Listing those who will die

Something extraordinary happened Wednesday night in the House of the Representatives. Rep. Alan Grayson (D-FL), gave a speech on health care. He continued speaking about the 44,000 Americans who die each year because of lack of health insurance. This time, he broke out the number who will die next year by the Congressional district of those who oppose the reform bill. Republicans went to great lengths to shut him up, but they didn’t (they start trying in Part Three). Watch it.

Part One

Part Two

Part Three

Part Four

Part Five

Part Six

Part Seven

Part Eight

29 thoughts on “Listing those who will die

  1. Chris Wohlwend

    Strong, strong, strong. We can only hope it will move the opposition. And that it will move voters. The link is going up on my Facebook wall and hopefully on many others. Thanks, Lee.

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  2. Lee Leslie Post author

    Thanks, Chris. Linking to Facebook and other sites like it is such an important thing to do. Not only for this story, but for Like The Dew (6 degrees and all that). I hope others will, too (just click the Facebook “Come on, share this” button).
    Grayson’s analogy to how we would react if 44,000 died in war, just shook me. The opposition stance is repugnant.

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  3. Brenden

    This speech demonstrates exactly how absurd the Democrat strategy to advance Marxist healthcare option by fomenting class warfare and paranoia. First, of course, Rep. Grayson blames Bush for everyone’s problems. That’s always helpful and lends greatly to his credibility. Second, he actually says:

    “if you find two people who are physically identical, and one of them has insurance and the other one does not… And the one who does not, that American is 40 percent more likely to die.”

    This is the entire premise of his argument. Surprise! — it is entirely false.

    Both Americans Rep. Grayson mentions face a precisely equal probability of death. That probably is uniformly distributed among all living creatures known to live, are living or yet to live. That’s right: 100.000 percent. Each insured and uninsured American will die with absolute certainty. Rep. Grayson is fomenting paranoia by the implication that 1) Republicans are deliberately trying to kill Americans by stopping the Socialist Option and 2) only the Democrats can save us from death.

    This speech is a deliberate, emotive obfuscation of the truth. He says we must extend insolvent medical welfare programs “or die!!!!”

    This ignoramous just stands there reading off numbers of dead in Republican Congressional districts as if that’s indicative of anything. What is the source of this data? How would the Socialist Option have saved them? Do any of you people believing this emotive theater have the ability to think for yourselves?

    This is evil and stupid, certainly.

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  4. Gita

    It’s a downright creative approach if you ask me.
    Grayson is being attacked all over the blogosphere by people like Brendan (above).
    But you know what they say: “If you’re attracting flak, you must be over the target.”
    He’s a strong guy with strong principles and the same direct manner of speaking that first drew so many people to Howard Dean and moveon.org.

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  5. Lee Leslie Post author

    Brenden -- I know, I know, I know… being pro-greed is a higher moral value in your ideal American than fairness. This isn’t about class (what happen to “all people are created equal”?), it’s about health care. I realize your stance against government-run most anything allows you to be at peace when ignoring the millions of people who suffer for lack of access to doctors for even simple care. I consider preserving human life among the highest of ideals. Certainly a higher ideal than preserving the campaign contributions being doled our to the self-rightous right or worrying about what they are going to say at the next tea party.

    Yeah, Grayson’s argument comparing two people was not well stated. Had he had your counsel, he may well have stated, “40 percent more likely to die prematurely.” He did, however, cite in his speech the source of his numbers. It might serve you well to watch it again.

    No, the projected numbers won’t hold up precisely nor would access to health care in this next year prevent all of the deaths. But the blood (that’s a figuratively reference) will be on the hands of those who vote against it for their role in the needless suffering and death -- makes me hope there is a hell.

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  6. Brenden

    Lee, this is why “Conservatives” don’t take arguments like yours seriously — and should not. I would qualify this statement to further say that normal, regular-thinking rational people should not take arguments like Rep. Grayson’s and by extension yours seriously either. You begin with the moral absolute of equality of outcome. That is: you, me, Bill Gates, homeless Ed or whomever get hit by a bus. Obviously we all will “need” healthcare or we will die. In this country, we all get it. That is an unambigously true statement. For now.

    After the fact, we all will “need” therapy, follow-up procedures and so on. At the margin, the patient’s ability to pay becomes an issue as to the next marginal level of medical care he can receive. Acute vs. long-term care. You are familiar with this. I hope.

