Say for sake of argument that Trump IS the smartest businessman on earth, and he could actually run an American version of NHS efficiently.
He is also 69 years old. Sooner or later he’d head for that big boardroom in the sky, and some not-so-capable person would take over for him.
It’s a key flaw of centrally managed systems.
Trump will be 70 this Summer, which is why he keeps evaluating everyone’s energy. He’s very cognizant that his own is an act.