Healthcare Wars 2017 Part 2 - What Did I Just Tell You About That Pony?

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At least until somebody writes a bill they can read

Single payer. Two words, a simple concept. There are variations, but the core principle is that every citizen is entitled to free health care, and the government sets up a system for paying the costs incurred with public funds. It's really two pieces - there is the insurance, or payment side, and the delivery side. On the payment side, it's easy - mostly. Just like Medicare or Social Security, the government merely sets up a straightforward bureaucracy to make the payments to doctors, hospitals, dentists, nurses, specialists, pharmacies and the rest of the health care delivery infrastructure. Because the government is a monopsony - the only buyer on the market - they can set their payment/reimbursement rates at any level they choose, much like a monopoly can set prices for their goods at any level regardless of market imperatives. The only 'challenging' portion of this part of the process is to raise the funds.

The other side of the Single Payer question in America is how to make the current privatized delivery system work in this new publicly funded process. Private for-profit insurance companies would just die - quickly - because no one would need to purchase insurance anymore, and only wealthy people would buy policies that provided them with access to better service than the public delivery infrastructure. So, somehow, in a free market in a democratic nation, the government would have to take control of virtually every doctor, hospital, pharmacy, dental office - trillions of dollars, millions of people - and then pay them a fraction of what they are used to receiving in the current for-profit private health care world.

So, when you think about it, it's hard to imagine what this single payer legislation would look like. You'd end up with a whole bunch of unemployed people in the private insurance industry, and whole bunch of doctors and hospitals that simply refused the government's mandated payment rates, only accepting patients from the remaining private insurers that paid full freight. And you'd end up with a massive constitutional problem - you can't privatize the health care delivery industry, and you can't force them to take patients they don't want.

And, of course, there's getting the people to buy in. 80% of Americans get their health insurance as part of their employment. That means they pay for insurance with lower wages, but that's baked into the cake by now. So they never see an actual insurance bill, and their only out-of-pocket expenses are deductibles and co-pays to their delivery providers. So now, if we come skipping up with our bright, progressive smiles and tell them that they're going to get a somewhat poorer - but perfectly acceptable - level of coverage, and we're only going to raise their income taxes 35% to give it to them, do you really think they're going to get really excited and tell their representatives to make it so?

See, that's what a pony looks like...
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Healthcare Wars 2017 Part 1 - No, You May Not Have a Pony

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And everybody gets a vote

The latest political battle over healthcare policy in the US is raging as debate over the Senate healthcare bill is extended through the summer recess. And the outpouring of outrage and resistance from the sane portion of the electorate is wonderful to see. But this bill (like the version the House passed last month) is deeply, desperately unpopular, with favorable polling running at below 20%. That means there are a LOT of Americans who are far from being politically liberal who are concerned for the well-being of their families and fighting just as hard as we are.

All of which gives us an opportunity to think about our political ideology and the belief system in which it operates. Last year, in the presidential primaries, there was a strong liberal cohort that was all in behind Bernie Sanders. Now, I'm not going to go back through all the problems with the Sanders campaign and message, but there is a larger point that is critically important to recognize at this point. That point is simply this - the other side has a vote too. Now, everyone you know might be politically liberal and broadly welcoming of tax increases to improve the lives of our fellow citizens, but that is not true of the population as a whole. Much of the nation is deeply suspicious of liberal economics, 'tax and spend' policies that have been deeply maligned by general consensus over the decades. Everyone from far-right tea party wingnuts to suburban 'social liberal/fiscal conservatives' are going to fight us every step of the way on any movement away from America's very limited activist government and safety net. There are more of them than there are of us.

You can demand single payer healthcare, tuition-free colleges (not even in the federal jurisdiction), Universal Basic Income and humane immigration policies all you want, but you're never going to get them. You do all the work - and get a little luck - you might just get some compromise, watered down version that improves everyone's life. Kind of like the ACA. In America, corporations make a profit by selling you a cure when you're sick or injured. That system is deeply entrenched, which is why American healthcare costs are so much higher than they are elsewhere in the world. Given time, favorable politics and a HUGE effort, President Obama was able to push through the greatest breakthrough in American healthcare in history. But make no mistake, it was a compromise, necessitated by the fact that every stakeholder in the system wasn't a liberal.

