Left Out

I want to thank Thomas Frank for his insightful article on the media’s treatment of Bernie Sanders [“Swat Team,” Essay, November]. Like many Americans, I initially dismissed Bernie’s candidacy because I’d never heard of him, but as time went on I found that I agreed with almost every one of his positions. It turns out that a lot of voters support single-payer health care, slowing down globalization, and an end to corporate welfare — and not all of us are Democrats. That Bernie’s popularity crossed party lines made him a much better bet than Hillary Clinton to defeat Trump, according to most polls, and yet the Washington Post continued to say that Bernie was hurting the Democrats by staying in the primary.

But I think Frank misses something important when he writes that Bernie would have been “dismissed as a marginal figure, more petrified wood than presidential timber” in other election cycles. It’s true that timing was a factor in Bernie’s rise, but his popularity was also a result of his perceived authenticity. During the course of the campaign, voters learned that Bernie had championed the same set of issues his whole life. Over decades, I have watched the bar for politicians sink lower and lower — to the point where Americans are regularly asked to excuse outright lies — so discovering Bernie Sanders was like stumbling across an oasis in a desert. What a relief to find someone whom I could actually vote for instead of resigning myself to the less repulsive option!

As his views and character have become known, Bernie has emerged as the most popular politician in the country. If the primaries were held again today, now that we have been freed from the illusion of Hillary’s inevitability, I think Bernie would be very hard to beat.

Scott Feuless
Houston

Frank’s essay on the Post certainly tallies with my own observations as a Sanders supporter. It amuses me, in a dark sort of way, that the media sees itself as a meritocracy when it consistently excludes and ignores the views of the left. It isn’t just that mainstream news outlets often miss the most important stories — for example, Snowden’s revelations about spying on Americans — it’s also that they produce and perpetuate disinformation.

Americans recently learned — after the fact, of course — that a powerful cabal of right-wing agents within the FBI had been agitating for Donald Trump through calculated leaks to the press. This should come as no surprise. Over the course of its history, the FBI has routinely targeted the left while enjoying the unquestioning support of the mainstream media. And now, after Trump’s win in November, we are counting on that same group of officials and reporters to have the courage to stand up to his administration. It doesn’t look good.

Bret Raushenbush
Depoe Bay, Ore.

Urgent Care

Trudy Lieberman warns Americans young and old about what she regards as the decades-long campaign to destroy Medicare [“Don’t Touch My Medicare!” Report, November]. It is a story that has rarely received the attention it deserves, and Lieberman does a great public service by bringing it to the forefront of the national conversation. She shows how right-wing foundations, which were committed to discrediting the Great Society programs of the Sixties, celebrated the free market as the best means of allocating goods and services. In the 1990s and 2000s, she explains, politicians abandoned traditional Medicare’s reliance on administered prices and moved instead toward commercial health insurance, weakening the original idea of “common benefits.”

Finally, Lieberman raises the question of whether the leaders of the Democratic Party will continue to debate Medicare on Republican “terms.” I certainly hope not. Those terms are misleading and a threat to the aspirations of Medicare’s architects, who sought to create a program that would be easy to understand for the average citizen. After half a century, Medicare does need a serious overhaul — one that will return the program to its roots, recovering its early simplicity and responsiveness, not one that transforms it into commercial insurance.

Theodore Marmor
Professor Emeritus of Public Policy and Management, Yale University
New Haven, Conn.

As a geriatric-primary-care physician and the author of a book on Medicare, I think Lieberman overlooks one key problem in her otherwise comprehensive article: the increasing specialization of medicine. Since neurosurgeons, radiologists, and other doctors in rarefied subfields are paid far more than generalists, medical schools are producing more and more of them. Specialists are now being paid exorbitant fees to perform controversial procedures without informing their elderly patients of the risks and benefits. Primary-care doctors, on the other hand, have a holistic view of each patient and are therefore able to evaluate health interventions more objectively.

Ample research has demonstrated that more specialization leads to less-effective care at a far higher cost. Each year Medicare pays billions of dollars for unnecessary procedures that provide no value to its beneficiaries, and, as a result, the program has become more expensive over time. Rather than raising taxes to cover Medicare’s rising costs, we should repair its most fundamental flaw and reemphasize the value of primary care.

Andy Lazris, M.D.
Columbia, Md.

It’s ridiculous that Medicare — a government health-insurance program for which more than 10,000 people qualify daily — relies on volunteers to enroll seniors and help them understand their options. I’m a health-policy wonk and retired physician, but even I needed more than an hour of dialogue with my area’s sole volunteer, three phone calls to the Medicare help line, and a thorough reading of the literature from the Centers for Medicare and Medicaid Services in order to decide on a course of action. Meanwhile, private insurers aggressively promote their plans. As my sixty-fifth birthday approached, my mailbox was flooded with glossy pamphlets advertising Medicare Advantage.

Lieberman does an excellent job of summarizing how we got to this point and where we’re heading next, which is likely to leave her readers demoralized and enraged. The Republican-led effort to privatize health care in the United States has been both insidious and unrelenting, and, because of how confusing Medicare is, many of us don’t even realize what we’re losing.

Tina Castañares, M.D.
Hood River, Ore.

City Limits

Rebecca Solnit’s account of San Francisco’s gentrification and the subsequent displacement of working-class urbanites [“Coming Apart,” Easy Chair, November], struck a chord with me. In 1962, I was discharged from the Army with $80 in cash, a wife I’d married during my tour of duty, and a ten-day-old son. Our plan was to rent an apartment in San Francisco, where I would find a union job and get a degree in creative writing. I worked at a wholesale meat market in the Mission District for $375 per month. For $125 a month, we rented a comfortable apartment on Funston Avenue, a short walk from Golden Gate Park. Tuition at San Francisco State was $48 a semester. Our income was enough for occasional trips to the theater, Giants games, and jazz concerts with artists such as John Coltrane and Cannonball Adderley. On birthdays and anniversaries we ate at some of the city’s best restaurants. I earned my degree, which led to a satisfactory and, I believe, useful life as a professor. The new economic realities that Solnit outlines so well make me doubt that any young American of modest means will be as lucky as I was.

Michael Baughman
Ashland, Ore.

Solnit laments the gentrification of American cities, but rural areas are also being disrupted by the twenty-first-century economy. I live in what used to be a small town on Cape Cod, but it now functions like an urban satellite, complete with shopping malls and fast-food chains. Fortunately, we have not yet been cursed with a Lowe’s or a Home Depot, and as a result we still have two thriving lumberyards. The owners of these competing businesses live in town and pay taxes on their homes. In contrast, national chains just suck money out of our local economy. A majority of the profits go to corporate headquarters in faraway places, where they fatten the One Percent while starving our local communities.

Richard Latimer
Falmouth, Mass.