Third Party & Independents Archives

November 24, 2003

Extremes to Demise

In response to Dustin Frelich’s excellently crafted article entitled Conservatives Debate Medicare, I reply in the following way. I understand the philosophy behind those Republicans who believe that social programs are bad for America. It is a philosophy born out of a gross misunderstanding and confusion about the bi-polar extremes of free enterprise fostered by Milton Friedman followers, and socialism as implemented under communist and authoritarian regimes. They fail to recognize that social programs saved this nation after the most horrible of depressions in the 1930’s and an extremely costly WWII which would have bankrupt this nation had it not been for the social programs that trained workers and put them to work on public works, and insured those who did work a modicum of financial dignity upon retirement.

They fail to recognize that social programs do in fact, work today in countries that are democratic and provide benefits America cannot provide its citizens. This is not to say that social programs don't come without opportunity costs. But free enterprise is not without its costs in greed, class segregation, and tiering of society. Free enterprise costs Americans billions each year in fraud, corruption, tax evasion, and a black market that is second to none in the world. There is no freer enterprise than the black market. It makes and enforces its own rules, pays no taxes, defeats all attempts to regulate it and gives very little benefit back to society. That is free enterprise in its purest form.

France has less than a 40 hour work week, and all citizens are assured of basic health and education and training services. Canada has a health care system that recognizes the immorality of being a wealthy nation and leaving 40 plus million of its citizens without health care, experiencing pain and suffering and shorter lives all because they can't afford the free enterprise health care. Granted, Canada will never be a major exporter of medical and pharmaceutical technology, and non emergencies wait months for an appointment, but that is the trade off. It does work and provides benefits America does not.

But, what frustrates me is the short-sightedness of both party's extremes. The ultra-liberals, who believe more or less, that in a wealthy nation all citizens should be relatively wealthy, would sacrifice Americaís economic engine driven by capital markets and investments and corporate growth, research and development.

The ultra conservatives on the other hand, would take us back to the 19th century when captains of industry and inherited wealth felt and acted as if they alone were entitled to make the laws that supported them and workers were little more than a natural resource to be consumed, depleted, and replaced at the lowest cost possible. They relied on the eleemosynary system to assist those who were infirm, disabled, too young or too old, or too uneducated to be employed as a cog in the machine. And during those times, free enterprise and the eleemosynary system, relating to charity or giving alms; dependent on charity utterly failed millions and millions of Americans resulting in premature deaths, horrible suffering and abuse in charitable institutions, and total abandonment by society of millions of persons due to there simply not being enough charity dollars to go around.

America has been a blend of socialism and free enterprise, a mixed economy, since FDR and this balancing act between free enterprise and social programs like public education, social security, government supported and union fought for employer paid health insurance and retirement plans, Medicare and Medicaid were a part of making America the most powerful economic, military, and international force in the world, in addition to becoming the envy of 100ís of millions throughout the world.

Ultra-conservatives would take us back to the 19th Century, and ultra Liberals would take down our ability to assist other nations financially, to lead the world in information and medical technology through a redistribution of wealth that would choke investments the size of which are necessary to remain a leading nation and force in the world for good.

In my opinion, the Republican party has gone considerably too far to the right to maintain America's 20th century heritage of growing living standards for all, and aging with dignity, and dramatically reducing suffering as a result of poverty and ending sub-subsistence level wages and benefits for an honest days work.

The Democrats at least are not working to end free enterprise or cripple America's economic leadership. But the Republicans appear hell bent on eliminating the concept of a wealthy nation sharing enough of its wealth through taxation and social programs to insure all of its citizens a fruitful, and relatively anxiety and stress free quality of life. A life for parents and care givers that grants them the ability to pass on the assurance of a quality of life to their children unrivaled in the rest of the world should be a goal for the wealthiest nation in the world.