Here's the point. Liberals aren't going to get elected in America demanding far left policies, as much as we want them and believe that they are the right thing to do. When liberals DO get elected, they aren't going to be able to force those same policies through a system with as much friction and as many veto points as ours. And don't tell me we just need to take control of both houses of congress - even if the Democrats do that, it won't result in congress being populated by liberals. There will be Democrats from across the political spectrum, and most of them will not be in favor of the kinds of policies that Bernie Sanders championed. We have to recognize reality, accept that we're going to have to negotiate, compromise and accept incremental improvements in the system. There's no magic potion, there's no sparkle, there's no pony. The US is a huge nation with a huge diverse population, a nation that has in recent history elected both GW Bush and Donald fucking Trump.

Pretending is not a strategy. Understanding reality, and working within its constraints is the best we can do. And when we remember that, we do pretty well - from the ACA to the Iran nuclear deal to DACA - and when we forget it we get our political asses handed to us, and we get things like this horrific health care legislation. We can do better when we get serious...
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How Do You Solve a Problem Like Korea

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Sorry - could NOT resist...

Well, it didn't take the Trump administration long to wade about neck deep into the geopolitical quagmire that is Korea. The North Korean leadership is such a perfect manifestation of a comic book villain - and always in character - that there's really no kind of common diplomatic ground on which to base a bilateral negotiation. A big part of the problem is that all North Korean press releases are targeted on their own internal audience, and therefore have no basis in reality. Think of some bizarre combination of Sean Spicer and Baghdad Bob. And now, of course there's also the chaos in the South Korean government resulting from the impeachment of President Park Geun-hye. It's an especially fraught time on the Korean Peninsula, and that makes Trump's blundering belligerence particularly dangerous.

But what are the real-world options that America and the West actually HAVE in North Korea? When you consider that Kim Jong-un is a third-generation dynastic leader whose primary goal is to retain power and control of the population at any cost, you realize that nothing will change until the regime changes, but conditions are so brutal and there are so many different factions empowered by the military that if the regime did collapse (or were to be removed by external force) the waves of refugees flowing into South Korea, China and Russia would, along with the helpless North Koreans still trapped in a collapsing state without a functioning economy would represent one of the greatest human tragedies of the last century.

Once you are realistic about Kim's goals and intentions, you understand why he would consider a strategic nuclear deterrent so important. It is the thing that innoculates his regime against attack, virtually no matter what provocative actions he chooses to take. And once he has road-mobile solid fuel ICBMs with enough range to reach the US, that deterrent becomes impossible to ignore. North Korea's previous conventional deterrent was to hold Seoul at risk with thousands of artillery tubes just across the border, but while that has been effective, Americans, to be quite frank, are less concerned about a million Korean casualties than they are about one American casualty. Kim's generals always understood that they might have to actually execute on that threat, so they made a perfectly rational decision to move to a nuclear capability. They can now hold Seoul - along with other targets in South Korea and even Japan - at risk with short range nuclear missiles as well as the massed artillery already in place.

Any strike on North Korea runs a very high risk of turning into a horrific regional conflagration, with several cities wiped out and millions of Korean (and possibly Japanese and Chinese) refugees desperate for aid and shelter. It seems perfectly clear that no amount of classic American tough-guy posturing is going to convince the North Korean leadership to do anything but keep pushing the development of their strategic deterrent. They'd literally be crazy to do anything else.

