Traveling with Parkinson's

In September, 2009, when I was 80, my doctor told me I had Parkinson’s.

Among the many things I wondered that day was: How would this new diagnosis change my lifelong love affair with travel?

Here’s the partial verdict thus far: not so much. At least not yet.

In May, 2010 -- within a year of that revelation about my health -- I journeyed for three weeks in Turkey. It was a rigorous adventure, and I spent days walking the crowded sidewalks of Istanbul, exploring the haunting ruins of ancient Greek cities along the Aegean coast, and hiking up and down the hills of Cappadoccia in central Turkey. I didn’t see many people my age in the remote places I visited, and I felt pretty good about that.

For the first time in my life, I used a cane – the collapsible, travel variety – on a few of the most arduous hikes. And I found the cane came with an extra bonus. Ten minutes after I entered a spectacular cave church -- the "Dark Church" -- in the Goreme Open Air Museum in Cappadoccia, the small space filled with a big tour group that completely  filled the place. Eager to escape the crowd, I bent over and stepped forward, holding my back with one hand, and maneuvering with the cane in the other. I felt like Moses fleeing Egypt, as the sea of tourists suddenly parted, and I made a quick escape.

Here's that cane, temporarily out of service as I snap a picture

in the rugged Honey Valley, Cappadoccia, Turkey.  

In June, 2011, I spent a momentous weekend in New York City. Quite by accident, I was there when Governor Como signed the Marriage Equality Act into law. As if those celebrations weren't enough, the city also hosted the Gay Pride parade that same weekend. I walked everywhere – no doubt fueled by adrenaline and buoyed by the uplifting spirit of the time – and felt fantastic.

Here I am at the Gay Pride Parade as the SAGE 

(Service & Advocacy for GLBT Elders) contingent marches by.

In August, 2011, I spent three weeks on the road in northern California and the Pacific Northwest. For much of the time, I was a happy passenger in a comfortable car, but there was still lots of walking – in Yosemite, around Mt. Hood, Crater Lake, Mt. Ranier, and in Seattle, along Oregon beaches, and in San Francisco. Essentially, that trip seemed effortless to me. At 82, I kept thinking about that wonderful experience as “the trip of a lifetime.”

I should have stayed out west! Right after returning home, I totaled my car, injured my back, experienced a 5.9 earthquake from my hospital bed, and endured a hurricane.

In March, 2012 – seems hard to believe it’s half a year ago already – I journeyed back to my beloved Nepal to attend the wedding of Nimesh and Bhawana. (The bride and groom are now comfortably settled in with me here in Washington.) The Kathmandu portion of that trip was packed with wedding events, and – aside from some mild fatigue and a stomach upset – I felt good. The hardest part of the Pokhara portion of the trip was saying goodbye to the people there I love. I don't like thinking I may never see Nepal again.
.

I accompany the groom (Nimesh) on his ride to the house of the bride (Bhawana).

Two grandfathers holding hands. That's Nimesh's granddad.

Here I am, ready to leave for the Pokhara airport with Laxmi and 
Rahel, who traveled with me to join Ramesh in the U.S. 
I'm saying a sad goodbye to Laxmi's mother and Ramesh's mother.

Then, over the recent Labor Day weekend, I traveled to New York City with Nimesh and Bhawana. I’ve been there dozens of times and was eager to see how I’d fare this time, especially compared with my hyper-active weekend there just last summer. The contrast was dramatic. Walking was much harder this year, but not because of my Parkinson's. This time, it was my back pain that caused the trouble. But being with my young housemates certainly made everything easier for me.

While I feel lucky to be doing as well as I am, I'll need to make some changes when I plan future travels.  Parkinson's is a progressive disease, so my range of travel options will certainly shrink. The travel recommendations below for people with Parkinson's may help me as the years roll on. Maybe they’ll be useful to you, too.

Resources: TRAVELING WITH PARKINSON

• Parkinson's Onboard: Traveling with Parkinson's: These excellent recommendations come from the National Parkinson Foundation.
• Traveling with Parkinson's Disease: This link provides some great suggestions. Leave it to WebMD.
• Traveling with PD: Here’s a column from PWP Peggy Willocks about her own travel experiences.
• Traveling with Parkinson's: This writer discusses his travel experiences as caregiver for his wife, who has PD.
• Tips for Traveling with Parkinson's Disease: Dr. Patrick McNamara offers these suggestions on About.com (part of the New York Times company).
• Traveling with a Parkinsonian: Susan Hamburger lists some helpful travel ideas for caregivers.

There are many more links. Just Google “travel with Parkinson’s disease.” How on earth did we ever manage before the internet made info collection so easy?

Mark Bittman: "Is Alzheimer's Type 3 Diabetes?"

Yesterday, I wrote about diabetes and Alzheimer’s.

Today, I noticed a burst of internet comments about an article published online yesterday by the New York Times’ well-known food writer Mark Bittman. The title: “Is Azheimer’s Type 3 Diabetes?”

While Bittman isn’t a medical scientist, he knows food. And in his thoughtful piece, he explains the role that food plays in brain health.

We’ve always asked, “If you could improve your health and appearance by eating more thoughtfully, would you?” Now, Bittman suggests, we should ask, “If you could preserve your brain function and sharply limit your risk of dementia and Alzheimer’s by eating more thoughtfully, would you?”

Bittman discusses junk foods, sugar, glucose, insulin, the different varieties of diabetes, brain plaques, dementia, and Alzheimer's. He knits together an explanation of how these issues are connected.

As I mentioned in my post on Monday about K.I.S.S (“Keep It Simple, Stupid”), in matters of health, it so often comes down to diet and exercise. Now, fearing dementia as I do, I feel like I have even more reason to be careful about my diet.

Bittman’s brief article is worth the two minutes it takes to read it. Maybe it will help strengthen your dietary resolve, too. Mark Bittman: Is Alzheimer's Type 3 Diabetes?

Diabetes Drug: Another New Hope for Alzheimer’s?

I often worry about the time I spend on the computer researching and writing this blog. But I just joined my housemates in the rec room, intending to ride my exercise bike and watch TV with them. My housemates were watching one of the endless "amateur hour" talent shows. This one was called The Voice. I had wanted to ride the bike for about 15 minutes, but I had to leave after just five minutes. What mind-numbing crap!

Dementia is another chronic worry. If I am headed in that direction, I'd surely speed up the process if I spent my evenings watching shows like that.

I find internet research on health topics fascinating and mentally stimulating. Maybe it also helps slow down any drift toward dementia. In any event, it's a more enjoyable way to spend an evening. Even with a good TV show, I tend to doze off after 9 pm, which makes it more difficult to sleep later. But the interactive demands of internet research keep me alert for hours.

So many new breakthroughs are happening in medical research! New studies involving the brain are especially fascinating, particularly for someone with Parkinson's, a disease that has certainly been reducing dopamine-generating cells in my brain for years. New findings establish two principles. First, the adult brain continues to grow and develop throughout our lives. Second, brain development in adulthood is shaped mostly by external stimuli. These conclusions suggest we can conduct healthy "workouts" for our brains, just as we do for our bodies.

The exercise bike for my brain includes scanning the online Science Daily's Mind & Brain News. In its  September 14 edition,, I found a report on the promise of a new diabetes drug to treat Alzheimer’s.

Insulin and Brain Health

In this study on mice, scientists at the University of Ulster used an experimental drug called (Val8)GLP-1, which mimics the activity of the natural protein GLP-1 (glucagon-like polypetide-1). This protein helps regulate the body’s response to blood sugar – the reason it has been useful in treating type 2 diabetes.

We’ve known for a long time that type 2 diabetes is a risk factor for developing Alzheimer’s. Research has shown that insulin plays a role in memory formation. When amyloid structures attach to neurons, the neurotoxins cut off insulin receptors, eventually producing insulin resistance in the brain. Developing diabetes then creates denser amyloid accumulation, making neurons even more insulin resistant. It’s a vicious cycle, in which diabetes and memory impairment develop concurrently, from the same cause.

