Exotourism could play a role.

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"We tried". The post The only Led Zeppelin song Geddy Lee thought he could pull off: “Too hard” first appeared on Far Out Magazine.

It is by now blindingly obvious to any rational observer of American politics that the Democratic Party is circling the drain. Depending on which poll you believe, its favorability rating among U.S. adults is somewhere between 23 percent (CNBC) and 34 percent (CBS). Nor is it difficult to divine what has led to this dismal state of affairs — the party has lurched so far to the left that most of its iconic leaders would be regarded as too conservative to win the Democratic presidential nomination. President John F. Kennedy’s inaugural address would sound so nationalistic to those who now run the party that it would instantly disqualify him as a contender for the 2028 nomination. He almost certainly has his eye on the White House, and even people like Bill Maher realize that he is the kind of person who has the potential to fix much of what ails most Democrats. That has created a second and even worse problem for the party — its leftist base is determined to banish any and all centrist Democrats to outer darkness and this has created a leadership vacuum. Pennsylvania Sen. John Fetterman is a case in point. Much to the displeasure of his Senate colleagues, Fetterman frequently disagrees with the party’s far left positions. Even worse, he goes on Fox News to discuss his refusal to robotically toe the party line. He recently committed that heresy by appearing on “Saturday in America” to discuss his opposition to the government shutdown engineered by Senate Minority Leader Chuck Schumer and other cynical Democrats. He compounded his apostacy by telling Kayleigh McEnany this: I do believe that there’s a critical mass of my fellow Democrats that are dug in until there’s an absolute ironclad kind of deal. And I do fundamentally believe that Leader Thune is an honorable guy and I do believe we can have a sincere conversation after we can open it up … Let’s just open it up and then we have our SNAP, we have everyone paid and then we can have that conversation to see if we can extend those tax credit deals because I believe there are enough Republicans that would like to see that too. The current Democrat “leadership” obviously doesn’t recognize it, but Fetterman isn’t saying such things merely to be an iconoclast. It’s pretty obvious that he sees a real need within his party for genuine leaders who can discern the difference between smart politics and dumb politics. He knows the Democrats have a serious brand problem and that the Schumer shutdown is making it worse. Fetterman is no conservative, but he seems to be developing his own “reasonable Democrat” brand and is marketing it to audiences that most of his colleagues ignore. Specifically, he’s talking to working class voters that have abandoned the Democrats. That’s clearly why he wears those hoodies and speaks in the working class vernacular. He also understands that it is dumb and dangerous to slander his Republican opponents and, by extension, millions of Independent voters who could potentially return to the Democrat fold if his colleagues would stop insulting anyone and everyone with whom they disagree. Consequently, he rejects the extremist rhetoric that polarizes the electorate and has the very real potential to trigger the emotionally unbalanced and getting people hurt or killed. This is why he committed the unforgivable sin of appearing on the Sean Hannity Show and criticized the manner in which former Vice President Kamala Harris conducted her mercifully short presidential campaign — particularly the slanderous things she said about President Trump. When Vice President Harris referred to President Trump as a fascist, I knew we had absolutely lost the plot. I happen to know and love a lot of people who voted for the President, and they are not fascists, they’re not Nazis, and they’re not trying to destroy the Constitution or any of those things. They just happen to have different priorities, and they love our country the same way Democrats do. That kind of rhetoric makes it easier for those kinds of extreme actions … like what happened to Charlie Kirk. He isn’t doing these things because he wants to spend the rest of his life in the Senate. His term ends in early 2029, when he will be about 60 years old, and it’s unlikely that he plans to run for reelection to “the world’s greatest deliberative body.” He almost certainly has his eye on the White House, and even people like Bill Maher realize that he is the kind of person who has the potential to fix much of what ails most Democrats — charisma and authenticity. As Maher put it, “Trump has that package and so does Fetterman. He’s only been a senator two years, and he is already more famous than most of his colleagues … Fetterman is that rare Democrat who is not afraid to put the woke nonsense peddlers in his own party in their own place.” All of which brings us back to JFK and his inaugural address. What would happen to a Democrat in 2025 who said something like this to an international audience: I have sworn before you and Almighty God the same solemn oath our forbears prescribed nearly a century and three-quarters ago … And yet the same revolutionary beliefs for which our forebears fought are still at issue around the globe — the belief that the rights of man come not from the generosity of the state but from the hand of God. Today’s Democrats now sneer at people who say such things and call them “Christian Nationalists.” John Fetterman is no JFK, but he knows that the majority of Americans think like JFK and will vote for people who share this vision. READ MORE from David Catron: The Ridiculous No Kings Protest Trump Proved ‘Experts’ Wrong About Tariffs Yes, Virginia, Jay Jones Is Evil

Here’s what happened last week in Jerusalem: As Vice President JD Vance stepped off Air Force Two to celebrate the ceasefire Donald Trump had just negotiated, the Knesset was voting to advance West Bank annexation. The timing was so outrageous that it felt intentional. It was worse: It was oblivious. The ceasefire itself is remarkable. President Trump achieved what two years of military operations couldn’t: Hamas agreed to release every hostage while the IDF maintains control of half of Gaza. He did this by leveraging Arab pressure on Hamas, threatening expanded Israeli operations, and applying the kind of focused presidential attention that actually moves negotiations forward. This is President Trump at his most effective: seeing past diplomatic pieties to the actual mechanics of power. The president who delivered peace deserves partners who understand its value. Yet some in Israel’s political and activist class seem determined to undermine the very framework that made this victory possible. Start with Israeli Minister of Finance Bezalel Smotrich’s contribution to international diplomacy. When asked about Saudi normalization, Smotrich suggested the Saudis could “keep riding camels in the Saudi desert” if they insist on Palestinian statehood. Saudi Arabia controls $800 billion in sovereign wealth funds and Mecca’s spiritual authority over 1.8 billion Muslims. They’re offering Israel something invaluable: regional integration backed by Islamic legitimacy. Smotrich’s response? A camel joke. The annexation bills are equally self-defeating. Trump stated clearly in September: “I will not allow Israel to annex the West Bank.” This wasn’t ambiguous. Yet the Knesset pushed forward anyway, passing preliminary votes on bills that would apply Israeli sovereignty to West Bank settlements. The message to Trump is unmistakable: Thanks for the peace deal, but we’ll take it from here. This fundamentally misreads Trump’s project. Unlike Obama’s naive hope for daylight between America and Israel, or Biden’s focus on Palestinian grievances, Trump offered Israel something real: peace through strength, integration through shared interests. He didn’t ask Israel to apologize for existing. He asked it to be smart about securing its future. Israel risks squandering an extraordinary opportunity. The Abraham Accords survived a two-year war that everyone predicted would destroy them. The UAE complained about Palestinian suffering but kept its ambassador in Tel Aviv. Bahrain maintained relations. Morocco continued  relations and security cooperation. Trump built something durable because he understood that Arab states care more about Iranian threats and economic development than Palestinian politics. Saudi Arabia, Indonesia, and Oman are watching. They see Israel’s military dominance: the decimation of Hamas’s leadership, Hezbollah’s degradation, successful strikes on Iran itself. They also see Israel’s technological advantages in water management, cybersecurity, and artificial intelligence, capabilities the Gulf states need as they diversify away from oil. The economic logic of partnership is overwhelming. What these states need is political cover. Their populations remain sympathetic to Palestinians. They need to sell normalization as something more than capitulation. This doesn’t require Israel to accept a Palestinian state tomorrow. It requires Israel to avoid gratuitous insults and unilateral moves that make Arab leaders look like fools for considering partnership. Smotrich apparently believes Israel can