Sunday, August 16, 2009


Last weekend, the healthcare controversy came to my door when friends from South Florida arrived for a visit. Years ago, they were former neighbors. We shared a backyard retention pond that had grown into a wildlife preserve. Each morning, I recall, my neighbor threw birdseed to the resident ducks and moorhens. She had a name for every critter. “My buddies,” she called them.

My former neighbors and now dear friends had an appointment at the Mayo Clinic in Jacksonville. Her cancer is treatable and manageable, but she suffers from fatigue and takes mega doses of Percocet and morphine to relieve pain. Last week, she and her husband checked into a Marriot Inn near the clinic for days of blood tests, X-Rays, MRIs, and consultations.

Since I live within two hours of Jacksonville, I invited them to stay for a weekend. On Saturday, we treated ourselves to a boat ride, dined on fennel and endive salad, baked grouper, and homemade hazelnut cake. On Sunday, we talked, watched sailboats lumber past my balcony, watched billowy cotton ball clouds turn red against a setting sun.

On Monday morning, just before their return trip to Jacksonville for more diagnostics, the hospital called their cell phone: Their insurance carrier had not “pre-authorized” the tests.

For my friends and millions of families like them, this is our current healthcare system: Arbitrary decisions made, not by medical doctors, but by insurance carriers that force them to chose between timely treatment or bankruptcy, living or dying.

To read conservative commentary is to enter a Universe of reverse polarity where private health insurers are the angels, and the devil by default is government. You read dire predictions about “Death Panels” run by bureaucrats who will eat your baby or kill your grandmother; but you will hear nothing about the Death Panels of private insurers who would kill my friend or bankrupt her family … and pocket their insurance premiums with a crocodile smile.

One can understand misplaced outrage with some justification. All of us, liberal and conservative alike, were rightfully angry about the $700 billion bailout of Wall Street and the outrageous bonuses paid to crooks and scoundrels at taxpayer expense. Yet, our rightwing friends ignore an inconvenient truth: The same greed and corruption that almost ruined Wall Street are ruining our healthcare system. Here is a snapshot of our current situation:

In 2008, total US healthcare spending reached $2.4 trillion, representing 17% of Gross Domestic Product (GDP). By 2017, healthcare spending will climb to 20% GDP.

How does our current healthcare system compare with other countries? At 17% GDP, we spend far more than Switzerland 10.9%, Germany 10.7%, Canada 9.7%, and France 9.5%.

Since 1999, health insurance premium costs have risen 120%. In contrast, cumulative inflation rose 44%, and cumulative wage growth rose 29%. When adjusted for inflation and runaway healthcare costs, real wages have fallen.

Has the most expensive healthcare system in the world reduced infant mortality? Not according to the 2009 World Factbook, published by our own CIA. The USA ranks below 45 nations: USA 6.26, Cuba 5.82, European Union 5.72, Canada 5.04, Switzerland 4.18, Germany 3.99, and France 3.33, as examples.

Bankruptcies: In 2007, medical bills accounted for 62.1% of personal insolvencies, an increase of 50% in six years.

In short, the most expensive healthcare system in the world is not making us healthy, wealthy, or wise. To maximize earnings, private insurers ‘cherry pick’ the most profitable subscribers, reject high-risk applicants, eliminate those with “pre-existing” conditions, limit benefits, drop customers, and charge higher premiums. One inevitable consequence of a profit-driven system is a large pool of “medically uninsurable” applicants who are denied access to affordable, quality healthcare.

Another consequence are high premium costs that partition our people into ‘haves’ and ‘have nots.’ An estimated 47 million people lack healthcare coverage, and medical debts will drive a million people each year into bankruptcy. In an anti-Universe, there are those who proclaim: “The U.S. has the best damn healthcare system in the world.” The real Universe knows otherwise (source):
When the Bush/Cheney administration proposed a prescription drug plan for seniors, Big Pharma won concessions that barred Medicare from negotiating lower prices or importing drugs from cheaper markets. Today, seniors pay 60% more for drugs than veterans because the Veterans Administration has the right to negotiate discounts whereas Medicare does not.

Private insurers, demanding an opportunity to compete with Medicare on “a level playing field,” won $177 billion in subsidies payable over 10 years. When one pays money but gets nothing in return, the more apt term is ‘extortion.’

Shortly after the prescription drug plan became law, 15 congressional and administration officials resigned to take multi-million dollar a year jobs with the drug lobby. Thus, crony capitalism perpetuates a feeding frenzy whose purpose is to privatize profits and socialize risks … turning subscribers and taxpayers into chum.

South of the border, Mexican drug cartels wage bloody turf wars for control over territory and profits. In an anti-Universe north of the border, healthcare cartels wage turf wars in Washington for control over profits and monopolies. In the real world, one plus one equals two. In the anti-Universe of K Street, healthcare cartels script this message: One plus one equals socialism, government-run Death Panels, euthanasia, dead babies and dead grandmothers, service rationing, even shortages of toilet paper.

How do you move the debate from the real world into the shadowy anti-Universe of astroturfing and public hysteria?

Easy! Hire a K Street public relations firm such as Shirley & Banister Public Affairs, whose client list includes: AETNA, CIGNA, Ann Coulter, the Heritage Foundation, and the Republican National Committee. Hire Jack Bonner and Associates to spread false rumors with forged letters. Hire Dick Armey, former Republican House Majority Leader, to organize protests and create the illusion of spontaneous public uprisings.

In a year of deep recession, job losses, home foreclosures, and massive bailouts at taxpayer expense, one can always capitalize on the passions of an angry citizenry fed up with chicanery and corruption … and the all-too-human tendency to seek scapegoats for ritual sacrifice. Those who disrupt town hall meetings are angry, but their anger is misplaced because little do they know that those who incite them do not have their best interests in mind.

Manipulating public opinion is easy when you are the CEO of a corporation with lots of money and lobbyists and politicians in your pocket ... and you can always find a willing mob of malcontents and misfits ready to do your bidding.

In three weeks, my friends from South Florida will return for another visit. Again, we will reminisce about the adorable critters of our fabled pond. Again, we will share a splendid meal, watch a DVD or two, or take a stroll on the beach and splash in the surf. How much time do we have left to enjoy a few precious moments?

Meanwhile the stories of my friends from South Florida and the plight of millions of people in their situation remain untold; their voices drowned beneath the chirps and scrapings of late summer cicadas. Real people in the real world have no lobbyist, no advocate to argue their case, influence the debate, or quell the angry mobs … and that is how America’s healthcare cartels win every time.
- - - - - - - - - - - - - - - - - - - - - - - - - -

Not since the 1960s have I witnessed a more rancorous and divisive debate. I end this post by calling attention to other noteworthy articles contributed by fellow writers in the Swash Zone:

Captain Fogg defends
The Public Option and debunks the deceits, falsehoods, and fabrications that have marred this debate.

Maleeper reminds us how our parents’ generation denounced the evils of socialized medicine in
Enough is Enough. How does this generation feel today? She explains: “Years ago my mother was convinced that Medicare would turn the USA into a communist country. Now, at 91, she uses it gratefully.”

Rockync undertakes the redoubtable task of reading the tome known as HR 3200. You can read her section-by-section synopsis
here and here. Rocky’s verdict? Nothing to fear thus far.

Bloggingdino offers
encouraging words but reminds us about the dangers of self-delusion: “We forget that civilization itself – quite aside from democracy or republican self-governance – is a fragile thing, that its strength and perpetuity must not be taken for granted, and that it demands patient cultivation and education if it is to remain viable from one generation to the next..”

On behalf of the above, I invite all readers and visitors to follow our contributors and join this discussion.


  1. Excellent post, 8pus. You put a lot of thought and research into this and it shows.
    The bipartisan squabbling has reached a fever pitch and the screaming serves to drown out the voices of regular folks like your friends who must struggle through the maze of our current system just to get the kind of treatment they have bought and paid for.
    And folks like me who have no insurance. It's not about the cost, which is ridiculously steep. I'd pay it to get the coverage I need, but the last time we tried to find insurance,the pre-existing riders attached would have made the insurance mostly unusable. We each have minor health issues which not only would be disqaulified from coverage but would include "related illnesses" being excluded. The list was so broad, we would, essentially, be making charitable contributions to the insurance execs.

  2. I just don't get this. How has this model of health uncare gotten such a grip on our society? I understand that the birthers and deathers are not thinking straight or are thinking as straight as Rush and company are telling them, but how do those guys manage to continually spin things so that what is an obviously bad system not come up so rotten?

    I'm sure someone has said somewhere that capitalism might work for things, but not for people. Seriously, corporations (and that includes healthcare companies) should not be allowed in any business that directly relates to people's health or that gives them life and death decision-making power.

