Editorials of The Times

It is now tragically apparent that degrading the Islamic State has not created an opening for peace in Syria. Instead, the country’s vicious president, Bashar Assad, and his enablers in Russia and Iran have exploited the battlefield successes against ISIS to unleash a new round of carnage on civilians, as the leaders of the United States and other world powers largely stand by, unwilling or unable to do anything to stop it. Shame on them all.

The Assad-led bombardment of eastern Ghouta, a Damascus suburb of about 400,000 people and one of the last rebel-held areas, is being called one of the most violent episodes of the seven-year war. Since Sunday at least 310 people, many of them children, have been killed. That’s in addition to nearly 500,000 Syrians killed countrywide since 2011.

Ghouta has been under siege for years, although it’s technically part of a negotiated de-escalation zone, leaving the district facing chronic shortages of food, medicine, medical personnel and other necessities.

This week’s massive attack — which has involved rocket fire, shelling, airstrikes and helicopter-dropped barrel bombs that struck hospitals and other civilian infrastructure — intensified the misery. It seems intended to force rebels to surrender so the government can reclaim the territory. Most of the civilian casualties resulted from airstrikes on residential areas, the United Nations’ human rights office said. There have been signs that a government ground assault may soon follow.

Photos posted on social media are excruciating. Terrified children, faces and bodies covered in blood. Shrouded corpses lined up on dirty concrete floors. Wounded patients on gurneys writhing in agony, lacking medical attention or even drugs to ease their pain. António Guterres, the United Nations secretary-general, called Ghouta a “hell on Earth.”

If there was any doubt about the barbarity of the pro-Assad forces, it was dispelled by Brig. Gen. Suheil al-Hassan, leader of the government’s Tiger Force. “I promise, I will teach them a lesson, in combat and in fire,” he said in a video shared by pro-government social media accounts. “You won’t find a rescuer. And if you do, you will be rescued with water like boiling oil. You’ll be rescued with blood.”

That’s the kind of evidence that must be used — sooner rather than later — to build a legal case to try Assad for war crimes. The same should be done for Russian leaders, who help keep Assad in power with political support and military air assets, and Iranian leaders, who provide tactical advice and ground troops. The United Nations human rights chief, Zeid Ra’ad al-Hussein, called what is going on in Ghouta a “monstrous campaign of annihilation” on Wednesday.

The United States and other governments have even accused Assad of using chemical weapons — banned under international law — in Ghouta and elsewhere in Syria. But world powers have done nothing, beyond an American airstrike last April ordered by President Donald Trump under questionable authority. Russia bears special responsibility because it guaranteed Assad would give up his chemical weapons as part of a 2013 deal with the United States, which the Syrian leader obviously did not do.

The U.N. Security Council has been particularly impotent at ending the killing between Assad, a member of a Shiite sect, and the Syrian opposition, made up mostly of Sunnis. Some 11 Syria-related Security Council resolutions have failed to pass because of Russian vetoes.

A new Swedish-Kuwaiti resolution, demanding a 30-day cease-fire in Syria so civilians can be resupplied or flee the war zone, seems destined for the same fate. Russia dismissed the resolution as “not realistic" — a reaction that highlights how protections for civilians in wartime, long a central tenet of international law, are being rapidly eroded.

Complicating things even more, the civil war between Assad and the opposition, once seen as the core of Syria’s instability, is now understood as just one element in a web of conflicts tearing Syria apart. In addition to Russia and Iran, Turkey, the United States and Israel all have a presence in Syria, and their competing interests are raising the specter of wider war, which must be avoided.

What of diplomatic solutions? Russia, after feigning to lead such an effort, lost credibility by siding with Assad and his route to more carnage. And while the State Department condemned the regime’s violence and named Russia as holding a “unique responsibility” for the suffering, Trump has effectively abandoned America’s international leadership role in the matter.

This week, as reports of new Syrian casualties rolled in, aid groups and political leaders once again condemned, lamented and called for action. UNICEF, the United Nations children’s agency, may have been more honest. Unable to muster more bromides, it issued a statement saying only, “No words will do justice to the children killed, their mothers, their fathers and their loved ones.”

Having failed in its effort to have Congress repeal the Affordable Care Act, the Trump administration has been relentlessly trying to destroy the health care law on its own. The latest move in that demolition derby came this week, when officials proposed giving insurance companies more leeway to sell junk health plans.

The Department of Health and Human Services wants to let companies sell temporary health insurance policies that last up to 364 days, up from 90 days now. Officials say that would benefit people who are struggling with rising health insurance costs, because the plans tend to be cheaper than those on the insurance exchanges created by the ACA, or Obamacare.

Not mentioned in the department’s talking points is the fact that these policies often do not cover things like mental health services, substance abuse treatment, cancer drugs and maternity care. As a result, people who buy such skimpy plans could end up being hit with exorbitant bills if they actually need medical care.

The Obama administration limited these short-term plans to three months because they are meant to be a stopgap for people between jobs or in other temporary situations. The Trump administration would effectively encourage younger and healthier people to stop buying comprehensive policies on the Obamacare exchanges. As a result, insurers selling ACA plans would be left covering an older and sicker population, forcing them to increase premiums.

This would not be devastating to most of the people who use exchanges, because they receive federal subsidies that limit how much they have to pay. But it could really hurt middle-class families who earn too much to qualify for government assistance (about $82,000 for a family of three) and are already facing big premium increases. People in this group would have the terrible predicament of spending a lot of money buying health insurance or taking a chance by buying a skimpy temporary plan, hoping that nobody in the family gets sick or injured.

This proposal is the latest in a series of steps the administration has taken to weaken the ACA and the health care system. In January, it proposed allowing employers and sole proprietorships to form associations for the purpose of buying insurance policies that do not have to comply with the protections of the ACA. And it recently began allowing states like Kentucky to take Medicaid benefits away from people who are not employed, creating a system of red tape intended to hurt poor people who have lost their jobs or are unable to work.

If the administration were actually serious about reducing health care costs, it would try to improve the ACA, not dismantle it. For example, President Donald Trump could work with Congress to offer subsidies to middle-class families who do not qualify for help under Obamacare. Or he could push for the creation of a national reinsurance program that would encourage insurers to offer policies in more parts of the country at lower costs by protecting them against steep losses from very sick patients.

But Trump and his Republican allies in Congress seem unwilling to pursue constructive health care policies because they are obsessed with undoing Obamacare. Regrettably, the cost for their rage will be the health care of millions of low-income and middle-class families.