Wednesday, September 1, 2010

The Fallacy of republican Health Care (3.6.09)

Where is the "freedom" in health care?  And where is the security?

Your friendly republican wants you to believe there is a "health care market place" and that market must not be constrained.  But where is their "market" located? 

Picture a castle.  With lovely turrets.  And flags flying from them.  The castle has a wall and a moat around it.  And there's nice bridge over the moat.  Beyond the moat there is a lovely lawn.  And all over the lawn little tents are set up. 

In every industrialized nation, except ours, people who need health care go straight to the castle.  Their government has given them the security of being able to pass over the bridge and into the castle.  Inside the castle, there's a lot going on.  People can find a doctor and get treatment.  They can find a hospital if they need one.  It's a pleasant place.  If someone is very sick, there's no need to worry about taking out loans to pay for treatment.  No fear of bankruptcy for costly hospital stays or surgeries or other expensive treatments.

But in America you aren't really free to cross the bridge and enter the castle, unless you first spend time in the health care market place - outside the castle.  That's what all the little tents are for.  Scattered around the lawn on the other side of the moat from the castle.  The tents are the marketplace.  Instead of going straight to the castle to get your health care, republicans want to trap you in the market place.  Where you'll go round and round and round, trying to figure out which health plan you want!  You'll get booklets full of plans and doctors and costs and so on.  By the time you've visited 4 or 5 of these tents, you may be exhausted.  But wait!  More tents.  More booklets.  More freedom to choose!

There's something in statistics called "degrees of freedom."  It's kind of a technical term and you can read it about it here.  Or you can skip that and I'll give you the punch line.
for each estimate you make, your model becomes less accurate.
If you're going to get health care, you want to take the shortest route to that care.  Not the longest.  Because the more steps you have to take, the less accurate the final result.   It's that simple!

So right now we in America are stuck outside the castle!  All because the republicans think that by expanding the "degrees of freedom" - the number of steps it takes to finally get to health care - that they are doing us a favor!  They're not.  The winners are not the human citizens!  The winners are the insurance corporations.  The so-called corporate citizens.  They are the ones sitting in the tents, driving people nuts with so many offers and lists of doctors and plans and glossy booklets.  But no matter how many tents you visit on the lawn - outside the castle - you never get any actual "health care."  And your degrees of freedom get less and less and less as you make your weary way from tent to tent to tent - trying to figure out what's already available in the castle!

Every other industrialized nation, except us, has a simple way to get inside the castle.  We have one too.  But you have to make it to 65 first!  Once you get to 65, you can have Medicare.  Using your simple social security number.  And once you have that, you can walk right past all the tents on the lawn, across the bridge (over the moat), and into the castle.  Remember, "for each estimate you make, your model becomes less accurate," but once inside the castle you're making only medical decisions!  They may not be perfect decisions but you can make them alongside your doctor. 

If you talk to the elderly, they love Medicare.  Because they can walk right into the castle and get it - as long as it's medical care or hospital care.  But they hate "Part D" (D stands for Drug.  And also for Deliberate Duping.)  It's a plan that republicans designed.  So naturally, it forces all elderly people to wander the drug marketplace - outside the castle.  The place of too many decisions, where - here is our punchline again - for each estimate you make, your model becomes less accurate. 

In geometry we learned that a line is the shortest distance between 2 points.  republicans profess to like freedom - so a republican line is not the shortest distance, but the longest distance!  Zig-zag, they tell us.  You'll have more freedom!  Here's what I say:  Make a bee-line to the castle!  Take the shortest possible route!  Bypass the republican fallacy that there is freedom to be had by taking more and more steps to make more and more decisions, which only enrich the insurance companies!  The only sensible, and actually more accurate, health care decision we should all make is:  Single Payer Health Care.

Single Payer.  Your direct route to health careThe shortest line between you and your doctor!


I'd like to link to Jesse Lavra's wonderful post here:
Which presents the other side of the coin:
GOP: Obama's health care plan would be too effective
My post and Jesse's post are bookends. I love his post!
Thanks for the compliment Thera. I agree with you on single payer, though I think it's fine if we have to start with some public-private arrangement and work our way there.
I'm with you. Because we both agree that ultimately private will fade when it has to compete with public. However, naturally, I'm advocating sanity from the start! :-)
Employer-provided healthcare is going away. We know this.
The premiums we are expected to pay for private insurance underwrite legions of lawyers who curb medical largesse (health care). Drugs are what they mean when they say we need that thing, healthcare, and drugs come from companies who ...
The current methods are not healthcare systems at all. They're places where people work and get scared they'll be layoffs if they pass out too much help. They're places where molecules are repacked to maintain portfolio growth, and where people are afraid of losing their livelihoods if the drug doesn't make it to market. The whole thing must be destroyed and supplanted with something deliberate.
I support the single payer principle in concept, but I really just want to see the survival motive removed. By this, I mean I want to make it harder for people to work for companies they have to insulate from responsibility in helping me restore my health when I get sick. Dog in the fight? Do not attempt to trick me into believing you're here to help me.

Well put. Private "health" insurance is an adversarial system which pits your and my health against company wealth! Thanks for that insight!
Here's another excellent blog I'm linking to:
It shows you, very simply, who republicans are trying to help - the fat-cat CEO's of the insurance companies. Not you!
Another excellent part of the story: 72% of Americans want govt involved here!
It's a pretty convincing set of arguments, folks!
And, doncha know, here's another current blog, which adds further info:
Talking to each other about health insurance failure
Articles and commentary: Have we reached a tipping point?
In case you missed these previous blogs:
A true story of a couple falling through the cracks of our health care system:
An analysis of advertising as part of a systemic deception to dupe consumers and citizens:
I also highly recommend the many short, informative blogs by OGD. Just scroll down here:
This is not to forget the many, many fine blogs by other bloggers here at TPM and elsewhere.
This is amazing! I'm now calling it the Blog In. Two more super health care posts:
National Nurses Movement (HR 676), with links and analysis (and previous blogs):
And seashell's post, suggesting that people already wait patiently for doctor's appointments:

Sorry: Health Care Blog In!
Last but not least, a blog where I sketched out my view of a unified public health system:

I was watching mornin joke and all they could talk about was how Obama is responsible for every damn thing wrong in this country after seven weeks in office. And the big news was how stupid it was to get a health care symposium going and 600 billion in costs and we are all going to hell in a handbasket and it is all The New President's fault and his Treasury Secretary and they still have not filled seventeen positions in the cabinet and....
Then the focus of the show was that the President has no intention of getting the health care costs down and under control and we are spending all the millionaire's money so they cannot hire anyone.
Besides promising myself I would stick with CSPAN I noted discussions this week about about an inherent contradiction in the repubs position on health care. And it goes like this.
The Dems wish to have the government set up its own health insurance company and this will be unfair competition with the private sphere.
But their position for fifty years has been that when the private sphere gets into the act, it will always out compete the government because the government is always mishandling things and unable to provide real competition because of government unions and blah blah blah.
Another post this morning shows the amount of money paid to the CEOs of health insurance companies in 2005. More recent figures 'were not available'. Tens of millions of dollars. But how much was paid to those a little farther down on the management ladder?
And of course the private sphere pays people minimum wages to sit at the phone all day selling the public health packages that cover nothing.
I am with Grouch as far as seeing any progress in this area. 48 million people need coverage now.
But TheraP, someone posted a bill demonstrating that the cost of some 'procedure was $10,000 and the doctor received $700.00.
I am for a single payer system. But right now I would like to see anything new.
Thanks for your wonderful and extensive comments, dd.
Yes, the republicans are selling "fallacies." On the one hand, they say private companies can do a better, cheaper job than the government. On the other, they say that to do that, the govt must get out of the way - and god forbid - should never regulate them!
I think we're on the way to single payer. Because people will see that Medicare is so simple. It gets the job done!
We need to get rid of Part D and have the govt do that also. That will save money on insurance premiums, which are outrageous, and on drugs, which the govt, under Part D, is forbidden to "regulate!"
republican design - designed to fail!
I just had a customer come in the store where I work and reguritate on me Morning Joes puke. I try not to discuss politics at work but I couldn't stand it. Her response was the banks need all the money now and americans don't have the big picture and in two months we are going to be in a world of crap and it is all obama's fault.
I asked her if she knew who Maiden Lane was and she said yes she knew all about her and it didn't matter, Obama was sending this country straight to hell. She did say she was glad to see me still smiling when she left - not knowing I was smiling about her ignorance.
That's it, word for word. Blue, I have vowed to get back to CSPAN in the morning, some day old hearing on the Hill. You know I did a skit on this and I really would not have to remove much to make it a rehash of a real show.
Maiden Lane. The black box. Not the black widow. :)
Damn...I'm getting cited here without even posting anything.
Just some un-sorted reactions to the general ideas you've set out above, Thera:
The insurance industry, it can not be repeated often enough, is not in the business of providing "coverage" for anything. They are in the business of generating investment capital, and see whatever coverage they do provide as part of the cost of doing that business. Business 101 states, unequivocally, that costs are to be reduced to an absolute minimum - therefore, they pay as little as they can get by with short of having to face torch-and-pitchfork wielding mobs in the outer lobby.
An excess of choice generates confusion, true, and then there is this question: How meaningful are the choices presented? (Disclosure: I think I first heard it put that cleanly in a speech by Noam Chomsky at the U of MN many, many years ago.) An illustrative example - we are walking along the soda aisle in the grocery store, and what do we see? An endless array of brightly colored cans and bottles, all containing flavored carbonated water. The flavorings are different, the "artwork" on the outside of the cans and bottles differs, in some cases wildly, and the two or three bottling giants differ enough that they engage in the shelf-space equivalent of total war. And yet, it's all flavored carbonated water, isn't it?
I have known and worked with both government and private sector bureaucrats. The private sector folks are, to a one, living in a culture where maximization of return is their in-house deity. As individuals, they may wish mightily to "do the right thing" - and most, indeed, do. Step too far out of line, they get pulled back, in many cases, quite harshly. Why? Someone at the next level upstream is a "true believer" in that in-house deity...
The public sector folks, while still human, with all the fallibility and frailties that status implies, are in an organization that, while occasionally too prone to what we might term "process-itis", has one goal: Deliver the service. And most if not all of them are there for that reason - they could almost always make more in the private sector. As compensation for their somewhat lower compensation, they get a modicum of protection from the whims of supervisory caprice, and a heapin' helpin' of abuse from the Libertarian-leaning Republican antigovernmental legions, who are equal parts antigovernment and mental, to be sure.
We're not going to get to single-payer in one step. That's not how real life works. We will get there, and each step toward that goal will come in its own time. More important than speed here is moving in the right direction.
Time to give my fingers a short rest...
Thank you, Old Grouch, for a superb comment! I love your analogy with "soda." But soda we can simply bypass! I don't drink soda. No matter how many commercials they show, trying to convince me to buy. So the other part of what you describe relates to advertising: The effort to convince people they need something superfluous!
Soda is superfluous. You could drink water more cheaply. And private insurance is superfluous - because, as you put it so well, it really provides nothing. It simply acts as a middleman, a gate-keeper, and extracts its pound of flesh every single time you try to pass the gate!