  3. This comment has been removed by the author.

  4. dmarks - yes, it was me who brought up the nonprofit aspect. As far as BCBS and the others in this current system, they are using all the same loopholes that the for profits are using to their advantage and probably lining the pockets of top execs with it.
    That's the kind of abuse that needs to stop. I have no problem with companies making money, but not by grinding people into dust.
    There must be a set of limits when it comes to the health of a nation and it must include returning healthcare to all nonprofit, otherwise it is not health that drives the system but shareholder profits and that just doesn't work in regard to health care.

  5. I removed the forgoing text from the original post because, it was pointed out to me, the post was to long. I didn't want to delete it outright, so I am parking it here:
    What happens when worlds collide and matter meets anti-matter? A release of energy, one would expect, but not the kind that inspires one with awe and wonder. More like the kind that leaves one incredulous:

    MARK (August 10, 2009 9:16 AM):
    This is not my idea of Liberty and freedom. It may be smart to be insured, but don't I have the right to decide whether i want to be smart or not? Don't I have a right to be stupid?

    TRUTH 101 (August 10, 2009 9:47 AM):
    I respect your standing up for your rights and freedom to not have health insurance. But I also know that if you break your leg, you're going to the emergency room, and if you don't pay, the rest of us will with higher premiums and taxes.”

    MARK (August 10, 2009 12:01 PM):
    Wrong. Hospitals are still privately run companies for now. The Hospital absorbs the costs for unpaid bills. Not the government. Not the taxpayers.”

    In the real world of TRUTH 101, citizenship and civic responsibility still account for something. In the Gospel of Mark, cheats and deadbeats are deserving of Constitutional protection, and a low credit score correlates with low IQ.

  6. Laura, the granddaddy when it comes to analyzing the relationship between people and things under capitalism is "Uncle Karl" Marx himself. I recommend his chapter "The Fetishism of the Commodity and the Secret Thereof" from Capital, Vol. 1. And here, at least, Marx made an excellent point: whatever its many merits, "Kapitalismus" is an amoral system in which objects often seem more alive and determinative of life events than those who create those objects. Commodities make the world go round; we exist to produce them. But enough commie-nism for one day. What we've got us is Kapitalismus whether we love it in general or simply respect it for its excellence when it is operating in areas of the economy where it belongs.

    But this Marx-talk is a clue to the problem with the notion that the market philosophy should be allowed free reign in health care and access thereto: there are perverse disincentives to the provision of care. The insurer takes your money happily enough, but the business model calls for aggressively denying and refusing care to people when they need it most. It also doesn't give a hoot whether you're covered in the first place, as those tens of millions who don't have regular access can attest. That's what we need to deal with.

    To those who oppose the public option – how about we simply make the private insurers behave themselves? No more "pre-existing conditions," rescission, and so forth. In effect, the private insurance market as it now stands is one big de facto death panel, isn't it? Without batting an eyelash, insurers make life-or-death decisions about ordinary people of all ages every day. They put profit first in such matters – how is it that anyone would trust them, given this priority and given a record of callous indifference to the value of individual life? Firms could be un-disincentived, so to speak, with "us the people" picking up the tab somehow or other when moral imperatives (not canceling on the sick or denying them coverage) must be met and the bills paid. You can take a private firm and tell it, "Look, you're private, but you provide a public good, so here are the parameters within which you must work. We will subsidize those measures that must be taken in the name of moral decency and full coverage." And then you spell out the provisions so that the companies involved do, indeed, have to provide a public good efficiently and with some touch of the spirit in which a public good ought to be provided. I presume this would be acceptable to them if they're still going to make money and if the alternative is to lose their right to provide the service altogether. If this can be done, I'd call it reform. Frankly, I think cutting out the middleman would make even more sense, but so be it.

    The status quo is lousy – the market has already shown us how it sorts out problems with coverage: cancel, deny, hack away to your cold heart's content. People not covered? Who cares? Let 'em die in the gutter. Supporters of an unregulated market need to understand that a system itself can function just fine, meeting its own criteria and goals for achievement, while an unconscionable number of those who are subject to that system fare quite poorly and even die. "The health-care industry" is doing fine, thanks – it's quite profitable. But those of us who actually need health care don't always fare so well. The market generates enormous wealth and even distributes it rather widely – but it doesn't care about the millions of miserable individuals to whom almost none of the goods go. And that's the sort of problem we need to deal with regarding health care, however we choose to do it.

  7. The minute you get "people on the left" rhetoric, you know you're dealing with a dishonest person trying to reason by category. This one also reasons by creative analogy, ad lapidem and by some kind of magic transubstantiation. In fact you could make a thesis out of it all. There are very few arguments actually illuminated by these strained and contrived right-left dichotomies.

    "I don't want the government either to be the business 'that directly relates to people's health or that gives them life and death decision-making power.'"

    So you would replace the police, fire departments, the FDA and perhaps the military with private contractors because of some fabricated fantasy about Dutchmen who kill their babies? Is this supposed to be reason? Not hard to reduce this to absurdity, is it? No matter who has a legal obligation to pay the bills your doctor submits, no power of life or death is thereby conveyed - stop lying about it. Denial of coverage by private companies gives one no recourse and does not have to be for a valid reason. Denial by Medicare, for instance is not based on the desires of shareholders and private insurance can be purchased to supplement it's limitations, so stop the bullshit.

    Sorry, the government already is in such a position and I don't think Medicare or the Veteran's administration or the FDA or your local fire department or county hospital has any death panels the way the HMO's do. It does not follow that if the government is paying your family doctor's bill, that it is going to tell your doctor to kill you no matter what stories you or your party come up with.

    The VA doesn't, Medicare doesn't, Social Security doesn't, but private industry does and we have no recourse and little information because they are private and good at collusion.

    You might seem to have an argument if we really did have a "system" that didn't let people die, that didn't reduce millions to second class citizens, that didn't stifle creativity and entrepreneurship and social mobility; that protected the public from hordes of untreated people with communicable diseases, that was the most expensive, one of the least effective and that didn't drive a million people into bankruptcy every year. Denial of services is the life blood of profitability and we all know it and yet you pretend and you proffer that profitability is the mother of fairness, ethics and effective community service. Private companies never cheat and always have the common good foremost in mind and will never, ever let those hundreds of millions in executive salaries, bonuses and perks stand in the way of keeping your sick kid on Chemo. Right, sure, you make all kinds of sense.

    And let's stop trying to link a Dutch hospital illegally practicing euthanasia on some terminally deformed infants a few years ago with a public option in a US health plan. Euthanasia, with or without informed and voluntary consent is illegal here -- get it? Illegal. There is no slippery slope, there is no slope, no logical progression between such events -- you're simply lying once again.

    I'll preempt your inevitable reference to Rahm Immanuel's father's comments about old people in a world of scarce medical resources by saying we are not a country of scarce resources and Rahm Immanuel's father will not be designing, administrating or having anything to do with any government health plan. No logical or factual or possible progression of events, only lies and scare tactics and selling the slippery slope fallacy as a logical argument.

    So what else do you have waiting? It will drive HMO's out of business? Sure, just like State Universities are driving Harvard out of business. Too expensive and inefficient? Vide supra and no, the public option has far, far less overhead. Next fallacy?

    Anyway, I don't know why you bother with this shoddy salesmanship and sleazy sophistry. Nobody here will buy it. It's not a Republican blog.

  8. I agree with your sentiments, completely, but the charlatan, Obama, has capitulated once again. The public option is history. More than likely it was a ruse from the very beginning, and the cooperative was always the plan. The only difference now will be that everyone will be forced to enroll in a plan, meaning no one can go naked.

    What will Obama capitulate on next? Meicare and Social Security? I said from the very beginning he was a wolf in sheep's clothing.

  9. "don't I have the right to be stupid?"

    Yes, but only when your stupidity harms no one else or their property. That's why we require car insurance, for instance: your stupidity can be costly.

    When your stupidity puts others or their property at risk because you get TB and travel on public transportation you don't have that right. When your neglected illnesses put you in the emergency room, you make my health care -- everyone's health care much more expensive. That will actually deprive some people of the ability to buy insurance. So your negligence is costly and ripples outward into society as a whole, giving that society the right to demand protection in the form of health insurance. Your unprotected health is a form of welfare I'm not willing to supply you any more than I am willing to support you because you can but won't work.

    OK? Simple enough?

