A small task for you today, my little fuzzy peaches, at reader request.
Let’s solve the health-care crisis. To quote a well-known public figure: Yes, we can.
I ask because I received an e-mail from a reader last week, with a link to a story with this non-inflammatory headline — Canadian Health Care We So Envy Lies In Ruins, Its Architect Admits. Ahem:
As this presidential campaign continues, the candidates’ comments about health care will continue to include stories of their own experiences and anecdotes of people across the country: the uninsured woman in Ohio, the diabetic in Detroit, the overworked doctor in Orlando, to name a few. But no one will mention Claude Castonguay — perhaps not surprising because this statesman isn’t an American and hasn’t held office in over three decades.
Castonguay is credited as the man who first conceived of Quebec’s provincial single-payer system, which eventually spread across the country and became the Canadian system we know today. In a story that begins by implicitly scorning the anecdote as a public-policy driver, the anecdote of Claude Castonguay (what a wonderful name) is given great weight, although his ideas about how to fix the Canadian system boil down to a pretty tame set of recommendations:
Castonguay advocates contracting out services to the private sector, going so far as suggesting that public hospitals rent space during off-hours to entrepreneurial doctors. He supports co-pays for patients who want to see physicians. Castonguay, the man who championed public health insurance in Canada, now urges for the legalization of private health insurance.
In my night-shift editing I read half a dozen pieces like this a week. Everyone has an idea how to fix American health care, but no one has the idea. Personally, I don’t believe the system is fixable in the state it is now. But I’m always willing to read one more idea. My favorite is the Wall Street Journal, which has some of the best health-care reporting in the world, but a whack editorial page bought and paid for by the American Medical Association. And my single favorite piece on that page in recent months was last year sometime, suggesting we could all learn something from the Amish, who don’t believe in health insurance, and who use such radical cost-containment practices as chipping in for one another and, my personal favorite, dickering.
Oh, how I can’t wait for the day when I dicker with my doctor. I bet he can’t, either. Unmentioned in the admiring WSJ editorial are the other documented Amish health-care cost-containment practices, which include alternative medicine (herbalists, midwives, etc.), bus trips to Mexico for the Third World option and, frequently, quackery. The Fort Wayne Journal Gazette had a pretty good series a few years ago, where a reporter followed one of these caravans. Among the anecdotes was a woman who’d had a serious ankle injury requiring reconstructive orthopedic surgery, and the incision stubbornly refused to heal, with chronic infections. (Dr. Nance would prescribe a hospital stay with heavy antibiotics to knock down the infection, followed by a rigorous home-care program emphasizing keeping the wound clean, with instruction for all her caregivers. Oh, and diabetes testing. This is just off the top of my head.) Her Mexican doctor advised removing all the surgical screws on the theory they were causing her infections, followed by poultices. I don’t know where the Amish woman is now. My guess is either pushing up daisies, or coping with life as a 19th-century amputee.
(A further note, also from the WSJ: Dickering doesn’t solve everything. Also, let’s recall the tragic case of the Amish Cook, who dropped dead at 66 from an aortic aneurysm, diagnosed by her herbalist as an iron deficiency, IIRC.)
I don’t mean to be flip, I really don’t. I’m glad the reader sent the link along. I know there’s no simple answer to this problem, or any answer. But here’s what I know:
A health-care system where a poor kid with asthma has to take three buses and a subway to his clinic doctor, and a doctor’s wife can get spa-level care while recovering from her breast augmentation — is not a good system.
A health-care system that rewards doctors more for choosing dermatology as a specialty (with all those lucrative, pay-out-of-deep-pockets anti-aging patients) than primary care (with all those poor kids with asthma) — is not a good system.
A health-care system where insurance is connected to your job, with no contingency for job loss other than COBRA — is not a good system.
There is no perfect system, and there might not even be a very good one. Life is a terminal disease, and some of us have trouble facing this fact. There may be no way to balance the truly miraculous technological and pharmaceutical advances that are driving the cost of health care into the stratosphere with the fact hardly anyone can pay for it. But maybe there’s a better way. This is your job today, little commenters of mine: Let’s fix it! You know we can!
And if you’re not up to it, in the bloggage, two internet-related stories about the campaign:
From Saturday’s WashPost, a woman offended by the Obama-is-a-Muslim e-mail tries to track it back to its source, with more success than you’d think.
And in Sunday’s NYT, a piece on DIY attack ads by freelancers.