At the end of any thoughtful analysis, the only possible answer is negotiation. If the west can offer North Korea enough benefits - and a credible promise not to attack - perhaps Kim can be convinced to give up his nukes. If he can't, a strategy of containment and a policy to live with a nuclear-armed North Korea is the only viable approach. And while the American military leadership will empahsize that this policy of containment would mean missile defense and a powerful military presence in South Korea, in reality - behind the bluster - it would mean accepting another member of the nuclear club and just trying really hard to prevent further proliferation.
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Big Dogs Bite with Big Teeth

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A lot of my American and liberal friends are absolutely frantic about Donald Trump and the risk to global peace he represents as president of the United States. In the aftermath of the missile strike on the Syrian airfield, it seems to many of them that he is leading us directly down a path that leads to superpower confrontation, war and nuclear Armageddon. And maybe he is! But I think I need to offer a few thoughts about that path, and what kinds of considerations are being tossed around in capitals from Moscow to Beijing to Brussels.

One of the first things to consider is that nobody really wants to go to war. Stop worrying about Tom Friedman and Bill Kristol. They have no control over the military apparatus, and even Trump will have to make a case for war and accept a scenario acceptable to the likes of Mattis and McMaster, and they are far from suicidal.

But it's actually much more than that. One of the common talking points we lefties always point out is the wildly disproportionate military spending of the United States. We always rush to point out that the US spends more on its military than the next ten nations combined.  It's not even close, and I think we all agree this is an unequivocal waste of money. But it is real, and if you start talking about war, then the calculation changes. How many nations would really want to face that? The simple fact is that the US can rain hell and destruction on any nation that wants to step up to the plate. It's true we've struggled with counter-insurgency and trans-national terrorist groups, but give us a nation's infrastructure and there's simply no better force on earth when it comes to wrecking stuff.

No nation - not Russia, not China, not even the Generals in North Korea - want to face the full wrath of a US in full 'blow 'em to hell' mode. After the F-22s knock out your fighters and the Wild Weasels and cruise missiles wreck your anti-air assets, you get US jets overhead 24x7 just hunting targets, wrecking infrastructure, killing leadership. Anything you put on or under the ocean will be wreckage on the bottom in less than a week, and anything you try to protect will be detected and destroyed because war is nothing less than a gigantic tantrum and the biggest guns always win.

It's also very important to understand why there have been precisely ZERO major power conflicts since 1945. The answer is those pesky nukes. Nobody - not the US, not Russia, not China, not Europe/NATO - wants to risk anything that might lead to out-of-control escalation. The risk of nuclear conflict isn't driven by starting wars - it's driven by ending them. In a major power conflict today, any side that came to recognize that they were losing would be likely to try to avoid such an existential outcome by using tactical nuclear weapons on the battlefield and trying desperately to limit the extent of the exchange. But nobody wants to find out if that might be possible without killing a billion people and turning dozens of major metropolitan areas into radioactive wastelands.

(I often gaze up at the stars at night and wonder how many planets are out there that had intelligent, even brilliant populations and now are smoldering ash because their clever denizens figured out how to split the atom.)

In the end, it's most likely that even a blustering ignorant buffoon like Trump can't change the overall global geopolitical calculation. Make no mistake, he'll do some stupid things and people will die as a result, but no other national leader is going to let Trump goad him into national suicide.
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Better Killing Through Chemistry

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Roaches check in...But they don't check out

Once again, the use of chemical weapons by a Middle Eastern despot has threatened to drive the world into a larger conflict. The red lines drawn around this type of weapon are a hundred years old, and have become a significant part of the conventional wisdom around the laws and ethics of warfare. But why is this, and should it actually be this way? In the case of Syria, for example, the Assad regime has murdered hundreds of thousands of Syrians using traditional weapons - high explosives, barrel bombs, artillery, rifles, torture, execution, famine and disease. So when he suddenly (and inexplicably, but that's another discussion for another day) kills a hundred residents of a Syrian village with four bombs containing Sarin, it's kind of hard to understand the sputtering rage and white-knuckled outrage it generated in the West.

But this is one of the arguments that sounds logical when you hear it, but kind of falls apart the more you think about it. Chemical weapons like Sarin and VX are essentially insecticides scaled up to kill humans instead of bugs. Why do we use insecticides? Because when we have a flea infestation, for example, it makes a lot more sense to use poison on them than it does to burn down the house. Even if there are risks and downsides to poisoning the fleas, the net outcome is a house still standing with no fleas in it.

