Why The Devil Will Need Mittens Long Before I Vote for Edwards

Note: I am so angry about this that I deliberately did not cuss in the whole post so that even conservatives could read the whole thing.

I was highly displeased with the way the Edwards campaign handled the Marcotte incident (though I was tickled to think that a woman could almost derail a whole presidential campaign merely for being uppity), and his stance on gay marriage irritates me, but I saw him here at the Ryman and I felt like he was a plausible candidate.

But, after reading this over at Little Pasture’s, I have to say that it will be a cold day in Hell before I vote for Edwards. I won’t vote for someone who so clearly hates me and my people (that being working poor people who’ve had to go without insurance at one point or another).

Here is the one good thing about Edwards’ plan: apparently there will be some insurer, somewhere, who cannot deny you coverage.

Here’s everything that stinks* about it:

1. It treats all of us as if we can’t be trusted. Seriously, I have to give the government a note from my insurance company saying I’ve been a good girl? I am not the property of my insurance company. I am their customer. My individual relationship with my insurance company is no business of the government and I don’t need the insurance industry to vouch for my character with the feds. I mean, seriously. Let’s talk some more about how screwed up the relationship between the government, private individuals, and corporations are. I, as an individual, petition the government to monitor corporations because corporations are large, governments are large, and I am, in comparison, tiny. The government does not ask corporations to monitor me in order to make sure I’m behaving. Do presidential candidates not understand basic personal liberties?

2. It treats people who don’t have insurance as if they are deliberately defrauding taxpayers, even though people who don’t have insurance are also taxpayers. Yes, there will always be some small group of people who are working the system. And yes, that very small sliver of people probably can afford insurance but don’t get it because they find it easier to just use the emergency room when they have a problem. But that number is vanishingly small. Most people who don’t have insurance don’t have insurance for two reasons: they can’t get it because no insurance company will take them or because they can’t afford it.

3. My money does not belong to the insurance company. I am not cheating the insurance company out of money if I don’t have insurance. When I pay taxes, those monies go to government programs. If you garnish my wages, it is because I am cheating someone out of money the courts have decided I owe them. The idea that the government could, without court intervention, take my money and give it to a for-profit corporation is enough to turn me into an anarchist. Again, does Edwards not understand that the healthcare crisis in this country is not that insurance companies aren’t getting enough money?

4. The problem with healthcare in this country is not that people refuse to get insurance but that they can’t get insurance. In other words, the problem is not with individual Americans, but with insurance companies. What about Edwards’ plan addresses the egregious behavior of insurance companies?

5. Many of the people who are bankrupted by medical care have health insurance. How does Edwards’ plan address that? It doesn’t seem to be a concern of his at all. In fact, his plan does nothing to encourage health insurance companies to change their ways; instead, it gives them more income and the weight of the government behind their collection efforts.

Here’s what I want. Either

1. Single-payer insurance run by the government. A portion of everyone’s taxes go towards paying for everyone’s healthcare.

or

2. We make for-profit health insurance illegal and make denying coverage to people also illegal, with government programs that help people who can’t afford insurance to afford it. Everyone pays in, everyone gets what they’re promised out, no caps on coverage.

But this? Yet another rich person proposing a program that seems designed specifically to demonize and punish the poor for being poor?

Absolutely not.

*And note, conservatives, it’s all I can do to not make this post as full of cusswords as a bar frequented by sailors on shore leave.

44 thoughts on “Why The Devil Will Need Mittens Long Before I Vote for Edwards

  1. I hate to break it to you, Aunt B., but there’s only one candidate who is on your healthcare wavelength, and we’re all supposed to treat him like a lunatic. (That’s why I’m voting for him in the primary.)

  2. I was just about to wonder whether there were any better alternatives circulating. I mean, nobody seems to have anything good to offer… which sucks, because I don’t particularly want to vote for anyone who is going to screw us over like this either.

  3. B, if you look at Edwards’s entire plan, it’s clearly aimed at creating a single-payer system, through a series of intermediate stages. So his first step is to make insurance mandatory. (His second, of which I wholeheartedly approve, is requiring all insurers to place their customers in the same risk pool with only age and sex adjustments, instead of keeping some in a low-rate pool and forcing others into a special, high-rate HIPAA-only pool. And then there are more steps after that.) The problem is, I don’t think you can get to single-payer in stages. Largely because there is no way to make private health insurance mandatory without creating extra paperwork and indignity. And I don’t think any candidate has the guts to flat-out state that we need to get rid of all the existing infrastructure of the industry and erect a new, single-payer system instead.