The University of Ulster study showed that (Val8)GLP-1:

• crossed the tricky blood-brain barrier without difficulty, 
• promoted growth of new cells in the brain’s hippocampus region, which plays a key role in consolidating memory, and 
• appeared to create no side effects at the doses tested. 

Said lead researcher Christian Hölscer:

We are really interested in the potential of diabetes drugs for protecting brain cells from damage and even promoting new brain cells to grow. This could have huge implications for diseases like Alzheimer's or Parkinson's, where brain cells are lost. It is very encouraging that the experimental drug we tested, (Val8)GLP-1, entered the brain and our work suggests that GLP-1 could be a really important target for boosting memory.

Of course, the reference to Parkinson’s is heartening to this PWP. Progress on one neurodegenerative condition, like AD, often carries implications for others, like PD.

Dr Simon Ridley, Head of Research at Alzheimer's Research UK offered the standard caveat: "We are pleased… that this experimental diabetes drug could also promote the growth of new brain cells. While we know losing brain cells is a key feature of Alzheimer's, there is a long way to go before we would know whether this drug could benefit people with the disease."

He added, "This research will help us understand the factors that keep nerve cells healthy, knowledge that could hold vital clues to tackling Alzheimer's.”

A Plethora of Alzheimer’s-Diabetes Links
Science Daily has regularly updated new developments in the growing connections between AD and PD. Here are just a few:

• April 17, 2009: Novel Mechanisms Might Causally Link Type-2 Diabetes To Alzheimer's Disease
• October 28, 2009: Does Diabetes Speed Up Memory Loss In Alzheimer's Disease?
• August 26, 2010: Insulin Resistance, Type 2 Diabetes May Be Linked to Plaques Associated With Alzheimer's Disease, Study Suggests
• October 13, 2010: Diabetes Gene Linked to Degeneration of Enzyme Involved in Alzheimer's Disease Onset and Progression

This was much more fun and interesting than watching The Voice!

K.I.S.S. ("Keep It Simple, Stupid"): Good Advice when Dealing with a Bad Lawn OR a Bad Back

Here's my backyard oasis today:

And here's the pathetic patch of lawn (?) that remains:

I've been struggling for years to make grass take hold here. It's a shady spot. The soil is poor and compacted. I tried a moss lawn for a couple years, but that didn't work. Then every spring and fall, I'd try seed starter, seed, fertilizing, aerating, watering... the works. Not much success. This fall, I planned to have it all dug up and reseeded, hoping that starting over might work.

Then Bill Eck, my Bartlett Tree Expert rep, suggested I contact Bill Patton, who runs Turf Center Lawns.  He stopped by last week and -- after looking at my miserable little patch of lawn -- made these recommendations:

• Get some hard fescue grass seed (best for shade) and spread it thinly so the seeds don't touch.
• Rake it in.
• Water thoroughly.

What I really liked was his "Do Not" list:

• Don't fertilize. (But he does recommend using fertilizer to get rid of moss.)
• Don't water except when seeding.
• Don't mow except when the grass gets very high.
• Don't mow in the hot weather. (Hooray!!)
• Don't bother aerating.

If I do the seeding now, I should repeat it in mid-October.

In the future, I should seed in:

• Early April
• Mid May
• Mid June
• Late August
• Mid September
• Mid October

That's it. I hate to think of the money I've spent over the years on fertilizers and other products sold to jump start a lawn. When I had big lawns, pushing a mower around every week or two during Washington summers wasn't much fun, either.

How much quieter the neighborhood would be in July and August if everyone followed Bill's advice not to mow in hot weather! Of course, the lawn care companies wouldn't be very happy.

K.I.S.S. and My Aching Back
During this morning's meditation hour, I was thinking about the back pain flareup I've been experiencing this week. I wondered if the "Keep It Simple, Stupid" slogan might also apply to dealing with the low back pain I've had for over a year.

That pain started when I fractured the L-1 vertebra in my car crash last August. My doc told me to expect the pain to persist until the vertebra healed, which would take about four months. The vertebra healed, but the pain persisted in exactly the same spot. Then my back doctor, after re-examining the X-rays, attributed the discomfort to osteoarthritis.

I signed up for physical therapy at the back doctor's satellite office, but didn't see any benefit. I saw the physical therapist who has worked miracles on other back problems I had in the past. The exercises helped my general back pain, but not the sharp pain coming from this new "hot spot."

Then I went to a doctor at the pain center at Sibley Hospital. He gave me steroid shots he said usually helped about 85 percent of people with osteoarthritis. They didn't help me. Then he injected pain-relief meds directly into the hot spot. That didn't work. Next up was a prescription pain-relief patch. Nope.

A wellness center opened in my neighborhood, and I decided to try acupuncture there. They also had an introductory offer for reiki. I did both for about a month. They were pleasant and relaxing, but the pain persisted.

Next was massage. Same result -- pleasant and relaxing, but that's all.

Finally, I've been seeing a chiropractor for the past few months. I felt some relief at first (or thought I did), but the pain remains. The increased pain this past week began the night after the chiropractor had been especially aggressive in shoving my neck around.

So, during this morning's meditation, it occurred to me that this back pain history seemed similar to my struggle with the back lawn. Maybe I should forget about all these fancy extras and get back to K.I.S.S. basics. I know from my blog-related medical research that for every ailment I check, the two top recommendations invariably are diet and exercise.

The most relief I've gotten  this past year has come from 1) taking the curcumin supplement I started this spring, and 2) using my meditation hour to just sit with the pain. Though I've tried lots of "alternative" tactics, I haven't used my exercise bike or simply "walked through the pain," my back doctor's recommendation from the start.

So, maybe it's time for K.I.S.S. here, too. Writers are often reminded that "less is more." Maybe that maxim applies to back pain therapy, too. Eat wisely and get back on the exercise bike. Lose some weight. Take more walks while this gorgeous fall weather lasts. And continue the work I've just started with a local rehab center's physical therapist to strengthen core muscles.

The trouble is -- this plan requires harder work than simply taking a pain pill, or getting an injection, or having a masseuse or chiropractor work on me.

The GI Bill: the Biggest-Ever Government Grant Program Transformed the Middle Class, the Economy, and Universities

With all the recent blathering about the role of the government in building a strong middle class, and about the 47 percent who are wards of the state, I'm surprised we've heard nothing about the biggest, most successful government aid program ever --the GI Bill. Enacted in 1944, that legislation provided assistance to returning WWII vets for college, businesses and home mortgages.

Suddenly, millions of servicemen were able to afford their own homes for the first time. As a result, residential construction jumped from 114,000 new homes in 1944 to 1.7 million in 1950.

Some 2.2 million vets attended college or graduate school, and 5.6 million prepared for vocations in auto mechanics, electrical wiring, and construction. They could attend any institution that admitted them, using benefits that covered even the costliest tuition and helped support spouses and children.

Before 1940, colleges were mostly for the privileged, but the GI Bill opened doors for rural people, offspring of first-generation immigrants, and veterans from working- and middle-class backgrounds. In so many cases, these vets were the first members of their families to attend college. This influx of vets transformed our colleges into the world-class institutions they are today.

Vocational training led to jobs with middle-class incomes and benefits. Millions took low-interest loans to start businesses.

Nearly three in ten veterans used low-interest mortgages to buy homes, farms or businesses. The economic impact was huge. In 1955, for example, the Veterans Administration backed close to a third of all housing starts.

Many famous people were helped by the GI Bill: Presidents Gerald Ford and George H.W. Bush; Supreme Court Justices William Rehnquist, John Paul Stevens and Byron White; U.S. Senators Bob Dole, John Glenn, George Mitchell and Daniel Patrick Moynihan; entertainers Harry Belefonte, Johnny Cash, Clint Eastwood, Paul Newman, and Walter Matthau.