    Under Socialist Obama-Pelosi-care, that next marginal level of service simply will not be available. The long-term care and therapy won’t be provided because gov’t will set the price level below practicioner cost. When the gov’t reimburses below the practicioner’s marginal cost — the practicioner goes out of business. This is reality; below-cost reimbursements happen right now. You know this but you’d prefer to blame the private insurance business. But the private insurance system has nothing to do with setting Medicare reimbursement rates. The only reason the system works now at all is the private insurers subsidize private practicioners’ below-cost gov’t reimbursements. This is a clear, tractable argument. These are all true statements.

    Typical of your argumentation, you say I’m “pro-greed” which is an emotive utter non-sequitor and makes you seem like an ignoramous. It utterly discredits your opionion and all who read it should dismiss it accordingly. That is not a counter-argument to anything I say. You begin your statements with moral absolutes: “We all need healthcare.” Then completely ignore the obviously more difficult discussion of that care is to be provided and funded.

    I know the reason: you don’t care. You demand the unjust wealthy should pay. This demonstrates your further ignorance about the acquisition of wealth under a competitive market system. You dismiss that system as unjust, and therefore justify its looting.

    Fairness. How is your view of healthcare at all more fair when everyone is left more vulnerable to illness, injury, disease and death?

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  7. Cliff Green

    Brenden, you write, “In this country, we all get (health care).” True, but where the poor and the uninsured get it is in hospital emergency rooms, which provide the most expensive medical care imaginable. People who finally show up in the ER are just that, emergency cases. In most instances, their problems could have been handled much more cheaply if they had had earlier access to medical care through a private physician. That requires insurance.
    Those of us fortunate enough to have health coverage already pay for people going to emergency rooms through higher premiums. This is “socialism” through the back door. You right-wingers can remain ideologically pure if you want, but you are merely in denial of the facts. (Or is that intentional? You know, just for show?)

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  8. Lee Leslie

    You are both wrong. In American, millions do not get health care. I’m not referring to just the uninsured. Sure, if you qualify as being poor or destitute, there is a safety net. But those of us who work hard, live modestly and afford health insurance have found in recent years that the premium increases, the deductible increases and the high coinsurance has made health care unaffordable. Middle class Americans (especially true for those who have pre-existing conditions) have learned that if they allow their insurance to lapse, they will never have it again. We afford the premiums, but have nothing left for the doctors or medications. Sure, it is a choice. Become homeless. Starve. Give up health insurance. Deny yourself care. Or, amass debt which can never be paid. Each of the choices reprehensible (moral absolute). Get your heads out of the sand. This is happening every single day to millions of families. Those who have life-threatening illnesses are going to die prematurely and needlessly.

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  9. Brenden

    I am the only one here paying attention to the facts.

    Who pays for national healthcare? How? What rate should doctors be reimbursed? Who decides about the allocation of scarce and expensive procedures? Who ensures that there are economic incentives that young men and women will endure years of difficult medical school; that researchers will develop new drugs; that engineers will design new medical devices and tools?

    When you pay doctors below market rates, you get fewer doctors, drugs, tools, procedures and so on. When there are incentives to take risks — you get more of all of the above. You also get less fraud (watch the “60 Minutes” about Medicare fraud). What you fail to understand and accept is that your Socialist medical welfare regime will leave everyone with the worst possible allocation of medical services.

    I know: the poor get less. They always will. For healthcare, they will be better off with a private system that allows for the full array of possibility. One where where those who can afford it decide what to allocate to the have-nots. The only hope for the poor and their children is the opportunity to compete and succeed. Socialism by design denies opportunity everywhere it’s tried. Let’s not try it here.

    Vote against Obama-(doesn’t)-care Republicans, Democrats… everyone! Lee says you will burn in Hell if you do so. Let’s show him what a tool he is!

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  10. Cliff Green

    Brenden writes: “For healthcare. they (the poor) will be better off with a private system that allows for the full array of possibility.”
    OK, all you English-speaking people out there, tell me what the f**k that sentence means.