Advertising. That's what we're up against in our struggle to reform the health care system in this country! The insurances will try to use every kind of falsehood and fallacy - to entice people into giving money to fat-cat CEO's and their investors. While making health care far more costly and effortful!
Oh, sure, go meta on me...
The soda analogy, while not perfect, really doesn't take advertising into account for another reason: We, like most mammals, are pretty well hardwired to like things that taste sweet. Soda would find a market even in the absence of ads, it just would likely not find quite so large a market.
Me? Water, right from the tap. I've been through my city's water treatment plant (fascinating place), and I know that what they send me is good.
I don't even like carbonation all that much any longer - unless it is very, very subtle and wrapped in good dark beer.
Now, the advertising thing is an item I'm going to have to muse on a bit before getting too far into it. So I'll return to this later today for that reason.
I look forward to your further thoughts. Carbonation? Superfluous too! I don't like it either.
There's a Calvin and Hobbes about this one. Calvin's dad is in the grocery store to buy peanut butter and can't decide between brands, extra crunchy and creamy, and other factors. I think he ends up yelling something into the store about 'how can I choose between extra crunchy and creamy when I don't see crunchy anywhere?" Eventually he's escorted outside the store.
Too much choice, as you say, leads to indecision and confusion. Remember the Bush prescription drug plan? A freaking monster that my grandparents abhorred. Whatever we decide upon, we've got to make it easy.
When people say we aren't going to get single payer in one step they believe they are being realistic, but respectfully, that is one of the major reasons why we won't. If you don't go for the thing you want---ever, you won't ever get it. We in America have never even tried to get single payer largely because the common wisdom says we aren't going to get there in one step. Everyone knows what needs to be done but the most difficult lot of naysayers are those who capitulate in advance by saying it can't be done. Nelson Mandela once said: "It always seems impossible until it is done."
No, the way the world works is that if you don't strive to get to where you want to go you never get there. People need to quit outsmarting themselves in the political strategy department. When people don't support single payer vocally then the timid leaders we elect don't feel obligated to support it either. If they don't support it, then the larger public doesn't even hear about it unless it is some right wing reactionary talking about how you'll have to wait 2 years to get a check up and you won't be able to choose your own doctor.
What is behind all of this defeatism in advance? The truth is that there are powerful interests who will oppose even the slightest reforms. Those interests will throw just as many resources into beating whatever "compromise" the capitulation squads come up with as they would put toward defeating the change we need which is single payer. Why do so many smart people not understand that conceding the battle in advance guarantees defeat? Half a loaf is no good anymore folks. This is not just the only opportunity we're going to have for a long time it is the last opoprtunity we will have to create a humane and civilized health care system that is not dominated by the pursuit of profit at the expense of human health. The time has come to fight for single payer not something that in some distant unknown future might possibly if we're lucky one day get us a single payer system. That certainly is not how the world works in matters such as this.
Imagine if Lincoln had made the Emancipation Proclamation good only for slaves over a certain age. Wouldn't have had quite the same effect would it? Woudl have eventually led to emancipation for all? Who knows, but it would have been morally wrong and would not have solved the problem would it? People need to buck up and do what is right for once and fighting for single payer is probably the most important thing we can do for ourselves and our country other than make sure we do what's necessary to reverse global warming which will put an end to humans and their health concerns entirely.
We have had 40 years of compromise in advance and whathas it gotten us other than a new depression in an imperialist state that can't provide a decent living or education to all it's citizens and which refuses to provide health care to them.
oleeb, I always stand in awe of your ability to comment with something so powerful, so profound, it could be a blog in itself!
Please, dear god, you have empowered oleeb to speak. Now empower the nation to act!
Imagine if Lincoln had made the Emancipation Proclamation good only for slaves over a certain age. Wouldn't have had quite the same effect would it? Would have eventually led to emancipation for all? Who knows, but it would have been morally wrong and would not have solved the problem would it? People need to buck up and do what is right for once and fighting for single payer is probably the most important thing we can do for ourselves and our country other than make sure we do what's necessary to reverse global warming which will put an end to humans and their health concerns entirely.
Lincoln only "emancipated" slaves in states engaged in fighting the Union. It was a gesture designed to encourage slave uprisings, and had no meaning until the Civil War ended and the 13th Amendment made slavery illegal nationwide, and for all time, as part of the "Supreme Law of the Land".
As for global warming, I suspect we're already too late. What we are going to need to do is a movement on two fronts. First, yes, we will have to reduce greenhouse gas emissions on all fronts, by many means. Second, and this is the part that often gets left out, we are going to need to do one hell of a lot of adapting to realities that are coming our way as a result of the thermal inertia of the oceans, the atmosphere, and the reduction in reflectivity (albedo) of polar ice caps melting. Sea levels will rise. The population will continue to grow worldwide, and people in places like China and India will want first-world living standards that they are not going to be able to achieve for multiple reasons, among them the insufficiency of natural resources to make that possible. And those populations, many of which live within a couple meters of sea level right now, will have to relocate, and find water, and food - which will be it's own concern, as arable land isn't increasing at the same rate, and ocean food fish stocks are headed for a precipitous drop.
Perhaps a good counter-analogy would be Japan attacking Pearl Harbor in 1941. Yamamoto knew that this led to an inevitable defeat for Japan - he was US-educated to a fair extent, and knew what he was beginning, in a way that the hubristic Tojo government did not, or would not bring itself to face. And yet, it took years, and hundreds of thousands of American lives, and many more Japanese lives, to bring the Pacific war to an (inevitable, yet costly) conclusion.
The private "health care" industry has sunk our battleships at berth. We need our carriers, our Halsey, our Nimitz, and our MacArthurian "island-hopping" campaign now.
We know where we need to be - it's important to have no illusions about how we get there.
I responded to you but it appears below. It's too lengthy to annoy people with by posting both here and there.
Substitute "conman" for "common" in your sentence, "We in America have never even tried to get single payer largely because the common wisdom says we aren't going to get there in one step", and you've reduced your very erudate and informative comment to its' essence.
If you missed it, watch this MSNBC newsperson hand Zack Wamp his ass, after he asserted that healthcare is not a right, it's a privilege. The YouTube vid was produced by FireDogLake, but I found it at Wonkette, and since they often mention TPM positively, they deserve the plug here.
Thank you, PCA. That is excellent. It tells us the bottom line for repubs: healthcare is just a privilege - likely for the favored few.
Here's what I found interesting. All the while Zack Wamp is speaking republican fallacies, there's a stock ticker going. Going down! Right next to him: The proof that republican policies do not work!
Watch the video. And notice the free advertising of the falling stock market - brought to you by republican privilege! (Your retirement savings: not a right, but a privilege - a losing one at that!)

Do you know who the MSNBC reporter is?
I do not. I hardly watch tv. Maybe someone else knows. But here's the question: How long will she have a job? This lady can think!
tamron hall (sp?)
Thank you, and the spelling is correct.
She was excellent, and clearly perplexed, as was I.
Here is a superb comment. And I've been waiting all morning for permission from Chris M, who sent it to me via email:
Get any expert's opinion on human evolution and the unlikely success story of how a species of soft pink hairless apes without large muscles, big fangs, or scary claws came to dominate the planet. On the top of all their lists will be our ability to form large cooperative groups where members can specialize to a given task. Organization and specialization is the keystone in the success of our species, even among different groups of humans. When an army of specialized soldiers meets a tribe of part-time warriors who must spread their time and energy among food gathering, home building, etc., inevitably the army of non-specialists falls to the army of specialists (unless they adopt the strategy of protracted guerilla warfare, but that requires a huge commitment on the part of the guerillas effectively making them highly specialized fighters).
What the Republican "health freedom" hopes to do is wrap the blanket of freedom around a much more malicious word, marginalization. By making every citizen responsible for his or her own health care solutions, we become marginalized and unable to effectively combat the highly organized and specialized health corporations. We lose our ability to leverage services and lower costs because if they cut us off, we're screwed, but if they swat us like bugs it makes no difference to them.
Universal care changes that because we let the government organize specialists for us to leverage better care and lower costs from providers. That's what they fear. Not the loss of freedom, but the loss of marginalized control over people.
Power in numbers. By creating a system that works for us, we create a better quality of life for everyone through specialization of services. It's the only way to break the bonds of marginalization. It won't destroy freedom, it will create more for us because we won't have to spend all our time worrying how we'll pay for mom's pills or dad's surgery or if our kid's late night trip to the ER will be covered by our convoluted private health care plan. It just will be.
Chris is a young man with prodigious analytic powers. Thank you, Chris, for letting me share your thoughts here.