Four Historians Assess the GI Bill
I found a July 4, 2000, PBS NewsHour program -- "The GI Bill's Legacy" -- in which Jim Lehrer (who will host the first presidential debate in October) interviewed historians Stephen Ambrose, Doris Kearns Goodwin, Haynes Johnson, and Michael Beschloss. Here is some of what they had to say:

Stephen Ambrose
The GI Bill was the best piece of legislation ever passed by the U.S. Congress, and it made modern America. The educational establishment boomed and then boomed and then boomed. The suburbs, starting with Levittown and others, were paid by GI's borrowing money on their GI Bill at a very low interest rate. Thousands and thousands of small businesses were started in this country and are still there thanks to the loans from the GI Bill.

It transformed our country....

But the GI Bill was designed to help veterans, not to transform America. No one had that idea in mind. But I'll tell you: millions of GIs who never, never dreamed that they might be able to go to college suddenly had the opportunity, and these guys went, and they became -- there's not a teacher in the country who isn't aware of this -- the best students we've ever had. [I can attest to this since I went to college with them and was impressed with their hard work and dedication. -- John]

God, they worked so hard, and they -- all of them -- came back to America feeling, "I just wasted the best years of my life. I know how to man a machine gun; I know how to fire a mortar; but I can't make a living out of this."

And now they had college opened up to them, and these guys [became] the students that every teacher in this country would just kill to have.

The American educational establishment of today, which is the envy of the world, was made by the GI Bill, and those veterans who came back brought about this enormous expansion and jobs for professors and jobs for technicians and jobs in the laboratories and students going to school learning and then going out into the world and applying what they have learned -- the beginning of modern America.

These GIs made modern America, and they did it because the government had enough sense to say we're going to educate these guys... we're going to give these guys an opportunity and they could go to Harvard. They could go to Stanford. They could go to the University of Chicago. They could go, as Art Buchwald did, to the Sorbonne in Paris and get 50 bucks a month if they weren't married, 75 if they were. Later on that figure was moved up, and they could study and work and improve themselves and the institutions that served them.

Doris Kearns Goodwin
I think few laws have had so much effect on so many people. It meant that blue collar workers, a whole generation of blue collar workers, were enabled to go to college, become doctors, lawyers, and engineers, and that their children would grow up in a middle-class family.

The president of Harvard said it would create "unqualified people, the most unqualified of this generation," coming into college. The president of the University of Chicago feared we'd be creating "educational hobos." But these were mature, responsible people, the best of their generation in college.

It shows what happens when you give people who don't have a chance an extraordinary opportunity.

Haynes Johnson
Five years after the war ended, twice as many Americans graduated from college [compared to 1940]. That's just the college part... there were 13 million homes built in the 50s. Eleven million of these with GI loans.... It did transform the country.

And the irony of this... this was the biggest government grant ever. Today people hate the government. This was once there was no debate about it. There's no controversy about it. There's no ideological argument about it.

Michael Beschloss
This had much greater impact on bringing Americans into the middle class than everything Roosevelt had tried to do over eight years in the 1930s.

At the time that the bill was debated in Congress it passed only by a very slim margin, and, in fact, a lot -- particularly Republicans -- said let's not pass this thing because a big part of the GI Bill was to give returning vets $20 a week for 52 weeks. They felt it would encourage sloth; that people would not try to get jobs. They thought that this would extend the welfare state, rather than do the opposite. [Emphasis mine.]

----------------------------

The more things change, the more they remain the same. 'Nuff said.

Michael J. Fox to His Kids when They Complain: "A Lady Had a Baby in a Tree!"

I'm a big admirer of both Micheal J. Fox and Ellen DeGeneres, so I loved this video clip:



I particularly liked his comments that reinforce my oft-repeated saying that "I have two diseases: Parkinson's disease and John Schappi's disease." (This is an adaptation of a comment I first heard from the moderator of my PD support group, who is a 25-year Parkinson's survivor.)

I think the same concept applies to everyone dealing with ailments. Yes, Parkinson's may be a bit more idiosyncratic than most diseases. But I don't believe there's any condition where "one size fits all." Drugs and rehabilitative therapies can create as many individual, specific results as there are people who use them. For that reason, it's vital we assume active roles in managing our own health care.

Getting back to Michael J. Fox....  He became famous -- and beloved -- playing Alan P. Keaton on the sitcom Family Ties. His other successes include the Back to the Future trilogy, and his award-winning lead role on Spin City, from which  he retired in 2000. That same year, he launched the Michael J. Fox Foundation for Parkinson's Research, which has become one of the world's leading organizations in the search for a cure.

I highly recommend his memoir, the New York Times bestseller, Lucky Man.

Finally, here's what Michael said in a recent interview about coming to terms with the disease:

I don’t look at life as a battle or as a fight. I don’t think I’m scrappy. I’m accepting. I say "living with" or "working through" Parkinson’s. Acceptance doesn’t mean resignation; it means understanding that something is what it is and that there’s got to be a way through it. I look at it like I’m a fluid that’s finding the fissures and cracks and flowing through.

Parkinson's, Genealogy and Risk of Prostate Cancer and Melanoma

After a week of posting about our miserable political system, it's a relief to get back to the real world of dealing with Parkinson's and aging and an aching back. Tackling these issues isn't as depressing as our politics. (I'm only half joking.)

Here's a just released study that I found interesting:

A recent study from Archives of Neurology suggests that people with Parkinson's disease (PD) may carry a higher risk for both melanoma (a form of skin cancer) and prostate cancer. I guess I'm Exhibit A, since I have PD and prostate cancer. I've also been treated twice for melanoma.

According to the research paper, the risk runs both ways. Those with PD have an increased risk of prostate cancer and those with prostate cancer have an increased risk of PD. The study analyzed the Utah Population Database, which includes personal and family information for over two million individuals. Amazingly, some of those records provide family information for more than 15 generations.

Here's a summary of the findings:

• An increased risk for PD was associated with an increased risk for both prostate cancer and melanoma.
• Prostate cancer was diagnosed in 212 individuals who died with PD, compared with a normal expected risk of only 124.
• There was elevated risk for prostate cancer among first-, second-, and third-degree relatives of people whn died with Parkinson's disease.
• There was significantly increased risk of death from PD among 22,147 men with a diagnosis of prostate cancer.
• Melanoma and prostate cancer were the only cancers in significant excess among those with PD. Colorectal, lung, pancreas, and stomach cancers were observed at lower than expected rates.

Note: Statistical analyses like these only show an association and do not prove cause and effect.

PD and Melanoma

The reported link between melanoma and PD is not new. For years, researchers have noted that people with PD carry a higher risk for melanoma. They've also debated whether that elevated risk is caused by having PD or taking levodopa, the gold-standard therapy for the disease. The Michael J. Fox Foundation (MJFF) has funded research to further investigate this association. 

In a 2010 interview with MJFF, Susan Bressman, chairman of the department of neurology at Beth Israel Center, explained why levodopa might make someone more likely to develop melanoma:

Levodopa is needed to make the skin pigment melanin. So it makes sense that if you introduce excess levodopa into the system or hype up the system in any way, you could increase risk for melanoma. The usual precaution a neurologist would take for a patient with a history of melanoma is to be cautious about treatment with dopaminergics.

Still, according to Bressman, recent studies have found that having PD causes the melanoma risk, not taking the drugs. While the jury is still out on what causes the PD-melanoma link, PD patients and their doctors should always be vigilant for signs of skin cancer.

I'll continue my annual checkups with my dermatologist. And I'll resolve, once again, to wear a cap and apply sunscreen when I go outside.

PD and Prostate Cancer
I just had my semi-annual checkup with my urologist yesterday and should receive my latest PSA report Friday. After 15 years of slowly increasing PSA numbers, I saw my PSA reading more than double last September. Then it dropped significantly in March. I asked my urologist yesterday if that unusual spike could be related to the trauma from my car crash in August. He said that the accident might be a factor, since urologists have speculated that stress may affect PSA levels. There's another reason I'm especially interested:  I've been taking curcumin for several months. Studies suggest that curcumin slows the progress of cancers in general, and prostate cancer in particular.