Both worth your time. And just for laughs:
A bunch of white kids fight the “Barack Hussein Obama” thing by taking “Hussein” as their own middle names, an “I am Spartacus” sort of protest. I am Salman Rushdie!
coozledad said on June 30, 2008 at 9:51 am
One piece of a solution might be to encourage physicians to do their residency among the rural or urban poor, perhaps in exchange for defraying med-school expenses. I think Duke has a sort of pilot program for this, or at least they did a few years back.
I just wish they could get physicians to stop being sales reps for the pharmaceutical industry, and encourage preventive medicine whenever possible.
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derwood said on June 30, 2008 at 9:55 am
I’m not sure I have the answer for our health care. I know I pay 12K a year in premium to cover my wife and me. That policy through my employer has a million dollar cap. That may sound like a lot, but it really isn’t.
I work with a bunch of people from Canada and they just shake their heads at our system. They are the first to admit that theirs isn’t perfect but they wouldn’t trade what they have with what we have.
My wife is a type I diabetic and I take a cholesterol pill. Neither one of us can buy insurance without being part of a group plan.
d
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brian stouder said on June 30, 2008 at 10:25 am
Everyone has an idea how to fix American health care (emphasis added)
yes.
There is no perfect system
yes indeed.
The semantic approach might be worth a glance. Once, a long time ago, it greatly impressed me when a pundit somewhere, discussing the American justice system shifted the argument by making the point that there is no unitary “system” at all. It’s a crazy-quilt of conflicting agendas and differing customs and so on….whereupon another person pointed out the agreed upon (more or less) ideals that over-arch everything – the US Constitution.
The rest of the argument is lost in the misty miasma of the endless yap-yap shows that I have taken in….but the point (it seems to me) is salient.
While indeed “There may be no way to balance the truly miraculous technological and pharmaceutical advances that are driving the cost of health care into the stratosphere with the fact hardly anyone can pay for it”,
still, if the political paradigm shifts so that we expect better (even as we continually fall short), then that’s something real.
Years ago there was much talk about a “Patient’s Bill of Rights” (etc), and I think that the metaphor was correct.
And not for nothing, but the anti-reform chorus from the right HAS (more or less) adopted this sort of rhetoric, and they view the pro-reform efforts as nothing short of revolutionary.
I think President Obama should use his rhetorical skills before a convention of governors (who afterall have a very large stake in the current ‘system’), and advocate federal assistance to state healthcare programs that succeed in covering children and providing affordable coverage to adults.
The mindset that Obama should foster should be something along the lines of the Declaration of Independence, while the states (with federal assistance) implement the concrete plans; just as in legal terms, the Declaration is “the apple of gold” on the Constitutional “picture of silver”
By way of saying, perfection may not be obtainable, but we certainly should strive to overthrow complacency with the status quo (“America has the best health care system on earth” etc etc)
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Jeff said on June 30, 2008 at 10:36 am
And the dateline for the “Hussein is my middle name” story?
Columbus, Ohio!
On the string of “is not a good system” notes, i can only offer in response the law of unintended consequences — fixing one thing has odd effects up and down the line. The conundrum right now is that we have an awkward sort of national health care, which creaks, but works, while allowing the wealthy to get superior care. I’m less willing to exercised about spa care for Doc’s second younger wife than i am about improving the access and quality for the poorer end of our system . . . which is why i worked so hard to get CHIP passed in West Virginia in the late 90’s.
The problem it gets wrapped up with is that if everyone who currently qualifies for Medicaid actually got it and used it, the system wouldn’t creak, it would scream the way a bridge does right before the collapse. So even children’s advocates were, and are (in the CHIP2 battles) often advocating a cautious approach for fear of bringing down the whole house of medical cards.
A big step would be to acknowledge the current system for what it is — Medicaid, VA, Medicare, CHIP, and laws governing public ERs (with some medical clinics run by nfps) covering all but the 40% on private/gov’t employee health care, avowedly as “Our National Health Care Policy.” Then we have to figure out how to expand that, and deal with illegal immigrants, who are essentially all of the increase in the uninsured over the last two decades. “Our National Health Care Policy” (ONHCP) actually works fairly well, but has holes.
Saying “we will guarantee every American health care as good as Congress gets” is not even remotely deliverable, and those saying this know it. (And guaranteeing that level to all immigrants regardless of legal status? Ay caramba…) Improving ONHCP for vulnerable populations is doable, but the doctor’s missus thing you can drive underground, but it’s better they stay out in the open where a certain amount of scrutiny is still available as a mild disinfectant.
