Hold your nose and swallow

medicinekidsClose your eyes. Hold your nose. Open your mouth. Now swallow. – That’s how my mom tried to keep me from gagging when taking medicine. That’s what our Democrat leaders are telling us now about health care “reform.”

Another gigantic example of big event legislation. A massive bill way too big to fail – or read – or understand – or debate. Chock full of things for just about every special interest so Dems can finally deliver a health care bill.

  • No insurance? We’ll give it to you.
  • Can’t afford insurance? We’ll help you.
  • Uninsurable? No longer.
  • Have insurance? We’re not going to change a thing.
  • On medicare? We’ll close the prescription donut hole.
  • Own insurance or pharma stocks? We’ll increase your markets and your profits.
  • A health care provider? We won’t set prices.
  • Against a woman’s right to choose? Us, too.
  • Against expanding Medicare? Us, too.
  • Against a public option? It will be in name only.
  • Anti-deficit? It’s paid for with savings and new taxes.
  • Anti-health care reform? Your state can opt out.
  • Anti-Obama? Won’t go into effect until after the next presidential election.
  • Anti-immigrant? Us, too.
  • Own a business? Have we got some loopholes for you.
  • Middle class poor with lots of debt? Okay, nothing for you, but didn’t we just pass a tax cut and credit card reform?
  • Healthy and just starting out? There are no jobs anyway, go for Medicaid.
  • Work on K Street? You’ll make your bonus.
  • An accountant or lawyer? Consider it a bailout.

H.R.3590 – Service Members Home Ownership Tax Act of 2009 (this is the actual name of Senate health care bill which is an amendment of a bill already in the cue to speed it up – aka: The Patient Protection and Affordable Care Act) runs some 2,074 pages containing 327,911 words (War and Peace has 561,893 words). It is the poster child example of the preferred way to govern these days: one gigantic omnibus bill that no one authors (or is to blame) and no one really knows who (or what lobby firm) added or compromised what that ends up in it. Bills that can be labeled, branded, lobbied, spun and base-rallied pro or con. Legislation to do everything, will last forever and we’ll fix down the road, depending upon who is in the majority down the road. This type of legislation is the reason politics is so partisan. And, this is what I hate about health care reform.

Dew_BillWordCounts

Note on the numbers in the chart: I downloaded the documents (transcripts of the older document) and used Microsoft Word’s word count tool. Some of the documents included signers, secretary notes, enactment dates, and other information that may cause count to vary slightly.

Couldn’t we have broken out a few things that we all believe in? Small, understandable bills that could be bipartisan? Simple language to solve some basic problems that simple people could believe government could actually accomplish? Incremental reforms to fix what we all might agree is broken?

  • Why do we have to debate the public option to get rules changed so preexisting conditions don’t prevent people from getting insurance?
  • Why do we have to debate whether every business will be forced to offer – and every individual will be forced to have – insurance in order that individuals and mom and pop businesses are allowed to join group plans at a reasonable cost?
  • Why do we have to agree not to negotiate prescription prices in order to have higher penalties for people who commit Medicare fraud?
  • Why do we have to debate subsidies for the uninsured, just so we can get rid of subsidies of private insurance companies offering Medicare (or at least require them to report quality of care results)?
  • Why do we have to debate changes in tort so that we can pass legislation to cover newborns who don’t have insurance?
  • Or require reporting on the effectiveness of drugs, medical tests and procedures? Or require electronic reporting? Or remove lifetime limits? Or limiting waiting periods? Or insurance plan transparency? Or transparency of physician ownership and investments? Or investments in primary care provider training? Or nursing student loans? Or funding for a National Health Service Corps? Or a national and state background checks for facilities and providers? Or medical bankruptcy prevention? Or improvements in access to immunizations? Or addressing childhood obesity? Or hospice reform? Or chronic disease prevention? Etc.

Wouldn’t it seem more civilized to pass specific bills that we agree on rather than bundling those we agree on with a bunch of controversial issues forcing our representatives to vote up or down on the whole package – or, God forbid, break with their party?

