While I believe, with Lemieux, that obstruction somewhere can be obstruction everywhere, I also believe that the attempts by the Republican majority in the Congress to dismantle Medicare and replace it with a half-filled bowl of sour porridge is both the most important issue on which to stand against what's coming and the most politically potent one, as well.

You may recall that C-Plus Augustus—having been re-elected by a margin of 35 electoral votes in 2004, and I didn't remember that it had been that close—decided that he had accrued enough "political capital" to monkey around with Social Security. That attempt got body-slammed and its defeat started the downward spiral of his approval ratings from which he never recovered fully.

This same thing should happen as regards any attempt by Speaker Paul Ryan, the zombie-eyed granny starver from the state of Wisconsin, to enact his golden dream of demolishing safety-net programs that he believes make old people with Medicare less "free" than old people who slowly waste away in darkened apartments. His idea is to set up a program with criminally inadequate vouchers, slap the name "Medicare" on it, and hope that people are as stupid as he thinks they are. There is every indication that HHS nominee Rep. Tom Price is more than willing to play Johnny Hooker to Ryan's Henry Gondorff.

(Yes, I know that the president-elect promised to protect Medicare during the campaign. I believe I heard that clearly, anyway, over the call of the snow-white unicorns.)

For progressives of any stripe, Medicare has to be a bright, hot line. One of the great triumphs of progressive government in the 20th century was its virtual elimination of hopeless poverty among the elderly. Because of Medicare, and Social Security before that, old people were freed up to have the opportunity to consider their quality of life, rather than living from one can of catfood to another. And there was no more shame in them than there was in young Paul Ryan when he was living off Social Security survivor benefits after the death of his father. (You're welcome, by the way.) There can be no backsliding on this one, no attempts to "work across the aisle," no appeals to "civility" or "bipartisanship." Loyalty to Medicare has to be a defining characteristic of a Democratic politician and any Democratic politician who doesn't like it deserves to be primaried out of office.

There was a ray of hope on Tuesday that seemed to indicate that the Democratic caucus is coming to this realization as well. Senator Joe Donnelly of Indiana, who's not anyone's idea of a progressive firebrand, came out and said he would not be voting for Price's confirmation specifically because of Price's record on Medicare.

"Tom Price has led the charge to privatize Medicare, and for this reason, I cannot support his nomination. I am ready to work with anyone who wants to improve access to quality health care for Hoosier families and seniors, but the nomination of Tom Price would put us on a direct path to end Medicare as we know it, which would raise health care costs and break a fundamental promise to seniors. I have fought to protect Medicare, and I will continue to oppose efforts to privatize Medicare or turn it into a voucher program." Last week Donnelly reiterated his commitment to Medicare and his opposition to privatizing Medicare, saying in part in a video message, "Let me say unequivocally to you now: I have fought to protect Medicare for this generation and for future generations. I have opposed efforts to privatize Medicare in the past, and I will oppose any effort to privatize Medicare or turn it into a voucher program in the future. If my colleagues have pragmatic ideas that strengthen Medicare, reduce the costs of care, crack down on waste, fraud and abuse, count me in, but if they want to phase out Medicare, or privatize the system, count me out."

Nobody has a mandate to bring about this kind of destructive change. Not a president-elect with two million fewer votes than the person he ran against, and certainly not some guy who represents 230,000 people in the First Congressional District in Wisconsin. This is the gurney on which to ride to glory.

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Charles P. Pierce Charles P Pierce is the author of four books, most recently Idiot America, and has been a working journalist since 1976.

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