Thanks for putting that up, and thanks to Chris M., for generating the analysis.
Your castle/moat/tents analogy is spot on. Unless I missed it, you left out that you have to pay the people in the tents just for the privilege of going across the moat; before any health care is delivered at all!
When Barack Obama talks about getting health care costs down, how can he not realize that paying people for doing nothing has got to be the place to start!
Yesterday when Rep Zach Wamp (R Tenn) came out and said that health care is a "privilege" he articulated one more nasty little Republican secret. Now we know:
1. They want Obama to fail, even if it means our country and its citizens will suffer
2. They believe that only the prosperous deserve health care
What else will we learn about these selfish losers?
Thanks for making explicit what was implicit, CVille Dem.
And here's another thing that I just realized: Those tents on the lawn. They look like competition. But really it's a cartel! They all work together to maximize each other's profits and maintain the fiction of competition. The "consumer" is doomed from the start. As the marketplace is rigged!
I think you are once again taking a bipartisan issue and blaming it on the republicans. Democrats have been right there every step of the way. If we are really going to solve this problem, it might make better sense to frame it in in a more historically accurate fashion.
Also, while I agree that Single Payer may be the best solution if we were starting from scratch, that isn't the America we live in. We have an existing health care system that is hugely complex with a tone of moving parts. Further, we have a country that is roughly divided between those who trust such a notion and those who don't or are skeptical. There are tons of problems with Medicare, not the least of which is that it only covers a small portion of the population and it only covers 80% of the billed amount.
Going into any discussion with preformed notions of the "perfect" solution is one to ensure that nothing gets done. It sets the conversation in an ideological frame rather than a logical one. If the numbers for a "Medicare for All" system work out, then it would be the solution that comes out of a rational and common sense process. If that isn't the right solution or requires a more innovative integration with existing systems, we must be willing to go down the path that makes the most sense.
I am not saying your critique of the medical system is wrong, though I do think your view is a bit narrow with regards to the full political, historical and sociological context of the discussion.
PS: I understand that "republicans" in Congress have been very vocal advocates of the status quo, more specifically over the last decade or so that they were in charge, but my main point is there is enough blame to go around that focusing too much on laying it doesn't help move the conversation forward.
I know I'm going out on a limb here, Jason, speaking for Thera - I believe we can take her comment thus: While some Democrats are not pressing hard for a change in the "status quo", almost no Republicans are. And the impetus for opposition does come primarily from that side of the aisle.
So if anything, she's at worst making the verbal equivalent of a "rounding error".
I just think that it is immaterial to the discussion at hand as to who is more at fault in how we got to our current straits. At best it attaches blame to something we already understand quite well, at worst it keeps the discussion at the combative rather than the curative.
Feel free to go out on any limbs here. Jason loves to distract. Or find tangential issues to dispute - while pretending he's somehow being conciliatory. :)
Yes, that is exactly what I am doing. I dispute a central part of your thesis and somehow that is tangential. Doctor, heal thyself.
Bluster on Bluster on...
Yhis guy should turn the page, his MO has worn itself to the bone.
Right on cue. The choir leaps to her lady's defense. Buzz off, duck. Thera can stick up for herself.
PS: Perhaps if you and your pals could make a point without slaying some perceived "enemy" in the process I could move on to something new.
Hmmmm . . .
Move on? Like maybe a change of altitude?
From listening to him pat himself on his own back it appears he's wasting his self-perceived talents and precious time 'round here bothering to lower himself to the level of the lower class.
Yo Ho Yo Ho . . .
Move on to more engaging debates about possible solutions. That is what I am here for, not the waste of space that your little asides add to most blogs.
Sparing with Boomers too damn old and stubborn to stop fighting the culture war they just won can be fun and all, but it is a tremendous waste of all of our times. I call the condition Post Partisan Traumatic Stress Disorder. You have all the classic symptoms - bombastic, immature, intractable, delusional, hypocritical, lecturing and I could certainly go on. Add into the mix a bad case of Boomer Persecution Complex, and whoa, Nelly, watch out. The chance for anything resembling a rational and reasonable and logical discussion is about zero.
I rarely blog about you (and TPMers like you) who can't seem to let their hate and anger go, but am more than happy to point out where your rhetoric doesn't live up to your stated ideals. I have seen a marked change from some people who previously couldn't debate a single point with first eviscerating "conservatives" or "republcians" or whomever.
This has nothing to do with my tone or tactics, but it is hardly surprising that you (once again) miss the point.
PS: I guess I should have added that I rarely blog about this trend anymore, since my previous entries on the subject have mostly had the affect I was looking for.
That a dozen or so "liberals" can't seem to get is immaterial to me now. You guys are the problem of the other democrats and liberals on this site since none of you will take a single piece of feedback from an "enemy" who nonetheless agree with most of your stated goals. Kind of a sad realization that your tactics are designed to deliver the exact opposite of your goals and pretty much Obama's biggest Achilles Heel right now.
Who will you blame when your own inability to change tactics causes the failure of all you are trying to accomplish?
I don't ever recall referring to Mister Bluster Butt as the "enemy."
Full of hogwash. yes. Full of horse crap, yes. But enemy? Nope!
Such credulity re-enforces my reason for using the moniker Bluster Butt.
We've seen the enemy and it is semantics.
"Move on to more engaging debates about possible solutions. That is what I am here for..."
Maybe not exactly, jason, and that is the point.
Cruise through this entire blog, if you will, and show me ONE quotation from among the many comments you have written that looks like it presents a solution to the topic being discussed. TheraP presented a pretty cogent argument promoting single-payer health care for all, modeled on Medicare.
Did you respond with critique of her proposal? No.**
Did you offer a reasoned proposal of your own? No.
Instead, you criticize TheraP for being confrontational; for being so bold as to state a position in the Health Care Debate. To wit:
jason sez: "Going into any discussion with preformed notions of the "perfect" solution is one to ensure that nothing gets done. It sets the conversation in an ideological frame rather than a logical one. If the numbers for a "Medicare for All" system work out, then it would be the solution that comes out of a rational and common sense process. If that isn't the right solution or requires a more innovative integration with existing systems, we must be willing to go down the path that makes the most sense."
How do you engage a discussion toward a solution to anything if the stakeholders don't first study the issue and then stake out a position from which to argue. These are debates, jason. No one ever enters a debate on anything as complex as the health care system with any kind of notion that they have the "perfect' solution; that their initial proposal will be wholly adopted by the powers that be. In your criticism of TheraP's intent here, you attack the straw man once again, as is your wont. Then...
jason sez "Also, while I agree that Single Payer may be the best solution if we were starting from scratch, that isn't the America we live in. We have an existing health care system that is hugely complex with a tone of moving parts. Further, we have a country that is roughly divided between those who trust such a notion and those who don't or are skeptical."
I understand your criticism - that of the weak-kneed, self-proclaimed "progressive" I've come to know who always frets that these debates and discussions and issues are too difficult for us mere mortals to comprehend, much less bear impact upon. Confrontation is to be avoided, for that is the course chosen by "partisan ideologues." Instead we should just somehow magically arrive at consensus.
One would naturally expect that in this debate (and all others, for that matter) there would be two opposing sides with any number of opinions laying someplace between the poles. Debate, like sex, is a pretty self indulgent exercise without any partners, and you seem to promote little more than masturbation (self-love) as your response to any request to engage others in an exchange of real ideas.
Get a grip (ahem!) jason. Staking out a position on anything as complicated as these issues that confront us all is not the rantings of a partisan ideologue. Instead, it is the exercise in democracy that is the responsibility of all to undertake. Gain an education of the issue as best we can. Then promote the solution as best we can, understanding that the education component of the exercise is necessarily not yet complete, and that compromise and revision will undoubtedly happen as a result of additional learning.
In the process, it is also our responsibility to call out opponents in the debate whenever it is deemed that their arguments are specious or otherwise untenable. It is hardly the irresponsible rantings of a partisan ideologue when this happens, but rather the continuing work of a real democracy such as was initiated in 1776 with our own Declaration of Independence.
**jason sez: "There are tons of problems with Medicare, not the least of which is that it only covers a small portion of the population and it only covers 80% of the billed amount." This arguably represents the rough beginnings of a reasoned critique, but is inadequate for obvious reasons, offered as a throw away aside to the main "point."