Why can’t we have a separate debate/vote on a public option or expanding Medicare? And a separate debate/vote on allowing insurance companies to compete in national markets? And a separate debate/vote on requiring everyone to have some form of coverage?

What is really going on here? Our leaders just don’t have much faith in us. They act as if they believe that the only way they can build a constituency to pass a bill is to make the issue seem to have epic proportions. To frame a debate as one that threatens our existence or our way of life. To excite the base, shake out the campaign contributions, get TV face time and get reelected. They did this to invade Iraq (Vietnam, Korea, Philippines, Mexico, Indian Wars, etc.). To bail out Wall Street (protect many other industries). And now, to pass health care “reform.”

We need our health care industry reformed. We must find ways to stablize costs. We must become more efficient and more competitive. We must do better in preventive care. We must discuss as a society, how the poor, the unfortunately sick and the innocent should receive health services. We also must find common ground, or we may lose more in the process than gained by any victory or defeat of the bill.

This bill is not about really about “reform” – I sincerely wish it were since I hear and read so much about it. Don’t get me wrong – there is a lot of great stuff mixed in the 2,074 pages – important, life-improving and life-and-money-saving stuff. But much of this bill and almost all of the cost, is about expansion of health care insurance for those who can’t afford insurance, don’t choose to buy it (preferring, in most cases I suspect, to eat or have shelter), or have been denied it. Reform is mostly packaging.

As a result, we’ll probably get a compromise of a “reform” law. A compromise of a benefit for the uninsured. Certainly a more divided country. And, we’ll probably have to do it all again some day soon because many of the real issues won’t have been honestly included, debated in daylight, voted on, or made sustainable.

On the other hand, what an historic achievement to get it this close. Maybe it really does take this cynical, scare-the-hell-out-of-everyone, Rahm Emanuel-pit bull-but-open-to-compromise-approach to get something done? Please weigh-in with your comments.


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26 thoughts on “Hold your nose and swallow

  1. Dave Sherman

    Sorry they were unable to overcome some basic bias and really give the situation the thought it merits. Knee jerk anti Dem disgust cetainly shines
    in a place one might expect actual factual discourse.

    Reply
  2. Lee Leslie Post author

    You are quite right, Dave, but it turns out that some basic bias turns out to be conditioned-paranoia (readers, too). I’m certainly not anti-Dem, I was just begging the question of why we must have these mega bills that seem to force partisanship and compromise (also put terribly important aspects of reform at risk of not passing or being delayed needlessly).

    If you have found errors of fact, please bring them to my attention. If my characterizations of seem unfair to Dems, it is only because the Republicans aren’t doing anything except trying to stop it or corrupt it at the behest of the same lobbyists who are working both sides of the aisle -- you are also invited to balance me out.

    Here are some basic bias that I can’t seem to overcome:
    • Campaign money is the root of all Washington DC evil.
    • Laws are written using cut and paste by corporate lobbyists and Congressional staff -- not our elected leaders who seldom read what they vote on.
    • Those in power (corporate, political, etc.) know that we aren’t listening to or watching much of anything, but the sensational and that we have almost no political memory -- they (the powerful) can, with impunity, do almost anything they want on all the little stuff -- and it is all the little stuff (a billion here and a billion there) that really matters.
    • This is really complicated stuff.
    • Tens of millions of people are suffering terribly in the US right this very moment. Hundreds of millions around the world.
    • Most of our leaders seems to be late middle-aged pink men who seem to enjoy talking nasty spin about each other on television.

    More to follow. Thanks for reading the Dew.

    Reply
  3. Brenden

    Ha! Lee being accused of being anti-Dem. Sweet. This toward a guy who supports a ruinous, destructive public option. Wow. I think I’ve finally read everything on the internets.

    Reply
  4. George

    I hope this bill goes down in flames. It is not going to do what needs to be done, and I don’t want anyone taking credit for “fixing health care” when it isn’t fixed.