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  11. Brenden

    It means the economic constraints of Socialist Pelosi-care will leave everyone worse off, meaning the least possible allocation of medical services available to everyone. Rich and poor alike. The poor will be better off under a competitve market system. When healthcare providers have economic incentives to perform, there will be a wider array of services. There poor would be able to get access in the form of welfare once providers have a reasonable and solvent system with reliable price discovery. Yes we are very far from that now. Unfortunately the first step is to stop this collectivist healthcare agenda so we can come up with a real solution that will not destroy the economy.

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  12. Cliff Green

    I’m not going to bite on the cheap-shot stuff where you right wingers have gone from Marxist Obamacare to Socialist Pelosi-care in your commentary. There’s nothing to be gained from going there. But, the idea that “the poor will be better off under a competitive market system” is silly on its face. We have a competive market system now, one that leaves more than 45 million Americans with no health care. “When healthcare providers have economic incentives to perform, there will be a wider array of services.” My God, man! Healthcare cost have been rising at a rate far higher than the rate of inflation for decades, yet more and more people lose coverage every year. “The poor would be able to get access in the form of welfare once providers have a reasonale and solvent system with reliabel price recovery.” I’m not sure what “reliable price recovery” means, but you guys complain that universal health is welfare, then you turn around and argue that welfare should provide health care. Make up your mind! Like you, I would love a real solution that would not destroy the economy. So, let’s hear it, genius!

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  13. Brenden

    The poor will be better off under a market system because the healthcare system will be better off. The gov’t will destroy the healthcare system if it’s allowed to take it over (or take over the paying patients as the public option proposes to do). All who use it including the poor will suffer needlessly. None of us right wingers are saying eliminate insolvent medical welfare — just do not expand it. We’re offering specific proposals that the left ignores: first, strengthen the private market by eliminating useless regulation, reform the torts and create a nationally competitive health insurance market. Those are very narrow, focused proposals. Then, when know the real costs of procedures, we can decide upon a solvent and sustainable allocation for the poor.

    Now you all will say (wrongly) “but that’s only less than 1 percent of the costs.” As if you knew. Fine, let’s find out what the figure is and what we can afford. I have written ad nauseam on price discovery but it basically amounts to what it costs a seller to produce and what the buyers can afford (supply/demand or bid/offer curves). That simple. But we do not know what anything in healthcare costs because it’s subsidized and regulated and tax-offsetted to death. Transactions occur through byzantine insurance kabuki dances that uselessly add cost. That’s why we know the problems we face are largely the fault of the federal gov’t: no private interest would choose to run a business in this manner.

    Do I have a solution? Not entirely but thanks for recognizing my genius. But I know this public option nonsense must be removed from the negotiating table before a reasonable discussion can occur. Until then, the only right winger strategy is to stop the public option at all costs. That is all we’re trying to do.

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  14. Cliff Green

    Finally, the admission: Stop the public option at all costs. This sounds less like a healthcare solution than an ideological position.

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  15. Brenden

    In your world there are no policy solutions, only conflicting ideologies. Do not confuse the ways of your leftist tribe for the laws of nature.

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  16. Cliff Green

    Under the laws of nature, the rich and the powerful feed upon the poor and the weak. Is that what you want, Brenden, you free marketeer you? And how, pray tell, would that be different from the “system” we have today?

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  17. Brenden

    What foolishness. “Feeding upon” people does not grow markets, promote wealth, increase standards of living, improve technology, increase knowledge or result in any outcome a pro-market person such as myself would see as social improvement. Preying upon the weak is your central false assumption about capitalism, and why any view you hold on gov’t spending policies and economics can be dismissed and scorned. I’m glad you collectivists are outing yourselves on this website though.

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  18. Lee Leslie

    What foolishness, indeed. When did growing markets, promoting wealth, etc. become more important than anything else? When did an economic system become more important than people or its tenets more important than our values? Competition, hard work that can lead to improving your life, innovation that is rewarded, etc. can be wonderful and help make the tedium of work for basic needs less onerous, but aren’t they just the means and not the end? Is there no room in your pro-market belief system for adjustments to allow more equal access to the system and allow for real competition? Isn’t the inevitable result of playing Monopoly that the wealth becomes so concentrated through the chance roll of the dice that the game ends and must start again for others to play? And hasn’t the pro-market game we play become further corrupted by the buying of political influence and special interest laws?