  4. I swear I have no overarching idea about how to fix insurance. I do have a few ideas, though.

    1. It should be illegal for doctor’s offices to ask you if you have insurance before making an appointment. We should go back to the days of you going to the doctor, getting billed and turning the bill in to your insurance to get paid or paying it yourself.

    2. Medical insurance, like car insurance, shouldn’t cover “little” things. You don’t bill your car insurance every time you fill your tank with gas, right? Same with health insurance.

    3. It should be illegal to deny anyone coverage.

  5. Edwards also called for mandatory checkups.

    He is at least honest in his understanding that a ‘right’ to health care must include a responsibility for those who benefit from that right.

    Think of it this way, the right to Free Speech does not include the freedom to cry “fire” in a crowded theatre.

    Edwards knows that the right to health care will not include the freedom to order extra fries.

  6. I don’t think you can get there in stages either. Not neatly planned out ones like this, anyway. It’s the same reason a lot of our hospital systems still use DOS, and there are defense planes that can be outperformed by my calculator.* It costs so damn much to make systemic changes that people aren’t going to be up for it even once, let alone many times over a period of years.

    That cost is in paperwork, in training, in personnel changeovers and making up new rules for cases caught in the middle, and so on and so forth. Which, of course, is rarely figured into the ‘real cost’ of anything… not the sexy numbers that make frontpages and get heated debates.

    This isn’t to say that I’m not for change… I want universal healthcare and I want it decades ago. I just don’t know if an incrementalist approach will actually get us where we’re going in any meaningful way.

    Now, if the change is singular but long-term (we change all the forms and make all the procedures now, and then we set deadlines for times to stop doing things this way and start doing them that way, and as soon as these papers have cleared out we train the people who were doing that to cover this job instead…), I could see it. That way, you have one major push to get things conceptually set, and then each meso-unit (department, group, etc.) has a relatively short list of changes that need to be done over a relatively long time period. That, I could see working.

    The problem, of course, would be that you’d pretty much have to do that ‘scrapping the system and putting in a new one’ thing, which would be difficult, if not impossible to do politically.

    * I’ll note that this isn’t true for the fast, shiny, frontline things. But it is true of a lot of other things, and if I could only remember the name of the airbase I was at, I’m sure I’d be able to give more information.

  7. Mmm, all that said, I personally don’t mind leaving the for profit structure we have in place iff there’s a corresponding governmental* structure that covers absolutely everyone to an adequate degree. If that means expanding Medicaid or whatever, fine… but everyone should be able to have health coverage, everyone should be able to afford health coverage, and this health coverage should actually cover things.

    That last being the important part. For me, an absolute minimum would include yearly preventative checkups, yearly dental visits, and basic mental health coverage (preventative and treatment-oriented) along with the expected treatment checkups when you need it, prenatal care, reproductive care, covered drugs and hospital stays and so on and so forth.

    My major point is that people shouldn’t die for lack of basic health coverage, and being laid off shouldn’t mean you’re screwed. I don’t mind if corporations continue to charge to offer fancy health suites (my healthcare, for instance, is pretty damn awesome due to some grandfathering in… they don’t even offer my plan any more. It’s the only thing worthwhile about the job arrangement, really.), as long as there’s a way to opt out (no “you can’t work here if you don’t sign up for our healthcare” stuff, and no lifetime contracts) and the healthcare being offered for everyone is decent. (Preferably wayyyyy better than my minimum, but I’d take what I could get, at this point.)

    * Or, for the libertarians, guaranteed private or charity, of equivalent quality, blah blah etc.

  8. Pingback: Volunteer Voters » Government And Corporate Collusion On Health Care

  9. the right to Free Speech does not include the freedom to cry “fire” in a crowded theatre.

    Why not? The phrase you cite, Mr. Rogers, is a commonly repeated misquote from a U.S. Supreme Court decision that was later overturned (a decent summary can be found here).
    In effect, the right to free speech can include the right to cry “fire” in a crowded theater, depending on the circumstances.

