Healthcare comprises almost 20% of the United States gross national product. In our effort to keep our readers informed about the topics that most impact on their lives we presented a writing last week by Dr. Robert Pearl entitled, “ In healthcare’s game of Monopoly, one player will control the board, ” in which Dr. Robert Pearl presented a private solutions to inefficiencies and problems that exist in America’s health care industry. Today we present a video from IssueOne examining the healthcare industry. Right now, healthcare lobbyists are legally allowed to buy our elected officials’ votes. As long as that’s the case, our representatives will continue to choose campaign donations over Americans’ lives. The healthcare industry spends more than anyone else lobbying politicians to rig the system on their behalf. That should be illegal, but it’s not.
Site Navigation
Search
Latest Stories
Join a growing community committed to civic renewal.
Subscribe to The Fulcrum and be part of the conversation.
Top Stories
Latest news
Read More
Social Security faces automatic cuts in 2032 and Medicare in 2033. New polling suggests that gives Democrats a powerful election issue. Here’s the case.
DNY59 / Getty Images
Will the Debt Crisis Engineered by Republicans Succeed in Cutting Social Security and Medicare?
Oct 30, 2026
Overview
The Republican Party’s long game to reduce administrative state entitlement spending centers on creating a debt crisis to provide an excuse for limiting such spending. It may soon pay off. That strategy involved a quarter-century of engineered tax cuts responsible for the stunning rise in sovereign U.S. debt, threatening an eventual economic crisis.
Social Security benefits are projected under current law to be automatically cut in 2032. And Medicare benefits are projected to be automatically cut in 2033. Congressional Republicans intend for those automatic cuts to occur, opposing new taxes to prevent cuts. And they are using the ballooning national debt as an excuse to also oppose new general revenue spending to prevent benefit cuts.
Few voters are aware of these looming automatic benefit cuts. But they are a compelling opportunity for Democrats to dramatize their support for current benefit levels of Social Security and Medicare.
Hobbling the Administrative State
Five Republican tax cuts for elites since 2002 supplemented by tax evasion and eroded tax enforcement caused Federal tax revenues to decline by 2.4% of GDP during 2002-2026 compared to 1995-2001. Budget deficits jumped. That missing revenue is why Republicans are borrowing 29 cents of every $1 the government spends – ballooning the national debt year after year.
To build public support for cutting entitlements, billionaires and Republicans are gaslighting voters, misrepresenting the source of that debt. Instead of tax cuts, Medicare and Medicaid are demonized in the Republican bluebook Project 2025 as “principal drivers” of the national debt: “our deficit problem is a Medicare and Medicaid problem.”
The Looming Entitlement Crisis
Social Security and Medicare are the largest entitlement programs, making them juicy targets for Republican elites. And opportunity beckons. If insolvent, current law requires an automatic 24% annual benefit reduction for the 75 million Social Security participants beginning in 2032 - an $18,400 annual reduction for a typical couple. And it requires a 12% cut in annual Medicare (hospital) reimbursements beginning in 2033 - raising out-of-pocket costs for 75 million Medicare patients.
These automatic reductions are catnip for Congressional Republicans. They can cut entitlements by simply sitting on their hands, refusing to raise taxes or spending to replenish the Social Security and Medicare trust funds. To obfuscate the cuts they actually make, Congressional Republicans mislabel their benefit reductions as “rooting out waste.”
At gravest risk is Medicare because Party elites since Reagan have been ideologically opposed to “socialized” medicine. For some time, Republican budgets have whittled down Medicare while gradually replacing it with for-profit private health insurers (Medicare Advantage) that deny care and provide lower quality care at a higher cost.
For Social Security, Republicans propose raising the retirement age to 69 from 67 which would reduce lifetime benefits 8%. Yet, 78% of respondents to a June 2026 Quinnipiac survey specifically opposed raising the retirement age to 70. Moreover, their proposed changes are too meager in any event to avoid trust fund insolvency and benefit cuts for Social Security and Medicare.
An Ace-in-the-Hole
That Republican stratagem is risky because Congressional Democrats have an ace-in-the-hole.
A question buried deep in a September 2026 survey of Senate battleground states found that support for reforms to sustain current Social Security benefits jumped from 49% to 91% once voters learn about the pending automatic cuts. In addition, Medicare is also extremely popular, with 85% of Americans opposing any benefit cuts.