    The problem with our health care system is not just that it is so complicated, it is that we have allowed an industry (insurance, private and public) to grow to a scale so great that it is a natural monopoly. Removing the public option does nothing by itself to fix our state-run private system. Assuming we could learn the lessons (inadequate regulation and failure to prevent some companies from becoming too big to fail) from our dismantling of state banking laws (hardly a safe assumption), we could move to a system that allows private insurance companies to operate regionally or nationally while phasing out public options (pretty to think so).

    But until then, what do we do to stabilize the insurance market? What do we do to see that the middle class and lower middle has access to basic health care? Currently only about 52% of Americans have employee-provided health insurance (2007 figures and it probably is under 50%). Medicare, Medicaid and VA cover another 27%. The rest of us try to afford individual coverage (generally, premium costs are 3-5 times that (or more) of employee-provided insurance and often with much higher deductibles and co-pays), have no coverage because of pre-existing conditions, unaffordability or just don’t to choose to buy coverage.

    Many of the “rest of us” 20% are looking for an option. The pool will help some, but a pool that includes a public option would force private companies to immediately offer policies at more lower/more competitive prices. Sure, that won’t be pro-market, but creating a national market that is competitive will take some time. Changing regulations to allow individuals and small businesses to form groups, could do some to overcome that, but that won’t come until the state-run system is dismantled and many of us, just can’t wait. Without the public option, government subsidies will be much higher. So the question that I ask my pro-market friend is, do you want more of your looted tax dollar used to subsidize private non-competitive insurance companies or less?

    I know, I know, I know, I’m a tool and my arguments shouldn’t be taken seriously, foment class warfare and paranoia, reveal my collectivist agenda, my ignorance and would cause the poor to suffer because there would be fewer doctors and no new drugs.

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  19. Brenden

    Wow, that was like sled-riding uphill underwater with a hangover and one arm. Before I refute the false choice you offer, let me say that you have it exactly wrong here: ” Without the public option, government subsidies will be much higher.” Under the public option, the gov’t forces doctors to subsidize the consumer and the fraudsters who will syphon the public system dry. And guess what? The doctors won’t have any of it and quit, leaving all consumers — wealthy and indigent — worse off. I suppose this may be a bit of an abstraction for you. So you are willing to run the experiment. I am not. Me and millions similarly disposed to scorn our plundering, plodding, inept, inefficient gov’t will not countenance any regulation that includes a mandate to have that same gov’t control our lives and ruin our economy any further. No discussion, no nothing. Public option dies quickly or we will all trudge along with our imperfect status quo.

    My looted tax dollars support 50 state insurance monopolies because 1) the gov’t promulgates these artificial regulatory barriers to competition and 2) Medicare sets price floors on reimbursements. The insurers have a profit incentive to reimburse at the lowest possible rate and tah-dah, there’s Medicare to reveal to them what that rate is.
    The source of much of the inefficiency in medical care is the federal gov’t’s role in it. So we must minimize it. The rest of the high costs relate to secular economic/technological factors that impinge upon the industry. That is, healthcare costs rise because it employs cutting edge technology and innovation each day. And I argue the pace of change is accelerating, making it even more expensive. You know the most expensive appliances, cars, audio/video, etc., cost the most money. The difference is you’re willing to plod along with your 20 year old dishwasher and 15 year old car. However, you are unwilling to accept 25 year old medical care.

    These are just the facts, man. No amount of wishing for a more just society will change them. Strike that: wishing for a society where everyone gets everything they want is actually highly destructive when the delivery method is the elected national gov’t.

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  20. Lee Leslie

    Whoa. It just ain’t so. Private insurance premiums are 20 to 30+% more expensive than public. Public subsidies for low income Americans to purchase private insurance will either be 20 to 30+% higher or buy 20 to 30+% less insurance. Plus, the cost increases to maintain private insurance is much higher -- since 1970 the annual costs per beneficiary for Medicare has risen 8.8% compared to an annual rates of 9.9% for private plans. That’s a fact.
    Sure there is fraud -- estimated to be about 4% (similar to private insurance). Sure we need to prosecute the doctors, labs and scam artists who commit it, but it is hardly bleeding the system dry.
    You assertion doctors won’t have any of it is ridiculous and proven false for 50 years.
    As for the reasons, there’s plenty of blame to go around -- government can change it and hasn’t, private insurance companies love the status quo so they can max their profits without competitors and both sides of the aisle profit from campaign contributions to keep it screwed up.
    As for the acceleration, for profit hospitals and labs are spending big on technology. Much of it grab market share and give issue to their advertising, not help help the patient. Facts? Hogwash. No amount of wishing for a more unjust society will change them.