In a free democracy, persons are free to ruin their lives. But in a free wealthy democracy, all citizens who work 40 hours a week provide the very stuff that makes our economic system great. Where would IBM or Microsoft or Chase Manhattan be without janitors, without clerks, security guards and on and on? They would be knee deep in disorganization that's where.

A janitor should be entitled to a decent wage that provides home ownership, a reliable vehicle, health insurance, a retirement plan, and the ability to save for his/her children's educational choices and assistance in getting their start in life as productive adults. For without that janitor, our nation would collapse. Without that clerk, that secretary, that server at Luby's, that maid at the hotel, free enterprise would grind to a halt in a heck of a hurry.

The white collar manager should make more than a janitor because the manager made a greater investment in either education or career experience, or simply was born with talents in more limited supply. But the laborerís work is as valuable to this nation as any white collar manager's and they should be entitled to a share of the nation's wealth that provides a life with dignity and hope, not struggle, frustration and despair. Without the laborer, there would be no great nation, just as without managers, there would be no great nation. Those whose work is indispensable to our economic system should earn a middle class wage and benefits, and if employers cannot bear the full load, some wealth distribution through a progressive tax system or at least a flat rate tax system is justified by history, economic practice of the past, rational and ethical grounds.

Nothing even close to this kind of thinking or debate is taking place in the Republican led Congress and it is clear from the Presidentís actions, that no such thoughts are contained in policies he is promoting. Much of the Presidentís rhetoric at election time and today are aimed at selling himself as some champion of quality of life for all Americans, but, his programs and policies and executive orders reflect nothing of the kind. I fear for Americaís future if centrists are unable to take the helm of this great government of ours in November of 2004, be they Republican, Democrat, Green or otherwise.

Posted by David R. Remer at November 24, 2003 03:00 AM
Comment #4003

“The Democrats at least are not working to end free enterprise or cripple America’s economic leadership.”

I can’t agree with you at all here. Many of the grand socializing plans would cripple our economy. We have the most innovative medical technologies even though we subsidize medical research for the entire world with our prices. That isn’t going to fair well under the proposed socialized programs.

If you want a safety net for the truly struggling poor, I’m with you on it. But you are going to have to descend from rhetoric and hit me with specifics before I’d be willing to go along with more radical redistributions schemes. How far down the ladder are you talking here? Bottom 10%? Bottom 25%? Bottom 95%? It makes a big difference to me, and the rhetoric is so universal as to be almost infinitely elastic.

“But the laborerís work is as valuable to this nation as any white collar manager’s and they should be entitled to a share of the nation’s wealth that provides a life with dignity and hope, not struggle, frustration and despair.”

I’ll agree with you for the most part on the last half of this sentence, but you are empirically incorrect on the first half. The problem of the work of a janitor vs. a manager or vs. a sports star is that of number of people given added value. The number of people ‘helped’ by a janitor is severely limited by time. The number of people ‘helped’ by a manager is often much larger. The number of people ‘helped’ by a sports star approaches the millions. This difference in people served is reflected in salary.

Lack of interchangeability is also a governing factor in increased salaries. A sports star not only serves millions, but he can’t be easily replaced. A manger serves hundreds and can be more easily replaced. A janitor seves maybe one or two hundred and can be readily replaced. All these factors and many more are signalled in price.

Tampering with the scarcity signals of price is what wrecks economies. Too progressive of a taxation scheme levels the pricing and has the same effect.

So, what are your proposed tolerances? Are we talking 3-4% tinkering around the edges? Or are we talking 20-30% massive restructuring.

As for France and Germany, I believe the jury is still out on their economic balance. Germany has been mired for a decade. Japan has too. France is entering a demographic nightmare with pensions that threatens to demolish productivity.

And it isn’t at all settled in economics circles that the New Deal helped bring us out of the Great Depression. Many economists believe that it may have prolonged the depression.

Posted by: Sebastian Holsclaw at November 24, 2003 03:48 AM
Comment #4004

“The problem of the work of a janitor vs. a manager or vs. a sports star is that of number of people given added value.”
The problem with this is that there is not a one-to-one correlation in the number of janitors to managers, and there never will be. And the impact on society of not ensuring a decent quality of life for all, cannot be quantified within a purely economic dimension.