Entitlement Reforms
These data suggest that advocating reforms to sustain these two entitlements is a promising major Democratic Party theme.
For Social Security, Democrats embrace The Roosevelt Institute and Biden administration’s proposed reforms. First, despite virtually all real income growth in recent decades flowing upward, the social security payroll-tax exempts income from wages above $184,500. That cap could be eliminated, a move supported by 85% of respondents surveyed by the American Association of Retired Persons. Second, the payroll tax could be expanded to tap non-wage income from sources favored by the wealthy that are presently exempt – large inheritances, corporate profits and capital gains.
Democrats also support reforms establishing a solid fiscal foundation for Medicare. As proposed by President Biden, for instance, the net investment income tax and Medicare payroll tax could be increased on incomes above $400,000. And a host of Republican tax cuts for high earners and corporations in 2017 and 2025 can be reversed. Other Democratic reform proposals would reduce the drain on the Medicare program by the unreliable Medicare Advantage program managed by private insurance firms illegally “upcoding.” They habitually over-charge Medicare for medical procedures by misclassifying enrollee ailments as sicker than they are. Finally, since Medicare reimburses health providers at about half of current private provider prices, a gradual expansion of Medicare (perhaps lowering the eligibility age to 62) would be a powerful weapon to lower health care costs nationwide.
All these Democratic entitlement reforms would be popular and obviate the need for benefit cuts.
Stewards of Social Security and Medicare
Democrats and Republicans are offering different solutions to the Social Security and Medicare debt crises. Partisanship aside, their solutions reflect how each Party perceives the role of government, the Administrative State and entitlement spending.
At the moment, surveys suggest that voters support Democratic plans to prevent the benefit cuts favored by Republicans. A major reason is that health care has emerged as the leading 2026 domestic concern, with 68% of independent voters worried about its cost. Some 35% of these swing voters trust Democrats to control health care costs compared to just 15% who trust Republicans. They also trust Democrats to manage the future of Medicare by a margin of 37% - 15%. And some 44% of these pivotal voters say health costs will have a “major impact” on which party’s candidate they support.
Independents also trust Democrats more than Republicans by an 11 percentage point margin to handle Social Security concerns.
Since FDR, Democrats have been stewards of Social Security and Medicare. Reflecting that responsibility, they should make preventing automatic benefit cuts an election issue.
George Tyler is a former deputy assistant treasury secretary and World Bank official. He is the author of books including Billionaire Democracy and What Went Wrong.
Keep ReadingShow less
Recommended
Chinese President Xi Jinping (L) and U.S. President Donald Trump followed by Chinese first lady Peng Liyuan and U.S. first lady Melania Trump arrive for a state dinner in the East Room of the White House on September 24, 2026 in Washington, DC.
Kevin Dietsch/Getty Images
When Leaders Disagree, Ceremony Plays an Important Role
Oct 30, 2026
When Chinese President Xi Jinping arrived at the White House on 24 September, the U.S. welcomed him with an elaborate display of ceremony. The Army Herald Trumpets sounded a fanfare, the Chinese and American national anthems were played, and the Old Guard Fife and Drum Corps performed. A military review was followed by a flyover involving a B-2 bomber and four F-22 fighter jets, according to the White House. It was an extraordinary production for two countries that still disagree on some of the most important issues in international politics.
Talks between President Donald Trump and Xi touched on trade, artificial intelligence and Taiwan. The visit was marked by warm words and some signs of cooperation, but it did not erase the fundamental competition between the United States and China. So why was all this ceremony staged? It is tempting to dismiss political pomp as mere window dressing: an expensive historical relic surrounding the serious business taking place behind closed doors. As a music historian, however, I think this misunderstands what ceremony does. Ceremony can become particularly valuable when words alone are not enough.
Long before governments could issue statements instantly, political authority communicated through sound and movement. Trumpets announced arrivals and bells marked public events. Processions established hierarchies, while anthems and military bands allowed states to demonstrate their relationships even before anyone issued a communiqué.
Today, a president can address millions of people in seconds, while citizens can follow diplomatic negotiations almost in real time. And yet, when another head of state arrives, we still raise flags, invite musicians and perform carefully rehearsed rituals. The purpose of ceremony is not necessarily to demonstrate agreement. Sometimes its purpose is to make disagreement manageable.