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nancy said on June 30, 2008 at 10:37 am
“Expect better” — that was the overwhelming impression I got from “Sicko.” You can argue all day about the French system, or the British NHS, or the Canadians, or the Japanese, or whoever, but all those citizens expect better from their governments, and by and large, get it.
This fascinates me.
T.R. Reid did a health-care-around-the-world piece for “Frontline,” and the Japanese system was fascinating. The Japanese love scans of all sorts. You get an MRI for everything more serious than a head cold, and it costs about $20. Amazing.
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nancy said on June 30, 2008 at 10:39 am
Oh, and Jeff, I wouldn’t resent the doc’s wife’s spa services if I didn’t see the logical end of that system — Donald Trump on his third kidney transplant, while everyone else dies or goes on dialysis.
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Jolene said on June 30, 2008 at 11:00 am
Expect better, indeed. Many Americans seem congenitally incapable of believing that we do not have “the best in the world” of whatever is being discussed–education, health care, transportation, whatever. This kills me because the data indicating that it’s untrue are so readily available. I sometimes feel that I want to go door-to-door describing the results of all the research we have describing the inadequacies of our health care system to one family at a time, followed up with a dose of international comparisons on quality and cost.
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Gasman said on June 30, 2008 at 11:09 am
For profit healthcare is immoral. As long as we pit profit motives of stockholders against patient care, patients will lose. I have grown weary of the conservative mantra that the free market will ALWAYS produce the best solution. The free market has had a free hand with the healthcare system for decades and it has produced only greater levels of bureaucracy which increase cost, decrease efficiency and compromise patient care. The current system seems to be good at maximizing cost and profits and not much else.
As to the litany of scary stories about the Canadian system vs. our own, my wife is a Canadian citizen as are all of her family and I have NEVER heard any major complaints from them. Her family is large, probably 3-4 dozen, and they range in age from cradle to one foot in the grave. They have had the typical range of maladies and procedures for such a cross section of people. The wait times have never been different for similar procedures here in the U.S. and they NEVER GET A MEDICAL BILL! The entire system operates more efficiently with a far lower cost than ours. My Canadian relatives reside primarily in Ontario, which is important because each province has autonomy regarding how healthcare is implemented. Several years ago, I had a visit to a doctor’s office in Ontario to address a chronic sinus infection and an office visit cost me all of $27 U.S. At the same time, such a visit in the U.S. would have been at least 5 times as much.
While any bureaucratic system anywhere will have inherent weaknesses, ours is a mishmash of ludimicrosity that fails miserably at its primary mission – to provide efficient and affordable healthcare to ALL Americans. Our moronic “Ours-Is-Always-Better-Cause-We’re-Number-One” attitude rarely works to our advantage because it keeps us from even considering any other way of doing anything. We lag behind dozens of nations in terms access to care, infant mortality, and many other unenviable categories. About the only thing we truly lead the world in is healthcare cost.
Screw the for profit model, it DOES NOT WORK! Building upon its crumbling structure makes no sense. Scrap the entire bloated system and start anew. Some version of the single payer system seems to be the way to achieve greater efficiency and universal coverage.
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Jolene said on June 30, 2008 at 11:19 am
In addition to the piece re the origins re the “Obama is a Muslim” email, the Post published a piece today re the end result of it. An excerpt:
“I think Obama would be a disaster, and there’s a lot of reasons,” said Pollard, explaining the rumors he had heard about the candidate from friends he goes camping with. “I understand he’s from Africa, and that the first thing he’s going to do if he gets into office is bring his family over here, illegally. He’s got that racist [pastor] who practically raised him, and then there’s the Muslim thing. He’s just not presidential material, if you ask me.”
When I read things like this, I just don’t know what to think, but among the possibilities is: How can people be so stupid? And my next impulse is to be grateful for islands of rationality and goodwill such as NN.com.
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colleen said on June 30, 2008 at 11:35 am
What Jolene said, in both of her posts.
Anyone actually FROM Canada I’ve heard speak about their health care system is fine with it, and wouldn’t want our system.
I’m also starting to doubt the idea that “let the free market decide” is a good idea at all. It leads to poison pet food from China, exploited workers, and god knows what else.
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moe99 said on June 30, 2008 at 12:03 pm
My daughter is spending her summer in rural Montana at a clinic there–the Univ. of WA places its incipient second year med students in a rural setting for the summer. So far she is really enjoying it. No idea if it will be a career calling for her.