Watch this space next week for an update.

How to Resolve Our Fiscal Crisis: Don't Let Anyone 60 or Older Vote in this Election

I originally planned to title this post "Our Entitlements Make Me Richer and My Children Poorer." But I changed it after reading Bob Laszewski's excellent analysis of both parties' Medicare reform proposals, which I summarized last week. Here's how he began his piece:

Let me start by saying something that will likely surprise you. If I could be king for a day, I would prohibit anyone over the age of 60 from voting in this election. This election is really about the future and the big decisions on the table are about the long-term government spending and entitlement issues that should be made by younger voters who will have to pay for them and will benefit or suffer from them.

We have turned people over 65 -- like me -- into a politically protected class. Because we vote at much higher rates than younger workers, politicians of both parties are afraid to touch our Social Security and Medicare benefits. Those programs must be revised to reflect the longer life expectancy and greater wealth of today's retirees. We must lighten the burden on our children and grandchildren, whose taxes support those programs, and who cannot save enough to fund their own retirements.

It is a long-standing axiom in America that every generation will live more comfortably than the last. I always know I'd do better than my father. Why shouldn't I? Shortly after I was born in 1929, my father lost his job and struggled to survive the Great Depression of the 1930s. In contrast, I graduated from college and entered the workforce in the early 1950s as the postwar boom took off.

Most of my contemporaries agree that it will be exceedingly difficult for our children and grandchildren to do as well as we did. Even if the adverse effects of the Great Recession fade with time, the younger generations will be saddled with the costs of an aging population and the expense of infrastructure maintenance deferred this past decade because of several futile wars.

The optimism that always defined Americans is being replaced with anger, since so many young people no longer assume they'll be better off than their parents.

Newsweek recently referred to Millennials as the "screwed generation." Here's what some of them have to say:



The Lucky Generation
My generation, those born between 1925 and 1945, is wedged between the better known "Greatest Generation" that grew up during the Great Depression of the 1930s and won World War II... and the "Baby Boom Generation" born in the two decades following the end of the war in 1945. In an earlier post I suggested that my generation should be called the "Lucky Generation," since we didn't have to fight in WWII and started working during the "Golden Age" for the U.S. economy -- the post-war boom years of 1947 to 1977. Here are some other ways we were lucky:

•  For most of our working years, our retirement security rested on a three-legged stool: 1) Social security; 2) an employer-provided  pension plan with guaranteed benefits; and 3) our own savings.  Toward the end of our careers, the second leg of that stool began to wobble, but we still benefited from it in the earlier years. 
•  Most of us built up equity in our houses through the boom years when real estate prices only went up. The 2008 recession -- and the collapse of the real estate bubble -- did not hurt us the way it has younger home owners.
•  Only  nine percent of Americans over 65 had incomes below the poverty line in 2010, according to the Census Bureau. By contrast, 13.7 percent of the general population was living in poverty.
•  The median net worth of households headed by an adult 65 or older rose 42 percent in real terms between 1984 and 2009, to $170,404. During the same period, the median net worth of a household headed by an adult younger than 35 shrank 68 percent to $3,662, according to the Pew Charitable Trusts.
•  Households headed by someone 75 or older had the highest net worth: $216,800.

The Younger Generations -- The Baby Boomers and the Millennials

Contrasted with my "Lucky Generation,"  here's what the younger generations face:

•  Chances are, the young will pay for today's elderly without themselves receiving comparable support. The ratio of workers to retirees, 5-to-1 in 1960, fell to 3-to-1 in 2010. That ratio is projected to slip to nearly 2-to-1 by 2025.
•  The traditional employer-sponsored retirement plans benefited people my age. (I took my benefits, based on my 40-year career with the same employer, in a lump-sum -- $800,000!) These plans have disappeared. Fewer than half of the nation's private sector workers have 401(k) plans, and more than a third of households have no retirement coverage during their work lives, according to the Center for Retirement Research at Boston College
• The Baby Boomers nearing retirement (people 55 to 65) on average had just $54,000  in 401(k) plans in 2010 and only $120,000 in all retirement accounts. And we're asking these workers to pay taxes to fund my Social Security benefits!
•  Today's workers don't have significant wealth in other assets to fall back on. Households in the 55-to-64 age bracket lost a third of their net worth between 2007 and 2010, leaving them with an average net worth of $179,000.
• The Census Bureau just reported that last year the 60 percent of households earning between roughly $20,000 and $101,000, earned 46.6 percent of all income, compared with 1990 when they earned over 50 percent of the income.

Where Does That Leave Us?
Joseph Stiglitz, in his new book, The Price of Inequality, sums it up pretty well:

America's inequality is undermining its values and identity.... America has become a country not "with justice for all" but rather with favoritism for the rich [and elderly] and justice for those who can afford it.

He warns of a society governed by "rules of the game that weaken the bargaining strength of workers vis-a-vis capital." At present, he says "the dearth of jobs and the asymmetries in globalization have created competition for jobs in which workers have lost and the owners of capital have won." We are becoming a country "in which the rich live in gated communities, send their children to expensive schools, and have access to first-rate medical care. Meanwhile the rest live in a world marked by insecurity, at best mediocre education, and in effect rationed health care."

Data just released shows inequality increasing and the trends moving toward Stiglitz's pessimistic vision of the future. Just last week the Census Bureau reported that income inequality increased by 1.6 percent during 2011, the biggest one-year increase in almost two decades. There's slim likelihood of change, no matter who wins the November election.

Living in Washington all these years, I've participated in marches for civil rights, women's rights, gay rights, anti-war protests, the "Million Man March," and others. Even with my back pains, I'd participate if young people were marching today to protest the inequality they are being subjected to by a government that taxes them to pay benefits to well-off seniors like me. But they aren't.

With our loss of optimism and belief in the American Dream, we seem to have lost our determination to fight for a fair deal for all. Instead, the zest for a fight seems to come from those who want to protect what they have and don't want to be taxed to help the less fortunate. Meanwhile, the Democrats, the party that fought for the New Deal and the Fair Deal, continue to find it politically rewarding to use demagoguery to attack the other party whenever it talks about revising entitlements.

Politicians of both parties assume that we seniors are greedy old geezers who will vote against anyone who proposes increasing our taxes or reducing our benefits. Are they right? What do you think?

Memory: Two Updates

At 83, I count my blessings that I am

• still living in my own house, 
• managing quite well on my own, 
• enjoying a pretty jam-packed retirement, 
• coping well with my various afflictions, and 
• feeling happy and contented most of the time

I've got two progressive diseases -- Parkinson's and prostate cancer -- but strangely enough I don't spend much time worrying about them. I worry more that the lousy short-term memory I've had most of my life is getting worse. Dementia – and its more acute cousin, Alzheimer’s – are my greatest fears.

Two articles about memory recently hit my inbox. One gave encouraging news about brain structure; the other focused on the role of genetics.

Brain Cells Don’t Keep Dying Off as We Age
Last month, a Johns Hopkins "Health Alert" reported that our brains do not experience a massive loss of cells as we get older, contrary to long-held beliefs. In fact, as science progresses, we learn more and more about the brain’s amazing plasticity – its ability to grow and change, and even “heal” itself.

Maybe most encouraging of all, there is considerable growth of new cells in the hippocampus, the part of the brain that consolidates our memories.

The article makes the point that our brains are organs, like our hearts and lungs. Brains are affected by the same things -- like diet and exercise -- that affect our other organs. While it may not be “news,” it’s good to read again that we have some measure of control over the quality and duration our memories, through the lifestyle choices we make.