  10. This comment has been removed by the author.

  11. This comment has been removed by the author.

  12. This comment has been removed by the author.

  13. Morocco,

    Great, another slippery slope -- maybe we can go skiing? (just kidding)

    I won't tell you you're not entitled not to trust him. Mistrust isn't altogether a bad thing -- and yes, I wish he wasn't trying to save the plan by compromise with the enemies of America (only my opinion) but saying it's a ruse is further than I would go. Maybe he thinks getting something is better than nothing and maybe he's right. He's in a better position than I am to assess what's possible to get through congress -- who I trust even less.

    I look on the idea that "public is bad and private is good as misguided," as I'm sure you know. I'm sure we can have both as easily as we have public and private schools, but there's little doubt about which costs more and little doubt that with only private schools we would develop an even bigger uneducated underclass, more people on welfare and a country with far less opportunity for all.

    Having tens of millions uninsured who will potentially either die or become wards of the state isn't good, stifles opportunity for millions and I would prefer some compromise plan that allowed health care to no plan at all but I still advocate a public option.

  14. This comment has been removed by the author.

  15. Oh Mark,

    I'm sloppy?

    You didn't actually read what I said and you've made it obvious.

    There is no question, for instance, that some Dutch doctors euthanized some newborns without parental permission. It was in the papers about 5 years ago. An Amsterdam journalist friend of mine wrote about it in fact.

    You however were asserting or at least insinuating that a public health care insurance option in ht US will lead to euthanasia, or so it appears through the slop and trollery of your rhetoric. That's not honest is it? Just what did you mean by bringing it up if that's not true?

    A bad thing happened in a country that has more social services than we do, so if we offer a public insurance option, a bad thing will happen here. That's your devious attempt at a false syllogism and you have the huevos to call me sloppy? The rest of your presentation was even worse.

    I mentioned Immanuel, as I said, to preempt that stock argument that the other people arguing from the same playbook as you are usually bring up next. Do you understand the word preempt? I didn't say you had already brought it up, which means you didn't read correctly and are only responding ad hominem and tu quoque in reflex mode as you inevitably do.

    Support some of your statements and support some of your logic or you don't get to call anyone sloppy or dishonest.

  16. Mark, old chap. Try as you might to sound reasonable, once again you're giving me a fallacy or at least a very false analogy.

    Might I venture to point out that the bill now in the House does not propose building government hospitals, but only reimbursing existing hospitals and doctors, just as the food stamp program is reimbursing existing grocery stores?

    Do you understand that by supporting the efficacy of the government food stamp program that you are making my case and disavowing yours?

    You're really in a piss poor position to be accusing me of sloppy reasoning, you know, and yet you keep digging deeper into the hole. . .

  17. This comment has been removed by the author.

  18. This comment has been removed by the author.

  19. Again I see some supposedly liberal folk doing that thing where the current president is declared a charlatan, a wolf, and god knows what else. This is premature, politically immature, and unkind -- Barack Obama is one of the best politicians to come along in a while. Let him work some more before you start hopping up and down and declaring him a right-wing corporatist stalking-horse. The fact that the rightists are calling him crazy incompatible things like "socialist fascist" indicates that something in their tiny, paranoid, warped minds tells them that B-a-r-a-c-k spells trouble for their cruel, irrational agenda, which apparently would entail nothing less than the dissolution of civilized life and a universal retreat into caves stocked with plenty of ammo and survival food.

    Something to consider:

    The crafting of public policy must be understood dialectically; it does not take place in a vacuum. One criterion by which to judge President Obama's performance on health-care access is the extent to which whatever policy he gets passed is productive of further improvement.

    Does it, in other words, generate a demand, an impetus, in the direction we need to go? If so, it's worthwhile. If it merely cements the status quo and doesn't lead us anywhere good in a reasonable amount of time, it will fairly be judged an inadequate performance.

    What might well work, in this light, is anything that induces (i.e. compels) a positive change in the behavior of insurers, change that might soon lead people who enjoy the benefits to see that they're paying extra to have something done that they (by means of the government) could do for themselves. In other words, anything that leads people to understand that private insurance is just short of parasitical would be a fine start.

    Why do you think the private concerns are so freaked out about health-care reform? They know that improvements in such an area are almost certain never to be rescinded and that they are likely to generate further demands for improvement. That's why.

    Understood dialectically, almost any solid improvement is a vehicle for further improvement, and these braying, self-interested asses know it. So does the president, I think it's fair to assume, so as the ancient Greek proverb goes, let progressives either "say something better than silence, or keep silent."

  20. This comment has been removed by the author.

  21. No dmarks, I've heard that one many times before and it's a baseless, historically and philosophically inaccurate claim: fascism and socialism have little in common other than that they're both bad. By all means, let's ban bad old Adolph from the scene of our discussions, but the truth is that Hitler had nothing but contempt for socialists -- he put the term in the Nazi Party's German name (NSDAP) simply to take advantage of ordinary people who thought it meant something good. He had absolutely no interest in socializing the means of production and nothing but utter contempt for the ordinary Deutschlander; he just wanted to cut deals with the big manufacturers who could gear up his damnable war machine. Which is fascism. (It's the Italians who worked up the economic and social theory, leading of course, to a takeover by Mussolini in the twenties.) People calling Obama a "fascist socialist" are doing so because they are frightened and hopelessly ignorant, not because they have a profound grasp of European history or economics.

  22. drmarks, I believe you are confusing "fascist" with "totalitarian". It is not technically possisble to be socialist/communist and fascist; it is possible to be socialist/communist and totalitarian.

  23. This comment has been removed by the author.

  24. Excellent post. Did you read Rick Perlstein's column in yesterday's WaPo? Headline says it all: "In America, Crazy Is a Preexisting Condition."

    This part in particular resonated:

    "The media didn't adjudicate the ever-present underbrush of American paranoia as a set of "conservative claims" to weigh, horse-race-style, against liberal claims. Back then, a more confident media unequivocally labeled the civic outrage represented by such discourse as "extremist" -- out of bounds."

    In other words, America has always had the crazy tin foil hatters. We didn't alway have a pliant media that treated this folks like they were mainstream.

    BTW, I love your blog. I've added it to my blogroll.

  25. This comment has been removed by the author.

  26. I'm no liberal, Bloggingdino. I'm not a conservative, either. Just someone who believes in principle. Healthcare Reform has been proferred since Carter's Administration in the seventies. That's 30 years. We've waited long enough. Conyers' Bill of Medicare For All was the only acceptable option, and that's not even being discussed.

    Obama and the Bluedog Dems are in the hip pocket of the Corporatocracy. They are political whores who have been purchased by the highest bidders. Obama just thumbed his nose, once again, at the increasingly dispossessed in this country. He cares not for the down-trodden and his actions betray his words.

    Obama is paving the way for a right-wing dictatorship in this country. As things continue to deteriorate, and he neglects his superficial base (even though his real base is the Corporations who elected him), the Dems will lose the support of numerous liberals and progressives in the 2010 and 2012 elections.

    Give him time? Tell that to the people who are suffering now. They don't have the luxury of time. The time is's long overdue, and Obama, and the Dem Congress, need to show what they're amde of. Unfortunately, they are showing what they're made of....which is nothing....they are empty vessels, merely purchased conduits to do the bidding of Corporations, and furthering the misery of U.S. citizens and all humanity.

    Let's foment a 10 million man march on Washington and throw the Corporations out once and for all. Let's demand publically financed elections and put an end to Corporate Legal Personhood now. Death to Corporations!! Let us find another way to work together. Corporations are not the way. Corporations are destroying humanity and the entire planet. It's a vampiric system that won't cease until there's no blood or soul left. We must act now.

  27. This comment has been removed by the author.

  28. Are you sure you want that?

    Yes, compared to what we have now, but in conjunction with numerous other reforms.

    Another thing we need to do is take back the media from corporate control and give it back to the people, where it belongs. Chavez has done this in Venezuela, and we need to do it here. All voices should be heard.

  29. Welcome, Southern Beale. I saw a comment you posted somewhere last week, can't recall where, followed the link to your blog and struck gold. I hope we will become fast friends.

    My beefs with the MSM are many. These days, news anchors like Lou Dobbs shrink wrap stories inside their opinions and attitudes. The talking heads format is downright annoying, the crosstalk is deafening, and the extremists gain a legitimacy they don't deserve. Most disturbing of all, tabloid trivia dominates airtime when we can use some really good in-depth analysis.

    Most of all, we forget the MSM are run by media conglomerates that act as corporatists. Their revenues come from advertisers who are also corporatists, Thus news channels feed off sensationalism to deliver audiences to advertisers. And they call this "news."

  30. This comment has been removed by the author.

  31. Dmarks, Karlmarx, earmarks, dogbarks. . .

    Who cares what I call you - you know damned well who I'm talking to and in persisting to claim that I am "sloppy" and am misrepresenting you, I might remind you that all this is still on view and most people here can read what you said and what I said and realize you still haven't substantiated any of your assertions.