Music is especially useful here because it can express recognition without requiring ideological consensus. Performing another country's national anthem does not imply approval of its government or policies. It signifies recognition of the state and the people represented by its leader. The same is true of many diplomatic rituals. A handshake does not resolve a trade dispute, and a state dinner does not ease tensions over Taiwan. These gestures instead create a temporary framework within which disagreements can take place.
Much of our public political culture is designed to highlight differences. Diplomacy sometimes has to do something more complex: acknowledge deep disagreements while preserving a relationship capable of weathering them. Ceremony offers a language that makes this possible. Of course, there is another side to political spectacle. Ritual can glorify power. Military ceremony deliberately demonstrates strength, and the B-2 bomber that flew over the White House was hardly a neutral prop.
Nor should carefully orchestrated hospitality be confused with diplomatic success. Governments can stage grand ceremonies while achieving very little, and pomp can divert attention from difficult political realities. Ceremony cannot replace successful diplomacy. But it does not lose its meaning simply because it does not lead to the signing of a treaty.
Consider the mixture of signals contained in the White House welcome. The Chinese national anthem was played alongside the American one. Xi was received with the honours accorded to a visiting head of state. At the same time, the ceremony demonstrated U.S. military might with extraordinary clarity. Hospitality and power were not contradictory messages. They were conveyed simultaneously.
This is something ritual does exceptionally well. Music historians encounter this throughout history: music has accompanied coronations, funerals and diplomatic events because it can communicate meaning without requiring everyone present to interpret that meaning in precisely the same way.
Relations between states, like relations between people, depend on more than the transmission of information. They also depend on recognition. A ceremony says: you have arrived; we recognise the significance of this meeting; for the duration of this encounter, we have agreed to occupy the same political space. None of this requires friendship.
In fact, ceremony may be most revealing precisely when friendship is absent. If two governments already agree, ritual reinforces an existing relationship. When they are deeply divided, the ritual itself can become part of the mechanism that allows them to remain in the same room.
Outside the ceremonial framework of the Trump-Xi meeting lay unresolved questions about trade, artificial intelligence and Taiwan. Inside it were trumpets, flags and carefully rehearsed movements. One did not preclude the other. The ceremony created a temporary language through which two rival powers could acknowledge one another without pretending that their differences had disappeared.
In an era when compromise is often seen as weakness and disagreement as a reason to stop listening, there may be something worth noting in this old diplomatic tradition. Sometimes the first achievement isn't agreement. It’s the fact that dialogue remains possible.
Stacy Jarvis is a Manchester-based music historian, culture writer and violinist. She writes about classical music, cultural history and the intersections between music, politics and society, with work appearing in The Washington Post, The Philadelphia Inquirer, The Conversation and other UK and international publications. She is also a radio contributor and is completing a PhD in Musicology at the University of Birmingham.
Keep ReadingShow less
Americans Voting in an Election
Getty Images
Voting Is Not Just a Privilege It Is Every Citizens’ Responsibility
Oct 29, 2026
Despite the consistent determinations that US elections are secure across the country and there is virtually no evidence of non-citizens voting, in reports released as recently as September 2026; President Trump has doubled down on his claims that voter fraud is a major problem in America and on October 20th, he announced a new $25 Million Fraud Whistleblower program to be administered by the Department of Justice.
This announcement achieves a variety of the president’s goals: (i) It intentionally perpetuates the misinformation, that voter fraud is a serious problem in the United States; (ii) it undermines the trust in the voting systems, as well as in the states administering the elections; (iii) it fosters distrust amongst neighbors, who are more likely to suspect people of color and report them for a reward. This has the concomitant benefit of (iv) intimidating people who are in fear of going to the polls and (v) It gives the illusion that the federal government is prepared to give away more free money (along with the Tariff rebate checks, the Trump Accounts, the DOGE dividend, the direct payments for healthcare and the $5,000 for supporting GOP midterm candidates.)
The President’s efforts to sow confusion surrounding the election, are consistent with the GOP’s decisions to close more than 1,688 different polling sites across 13 states between the 2013 Shelby County v. Holder decision by the U.S. Supreme Court and 2018. After Shelby, the states were no longer required to notify voters of changes of polling place relocations.