    Reply
  5. Lee Leslie Post author

    George: As they say, be careful what you wish for. While this bill won’t “fix” health care, a quick look at what happened last time when Congress tried and failed to pass a health care bill: in 1993 when Hillarycare was debated, only about 2% of the health insurance was managed care requiring co-payment charges (disincentives to see a doctor or get health care). Now 97% of private policies require co-payments. Along with it came exploding premium costs and number of Americans uninsured. Private insurance companies have already announced double digit premium increases. Many of our most popular prescription drugs have also announced increases. I can only imagine what the insurance/pharma consortium will do if they defeat this bill.

    This bill won’t fix health care. It will fix some things -- many onerous things. Likely it will break some others that I hope our leaders will have appetite to fix when they realize it. It will help tens of millions in desperate shape. It will cost us all as private companies adjust premiums to cover the required expansion of coverages. But the costs of not passing will be disastrous long-term. As will the human costs.

    I just wish that we hadn’t tried to do so much with one bill causing such division in our society. I just wish we could have first passed what we most all of us could have agreed on -- one improvement at a time, leaving the contentious issues for later. I believe it would have helped restore some confidence in our government and our process which we all badly need. But we’ve gone too far. The battle lines are drawn. It seems inevitable now that with enough arm twisting, compromise and out and out bribery, some holdout Senators will vote for a bill that will pass. At that time, we’ll need to close our eyes, hold our noses, open our mouths and swallow. That aftertaste will be bitter, but not doing it will be worse.

    Reply
  6. Brenden

    It’s support of people like you that guarantee this measure will fail. Even if it passes, the economic damage wrought by this political grab-bag of pay-offs will ruin the healthcare system. So Obama, Pelosi & Co., can rule over its ashes. Doctors will flee, deficits will increase, unemployment will spread and our standard of living will fall. This is exactly what the authors of legislation like this want because it increases dependence upon the gov’t. Your attitude in the following statement illustrates the point well:

    “It will fix some things – many onerous things. Likely it will break some others that I hope our leaders will have appetite to fix when they realize it.”

    If it risks making problems worse, then why support it? In fact, you have no conception of the damage any version of the House and Senate bill will cause. You don’t want to understand because you have invested so much in supporting it.

    People thinking like you don’t care what comes out of Congress. I posit a few possible motivations. 1) You naively **hope** Obama, Reid and Pelosi’s political skills can solve the nation’s medical problems. 2) You just want want your side to score a few political points to justify your support for these kleptocrats in power. Or 3) You actually WANT the system to fail, so the people with more resources to gain access to functioning healthcare are equally burdened with a ruined healthcare system as the poor. Because that’s fair. The fastest way to confiscate private property without forcible coercion is to saddle the productive sector with unsupportable debts.

    The other principle you don’t give a damn about is the Constitution. What right does the gov’t have to MAKE people purchase insurance? Any obligation required by gov’t upon the citizen to forcibly spend their money to participate in a gov’t program will be challenged in the courts — and rightly overturned. All it is fundementally is a tax increase anyway that creates a vast gov’t program that will never be solvent and never disappear. You know, like Medicare.

    This gov’t is greatly expanding its powers over the citizens. The political leadership’s only goal is autocratic control of another vast sector of the economy. That is the only truth that’s been revealed in the 2,000-plus pages of legislation, Saturday night “emergency” votes, arm-twisting and lies.

    “At that time, we’ll need to close our eyes, hold our noses, open our mouths and swallow.”

    Nope: we must inhale deeply, gather all our respiratory excreta, and spit this loogie back in their faces.

    Reply
  7. Austen Risolvato

    First I’d like to say to Dave that if Lee’s anti-Dem then pigs have recently learned how to fly.