Who the hell are you to criticize anything I write when it has absolutely nothing to do with you? You act as though you are the God of the blogs. Well, forgive me I decide not to take advice from some partisan fool on a message board who can't even blog under his own name or offer anything original other than critiques of why whatever I have to say is somehow incorrect.
You are also the master of the ad hominem attack. You and the duck should get a room.
This blog isn't about solutions. It is about blame. It is about once again pitting liberals and conservatives against each other, which means NOTHING will get done. It is about pouring the dividing lines in cement and making sure we never get out of this Boomer culture war bullshit. Perhaps you should move out of your glass house before yous tart throwing stones. Or, perhaps write a blog of your own instead of spending all your time disputing points I NEVER MADE.
Sheesh. It is like talking to three year olds around here sometimes.
PS: If you had read my entire comment, you would have noticed that the quote you pulled was saying what I would like to do, rather than what I am forced to do by unimaginative and backward Partisan Warriors such as yourself.
I have plenty of comments about solutions. Pretending that all of my comments are exactly like what is found on this blog or in response to you and the duck is once more, intellectually dishonest and makes me thing you really have no integrity at all, despite your stated willingness to debate in a more agreeable fashion.
Staking out a position as being the best solution is a lot different than saying that position is the ONLY solution, which is what you and TheraP and many other around have done with single payer health care. Anyone who doesn't agree with the Medicare-for-All Choir is shouted down as being a tool of The Man.
You guys are as predictable as you are damaged and deranged.
jason sez: "Staking out a position as being the best solution is a lot different than saying that position is the ONLY solution, which is what you and TheraP and many other around have done with single payer health care. "
I would not pretend to speak for TheraP or anyone else for that matter.
But I do resent being told by you or anyone else that I somehow misunderstand the intended meaning of my own words, fer chrissakes!
Nowhere have I proposed that single payer is the ONLY solution, as I made clear even in the comments you responded to directly. It is the best solution I have found thus far and which I promote in the marketplace of ideas. In so doing, I welcome opportunity for anyone to join me in debate and compel me to compromise or change that view in light of facts and perspectives not previously considered. That, my friend, is what debate and democratic discussion is all about. You offer nothing as an alternative, even as you castigate this effort as the damaged and deranged rantings of a Partisan Warrior.
Keep moving, folks. Nothing to see here.
Quit stroking and pull up your pantaloons, little boy, and join us in the real world. And cease and desist in any attempt to claim "ownership" of my thoughts in an effort to continue your construction of strawmen in furtherance of your blustering brain farts. (That last is in fact an ad hominem comment, just so we're clear on that.) You are hardly worthy of such an assumption.
I will once again try my best to ignore you on these pages as I have done these many weeks, as it is an exercise in futility to actually expect a coherent thought from you that contributes at all to these discussions. But do not be surprised at others who will undoubtedly continue calling you out for your intellectually dishonest tripe that you promote as legitimate discourse.
Oh, and by the way, in the interest of dismembering another of your strawmen, the name is Jeff Pieterick. Hasn't changed since the last time I provided it in response to your same pathetic attempt to assume some higher ethical ground because you don't use a username. Then again, just who is jason everett miller, hmmm? Is that really you?
I agree, SJ. There is no point in arguing with jason. Let him rant! If he convinces anyone, ok by me! But he's posting in a place where he'll convince few, if any. It's become comical. :)
Then post under your own name instead of dropping it like some sort of offering in some obscure thread. Have some courage of your convictions, Jeff. I have never once hidden who I really am, but you are all over the place, one minute defending the people's right to an opinion and the next shouting down every opinion you don't agree with.
Hypocrisy springs to mind as a definition for such behavior, Jeff, but you've never been too concerned with self reflection. Only self aggrandizement and self deception.
You misunderstand every point I make, purposely so it seems, in order to spin up some fake outrage or controversy that has nothing to do with my main criticism about this blog - which is that attaching blame to any one group of people for our current troubles is intellectually dishonest and immaterial to boot. You are a dedicated member of the choir, Jeff, and don't seem to be embarrassed by the fact.
Sad and ironic given your stated goals for this country. You would rather be "right" than be successful. Sounds just like the tactics of the Rabid Right, despite your denials.
Uhhhhh . . .
Maybe Mister Bluster Butt should, as the saying goes, bugger off if he doesn't like the "three year olds" and "damaged and deranged" around here.
With that said, for me to establish clear, justifiable definitions of dingbatitis and sensationalism that appears in the tracts of ol' Bluster so that you can defend a decision to take action when Mr. Bluster Butt damns those that dare to attempt to talk back, one must first understand and acknowledge the basic humanness of each of us. Something never taken into consideration by ol' Bluster Butt.
Also, we must acknowledge that one positive outcome of the law of unintended consequences is that if we acknowledge that ol' Bluster draws his outrageous conclusions from arbitrary guesstimates then ol' Bluster won't be able to persuade many of his opponents to enter into a one-way 'dialogue' with him.
Although not without overlap and simplification, I plan to identify three primary positions on his methods. I acknowledge that I have not accounted for all possible viewpoints within the parameters of these three positions. Nevertheless, honest people will admit that his plaints are often tinctured with horse-crapism. But concerned people are not afraid to make a cause célèbre out of exposing Bluster's causeries for what they really are.
Also, if allowed, Mr. Bluster Butt will rattle off a load of meaningless crap just to confuse, befuddle, and neutralize opposition. And that particular portion of this comment has been brought to you by the Department of Undoubtable Blinding Obviousness.
What might not be so obvious, however, is that mass confusion, diffusion and illusion are the equivalent of steroids for ol' Bluster Butt. And keep in mind, if one shows any form of irritation, ol' Bluster is only further energized and ramps up his efforts to empty the meaning of such concepts as "self," "justice," "freedom," and a myriad of other profundities.
But those with an IQ above that of a fence post already knew that. Now Mr. Bluster Butt just has to try his best to figure it out.
Summa summarum, I am not particularly impressed with Mr. Bluster Butt's blathering line of blubbering babbling bullshit.
Actually, duck, you won't be chasing me off no matter how many fifty-cent words you throw into your harangues. Someone has to keep this place from becoming Daily Kos or Huffington Post.
Keep on proving every point I have ever made by simply posting your same lame comments to me, over and over again. The only credibility your damage is your own. You are shining example of a stereotype come to life.
You have become that which you have so long battled against - dogmatic, close-minded and unable to squeeze an ounce of empathy or objective analysis from that cold, dead lump in your chest that you call a heart.
Jason, you're ignoring the principle of the necessity of the strawman, maybe on purpose.
Agree that there is enough blame to go around. I think the point is that the past is the past at this point and we have to deal with the problem at hand. Dealing with the problem at hand is not what the republican game plan is. They want to maintain the status quo, which is the problem with blame that concededly can be attributed to all. That is the way I perceive the situation. The republicans should have a gameplan to address the problem and they don't. In essence, they want to put lipstick on a pig and continue the highly costly and inefficient system that we have today. The untrue selling point is "freedom of choice" and there is none, which I think is the point of therap's analogy.
By the way, if you haven't seen it, this is funny and kind of aptly summarizes the situation.
The bottom line is funny concerning the post office analogy and I think that analogy would apply to healthcare.
I guess for me the conversation has moved beyond the typical democrat and republican framing. If the current GOP leadership wants to offer status quo as a solution (which is no solution at all) that will be their epitaph come 2010 and 2012. I don't think it does progressives any good to contrast their common sense and evolutionary ideas to what amounts to Creation Science. When ideas compete against ideology, the latter typically prevails if the framing is Us versus Them.
That was a funny clip, though I still think Maher is missing the point. Both parties have created this atmosphere. It wasn't until Obama was elected that at least some room was made to start changing hearts and minds as well as out-dated and destructive government policies. To my way of thinking, we can only fold in our more brainwashed fellow citizens by figuring out a way to have these discussions without falling back into the same old partisan framing.
That type of politics has clearly failed to deliver a sustainable America society. We have a huge opportunity, but it will require a substantial change in tactics and tone to actually deliver on that promise.
It just keeps being the same ol' thing, eh jason?
You continue spouting platitudes about "moving beyond typical democrat and republican framing" and about people who "contrast their common sense and evolutionary ideas to what amounts to Creation Science" and on and on. It sounds real intellectual, almost like it's founded upon some kind of supreme observation that will be followed up with a "new way" of conducting politics in this Republic.
And you deliver here, too: More Platitudes and vacuous generalities! Examples, taken just from this one comment:
* "Both parties have created this atmosphere." * "It wasn't until Obama was elected that at least some room was made to start changing hearts and minds as well as out-dated and destructive government policies."
* etc. (Which means look at every individual sentence in the remainder of your comment to find "profound" thinking wrapped around thin air.)
Where this becomes almost comical is the way in which you respond to virtually anyone who would dare propose a solution to whatever political problem we are facing. Any position taken is deemed to be "ideological" in a damned sense of the term. How much more effective we would be if we would all just somehow seek the middle ground; if we would all just arrive at consensus instead of all the nasty confrontational business of point-counterpoint that attends political debate in the real world.
Wish to promote single-payer health care? Well, jason might agree that this is the ultimately preferred choice but will denigrate the promoter for being an irresponsible "ideologue." Nah, if we would simply follow the more supreme intellect (jason) toward a solution, we would at last arrive at the land of milk and honey instead of confronting such "failures" as we have in the past.
At least, that's the insinuation in your response to almost anything proposed that is of value in these discussions. It is insultingly arrogant, to be sure, but more importantly it sidetracks too many good and relevant discussions.
It is my choice instead to be a progressive, which I see as taking one step in front of the other toward a better world, while laying out my roadmap from all ideas offered, whether they be presented by "ideologues" or confused "Progressive Republicans;" shamans or priests; or fools or knaves. All that matters to me is that they be on point and sincere in efforts at truly contributing to the discussion.
Unfortunately, what I see from you is too often the smug sniff of arrogance from someone who would have us believe that he (Oh, and his sidekick Obama, too!) knows the better way if only we (and Obama, even) would take him at his word.
Little to be found here, folks, you'd do best to move on.
And BTW, TheraP. Great post, and keep fighting the good fight for single-payer healthcare. Let's get all options on the table before anyone even THINKS about anything like compromise. We reprobate old ideologues wouldn't have it any other way.
I am only "denigrating" the idea that your proposed solutions need some sort of foil to be used as a means of selling the underlying ideas. It's not the position that is ideological, it is the presentation.
All such tactics do is create political fall out that is not helpful to the long-term cause of progressive change. By "blaming" our current situation on any one group when the actual history is much more complex or assuming that the whole host of different solutions available as being intellectual dishonesty.
As usual, you don't understand my position and go to great lengths to rebut a point I never made.
TheraP. I was too foggy this morning to do anything other than rant. This is a fine metaphor. I will probably steal a couple paragraphs for my castling.
If that is ok.
If I start getting too specific I will end up talking about workers compensation health benefits, no-fault car insurance health benefits, . I am telling you we could get rid of 100 state plans in one swoop and apply all those premiums to something better. Just take 100x 50 private companies (probably owned by 7). 5000 private companies out of the picture.
Oh well. As always you have really fine comments going on here.
Absolutely! I would be honored if you use anything of mine in your wonderful tales! I actually was fascinated that you got sort of close in this morning's tale.
Thank you, kind sir, for the endorsement! :-)
TheraP -- Your analogy (as well as the image evoked) of the tents, especially joined as a cartel, is compelling. This ties in really well with your blog about deceptive advertising.
I think Oleeb has a point about going for broke on single payer now, because we're going broke, anyway.
And if that fails, despite our best efforts, was it C'ville who suggested at one point that we start the move towards single payer by covering all children and, simultaneously, lowering the age of Medicare eligibility every year in five year age groups?
When I lived in Canada I was initially shocked by the % of sales tax. But if such an increase would fund the system, so be it.

