The sleaze factor comes from seeing the President of the United States laugh about someone's kidneys failing them.  What kind of person thinks kidney failure is funny?  Laugh at locking a mass murderer in a room with a bug and you're radical. Laugh at the idea of someone you dislike suffering kidney failure and you are a purveyor of compassion, a role model, a real man.
This country is in worse shape than I thought if people don't see how sick this truly is.