Now think about a dictator like Bashar al-Assad or Saddam Hussein or Omar al-Bashir or any one of a dozen others. They have the infrastructure - pharmaceutical and insecticide production - to produce chemical weapons cheaply and in volume. They have dissident and/or insurgent populations within their borders. Usually, when they are faced with revolt or civil war they have to destroy a huge amount of their own infrastructure to eliminate the rebels. If they could just spray the towns and villages with human insecticide, wait 48 hours and march in and clean up the mess, these pesky revolutions would be easy to deal with.

Well, why don't they do that? Because ever since the end of World War One the world has had an ironclad convention against their use. Nations still stockpiled them - in the face of an existential defeat, one more bad decision isn't going to be a game changer. But it was clearly understood that to use them (without at least tacit agreement from the appropriate superpowers) was to risk significant punitive attacks from nations not even otherwise a party to the conflict. The idea was global deterrence, and it has worked pretty well. Of course, Saddam Hussein used Sarin gas regularly in the Iran-Iraq war and against Halabja in the al-Anfal campaign, but the US was allied with Saddam's Iraq in that war, and agreed to look the other way.

Now we may begin to see a breakdown in this generally agreed-upon convention. If it begins to be safe, even normalized for dictators to use chemical weapons against their own people in order to retain power, then we won't be seeing 100 dead here or a thousand dead there. We'll be seeing the wholesale slaughter of entire communities because it is faster, cheaper and more efficient than going in and fighting to take those communities back from the rebels. When we argue against an ironclad guaranteed imposition of a high asset cost for any leader who uses poison gas, we are merely helping create a world where the use of poison gas is commonplace.

And I promise you, dear reader, that is not a world you're going to want your kids to live in...
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Generalizing

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Two US Generals are in the news today for very different reasons, but they are both American warriors who we should know a lot more about. They fought in different wars decades apart, in wildly different methods. One took a legendary Cavalry unit into the jungles of Southeast Asia and fought the very first pitched battle of the Vietnam war, and proved that with the right air and artillery support the American grunts could take and hold any piece of ground they wanted, no matter the resistance. The other led an armored brigade in the largest tank battle since the Second World War - a battle so deep in the Iraqi desert that history remembers it only by it's map coordinates - the battle of 73 Easting.

HR McMaster

Lieutenant General Herbert Raymond "H. R." McMaster last week accepted President Donald Trumps appointment as National Security Adviser. McMaster is a well respected leader, thoughtful and intelligent, and has often shown a willingness to innovate that is quite unusual in the US Army.

In late February of 1991, he was a captain commanding E (Eagle) Troop of 2ACR (Second Armored Cavalry Regiment). McMaster had 120 soldiers, a dozen Bradley Infantry Fighting Vehicles and nine M1A1 Abrams tanks under his direct command. The 2nd ACR rolled across the Saudi border late on the night of February 23d and struck out east across the Iraqi desert with McMaster's Eagle in the vanguard. The mission was to cut off the Iraqi retreat north from Kuwait and cover the Marines in Kuwait from the heavy Republican Guard armored forces known to be in Northern Iraq - particularly the feared Tawakalna Division and the Iraqi 50th Armored Brigade.

The next few days VII Corps raced across Iraq behind 2ACR Eagle, Iron, Killer and Ghost troops, facing light and mixed resistance from Saddam Hussein's terrified conscript troops scattered across the desert. The key was the Republican Guard armored divisions, and the American armor had to get there in time.

By the morning of the 26th, 3d Squadron was in contact with the Iraqi 50th Armored to the south, and command had ordered the 2nd ACR and the UK 1st Armored to pivot east to attack the Republican Guards tanks. By 9am a violent sandstorm kicked up, and while the vehicles could maneuver as ordered, they advanced slowly due to a complete lack of air support. By 3 o'clock the 3d Armored Division was in position with 2nd ACR at 50 Easting, and General Franks was frustrated, waiting for the 1st Infantry to get into position. He ordered 2nd ACR to attack out to 70 Easting, and the battle was joined.