    Enough of my nitpicking. I agree wholeheartedly with the underlying sentiment of your larger point, which is that part of staying healthy is preventive (one might even call it a holistic approach). That’s why I think better health and dietary education should be a part of any national health campaign. (It would wind up taking some money out of the crap food and pharma industries, but I can live with that.) But attaching punitive action to checkups reflects the kind of totalitarian impulse that we all should be fighting against right now.

  10. Church Secretary,

    I wasn’t quoting. I was making a different point, that when you start creating ‘rights,’ you quickly run into conflicting rights.

    For example, does the ‘right’ to health care mean that 95 year olds have the same right to heart transplants as teens? Do alcoholics who refuse treatment have a right to liver transplants? On what basis do you balance ‘rights?’

    Rather than creating more ‘rights.’ why not make the argument that having certain health care services available to all people is good public policy? You might be surprised how much support there would be for specific health care reform measures in that context.

    And, by the way, just because a decision is overturned does not make it a bad decision. That is, in fact, one of the best arguments against making most public policy by invoking ‘rights.’ Shift a justice or two and the ‘right’ changes.

  11. [quote]Katherine, What do you consider “little” ? pap smears ? mole removal? dizziness? just asking[/quote]

    I’m not Katherine, but my auto insurance and home owner’s insurance have straight deductibles, no co-pay. Nothing comes out of my insurance agencies pocket until I meet my deductible of $500 or $1000. I believe most people don’t meet their car or home owner’s (or renter’s) insurance deductibles every year, or even most years. So why do we expect health insurance to start paying out for routine maintenance tasks like annual checkups?

    Not charging people for annual checkups and other preventative care items makes sense in a lot of ways, but that’s a straight subsidy and should not be called “insurance”.

  12. This post brought up some great points. I’m not sure what the solution is for the health care problems we face, but mandatory coverage (and the government billing us for it) seems a little too “Big Brother” to me. I’d also like to know why the CEOs of the medical and pharmaceutical corporations are pulling in millions of dollars in salaries and incentives while so many consumers are unable to afford their products and services. Maybe Edwards should include an addition to their tax forms that forces them to list the number of people they’ve screwed over during the year.

  13. Mr. Rogers, I think you’re focusing too hard on the word “rights.” My opinion– and I think most U.S. citizens are probably in agreement with me on this– is that all of us should have health care, period. The examples you offer are somewhat extreme extrapolations of issues already being faced in our current for-profit system. I’m not saying those issues are irrelevant, just that they are tangential.

    Rather than diverting ourselves with semantic waltzes, I think it is better to focus on the simpler choices. I like Moonbeam’s approach; do we want to provide everyone with health care, or do we want to keep fattening the coffers of a relative few wealthy CEOs and stockholders? Edwards’ problem is that he is unwilling to confront those insanely wealthy and powerful interests. He is joined in his unwillingness by nearly all the other candidates of both parties.

  14. Fuck. Shit. Cunt. Bitch. Hell. Flavor Flav. Dammit. Cock.

    There, because you couldn’t.

    And as an aside, I have severe reservations about the practicality of any system that takes the profit motive out of the equation. Not saying that our current system is whiz-bang, just skeptical about the ‘solutions’ being offered.

    Kind of like the devil I know, if you know what I mean.

  15. I have severe reservations about the practicality of any system that takes the profit motive out of the equation.

    I hope those reservations don’t cause you to hesitate the next time you consider dialing 911.

  16. Flavor Flav? Lee, there are some standards here, you know.

    I see good (not perfect, but good, and better than what we have here in many ways) health care systems in other countries. Those systems weren’t there ab initio, but were developed within living memory, and in clearly recorded manners. There must be modern historians who can tell us useful things about the plusses and minuses of how they were adopted.

  17. Did y’all catch the story of the women who was rejected from emigrating to New Zealand because she was overweight and would have been an undue burden on the healthcare system?

    http://www.upi.com/NewsTrack/Quirks/2007/11/19/overweight_spouse_cant_emigrate/2534/

    It blends in with the issue, that if you are going to hand over your health to the state, “for free”, then you make yourself a ward of the state.
    It’s also simple supply and demand, that if you make a
    service “free”, then the demand will eventually overwhelm the supply. The only solution is to directly restrict the supply. This translates to longer waits, and rejection of services for those deemed unworthy, as Mark Rogers said earlier.

