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    The Myth of Free-Market Health Care

    “9-1-1. Please state the nature of your emergency.”

    “My husband has just collapsed on the floor! He’s breathing funny and gripping his arm! I’m afraid he may be having a heart attack!”

    “Can you please describe the symptoms and what he was doing just prior to his collapse?”

    “He wasn’t doing anything! He’d been sitting and reading. Then he got up and walked into the kitchen and he just started feeling faint. He slumped to his knees, starting breathing erratically, clutched his arm, and worked himself down to the floor! He’s like that right now!”

    “What is the location of the emergency?”

    “We live at 555 Main Avenue!”

    “Thank you. We’ll send an ambulance right over.”

    “Uhhh…. Hold on just one second…. Is there more than one ambulance company?”

    “Excuse me?”

    “I know how important it is that we participate in our own health care decisions these days as a way to keep costs down for everybody. I just want to make sure I’m choosing the best alternative.”

    “I thought you said your husband was having a heart attack?”

    “I think he is, but that doesn’t mean I don’t want to be responsible about our health care decisions! Is there more than once ambulance provider in my area?”

    “I don’t know. We just use a central dispatcher. I assume they just send whomever is closest.”

    “Would you happen to have that number? I just want to check. Thanks.”




    “Central dispatch. Henry speaking.”

    “Hi, Henry. Hate to bother you, but my husband is having a heart attack and….”

    “Oh my God! Did you call 9-1-1?”

    “Yes, but they didn’t know which ambulances you use, so they sent me to you. I’m trying to make the most responsible health care decisions that I can. For myself and my husband.”

    “And you don’t think the most responsible decision for your husband is just to have an ambulance come right away and save his life!!???”

    “Well…. I used to think that, but apparently that’s not the way it works anymore. It’s a free market approach, as I understand it, and it’s up to me to be an informed consumer. So tell me, which ambulance services do you use?”

    “We use RightAway and AlwaysThere. Whichever one is closest is the one we send.”

    “I see. Do you happen to know what insurance plans they’re part of?

    “Excuse me?”

    “Well, it’s a big difference if I go in-plan or out-of-plan, so I’d like to know.”

    “I’m not sure. I guess… I guess you’d have to call your insurance carrier. But, ma’am, doesn’t your husband need an ambulance right now?”

    “He seems to be holding on.  I’ll check with my insurance carrier first, then get back to you.  Thanks.”




    “If you are calling regarding about making a payment, please press ‘1.’ If you are calling regarding types of coverage in your plan, please press ‘2.’ If you are a health care provider, please press ‘3.’ For all other calls, please press ‘4.’”


    Your wait time is approximately…. four…. Minutes.


    “Thank you for calling AllYourNeeds Insurance. How can I help you?”

    “I’d like to know if either RightAway or AlwaysThere ambulance services is in my health plan.”

    “Very good. I can certainly help you with that. May I have the first three letters of your plan ID?”


    “Ahhh.  I see you’ve come through the National Health Care Exchange. You’ll need to talk to a different department. Let me give you that number.”




    “9-1-1. Please state the nature of your emergency.”

    “Yes. I called earlier? About my husband having a heart attack?”

    “You must have spoken with someone else. Did an ambulance arrive?”

    “Well, that’s just it. The person I spoke to wasn’t sure about which ambulance I should use, or which one was in my insurance plan. And I know it’s my responsibility to know these things because it’s a free market and everything and I’m supposed to be an informed consumer.”

    “Excuse me?”

    “Anyway, I did find out what I needed to. AlwaysThere is in my plan, and I get 80% coverage to the nearest hospital provided it’s not more than 50 miles away, and if the hospital is also in my plan.”

    “So you haven’t had an ambulance yet??!??”


    “I’ll dispatch one right away!”

    “That’s okay. It’s not really necessary anymore.”



    Artwork Copyright: unkreatives / 123RF Stock Photo


    Voter ID Laws Redux: The Non-Problem That Just Won’t Go Away!

    Much of today’s post was actually written two years ago, about a month before the 2012 presidential election. (Hence the “redux” in the title.) But we have a problem that just won’t go away, and so it seems an update is timely.