    Most people here don't find me sloppy or dishonest or in the habit of putting words in the mouths of hysterical lowbrow liars like you who contradict themselves with every other sentence. If that were so I wouldn't be here.

    What a humorous attempt to turn my colleagues against me, you pathetic little troll. Go back and read or shut the fuck up. You're just not smart enough to be here.

  32. This comment has been removed by the author.

  33. This comment has been removed by the author.

  34. "So, based on these definitions, isn't it possible to be fascist and at the same time be socialist/communist?"

    What about a constitutional, communist, military,theocratic monarchy with a side order of fries? Only two possible choices, right?

    Ignoring the framework for a dodgy syllogism you appear to be constructing here, (You're assuming falsely that these two selected descriptions fit all circumstances when they do not)

    I'll ask for the record if you are indulging in distraction by trying to redirect the discussion by introducing a strained equivalence of dubious significance for the sake of mental gymnastics, or are you attempting further to muddy the discussion about health care with the use of poison labels like Communism? (argumentum ad lapidem)

    Sorry if that's too sloppy a question for an acute intellect such as yours, but then I truly don't care what you think, or what sloppy sludge you'll try to sell as something other than prejudice so don't get too worked up about it.

  35. This comment has been removed by the author.

  36. This comment has been removed by the author.

  37. The burden is on you, Marxy boy. I didn't say you said what you say that I said you said. You're making it up and putting on a show looking for sympathy so you can divide and conquer, right?

    All you are about is trying to call things socialism in order to end the discussion. I don't need to go further, but here are a couple of examples"

    "I don't want the government either to be the business "that directly relates to people's health or that gives them life and death decision-making power."

    Of course all governments have that and always have, but I think that's contradicted by saying the food stamp program is good. I think your weak qualification that food stamp recipients are needy and therefore it's OK ignores that uninsurable people are also needy is sloppy illogical thinking, poorly expressed. I couldn't care less if you agree.

    "Then you get situations like the actual death panels in the Netherlands that kill children against the wishes of the families, or the infamous letter from the government healthcare agency in Oregon telling a patient that she'd be better off dead."

    You're trying to tie these results to a public health insurance options and to socialism without the existence of any causal link. Why else would that appear in context? That's ridiculous and dishonest, should I continue? It might take all day, particularly if you're going to claim you didn't write this fallacious farrago.

    I think not. but go on and keep asserting I said you said anything at all about Rahm Emannuel's miserable father -- I didn't and either you can't read, won't read or are dishonest as has been demonstrated.

  38. Jesus h christ - have you nothing better to do than keep up your childish denial fest?

    Why is this so important to you? You're not talking to people you can persuade or who are sympathetic, but you act like a cornered animal.

    I will let people judge your worth without further comment since doubtless this will have 942 more of your posts in front of it before I can hit the submit button.

  39. Dmarks -- I appreciate your civility. To elaborate, I tend to use a word like "socialism" in the philosophical sense, meaning that it applies only to a fully socialist society that rejects the principle of market economics. (Marx called his notions "scientific socialism," as opposed to utopian views, or watered-down versions.)

    Too many people use the term in a slaphappy way to mean basically, "any government involvement in social or economic affairs." But of course that's so broad a definition as to be pointless, right? I mean, All advanced economies are mixtures of loosely socialist-inspired practices and free-market ones. If those most vehemently opposing "socialized medicine" were to realize this fact of modernity, the debate would be more productive and the slippery slope screechings would fall away, leaving the rest of us to get the job done and stop the suffering of those who can't get proper care.

    Anyhow, socialism and fascism are two very different "proposed solutions" to a common crisis: a drastic failure of the European capitalist order, mass poverty and suffering, competition for scarce resources in Europe and elsewhere. The fascists offered misleading rhetoric against big capital, but in truth they had nothing against it so long as it did what it was told.

    Finally, I gotta say, Capt. Fogg, your description "a constitutional, communist, military, theocratic monarchy with a side order of fries" is so much fun that I'm almost willing to sign on. Do they have cool uniforms too?

  40. This comment has been removed by the author.

  41. This comment has been removed by the author.

  42. Hello Morocco Bama,

    I agree that if Obama fails miserably, we could all be headed down a sorry path -- Lincoln reminded us long ago that republics are born and die, that there are no guarantees of longevity. I can understand that your remarks need not indicate silly-left identification or right-wing trollery; my point has to do, really, with what I perceive as the probable effect of the kind of words you use. I think you begin from the standpoint of expecting purity on the part of our elected officials, so their willingness to do business with business, so to speak, then seems like the worst kind of betrayal. I don't think it's fair to characterize Obama that way, and I think it only makes it more likely that we'll all end up going down that sorry path towards collapse and rightist authoritarian takeover. Which we don't want. If this guy fails, we may be in big trouble. If he succeeds in getting at least some improvements, we might just be okay. That's where my money is.

    If I had my way, we would have single-payer access. But the reason why that won't happen is that congress is considerably farther to the right than the electorate, not because Obama is a corporatist devil-worshiper. He seems to me a decent man, and I see no call whatsoever to make claims of extreme corruption or deviousness against him. Political realism is sometimes frustrating and disappointing, but the alternatives are much, much worse. Oscar Wilde was alarmingly close to the truth when he wrote that "democracy is the bludgeoning of the people, by the people, for the people." Well, let's keep cool anyhow.

  43. Sheesh, Dmarks. Political theory is not a strong point for a cephalopod, having spent my entire life immersed in water and the fine arts of ink and camouflage. Nevertheless, I’ll venture a comment.

    It seems definitions of capitalism, fascism, and socialism are inadequate as there is always an abyss between words and deeds. To borrow from Aesop, we touch these -isms as blind men if fail to take words and deeds into account. As Bloddingdino states above, the Nazis adopted the term “socialist” to deceive, but congruency in terminology or theory does not mean congruency in actions. I am not talking about the noble lies and pious deceptions of classical theory; I refer to guile in the Miltonian sense, a word that connotes evil.

    What communism and fascism share is totalitarianism, not socialism, and the operant word is “power.” When I think of capitalism and socialism, the words “inequality” and “equality” respectively come to mind. As Bloggingdino reminds us, most western economies are mixed, meaning enough capitalism to spark creativity and initiative and enough socialism to insure at least some minimum standard of equitable treatment.

    This post on healthcare reform is about restoring a healthy balance between private and public options, like the private versus public university analogy.

    Before the Euro became a common currency, the French had these words minted on every coin: Liberté, Egalité, Fraternité. These words served as a constant reminder to every citizen every time they bought a baguette: The values espoused by their culture, government, and society. Too bad e pluribus unum does not have the same impact or convey the same message.

    And BTW, nothing like a good, spirited discussion, n'est-ce pas?

  44. "You claimed I was about to. Based on some imaginary book or something like that. But I accept it if you have entirely withdrawn the entire bogus Papa Emmanuel claim."

    The others are toying with you as a cat would with a mouse and believe me you are the rodent here. Beware when a cat smiles. It's rarely a joke you'll appreciate.

    I'm not so kind as they nor so tolerant of an ass and I will mention that suggesting that the next item on the list every other rodent is stuffing comment boxes with was the Emmanuel story is not saying you said it, nor is my endless repetition of what I did write, any kind of retraction. You can keep trying to wring a victory out of your soiled diaper as long as you want, but you're still an ass dumb enough to think you're not transparent in your motivations.

    You lose, you lost, you've made no points, gained no agreement, persuaded no one of your honesty or good intent.

  45. This comment has been removed by the author.

  46. Dino,

    "Finally, I gotta say, Capt. Fogg, your description "a constitutional, communist, military, theocratic monarchy with a side order of fries" is so much fun that I'm almost willing to sign on. Do they have cool uniforms too? "

    But you see I didn't say that but said that I said that you said that I said I didn't say until after I said what I didn't say so it's obvious that you can't read and are a very sloppy dinosaur indeed.

    Let me say that again 764 times because you just don't understand that I didn't say what I said but meant what I didn't say but you thought I would say in case you didn't say. Make sense? Of course it does and now I've got the best of you and it's obvious from what I did or didn't say that what I meant to say wasn't what I said but what I was trying to sneak in the back door. You sure are a dishonest old Sauropod which is what you said before you said you were a theropod which obviously means some kind of communist although I didn't say that until after I didn't say it and by the way theropods eat their young, but don't tell me I meant anything by saying that because I didn't say that I only said that because so do communists, not that I'm insinuating anything. I just like what all these words look like, not what they mean and they don't mean anything but what I say they do unless I say they don't and I certainly do.