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  21. Cliff Green

    Brenden, I do not hold a single false assumption about capitalism.
    Capitalism is based upon the premise that it is morally permissable to charge more for goods and services than they are worth. Period. All the rest is commentary.

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  22. Brenden

    Cliff, you don’t know anything about capitalism. You already admit you don’t have any idea about price discovery so how could possibly know what goods and services “are worth”? You don’t have any rational, defensible notion of value. If so, what is it? I assume you’re just going to the store, looking at prices and say, “Gee, if it weren’t for capitalism all this stuff would be 15 percent cheaper.” You view “the rest” as commentary because you don’t understand the fundementals, so you cannot extend that ignorance any further. You participating in this economics of healthcare discussion is like you lecturing on stochastic calculus without knowledge of addition and multiplication.

    Lee, private premiums are more expensive than public because doctors charge private individuals more to subsidize indigent care. Whatever you’re percentage allocation amounts to, it hardly matters because you don’t capture in your analysis the fact that the public medical welfare is insolvent. Medical welfare is a huge component of this historic, unsustainable and growing national deficit. So vastly extending this program is a very bad idea for the national fisc.

    And as it relates to fraud: the fundemental reason fraud exists is because when you send your reimbursement request to Medicare — they are legislatively bound to reimburse you within a certain amount of time. So it’s very easy to plunder the system. If you extend that system to the entire country, you will greatly compound that plunder. You will then require a vastly more expensive anti-fraud regime — which again cost untold billions. Four percent my ass — and even four percent of $2Tril is eighty freakin billion bucks. And none of that money would end up healing a single patient. Further, private doctors and insurers have a profit motive to police their own patients and policy holders. You cannot legislate that aspect of cost reduction.

    Finally, you say that costs have risen about 10 percent annually. That’s fine but within those numbers is a technology premium that captures the economic value of improved healthcare. That is, healthcare is vastly more expensive now but vastly more advanced than in 1970 as well. So we all must pay the price if we want to see this advancement accelerate. Or we can pay less for low quality care.

    A final point is that the public option is fundementally about gov’t control. They want it, and you all want to give it to them. I do not, and will fight it.

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  23. Lee Leslie

    I give you that one of the reasons private premiums is more expensive is that negotiated reimbursements are typically higher than mandated reimbursements (I presume the $190+ million the AMA spends on lobbying is directed toward keeping the reimbursements in line with what they want). However, stating that those higher premiums subsidize indigent care is an unfair characterization -- every business must budget for bad debt and those who perform non-paid work above that that, do it voluntarily. The higher private premiums are about executive salaries, marketing and profits. Expanding subsidies for those higher costs with taxpayer money seems stupid and, at best, is a horrible expensive waste that will concentrate more money and power in a few boardrooms answerable to no one.

    I give you that medical welfare is a huge component of this historic, unsustainable and growing national debt. That is why reform is so necessary.

    On your final point, how we go forward managing the monopolies (private and public) is what much of this is about. I have no desire for government control given how private business has so corrupted the political process and continues to attempt corruption of our civil service system, but I don’t have a better short-term solution.

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  24. Brenden

    Holy crap I think you and I agree on a principle if not a solution. You and I both agree that monopolist practices add cost. But these insurance monopolies are GOV’T created, sponsored and sustained. All you need do to eliminate them is allow a national market for health insurance. That is, I should be able to buy my insurance in any city, county or state from Anchorage to Key West. Even if the large insurers had pricing power contributing to their profit (which is necessary), there’d only be a handful across the whole country rather than a handful of monopolies in each state. We’d no longer pay for state-by-state regulatory regimes or 50 flavors of medical liability law. Doctors malpractice insurance premiums would plument. This is the place to start reform, then tackle the third-party employer-insurer issue.