    It’s as unstoppable as night following day.

  18. Sorry, Ex, how is “restricting the supply” not a description of what’s been happening in this country for the past 20 years or so? And why does it not make sense to take obscene profits for executives and the multiple layers of bureaucratic paperwork from multiple private profit-making corporations infecting the system right now out of the equation?

  19. I hate the healthcare Borg as much as anyone. One of the biggest problems with it is a lack of accountability. This is made possible BY the bureaucratic paperwork, of which complain. Transferring it to the feds will only increase that problem.
    As for restricting the supply, there’s a difference between something being expensive and something being illegal.

  20. It blends in with the issue, that if you are going to hand over your health to the state, “for free”, then you make yourself a ward of the state.
    It’s also simple supply and demand, that if you make a
    service “free”, then the demand will eventually overwhelm the supply.

    no matter who your healthcare is “handed over” to, your healthcare provider gains real and important power over your life. that sort of follows from the definition of healthcare, and if you think private insurance companies are any more benevolent warders than the state would be, you haven’t seen Sicko. (it’s out on DVD now, hint, hint.)

    and no, healthcare really doesn’t follow simple supply and demand rules, because healthcare is not a luxury; demand is unusually inelastic. making it free at point of need might increase demand somewhat, but does not increase it without limit, as we can see by looking at countries where healthcare is free at point of need. (if you can’t think of any such countries, watch Sicko.)

    healthcare is not like other goods or services, because human lives hinge on it much more directly. treating it as if it could be run for profit — for anybody’s profit, especially third parties like the insurance companies — reduces lives to dollar amounts far more cynically and callously than most of us are willing to put up with. some degree of reckoning about the monetary values of living people is inevitable in society, but more than a very little of it tends to violently offend us. there is good reason why our health should not be bought and sold for other people’s profit.

    supply of healthcare naturally, always, has to be rationed, because — reckoning callously about the cash value of lives here — we can’t afford to provide infinite amounts of it to everybody. that’s a given fact, follows from Malthus really. hence every system of healthcare can be seen as a rationing system, in some sense. that is so not just in the current U.S. system, but especially in the U.S. system, which rations healthcare based on the “size of your bank account” criterion. the complaint is that that is a miserably awful criterion and we ought to find a better one.

  21. […] a lack of accountability. This is made possible BY the bureaucratic paperwork, […]

    and once you’ve eliminated the paperwork, pray tell how will you hold anybody accountable?

  22. May I just express my deep love for any thread containing the phrase “I like Moonbeam’s approach”?

    Lyrl, that’s something I’d not considered–your point that it might be useful to make a distinction between “paying for shit we all need” and “insurance.” Insurance is, at heart, a gamble. You pay in betting that someday you’ll need more money out of the system than you’ve put in. The insurance companies are betting that, if they dick you around enough, they can keep more people paying into the system than they have to pay out.

    Now, it may be that it’s less expensive for them to cover basic checkups because they’ve negotiated a good price with doctors and finding stuff early is less expensive than finding it later.

    Anyway, it may be that there’s a lesson for the government and non-profit entities (which hospitals are) in that: that it’s cheaper to give us all a base level of healthcare for free than to wait for those of us who don’t have insurance to show up in the ER.

    Not that I’m going to solve the healthcare problems in this country myself. I just hate to see this turn into yet another way that rich people collude to rig the system and then blame poor people for their failure to navigate a rigged system.

  23. It’s true that healthcare is a necesity, but if competition is allowed, that takes away a lot of the power. We only have one government.
    Please. Moore is a propagandist. This has been shown over and over. How could you believe anything in his movies?

    You complain about healthcare being rationed based on the size of my bank account. At least I have some control over the size of my bank account. My decisions either benefit or hinder me.

    Can’t continue. gotta go to a meeting.

  24. Exador: As for restricting the supply, there’s a difference between something being expensive and something being illegal.

    Technically, that’s completely true. In practice, it’s fairly common for insurance companies in the US right now to make insurance that actually covers needed services so expensive that for certain classes of people no one is able to afford the policies: they are offered on paper, but in practice they don’t exist. It’s like a literacy test for voting. We can all agree that basic literacy is not too much to ask of citizens, but we know that historically, those tests have been misused to exclude certain large classes of citizens from being able to vote.