    Secondly, while I hold great value in the principles our country was founded on, they were founded on a revolution fought to free us from an unchanging rule, and based on 13 states, that didn’t have near as many people in them then as they do now. The document that Brenden references is 222 years old. The very same document that, while referring to the census states:

    “Representatives and direct Taxes shall be apportioned among the several States which may be included within this Union, according to their respective Numbers, which shall be determined by adding to the whole Number of free Persons, including those bound to Service for a Term of Years, and excluding Indians not taxed, THREE FIFTHS OF ALL OTHER PERSONS.”

    (Article 1, Section 2) Clearly there are elements of this document which are archaic, it’s why we have amendments, because eventually our leaders recognized the need to modernize elements of the Constitution. And I’d like to ask, if Brenden is a self proclaimed Constitutional scholar? I certainly am not, but before I reference it with a reverence that I often here associated with ancient religious writings, I like to double check it and make sure that I’m not referring to something that may no longer have the best interest of the citizens in this country in mind.

    As for Medicare, yes, it should be fixed, but is the idea of something I ever want to go away? No. It’s helped a lot of people in this country.

    And at least there are SOME efforts being made in the direction of health care, more so than any since the Clinton administration. Whenever I hear opposition to this debate I think of my uncle, who was in a Waffle House when his waitress had a seizure. He held her until emergency assistance arrived, and the whole time she was begging them NOT to call 911 because she didn’t have health insurance. This American woman who put in an honest day’s work couldn’t afford care she so clearly needed, and was more afraid of the ambulance bill than the serious medical condition she faced. SOMETHING NEEDS TO HAPPEN.

    And I’d rather people try than spend their time bitching about those who do on the internet.

    Reply
  8. Lee Leslie Post author

    Brenden -- I really appreciate your comments, but there’s no plot by people like me to grab power, get credit, expand government or confiscate property. Your so-called “truth” seems more of a paranoid rant.

    This story is about my concern for how far reaching the bills are, the unknown effects and that it is so partisan. I have problems with many details including the funding and mandates. I wish it were different. Had either party (both are to blame at different times) made earnest efforts during the past 60 years, it wouldn’t have come to this. This cynical mega/omnibus bill approach became the tactic chosen, learning the lessons of the failed efforts, to get it passed.

    This is a life and death problem and admire those who have worked so hard trying to solve it, but will stand beside you to spit most any other time.

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  9. Gypsy Alderman

    Thanks Lee. Too many people are afraid to speak-up against health care “reform” due to political correctness (Lord help us!)The word that best describes my feeling for the whole mess is: TERRIFIED. Knowing that the people safely tucked inside the Belt Way--people that will in no way have this bill affect their own lives--have got me basically hog tied w/their 300,000+++ worded plans of raising my taxes while lowering my social security and medicare benefits to pay for one more broken system. It gives me night terrors.
    Has anyone else noticed the not-so-subtle message to Baby-Boomers in recent years?:
    “There’s Too Many of you & you’re just Living Too Damn Long!”
    I’ve found the more words one of these “help the people” bills has—the more dangers it’s hiding.
    Go ahead, call me paranoid…I just call myself wide awake.
    By the way, the delivery of the flu vaccine, the one the government ALERTED everyone to (by way of continuous TV & print announcements prior to its release)the one they described as being absolutely necessary for anyone wanting to be a good citizen (by not spreading disease)has been so slowly delivered to the Northwest, people stopped getting in line for it. They dropped the “Must-Haves” from Everyone to all persons w/preexisting conditions, pregnant women and children down to most children under 5 and pregnant women (when available from their own physicians.) A preview of government “care”?
    Gypsy

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  10. Brenden

    This is why all your gov’t spending/control regimes will fail. The federal gov’t has demonstrated for decades that they are ill-equipped to handle the healthcare problem. I mean, this what you started on about in the first place! The only people who have any hope of helping the sick and injured are the practicioners. If we do not put them first — meaning, put their professional, economic requirements first — any measure is doomed to fail. Without a substantial reward for their sacrifice to become doctors, they won’t make the effort. If you want to defend and support doctors, you will get gov’t the hell out of their way. They can decide how to care for the indigent. They can also decide how to allocate scarce, expensive, cutting-edge treatments. The federal gov’t has no expertise in this area and has no business sticking its bureaucratic nose in where it does not belong.