If you write off people purely on their percieved economic value, you will quickly arrive at a society that is unequal, unhealthy and unhappy.
David R. is spot on in his analysis. If you do not (re)distribute wealth in order to provide a more equitable society, everyone ultimately suffers.

Posted by: Bob Hope at November 24, 2003 07:09 AM
Comment #4008

Sebastion, we have a philosophical difference. Your premise, based on Milton Friedman’s work, that economic value is determined by supply and demand is absolutely correct when it comes to toasters, autos, or condo’s. Where we differ is in the application of such a premise to the value of human life and dignity. You would appear to treat the janitor as I indicated ultra right Republican’s now do, as a commodity to be bought, sold, consumed, depleted, and replaced.

As indicated by Adam Smith, in Theory of Moral Sentiment, the percursor to Wealth of Nations which was a founding work upon which Milton Friedman built his own econometrics; religion, morality, and ethics must impose a different value system when it comes to human life.

To reduce the janitor to the value of supply and demand is to reduce the value of employment to that of a commodity. Commodities have no rights, no dignity, no intrinsic value and should be discarded when their usefullness has reached an end. Aldous Huxley carried this premise to its logical conclusion in his book Brave New World with female torsos hanging on hooks kept alive by tubes for one purpose only, optimum reproduction for the needs and dictates of the state.

Your argument does just this to the value of workers. Nothing instructs and angers ultra-conservatives more, than a general strike by garbage workers. The reason is that when N.Y. city lives knee deep in its own filth and waste because garbage workers went on strike, (historical fact) the value of their work is driven home in the public eye. Garbage workers are as important to the health and wealth of this nation as managers in the sense that without them, we are all doomed to disease, disorganization and a lowered quality of life.

Hence, workers cannot be reduced to their economic value alone - it flies in the face of all major religions which elevate the value of a human being above that of inanimate objects, it flies in the face of all notions of human dignity and freedom which our founding fathers so eloquently debated for years. If flies in the face of social peace and harmony. For if workers are valued only as commodities, the seeds of revolution are spread throughout the land like Johnny’s appleseeds.

Posted by: David R Remer at November 24, 2003 11:23 AM
Comment #4012

Good discussion. My main question in this argument is why would one’s sense of morality or immorality depend on a government supervised redistibution of wealth? Why is the government viewed as the proper vehicle for this? Our government was not set up, nor is it run, to provide a welfare state. Government, along with other organizations, should provide equal opportunity, not equal results. Government should provide the framework so that all people are created equal under the law. That does not assume that all people have the same talents. I will never run a multi billion dollar company, or make millions hitting baseballs, but that does not mean that those people who can, should somehow subsidize my living. People who think otherwise are entitled to their opinion, but the government redistribution of wealth and resources is not a morality question.

To those who think that the goverment should be responsible for this, outline how, even in general terms. It is one thing to extoll the perceived virtues of an equal outcome society, but quite another to put that into practice. In fact, one has never been put into place, but not for lack of attempts.

Posted by: Rob at November 24, 2003 01:43 PM
Comment #4013

Rob, excellent question. And there is an answer. In a democracy, the concept is that government is run by the people, and for the people. The body politic is the people. The American people are a compassionate and generous people by historical record. The body politic of America is also one that prides its civilization on ethics and moral application of rules governing the society. This is self evident by the reading of the documents of our founding fathers.

Therefore, a democratic government by the people and for the people cannot escape reflecting the ethical and moral directions and sentiments of the people. If a democratic government fails to reflect the moral and ethical composition of the people, it will no longer be a democracy. In other words, it will no longer reflect the will of the people to be governed by the people and for the people.