have security through military dominance alone. This misunderstands how modern power works. Israel’s qualitative military edge is real but fragile. It depends on American weapons, American diplomatic protection, and American intelligence sharing. Trump has been extraordinarily generous on all three fronts: moving the embassy to Jerusalem, recognizing Golan Heights annexation, eliminating Soleimani. But generosity creates obligations. Netanyahu seems to understand this. Reports indicate he urged Likud members to abstain from the annexation votes. But Netanyahu’s cautious realism is being drowned out by ministers who mistake social media applause for strategic victory. The pattern is familiar and depressing. Israel wins a military victory. Its politics shift rightward. It overreaches. International isolation follows. Eventually, a crisis forces compromise under worse conditions than were originally available. This cycle has repeated for decades. Trump is offering Israel a way out of this pattern: a regional architecture where Israeli security comes through integration rather than isolation, where its technological advantages serve regional prosperity, and where former enemies become stakeholders in stability. This isn’t naive optimism. It’s the framework that transformed Europe after World War II and East Asia after the Cold War. The next moves are critical. Israel can embrace Trump’s vision — apologize for Smotrich’s insult, table the annexation bills, and work within Trump’s framework. Or it can continue treating the president’s peace plan as a suggestion rather than the lifeline it actually is. The president who delivered peace deserves partners who understand its value. Israel needs to decide whether it wants to be that partner or whether it prefers isolation, punctuated by periodic violence and permanent dependence on American goodwill that may not always be there. Trump is offering Israel a future. The least it could do is accept it. READ MORE from Paul Packer: How Universities Created Zohran Mamdani When American Power Meets Jewish Survival One Year After Oct 7., the Heartbreak and Hope of Israel and the Jewish People

Twenty years ago, Europe still felt whole. Streets were still. Nights were calm. Many slept without worry. You could wander Marseille’s streets without a thought or lose yourself in Venice’s narrow lanes without a trace of fear. Today, that sense of sanity feels like an artifact from an ancient time. The latest World Safety Index report confirms what most already sense. Europe is no longer secure. France and Italy — once the crown jewels of the continent — now rank below Rwanda and Bangladesh for public safety. And yet, the political class keeps pretending all is well. They talk about green revolutions and digital rights while the public buys pepper spray. Once vibrant districts now vibrate with dread. Riots erupt on cue; knife attacks barely draw a headline. The “City of Light” has dimmed to a nervous glow. And Italy, the land that once gave the world law and order, now seems to live without much of either. Tourists still pose by the ruins of the past, unaware that the present is crumbling. Only six in 10 Italians say they feel safe walking alone at night. The country that once ruled empires can no longer rule its own streets. What unites both nations is more than geography — it’s a shared failure of courage. Paris and Rome, like London, Dublin, Brussels, and Stockholm, have absorbed massive waves of immigration from North Africa and the Middle East. Is it a coincidence that these once-respectable cities now rank among the most violent in Europe? That their streets, once defined by culture and civility, are now defined by rapes, stabbings, and gang wars? Policymakers pretend culture plays no role, but objective reality tells a different story. In fact, many of Europe’s most dangerous cities today are the ones long celebrated as “cosmopolitan.” Once symbols of sophistication, the likes of Milan, Naples, and Marseille now rank alongside or below cities like Sarajevo and Odessa for violent crime. The same cities that once defined prosperity and progress now stand as textbook cases in chaos. High unemployment rates in immigrant communities, combined with poor integration and alienation, have created a perfect storm. Many newcomers arrive from countries where violent crime is a fact of daily life. Where survival often depends on aggression, not restraint. When those habits are brought into societies built on order and trust, they don’t vanish at the border. They persist, mutate, and multiply. Add in lenient laws and a political class terrified of being called intolerant, and you have the modern European city: uneasy, divided, and