise of the authoritarian plutocracy that now seems to have a firm grip on Washington.

Hochschild wrote this book during the Biden administration and the lead-up to the 2024 elections. I assume she finished it before Trump named Vance as his vice president: a man who first came to prominence with his own account of Appalachian pride and shame. Hochschild doesn’t discuss his Hillbilly Elegy, though it is listed in her references.

Hochschild brilliantly captures the pain of men who feel left behind and conveys something of life in rural Kentucky that goes beyond easy stereotypes. I could feel empathy for many of the people she comes across. But I was unpersuaded there is much room for optimism that the appeal of Trump, and those who follow him, will easily be defeated. More

While Australia was busy defending the Pharmaceutical Benefits Scheme against threats from the United States in recent weeks, another issue related to the supply and trade of medicines was flying under the radar.

Buried on page 19 of the Trump’s administration’s allegations of barriers to trade was a single paragraph related to Australia’s access to generic medicines. These are cheaper alternatives to branded medicines that are no longer under patent.

The US is concerned about how much notice their drug companies have that Australia will introduce a generic version of their product. Once a single generic version of a medicine is listed on the PBS, the price drops. The US argues that lack of advance notice is a barrier to trade.

There is pressure for Australia to emulate aspects of the US system, where drug companies can delay generic copies of their medicines by 30 months.

If the US plays hardball on this issue, perhaps in return for other concessions, this could delay Australia’s access to cheaper generic drugs.

It would also mean significant pressure on Australia’s drug budget, as the government could be forced to pay for the more expensive branded versions to ensure supply.

What’s the current process?

Drug companies use patents to protect their intellectual property and prohibit other manufacturers from copying the drug. The standard patent term in Australia is 20 years, but the time a product is protected by patents can be extended in a number of ways. When patents expire, other companies are able to bring generic versions to market.

A generic manufacturer wanting to market its drug in Australia must apply to the Therapeutic Goods Administration (TGA) for regulatory approval. Before approval is granted, the generic company must provide a certificate to the TGA that states either:

a) that the product will not infringe a valid patent, or

b) that it has notified the patent-holder of its intention to market the product.

The certificate can be provided after the TGA has evaluated the generic – before it grants approval.

If the generic company chooses option “a”, the manufacturer of the patented product may not find out the competing product is going to be launched until after the TGA has approved it.

The patent-holder can then apply for a court order to temporarily stop the generic from coming to market, while legal battles are fought over patent-related issues.

However, if the first generic has already launched and been added to the PBS, it triggers an automatic 25% price drop. This affects all versions of the drug, including the patented product.

In Australia, patented drug companies that try to delay generics by taking legal action without good reason can face penalties and be required to pay compensation.

Patented drug companies don’t like this system. They want to know as early as possible that a generic is planning to launch so they can initiate legal action and prevent or delay generic entry and the associated price reductions.

Is Australia’s system consistent with our trade obligations?

Australia introduced its patent notification system at the request of the US, to comply with the Australia-US Free Trade Agreement (AUSFTA). The World Trade Organization doesn’t require patent notification.

Australia’s system is different to that of the United States. But it’s consistent with the rules negotiated between the two countries.

US drug companies have long argued Australia’s system is a barrier to trade. They want Australia to change it to be more like the US system.

Why is the US arguing this is a barrier to trade?

The Trump Administration’s 2025 report on foreign trade barriers states “US and Australian pharmaceutical companies have expressed concerns about delays” in the patent notification process.

The report also mentions US concerns about the potential for penalties and compensation when a patent owner takes legal action against a generic company.

This report reflects long-standing concerns of the US pharmaceutical industry. In March, its drug makers trade association wrote to the US trade representative complaining that “lack of adequate notification” is an unfair trade practice. It argued this creates uncertainty for patent-holders, prevents resolution of patent challenges before generics enter the market, and penalises patented-drug companies for trying to protect their rights.

Medicines Australia, which represents the Australian subsidiaries of many big patented drug makers, echoes these concerns.

Prime Minister Anthony Albanese says he won’t use the PBS as a bargaining chip in trade negotiations with the US.
Lukas Coch/AAP

What does the US want instead?

The US patent notification system is much more favourable to the patented drug companies than Australia’s.

In the US, the generic company must notify the patented drug company within 20 days of filing an application for approval.

Then, within 45 days of receiving the notification, the patent-holder can ask the regulator to impose a 30-month delay on approval for the generic.

This means there is an automatic 30-month delay on the launch of the generic, unless patents expire in the meantime or the court decides earlier that valid patents aren’t being infringed.

What could happen if Australia bowed to pressure from the US?

Changing Australia’s system to be more like the US would delay generics entering the market in Australia and keep the price of drugs higher for longer.

The quicker generics can be added to the PBS, the less the government pays. When the first generic is listed on the PBS, a 25% price cut is applied to all versions of the product, including the patented version.

Over time, as more generics get added, prices continue to fall. Having plenty of generic competition can eventually result in prices lower than the PBS co-payment, resulting in savings for consumers.

In the longer term, lost savings from timely listing of generics on the PBS would reduce value for money and add cost pressure.

In time, it could also delay savings for consumers from drugs priced below the PBS co-payment.

Both major parties are saying they won’t use the PBS as a bargaining chip in negotiations with the US over tariffs. They also need to resist pressure to slow down access to generic drugs. More