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The GOP Has Become a Malevolent Force in American Life

The GOP Has Become a Malevolent Force in American Life

Consider these words written in 2012 by non-partisan political scientists Thomas Mann and Norm Ornstein:

The GOP has become an insurgent outlier in American politics. It is ideologically extreme; scornful of compromise; unmoved by conventional understanding of facts, evidence and science; and dismissive of the legitimacy of its political opposition.

Eight years on things have got demonstrably worse. Republicans continue efforts to repeal the Affordable Care Act both legislatively (in 2017, which failed) or in court as GOP states led by Texas pursue a lawsuit currently pending before the Supreme Court that may see the ACA overturned next spring. The consequences to millions of Americans would be devastating.
This in the face of a virulent pandemic with more millions of Americans losing their jobs and their health care who will likely need the ACA. In the current health crisis, the Republicans’ rush to open up the economy before infection rates have decreased or we have adequate testing and contact tracing capabilities promises to cause thousands of unnecessary deaths – particularly among the elderly.

Meanwhile the GOP’s stubborn and obtuse denial of climate change threatens the future of our children and grandchildren. The depressing litany of destructive policies the GOP has embraced over the years whether its unravelling environmental protections and workplace safety regulations, beating up on the poor in America, suppressing voting rights of minorities to name but a handful, do enormous harm to the American people. The reality is of a political party and conservative movement that rejects the worth and role of government to do good and runs it incompetently to prove its point, while doing everything possible to impede the other party from governing effectively.

In this the GOP is robustly supported by its perpetually angry base, and a right-wing media machine that pushes both to the extremes. Negative partisanship is bipartisan but at least most Democrats get their news from reliable mainstream media as opposed to Republicans who are far more likely to be misinformed thanks to conservative media even on something as critical as the coronavirus. The latest conservative conspiracy theory, for example, is that the COVID-19 death rate is vastly exaggerated, a dangerous illusion that promotes a lethal complacency.

In short, Republican governance at every level is severely hazardous to our health and well being. In the present emergency, a GOP administration first weakened the federal government’s ability to combat a theoretical pandemic then thoroughly botched its response to a real one. And while a pragmatic Democratic House has tried gamely to bring some sanity to the government’s response to the economic and health calamities, it’s an uphill struggle against an ideologically driven, boneheaded GOP majority in the Senate. For example, an obvious need to support states with an infusion of federal funding as their economies tank and their revenues plummet is being blocked by a hatefully partisan GOP leadership that sees it as disproportionately (and erroneously) benefitting Democratic states.

When this catastrophe is finally over, Americans need to have a serious conversation on the future of our democracy in light of the bitter divisions that are unlikely to ameliorate even without the vile and divisive presence of either Trump or Senator “Moscow” Mitch McConnell. I don’t pretend to know the answer but I do know that we can never move forward as a country while this extreme polarization, without parallel in any other democratic nation, persists.

What Ballard Looks Like During the Coronavirus Pandemic

What Ballard Looks Like During the Coronavirus Pandemic

Ballard is the neighborhood where I live in Northwest Seattle, Washington that was a sleepy little Scandinavian neighborhood when I moved in. It’s gone through many changes over the past few decades that have made it a destination for Seattleites and for tourists from all over the country and the world. It’s where people go to drink, because there are many great bars and restaurants, plus the world famous Tractor Tavern music venue.

I took a walk through Ballard last weekend to see how the coronavirus shutdown has changed it.

Ballard was a bustling neighborhood with many thriving locally owned businesses, but now they are all hurting because of the severe economic slowdown brought on by the social distancing required to stop the spread of the highly contagious, deadly coronavirus. I can only hope the pandemic soon wanes and that Ballard, Seattle, Washington, and the rest of America and the world can get back to normal. I want all of these businesses to survive, but I don’t think all of them can without some huge help from the state and federal government, and from all the locals pitching in to buy what they can from them when they can.

The Great Recession was about “Too Big to Fail”. This recession is going to be all about “Too Small to Fail”.

Update: While drafting this post last night, I was listening to The Roadhouse with Greg Vandy, the best weekly radio show on KEXP. During his show Greg informed us listeners about You Don’t Bother Me: A Fundraiser For Ballard Ave Music Venues put together by Seattle band, The Cupholders.

This compilation is a fundraiser for the staff of the Ballard Avenue music venues that have been forced to shut down due to the Covid-19 pandemic.