    The constitution was designed to defend private property, intellectual property and the freedom to contract/transact. I guess Austen would trade those guaranties in the name of pragmatism and victim-class protection (with such victim-classes defined by the gov’t for their perpetual benefit). I’m sure it comforts Austen that access to his private medical records will be overseen by various unknown, medically untrained bureaucrats whose No. 1 job is to maintain their bosses’ political turf. What a great idea! As for me, you can pry such gov’t restraints and liberties from my cold, dead hands.

    You think the gov’t will save you, will cure you? How can you possibly think that given their compounding failures that have resulted in these legislative embarassments? How can you say “but we must have something” when all you’re being offered is a steaming pile of tax increases, lower-quality healthcare and endless expansions of gov’t power? It’s a joke that anyone takes these measures seriously other than as a threat to their healthcare and liberty.

    Reply
  11. Austen Risolvato

    Brenden --
    Last time I checked, whether you like it or not, as a citizen of this country, “my” government is “yours” too. Next I’ll take this moment to point out that I am not man, but a woman, so I don’t know who you’re referencing when you say “his private medical records”. Then again if you had any knowledge of English Literature, or read a book in high school you’d know that Austen, spelled with an “e” is the feminine spelling (See: Jane Austen, author of such classics as Pride & Prejudice, Sense & Sensibility, Emma, etc. Or simply pay attention to pop culture next time an acclaimed actress is playing her in a movie). Or you could click on the link to my name, since I am a registered member of this site. There’s a picture, I’m a female.

    Following this, in reference to your argument, I’d rather have some bureaucrats who’re medically untrained be able to see my private medical records than be denied coverage for a pre-existing condition that I was born with and had no control over. Or simply the fact that due to certain pre-existing conditions, I’m already judged, so who the hell cares as long as I get the care I need?

    Victim-class protection? What tax bracket do you fall into that you would say such a thing? What “class” is it that you exist in that you think makes you better than someone else? Why doesn’t America go ahead and adopt a caste system with your logic. Damn every person in this country to one of four classes, and state that they can’t ever be anything other than what they’re born into? Isn’t this the country where people have the opportunity to work hard and make something of themselves? Or would you rather family dynasties control the country as a monarchy?

    And why is it that you seem to have absolutely NO faith in the government what so ever? I exercise my constitutional right to vote for my leaders, from the bottom up. And I choose to (not blindly) believe that they will, by and large, take the time and energy to make the decisions my tax dollars pay their salary for. I choose not to turn my back on them but live in the country they keep functioning for me. You don’t like it? Move, I’m sure there are countries on this planet who will be happy to have you there to think only one way, not open your mind to other ideas, and live in a state of what for you I’m sure would be bliss.

    In the meantime I sincerely hope that if this is truly how you feel you’re out there doing something about it. Because, while I may not agree with you, things in this country CAN change, CAN be done, by those who agree with each other banding together, knocking on doors, fundraising for the people they want to lead. I truly hope that you don’t simply spend all your time complaining and playing “I’m better than you, and I know more than you”, on a (really great) website that encourages debate and the exchange of ideas.

    Talk is cheap. You don’t like it? Do something about it and quit bitching every time someone writes something in cyberspace you don’t like. The most beautiful part of this country (to me) is that we all get to coexist and not agree. Democracy is a great thing, isn’t it?

    Reply
  12. Lee Leslie Post author

    Gypsy -- Thank you, I think, but I’m not against health care “reform”. I’m against the political gamesmanship that creates 2,000+ page bills so complicated that debate is all but rendered moot; critically important reforms aren’t passed by acclamation; that controversial issues force partisanship; implementation is delayed to pretend affordability; and that passing it forces unmerited changes to buy swing votes (or, in Mary Landrieu’s case, a $350 million bribe -- that does make me wonder why more Southern Senators don’t sell their votes, because we could all use some stimulus).