Posted by: David R. Remer at November 24, 2003 02:10 PM
Comment #4019

Articulate reply, but one that does not necessarily address my question. Your argument assumes that the American Public favors a system of government that redistributes wealth. While I have never seen a poll asking that question, I would think that the answer to that question would come back quite emphatically against. An example I think appropriate is an affordable housing project. Everyone is for that, yet when it comes time to build, people object to the housing in their community. Universal equality sounds good, but that is simply not the way that we are created.

I would also take quite an exception to the idea that the Founding Fathers were proponents of a system of government that provided equally for all. As Adams would say, people are created equal under the law, and should have equal protection granted, but that does not mean their talents are equal. Walk down the street and you quickly realize that people are clearly not created equal. The Founding Fathers had a tremendous amount of debate on how to create a government that can raise taxes to defend itself, without encroaching on one’s liberties. Jefferson/Madison wanted less government intervention and focused on state’s rights. The fear they had was government becoming too controlling, and they did not want government as a counter balance to natural inefficiencies.

If one disagrees, why stop at income re-distribution. Why not mandate that those with a good sense of humor be limited to x amount of jokes/witty remarks per day to make those not as witty feel better? Why not censor brilliant thinkers for fear that their brilliant thoughts make the rest of us feel less intelligent? Life is inherently unfair, and we should avoid at all costs a system of government that seeks to balance people’s natural differences. People should accept who they are, and try to make the best of whatever situation they find themselves in. Individuality not government, is the answer.

Posted by: Rob Sherry at November 24, 2003 04:54 PM
Comment #4021

To those who think that the goverment should be responsible for this, outline how, even in general terms. It is one thing to extoll the perceived virtues of an equal outcome society, but quite another to put that into practice. In fact, one has never been put into place, but not for lack of attempts.

In regards to the discussion that’s been going on here, I think that the following quote from the Declaration of Independence is a good starting point:

We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.—That to secure these rights, Governments are instituted among Men…

The way I read this passage, life is an unalienable right. Providing healthcare for those who could not afford it is the government securing that right for its people. In regards to the more leftist views in regards to income distribution, the Declaration of Independence only provides for the pursuit of happiness, and in that respect the government’s role is to provide the tools for the persuit, not a guarantee — equal protection, education, freedom to pursue their interests in careers, etc.

Posted by: blipsman at November 24, 2003 05:36 PM
Comment #4022

Blipsman, thanks, I could not have come up with a more eloquent response. On the money.

Posted by: David R. Remer at November 24, 2003 05:46 PM
Comment #4023

Rob, we Americans must get away from the extremes of Socialism good, Free Enterprise, bad; and vice versa, in my opinion. As I said in my article, the manager should be paid more, and free market forces should create eschalons of pays scales in accordance with supply and demand and competitive bidding. But, not to the exlusion of a middle class living standard for anyone who works 40 hours a week serving our economy in whatever capacity. And that has to include affordable and accessible quality health care.

We can and must have both, for no great nation in history has survived a growing underprivileged class without becoming authoritarian and abusive toward its citizenry. And even these did not survive long in historical terms, either.

The cost of our health care system has driven far too many heretofore middle class families into the lower middle class. And if having health care is a measure of middle class status, it has driven millions right out of the middle class altogether. This constitutes a growing underprivileged class and there should be great concern and rational, practical solutions if we are to avoid the demise of 1st World status. I am not seeing any rational or practical solutions coming from the ultra-conservatives or the ultra-liberals, only ideological paths to self-induced demise for our nation.

Posted by: David R. Remer at November 24, 2003 06:07 PM
Comment #4024

Universal health care is a tough topic. I just looked up and found that 15% of Americans do not have healthcare. I think that blipsman’s post stating that universal healthcare counts as an unalienable right is somewhat of a stretch. That portion of the Declaration of Indepenedence is talking about human freedom given from our creator, and the duty of government to secure that freedom. This was written in the context of a monarchy dominated Europe, and with special consideration to British monarchy. They saw a centralized and controlling government as an evil that limited the freedom of its citizenry, quite the contrary to a reliance on the government for things such as healthcare and income redistribution.