    All this of course is not about health care, it's about me and how brilliant I am and doing all you scaly folks a favor by telling you so you'll know even though I never did.

    Getting tired now -- too bad because I'll keep saying I didn't say what you said I said about what you didn't say and of course there's nothing to be understood but what I actually said although I didn't say it.

    Had enough - yay! I win! I win!

    I'll be back later to say it all again too!

  47. Today marks the 50th Anniversary of the release of Miles Davis' 'Kind of Blue', arguable the greatest jazz album ever recorded. It is the largest selling jazz record ever and is, in all ways, perfect.


    Hitler was not a jazz fan. Mussolini may have been. We don't know. His son Aldo however was a jazz pianist who, interestingly enough, never repudiated his fathers politics.

  48. Capt. Fogg,

    That's what YOU say even if you say you said you didn't say you said it! Just exactly what an uppity communist human supporter of that Kenyan Indonesian islamo-socialist-fascist death-paneler Obama bin Lyin WOULD say! (Hu)man up and face the music -- I and all twelve-and-a-half million of our discerning daily readers know you and Mussolini's four jazz pianist relatives have been OWNED by a large reptile with a walnut-sized brain! Who didn't just say any of that, at least not the way you deceitfully misunderstood it.

    Daaaaaammmmmmmnnnn! Chalk up another victory for the bloggingdino! (Cut to large khaki dino leaping up and down gleefully, its happiness only dampened by the inescapable fact that it has no opposable digits on its forepaws, and never will have them.)

    But seriously, I think Octo's idea of consolidating the health-care issue into one big entry was a fine one that has generated useful discussion so far.

  49. Useful more to the hooligans who arrive making cagey references to imagined evils of European Socialism, euthanasia and such and then just casually begin another ill-constructed discussion of how socialism and other forms of demonic authoritarianism are really pretty much the same and expect you not to see the agenda and accusing you of misquoting it.

    Useful to the operatives who have turned it into a free for all instead of an kind of reasonable discussion of ideas. It's what you get for giving them the respect they don't deserve.

    At least in the Munich beer halls they serve beer. Pretty good beer too.

    Hey but I never said that and I'll keep disrupting the meeting until it becomes true by the power of faith and denial and a sack full of lies.

    It's like Gresham's law. Bad comments drive good ones right out of the blog.

  50. Let's be brutally honest, people die. It doesn't matter how much you spend, sooner or later it is going to happen.
    So the question is who gets to decide enough is enough. Is it a question of when, how, but the who is the argument. Do we want individuals themselves, private business, or government making the decisions. We would like it to be decided by the individual and his/her family but current reality dictates that more often then not the other two are going to be the party crashers.
    Throughout history we have seen the results of government making decisions of who lives and who dies. It is probably the reason Hitler jumps to the forefront of our minds so fast, yet there were many others. The government by its very existence knows way to much about us, and in turn could make decisions based on political expediency and persuasion of power. This is not expectable by those who truly wish to be free as our constitution would allow. We are not like other nations who have gone before us, and perhaps it is unfit to use them as a comparison.

    The question of private business has yet an answer. The key is money. It is always the key and no matter the group this will always be the dominant question. The decision of the individual often comes down to money. The decision of the government often comes down to money. The decision by business will of course be based on money.
    To this conjures up another question, How Much is Enough? Is there a limit? Should there be?
    Star Trek is best quoted here, "The good of the many out way the good of the few, or the one." Is this an expectable reality? If so then someone must draw the line. I would prefer private business. There are far to many other things on the mind of government for me to grant them this.

  51. Capt. Fogg,

    I think there are some very good comments in here, any rhetorical stuff aside. I would pick up briefly on something Southern Beale wrote -- yes, I saw that column by Perlstein, and the analysis therein seemed accurate to me: it wouldn't be too difficult, I suppose, to put together a "Retrospective of Crazy" exhibition serving up the insane or devious pseudo-arguments set forth at various periods of our history to justify all sorts of injustice and prejudice. Any hint of progress or genuine decency brings the crazy folk out of the woodwork. But now any sort of polite agreement amongst the much-maligned "media elites" NOT to talk about that stuff seems to have broken down. All one has to do is pack heat, or scream real loud, or burst into tears whilst slobbering something about "the way things used to be in this great country of ours" (i.e. before we had a mixed-race president, I take it) and one ends up on national television purportedly speaking for all of us. That phenomenon makes it incredibly difficult to have a reasoned, calm discussion about anything. It's as if the 2% edges of the discursive Bell Curve are the only sides that really get our attention. What 70% of Americans may well want is filtered out in favor of the cruel and the misguided. And that filtering, of course, serves powerful interests. But I'll no more on it for the present, because it only leads to the lugubrious possibility that we are, indeed, a republic in steep decline.

    Progressives/liberals need to stay cool and try to get a decent reform package through the Congress. We done some good things before, and we can do them again, in spite of the noise.

  52. Without getting into all of the various definitions if "isms" etc that have been bandied around here already - I am increasingly a socialist or whatever you want to call it. Why? Because in almost 5 decades of life (the last 3 of which I've been politically tuned in) I have forever seen around me - with growing fervor as the years tick by - examples of capitalistic greed. AND I am sick & tired of it & of apologists for it.
    Political theory aside - I am sick of living in a greedy, unkind, self-centered, sanctimonious world that is tied up in a capitalist bow which trumpets the words - "AH! The American Dream!"

    Any country that would allow health care to be for profit & decisions about people's well-being a matter of profit is greedy & selfish beyond belief.

    It's that simple.

    This country is FAILING to do the right thing - again - & I blame both parties in Washington for this continual outrage.

    AND - is it me or are the people ranting & raving about Obama's ideas actually insured? Why aren't the uninsured raising equal hell? I find it continually fascinating that it is those paranoid of losing something that hoot the loudest & not those with everything to gain.

    Maybe I'm missing something.

    I'm taking my cranky self elsewhere. This is why I have been largely mute on all of these health care posts - great as they have been - I have lived the hell of it too personally to be able to calmly discuss it. I am long out of patience -

    Thanks for listening.

  53. Um, you do know there is no provision in the health care bill to allow the government to withhold health care, much less a Death Panel making life or death decisions? No matter how much you detest government in principle, the facts are the facts.

    The only thing we would be letting the government do is what we're already allowing them to do with veterans and medicare participants -- we're allowing to pay the bill!

    The idea that the plan would allow such decisions to be made by the government is false, specious, and not true. How many times does it have to be said?

    The point of reform is the huge problem with private companies literally killing and bankrupting people every day.

  54. Arthurstone

    Hitler wasn't a fan of modern art or music. German expressionism used to drive him bonkers and most anything but kitchy postcards of the alps he considered "decadent" or "Entartet"

    There are a lot of things far right minds cannot understand, maybe that's why they're so hostile?

  55. "Um, you do know there is no provision in the health care bill to allow the government to withhold health care"
    There are all sorts of limitations undisclosed waiting to be determined by the top administrator. You will read this provision over and over throughout the entire bill. These limitations do not specifically determine death of the patient but the end will be closer.
    The Death Panel thing is more of a joke. The issue is death with dignity counseling. Look at the many triggers of this. It takes advantage of those who are most vulnerable. There is no clause once decisions are placed in writing to stop this vile activity.

    A real look at the bill will give you plenty of pause. The constant reminder that someone has yet to define the limits of any specific area of care should scare the hell out of you. You are singing praises of a plan that is a hollow shell. Until they put flesh and bones on this skeleton the answer is NO.

  56. To Ablur,

    I would say that in a republic, people should not get into this mode of thinking. You're coming too close to describing the gov. as an enemy or quite likely to become such. A certain former president's anti-constitutional antics aside, we're still not living in Orwell's 1984 nightmare state. I will trust big business with my life as I will an adder fanged. At least with the US gov., there's some rational expectation that they ought to represent and serve my interests, however imperfectly. I can say that while still maintaining a healthy distrust of anyone who wants too much power -- something the Founders counseled, of course.

    With regard to insurers, I discover no such expectation of representation. They are effectively monopolists over a large segment of the population, and money tends to make them behave with destructive indifference, not equanimity. They aren't likely to do right consistently unless you make them do it, by law. Trust doesn't even enter into the picture. The "cash-nexus" sees to that, for anyone who understands the deep resonance of that Carlylean phrase.

  57. To Bdino - You can change companies and demand concessions as a public. You can't change government. They are all knowing and will have a monopoly on care.

  58. Squid, my -ism inclination has tilted toward socialist ever since I lived in England, and that was over 20 years ago. What disturbs me as much as the inequalities of runaway capitalism are the phony values that bend and contort people into inhuman forms. The American Dream is a materialist and acquisitive dream, not a philosophical or spiritual quest, and Willy Loman represents capitalism's quintessential casualty.