increasingly unsafe. One needn’t be a scholar of sociology to draw the line. When cultural cohesion fades, crime follows. When shared values disappear, so does accountability. However, amidst this continental collapse, one country stands apart. Denmark. While others drown in denial, it enforces its borders, protects its citizens, and insists on the kind of stability the rest of the continent now romanticizes. Where France burns and Italy buckles, Denmark thrives. Nearly nine in 10 Danes feel secure walking home at night, an achievement that seems almost old-fashioned. Denmark achieved this through self-reliance and the strength to say no when Europe said yes In Denmark, borders matter. Laws are upheld. Tradition is practiced, protected, and passed on. Critics abroad call it cold. The Danes call it “Tuesday.” But Denmark is the exception. Europe now mistakes decay for decency. Leaders chant of open borders and open hearts, as if goodwill could blunt a blade to the heart. They gather in conference halls while their people reinforce their homes. The continent that once raised cathedrals now fortifies its stations. The same cities that boast of compassion cower before consequence. Their words rise higher, while their streets run red below. Daily life tells the story best. Shopkeepers pay small gangs to “mind” their businesses. Police drive through neighborhoods without stopping, like guests in their own homes. Europe — more specifically, Western Europe — resembles an insane asylum where doctors nod politely as patients rewrite the rules. And yet, the political class keeps pretending all is well. They talk about green revolutions and digital rights while the public buys pepper spray and security cameras. They brand anyone who mentions crime as backward or hateful. The irony would be amusing if it weren’t so costly. It’s hard to save the planet when you can’t save your own streets. In Europe today, making it through the evening commute is no small feat; survival itself feels like triumph. This isn’t nostalgia, but brutal arithmetic. A society that cannot protect its citizens cannot preserve itself. Europe has turned self-doubt into a political doctrine. The continent that once stood for discipline now bows to dysfunction. Security, once assumed, is now a luxury for the lucky. It’s governance by guilt and media-managed denial. Denmark reminds us of what Europe once understood. Safety isn’t a privilege but the price of civilization. To many, the Danish approach looks radical. In truth, it’s simply responsible. It doesn’t assume that everyone who arrives shares the same values, or that every creed can coexist without conflict. It believes in fairness, not fantasy. Elsewhere, from Birmingham to Berlin, Madrid to Malmö, people have given up on safety — and on those who were meant to guarantee it. READ MORE from John Mac Ghlionn: The Donut Symbolizes American Exceptionalism Is the Right Pining for Racial Purity? The Myth of the Radical Young Right  

I’m a bit late with this. But word only recently reached me of the premature death of Mike Greenwell, former all-star left fielder for the Boston Red Sox and a member of the Lee County, Florida (Ft. Myers) County Commission. He died October 10 in Boston where he was undergoing experimental treatment for medullary thyroid cancer. He was 62. Thanks to his business acumen … and his standing in the community, Greenwell entered into an unexpected political career in 2022 Greenwell followed his successful baseball career with equally successful business and political careers back in Southwest Florida where he lived most of his life. He was also a solid family man, making his time on Earth a life in full. Greenwell spent his entire 1985 through 1996 Major League Baseball career with the Red Sox, playing a solid left field and posting a more-than-respectable lifetime batting average of .303. He was chosen to play for the American League in the All-Star Game of 1988, which was his best season. He batted .325 that year with 39 doubles and 22 home runs. He was runner-up in the AL MVP voting that year. More .300+ seasons followed as well as another trip to the All-Star Game. He was inducted into the Red Sox Hall of Fame in 2008. As good a player as he was for the Sawks, Greenwell suffered from what I call the Larry Holmes syndrome. Longtime fans of the sweet science (this includes me) know that Holmes was a good heavyweight champion. He was Smokin’ Joe Frazier tough and had one of the best jabs ever. He could snap a heavyweight’s head back with it. But he had the misfortune of following the supremely talented but otherwise odious Muhammed Ali. The very definition of a tough act to follow. Like the luckless Larry, Greenwell was obliged to strut his considerable baseball stuff in the shadow, not just of Fenway Park’s Green Monster, but in the shadow of three Baseball Hall of Famers. Three very tough acts to follow.  