    As for the H1N1, our government has done an incredible job even having a working vaccine -- given the complexity of production (each batch is grown in a chicken egg), it is not surprising that targets were met precisely -- don’t forget, one of their roles is minimizing panic and over-promising a wee bit, in this case, is good government. The supplies are getting much better -- my wife got hers yesterday. Check with your provider. You might be surprised that the reality maybe better than it is being reported.

    Brenden -- How about dropping the dogmatic spin rant and add facts to your arguments. All gov’t spending/control regimes fail? By what standard? The federal gov’t has demonstrated for decades that they are ill-equipped? How? Why don’t we equip them? This is what I started in the first place? I did not. Putting practitioner economic requirements first? They don’t even do that. You so underestimate doctors and other medical professionals. Private medical records are now maintained by insurance companies, pharmacy conglomerates and Equifax -- you really believe yours are safe?

    The US Constitution was NOT designed to defend private property or intellectual property. The Constitution was designed as a legal framework (3 branches of government, that sort of thing -- it is a good read and I encourage you to take a look) for a federal government to do things they couldn’t achieve on their own -- things like facilitating justice, commerce, peace between the regions, defense, taxes, etc. and to replace the Articles of Confederation. Defend private property, intellectual property? Nah, the Constitution doesn’t mention it. You must be thinking about some of those amendments to the Constitution that came later out of Congress (that were written and negotiated just like laws are today) and were ratified by the states.

    Reply
  13. Mary Lee (aka Bootsie Lucas)

    Whew! Just read every word of this story and the comments. Excellent points, Lee. I hope you’re running for something because I’m voting for you.

    Reply
  14. Lee Leslie Post author

    Thanks, Bootsie, but modern politics is for those of smaller girth, brighter grins, shorter sound bites, longer attention span, deeper pockets, greater ambition and more pleasant public dispositions. As Alex Salmond said before he became First Minister of Scotland, “if nominated I’ll decline. If drafted I’ll defer. And if elected I’ll resign.”

    Reply
  15. Brenden

    Since you rely mostly upon sympathetic emotive argumentation, contempt is usually the quickest means of drawing out your premises. Again, I am not disappointed: “Or simply the fact that due to certain pre-existing conditions, I’m already judged, so who the hell cares as long as I get the care I need?” Hah, who cares indeed. This is fundementally why the solutions you seek will fail. Again, you don’t care how the system is funded or allocated. You merely want a blank check from the gov’t to solve all your problems. We cannot take such arguments seriously. They are devoid of merit and lead to precisely the sort of politicized paranoia that drives the healthcare discussion.

    I don’t propose to create economic class systems, that’s (unsurprisingly) your suggestion. I refer to legal classes of victims. The gov’t needs to create legal victims to propose solutions to solve their problems. Then control their access to resources. This is all what these plundering healthcare measures seek to do. Why would I have faith in the gov’t to cure my medical problems? Why would I have faith in such a gov’t when people like you seek unending largesse?

    And I am “doing something” by refuting your faulty logic here and demonstrating the consequences of the failed policies which you seek. You are trying to convince people of an argument that’s highly destructive. I am merely showing them why you’re wrong.

    Lee, you want facts. I admit I don’t know precisely the present value of unfunded medical welfare liabilities. But I am fairly certain that it is either a 13 or 14-digit number. You can go look that one up. Then go check on the overall federal deficit. These are the facts that matter. A hugely unfunded federal deficit growing larger every day is all the evidence of failure that one requires. Then maybe we can talk about the long term implications for the currency, interest rates, unemployment, trade, foreign policy and the standard of living if we pass a massively more insolvent public option.

    “Defend private property, intellectual property? Nah, the Constitution doesn’t mention it.” Lee: you are ASS-WRONG!!!