What We Don’t Control: Genes
Another article was reported by Dr. Shari Barnett of ABC News. She told the story of Ralph Light, 94, an active gardener, living with his wife of 68 years, reader of two or three novels a week... and brother of four siblings who lived long, dementia-free lives.

Barnett reports on a study conducted by Mount Sinai School of Medicine, which examined 277 dementia-free male veterans, all 75 or older, to measure levels of C-reactive protein. Higher levels of this substance are associated with increased dementia risk. The question becomes: how have men with high levels of C-reactive protein – who also have no evidence of cognitive impairment – managed to develop some kind of “immunity” to dementia? The answer could have powerful implications in the quest for treatment, and even prevention, of Alzheimer's.

This study, and another similar follow-up investigation, included interviews with relatives of these mentally healthy vets with high C-reactive protein levels. Results were not surprising: the study subjects who were “resistant” to high C-reactive protein levels were 30% less likely to have relatives with dementia.

Yes, it's another validation that our DNA deals us a hand we’re stuck with. But we can still play it cleverly.

Dr. John Messmer, associate professor of family and community medicine at Penn State College of Medicine in Hershey, Pennsylvania, commented on the study:

Mr. Light's family likely has a good genetic profile plus a lifetime of physical activity and is not overweight or a smoker. And he is engaged in life. All the research being done on dementia may one day help us to understand it better, but for now, there are basic recommendations to reduce one's risk: do not use tobacco, maintain a strictly normal weight (BMI under 25), exercise regularly, eat a diet high in vegetables and fruits, stay engaged in the community.

Check, check, check, and check.

Let's Hope Joe Biden is Wrong about Social Security

I've been posting this week about the political debate over Medicare reform, a major issue in our search for ways to resolve our fiscal crisis. Fixing Social Security is also a crucial factor. An off-the-cuff remark by Joe Biden last week illustrated the tendency of Democratic pols to demagogue on this issue.

I love Joe Biden. He's a "Happy Warrior" who loves people and the rough-and-tumble of politics (unlike his boss). But he often wanders off the reservation boundaries established by Obama's re-election campaign strategists, who prefer ambiguous campaign remarks to clear position statements.

Joe did it again recently at a campaign stop in southern Virginia, where he encountered a coffee shop patron who said, "I'm glad you all are not talking about doing anything with Social Security." Biden responded, "I guarantee you, flat guarantee you, there will be no changes in Social Security. I flat guarantee you."

Not good. Social Security is going broke. The trustees of the Social Security Trust Fund -- who include the President's cabinet secretaries at treasury, labor, and health and human services -- said in their annual report (delivered to Biden in April in his capacity as Senate President) that the disability portion of the trust fund "becomes exhausted in 2016, so legislative action is needed as soon as possible." The overall fund, combining retirement and disability, will "become exhausted and unable to pay scheduled benefits in full on a timely basis in 2033."

This leaves Congress with four choices, the trustees explained:

• raise the payroll tax, 
• reduce benefits, 
• direct other revenues to Social Security, or
• create some combination of the above. 

The report concluded: "With informed discussion, creative thinking, and timely legislative action, Social Security can continue to protect future generations."

Virtually all experts agree that fixing Social Security is easy compared to reining in the costs of Medicare, Medicaid, and other health care features. Social Security could be shored up with a few simple tweaks: change the inflation calculator to the one that slows down the rate of cost-of-living increases, and moderately raise the ceiling on incomes subject to the payroll tax.

This year, the ceiling on earnings subject to the Social Security tax is $110,100. The payroll tax is 4.2 percent for employees and 6.2 percent for employers. (There is no income limit on the Medicare tax rate, which is 1.45 percent for both employees and employers.)

A History Lesson
Often cited as one of the great achievements of the Reagan Administration is the bipartisan compromise on Social Security than was hammered out by a commission headed by Federal Reserve Board Chairman Alan Greenspan, and signed by President Reagan. It saved Social Security for the Greatest Generation just as they were entering retirement.

The deal gradually raised the payroll tax rate, indexed the ceiling on income subject to the taxation, and lifted the retirement age to 67, but not until the middle part of the Baby Boomers reach retirement age. Those born in 1960 or later are subject to the normal retirement age of 67.

The payroll tax ceiling agreed to in that deal was designed to hit about 90 percent of wages and salary income subject to the tax. The architects of the compromise calculated the revenue would be sufficient to maintain the system for the next 75 years -- to 2058.

But, as noted above, the Social Security Trustees in their April annual report said Social Security would go broke in 2033, not 2058 as predicted by the Greenspan commission. What happened? No surprise. The culprit is the extraordinary rise in income inequality over the last 30 years.

The total share of wages subject to taxation has fallen from 90 percent to about 83 percent, not because a greater number of people are making more than the salary cap; that number has actually gone down. In 1983,  6.3 percent of employees made more than the cap. Today, that number has fallen below 6.0 percent.

People above the cap are making a hell of a lot more money. The 1983 Greenspan commission had no way of predicting the huge salaries being paid to CEOs and Wall Street gamblers these days. Changing the payroll tax so that it gets back to covering 90 percent of earnings would go a long way to adding years to the fiscal soundness of Social Security.

Where the Politicians Are on the Social Security Changes
In spite of Biden's off-the-cuff comment about not changing Social Security, I bet he wouldn't object to raising the salary cap on payroll taxes. In a speech earlier this year, President Obama suggested doing just that. And during the failed negotiations with House Speaker John Boehner last summer, the president put cost-of-living calculation adjustments on the table.

(Bob Woodward's recent book about these negotiations shows how Obama's reluctance to engage in the usual political schmoozing got in the way of working out a deal. Larry Summers, President Clinton's treasury secretary and an economic adviser to Obama, is quoted as saying Obama "really doesn't like these guys," referring to the congressional negotiators from both parties.)

Congressman Ryan has opposed any increases in Social Security taxes. As usual, it's difficult to figure out Mitt Romney's current position.

In yesterday's post about the difficult, complicated matter of Medicare reform, I said both sides actually seemed closer together in their proposals than the debate noise might suggest. With Social Security, a fix would be much easier to structure, along the lines of the compromise reached by the 1983 Greenspan Commission.

But in 1983, we had a functioning democracy. Today, we don't.

The Medicare Debate: An Expert's View

These days, it's tough to find links from unbiased experts when you're searching for political topics on Google. I thought I'd hit paydirt on one particular piece about Medicare reform, until I saw that two colorful -- and controversial -- celebrities had given the author their endorsements: C. Everett Koop, Reagan's Surgeon General, and John McLaughlin, the bombastic host of his own TV talk show, The McLaughlin Group. Hmmmm.

Nevertheless, the author of the promising link-- Robert Laszewski -- is regarded as a leading authority on health care reform. His analysis of the two parties' Medicare proposals is thought-provoking and balanced. See what you think.

But first, bear with me a moment.

A Personal Note and Plea: I've been getting some good comments and e-mails after saying I'm so fed up with politics today that I may not vote this year, and that I'm not donating any money. Believe it or not, I recognize that I've spent a lifetime careening back and forth on issues from one side of the road to the other, and it can take me a long time (or never) to find that ever-elusive middle of the road. One reason I'm writing this blog is that I need others to offer occasional course corrections. So, please keep the critical comments coming!

If you're tiring of my political commentary, ALERT: I've got a couple more I want to put up (and see if they get shot down). I promise we'll return to the real world next week.

The Medicare Expert
Bob Laszewski's blog --Health Care Policy and Marketplace Review -- struck me as clear and balanced. Speaking.com shows him among the top five speakers on health care reform. Here's their blurb:

Robert Laszewski is president of Health Policy and Strategy Associates and national advisor on health policy issues for Ernst & Young. He is widely regarded as one of the most influential independent consultants on health care reform. As an executive of Liberty Mutual Insurance Group, Laszewski participated as a member of the non-partisan Alliance for Health Reform chaired by Senator Jay Rockefeller. USA Today called him "one of the boldest advocates for reform." In his current role, he is an advisor to an impressive list of organizations concerned about the changing marketplace environment for health care.