The bartenders, sound technicians & door attendants at Conor Byrne Pub, Hotel Albatross, The Sunset Tavern & The Tractor Tavern are our family and make sure that we as musicians have a place to play as well as build and sustain our community.

To celebrate these noble warriors, all the artists on this compilation have recorded their own version of Casey Ruff’s song “You Don’t Bother Me” a song celebrating friendships, good times and hangovers made on Ballard Avenue

Facebook page here.

Also, there are links in the photo captions to most all of the businesses in the photo gallery, but you’ll need to scroll over the words to see them. Try it!

Coronavirus Stimulus Bill Sabotaged by Republicans

Coronavirus Stimulus Bill Sabotaged by Republicans

Senate Republicans don’t care about people. They only care about big business, corporate donors, and their extremely wealthy friends. We knew that when a Republican controlled senate passed President Trump’s Tax Cuts and Jobs Act in December 2017. It gave huge tax cuts to corporations and provided a big tax loophole for pass-through income. The bill was advertised as a move that would lower taxes for workers and help businesses expand by providing them with more cash. Most workers saw very small decreases in their taxes and some actually saw their taxes go up a little, but businesses were left with a lot more cash in pocket and they used it to buy back their own stock to line the pockets of their already obscenely rich corporate executives. They did not increase investment any more than they would have otherwise and they did not provide any substantial increases in wages or benefits for workers. Some cities and states saw increases in wages because they mandated higher minimum wages themselves. Republicans in congress refused to increase the minimum wage like they always do.

Trump’s tax-cut was an expensive failure.

So they were fine with their 1.5 Trillion Dollar tax cut for the rich, but they aren’t so fine with a new and much needed coronavirus stimulus bill that will cost somewhere between one to two trillion dollars if most of that money is funneled to the people who really need it – the unemployed workers.

The Democrats focused their efforts on people first, not profits first. They would direct the money to the millions of people in the service industry (restaurants, bars, hotels, ride-share drivers, salon workers, dental hygienists, etc.) who are all out of work. This is a huge sector of our economy. Workers need cash to buy food, pay rent and mortgages, and obtain healthcare – all urgent stuff. The stimulus bill should provide that urgent aid first. A one-time check in the $500 to $1,200 won’t provide the long-term aid they are going to need.

The spending should cover the cost of extending the unemployment insurance for at least a year or two. It should probably force large employers to provide sick pay for as long as is necessary for their workers to recover from COVID-19. The bill should prevent people from losing their jobs because of government-mandated work stoppages. It should make sure that everyone afflicted with the disease gets the healthcare they need regardless of whether or not they have insurance. To put it simply, the stimulus bill can’t be about “creating jobs” right now. It should be all about alleviating hardship and suffering caused by the outbreak, because it can’t help put people back to work until the pandemic is gone, and it looks like that isn’t going to happen for months.

The Republicans’ bill includes $5B for a corporate slush fund. It’s weak on worker retention and has loopholes. It’s treasury lending section is vague. It doesn’t provide provisions to protect people from evictions and foreclosures. It provides zero money for state and local governments. Is that because the states hardest hit are blue states? No additional spending on SNAP when the program will obviously be under extreme pressure. No direct payments for people who did not file tax returns in 2018 or 2019. It offers no help for the uninsured and no help for people with student loans.

What this all adds up to is, as James Martin wrote in The New York Times today, a Moral Evil. That’s suffering caused by the actions of individuals or, in this case, the inaction of individuals. And even worse; the deliberate redirection of resources that should be used to alleviate suffering of the most vulnerable people to the least vulnerable, most wealthy people in our country. That’s right. Who do you think will be the recipients of a slush fund?

Maybe enough Republicans in the Senate will read The Bible tonight and decide to do what Jesus would do (from the James Martin column):

Needless to say, when caring for someone with coronavirus, one should take the necessary precautions in order not to pass on the infection. But for Jesus, the sick or dying person was not the “other,” not one to be blamed, but our brother and sister. When Jesus saw a person in need, the Gospels tell us that his heart was “moved with pity.” He is a model for how we are to care during this crisis: with hearts moved by pity.

I’m not betting on it.

Voting in Republicans to control the Congress and more states is a truly dumb idea.

Voting in Republicans to control the Congress and more states is a truly dumb idea.