    But how you abstract from this a need for a national medical welfare I will never understand or agree. You want to blame business for corrupting the gov’t? That’s absurd. You’re just another anti-capitalist collectivist fellow traveler with Cliff. The gov’t is willfully acting to take unjust, unconstitutional control of the citizens’ lives via state-controlled and rationed medical service. No private practicioner is paying it to do so. Doctors don’t want this public option, insurers don’t want it — no private risk-taker wants gov’t to take control of anything because your noble civil servants will ruin them. The bureaucratic appetite for risk is defined by their state-sponsored resource allocation, and maintaining and growing that allocation — at the taxpayers’ expense. That calculus has nothing to do with a cycle learning, improvement, utility maximization and wealth creation that defines free enterprise. The bureaucratic ethos is solely a lust for power and control.

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  25. Lee Leslie

    Brenden -- We’ve always agreed monopolistic practices are at the root of the problem and a national insurance market is the cheapest and quickest way to competition. The devil is, of course, in the details of regulation, anti-trust enforcement and how and when a public system could be dismantled or spun private.

    Further, I’m all for the “national medical welfare” to be discussed and determined as separate from the above. They are separate issues and should stay that way.

    As for blaming business for corrupting government, it is as they say, just “bizness.” The politicians hands are out and the cheapest marketing dollars business spends are in the bribes for favors and contracts. Money buys power. More money buys more power. Sure, there are non-business entities (individuals, associations, unions, countries, etc.) who do the same, but for sheer scale of the corruption, nothing and nobody beats business. I can only imagine the hailstorm of business lobbying that would occur if a bill were to be floated to move toward a national insurance market -- it takes my breath away. For business, change is scary and special interest incrementalism is nirvana. Hundreds of millions in bribes are being spent to keep the system just the way it is. Private insurance companies love that the government has the responsibility for the aged, veterans and indigent and leaves the healthy and wealthy for them. You blame government for all of this, but every regulation that created government was thought and bought by business. Democracy and free enterprise in our country is largely faith-based. We’ve never had them, but from time to time, we have enough of each that keeps us sheep in line for cliff.

    I’m not anti-capitalist. I love the idea of free enterprise and entrepreneurship. I regret that we abandoned the tradition that corporate status was rare, took an act of the legislature and was for the public good. I regret that we abandoned laws to protect competition and banking that have allowed business to become too big to fail (as a group, the unemployed and under-employeed may also be too big to fail, but maybe not, as long as they fail one at a time). I regret that we bailout and especially that we do it from the top down. But, what the hey, that’s the game we play in this world economy we call home.

    Happy we found common ground.

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  26. Brenden

    You have it backward again. Gov’t is statist; private enterprise is dynamic. Gov’t expands welfare programs to buy votes from the masses — not because insurers backing up gobs of cash for them to do so. Business obviously abhors deficit spending and increased taxation because they are economically ruinous. Yet these are precisely the outcomes of your beloved insolvent welfare programs. Your notion of “special interest incrementalism,” backed by a commercial cabal, driving national welfare programs is utterly false. The drive behind these insolvent programs is Fabian Socialism, plain and simple. Incompentents long on ambition but short on ability flock to work for the gov’t to plunder the resources from the productive — the folks who they know they cannot compete against on a level playing field.

    The gov’t seeks to give a citizen access to resource, then exercise control over that citizen through rationing and regulation to maintain their statist control. Yep, just like the ol’ USSR. Thus promoting more gov’t statism, more deficits and more control. These insolvement welfare programs are mere pretense for socialism — it’s not about “helping people” and it never was! You state the free enterprise dynamism that created this greatest of countries is “faith-based”? What do think created our standard of living, the variety of goods and services we enjoy? Was it a corrupted cabal of plutocrats bent on slavery? You so take for granted the free enterprise system that thrives (thrived) here that you’d happily trade it for a few gov’t-issued magic beans. The public option is not going to fix the healthcare system and it never was designed to do so. It is only about autocratic control and always was.

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  27. Lee Leslie

    Lighten up, man. I wish I could believe a political form of government like ours could be as competent as you describe. Take some deep breaths. Watch a movie or something. Maybe take a walk. McCarthy’s gone and his dream still hasn’t happened. We’ll talk again soon and maybe it will okay until then.

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  28. Brenden

    Oh, yeah, dude, whatever…. Lighten up. Productivity and hard work don’t matter. We’ll just, you know, like let the gov’t pay for everything and it’ll be totally cool. That would be awesome. I mean, they have all the money. And then they can, like, take it from rich people. Yeah, dude. Lighten up. …blub…blub…blub… lighten up another bong hit dude…

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