More on the “Ohio is a fertile ground for bigots” meme:
http://pandagon.net/index.php/site/comments/the_gay_muslim_chronicles/
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whitebeard said on June 30, 2008 at 12:07 pm
Ah, health care issues are meat and potatoes to any Canadian worth his salt. I was on the city desk at The Montreal Star when universal health care or single-payer health care came into being in Quebec, after a brief unpleasant battle between a band of money-grubbing doctors with really fat wallets and the architects of a health care system that CARED.
As for the Canadian system (with each province in charge of its own health care role) being in ruins, what a bunch of hogwash. In any system, health, taxes, transportation, you can find a headline-grabbing incident and claim it represents a complete failure.
I have Medicare here in Connecticut, which is a federal single-payer system and will stay that way if the Repuglicans are driven out of the temple in this general election.
And as for Claude Castonguay’s task force report on the need for user fees and a Quebec sales tax, “He took issue with how media reports interpreted his recommendations and said they were misrepresented as a road map to privatization.” CBC News back on Feb. 20 http://www.cbc.ca/health/story/2008/02/20/qc-castonguayreax0220.html?ref=rss
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Jeff said on June 30, 2008 at 12:23 pm
Hear, hear for “Expect better” — a vital component of any national health care worth having, here or anywhere. And someone (i think Jolene) said it is a problem that we think ours is best: in my mangled way, that’s what i meant. It’s not that ours is perfect, or non-existent, it’s that we have a national health care policy, and it needs work.
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Jolene said on June 30, 2008 at 12:30 pm
A couple notes from my PBS viewing: First, last night I watched “Traces of the Trade”, a 90-minute film about several members of a white American family who learn that their ancestors were slave traders and the journey they undertake–both psychological and physical–to learn what happened then and how we got to where we are today. May have already been shown in your area, but worth checking to see whether it’s still possible to catch it. It’s on the P.O.V. show.
Second, on Charlie Rose, I saw an interview w/ the brothers Emanuel, i.e., Rahm, the Illinois congressman; Zeke, oncologist and bioethicist; and Avi, Hollywood agent. Very interesting history of a family, but germane to today’s topic is the recent publication of a new book by Zeke outlining a way to reform our healthcare system. Called Healthcare, Guaranteed, the book describes an all-encompassing approach to single-payer universal health care. His idea is to set forth some simple ideas to serve as a starting point. Might be worth a read.
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whitebeard said on June 30, 2008 at 12:34 pm
When I wrote about that band of money-grubbing doctors with really fat wallets that pretended to speak for every doctor in the province of Quebec, I forgot to mention the good guys, the good doctors who did care.
When the general practioners went on strike against the plan and held a meeting and my newspaper’s medical reporter went AWOL (he said he was hungry so he stopped for lunch on the biggest story of the decade) I called the head honcho at the meeting and asked if they had voted to return to work.
He answered that, of course, they were going back to work and I knew in my mind that his fellow doctors favored universal health care and no worries about being paid in a timely fashion.
In the next decade before I moved south to the U.S., after numerous doctor visits, hospital emergency room visits, hospital stays and even major eye surgery (a detached retina) I never heard a doctor or hospital worker complain about the new system, and believe me, I asked every chance I could.
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Jolene said on June 30, 2008 at 12:49 pm
One more good thing to watch: Peter Hart conducting a political focus group made up of PA voters on C-SPAN this evening. I’ll stop now.
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brian stouder said on June 30, 2008 at 1:27 pm
Years ago, I got invited to a ‘focus group’ conducted by the Hart group. It was very interesting; if I recall correctly, it was conducted back O’bannon was running against Mutz for governor. Lots of open questions about White River, fish kills, environmental policy, and the like. They had a pleasant moderator, and a video recorder, and I recall that all of the participants were well-mannered (can’t recall if anyone tried to hog the platform…presumeably a deft moderator precludes that)
It might have lasted two hours or so – and at the end, we each got paid $40 cash!