  25. how is competition supposed to work in the healthcare field, anyway? let’s run a few hypotheticals.

    worst case, immediate need of emergency help; i’m in a car crash, unconscious and bleeding. i do not want any healthcare providers to be “competing” to get my “business”, i want the nearest EMT to damn well get there and keep me alive. “competition” here would be homicidally stupid.

    next better, acute need of non-emergency help. my appendix is bursting, but i can still catch a cab to the nearest hospital without needing an ambulance. that’d be because the nearest hospital is in my town. but there’s only one hospital in my small town — if i want “competition”, i’ll need to drive at least half an hour, which would be suicidally stupid in an acute situation. even in a large city with several hospitals, i think i’d still head for the nearest one, because not being a doctor i really don’t know how much time i’ve got, and i certainly don’t have time to shop for a doctor to tell me that.

    one more step, short-term need of help; a severe toothache. only now can i begin to shop around for providers. but what criterion do i use to select a dentist by? i’d love to ask around for the one with the best reputation and the best training, but really, most people don’t need a dentist often enough to have experience of more than a very few.

    the reputation doctors and dentists have for quality of service is questionable — their patients likely don’t have a good basis for comparison, and likely aren’t expert enough to judge outcomes all that well. i could try to find the dentist with the worst set of teeth, but more likely i’ll go with the most expensive one i can afford… except that dentists know that, and set their prices accordingly, so that’s not a good criterion either.

    final step, long-term needs and preventative care. maybe here, medical competition could finally do me some good. maybe, but it seems to me that the most crucial parts of healthcare have already been ruled out. besides, for long-term preventative care, what i really want is to find one doctor i can stick with that’ll end up knowing my history and background well; changing providers a lot in order to benefit from competition would interfere with that.

    and if Moore’s not telling the truth in his documentaries, sue him. if you feel he’s lied to you, you can actually do that, y’know; one of the problems he had making Sicko was getting indemnification insurance for a movie about the shortcomings of the insurance industry. (he and his team went into this a bit in a panel discussion i attended this summer. i also got the chance to see some of the outtakes, but that’s another story…)

    oddly enough, he doesn’t tend to get sued much, for a documentary filmmaker of his reputation… maybe that’s because, on the whole, he tends to tell the truth and document the facts he presents in some detail? i know he’s not lying about socialized medicine in other countries — i grew up in Europe, you’ll recall. (others agree that he gets it straight, too.)

    At least I have some control over the size of my bank account.

    until you run into a serious healthcare emergency. those tend to bankrupt people in this country, even if you do have insurance. then you can’t work, and can’t afford the treatment to get you back to work, and can’t afford the bills you’ve run up for treatment to keep you alive… how much control have you left, then?

    plus, that statement spits in the face of people who need medical help yet aren’t economically well off. it’s blaming the poor for being poor, and using their illnesses to punish them for their poverty. i’m rather proud of myself for not flying into a furious rage at you for doing that, by this point. that sort of callousness properly deserves… well, you’re not about to get what you deserve, so no matter.

  26. Part of the ‘competition” factor is there is precious little transparency in what medical procedures cost. Why can’t we get at least some good faith estimates?

  27. Because, to enhance their profits, insurance companies routinely assume physicians and laboratories are overcharging for their services and cut their payments. So that physicians and laboratories routinely inflate their charges to a level that they guess will bring them full reimbursement of what their services actually are worth. And the amount any given patient is billed depends on what point in the cycle any particualr physician is at with any specific insurance company when the physician deals with the patient.

  28. One problem with government health care… they aren’t really accountable. Sure you can vote against the incumbent, but that does nothing to the bureaucrat. At least right now if my insurance company screws me I can find a government agency to complain to.

    You also have to consider scale. The larger a system is, the more opportunity for losses due to waste and friction. I’m not aware of any country near the population of the US that has government sponsored health care. But, I’m not really that familiar with other country’s health care systems.