In the first two years of his presidency Barak Obama and a Democratic majority in Congress saved the United States auto industry from bankruptcy, enacted a stimulus package that effectively cushioned a collapsing economy and likely prevented another Great Depression, passed the Dodd Frank law to make it much less likely we will suffer another banking meltdown in the future and, last but not least, enacted the Affordable Care Act which is already driving down the rate of medically uninsured Americans and promises to reduce it still further in future years.

In 2010, however, a Republican takeover of the US House of Representatives effectively ended any possibility for further problem solving from the federal government as the GOP House majority, and a filibuster-happy GOP minority in the US Senate, blocked additional efforts to boost the economy and, indeed, sought to do further damage to it by slashing government spending at a time when the private sector was still contracting.

Despite the GOP’s destructive efforts, however, the US economy has improved significantly albeit much more slowly than would have been the case had we enacted another stimulus heavy with infrastructure spending, as Obama and Democrats wanted. In fact, congressional Republicans by their unprecedented obstructionism have behaved as though they wanted the economy to remain in the tank just to score political points.

And they appear to have succeeded. Polls show it is all but certain that the country will vote next Tuesday for full Republican control of the Congress, and an expansion of that party’s control of governorships and state legislatures. Even millennials seem to be deserting Democrats, and lukewarm support from women cannot balance strong support for the GOP among (white) men. In short things appear pretty bleak.

But it would be useful to know what policies embraced by Republicans have won the support of the electorate in this election cycle.

Is it the Republican desire to unravel environmental laws and rules such as those to reduce carbon emissions from coal-fired plants or to drastically expand drilling for oil and gas on public lands and off-shore? Is it their enthusiasm for slashing food aid and other crucial support for America’s poorest citizens?

Or perhaps it is the GOP’s oft-stated intention to repeal the Affordable Care Act and strip 10 million Americans of their newly acquired health coverage that appeals to the electorate? But there again, maybe it’s the party’s economic agenda to cut taxes on corporations and the wealthy while blocking any move to increase the minimum wage that attracts voters?

Many believe the 2014 midterm elections don’t matter but I disagree and here’s just one example from The New Republic  to illustrate why.  To summarize, if the conservative and somewhat erratic GOP governor of Maine is defeated, 70,000 low-income residents of the state stand to gain health insurance through the ACA’s Medicaid expansion. If he‘s re-elected, they don’t. That’s pretty simple but the lives of real people who struggle every day will be affected.

In 2010 a wave of GOP state-level victories led directly, as in Maine, to a denial of health care coverage for millions of Americans. Let’s not make the same mistake in 2014.

All elections matter so get off your duff; make the right choice and VOTE on November 4th!

Obama’s 2014 State of the Union Blues

Obama’s 2014 State of the Union Blues

President Obama’s fifth State of the Union speech last night was a recognition that he can have no congressional agenda beyond maybe immigration reform for the rest of his term in office. Of course he dressed it up in ways to suggest that he is still relevant and I don’t disagree with that. He can still make a difference; he just can’t make as much of a difference as he or we would like, thanks to bitter and hateful GOP intransigence. The latter will continue their campaign of obstruction to the end of his presidency no matter the harm to our economy and to the country’s overall wellbeing.

Other views on the SOTU speech, how we got here and Obama’s potential to drive national policy from here are a good read: Greg Sargent and Eugene Robinson in The Washington Post, Jonathan Cohn in the New Republic and Jonathan Chait in the New York Magazine Daily Intelligencer in particular. There is also this bleaker view from Matt Miller, which is closer to my own.

For Obama it seems likely things will only get worse with Republican prospects for winning seats and possibly control of the Senate and maintaining control of the House appearing favorable at this point, inexplicable as that may seem.

For me, Obama’s speech was a clarion call for states to continue to pick up the slack from a dysfunctional federal government for sensible economic policies such as raising the minimum wage, and more stringent regulatory action on fracking for oil and gas, the humane treatment of farm animals, GMO food labelling and gun control. As long as the GOP in our capital retains sufficient power to stymie the nation’s forward progress, we must look to the states to set the agenda.