I remember pondering what they really gained from it…it would be interesting to see that C-SPAN show
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Gasman said on June 30, 2008 at 1:49 pm
If you think the healthcare crisis was bad before, wait until the real impact of $4+/gal. (do I hear $5, $6, even $7?) gas hits middle income America. When gas was $2/gal. people were already finding it difficult to afford, or even obtain, healthcare. When millions more average Americans are facing the very real probability foreclosure of their homes and they are spending up to a third of their income in gasoline, do you think that they will be spending any money on healthcare voluntarily? We are deep in the weeds on this issue and so far, the Republicans have been unable to provide any leadership. In fact, the only time in 28 years that an attempt was made to even discuss the situation, the Rs found it more profitable to attack and vilify Hillary Clinton than to actually do anything useful. I say “No Republicans in 2008.”
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Jeff (the mild-mannered one) said on June 30, 2008 at 2:43 pm
What’s going to get weird is when bidness (the wreckage of GM-Ford-syler, Buy n Large, USX-Bethlehem, Boeing-boeing, etc.) all get into the idea of single payer, non-employee based health insurance, and try to get out from under their retirees as well as current staff.
There’s a case to be made that global competitiveness means we need to have federal single payer, and you can argue that entrepreneurship and innovation have been directly stifled by employer-based health care keeping people in dead-end, no-longer-a-fit jobs just to keep that vital necessity.
But it won’t be paid for unless *at minimum* corporations keep paying to *someone* the amount they’re currently putting up for Health Care, and they’re gonna try to shift the load like Hercules did Atlas. Meanwhile, smaller biznesses are going to be even harder to nail down (for the amount they’re currently contributing).
It’s all gonna be up for grabs when the credit markets go nuts in late August as parental tuition withdrawals uncover the really severe credit shortage going on right now. When China isn’t stockpiling steel and oil after Aug. 24, there will be some easing, but financial markets are in for a wild, wild summer — does this help keep focus on health care? I don’t think so.
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beb said on June 30, 2008 at 3:39 pm
The Big 3 car makers have long whined about how much their employee health coverage costs and how it prevents them from being competive with Japan/Korea/China. And yet they never seem to be the table for single payer universal health insurance. Or any kind of insurance. Do they know something we don’t or do that just want to ame cars without workesr? Like MM Jeff says above, universal health care would be in their interest, so why aren’t they interested.
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Jeff (the mild-mannered one) said on June 30, 2008 at 3:49 pm
Because they can’t figure out how to get single payer without still having enough control to be able to game the system — their payments would be clear and obvious under single-payer, and due each year/quarter. When they figure a formula for how to shift it without having to pay what they already owe (let alone what they’re gonna owe the next few years), they will be at the front of the parade, calling for “action on the part of Washington!”
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Jen said on June 30, 2008 at 4:11 pm
I, unfortunately, have no answers to fixing the health care system. When my fiance lost his job in the beginning of May, he could either pay $500 a month for COBRA coverage or go without insurance. The problem with going without insurance is that he is a cancer survivor, which really screws things up (if his coverage lapsed, the next insurance company could refuse to pay for anything that had to do with his pre-existing condition, and I’m afraid that they would have tried to make EVERYTHING connected to the fact he had cancer five years ago).
We solved the problem by eloping six months before our scheduled wedding so he could get on my health insurance. (We’ve now been married for a little over a month.) But it sucks that a 23-year-old had to choose between losing his life savings now by taking COBRA and losing his life savings later if the insurance company refuses to pay for medical treatments. Thank goodness we had a third option, but he would have been in huge trouble had we not been together and already planning to get married. The whole ordeal has been horribly frustrating.
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Deggjr said on June 30, 2008 at 6:29 pm
Here are two ideas:
1) Health care prices are the same for everybody. Big corporations get huge discounts off of list price (60-70%), small business and individuals pay list price.
2) Premiums have the same taxability for everybody. An individual who is paying non-COBRA premiums can only deduct the excess of 7%. Large and small business deduct starting with first dollar.
Two caveats. One, this is my understanding. Two, even if these ideas are implemented, the crisis is not over.
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Cynthia said on June 30, 2008 at 8:57 pm
This is a very interesting discussion about health care. Like all of you, i have no real answers either.
I’m very skeptical about a single-payor system (read gov’t) because I just don’t like the idea of creating a huge new bureaucracy.
I think health care should be mandatory, like car insurance, with mandated minimum amounts of coverage. I like the idea of my insurance being portable and not dependent upon having a job. I also like the idea of being able to choose a plan that fits my and my family’s needs and having the option of choosing just a catastrophic type policy if I can afford it. If I don’t like the plan I’ve chosen or find the service inferior, I want to be able to switch to a new plan as easily as I change car insurance.