    I am registered as an independent, not a Democrat. Frankly no political party allowed to operate in this country comes even close to what I would want. Even if there were a quasi-socialist party to my liking, I would still distrust it because I know that the default condition of the human species is always chicanery and corruption.

    All the more reason why healthcare should include a public option contrary to the paranoid hysterical, histrionic ravings of those who argue otherwise.

  59. Yes, you can change your gov. It's called voting.

  60. Any program enacted by government comes the closest to eternal life.

    Fixes are slow and results are poor.

    The private sector changes on demand and follows the "vote" of money.

  61. I'm taking my cranky self elsewhere. This is why I have been largely mute on all of these health care posts - great as they have been - I have lived the hell of it too personally to be able to calmly discuss it. I am long out of patience ---SQUID

    Those are my sentiments as well. I have read this fine post and linked to it over at my blog with an additional note on how sane blogging is done.

    I suffered through breast cancer 3 years ago without insurance.

    I'm reluctant to say more publicly about this, since I have been smeared so relentlessly by rightwing bloggers, and I really don't want them sniffing out my personal stories so that they can further demean me.

    I'll say this. Mass. General Hospital and the state of Massachusetts were there to get me through the nightmare.

  62. Ablur, That's naive to the point of being mind-bending. Signing off on any further responses to your posts.

  63. Shaw, I could not imagine what it is like facing a potentially lethal illness such as breast cancer without health insurance. My apologies to you that this comment thread got so side tracked on "isms" and other stuff when the core issue is about a fundamental human right to decent health care.

    Not to offend folks like Ablur and Mark, but it is a self-indulgence to go off on these tangents while ignoring the real suffering of others. I can well understand feelings of exasperation and hurt when the callous disregard of others hit you in the face.

    So, before this comment thread ends, I ask everyone to stay on topic ... with sensitivity and respect. It would also be true to the topic if more folks came forward and shared examples of what it is like facing such an illness either uninsured or under-insured.

    That is what this debate is supposed to be about.

  64. Thank you 8pus for bringing this post back to what matters most - I'm one of those who doesn't have insurance. Tried to get it and I would pay for it even though what I've been quoted is ricidiculously high. But, the pre-existing conditions riders along with the "related illnesses" riders would leave my husband and I essentially making charitable donations to insurance execs.
    It's really no coverage at all.
    Over the past few days, I've developed a problem that is probably going to require me to see a specialist and have expensive procedures - frankly, I don't give a shit what the hell anyone calls it; I need reasonable health insurance with sane coverage now.

  65. Squid said, "Political theory aside - I am sick of living in a greedy, unkind, self-centered, sanctimonious world that is tied up in a capitalist bow which trumpets the words - "AH! The American Dream!"

    Any country that would allow health care to be for profit & decisions about people's well-being a matter of profit is greedy & selfish beyond belief."
    My sentiments exactly; thank you for putting it so succinctly.

  66. Rocky, Shaw, Octo, and Squid --

    Yes indeed -- what you say is why Medicare for all would be best, if we can get it. The evidence against "the market" in health-care access came in long ago, as anyone living in the real world should know. The fact that we still have to argue the matter indicates that a lot of people never learn anything, perhaps not even from that great teacher sad experience.

    I'm trying to remain cautiously optimistic about our prospects for genuine reform soon. That's not easy to do just now, but dinos are rather stubborn animals.

    On "isms," yes they are annoying. At the same time, they must from time to time be addressed because some folk wield their misguided (or in some cases dishonest) definitions like weapons of mass destruction to turn back the clock.

    I think the Administration sort of opened themselves up to such shenanigans by not simply calling the reforms something strong like "Medicare for All." Most people seem to like Medicare a lot, as I think they should -- it works.

    There are the facts on the ground -- real people's lives and how the current patchwork system deals with our health issues -- and then there's the image campaign. With a change this huge in the offing, image is important, and it is here that the Administration has given the opposition some openings. But we should all hang in there, write to our reps and senators about our own values and situations, and see what can be done.

    As I write this, some dumbass in a pretty suit on one of the cable shows is driveling about how "we" "don't want" "socialized medicine." They never give up. It's amazing how stupid a person can be and yet get elected to high office.

  67. Octo asked for personal stories - my retired parents - my father has a severe illness - has had for years - on their old health care plan they always received two "eob's" - one from their insurer one from medicare. Then their former employer (who still covers them) switched health insurance companies. NOW my parents receive ONE "eob" from the insurance company ONLY. Guess why? Because the new insurance company controls medicare - that's right - the gov, so we found, has struck some deal with some PRIVATE insurers to "handle" medicare. And NOW - my parents' have to pay MORE to cover my very ill father's care because NOW that the PRIVATE company is handling what WAS a public plan (medicare) their benefits have been slashed.

    Need I fill in the blanks for anyone still believing private FOR PROFIT is better?!!!

  68. The system we have now protects profits and not health. Many right leaners have offered the suggestion of reducing costs by promoting preventative health care measurers. These of course are the same people that want to eliminate physical education in our schools because it costs too much. God forbid our taxes go up a bit in spite of fat children.

    The point is, you can't reason or speak logically to these people. Town hall meetings are packed with people, many that have no health insurance themselves, repeating the same nonsense Beck and Limbaugh told them to say about socialism and freedom. Your kid is crying because his leg is broken you don't care if the doctor's name is Hitler. You want your kid to stop hurting. The focus needs to be on the people of our Nation as a whole. The insurance lobby has done a remarkable job keeping it on meaningless scary phrases.

  69. My mother-in-law has a heart problem. Her heart has always beat with its own pattern. She is 73 and very active. She has to take medication to help with beat regularity. She has been taking this medication for years. Since switching to full medicare 8 years ago, she is no longer allowed to have the medication she has always taken. It doesn't match their formilay. They keep rotting different medications trying to find one that works. When we already know what one works. Sorry can't do that one. There current thought is to give her lots of blood thinners. One wasn't good enough, so why not two different ones.
    She has had to go to the hospital twice for nose bleeds. They still refuse to give her what works.
    40 years of private health insurance and she was always able to get them to make an exception. Not the government, they know better. She probably won't last another year on our fabulous government system.

  70. As many of you know, my husband and I took care of a cousin with lung cancer until her death last month.
    We are also handling (untangling) her estate which includes making sense of all the final medical bills.
    Her "great" private insurance has refused to cover roughly 1/2 of some very large bills. But that is not the galling part.
    What really makes my blood boil is their denial of payment for an ambulance to transport her from the hospital to Hospice.
    She would die just a day and a half later, she was on a morphine pump, plus shots and one lung was filled with fluid - the insurance company denied the ambulance claim BECAUSE THEY DETERMINED THAT SHE COULD HAVE BEEN DRIVEN BY CAR TO HOSPICE!
    ablur - go to the drug company's website. Most of them have programs to help people who can't afford to buy their expensive drugs. I have had private insurance that refused to pay for a name brand drug that worked for me because there was a generic in THEIR formulary that they insisted was just as good. I had to buy my own medicine - so much for the fabulous PRIVATE system!

  71. A certain clinical coldness is the problem most easily identified as accompanying a big bureaucratic organization – not wanting to make an exception or listen carefully to what an individual really needs to stay healthy. (Ablur's example speaks to that problem, I think.) That said, many people seem to have found private firms guilty of similar coldness, so "bureaucracy" isn't only the province of government, alas. It's especially hurtful, in my view, when one suspects that confusion and failure to listen are actually part of the offender's business model for maximizing profit. But either way, it's a problem not to be dismissed.

    Personally, I haven't had huge problems with Medicare. They took care of a relative quite well over a terrible period of several weeks, and paid just about all the bills, though I'm sorry to say that old age won out in the end. Neither have I encountered major issues with my own private individual plan, with the exception that they informed me when I broke a bone during a bike ride that, well, ambulance trips aren't covered. Hmmmm…. I guess those flashy contraptions aren't medically necessary. Man, did I feel like a stupid dinosaur when I realized that my three-block ride to the local emergency room had cost me about $900! I don't think it even counted towards my deductible. So I second Rocky's post. Ambulances are not "bells and whistles."

    One problem I've seen has to do with hospital billing procedures – during my relative's illness, I found some hospital personnel disorganized and inefficient: failing to submit necessary information already given to them was a common issue, and that was hard to understand since if you don't fill out the paperwork properly before sending it off to Medicare, you don't get paid anytime soon. But Medicare personnel were unfailingly polite and helpful, and such issues were eventually resolved by means of their advice.