Conservative Shift on Unemployment Benefits: from George W. Bush to Frank Luntz

Conservative Shift on Unemployment Benefits: from George W. Bush to Frank Luntz

“These Americans rely on their unemployment benefits to pay for the mortgage or rent, food, and other critical bills. They need our assistance in these difficult times, and we cannot let them down.” – George W. Bush, 2002

“You should not expect a handout. You should not even expect a safety net. When my house burns down, I should not go to the government to rebuild it. I should have the savings, and if I don’t, my neighbors should pitch in for me, because I would do that for them.” – Frank Luntz, The Atlantic, 1/6/2014

Easy for him to say. He lives in a 14,000 square-foot mansion in Los Angeles. What if he lived in a modest house near the Jersey shore when Hurricane Sandy struck? Would his neighbors be able to pitch in? His neighbor’s neighbors? No.

I’ve heard this impracticable conservative pitch for replacing government assistance with charitable giving many times before. It may very well work on a very small scale like within your neighborhood or within your church or whatever, but it can’t work on a large scale when millions or, worse yet, tens of millions of people are affected by a natural disaster or a Wall Street disaster. Well not unless everyone gets paid millions of dollars like Frank Luntz is to sell his twisted political language to the Republican party and Fox News.

Paul Ryan’s Coded Language on the Budget Deal

Paul Ryan’s Coded Language on the Budget Deal

During last night’s budget-deal press conference featuring Patty Murray and Paul Ryan, Mr. Ryan said: “Nobody here had to sacrifice core principles”.

That translates to, “I held true to my supreme belief that the vast wealth of the super rich must never be compromised”.

And he said: “It reduces the deficit — without raising taxes. And it cuts spending in a smarter way. It’s a firm step in the right direction, and I ask all my colleagues in the House to support it”.

That translates to, “When it comes to deficit reduction, the only people who have to pay more are the middle class and the poor. See? I gave up nothing while getting Senator Murray to allow increased revenue from the serfs through higher airline-passenger security fees, a 1.3% increase to the amount new civilian employees will have to contribute from their pay to the federal pension plan, and lower cost-of-living increases to benefits going to military retirees. Our rich benefactors end up paying nothing more to the federal government other than a few extra dollars on their airline tickets. We win! So come on everybody, support this “compromise” bill that once again screws the middle class! Shhhhh… be careful not to say this out loud. Oh and as and added bonus, we get to put off our blackmail tactics that piss off the electorate until after the 2014 midterm elections.

Reports of Obamacare’s demise greatly exaggerated.

Reports of Obamacare’s demise greatly exaggerated.

To listen to Republicans, pundits and much of the media, the Affordable Care Act is already gasping for air; emitting what many hope is its death rattle. For Republicans and Fox News, Christmas has clearly come early thanks to the botched rollout (how many times have we heard or seen that phrase?) of the landmark health law.

The latest polls show that both President Obama and his signature legislative achievement have taken a serious hit. Some Democrats have already assumed that defensive crouch that seems to come so naturally to them when the going gets rough – witness the 39 cowards in the House who, disgracefully, voted for a GOP bill that would have seriously undermined the ACA.

The federal website’s dysfunction was bad enough but Obama’s inaccurate assurances that everyone who had insurance and a doctor they liked could keep them, making no exception for the mostly rubbish individual policies that failed by a country mile to meet even the modest basic requirements of the ACA, created an instant political storm. To make matters worse, this last problem was compounded by the failure of the website since those who had received policy cancellation letters were stymied in their efforts to find a new policy that would likely be both affordable (when subsidies were factored) and more comprehensive in most cases.

No question this was not the place those who support this law wanted to be at this point. Nevertheless, it is way too early to panic and even more absurd to speak of the law’s demise.

Amid the media hype and feeding frenzy that’s been targeting the administration’s missteps in the initial implementation of the law (where is that “liberal media” when you need it?) the steady progress being made in states that have embraced Obamacare has been largely overlooked, as this piece in The Washington Post by the governors of Washington State, Kentucky and Connecticut highlights and this piece from The Los Angeles Times.

Fourteen states plus the District of Columbia have their own health insurance exchanges and most of these are operating smoothly (Oregon’s is not functioning at present although the state has enrolled 70,000 newly eligible people into Medicaid). There is every reason to believe that enrollment in these states, which constitute about a third of all Americans, in both the private exchanges and in expanded Medicaid will continue to pick up. For all the current furor over the website’s problems, the angst that has accompanied the issuance of cancellation letters to a much smaller segment of the insurance market than the one which will benefit unambiguously from enrollment under the ACA, raises the following question: Who exactly is going to tell these new enrollees and the millions more to come, that their insurance will be cancelled? The answer is: Nobody.