    Ariticle effing ONE: “To promote the Progress of Science and useful Arts, by securing for limited Times to Authors and Inventors the exclusive Right to their respective Writings and Discoveries…” Amendment 4: searches and seizures. Amendment 5: compensation for takings. A fundemental principle driving the constition was limiting gov’t so that people could be “secure in their persons, houses, papers, and effects, against unreasonable searches and seizures,” That you see the document as a justification for gov’t “facilitating” our lives demonstrates precisely your perspective. And why the stuff you write on this site must be refuted. God forbid we elect more people like you. We got enough already.

    Last Ms. Austen, I assure I have read literature, hold degrees in it in two languages, along with advanced degrees in finance and economics, topics that plainly elude you. Though I have not read “Emma,” I’m sure I could do so and understand it. Why don’t you try, “Microeconomic Theory” by Andreu Mas-Collell or “General Theory of Employment, Interest and Money” by Keynes? Let me know if you make it past the first two pages of the introductions.

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  16. Terri Evans

    Brenden, you are always referring to your degrees and advanced degrees. Good on you and all that stuff, however, this is the first time you’ve disclosed your “literature degrees in two languages.” Just curious about the languages — are they “rant” and “rage” perhaps?

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  17. Lee Leslie Post author

    Brenden -- My contempt is for your repetitive jargon, not you, and frankly not your point of view. We have common ground on many of these issues. My point in this article (see a few thousand words above) was that these megabills prevent legislation being offered that is limited to issues which would have bipartisan support. That would allow those issues on which we disagree to be debated by themselves.

    As an example, I believe, as a society, that we should amortize heath care over our lifetimes. Not because I want something for free, but because it makes sense. Not because of a pre-existing condition, but because of the arbitrariness of how illness strikes. Not because I’m middle age, but because illness can strike at any age. But I would prefer this specific approach be debated and considered separately from the other thousand or so issues in this bill.

    Consider, just for a moment, what can happen when you lose your private health insurance (at any age). Even if you lose your job for no fault of your own, you lose your private insurance. Should you find that you cannot keep that certificate of insurability, you find there are no options short of losing everything and going on the dole. That doesn’t seem right or humane (perhaps irrelevant). It also doesn’t seem good for our society or our economic health as a nation. These things need to be changed and free enterprise has failed at solving it. Only through regulation can it be addressed. Sure, insurance companies are going to raise premiums for everyone to cover their increased risks, but amortized over all of policies, the increase should be minimal. Sure, it removes the freedom to take a risk that society would have to cover if you lost your insurance, but that is, in my opinion, an appropriate decision for our society to make.

    I do care how it is funded and have said so specifically on this site many times in conversations with you. Go back and read them. An expansion of subsidies to help people afford coverage is an important ideal. It should be, however, in a separate piece of legislation that should be consider only its merit with free and open debate. Likewise, paid public option. Likewise, how we solve the current underfunded medical liabilities.

    As to Article One: oops. I remembered that coming later and stand corrected. I was “ass-wrong.” Though we really ought to talk sometime about the intent of that provision and how it has been subverted by changing “limited” time to lifetimes and beyond -- another time, perhaps. As to the amendments you mention, I referenced them and they were not in the original document. The amendments added by elected leaders and ratified. Your trust seems to be in people who were elected by property-owning white men now long dead. I wish you could have faith in those alive today.

    As to your personal insults for Austen (my daughter), you are a pompous ass (that is contempt) and should be ashamed.

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  18. Brenden

    I see you’ve changed the concluding phrasing of the original post but the title remains “Hold your nose and swallow.” On this point there is no agreement between us. I cannot accept either of these abominations out of Congress for the sake of the incremental change you believe it will achieve. On the contrary, it will bring incremental failure. You say you’re for a paid public option — but let’s just pass these insolvent measures first. Measures that will include an expansion of a non-medical purely political bureaucracy and eventually include buy-offs for every fence-sitting senator. Mary Landreiu set the price floor at $300 million just to stop a filibuster. How much higher will her price go to vote for it? How many senators/reps demand the same tribute for their vote? Don’t you realize that’s a complete contradiction between your advocacy of a “paid-for” program and your support for these monstrosities? They’re not paid for. They don’t fix anything. Your position is totally dishonest.