    My main concern about private insurance isn't about the small stuff they won't pay for – it's what I suspect they would do if I suffered something catastrophic. I see no reason to trust them, and anyone who reads journalistic accounts knows there are plenty of concrete instances in which private insurers have kicked people when they were down. The minute you become a liability, you're in peril of being culled from the customer-herd. So much for security and peace of mind, which is partly what they're supposed to be selling, isn't it?

    Finally, I have learned over the years that when someone you care about is very ill, it's vital – a matter of life or death, really – to stay on top of the care that person is getting. Doctors and nurses may have the best intentions and much skill, but they're also incredibly busy, stressed-out, and don't always have all the information they need about the many patients they are treating simultaneously. Insist on talking with them and keeping them informed. Visit the patient as often as you can, and get other family members to help if at all possible. DO NOT BE PASSIVE OR SILENT in the face of a loved one's illness, or simply trust that the doctor will always do everything that needs to be done in a timely manner and make all the right decisions. Doctors, too, are capable of turning startlingly passive and becoming uncommunicative in a crisis, and it's arguable whether such passiveness and silence always stem from the wisest application of the dictum "do no harm." They need your and the patient's input, even if a few of them don't seem eager to acknowledge the fact.

  72. "The private sector changes on demand and follows the "vote" of money."

    Or so the party line holds. In fact, money votes most often for monoply and fewer choices - when it is allowed to do so. It's a shame that one can't present proof of this without being shouted down as a "socialist" by people who redifine their terms faster than the HIV virus can mutate.

    Nearly all arguments against government involvement in anything except war are repetitions of such credos without factual support of much substance. They are essentially faith-based arguments which in today's American means hate-defended arguments.

    People take it on faith that Canadians have to wait eons for an appendectomy and it cascades from the mouth of one expert after another, but of course it doesn't seem to be true. Today's Newsweek claims that Americans wait longer to see a doctor than almost anyone in a first world country. Same goes for arguments about efficiency - all credo, few facts.

    It's quite possible that one private insurance company treated a patient better than Medicare and I don't question the story. I do question the extrapolation which shows that all private companies are better than medicare. There is no evidence for that pronouncement and much against it.

    But worst of all is the refusal to admit that so far, the plans posed by the Democrats will allow anyone to make the choice for himself rather than trust to the mythological tendency of profit based systems to put a customer's health above their stockholders dividends.

    I don't understand why people have abandoned reason when discussing health care, but they certainly have and they probably have abandoned most of it with regard to anything to do with any kind of reform. We simply can't discuss it without wild hyperbole and hysterical fugue.

    Personally I'm too sick of the ignorant, deluded blowhards, bullshitters, bullies and boors to have much more interest in the subject. A nation of pathologically cheap chiselers and irrational believers too confused to see the need to invest in the modern world might not be worth saving.

  73. Oh yes, I forgot to apologize for the sloppy writing and dishonest reasoning. Everything I write is like that, you know.

  74. Should I even attempt to discuss Economics?
    Supply and Demand has been a common understanding for thousands of years. It took capitalism to fully utilize this common understanding.
    The private health insurance industry doesn't have a monopoly, the new government version will. If you perceive and fear the monopoly of health insurance then a government program should scare the hell out of you.
    It takes years for a government program to change often too late for the good the change was for. Private business reacts and changes in weeks and often just days. True customer needs can be met and adjusted too on the fly. Not possible under a government program.
    The horrible act of making a profit is the sole reason private healthcare seems to be hated. The alternative is taking a loss. Our government is indeed the quintessential leader in that category. Obama has already surpassed every president in deficit spending.
    I addressed this plainly above, everyone is going to die. Do you want no expense spared to save every life? In fairness no one of us is of any greater value then another. When the money runs out and others are in line with needs, what do we do? Will you be able to look in the eyes of your loved one who is suffering and say, "They ran out of money to save that guy over there. They don't have any left to help you." Someone has to set limits, morally, ethically, choices have to be made so everyone doesn't suffer for the good of the one.
    We have all played the "life boat" game.

  75. "The horrible act of making a profit is the sole reason private healthcare seems to be hated. " Now that is surely not what folk here are saying. Do you really think that's a convincing summary? Profit is fine in sectors where it makes sense to let it work. Health insurance, I think most have been suggesting, isn't one of those sectors. And it seems best not to reduce debatable social matters to bogus "laws of nature" like supply and demand, if indeed that's where you're going. We don't need to bind ourselves to such principles in all areas of life and then sit around braying when they don't serve us well.

  76. Where do you draw the line? How much is enough? Could you tell your love one we have no more?

    There is no endless supply! The dreamy prose is nice but break it down to reality for me.

  77. Dinosaurs have no dreams worthy of the name. And who said anything about there needing to be an endless supply or a bottomless commitment to health care? I would suggest that our society's resources are more than sufficient for dealing with our health needs and a lot of other things besides. You apparently assume a social sphere in which somebody has to get eaten by the sharks so that others may live. Does that mean that you are a flat-out C19-style social Darwinist addicted to the principle of scarcity and "nature, red in tooth and claw"? If so, try mediation when you speak of humanity and nature in the same breath. It's a useful thing and, like language, sort of separates people from animals. Look it up. I've no more time for this foolishness. I'm just a lizard anyhow….

    Now, perhaps you cannot imagine the humane generation of a system in which adequate resources are generated and distributed sufficient to take care of the total needs of the population subject to that system. In other words, there's no reason to suppose that even if we helped everybody who needed help (even lots of it), the result would eat up the entire GDP, or half of it, or anything approaching that. (I've read somewhere that the figure is about 17.5% at present and rising under our current irrational system.) If we want good health care for all, we need to make it a social priority, not use the rhetoric of slashing and burning, cutting to the bone, shoving people out of the lifeboat, and so forth. I refuse to be drawn into a competition over who can be the most mean-spirited, parsimonious jackass in the room. To paraphrase Groucho, that's a club I wouldn't care to join.

  78. Yes, and France is 9.6%. I read the WHO report.

    Reality does not skip over some and impose its limits on others just because you wish it.
    Look at the vast deceases demanding a cure that no amount of money will resolve and return the life. I pray that all those causes can one day be solved. I know many who suffer an extended name affliction that many attempt to raise money to cure.
    Life has limitations. If there can be no recognition of this fact there can be no discussion that will yield any value. Perhaps all this is utter foolishness.

  79. Right, people eventually die and life is "limited," so let's all just give up. I think you may be confusing health care with faith healing or the quest for the holy grail or something. Instead, it's about making us well if possible, and alleviating our suffering when it isn't possible to cure us. It is about the amelioration of the human condition. It's about being civilized, dammit. Your entire response is a non sequitur. Gotta get some work done. Peace out, y'all.

  80. ablur (@6:28 PM, August 18, 2009): “Should I even attempt to discuss Economics?”

    Are you suicidal? There are folks in this forum with degrees in economics, like the London of School of Economics, for instance, and Octopus hates to see the sight of blood.

    ablur: “ The private health insurance industry doesn't have a monopoly …

    You didn’t read this post or any of the citations linked herein. You didn’t read this comment (@9:23 PM, August 17, 2009): “ I suffered through breast cancer 3 years ago without insurance.” Or this comment (@11:25 PM, August 17, 2009): “ I'm one of those who doesn't have insurance.” Or this comment (@8:14 AM, August 18, 2009): “ And NOW - my parents' have to pay MORE to cover my very ill father's care because NOW that the PRIVATE company is handling what WAS a public plan (medicare) their benefits have been slashed.”

    Ablur, do you always live inside your own head and NEVER read or listen to ANYONE else??

    ablur: “ Private business reacts and changes in weeks and often just days.”

    Like General Motors? Chrysler Corporation? AIG? Lehman Brothers? Bear Stearns?

    ablur: “ Obama has already surpassed every president in deficit spending.

    Oh really? Then feast your eyes on this.

    ablur: “ I addressed this plainly above …

    So far, your score is zero. Oh, yes, I forgot to quote one more comment:

    bloggingdino (@9:26 PM, August 17, 2009): “Ablur, That's naive to the point of being mind-bending..”

    Agreed. Octopus is late for an appointment ... getting my tentacles waxed. Now go away ... pleeeze!

  81. In 1990 our employee health insurance was provided to us by BC/BS and less than half of our employees elected to buy health insurance.

    It was expensive and had gone up every year, their bill paying was a disaster and their network of doctors was quite limited.

    So, we decided to set up our own insurance and we took the big jump into self funded insurance. We wrote our own policy, developed a network of doctors and started paying our own bills and we set our rates at what BC/BS was charging us.

    We were self funded for 10 years. Not once did we raise the rates our employees paid. After 3 years we added dental coverage to our self funded insurance plan. We ended up insuring over 85% of our workforce and actually had people applying for jobs because they heard our fringe benefits were awesome.