I see that healthcare is a problem, but once again fail to see why government should be the organization handling the issue. Government is not a panacea, it is a large, bureaucratic money eating machine. As this problem gains more notice, I think a non profit foundation can provide much more value to those lacking health care than Uncle Sam. I work with the goverment on a daily basis and I would not want them to be in charge of adminstering my health care. Our government can not even pass an Energy bill without trying to factor in a rain forest museum in Iowa, you want these people in charge of people’s lives? It would be a collosal waste of money, and not even provide a good service to those who need it.

Posted by: Rob at November 24, 2003 06:41 PM
Comment #4026

Rob, the idea of a non-profit organization has genuine merit, and I have never heard this idea brought up before. This is the kind of creative thinking that we need in congress.

I agree that Government is wasteful and returns less service for the dollar than most private sector organizations are compelled to for the sake of survival. What I would like to see is the government held accountable, but, doesn’t appear the voters are very interested in voting their own pork producing representatives out of office.

Perhaps the Government could provide the charter for a non-profit Medicare representing the interests of seniors giving them an alternative program to for profit plans to buy into.

But, what is to be done with the senior citizens who worked most of their lives at 3$ per hour on average and retired with not enough means to buy into any program. Just let them suffer and die? If they didn’t earn enough in life, they should just croak, often through a protracted painfilled slow death?

After all, even a non-profit has to generate enough revenue to break even after incurring costs for overhead, personnel, services purchased, etc.

It is indeed a perplexing problem.

Posted by: David R. Remer at November 25, 2003 11:12 AM
Comment #4027

Rob, you are quite right in stating that the words quoted by blipsman are very debateable regarding whether our founding documents should be interpreted as guraranteeing health care to all. The issues of life, liberty, and the pursuit of happiness were indeed written to mean that government has no right to infringe upon these rights without due process and overwhelming justification.

But the issue is correctly pointed out by blipsman that in the eyes of the law of this land, all persons are create equal and are to be regarded as equal in the eyes of the law.

Government works best when it provides for the common welfare of all citizens that which cannot be provided for in any other way. The interstate highway system, Hoover Dam, and a host of other projects which have provided for the common good of the nation where states and individuals alone could not provide.

Anyone who has worked with the aged in a hospital, hospice, or clinic, knows what suffering is. The free enterprise system has taken a health care system of 100 years ago where an aging father’s son would pay the local Dr. with a pig or a few bales of hay for the doc’s horse, in return for the Doc’s services to assist the aging Dad.

The free enterprise system has also demanded that people who want jobs, must go to where the jobs are, but, don’t bring your family, because we are not hiring them, only you. The extended family in America all living in the same locale is virturally non-existent. The costs of medical care for aging are so high, that if the offspring of working families wanted, and most probably do, to put up the money to relieve the suffering of the aged, it would bankrupt them and the futures of their children.

Compassion demands that we not leave the elderly to die alone in slum apartments suffering horrible for lack of oxygen, food, or pain medicines. Compassion demands that we not set up death houses where we send the elederly to die amongst each other with minimal care or supervision for the sole purpose of removing them from our neighborhoods and sight.

And where is that compassion to come from? Apparently not from the conservatives who don’t want to see any tax dollars spent on the problem. If the elderly can’t afford the skyrocketing free enterprise health care system which exists today, what is to be done? Who is going to step forward with the compassion to assist them? Who is going to help them preserve the dignity that comes from knowing someone cares about them and will assist them when they are invalid and in pain?

Charitable organizations? As we all know, Charitable organization’s funds extend only so far, and go up and down with the economy, and for those who get in under the wire before the funds run out, help is available, and for those who got to the charity after the doors were closed, are just out of luck. There is a role for charitable organizations, but, the charitable giving is nowhere close to meeting the needs to deal with the aging of the baby boom generation.

Posted by: David R. Remer at November 25, 2003 11:40 AM
Comment #4034

Wow, a coherent discussion. I’m glad I stumbled on to this site.