McMaster was in the lead tank, with his other 8 Abrams spread out line abreast, with the mounted infantry in Bradleys just behind. By 3:45 they were in close combat with the well organized and professional  Tawakalna Division in prepared defensive positions. It was a knife fight in a phone booth, but the better trained, technologically superior forces under McMaster's viciously aggressive leadership shredded the defensive lines and charged through.

At 4:10 Eagle took fire from a small village, and swept through it destroying gun positions and killing or taking prisoner the dismounted Iraqi infantry. Ten minutes later McMaster led Eagle up and over a sharp ridge and came face to face with an Iraqi tank company on the reverse slope. He fired on the first T-72, destroying it, and his other tanks made short work of the other eight. From that position, he could see Iraqi tanks and defensive positions just 3 kilometers east. Despite having been ordered to limit his advance to 70 Easting, he charged to some high ground at 74 Easting and opened fire. These were by far the best Iraqi troops the men of Eagle had encountered. They held fast, and their tankers tried to maneuver and engage the American Abrams tanks in their T-72s. They were brave and professional, but they were surprised and at a tremendous technological disadvantage, and McMaster wasn't offering any quarter. Eagle destroyed 18 Iraqi tanks in the first minutes of the fight, and McMaster ordered two of his Bradley's north to regain contact with Captain Joe Sartiano's Ghost troop.

From there, the fight moved north from Eagle's position into a wadi with Ghost in overwatch. There followed several hours of fierce fighting as wave after wave of Republican Guards tried to retreat through the Wadi and encountered Ghost Troop's tanks and troops. The fighting along 74 Easting went on until about 10:30 the night of the 26th, when the 1st Infantry Division pushed through the line held by 2nd ACR and let the attack on Objective Norfolk.

HR McMaster was awarded the Silver Star for the battle, and he went on to serve on the CENTCOM staff as Deputy to General John Abizaid. When the US went to war in Iraq again, he took command of the 3d Armored Cavalry Regiment and was assigned the mission of securing the city of Tal Afar. His unconventional and innovative approach to that mission was noticed by many, particularly because of the favorable coverage in places like PBS Frontline, CBS 60 Minutes and a long-read article in The New Yorker.

In 2008 he was promoted to Brigadier General and assigned to Doctrine and Training Command, and in 2012 he was given his second star and assigned command of the Army Maneuver Center of Excellence. In 2014 he was promoted to Lieutenant General and given command of the Army Capabilities Integration Center under Training and Doctrine Command.

Of all Trump's cabinet picks, this may very well be the best one. It is telling that McMaster wasn't Trump's first choice, or even second. But he will serve as a strong, independent voice in the White House, and as a man who truly knows war, a soldier who has killed in battle, he will serve to temper a civilian leadership that seems all to ready to send our young men and women in harms way.

Hal Moore

On a sadder note, another Lieutenant General - this one the legendary Hal Moore - died a few weeks ago just three days before his 95th birthday. Moore had a long and distinguished
Army career, but he can never be separated from the Battle of Ia Drang in November of 1965. Before that, the US leadership had struggled to understand the kind of war - and the kind of enemy - they faced in Vietnam. This wasn't the kind of war they understood. They wanted to find a way to engage the enemy in large pitched battles where greater US firepower could annihilate them. The job fell to Lt. Colonel Moore's 7th Cavalry - the same unit led by GA Custer at the Little Big Horn, and recently redesignated 'Airmobile' - to create that kind of battle.