    The biggest mistake I ever made was getting out of the insurance business in 2000. I made this decision because our claims payor was having issues and I believed that we did not have the expertise to continue on with our own insurance. It was consuming so much time and effort we could not focus on our business...

    Since then our rates have gone up every year and we have changed carriers three times. It is just one disaster and pissed off employee everytime you turn around.

    Even my doctor doesn't like our current insurance company because he says it takes forever for them to pay him (he misses us paying in three weeks and whined about bringing back our self funded insurance again!)

    We will never get meaningful healthcare reform because the insurance industry will not allow it and thus Americans will be bled dry with higher costs every year and more government debt because of the ever increasing cost of funding medicare and medicad (lets not forget we have the Iraq War and the vets to fund and we have the baby boomers retiring shortly).

    We don't have meaningful debate because the public doesn't understand healthcare and the lobbyists are keeping it that way.

    Eventually healthcare will be 'socialized' because the federal government is already the largest player in the healthcare world and only going to get larger.

    Insurance companies will continue to only cover the healthy and throwing the rest into medicad/medicare and or letting them opt for free treatment at the expense of our hospitals.

  82. TAO, fascinating! Although I have heard of the self-funded insurance option before, this is the first mention in this post. How does it work? What is the optimum range (min or max) of employees to make such a plan viable? Did you use a consultant or service to establish this plan. Are there independent claims paying services available? What are the risks/impediments/barriers to entry, other than the ones you mentioned?

    Why do I ask? For the private HC insurance industry In the 1990s, the ratio of profits to disbursements stood at 5% and 95% respectively. Today, the ratio is 20% and 80% respectively, a four-fold increase. Assuming the current healthcare reform initiative fails, would this represent a viable option within the private sector until the next window of opportunity opens for a public option?

  83. Tao and Octo,

    Yes, that is an attractive idea. If co-ops were implemented on a huge scale, as some politicians are suggesting, I suppose there would have to be an initial guarantee that the co-ops would remain viable long enough to get off the ground, and then some. Credit unions have no trouble getting members because they are backed by the feds just like the for-profit banks. One feels that they are sound institutions and a good alternative to the for-profit giants.

    On the whole, I would prefer a gov.-run public option if we can get it because it seems like that would be the most secure thing. What do you think?

  84. Surfed your blog.

    Thanks for posting some of the provisions of the bill amendment by amendment.

    Thanks for exposing the false arguments of the bill.

    Thanks for visiting my non-political blog.

    I will blogroll the Swash Zone, and be back.

  85. Welcome, Tom, and thanks for visiting ... especially for your support of healthcare reform.

    Some good news this morning: There is a rumor circulating that the Dems may use the nuclear option to pass the reform bill in the Senate. Drastic times call for drastic measures.

    Of course, the risk is that when the political pendulum swings, this will someday be used against the Dems, but when one considers the immorality of a "have' and "have not" society, I say: pourquoi pas!

  86. "I say: pourquoi pas!"

    Spoken like a true Liberal. We Conservatives prefer "Warum nicht"

    It's important to see everything in terms of Conservative and liberal in order to keep facts and logic at bay. But seriously. . .

    I continue to marvel over the observation that, seemingly alone amongst the various public Vs. private options life gives us, health care stands alone. That suggests that the fierceness and desperation of the arguments against a public health care option is really an artificial one.

    Public Vs. Private education, public vs private law enforcement, weather forecasting, tax collection, inspection of food, drug testing, public vs toll roads, bridges, airports, fire departments, ambulance services and the host of other things that co-exist: these discussions run along different and more rational lines.

    Whether a bridge should be privately funded rather than by the state; does that bring on comparisons to Hitler and sly suggestions that it leads to euthanizing infants and Communism like DSnarks said but didn't say? Rarely, although it's really the same kind of argument and the results of those decisions never have the apocalyptic results the apoplectic detractors of public health care predict.

    As I've been saying, Eisenhower's national highway program was an extraordinary expenditure of public funds that could have been funded privately. Ike was not a Commie and there were no dire results, booted the economy enormously -- and yet it's still possible to build all kinds of things in the private sector.

    Public land grant Universities haven't put private schools like Harvard out of business and a public health care option will neither put private health care out of business or drive us to killing our grandmothers. So why the hysterical lies and flights of fake speculation?

    In fact we have had public health care options for decades and it's been a boon to private insurers.

    How dull does one have to be not to see that the argument is about something else and is as dishonest as it is irrational? How obvious is it that our friends from Trollhattan are only here to divert the discussion onto some side track where it can be derailed and buried in mud and slime.

    That's what they're here to do. That's all they're here to do and they will continue to try it until they burst open like one of Limbaugh's anal cysts and if you cut their opinions into little pieces, they will reassemble and come back at you with the same stupid, irrational, transparent, faith-based diversions.

  87. Capt. Fogg,

    One problem with the whole concept of debate is that it would appear to call for intelligent opposition. On an issue such as health care reform, there doesn't seem to be any, whatever their intentions. All you can do is either ignore them (the best way and our usual way here on SWASH) or use their juvenile hokum to make some valid point of your own that relates to the subject at hand, thereby avoiding the "sidetracking" you mention.

    I think conservatives in congress want to hold the line at the very least, and to turn the clock back several decades if they can. Perhaps they would prefer to live in a Hobbesian universe. Keep it solitary, nasty, brutish and short, eh? Because anything more would smack of artifice, and artifice implies imagination and intelligence. As so often Jon Stewart of The Daily Show cuts to the heart of the matter when he characterizes some of the town-hallers' arguments against our too-too artificial and intelligent president, "Obama scary! Obama make sun go away! Grrrrr!" That's pretty much what democracy without education leads to, isn't it? Must have coffee now. Me so scared of Obama me can't think!

  88. Capt. Fogg,

    An dino addendum to previous comment -- in response to your question about why there is so much to-do about public/private distinctions in health care, I believe that for the far right elements now ascendant in conservative speech and behavior, universal access to health care may be the Alamo. If we get anything even remotely resembling single-payer -- a "public option" or perhaps even strong non-profit, gov-assisted co-ops -- WE WILL BE JUST LIKE THOSE EUROPEAN SOCIALISTS!

    A vigorous, irreversible reform in health care would bring us up to speed with the European World-Government Promoting Great Satan, so it must be opposed with every weapon in the arsenal of destructive fanaticism.

    In a sense, their fear (while primitive, even atavistic) isn't misplaced: giving ourselves decent, near-universal access to health care would undeniably show that we are becoming more cosmopolitan, more "Euro" in our sensibilities. And that can't happen.

  89. To all,

    This morning's HuffPo offers a hilarious clip of the Honorable Rep. Barney Frank going after an anti-O opponent with his usual razor-sharp wit. See "Barney Frank Confronts Woman ..." This guy is always worth listening to.

  90. Thanks dino. Why fantasists like this pathetic woman aren't called on their bull***t more frequently is beyond me.

    Excellent. Frank is a treasure. My representative Jim McDermott has the same sensibility with a bit less biting sense of humor. We need lots more of these sort of representatives in DC.

    The Kent Conrads and Max Bachuses are irksome.

  91. Amongst the Republirabble I have to deal with, the very mention of Nancy Pelosi or Barney Frank produces an instant round of thigh slapping guffaws. It doesn't seem that any of them can give me a reason other than to say they're ridiculous, liberal and ruining the country.

    Being a straw man seems to have little to do with the kind of straw you're stuffed with.

  92. I couldn't believe the video I saw of that lady saying "Heil Hitler" to a Jewish, Israeli-American showing support for the public option.

    He firstly yelled at the lady who said the "Heil Hitler" saying, "How dare you say that to a Jew?!!" Then we proceeded to tell her how he needed something minor done at the E.R. and it cost him $8,000.

    Do you know what that lady did in response? She mocked him by mimicing a crying baby!!! These people are sociopaths and I'm not kidding. O.k., not all who oppose the public option are sociopaths but many fall under the clinical definition according to their words and actions.

  93. This comment has been removed by the author.

  94. Yes, I saw that.

    I don't remember who famously wrote that all the death camps of the Third Reach could be staffed from any small American town, but it's being illustrated over and over again.

    People are capable of doing anything at all if they get just a little support and little old ladies can stand by while children are thrown in ovens.

    God damn them all.

  95. I'm late here, but this is an excellent post, Octo, and the discussion that followed quite enlightening.

  96. This comment has been removed by a blog administrator.


We welcome civil discourse from all people but express no obligation to allow contributors and readers to be trolled. Any comment that sinks to the level of bigotry, defamation, personal insults, off-topic rants, and profanity will be deleted without notice.