From 1939 through 1987, when Greenwell took it over as a regular, left field in Fenway Park had been patrolled by, in order: Ted Williams, Carl Yastremsky, and Jim Rice. Williams is a baseball deity. He often said his goal was to be the greatest hitter who ever lived. It’s a tough case to make that he didn’t achieve this. The powerful Rice was a monster slugger, finishing his career with 382 home runs. Yaz, who finished his long career with more than 3,000 base hits, was the best defender of the three. Fenway’s left field, with the 37 foot high Green Monster of a fence and only about a foot of foul territory, creates some of the most eccentric caroms in the bigs. Yaz played these as well as Itzhak Perlman plays the fiddle. He — Yaz, not Perlman — turned extra base hits into singles. These are the talents Greenwell had to follow. But what a quartet. No shame in being number four in this succession. Left field in Fenway was in more than just good hands for more than a half century. We shouldn’t leave the subject of Fenway Park, the oldest ball yard in the bigs, opened in 1912, without pointing out that it’s not just left field that’s eccentric there. Fenway was built, like all big league ball yards early last century, to fit into densely populated urban neighborhoods in the Northeast and Midwest. Ball yards had to fit the neighborhood. Not the other way around. The era of charmless suburban sports palaces, named after soulless corporations and surrounded by parking lots bigger than the Dutton Ranch in Montana, was many decades away when Fenway Park was shoe-horned into and named after the Fenway neighborhood of  Boston. As a result, Fenway’s entire outfield is eccentric. It tracks from the Pesky Pole just 309 feet from home plate in far right field, deepening quickly in front of the visiting team and Sawks bullpens, to that bizarre little triangular cut-out in deep, strait-away center, then to the Green Monster in left. The entire outfield line follows roughly the path one might run if being chased by a lunatic with a Weed-Whacker. This eccentric and charming ball yard was Greenwell’s office for a dozen years. I have long-time friends in New Hampshire and Vermont. When I visit in summer a trip to Fenway is always included. So I’ve been privileged to see Greenwell, and other Sawks worthies, at work in their natural habitat. I’m the better for it. If Annie Savoy was right, and there is a Church of Baseball, Fenway Park would be its Canterbury Cathedral. (Yankees fans’ objections are noted.) Many professional athletes in all sports have trouble after the cheering stops finding productive ways to fill their days, as police blotters and bankruptcy courts across the nation can attest. Greenwell had no such problem. He returned home to Southwest Florida and in short order became a successful businessman. He operated Big League Builders, a general construction company, and developed housing and commercial properties. One of his developments was Mike Greenwell’s Bat-A-Ball & Family Fun Park, a baseball-themed park in Cape Coral containing batting cages, bumper cars, and midway rides. His field of dreams was a large produce farm near Ft. Myers. While operating these businesses he still found time to coach Little League baseball. Thanks to his business acumen, his personal popularity, and his standing in the community, Greenwell entered into an unexpected political career in 2022 when Florida Governor Ron DeSantis appointed him to complete the unexpired term of a Lee County commissioner who died in office. He easily won a four-year term on his own in 2024. A term he was unable to complete. Greenwell leaves behind his wife of 45 years, Tracy, and two sons, Bo and Garrett. They have every reason to be proud of their husband and father. Lee County, Florida is the better for what Greenwell did there and for the kind of man he was. RIP Mike Greenwell, a .300 hitter in baseball, and a .300 hitter in life. READ MORE from Larry Thornberry: Octogenarians Can Solve Murders Too Me and Sundance — the Last Movie Star? Class Clown: The Memoirs of a Professional Wiseass — Proof You Can Joke Your Way Through Life    