You've nailed a number of points so well - in a short comment! With style!
great post, and great comments with links that make the discussion even more informative and dynamic.
Frustrating that this health care debate has been going on for so long in this country.
Worse than frustrating. Because during this time, for millions of Americans, cancer spread faster than coverage.

Which is why fixing our health care system, no matter how effective or in what form it finally takes, will fail miserably in the long run if we don't address our food problem and lack of exercise problem and our environmental problem, all of which are leading causes of the bulk of our medical costs in treating disease rather than avoiding it.
Absolutely true and that is what is going on in europe because of government run healthcare. The government has to pay the bill so they are very proactive in addressing environmental problems that might cause health problems. Europe is very far advanced, much farther ahead than the us, in dealing with these issues.
It's sadly ironic that the us started the drive on dealing with environmental problems through the epa. However, the epa has been coopted in large part by industry over the last 30 years and is not nearly as effective as it's european counterparts. The entities that push the epa to act, again ironically, are state epa's because states are more directly involved in dealing with environmental issues that impact the health of their citizens. When the states jump in, the epa follows to not be embarrassed and then takes over the situation to try and lesson the impact on industry.
Great points. The closest America has to European thinking on these critical issues is the city of San Francisco.
I am happy that Obama's administration has shown an interest in addressing these other issues as well as health care. His education initiative will have the biggest long-term impact, though, because we will never move toward European thinking on some of these things until many of our fellow citizens have the right information to make informed choices in their own life and at the ballot box.
We have a huge incumbent problem that will keep us on this Möbius strip of governmental inertia that has been killing us for at least the last four decades unless we can start turning out for primaries in the same percentages (or more) that we turn out for the general.
You wrote:
"Lincoln only "emancipated" slaves in states engaged in fighting the Union. It was a gesture designed to encourage slave uprisings, and had no meaning until the Civil War ended and the 13th Amendment made slavery illegal nationwide, and for all time, as part of the "Supreme Law of the Land"."
False. The EP was more than a gesture and to say it "had no meaning until the Civil War ended" is absolutely and demonstrably untrue. The EP cause thousands upon vast numbers of slaves to be freed legally as of Jan. 1, 1863
in all the states in rebellion. Thousands upon thousands immediately began escaping their captors to join up with the liberating union armies. The armies themselves liberated slaves daily and in no small numbers all over the south.
But more to the point, your naysaying response is not responsive to my hypothetical about if the EP had been only for slaves of a certain age.
You then go on to posit that in your personal estimation it's probably too late to do anything about global warming. Glad you never advised Jonas Salk, Thomas Edison, or millions of others who possessed a can do attitude as opposed to your "can't do" attitude.
Then you go on to write:
"The private "health care" industry has sunk our battleships at berth. We need our carriers, our Halsey, our Nimitz, and our MacArthurian "island-hopping" campaign now.
We know where we need to be - it's important to have no illusions about how we get there."
Again, simply untrue. First of all, why would the health care industry bother when they have opponents like you who are happy to sink their own battleships and carriers for them? If you can't sink em outright you counsel everyone to keep em in port. All the easier to bomb them then eh?
We have never once attempted to get a single payer plan in this country. Not once. So what you say is not true.
The only thing stopping us each and every time is the myopic "realism" of persons like yourself. We have been island hopping now for well over 40 years on health care and throughout that time we have known what the best solution is and throughout that time have we been met with a chorus by your kindred spirits saying: "don't even try because it won't work." How do you know it won't work? You don't. But it is certain that if you don't try it won't work. I'm tired of not trying. I think we should try for once.
What good has all this incrementalist BS island hopping gotten us anyway eh? A tiny handful of all too rare and miniscule "victories" that haven't substantively changed the situation at all.
The table is still being run by the same rapacious interests who are stunned and quite grateful that our side is so cowed and timid they don't even try to establish a single payer system. They let folks like yourself and sadly, the President, do their work for them. They fight the slightest reforms as fiercely as they would fight single payer only because they know that will keep can't doers discouraged and doing their bidding on the real issue (that bidding is of course to keep single payer off the table).
What really do we have to lose by actually proposing and attempting to pass single payer? We might not "get" anything because we could or will lose will be your response. But I am forced to ask what then is the difference between my approach and yours except that mine puts single payer on the agenda and keeps it there? The incrementalist approach yields nothing for the people of the country and only perpetuates a rotten system. Just look at the record for God's sake! If it covers more people it will only do so at massively greater cost than single payer would do so the marginal benefit is absolutely minimal at best.
We have nothing at all to lose and everything to gain by doing the right thing. Under your wise and realistic approach we stand to gain little at the very best, a few crumbs, because that is the usual yield of trying to bargain for half a loaf in a den of thieves. I say, bust em up, realize the loaf is in our hands right now as long and that as long we don't hand it to the thieves once again we can keep it!
I guess this is just one of those situations where the single payer people need to ask the naysaying "realists" to finally get out of the way so we can get something done because despite all your talk, it's your approach that is unrealistic and doesn't yield results.