50 kilometers south of Pleiku in Gia Lai province is the Ia Drang valley. 'Ia' is Hmong for river, so it is the valley of the river Drang. Cambodia is only 15 km to the east, and even worse, sits in the shadow of the Chu Pong Massif, a huge mountain complex that at the time of the battle was the home of two regiments of North Vietnamese Army troops. On the morning of November 14th, 1965, 7th Cavalry Hueys began delivering troops of the 1st Battalion. By noon Moore had the 200 troopers of A and B Companies on the ground at LZ Xray. Earlier that morning the first troops on the ground had captured an NVA soldier who was more than happy to inform the that there were three Battalions of North Vietnamese regulars on the mountain above them. The Cavalry troopers set up a perimeter oriented east and south towards the mountain across a dry creek bed, with Moore's HQ detachment in the center of the LZ behind them. The first shots were fired about 12:15. Nobody knew it, but the next 46 hours would be hell unlike anything they had ever known.

For the next 2½ hours A and B Companies fought a desperate close range battle with hundreds of NVA soldiers at the creekbed while Moore desperately worked to get the rest of his Battalion on the LZ and in the fight. At 2:30, C Company was inserted, but many were killed and wounded just trying to get off the helicopter and behind some kind of cover. About that time, the NVA shifted their attack to the south. The newly arrived C Company troopers reinforced the southern perimeter to A Company's left and within minutes was trying to hold against an assault by 200 enemy troops. At this point Moore and his team began directing heavy, effective artillery from Plei Me and air support had begun to arrive. By 4 o'clock the NVA withdrew, leaving behind over a hundred dead.

By then, Moore's final company, D, was on the ground and in the fight. They reinforced A Company on the creek bed just as the NVA attacked again. The American troops had very effectively positioned their M-60 machine guns, and they managed to - just barely - keep the A Company line from being broken and the LZ overrun. By this time, the medevac choppers had refused to fly into LZ Xray to evacuate the wounded due to the intense volume of incoming fire - rifles, machine guns, mortars and rockets - so the crews of the assault choppers kept coming back, time after time, hauling in water and ammunition and hauling out wounded soldiers. Two Huey pilots would win the Medal of Honor that bloody day on LZ Xray.

As the afternoon wore on, Moore was able to reposition his troopers to provide a 360° perimeter and get his mortar teams set up behind A and B Companies to provide additional fire support. As it got dark, the Americans dug in and the NVA began to send small units to probe their lines. Colonel Moore ordered his machine guns to hold fire so as not to give away their positions, and the troopers fought off these attacks with rifles, grenades and mortars.

At 6:30 the next morning, just before sunrise, the NVA launched a heavy attack at C Company's left flank. They closed to within a few dozen meters of the Americans positions, their fire tearing through the LZ and causing casualties around the entire perimeter. C Company was able to hold, although they took a lot of casualties. An hour later they launced a second attack against the southern perimeter, and C Company began to waver. If they broke, the NVA would pour through the break in the line and overrun the entire Battalion. Moore immediately ordered his radioman to call a 'Broken Arrow'. This was a combat infantry commander's last, desperate option. If he's about to be overrun, a Broken Arrow was issued and EVERY American combat aircraft in the entire country was detached from it's mission and sent to the site of the battle.

At 8 o'clock the airstrikes began to arrive, but with the NVA forces just a few meters away, there was no margin of error. One American F-100 dropped napalm inside the LZ Xray perimeter, resulting in a number of friendly fire casualties. But the air support and an endless artillery barrage had turned the battle and the last moment. By 10am the NVA buglers sounded withdraw and the battle was over. Sporadic firefights continued, but by noon the exhausted 7th Cavalry troops were reinforced by soldiers from the 2nd Battalion, 5th Cavalry, and the medevac flights were finally resumed.

The next morning, November 16th, LZ Xray was secured and the 7th Cavalry survivors extracted. Through it all, Colonel Hal Moore was a calm, professional leader. He was everywhere on Xray, keeping his troops in the fight, moving men and supplies, positioning weapons, and calling fire support. We know so much about this fight because through it all, from the very first lift into LZ Xray, noted journalist and writer Joe Galloway was at Col. Moore's side. In 1998, Galloway was awarded the Bronze Star with V (for valor) Device, the highest military award won by a civilian in the Vietnam war.

Hal Moore was the epitome of what a military commander should be. A polite Kentuckian, he cared for his men but he understood that he had to accomplish the mission. He carried the weight of all those young men he lost for the rest of his life, and he never broke faith with them. He was amongst the best of us, and he is missed.