  29. To address a couple of Nomen’s hypotheticals, a lot of competition in health care occurs before you need it. Competition goes well beyond price-shopping.

    worst case, immediate need of emergency help; i’m in a car crash, unconscious and bleeding. i do not want any healthcare providers to be “competing” to get my “business”
    The competition came before your accident. Lots of local governments have contracts with private amublance companies. They keep cost down because if it gets to expensive their contract doesn’t get reneweed.

    but there’s only one hospital in my small town
    Yeah, but if that hospital screws people over too much, another one can always set up in town.

    most people don’t need a dentist often enough to have experience of more than a very few.
    If you’re actually taking care of your teeth you already have a dentist that you know because you go to him yearly anyhow. And you shopped around to find the best before you got into a pushed situation where you needed someone fast.

    changing providers a lot in order to benefit from competition would interfere with that.
    Like I said above, price-shopping isn’t the only way competition works. The doctor knows he can lose your business if he gives you too hard a time.

  30. This sort of issue is very difficult to debate, because the Right Wing Noise Machine has done a splendid job not only of selling the unfettered free-market fantasy, but also of educating all the little wingers out there how to muddy the waters of discourse with specious arguments. By “specious,” I mean arguments that don’t stand up under the least amount of scrutiny. But, as the wingers have learned, if you throw enough shit on the wall your opponents will get tired of the smell and walk away. I’ve shoveled and cleaned up enough shit in my life that the smell doesn’t bother me; it means it’s time for some clean-up. Maybe that’s what I love about the Great Propagandist Michael Moore. He loves to wade in and clean it up, too. (That’s why the RWNM– with its numerous auxiliaries in corporate media– love to smear Moore. Strangely, though, his movies still sell and they can’t make any of their shit stick to him.)

    Anyway, let’s take a few of these specious arguments to task:

    Exador says:

    You complain about healthcare being rationed based on the size of my bank account. At least I have some control over the size of my bank account.

    Really, sir? If your health care bills pile up, and your illness/injury decreases your earning power, how much control will you have over the size of your bank account then? The crappy health insurance Ponzi scheme is great until you really need it. That’s when the loaded dice roll.

    W says:

    One problem with government health care… they aren’t really accountable. Sure you can vote against the incumbent, but that does nothing to the bureaucrat. At least right now if my insurance company screws me I can find a government agency to complain to.

    I just love circular reasoning that defeats itself. So, W, you don’t trust a government bureaucrat (with no profit motive for which to screw you over) because you don’t think she’d be accountable? This is pure reactionary discourse, my friend; you couldn’t have given this a microsecond of thought. If your insurance company (run by corporate bureaucrats) fucks you over, and you have to go to a government agency* for satisfaction, how is that better than not having the middleman with a profit motive?

    W said:

    Lots of local governments have contracts with private amublance companies. They keep cost down because if it gets to expensive their contract doesn’t get reneweed.

    Did you stop to think how they are keeping costs down? It can’t be by skimping on labor and quality of service, can it? I guarantee you: in Chicago, if most people have an urgent injury or illness and they require emergency transport, they ain’t gonna call a private ambulance.

    but there’s only one hospital in my small town
    Yeah, but if that hospital screws people over too much, another one can always set up in town.

    Sure, unless they don’t think they’re going to make a profit. If the per capita income in your small town is too low, do you seriously think a for-profit hospital is going to bother with it? Unless, of course, you have a high enough number of people who have Medicare. Oops! That be a tax-and-spend gubmint program. Never mind.

    C’mon, guys. Quantity is no substitute for quality. You have to come up with some better arguments. My two-year-old daughter can see through this stuff. Aunt B., would it be impolitic to shift this discussion to an examination of why these right-wingers are really afraid of universal health care?

    *run by gov’t bureaucrats who are supervised at the highest levels by bureaucrats who– if they aren’t former and future health insurance bureaucrats themselves– are appointed by politicians who get massive campaign funding from insurance companies. If you cut out the insurance companies, then you eliminate the profit motive and the middleman and– oh, never mind.

  31. Yeah, but if that hospital screws people over too much, another one can always set up in town.

    Actually, that probably wouldn’t happen. “Setting up” a hospital is a monumental undertaking, and yes, CS is right, there would have to be an enormous financial upside, which isn’t likely in a small or even medium sized town. My partner knows about this all too well. She worked for a hospital rife with nepotism, and corruption, mostly because they knew that as the only game in town, they could do so with impunity.