This was supposed to have been in response to Old Grouch above.
You have an amazing talent for making perfection the enemy of good.
The two of you are both wonderful, valued members of the Cafe. You come at things differently. You're able to analyze and dispute politely and in ways that assist us all in understanting nuances, coming to terms with the ideals and with the realities.
Kudos to you both!
Now if only I could spell!
I wish we had such a instrument as a national referendum to put this issue in its' proper place. I have no doubt that if such a referendum were conducted we would endorse single payer and then we could plan on how to get there as quickly and painlessly, (for citizens, not corporations), as possibly.
Hear, hear!
Put it to a vote!
TheraP ridicules a strawman and does it nicely. She defends the virtue of uniformity over diversity when it comes to health care and paying for it.
The fact is that not everyone has uniform health care values or needs, whether viewed at a moment in time or over a lifetime or over generations. Another fact: Health care is not monolithic, treatments and diagnoses are often heuristic and sometimes conflicting. And except in a non-evolving autocracy, having options is a fundamental principle of both nature and nurture. It's easy to misunderstand "degrees of freedom" and then play with words, harder to build an effective system which accounts for real degrees of freedom, whether in natural or culture reality.
As we all know, personal responsibility does play a role in health, and therefore consequently in health care needs. And as we've seen on Wall St. recently "moral hazard" is a fact of the human condition. We won't make good progress if we only castigate strawmen or fence with windmills. If you want to argue that health care is a right rather than a privilege, you must also argue with equal eloquence for individual responsibility.
The USA is, and should remain, neither an anarcho-libertarian free market nor a communistic autocracy, when it comes to health care. The public interest in proper health care is not zero, nor should the individual get it for free.
TheraP's post demonstrates how not to take the straight line to a destination. To expedite, I suggest finding a better frame next time.
There are two key 2-D frames to consider from the demand side: Need and access, and cost and payment. There are similar frames from the supply side (doctors, hospitals, technology, ...).
A third frame is that of transition, if the "system" is to be transformed from the mucked up status quo, what are the transition costs (dollar and otherwise)? Economic and human dislocations need to be planned for and paid for.
A rational solution will not ignore any of these.

Nice comment. Second all of the above.
Thanks. I think the "sanctity of life" issue is not discussed enough. We mostly hear it from anti-social Fundamentalists who want to dictate the behavior of women of childbearing ages. But it applies to end of life scenarios, too.
Something like 1% of patients need over $150K medical care while the vast majority don't need anything more than a few $100s per year. I've seen stats presented at TPM showing that huge fraction of health care cost is spent in the last months of life. There are two illustrative scenarios:
Spend a lot of money at decent odds of success failing to save a life which could on to be very productive (say, a 20 year old accident victim in good health), and spend a lot of money keeping a bed-ridden octagenarian from dying so quickly, aka decent odds of death.
Both fit the simple criteria of $$ and end-of-life. The values in the two scenarios should be very clear, and very clearly different. While the contrast is clear, the frame is of course simple to the point of being simplistic. But it is accurately illustrative of a value conflict(s).
Until the culture shifts, both are technically legit expenses of money in service to health care. And with individuals spending their own earned income, few would complain more than perhaps an eye roll's worth. But with second or third party involvement in payment or delivery of services, the question of allocation of finite resources applies. At some point someone other than the individual may have to say "pull the plug".
We don't need to make it a blanket 'either or' issue to see the problem.
It would be interesting to see a more detailed breakdown of recent actual cost distributions over the "space" my comment defines. I have no idea where to find such, much less create my own graphs out of some raw data which might not be readily available.
Ah . . . No problem . . .
They shoot horses don't they?
Why not Granny?
Assisted suicide?
Such a trend could have "deflationary spiral" attributes.
No matter what system we have, even with single payer, this problem is going to get very much worse with the aging of boomers, many of whom will demand as much high-tech extension of life as possible. I am expecting a new "generation gap" war on that, especially with the piling on of the debt we are now doing for the economic crisis. If resentment towards boomers' demanding the best at Medicare age does not happen, I will be presently surprised.
My personal experience with the recent deaths of a parent (with good insurance covering more than Medicare does,) and of many of my parents' sisters and brothers, is that many doctors and providers are very much already on board with the "cut costs for those near the end of life" thing, often too much so, and often cruelly so in the case of people in their 70's with chronic conditions.
They push to get people in hospice rather than allowing them the chance that they might try with a younger person. There is little love lost on elderly already, the medical practioner culture has changed away from intervention with the elderly that used to be the case. I know for a fact that not everyone of Ted Kennedy's age gets the treatments he is getting, even if they want it, and not everyone of Barbara Bush's age gets the kind of surgical intervention she got. They either do not get told of the possibility or they are discouraged from doing it. I heard many stories from other families in intensive care in two different hospitals. Many doctors are already sold on the "send them to hospice, I could only give them a few more years" thing, and families have to go to alternative providers if the patient wants to try to live for a few more years. I heard several stories of people doing so, of one doctor giving up because of age and another willing to try, and, at great cost and stress, the family getting another good decade of life for a parent.
Here's one example: you are 75, you need dialysis three times a week from diabetes. You can't enjoy a lot of things you used to, but you still like blogging on TPMCafe, and watching political pundits on TV. You develop a condition like Barbara Bush's. An operation is iffy because of your kidneys, but might give you 5 more years. You want those years. Should we deny them to you because of your 50/50 chance and age and because you don't have private funds like the Bushes and Kennedy's to pay for it? We already denied you a kidney transplant at 65, they all go to younger people. That's why your heart valve went bad, because of the complications from dialysis, it's real tough on bodies.
It is a very difficult moral problem and a ticking time bomb for health care reform with the boomer generation, not as meek as the "greatest generation," and much more questioning of authority, ready to access all those expensive techniques for extending life and quality of life. I suspect not as many boomers will be going as quietly to hospice as their parents are doing, with the internet and all at their fingertips. They are not all going to agree with the "it's your time to die painlessly in hospice" approach that so many in the medical profession seem to have been won over to. They are going to want the state of the art cancer treatment that Ted Kennedy got, their last few years is as valuable as his.
Very thought provoking comment, it will be interesting to see how the babyboomers react to their mortality. I am sure that a few of them will make quite a scene over a perceived denial of treatments. I can't help but hope that they are privately insured.
Thanks for the thoughtful elaboration on the problems of allocation of scarce (and costly) resources.
I won't try to predict boomer psychology. If cultural shifts do happen, they could lead or lag resource limitations. I know that my current personal position is that I would rather see my assets go to people I know than to be churned up in end of life medical care. And that applies even if my assets would be Medicare.