In addition, since 2024, according to the Brennan Center for Justice, 22 states have enacted 38 restrictive voting laws which are in effect at the midterms, 12 states have enacted stricter voter ID laws or invalidated previously acceptable IDs for voting.
When one considers the impact of the gerrymandering wars, it is a wonder that anyone who is not a dedicated follower or a political devotee, will know where to cast their ballot and in advance of seeing their ballot, who they will be voting for.
The President in March, issued a sweeping executive order intended to federalize the administration of U.S. Elections. It would require people to prove their citizenship at registration, change the certification standards of voting machines, prohibit the counting of ballots postmarked before the election day but received thereafter. It would have also put DOGE and the Department of Homeland Security, in charge of monitoring the voter rolls and other available records. The courts blocked or suspended most of the president’s election initiatives, but this combined with the January 6th 2021violent assault on the Congress seeking to overturn the 2020 election, provide grim reminders of the extent to which the president will go to achieve his goal of retaining power.
In addition to his other efforts, Reuters reports as recently as October 14th, that it is highly probable that the President could:
- Allege election fraud or that voting machines have been compromised.
- Pressure election officials to change or cancel results.
- Seize ballots or manipulate voting machines.
- Have federal election monitors interfere with voting.
- Deploy ICE officers to provide an intimidating presence near polling sites.
- Deploy US troops to the polling sites.
- Declare a national emergency over voting fraud.
- Initiate federal investigations and charges against election officials.
- The GOP might refuse to acknowledge the election results (as some tried on 6 Jan 2021) and refuse to swear in the new members of congress.
These concerns are amplified, when combined with fact, that the GOP’s largest donors this election cycle, who have contributed $9.8 billion the through the 25th of September, (we note that the numbers have gotten fuzzier since the secret super PACs and Crypto contributors) have also been provided ample opportunities to evade election commission oversight.
So, what can you do.
- BY ALL MEANS VOTE
- If you have a mail in ballot return it as soon as possible.
- Several states have drop boxes to receive absentee ballots. If you can return your ballot early or have someone (if that is permitted in your state) return your ballot, to a drop box in advance of the election date.
- Mail your ballot in plenty of time to get there by the election date. Ten days before November 3rd, is recommended. As mentioned, some states will count ballots, as long as they are postmarked before the election date. Some will not. There is an effort by the president to force polls to cease counting on the date of the election. Do not risk this, vote early.
- Many states permit you to track whether or not your ballot has been received.
- If you have a mail in ballot return it as soon as possible.
- Vote Early
- Many states have early voting. Some open polls several weeks early, others permit early voting at the local election commission. Filing your vote early, provides the comfort of knowing you have voted and your ballot has been received, regardless of what happens on the day of the election.
- Demand your right to vote
- If you are at the polls on November 3rd, ensure that your vote is accepted. There will be poll watchers, representatives of political parties, legal advisers and others who will assist you to resolve any issues that may arise. In general, they are extremely professional, courteous and it is highly likely that they have dealt with whatever issue(s) you may have and will be able to craft a resolution.
- Do not let anyone take away your ability to vote or intimidate you. In the worst-case scenario, one of those lawyers or party representatives will escalate any challenge to your vote to the on-site supervisor, election commission or even the courts. In most cases, that is not necessary and most situations will be resolved quite easily. In some cases, and in some states, it is appropriate to cast a provisional ballot, while the issues are resolved.
Many people believe that this election is extremely important. That issue is for each individual to decide. What most of us can agree upon is, that if you are a citizen you are entitled to vote. In our democracy it is imperative that you exercise that privilege.
Walter H. White, Jr. is a member of the Board of Lawyers Defending American Democracy, a founding director and past chair of the ABA Center for Human Rights and has served as an election observer in the former Soviet Union on behalf of the Organization for Economic Co-operation and Development.
Keep ReadingShow less
Political Polarization and Extremism
Getty Images
Both Parties Have Forgotten How to Lose: It’s Time for Guardrails
Oct 29, 2026
On November 3 Americans vote in the midterm elections, and the most important question may be whether the losers accept the result. A Pew survey this summer found that just 55 percent of Americans are confident the midterms will be run fairly and accurately, down from 64 percent in 2022. The partisan detail is more revealing. Since 2024, Republican confidence has risen and Democratic confidence has fallen from 77 percent to 58 percent. Trust in the referee now depends on who holds power.