It’s time to debunk once and for all the idea that Daddy plants a little seed in Mommy. I’ve tried it — it doesn’t work. Not with geraniums, not with tulips. We’ve swallowed this lie about the origin of babies for far too long. After several decades of research, I can assure you: if you want to have babies, the last thing you should do is plant seeds anywhere. You’ll grow gardens, which also require care, but it’s not quite the same thing. If you don’t believe me, try changing a rosebush’s diaper without getting pricked. Obviously, deliveries aren’t immediate. From the moment you place the order until the stork arrives, several months go by. There have been long-standing debates about where babies really come from. Most likely, they come from playgrounds — which would explain why they spend their days wanting to go back there. After all, we all want to return to our origins. And I don’t know a single kid who’s dying to go back to the Gardening & Outdoor aisle at Home Depot. It’s possible that in this whole baby-making business there are several ways to reach the same destination. In principle, to make a baby, you need a man, a woman, and a mountain of paperwork. Try not to ask a progressive, because they’ll tell you you don’t need the man, the woman, or the paperwork. Although, if you leave an iPhone 17 Pro in the middle of the street and wait long enough, hundreds of children will show up. One of them might even be yours. As for the biological process itself, it should be clarified once and for all that the male’s role is crucial when it comes to expanding the family. Someone has to book the emergency flight for when the stork is ready. As for the woman, her participation is equally vital: someone has to remember not to leave the baby at the airport on the way back. Sometimes, it’s urgent for the baby to arrive as soon as possible — for example, when the school year is about to start. It looks terrible to be the only one walking the dog while everyone else drops their kids off at school. That’s when we decide to put the man and the woman in a dimly lit room. The pantry will do. First, there’s a romantic dinner. Later, after the customary compliments, comes the climax of the process: the man opens his surprise package and pulls out the gift meant for the future mother — a stork. From then on, a series of shady dealings occur that lead the stork to take flight and disappear in an unknown direction. The rest is well known: let time pass, the baby in the beak, the diapers, the bottles. The parents might gain a few pounds while waiting. They usually calm their nerves by signing up for McDonald’s. Obviously, deliveries aren’t immediate. From the moment you place the order until the stork arrives, several months go by — just enough time to set up the nursery and the crib, so the baby doesn’t have to sleep in your arms until college. Besides, storks have been overwhelmed lately, flying nonstop, because people have stopped believing in the nonsense of overpopulation. Young couples want to have babies again, be happy, and hate socialism. God might’ve considered a slightly faster bird for the job. I can think of one, but I can’t say it without my lawyer present. Then there’s the matter of sneezing and its role in every baby boom. Some animal-like types reproduce by spores. So I guess you should avoid sneezing on a woman unless you’re ready to have kids with her. For some scientific reason beyond me, spores are released when you sneeze, which apparently drives the storks flying overhead insane — dropping babies at random all over the place. I know of at least one other way to make babies. It also involves a mom, a dad, and a few specific conditions. But I’m not entirely sure what the stork’s role is in that one. As for the baby, I assume it flies in from somewhere far away — maybe in Mom’s beak. Meanwhile, Dad is probably trying to grill the stork while watching a football game, instead of building the crib, which is what he should be doing. Anyway, I have no real idea where babies come from. I think the science that studies this whole matter is called pornography. READ MORE from Itxu Diaz: France Was Once a Prosperous, Wealthy, and Safe Place A Brief World History of Conversation Trump Is Europe’s Alarm Clock

As the Trump administration prepares to force its Most Favored Nation price controls on drug makers, a major U.S. lobbying group is pushing for a change to drug discounts law that would necessitate a taxpayer-funded bailout of rural hospitals to the tune of at least $100 billion. Concerns about the need for a taxpayer-funded bailout of 340B, should it be dismantled or reformed more significantly, are not new. That’s the conclusion to be drawn from a new report from the American Hospital Association, which found that the 340B Drug Pricing Program provided almost $100 billion in total benefits to 1,166 rural hospitals in 2022, a 47 percent increase from 2019. The report underlines exactly how reliant on the program — which advocates have long touted as a zero-taxpayer dollar solution to rural health