    I don’t deny the reality of the problems only the damage wrought of gov’t-controlled solutions. You and others constantly demand that we need all these immediate changes NOW!! and then we’ll deal with the collateral damage later. Not everyone agrees. They know the collateral damage won’t be trivial with unemployment already past 10 percent.

    As to personal insults, I ain’t sweatin’ it. I give as good as I get. Enjoy the reading list.

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  19. Dallas

    Thanks, Lee, for what I read as an artful cry for simplicity. How could all this dust be kicked up over the notion that Obama & team — and all of us, regardless of political leaning — would have been far better off if the healthcare package had been un-bundled, i.e. the easy separated from the hard, so that we could actually see and understand each proposal? Why on earth would anyone rant against simplicity? Complexity is the delight of special interests and the source of the exaggerations, lies and moronic behavior on both sides of the aisle. Complexity is the hell of it, and reform is impossible, apparently, because of it.

    P.S. If you think Medicare (government) doesn’t work well, then you aren’t a user. Medicare is simple and clear, and it works exactly how it says it will. Which of us out there can say that about coverage from corporate insurance providers, with their non-competitive geographic advantages, and their jargon-loaded, incomprehensible explanations mailed to our homes, explaining why such-and-such is not covered?

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  20. Brenden

    How can you think Medicare works well when it’s many trillions of dollars in debt, and the gov’t that funds it is many more trillions of dollars in debt? How can you think that extending this insolvent program by a gov’t whose needs are expressly and entirely politicial — NOT medical; evidenced in the very bills now under consideration — will improve the situation? You can only hold such beliefs if your motives are entirely political and further that you think it’s OK to soak your neighbor to pay your bills under gov’t coercion. This whole discussion is an exercise in fabian socialism. You’re welcome.

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  21. Lee Leslie Post author

    Brenden, you are not alone in your confusion on this issue. Many people get mixed up and falsely judge Medicare based on both parties spending Medicare surpluses on other programs while lacking the political will to either raise limits, rates or address fundamental reforms in light of the greying of American workers. The Medicare program has proven to work well for its users for over 50 years and at lower costs and rates of increase than private insurance. You are, however, correct that the bills in Congress are not likely to improve the long-term Medicare funding situation. A far better plan toward fixing Medicare would be to simply allow younger workers to buy in to Medicare, covering their 100% of their costs, which would amortize the administrative expenses, provide better preventive care and lower overall costs across all age groups. Another commonsense solution would be to find a way to allow the tens of millions of younger and undocumented workers to contribute toward Medicare.
    On Fabian socialism, isn’t that preferred by Libertarians to revolutionary socialism?

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  22. Brenden

    Confused? I don’t think so. I’m merely trying to correct the many, many false assertions you present. So you’re saying Medicare would post a surplus but for politicians spending that money on other programs? Um, no. Medicare is a large part of the national deficit.

    Moving all the workers into a gov’t-run program will destroy healthcare. Gov’t will set all prices. There will be no incentive for practicioners to take risks or see more patients than necessary. They will be paid like union pipefitters (or worse than them), punching in from 9 to 5 and seeing as few patients as possible according to their contract. And forget about technological advancement. No pharmaceutical company, no surgeon, no engineer will take the huge financial risk to invent new drugs, tools and technology. Leaves everyone worse off.

    Fraud will explode under a gov’t-run system. Right now criminals make off with billions of gov’t money. In response, all bureaucrats do is complain they don’t have large enough budgets to fight the problem. None of that money goes healthcare.

    I prefer revolutionary socialsts. I can shoot at them.

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  23. Lee Leslie Post author

    I give you that unfunded general fund add-ons and political accounting hijinks by Bush 2 in 2001 to make his case for tax cuts make both assertions -- mine of surplus years and yours of deficit -- accurate. The rest is just the same old argument that the future will be different from proven experience of the past 50 years. Happy to hear your preference -- the headline should read, “Libertarians support single payer health care.”

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