Madisonís model is the middle ground between “rugged individualism” and socialism or nationalism, and it is unfortunate that we have strayed so far away from the constitution and the 10th amendment (although he was against the Bill of Rights). Medicare is just but an example of our federal government overstepping its intended role and taking away the opportunity of local officials and States to provide the services necessary for their constituents.

Posted by: George W at November 25, 2003 03:45 PM
Comment #4055

“In a democracy, the concept is that government is run by the people, and for the people. The body politic is the people. The American people are a compassionate and generous people by historical record. The body politic of America is also one that prides its civilization on ethics and moral application of rules governing the society. This is self evident by the reading of the documents of our founding fathers.

Therefore, a democratic government by the people and for the people cannot escape reflecting the ethical and moral directions and sentiments of the people. If a democratic government fails to reflect the moral and ethical composition of the people, it will no longer be a democracy. In other words, it will no longer reflect the will of the people to be governed by the people and for the people.”

The history of the United States involves citizens giving very genereously as individuals . What if the demos isn’t interested in providing comprehensive health care through the government?

Posted by: Sebastian Holsclaw at November 26, 2003 03:14 AM
Comment #4058

“If a democratic government fails to reflect the moral and ethical composition of the people, it will no longer be a democracy.” Yet I am sure you probably defended Tony Blair’s strong leadership in choosing to lead his country into war despite the fact that a majority of the UK’s population was against it. He was certainly not reflecting the moral and ethical composition of the people. Perhaps health care is another issue that requires strong leadership and vision, for the good of the people.

And to tie this in with the original point made by David R. the biggest contribution to ill health is poverty. The nations (i.e. their governements) that have done the most to reduce the income inequality amongst their citizens have done the most to improve the health of their citizens.

The following is taken from

The American Journal of Epidemiology states that “a vast body of evidence has shown consistently that those in the lower classes have higher mortality, morbidity and disability rates” and these “are in part due to inadequate medical care services as well as to the impact of a toxic and hazardous physical environment.”

And in an even more important finding, studies from Harvard and Berkeley have proven that income inequality — not just absolute poverty — is equally important. States with the highest levels of income inequality also have the highest mortality and morbidity rates. The reason why relative poverty matters is because prices and opportunities are relative too - the U.S. may have the best medical technology in the world, but at $10,000 a procedure, who can afford it?

Posted by: Bob Hope at November 26, 2003 10:20 AM
Comment #4061

George W, your point is logical but not valid because each state does not maintain its own seperate insurance and health industry. Insurance and health corporations have nation wide reach and that is good, because the economies of scale create the potential for national health and insurance companies to provide lower cost services than 50 seperate state providers bounded by state boundaries.

Hence, the need for the federal government involvement instead of state. Madison recognized and the Constitution provides for the federal government exercising power where state governments lack the jurisdiction or capacity to deal with national needs, like defense.

Posted by: David R. Remer at November 26, 2003 02:55 PM
Comment #4089

“Hence, the need for the federal government involvement instead of state.” There is a pretty hefty difference between federal government involvement and federal government control. A universalized Medicare will be federal government control. And like all centrally planned sectors of the economy, its most efficient growth will be in inefficient government departments.

Posted by: Sebastian Holsclaw at November 28, 2003 11:31 PM
Comment #4091

I like a blend of both of our proposals, the fedral government acts as the recipient of a single payer medical system which is administered by a non-profit organization/s.

Also, I know it is a whole new subject, but, why is federal government so inefficient in the administration of tax dollars? And if that is true, does it apply to the current government? Again, if it is true, is it an insoluble problem? These questions are not a ploy. I am literally ignorant of whether government administered programs are less efficient or not, and if so, why?

I used to be a tremendous fan of Big Bend National Park in southern Texas. Went camping a couple times a year in the 70’s and early 80’s. Then, the parks were managed by the Department of Interior and there were about as many as 30 Rangers on a camping season day issuing tickets for littering, speeding, or discharge of firearms. Then the in the mid-80’s someone proposed contracting the management of the parks out and running them more like a business with use fees and concessionaire licenses.