I checked several of his speeches and op-ed pieces, and he seemed to present a balanced, expert perspective. And, heck, as a lifelong liberal, I'm trying to keep this blog balanced. In my earlier political post featuring columnist Stephen Pearlstein, I didn't worry about his having worked for Senator Durkin (D-IL). So here we go.

Romney-Ryan Medicare Plan vs. Obama Medicare Plans 
Laszeweski's blog post is worth reading in full, but here's a summary. He first asks the question: Who's telling the truth on Medicare?  His answer: "They both are and they both aren't." Then he addresses these questions:

Will current seniors suffer under the Romney-Ryan Medicare Plan?
Aware of senior voting power, both parties see similar futures for seniors. "If you are over age 70, there is virtually no chance there will be any significant changes in Medicare benefits in your lifetime," Laszewski says. "Even if you are over 6o, the chances that there will be any major structural changes to Medicare benefits as long as you are around are quite small."

Can Medicare as we know it be preserved for the next generation?
"Absolutely not," is Laszewski's quick answer. But here Laszewski gives Romney/Ryan better marks than he does Obama.

On Romney/Ryan he says:

I will tell you that Romney and Ryan have taken the more courageous political stand -- they say Medicare can't be preserved and big fixes have to happen. Now, that doesn't mean necessarily they have the right policy answer, only that they are willing to face the problem.

As for Obama:

Obama and the Democrats are being disingenuous by trying to use the Romney-Ryan plan to scare voters without facing this tough issue in a direct way themselves.

The Republicans have been harping since the 2010 elections on the $700 billion cuts in Medicare that Obama and the Democrats used to help pay for the Affordable Care Act, but doesn't Ryan have the same Medicare cuts in his budget plan?
Short answer: Yes. Laszewski provides a detailed review of the claims being made by both sides on this $700 billion and concludes:

Both sides are making the same cuts and have really been playing games with this one.

Republicans are using the success of the Medicare Prescription Drug Plan as evidence that the market can control health care costs. Is this evidence on their side?
Short answer: "Not in any kind of clear cut way."

It's clear that Medicare drug costs are coming in way below what the Congressional Budget Office predicted when the new drug benefit was added to Medicare in 2003. However, all drug costs are coming in lower than predicted. In 2003, drug costs were exploding. Since then, the greatly increased use of generic drugs and fewer new expensive drugs in the pipeline have helped reduce drug spending. Also Medicare Part D (the drug benefit) enrollment has cost less than originally projected.

Romney and Ryan say their plan will include the traditional Medicare plan as one of the options. But critics say there is a good chance Medicare will end up with the sickest seniors, while rich people are able to buy the private plans, thereby destroying the Medicare program everyone has enjoyed. Is this true?
Short answer: Probably not.

Ryan has sponsored several different Medicare plans. Under the more detailed Wyden-Ryan Medicare Plan (which Ryan co-sponsored with Democratic Senator Wyden of Oregon), if one of the health insurance options attracts a disproportionate number of sick people, it gets more money to offset the resulting higher costs. This provision would protect Medicare or any other plan, Laszewski says, adding, "So, it is not clear to me how, if the traditional Medicare plan got sicker people, it would make it more expensive for consumers after these inter-plan adjustments."

The Romney/Ryan plan relies on the marketplace to control costs but there is no evidence that the market does a better job than government-run plans?
"That is right," Laszewski says, "but Romney and Ryan are calling for a different kind of health market." While there's no proof based on past practices that the market has controlled costs, we have never tried a market like the one Romney and Ryan propose.

They are proposing a very different system where health plans have to bid their price in each market. They argue that competitive bidding will result in real competition in the market and, with seniors being given limited  support in the government's vouchers, they will have a greater incentive to shop for plans that cost less. All of which, they argue, will result in controlling costs.

Most health policy experts believe that we must fundamentally change the health care delivery system from the current fee-for-service system that largely pays for quantity, to one that pays for quality and cost control. The Democratic health care reform law has lots of pilot programs to test these new ideas. It is also likely, Laszewski says, that the new Medicare cost board enacted as part of the Affordable Care Act will end up requiring providers to get their payments through these new payment programs in order to control costs.

The Republicans also embrace these same ideas for new programs that pay providers a fixed amount for health care. These new payment systems, he says, also would take better advantage of electronic payment management systems and administrative simplification.

All of these ideas, generally accepted by Democrats and Republicans, have yet to be proven, he cautions.

What do Obama and the Democrats propose as an alternative to Romney and Ryan?
Laszewski faults the Democrats for taking "the safer political path" by letting the other guys make controversial proposals and saying little about how they see Medicare operating differently in ten years.

But he says he is optimistic that the Medicare cost control board called for under the Obama Affordable Care Act "could do a lot of good toward pushing the Medicare program to more sustainable payment models." That board begins its work in 2015 under the ACA, but not until 2020 for the largest category of costs -- the hospitals. And, he adds, if the ACA board is successful in remaking Medicare, it will not be the "Medicare as we have known it" that the Democrats claim they can preserve.

Republicans criticize the Medicare cost board for being a "non-elected bunch of bureaucrats." But Laszewski says that our elected members of Congress -- Republicans and Democratics -- have not shown the political courage to make the tough decisions to reform Medicare.

He says he also is optimistic that the system of competitive bidding and consumer choice envisioned in the Romney/Ryan Medicare plan "could push the Medicare system toward more sustainability."

Both parties' reform plans "are untried solutions and controversial among the experts," he cautions.

Obama says that Paul Ryan's Medicare plan will increase a senior's health costs by $6,400 a year. Is this accurate?
No. That estimate is based upon a Congressional Budget Office (CBO) estimate of an earlier version of Ryan's plan, Laszewski says.

In his latest plan, Ryan increased the rate at which the federal premium support (the "vouchers") would grow as medical costs increase. He opened up the plan by allowing Medicare to be offered as one of the coverage choices. All seniors would be assured that they could afford at least the two least costly plans on the same basis as Medicare subsidizes them today. There is no way to tell which two plans they would be or whether traditional Medicare would be one of them. But these plans would have to offer at least the traditional Medicare benefits.

The CBO has not yet provided estimates on the revised Ryan plan. But Obama and the Democrats should be doing comparisons using this plan, which is a big change from the 2011 Ryan plan.

Bottom Line Question: Whose Medicare Plan Will Work?
"My sense is that either could work," Laszewski says. "It all depends how they are implemented."

Put a conservative and a liberal in the same room and give them all the facts about Medicare and health care spending, what has and hasn't worked in government and in the market, and then ask them to come to a conclusion. The liberal would like the Democratic approach that relies on the government, and the conservative would come out on the side of consumer choice and markets.

My Take on This 
So after all that, we end up where we started.  But I was struck by one thing in reading Laszewski's analysis.
Both sides are proposing $700 billion cuts in Medicare.  Both have the same idea that Medicare needs to be shifted away from fee-for-service to a system that puts more emphasis on quality of service rather than quantity and on cost control.  Obama's ACA uses insurance exchange programs for those not covered by Medicare and Romney/Ryan proposes them for Medicare reform

If we had a normal functioning democracy, you'd think a compromise resolution of the issue should be easy. But we don't have a normal function democracy.

How Ryan's Medicare Plan Would Affect My Almost-54-Year-Old Son and Everyone Younger

The debate about the Ryan Medicare plan has focused on the proposal to introduce a voucher program, with traditional Medicare as one of many options. That plan wouldn't take effect for 10 years. Everyone now 55 or older (not just those 65-plus) would be assured of continued coverage.

So far, there's not been much debate about that aspect of the plan. Let's take my son, who will turn 54 in December, as an example. In the unlikely event that Ryan's plan is enacted next year, my son -- and everyone his age and younger -- would have to continue paying taxes for the next ten years to subsidize Medicare. Then, when he's ready to retire, he'll be told, "Sorry, you are no longer automatically entitled to Medicare. It might be one of your choices. Then again, it might not."