funding challenges — hospitals in red America really are. It also puts a specific figure on the size of a taxpayer-funded bailout that would inevitably be sought, were the program to disappear — though advocates note the hit to taxpayers would be even higher than $100 billion if facilities other than purely rural hospitals suffered financially from the curtailment of 340B. Roughly $46.3 billion of the total $100 billion identified in the AHA report was used to plug holes in multiple areas where government funding was lacking including unreimbursed Medicaid and other government program costs or for financial assistance. Another $17.5 billion was used to cover Medicare shortfalls. $1.5 billion went to covering bad debt, including where patients were unable to pay amounts legally owed for treatment. That’s a big deal for rural hospitals. Center for Healthcare Quality and Payment Reform officials voiced major concern about the financial viability of more than 700 rural hospitals, validating hospital arguments that in many rural areas, hospitals themselves are on life support. The report underlines how 340B program gives them a cash lifeline as they prepare for more expenses, particularly as inflation remains sticky across the country. It also emerges against a backdrop of Medicaid reforms in the “One Big, Beautiful Bill” potentially having more of the effect sought by deficit hawks and less the effect sought by Republicans representing deep red, rural districts. 60 percent of 340B hospitals are in rural areas, and red states like Louisiana, Arkansas, Missouri, Kansas, and West Virginia have been out front in moving to protect the program via state legislation. For years, the Pharmaceutical Research and Manufacturers of America (PhRMA) has lobbied for what it calls reforms to 340B, a 1990s era program requiring drugmakers to sell certain drugs to safety-net providers at discounted prices if they also want to sell those drugs to Medicaid and Medicare. PhRMA has claimed tax-exempt hospitals and clinics abuse the program by artificially raising the price of medicines acquired at a discount and then sold to wealthier patients to boost revenues. They’ve called it a “hidden tax” on patients. The group seemed to secure a victory when Health and Human Services Secretary Robert F. Kennedy Jr. announced a new Rebate Model Pilot Program this summer. The government called the 340B pilot program a “methodical and thoughtful approach” focused on transparency and fairness. Hospitals say the scheme falls afoul of law governing the program. Traditionally, hospitals pay a discounted price for medications. But under the proposal, hospitals pay the higher price and receive a “post-purchase rebate” to make up the difference between what they paid and the 340B price. Rural hospitals, especially worry this will increase bureaucracy for which they lack staff and budget and could result in them never receiving rebates by leaving too much decision making authority with pharmaceutical companies who have no incentive to pay out full rebates. Nonetheless, the Pilot Program is a relatively small tweak compared to the much greater changes to 340B sought by PhRMA, which hospitals say would amount to dismantling the program. Concerns about the need for a taxpayer-funded bailout of 340B, should it be dismantled or reformed more significantly, are not new. Last year, Joe Grogan, a former assistant to President Donald Trump, explained to the Association for Value-Based Cancer Care Annual Summit: “If you solve the 340B problems, there’s no question, some hospitals are going to be under pressure.” Grogan is no fan of 340B, in fact, he said the program has gotten “so big and out of control.” Grogan also previously worked for Gilead, a drugmaker that has been pegged as the most 340B-averse within the industry. But even Grogan acknowledged the Catch-22 by saying the federal government didn’t “have the money to shore up the community hospitals and solve the 340B problem.” This means if drugmakers have their way, the federal government likely ends up spending $100 billion of taxpayer funds to bail out rural hospitals, rather than see them shut down. That will prove a hard pill for Republicans to swallow, whether they are those concerned about the existing size of the debt and deficit or those worried about Democratic attacks on Medicaid cuts sticking, even in dark red areas. READ MORE from Taylor Millard: Britain’s Online Safety Act Might Come to America Mexico Escapes the Tariff: Happy Cinco de Mayo! Happy Hour May No Longer Be So Happy Taylor Millard is a writer in Alexandria, Virginia. His work has been featured in the Spectator, Washington Examiner, Inside Sources, and other publications.