I am a fan of hospice myself. Life is a trade-off. Too many people, of all ages, cannot face death.
We will all die.
I hope to die as humanely as possible. And I would be loath to undergo painful procedures if they would mean only a bit longer life.

Where's California? They could do this now.
We are too busy destroying the state constitution so equality for all is non-existent. The statement by Ken Starr yesterday, when he verified to the Justices (Prop. 8) that yes, he did agree that even "free speech" is at the will of the people (i.e. voters), is just astounding.
Regarding health care, the only people that don't want it nationalized are those in the industry or people with really great health insurance that pay little for it due to retirement, etc. It makes me sick how selfish people are about their fellow man/woman. My mother is at the top of this group, insisting all is fine and leave it alone, and how can she not compute Medicare IS national health care?!
My son, Dr., and my brother, Dr., both support national health care. The physicians get it, they are getting screwed right now. It is the providers and drug companies that are running the ship. Sorry, I had to vent. :)
My liberal Democrat MD parent has long supported Single Payer.

Democratic, not democrat.
These folks never learned grammar. Or logic.
You wouldn't say, "I consider myself to be a democratic." One would be a liberal democrat or might agree with democratic policies and both usages of the word would be correct.
However, you would say my liberal democratic friend, not my liberal democrat friend. Democrat is a noun. Democratic is an adjective.
Yes, but a person can still be described as both a democrat and a parent and from MD. In this case it is three nouns describing a single person. It didn't have to be an adjective and would be awkward as one in that sentence. In either case, I hardly think eds meant democrat as an insult or as an example of the neoconservative tactic at denigrating the word as calling this comment out seems to imply.
Silly, huh. The parent is a member of the Democratic Party, so the parent is a capital 'D' Democrat.
If I'd written "Democrat Party" it would have been a joke or a odd tease. Looks like it was taken as a tease anyway!

Some of the Old Warriors around here are clearly becoming unhinged.
And so it is appropriate that someone might be called a "Conservative Republic MD parent?"
What a ridiculous argument you make in defense of what is essentially nothing more than a juvenile, schoolyard type insult.
Case closed.
Sleepin' Jesus - on the case!
Glad to have you back, SJ! :)
You dismiss the fact that eds wasn't using it as an insult. Your first mistake in logic.
Then you miss the grammatical argument as well. In this case, liberal is being used as an adjective for the noun democrat. Finally, since the verb and adjective forms of "republican" are the same, your rebuttal of using "republic" in place of republican is really the only ridiculous piece of analysis in this thread.
Case closed.
I wish that I could write imaginatively. Painting ideas as pictures in others' minds with words. I am more systematic with my writing in that I go straight to the point, going for the throat full throttle, only stopping for the occasional snark.
I enjoyed this picture, TheraP.
Your writing is much appreciated. We each have our skills. I was a former teacher of young children (for about 8 years). And I was trying to find a way to convey information to people who have little background in politics or "issues" - but need to understand how they are being duped by advertising and "authorities" trying to preserve capital for the corporations instead of rights for citizens.
Thanks for your kind words. And keep posting in your own personal style. Because you do an excellent job of analyzing and laying out an argument. :)
Thera: OT. Things worked out fine. Spouse got a great job, I am a weekend wife now :), but that is much better than the stress. Thanks for all your support, and wow, you are my rock star. We truly think alike on health care. BTW, I agree with the ideology - go for one payer, and hammer home that we want Medicare for all. It will also be necessary to constantly reiterate the cost savings as all we will hear will be the cost of implementing. Short and to the point, savings, savings, savings long term and keep the message simple, 'Medicare for all' type plan.
You are so right that I have been concerned about you! More than you could imagine!
This is wonderful news. Very hard to be separated from your spouse, but better than losing your home.
Thank you so, so much for this update. What a cause for rejoicing!
And yes, simplicity in the message. Medicare for all!
I like your metaphor enough to run with it, so I'm just going to add that the "freedom" with which Republicans concern themselves is never yours or mine, but always the freedom of the tent owners to defraud the peasantry in a realm where full disclosure is the most insidious form of dishonesty.
Now I will pay you the complement of repeating your words (in bold):
the "freedom" with which Republicans concern themselves is never yours or mine, but always the freedom of the tent owners to defraud the peasantry in a realm where full disclosure is the most insidious form of dishonesty.
I know this is about health care, but it's redundant.
Everything republicans do are a fallacy or a distortion of truth or a self deluded manifestation of another idea. These false constructs are a necessity in order to achieve the real goal.
In the common colloquialism, it's known as a lie.
Unfortunately sometimes redundancies are necessities. This is one of those times!
Awesome analogy. Thank you very much therap. I loved reading it. Maybe you should send this analogy to your senators. You might hear it sometime on the floor of the senate.
Glad you found it helpful, Michael. Any time you'd like to "steal" my ideas and send them off anywhere, be my guest. Once I place something here, it is a common property.
In case anyone comes back, I just saw this article and it is astounding concerning this information, which is the money quote:
Many Americans may not realize the government already picks up nearly half the nation's $2.4 trillion health care bill, through programs including Medicare and Medicaid.
Unbelievable. Get costs under control and bring in all people with health insurance and the total healthcare cost will go down. Obama's set aside of another 700 billion is right on target for the costs for healthcare for all, provided costs are brought in line. Amazing.
I've been aware of it, Michael, which I why I have advocated folding all govt health care, including military health care, into one system which I call "public health."
I made that suggestion months ago here:
That blog contains an extensive proposal, which not only sketches out how we can integrate health care but also how we can integrate medical education into that and restructure the fee system.
Take a look. :)

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