Thus, under the Ryan plan, most Baby Boomers would be assured of Medicare coverage... EXCEPT those born in 1959 and later.

The 2010 Census shows about 77 million people 55 and older, about 25% of the 308 million total. Those same 77 million would be supported by only 158 WORKING-AGE fellow-Americans. In a nutshell, every 55-and-older's benefits would be supported by only TWO working people.

Strangely, recent polls show younger people more supportive of the Romney/Ryan plan than seniors. I guess younger generations assume that nothing like their father's Medicare will be available to them (they're right), and they like the fact that Romney/Ryan at lease promises them something. 

Do Obama and the Democrats Have Something Better to Offer My Son?

The short answer is no. Medicare needs to be restructured. It's one of the most important issues we face, and it must be addressed now, not in ten years. Obama's Affordable Care Act made a welcome start, but more needs to be done.

But both political parties avoid proposing necessary changes to Medicare for today's beneficiaries. The reason is simple: seniors vote in larger numbers than younger Americans, and the leading edge of the Baby Boom Generation (the pig in our political python) is retiring now. AARP threatens politicians with extinction if they even think about making major changes to "Medicare as we know it." That organization, as its numbers grow, will only become more powerful, rivaling the National Rife Association in its ability to prevent major reforms.

I've just come across an excellent analysis -- "Who's telling the truth about Medicare?" -- by one of the nation's leading health care experts. I'll take up that issue tomorrow.

Promised Post on Ryan's Medicare Plan -- Check this space tomorrow

In yesterday's post, I said  I'd be doing a post for today on Ryan's Medicare plan. I forgot that today was my senior bridge day and that my kids and I were going out tonight to celebrate my daughter's birthday. So I've declared a day's holiday from posting.

Pearlstein: Both Romney and Obama Lack Leadership IQ

I've been hesitant about polluting this blog with politics. A life-long political junkie, I'm fed up today. Extremists on both sides have taken over the stage, egged on by the media, which loves conflict and controversy. The rest of us have become a silent majority, watching the train wreck of our collapsing political system.

The conventions' deceptions and distortions from leaders of both parties on issues I care about made me change my mind about keeping this blog politics-free.

I had planned to publish a post today in response to a recent comment from my son. He said he'd been watching my blog to see if I'd have anything to say about Ryan's plan for Medicare. I do have something to say and my son, who will turn 54 in December, is a perfect example of what troubles me about Ryan's plan. I'll get to that tomorrow. Then the next day, I'll take up my concern about what Biden has said.

For now, I want to discuss Steven Pearlstein's column in today's Washington Post. I urge you to read it: Leadership IQ and the race for the White House.

Just before reading this piece, I had an e-mail exchange with a friend. I had complained that Obama, when given a choice between good politics and good policy, has too often chosen the former. My friend responded: "I'm not sure that's true. It probably would have been better politics to give up on the Affordable Care Act and not do the auto bailout.

I thought, "He's got a point there." Then I read Pearlstein's column, which explained -- I thought -- why my friend and I were both right. The 2010 election results changed Obama from leader to politician.

Where I'm Coming From
Since I plan to write several posts on political issues, you should know where I'm coming from. I'm a lifelong "liberal Democrat," a designaton most Democratic politicians are afraid to use these days. But I'm not a politician.

Nor do I march in lockstep with the Democratic leadership. For example, I didn't vote in the 1996 presidential election, the first one I ever missed. I was angry with President Clinton. When Newt Gingrich proposed changes in Social Security in his 1994 "Contract with America," Clinton and the congressional Democrats should have taken up the challenge to see if negotiation on this crucial issue was possible. Instead, they did what the Democrats do all too often: resort to demagoguery aimed at frightening seniors anytime Republicans propose touching social security.

I can safely play this silly game of not voting because I live in the District, where the Democrats are sure to win with or without my vote. Still, I'm considering withholding my vote again this year. And I haven't given Obama and the Democrats a dime this year, contrasted with thousands of dollars four years ago.

About a year ago, I thought Romney might be a better choice for president. The Republicans would continue to control the House and would probably take the Senate, too, because more Democrats were up for re-election. I thought a second-term Obama would therefore be doomed to continued stalemate, while a moderate Republican might be able to enact some needed changes. I entertained those notions before Romney made it clear that he would go wherever the political winds were blowing... and those winds are gusting in the direction of the Tea Party.

Where Pearlstein Is Coming From
Pearlstein writes a column for the business section of the Washington Post twice a week. In 2008, he received the Pulitzer Prize for Commentary for his "insightful columns that explore the nation's complex economic ills with masterful clarity."

He, too, has a liberal Democrat background. He worked on the staff of Senator Durkin (D-IL) for several years. But he's spent most of his working life in journalism.

The Essential Leadership Traits
Pearlstein says at the outset that he's trying to keep his ideology and policy preference out of the analysis of Romney's and Obama's "leadership IQ." From contributors like Warren Bennis and Tom Peters to The Post's "On Leadership" website, Pearlstein says:

... we know that the essential elements of successful leadership are authenticity and truthfulness, an unwavering set of core values, strong personal ethics, a passion for a larger purpose outside of yourself, the ability to communicate an inspiring vision, empathy and emotional intelligence, persistence, self-discipline and a boldness that sometimes borders on narcissism. 

How Do Romney and Obama Rate? 
Here's Pearlstein's summary:

So, let me put it right out there: Although Barack Obama is yet to fully deliver on his considerable leadership promise, Mitt Romney -- for all his history of running things and running for things -- remains clueless about what genuine leadership is all about.

Pearlstein presents a searing indictment of Romney, whose biggest problem is "his stunning lack of authenticity." That assessment is based on Romney's "reinvention from centrist and pragmatic Massachusetts Republican into a dogmatic social and economic conservative, totally disavowing explicit positions on abortion, gay rights, immigration, the bank bailout, environmental regulation and, of course, the health reform in Massachusetts that was once his signature  political achievement."

"Phony is the word that keeps coming to mind," Pearlstein says. He presents more evidence to back up his failing grade for Romney and concludes:

Despite his obvious intelligence, self-discipline and managerial ability, by any honest measure Mitt Romney fails the leadership test.

American voters apparently have misgivings about Romney on this score. Given the lackluster state of the economy, he should be far ahead in the polls, not tied with Obama.

The Obama analysis was even more interesting. Pearlstein thinks the president showed great leadership potential in his best-selling books, in his election campaign, and his early years in office:

Whether you subscribe to them or not, he has a vision, a set of core values, a passion for a cause beyond himself.... As president, he has sometimes shown courage and persistence in pursuing unpopular initiatives, along with that boldness that sometimes borders on narcissism.  His empathy seems genuine. His public persona seems authentic and well-integrated with who he really is.

Where he has fallen short of his leadership promise, however, is by failing to tell the hard truths (Romney is not better) and making good on his promise to change the way business is done in Washington.

I wholeheartedly agree that Obama has failed to tell the public the hard truth. But I think he wasted too much time trying to make good on his promise to change the way things are done in Washington. It was clear early on that the Republicans had no interest in working with Obama and were only interested in destroying his presidency.

I also agree with Pearlstein's conclusion that after the 2010 election, Obama changed from being a potentially good leader to a traditional politician:

With the electoral drubbing that his party took in November 2010 and the sharp decline in his own poll numbers, Obama stopped being a leader with a passion for a larger purpose outside of himself. He became just another politician focused on his own re-election, pandering to the public and key constituencies, refusing to come clean about the sacrifices that would be required while demonizing Republicans with the same relentless advertising based on exaggeration and half-truths that Republicans had used so successfully against him.

The Obama strategists no doubt would argue that this is the only way to win re-election. Pearlstein thinks -- correctly I believe -- that sticking to a leadership strategy based on authenticity, core values, and courageous truth-telling would have been more effective, and a sure way to expose Romney's phoniness. (And to get big bucks from me.)