Republicans were desperate to kill the ACA before it could be implemented because they feared that once the number of beneficiaries had reached a sufficient level, it would be impossible to turn back the clock. That dynamic has not changed, irrespective of the rollout issues. Furthermore, there is nothing in what has happened so far to cast any significant doubt that the law will not work as intended.

However, it is becoming clear that the benefits of the law will not be spread evenly throughout the country. For example, the populations of the fourteen states plus DC who have wholeheartedly embraced Obamacare stand to see a large reduction in the number of uninsured sooner rather than later over the next 1-3 years. It’s not merely that these mostly Blue States (Kentucky being the exception) have established their own exchanges and agreed to the Medicaid expansion. It’s that they also are putting federal and their own resources to work with communication and outreach strategies to enroll as many of their eligible residents as possible.

At the other end of the spectrum, we have the twenty-one states (four others are undecided) who have refused both the Medicaid expansion or to establish their own exchanges. For the folks in these GOP-led states, the adverse consequences go well beyond the current difficulties with the federal website. Some states have actively impeded the work of organizations and individuals tasked with providing information and assistance (“navigators”) to residents who may be eligible for enrollment under the ACA. This lack of cooperation combined with constantly talking down the law will inevitably have the effect of dampening enrollment.

Furthermore, a significant number of working poor in the Red States who would have qualified under the Medicaid expansion that their states have refused, will also be ineligible for federal subsidies with which to purchase a private plan on the exchanges because their incomes do not meet the minimum threshold. How’s that for a double whammy, compliments of their Republican legislators and/or governor.

The bad news for the poorer residents of these Red States does not end there, however, as this story from The New York Times shows. Hospitals in mostly rural areas which provide safety-net care for many without health insurance are seeing their federal subsidies slashed because it was assumed that the beneficiaries would be covered under the Medicaid expansion. Some of the hospitals have closed or may do so without the subsidies. Needless to say the GOP governors and legislators in these states are not picking up the slack.

The fact is that for many millions of Americans, Obamacare holds the very real promise of freedom from the insecurity and stress that comes from lacking health care coverage. However, that benefit will only accrue nationally if all states recognize the enormous opportunity offered by the ACA to make the lives of our citizens better and more secure.

GOP intransigence and blackmail may be about to bear fruit

GOP intransigence and blackmail may be about to bear fruit

The GOP had a plan in 2009: Bitterly oppose and obstruct every policy initiative the Obama administration and congressional Democrats proposed, create tumult and crises, then blame Obama and the Democrats for the gridlock which, they could then argue, would be fixed only by electing a Republican president to break the paralysis.

For their plan to work, GOP congressional leaders Mitch McConnell of the Senate and John Boehner in the House required three essential elements: party discipline in the congress, a rabid base that supported their intransigence and an inattentive and largely uninformed electorate.

Imposing party discipline has rarely been a problem for Republicans and so it has proved over the last 4 years even with the very occasional flashes of independence displayed early on by the so-called “moderate” Maine women (Senators Snowe and Collins).

And with the Tea Party now the driving force of the GOP, McConnell/Boehner had an extremist base that not merely supported the strategy but punished anyone deemed a compromiser. Such conservative icons as Richard Lugar of Indiana paid the price.

Finally, a huge swath of the American electorate either failed to see what was going on or simply dismissed it as politics as usual. It wasn’t.

In all the years I’ve lived in the US I cannot remember a time when one of the two major parties so blatantly put its interests before those of the country to discredit a president of the other party and, ultimately, regain the White House.

The beauty of the American political system we’ve always been told is that compromise is an essential feature. But there is no spirit of compromise in today’s GOP. Or rather, the word is only used in connections with an expectation that Democrats will compromise with a President Romney and GOP congressional leaders; conversely, the latter will never do the same for a re-elected Obama.

There is an underlying element of blackmail in this strategy. In effect the GOP is making clear they will render the country ungovernable under a Democratic president. And they are willing to wreak great damage to the country if necessary; we saw an example of this clearly with the actions of House Republicans in the negotiations over raising the nation’s debt limit in 2011. And they are now threatening as much for the looming “fiscal cliff” as it has come to be known.

And it’s working. Ezra Klein in The Washington Post cites the shameful (my word not Klein’s) endorsement of two newspapers which supported Obama in 2008 and have now endorsed Romney for 2012 precisely because they see continuing gridlock with Obama and the GOP leadership, but the possibility of compromise if Romney wins the White House.