Democracy rests on a kind of sportsmanship agreement. The theologian Reinhold Niebuhr put it well: man’s capacity for justice makes democracy possible, but his inclination to injustice makes it necessary. B. R. Ambedkar, the chief architect of India’s constitution, called democracy a method of bringing revolutionary change without bloodshed. Both understood that the system works only if the losing side agrees to try again next time instead of burning down the field. Americans in both parties are forgetting how to do that.
Attacking the Referee
The Supreme Court is democracy’s referee, and this year both sides went after it. When the Court ruled 6-3 in February that a 1977 emergency-powers law gave the president no authority to impose his sweeping global tariffs, President Trump called the justices who ruled against him a “disgrace.” When the same Court narrowed the Voting Rights Act in April, House Democratic leader Hakeem Jeffries denounced “this illegitimate Supreme Court majority.” Different targets, same reflex. Every justice was nominated by an elected president and confirmed by an elected Senate. Calling the Court illegitimate whenever it rules against you rejects the voters who built it.
Rewriting the Rules Mid-Game
The second failure is refusing to accept the score, and now, changing the rules before the game is even played. Al Gore conceded in 2000 after a recount that split the country. In 2017, dozens of House Democrats boycotted Donald Trump’s inauguration; four years later, Trump refused to accept his own defeat, and January 6 followed. Each side nurses a real grievance: Democrats remember a Supreme Court seat held open for most of 2016, and Republicans remember a Russia investigation that shadowed a presidency and ended without a conspiracy charge. Since the summer of 2025, seven Republican-led states have redrawn their congressional maps in the middle of the decade, beginning with Texas at the White House’s urging. California voters answered with a partisan map of their own, and Virginia Democrats tried the same until their state’s Supreme Court struck down the new map. After the Voting Rights Act ruling, Jeffries said “all options are on the table.” Each side calls its move self-defense. Each move becomes the other side’s excuse, like a team that moves the goalposts at halftime and then complains when the other team does the same.
Paralysis follows. Last fall’s 43-day shutdown was the longest full shutdown in American history, and this spring the Department of Homeland Security went unfunded for a record 76 days while airport screeners missed paychecks. In April, Gallup found that just 10 percent of Americans approve of Congress.
Building the Guardrails
It was not always this way. In 1983, with Social Security months from running dry, Ronald Reagan and Tip O’Neill, who disagreed loudly and often, backed a bipartisan commission and shared the political risk of fixing it. Neither man pretended to like the other. That kind of restraint can no longer be assumed, so it has to be built in.
Four reforms would help. The Senate should guarantee every Supreme Court nominee a hearing and a floor vote within 90 days, whichever party holds the gavel. Congress should create a bipartisan commission to settle candidate-eligibility disputes before ballots are printed, a job the Supreme Court said in Trump v. Anderson belongs to Congress. It should also build on the bipartisan Electoral Count Reform Act of 2022 with an independent, staggered-term body to oversee certification, and it should ban mid-decade redistricting outright. And states should adopt open primaries paired with ranked-choice general elections, the system Alaska’s voters narrowly chose to keep in 2024, so candidates must win support beyond their loudest faction.
None of this requires a constitutional amendment, and none of it favors either party. Democracies rarely collapse in a single dramatic moment. They wear down one broken norm at a time. On November 3, one side will lose. The country will be better off if it still remembers how.
Meda Parameswara Reddy, Ph.D., is the Director of the Reddy Center for Critical and Integrated Thinking. A former R&D executive holding 30 U.S. patents, he has published 87 articles, appearing in Proc. Natl. Acad. Sci. (PNAS), RealClear Markets, Science and Defense platforms; Washington Examiner, SpaceNews, The Fulcrum, The Humanist, American Thinker, and South Asia Monitor (on the editorial board, and also hosts the show “SAM Dialogues with Dr. M. P. Reddy.”) Website: mpreddyinsights.com | Contact: mpreddy54@yahoo.com, https://lnkd.in/gn2zQJbs
Keep ReadingShow less
Load More