Obama's defenders also assure us that after winning re-election, he'll show that he can live up to his leadership potential. Pearlstein concludes:

I'd be skeptical that anyone who wins office by playing the old Washington political game will have the power -- let alone the instinct -- to change it.

What I Would Add
Being an effective president in our political system requires more than the leadership traits Pearlstein describes. It requires innate political skills to work one-on-one with other politicians... skills Obama has not shown.

Seeing him speak at the convention after Joe Biden and Bill Clinton reminded me how Obama lacks the "schmoozing" talent those other two veterans possess. It's a talent that comes naturally to fun-loving, people-loving guys like Biden and Clinton. Michelle seems to connect better than Barak. The president may have compassion for people generally, but he doesn't really seem to care much for those outside his family and friends, and he particularly doesn't like dealing with politicians. He's essentially a loner. Tellingly, as a young man he lived in New York City for a few years without developing any meaningful friendships.

If you don't like dealing with people, they aren't likely to want to deal with you..

Remember Barbra Streisand's song about "people... people who need people"? They're certainly missing in action from the top of both presidential tickets this year.

Thank God I've got Griffin and the Redskins to cheer me up this fall! Rather than "Hail to the Chief," it will be "Hail to the Redskins" -- I hope.

Reminder: For all of you who are ready to fire off a comment or email reminding me that the President nominates the Supreme Court Justices, remember I said I can indulge myself in not voting ONLY because I live in DC,  I certainly would NOT recommend this for anyone living in a jurisdiction where your vote could make a difference!

Watch the first 90 seconds of this and then ask "What the hell happened?"

A NYC Weekend at Age 83: Will I Manage as Well as I Did Last Year? Part 2

This update completes my recap, begun Wednesday (http://bit.ly/TXagmT) on my Labor Day weekend in New York City with my housemates Nimesh and Bhawana. It was Bhawana's first visit to NYC and my first trip since my car crash last August and the resulting lower back pain that flares up when I walk. 

I ended Wednesday's post by saying I'd finish it on Thursday. It was ready to go about midnight on Wednesday, when I hit a mysterious key and everytthing disappeared. [expletive deleted]

So... we thoroughly enjoyed the the Saturday matinee of the hit musical The Book of Mormon. Nimesh got a signed playbill and photo with one of the stars, and bought a t-shirt souvenir which he immediately donned as we headed to the subway for our next adventure. 

The title of the musical's most popular song (the one that made us laugh every time we heard it in the car last summer) is emblazoned on the t-shirt: "Hasa Diga Eebowai." Ugandan natives sing it to explain their philosophy of life to the newly-arrived young Mormon missionaries: http://www.youtube.com/watch?v=-IjBi1eEaAA.

We headed to the High Street subway station at the Brooklyn end of the Brooklyn Bridge. I wanted to show Nimesh and Bhawana one of my favorite things to do in NYC: walk back to Manhattan on the bridge, enjoying the spectacular skyline views and making the short walk to Chinatown. An enterprising plan for a guy with a bad back!

Here I am, exiting the station, wondering about the latest example of my tendency to overdo it:

Fortunately, a cab driver had told us we should go to Grimaldi's Pizzeria (http://www.grimaldis.com/) for the "best pizza in the city." We decided to check it out before crossing the bridge. When we got there just after 5pm, there was already block-long line waiting to get in. Since standing in line is one of my least favorite things to do, we moved on to a riverfront restaurant down the street, where we enjoyed an early supper and a magnificent vista of the city. 

Here I am, looking back at the bridge thinking "I'd rather enjoy the view sitting here than see the same thing walking up there."

And the view was terrific:

As a bonus, we found a ferry stop under the bridge that terminated at 34th Street in Manhattan: a much more scenic, fun way back into town than by subway! 

Hmmm. I wonder if we could peddle that photo to Frommer's. Here, Nimesh is holding Frommer's New York City day by day -- 25 Smart Ways to See the City.

The ferry gets ready to cross the river to its final stop, just to the left of the UN Building:

Nimesh and Bhawana had heard from some of their DC friends who were also spending the weekend in NYC. They had all agreed to meet up on the High Line, the abandoned West Side rail line smartly renovated as an urban park and walk. I'd never been there, and it was one of the items on my friend Bonnie's list of things to do. Although the gauge on my energy tank was slipping toward empty, I tagged along. Fortunately, there were lots of benches along the walk. Here I am, at the end of the Nepali lineup: 

Nearly out of steam, I headed back to the hotel. Along the way, still on the High Line, I decided to pause and meditate for a few minutes, hoping to replenish my energy tank. I positioned myself on a bench, adjusted  my hands into my "secret handshake," and closed my eyes. When I opened them again, I found the lighted Empire State Building to the left, and the Chrysler Building on the right. Between them, and framed by two smaller buildings, was the just-risen full moon. Wow! Where was my camera when I really needed it?

Of course, the young'uns kept on going; after all, it was Saturday night in the Big City. Here they are, settling in for dinner around midnight at a Nepali restaurant in the Bronx:

I was back at the hotel, sound asleep.

Sunday

Understandably, Nimesh and Bhawana were late risers on Sunday, so I had a nice couple of hours with my coffee and the Sunday New York Times. I searched Google for brunch recommendations in Chelsea or Greenwich Village. I found the Green Table in the Chelsea Market, which Bonnie had also recommended.  So when my fellow travelers awoke, we headed there. A great choice: the Market was vibrantly alive, and the Green Table food was excellent.

Since it was morning and my energy was high, I decided we should walk from the Chelsea Market to one of my favorite spots: Washington Square. That stroll would give us a chance to check off another of Bonnie's suggestions: a walk along famous Bleecker Street in the Village. 

One of my regrets is not having spent a year or two working in NYC and living in the Village or Chelsea. City life is great for the young and care-free, or for the old and wealthy... or reasonably well-to-do. For those in between, that trite adage is probably true: "New York is a great place to visit but I wouldn't want to live there."

When we got to Washington Square, we listened to a good jazz combo. Later, we watched a musician readying his grand piano on the sidevalk in another part of the park. Of course, we took the usual photos, with the arch and fountain as backdrops:

Then we headed for Battery Park and the ferry to the Statute of Liberty and Ellis Island. I had never toured either, for the same reason that kept me from making the tour this time: I don't stand in long lines. (I was trying to think of the last time I stood in a long line. It was probably the hour-long line to get into the National Cathedral in Washington to hear the Dali Lama speak. I was with a group of Nepali friends; we phoned in a pizza order and had it delivered to us in the line that stretched down Massachusetts Avenue.)

We hadn't read Frommer's tip that you could eliminate the wait for the Statute of Liberty ferry by buying and printing online tickets. So, Nimesh stood in the long line while I sat on a bench and ate an ice cream bar. But then, there was the long, long security-check line before boarding the ferry:

After standing for about five minutes, I said, "I'm sorry but I'm going to head back to the hotel." Nimesh and Bhawana soldiered on, and got to the Statute of Liberty:

They decided to scratch the Ellis Island tour. When they got back to Battery Park, they walked up to the financial district so Nimesh could deliver a well-placed kick to the Wall Street Bull:

In the evening, they went to Brooklyn to meet with several of Nimesh's relatives. I enjoyed a quiet, recuperative evening back at the hotel. 

Labor Day Monday

Before checking out of the hotel and heading for Penn Station, Nimesh and Bhawana made a pilgrimage to the younger generation's Mecca:

The old man was happy to be headed home after this "test drive" to NYC:

And Bhawana survived her introduction to Manhattan's madness:

As I said, I was eager to see how I'd handle this trip, the first since my car crash last August. That accident added lower back pain -- a particular new worry -- to my list of afflictions. I've got a few observations, and some ideas that might make future travels easier for me, but I'll hold them for another day.