The conservative pseudo-intellectual David Brooks in The New York Times explicitly makes the case for Romney in citing the virtual impossibility of congressional Republicans meeting Obama half-way. Of course in doing so, he dishes out his usual cloud-cuckoo palaver about Romney’s likely tack to the center, magically dragging along congressional Republicans as he does so. Sure he will.

Republicans are confident they will prevail in large part because, unlike themselves, Democrats are not a reckless, destructive force willing to tolerate harm to the country through governmental failure or inertia. And they’re right.

Yet there is great peril in all this for the country. To vindicate the GOP strategy is to encourage repeat performances whenever a Democrat wins the presidency. To blackmail the country into electing a GOP president or face governmental paralysis will effectively disenfranchise the half of the electorate that doesn’t share the GOP’s narrow and mean-spirited ideology, one which would move us inexorably towards a survival of the fittest society.

More importantly, it would fundamentally undermine the very foundation of the American form of government and conceivably usher in what looks more like a parliamentary system where one party can rule. And we know which one that will be.

Up to now, Americans have failed to recognize today’s Republican Party for the extremist and destructive force it represents. And it is well past time for the American people to wake up and deliver the electoral blow that is the only way to pull it back to the mainstream.

The efficient management of Medicare is the way to save it

The efficient management of Medicare is the way to save it

Medicare is a government program that provides a fee-for-service benefit to cover most of the health care needs of seniors in America. As with health care in general, Medicare costs have increased substantially but, nevertheless, delivers care more efficiently than the private sector insurance industry thanks largely to much lower overhead costs and a slower rate of growth.

The Republicans led by Mitt Romney and Paul Ryan under the pretext of “saving Medicare” propose a plan whereby seniors would be paid a fixed amount which they could use either for the traditional program or private insurance. This they euphemistically call “premium support”. The plan would spare current seniors already receiving Medicare (got to keep those votes in the GOP column!) and is aimed at coming generations of seniors. One may ask why, if the plan is so great, it shouldn’t take effect immediately after the plan is enacted. Maybe we’ll come back to that point.

We all know that Medicare has looming funding problems that threaten the future viability of the program. The GOP’s hated of Medicare is matched only by their fear of messing with an entitlement that happens to be popular across all age groups. Their solution to the conundrum has two steps: the first is to devise a plan that under the guise of saving Medicare effectively ends it in its current form through partial privatization.

The second step is to demonize efforts by Democrats and other supporters of traditional Medicare to find efficiencies within the existing system. How can anyone forget the GOP-Tea Party screams of “death panels” during the Affordable Care Act debate and opposition to such common-sense ideas as the Independent Payment Advisory Board (IPAB), an independent body comprised of medical experts tasked with recommending efficiency changes to Medicare’s payment system.

So the GOP impedes efforts to improve the efficiency of traditional Medicare, and then argues that the only way to reduce the program’s long term costs is to end it as a guaranteed benefit and introduce what they characterize as market efficiencies.

The problem is that, as with any free market approach to health care, the profit motive gets in the way. It’s difficult, after all, to make money from sick people, particularly the chronically ailing. The GOP plan, therefore, is likely to shift some of the costs of their care to many seniors themselves since it is unlikely the price support will keep pace with the rise in health care costs. The GOP trumpets that seniors will have lots more choices than they do now but, in truth, how many seniors are equipped to shop for a health care plan that suits their particular circumstances – and get it right? It’s difficult enough for younger working adults to manage. For an aging and financially vulnerable group like seniors, the risks in getting it wrong are far greater. No wonder the GOP grandfathered in (no pun intended) current seniors to keep the existing system.

The traditional Medicare system remains the best way to go. This is not to say that we can’t find innovative new ways, including the use of financial incentives for the private health care providers that deliver services to seniors, to make Medicare more cost-effective. For example, by adopting a fixed fee-for-care approach that emphasizes outcomes rather than the current fee-for-service system is an idea that deserves serious consideration.

But we need to move beyond sterile accusations of rationing health care. If the system is to survive, rationalization of Medicare services will be essential and unavoidable. We can do it the irrational GOP way which is to let the market decide who gets what services regardless of the health needs of the individual. Or we can keep the existing Medicare system with its guaranteed benefit, and work to make it more efficient and cost effective from within.

I think for most of us, it’s a no-brainer.