  32. CS, switch to decaf. You’ve been a little jacked up lately, even for you.

    That bit about the bank account also ties into maintaining a job with decent health care coverage. Really, my point was that I’d rather have more control and less security than you government-is-god types. I’d rather make the choices to keep myself reasonably healthy and covered, and keep more of my money.

    Profit motive is also a motive to retain customers, something the gubmint is alone in its ability to not require.

    Also, again, we have only one government. That’s the best of monopolies. Even better, really, since it is only accountable to votes, and we all know what a joke that is.

    Yes, the bureaucrats are not your friend. That’s what we’ve been trying to say. More direct accountability and competition would make the situation better.

    A little less tinfoil hat conspiracy theories of the evils of capitalism would help your point.

  33. And even if a new hospital did just set up in town, it just pulls you back to Nomen’s hypothetical land. When you need a hospital, you need it right then. And sure, if you’re lucky enough, you’ll have the necessary information (not always even remotely the case – can you tell me right now, department by department, what the better hospital is for whatever might ail you? If you have a heart attack, will you have time to do the research to make that distinction?) and flexibility of condition and insurance and finances (ambulance rides are expensive) to make that choice. That’s great news for the cancer patients, people on dialysis, and pregnant women on schedule to be induced, but it doesn’t do so great for people with more acute problems.

    More to the point, hospitals, by virtue of their size and complexity, tend to vary a lot. One might have the fancy-pants orthopedic surgeon, while the other one might have the hot-shot oncologist, and neither one might be very useful for the seizures you’re having. The current system, due in no small part to that profit motive, makes going between hospitals very difficult. Single-payer insurance would mitigate that to a degree by allowing greater freedom of movement and more choice… which, yes, under various models would allow more competition.

    (Which is a whole ‘nother issue. There are single-payer ideas that would keep and promote competition without dicking over the poor, the sick, and the out of work. But I have to leave for a doctor’s appointment, so I can’t finish that thought.)

  34. Also, again, we have only one government. That’s the best of monopolies. Even better, really, since it is only accountable to votes, and we all know what a joke that is.

    It’s such a joke because so much of the electorate regularly votes for politicians who’ve convinced them that it is in their best interest to fuck themselves over. It is only a monopoly as long as the majority of the electorate (including those who don’t vote) keeps opting for the status quo (or worse).

    Also, what Mack and Magniloquence said.

  35. You’re exactly right. I guess I’m more of a pessimist; I see the elections becoming even more of a beauty contest as the years pass. Our infotainment culture drives it. More and more people are completely ignorant of politics, but know Paris Hilton’s dog’s name.

  36. You got that right, Exador. But that’s our fault. We don’t demand substance. We’re so locked in to being consumers that we don’t give much serious thought to being citizens. One should be a good consumer, but citizenship is far more important in a representative republic.

  37. Was it Bridgett who was talking about the shift in our concept of citizenship from stakeholder to shareholder? Figuring out how to start shifting that back would be a worthy project.

  38. Dear Aunt B,
    Here are a few reasons that point to Mr. Edwards being the Dem’s nominee:
    1 Hillary is a woman. America is not liberal enough to vote for a woman.
    2 Barrak is black. America is not intelligent enough to vote for a black man.
    3 If those two lose Edwards wins.
    4 Edwards is pretty. Neither of the two above mentioned candidates are pretty.
    5 Remember the last non election for prez hung on an anti gay marriage question.
    6. Sorry to announce this but Huckleberry will probably be the next prez. Because America is neither liberal nor intelligent. (There are some exceptions)

  39. America is neither liberal nor intelligent.

    There seem to be a fair number of Americans who dislike being called liberal, but they love what liberalism has brought them… whether they know it, or not.
    .

  40. old Joe’s first two points, seconded. neither Clinton nor Obama can be elected in this country, not today — maybe in a generation or two, but not today. they need to run and get votes, or else that “generation or two” becomes “two generations or three”, but they can’t win now.

    none of the other dems can pull off a landslide. and the last two elections showed us what happens if a democrat does not win by a landslide margin. close calls or small (D) wins are (R) wins, in today’s america. full stop, end of story — the supreme court is even more conservative now than in 2000.

    so, the next prez will be a republican. not sure which one, because damfino what internal ranking systems the repubs use to choose their candidate; to me, it looks like “stupidest one gets it”, which would be either Giuliani or Huckabee.

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