Within 10 years, the park went from being called Big Bend National Park to Pig Pend National Park because of all the trash evident throughout. Also, the first murders since the park’s creation made headlines, and illegal hunting became a problem, as the daily ranger staff dropped to as low as 8 rangers a day supervising a park larger than some northeast States.

OK, I guess we save the tax payers some money, but, Big Bend is not where naturalists who want time alone with nature in a pristine environment, like myself and friends, would even consider going today. Opportunity costs cuts both ways I guess. In the case of Big Bend, we got what we paid for, then and now.

Posted by: David R. Remer at November 29, 2003 10:10 AM
Comment #4106

Thanks for your reply David, although I really donít buy into your argument. The private insurance industry, although financed through underwriters who write policies in many States, is heavily regulated by the individual States and is governed by State law. That is why rates are so vastly different from State to State. As for the healthcare system, our healthcare delivery systems are primarily controlled by local governments (counties where I live in South Carolina), local non-profit and charitable organizations, and State institutions. Healthcare is regulated by the States (Again in South Carolina it is the responsibility of the Dept. of Health and Environmental Control). Healthcare and Insurance are both very much State issues, and yet through Medicare, Medicaid, and through the use of Grants and Cooperative Agreements the Federal government has hijacked the issue (and the money) and gained a measure of control of our lives.

Posted by: George W at December 1, 2003 10:47 AM
Comment #4115

But, George, what about Blue Cross Blue Shield and a host of other national and multi-national corporations. They may be regulated by the states, but, we all know how deep their pockets are at election time and it doesn’t take that much to at the state level to get those favorable to the industry in office. I know, I live in Texas, where the consumer’s rights in the law and courts against insurance companies is a very hit and miss prospect.

Reports very early this year indicated the health care system in America is very dangerous for your health. Some 40% of persons receiving care for 4 major and common maladies are failing to receive the AMA proscribed treatment or medications. Why? Because they are inundated by so much information from pharmaceuticals, and a host of journal publications discussing the newest or latest in treatments, many of which have not been tested over long enough periods to determine effects. Also, insurance companies weigh into this by proscribing what procedures and medications the Dr. should use if coverage is to be provided.

It is national because the influences on the local rural clinic or GP all the way to the major medical centers are national. I have never known a law or code on the books to stand in the way of profits in America especially when the stakes are counted in the billions.

As for health care facilities, they like most other industries are going the way of oligopoly. We have a huge medical center in San Antonio, Texas.

Posted by: David R. Remer at December 1, 2003 06:29 PM
Comment #4140

Thanks again David for the Discussion. Let me end by saying that I believe that Government is necessary to advance the quality of life in this country. I also believe that the larger the base a government is trying to provide services to (i.e. national verses state or local) the less efficient and certainly less personal its effect becomes. And since healthcare is, to me anyway, an extremely personal issue, any government involvement should be done at the lowest level possible where my voice is better heard.

Next thing you know they will be a cry, no doubt as a result of lobbying by PETA, to provide national vetinary care (if you’ve been to the vet lately you know how much that stuff can cost). I want Part B coverage for my horses!


Posted by: George W at December 2, 2003 11:56 AM
Comment #4141

George, our discussion has been a pleasure for me because I enjoy being challenged to think and see from other perspectives.

Regarding your last statements, I must say, that I agree with you. The larger and more intrusive any beauracracy including government becomes, the less efficient it becomes, because it loses agility and timliness to respond to changes. Also, the greater the risk to freedom of choice with the growth of government.

On these principles I cannot argue. My stance on Medicare is born out of the recognition of suffering and premature death due to lack of financial resources on a scale in this country that stamps the words, selfish and incapable upon our nation.

Thank you for a great discussion.

Posted by: David R. Remer at December 2, 2003 12:10 PM