** Pedantic note**

An 'Easting' (along with a 'Northing') is a Cartesian coordinate used to designate distances on an x/y basis. It's part of a mapping protocol called the Universal Transverse Mercator system (UTM). It is useful for designating locations that otherwise have little in the way of landmarks, particularly if you happen to actually BE in that trackless place. It gave the tankers in their fast moving vehicles a way to figure out where to go and where to stop that was more effective than latitude and longitude at that scale.
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The Two Kinds of Fake News

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But hey, you can go ahead and read it if you want

Fake news. It first came up in the campaign as a term to describe the articles Eastern European trolls would post on social media. They were designed to look like regular online news outlets, but they had outrageous headlines and utterly false stories designed to accumulate clicks and go viral across the social media ecosystem. A large portion of the American electorate, having become accustomed to dishonest outlets like Fox, Drudge and Limbaugh, were more than happy to accept any story that reinforced the beliefs they already held. This time around, however, that process was accelerated and deepened by a large number of Bernie Sanders deadenders who were more than happy to click, share and forward anything they perceived as damaging to the Hillary Clinton campaign - no matter how tendentious and nonsensical it might be.

Now you had these fake news stories being blasted around the internet by both the far-left and the far-right, and as a result no matter which faction you identified with, you could find people you wanted to trust telling you things you wanted to hear. It was clumsy, and often stupid, but over time it had an effect - not only convincing individuals but keeping various narratives alive in the more traditional media outlets due to endless, heavy daily interest.

Now, after the election, it's not a big factor anymore. Except that with the entrance of the term 'fake news' into the common vernacular, it has become synonymous with 'any news I don't want to believe'. The Trump administration in particular has embraced the concept. They've been questioning the reliability and credibility of major news outlets for months, so it's now easy for them to label stories they couldn't otherwise deny or avoid as 'fake news' and claim that it is actually THEY that have the credibility.

All this happened, and it was a problem. But we all know that if we WANT to, we can easily identify genuine fake news by using the available sources to confirm what we're being told. Of course, there are still a LOT of Americans who don't want to check the veracity of a story they like - they'd rather just believe it and forward it to all their friends,. But there's another kind of fake news - and it's a much bigger problem for the professional news media themselves.

We have a President and and administration that lies constantly, and glaringly. They don't obfuscate, they don't dissemble, they LIE. They make up facts to support any policy goal or ideological contention, whether they need to or not. They don't care about being fact-checked, they don't care about being directly called out on live television. They get their chosen narrative out there, and they know that there is a constituency that will believe it. They use this method to discredit institutions like voting and the courts. They use it to spread fear of crime and terrorism. They use it to constantly fluff the ego of our sociopath in chief.

Now it's true that political leaders have lied since time immemorial. But this time is truly different - it's so relentless, so unapologetic, so easily debunked that it can't be whitewashed or shrugged off. Now we have all our major media outlets routinely pointing out one blatant lie after another coming directly from the president and then repeated by his cabinet and communications staff. From millions of 'illegal' votes to the worst murder rate in 47 years, this is simultaneously embarrassing and toxic. And it raises an important question.

What should journalists and news outlets do? Should they allow these people to come on their air and look into the camera and lie repeatedly and outrageously to their audience? They haven't developed a methodology for pushing back on the lies - nothing works, they just keep repeating the lies and doubling down, claiming to have 'evidence' to support them. Evidence we never see. Or should they adopt some kind of 'three strikes and you're out' rule? Perhaps they should announce that anyone who comes on their shows and tells a cumulative total of three clear, easily established lies will not be invited back.

Or is there some other approach new outlets could take? Print journalism is easy - they can include the quotes and the fact checking in the story together. It's really the television and the radio where these lies get out into the wild and can never be truly called back. But in the Trump era, journalists and media outlets are going to have to figure this out. Because the rules have changed, and they can no longer do their jobs if they don't find a way to adapt.
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