I do think the gov’t (state or federal) should mandate certain features, such as no refusal for pre-existing conditions, payment for experimental procedures, annual rate reviews by state gov’ts, mandatory health savings plans for all Americans, and mandatory contribution to the cost of your personal health care with a minimum and maximum. I know health care is expensive, but there are a lot of people who don’t know the real cost because their employer is picking up the majority of the tab.
Finally, on a federal or state level there should be subsidies for the truly needy.
I’d like to see a top-notch commission comprised of an equal number of doctors, health care administrators, nurses, pharmaceutical experts and ordinary citizens with a modicum of intelligence set up to really study the issue, and look at what other countries are doing better than we are and make real, substantial, thoughtful recommendations or even propose a new system that can be discussed rationally.
This country needs a real conversation and debate about this, as well as other important issues. All we seem to be getting from politicians from both sides are empty promises and platitudes.
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MichaelG said on June 30, 2008 at 10:15 pm
Obviously, single payer is the way to go. There’s nothing wrong with a well run bureaucracy. Think Toyota isn’t a bureaucracy? The big thing is to keep the insurance companies out of the mix.
Also, all anybody seems to talk about is how to meet the costs. Is anybody looking at what the costs truly are? At why the costs are skyrocketing? There must be something other than profiteering on the part of the industry. They wouldn’t pad costs would they? So what has caused costs to increase so dramatically? What can be done to hold them within reason? Has anybody even taken a casual look at the health care mega corps and their cost structure? The politicians couldn’t be . . . No, even such a cynic as moi couldn’t believe that. I mean, look at the wonderful, classically simple drug bill that the Bush administration has given us. It cuts out the insurance companies while creating a mechanism to allow negotiating the most favorable prices from the drug companies. Doesn’t it?
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Mosef said on July 1, 2008 at 12:37 am
This is a “don’t get me started” topic for me. I received a health care masters degree, and could go on and on (and ON) with Rx for change. But NNC.com is not the time or the place. However, I would like to bring up a statistic I learned at grad school (UCLA). Approximately 80% of health care expenditures are spent in the last year of life. Speaking from a strictly utilitarian perspective, this is not a sensible allocation of resources.
Of course, people have a greater need for medical care as they age, and the guaranteed coverage ensured by Medicare increases demand for services. But there is a national conversation to be had about how do we, as a society, want to distribute our health care dollars. Does grandma have to go out in the ICU after heart surgery at 83 while kids lack basic preventive serives? Before anyone writes “But why do we have to chose?” Because we do. Because allocation of resources is a basic function of families, businesses, and governments. It’s called reality. So let’s talk.
Personally, the Alice in Wonderland aspect of the health care industry made me nuts. I got a masters in finance and changed careers.
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MichaelG said on July 1, 2008 at 8:50 am
Now you want to put some kind of needs/qualification test on medical care? Gonna put the old people out on the ice? Stake ’em out on the hillside for the wolves? So how old are you Mo?
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brian stouder said on July 1, 2008 at 8:59 am
Stake ‘em out on the hillside for the wolves?
Just finishing White Fang; Call of the Wild was last week. It’s when you see that one she-wolf, larger than the others and with the reddish tint; the one that sashays…..THAT’s when you have to worry! (well, and when you see the reflections of the packs’ eyes, as they work themselves closer and closer in to your camp fire, in the middle of the night)
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caliban said on July 1, 2008 at 1:57 pm
Hillary had the idea. Tip O’Neill didn’t like it. There’s nothing wrong with Canada’s health care system, other than that ghouls like the Frist family aren’t raking in big bucks.
Cuba has a better health care system, with no money. Granted, boob jobs may require a wait.
Privatizers will pay mucho dineiro to so-called experts to ‘splain this crap, but that sure as hell won’t make it true. Check out recidivism rates from the Erlichman school of free enterprise Christian prison reform. Why are there more contractors than soldiers in Iraq? Somebody’s making a pile and nobody’s getting a bang for the bucks.
With regard to healthcare, seems to me it’s everybody’s duty as a human being. Commonweal. That’s why we agree to pay taxes, and Grover Norquist should die a painful death in an ER waiting room. But no. He’s got the best coverage rich asshole’s money can buy.
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baldheadeddork said on July 1, 2008 at 11:57 pm
Sorry I missed this yesterday.
Question for everyone, that for me is at the center of any discussion on changing the system:
Can you get effective reform (either lower costs for those who have coverage or more people covered for the same cost) with the for-profit insurance industry as the gatekeeper for healthcare?
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