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June 19, 2009

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Regarding health care - I was talking to a friend while doing "pub research" about single-payer and he began foaming at the mouth about "illegals" (this is AZ, after all). He bizarrely said he'd support it if there were a Constitutional amendment barring "anchor babies" from automatic citizenship.

The sickness is really, really deep.

Petro's anecdote does illustrate why social democracy is so suspect in this nation: someone you don't like might get something. It's how the right keeps winning the war for the American mind even as it loses elections. Define, ridicule, condemn, repeat. So tens of millions of stressed-out Americans are certain a single-payer system would mean waiting lines for everything.

Obama wanted to levitate this debate out its Rorschach-Test trenches. He would be calm, bipartisan, and fair. And people like him! Still, no dice. We're a nation of self-defeating cynics, certain even our Best Black Friend wants to make us wait in lines and pay higher gas taxes.

We don't have a real debate in this country because reality is a cartoon now. We can no more talk about real costs, real tasks , and real solutions because our conversation is more like shrieking and howling. I know sane people who are convinced that there's enough oil off Santa Barbara to keep us Happy Motoring for decades to come.

I almost drove to Nogales this morning. I have good health insurance (costly as it is) but waiting in my doctor's office is like an exercise in nausea control. If I drove to Mexico, bought my meds there, I'd save myself from that nausea along with all the high co-pays and all the waiting that only happens - we're told - in countries with "socialized medicine". I'm luckier than most but I'm reduced to whining how insane it is that we bankrupt ourselves so doctors, insurance companies, and Big Pharma don't ever lose anything.

That's the key. We can't win if it means someone rich loses anything.

Great blog essay, Mr. Talton! I find myself in agreement with pretty much everything I read, but wanted to chime in. Where to begin? (I'm going to keep it brief because I'm exhausted tonight.)

First, health care. Virtually all of the mainstream media coverage of this issue ignores the fact that we already have rationing and control by bureaucrats. They just happen to be private bureaucrats working for insurance companies and HMOs, looking after the bottom line, and the doctors and medical institutions under contract to them and acting as their gatekeepers.

We also have rationing in the form of high costs, which discourage or prevent individuals from getting needed health care (both preventive and post-diagnosis).

And finally, we have rationing in the form of inadequate medical staff, particularly general practitioners, because the system rewards specialists rather than the front line family doctor who is in the best position to diagnose early (thus saving everyone money and improving health). Also, chronic illnesses require early and regular GP attention to diagnose and manage: if you wait until hospitalization is required, it quickly gets more expensive. Guess which model the American medical system follows?

Not to pen an essay myself, but here's a "quick stat" from last weekend's USA Today: the wait to see new doctors (including general practitioners, OB/GYNs, cardiologists, orthopedic surgeons, and dermatologists), averages 20.5 days in the United States. Nights and weekends? Forget it. The highest metro area wait was Boston (49.6 days) and the lowest was in Atlanta (11.2 days). The source for this was a Merritt Hawkins & Associates survey of 1,162 medical offices (Sept. 2008 to March 2009).

Regarding the economic "recovery", today I saw an Associated Press article which noted that for the first time since January, the number of unemployment claims decreased; however, the article also notes that this should probably be attributed to the fact that so many individuals have exhausted their unemployment benefits: in May more than 49 percent of unemployment claimants had exhausted their standard (26 weeks) benefits (this is a monthly record, by the way). By contrast, unemployment is expected to remain high into 2010.

Korea worries me. It seems as though the country (with its nuclear arsenal and missiles) is in the hands of someone suffering from Alzheimers. Not that North Korea's "Great Leader" has ever been known for stability and fine judgment, but the latest outbreak of kookiness and hostility seems to have come from nowhere. North Korea just finished begging their way out of the sanctions doghouse, and now this?

I read that PETA formally complained after reports of President Obama swatting a fly. Does this sound like something Rush Limbaugh would make up to discredit his political enemies? Yes, but apparently it's true.

More generally, the left should: (a) understand that
both material resources and political capital are finite resources which need to be devoted to the big problems first; (b) pick their battles; (c) know their audience and formulate their rhetoric and arguments accordingly; (d) argue all they like in private, but reach a consensus on any public positions and then use party discipline to enforce those decisions.

Regarding chess, there are two basic strategies for winning: (1) attack vigorously, sacrificing material as necessary to win, but in any case developing with a threat to keep your opponent on the defensive, making him play your game, respond to your moves, and keeping him busy but on your terms as much as possible, so that he is the one who regards compromise as a relief rather than a last resort; (2) cover all the bases and slowly squeeze him like an anaconda until he cries uncle.

I wonder how many Americans lost their homes today to medical bills?

Why haven't I been told?

Why isn't that part of the argument? Why don't I hear simple cogent arguments and painful experiences with the "relentless panache of the Aflac duck"?

How come Democratic candidates and the Democratic Party only play those sorrowful ads at election time? Even the Republicans get into the act and play some maudlin mood ads. They are all SO concerned about my future. Going to visit hospitals, and all that happy bullshit...

If twangy heart-songs were important from July to November 2008 surely they are equally important now?

If you want to win a policy argument in America you have to hit the gut, and play the violin, and scare the crap out of people: There but for the grace of God goes my home...

After all, that's the ruse these assholes leveraged to get elected. The fact that they don't use the same tactics after getting in power tells you everything you need to know.

Re: The Brookings Institution report.

Can anyone link me to the brookings report that is referred to in this essay?

For whatever reason, I can't find it on there website

Thanks!

The report is now hot-linked above. Or use this url:
http://www.brookings.edu/reports/2009/06_metro_monitor.aspx

Completely true. And you have to wonder about a population whose political ideological is "anything not democrat".

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