    Though I know I can sound like a broken record sometimes, certain points are worth making over and over again.  Here’s one of ‘em: some things are simply not about right and left, but about right and wrong.  This whole Voter ID “initiative” strikes me as one of those things and, sadly, as we come up to the very important 2014 mid-terms, the problem deserves center stage once more.

    How prevalent is the issue still? Here are two examples:

    A few years back I was a member of the Bedford Republican Club, a smallish but official group that meets monthly in the town’s library, and which I left because it had taken a decidedly extremist swing to the right. However, I’m still on the email list, and just yesterday received the minutes from their most recent meeting. The key topic that night? Voter fraud. Here are a couple of “facts” that were given to the audience by the speaker, Ed Naile, from the Coalition of New Hampshire Taxpayers, a group that claims to be (and may actually be) “grassroots”:

    • Illegal immigrants have been caught voting in New Hampshire
    • Democratic legislators are “gutting our election laws” to make it harder to find these cases
    • Democrats are “rigging the election game” in North Carolina
    • The IRS is targeting voter-fraud activists

    None of these are substantiated other than through innuendo and convenient opinion, of course. But, Lord! do they get the blood boiling and the extremists to the polls!

    The second case is the SCOTUS decision regarding Texas, where the Supreme Court allowed to stand a federal judge’s ruling that election laws shouldn’t be altered so close to an election. The ruling means that identification will be required to vote in the upcoming mid-terms, a situation which Sherrilyn Ifill, president of the NAACP Legal Defense Fund, says “means [that] hundreds of thousands of eligible voters in Texas will be unable to participate in November's election because Texas has erected an obstacle course designed to discourage voting."

    I’ve said it before and I’ll say it again: Every single eligible citizen should be allowed unhindered access to the voting booth. If your party cannot win on the merits of position and argument, then that’s your problem, not the problem of those people whom you are punishing through limited access to the polls.

    To be clear: I’m not against the fundamental concept of providing identification when you vote; I actually think it makes sense.  Back in 2006, when I first had occasion to vote in New Hampshire, I was surprised when I tried to hand my driver’s license to the poll volunteer (an elderly woman who liked to chat a bit if the line wasn’t too long). She waved it off with a cute little, “You don’t need that, honey.” (Seriously.  She said, “honey.”)

    I’d always used my ID to vote in the past, so I thought this was just one of those New Hampshire live-free-or-die things, an exception to the rule.  Turns out I was wrong.  All those years when I’d been handing over my license, the volunteers had apparently just been using it to check the spelling of my name.  It wasn’t a requirement at all. (Now it is, by the way. In New Hampshire, too, we’ve fallen for a well-told story….)

    Ah, but what if there’s no real purpose to it?  Just because something feels right doesn’t mean we should do it, particularly if it serves no purpose.  It’s sort of like bathing in Cool Whip. Perhaps the experience would be soft and refreshing, but if it doesn’t actually do anything, then why bother?

    If there’s no purpose, no real problem to be solved, then I’m just fine with this fundamental concept remaining just that: a concept.  It’s nice and all, but I’m okay with believing that an ID should be required yet also believing that there’s just no need for it.

    Unless, of course your problem is that you might lose.

    And that, apparently, is what the GOP continually fears: that those perfectly entitled, perfectly legal, voting citizens who just happen not to be Republicans are going to go vote. That the continual demographic shift (and concurrent demise of old, white Republicans) will eventually augur the death of any real conservative influence. And so a strategy aimed at disenfranchising tens of thousands of voters rolls across the landscape. It’s simply heinous. Abhorrent. Detestable. Loathsome. Vile. It makes me more embarrassed to be a member of the Republican Party than any single event in history—and that includes nominating Sarah Palin for veep.

    And let me just say that the arguments in favor of voter ID basically, well, suck.  Here are the two most common examples, just so you can see what I mean:

    • You have to have ID to buy a car, don’t you? Or to get a fishing license?  So why not an ID for something much more important, like voting?  The answer to that one is simple:  the Constitution doesn’t guarantee you the right to buy a car or go fishing. The Constitution doesn’t even guarantee you access to public lands.  The Constitution does, however, guarantee you the right to vote—and without obstruction.
    • But voter fraud is a real risk!  Don’t you know that there are thousands and thousands of dead people on the voter roles!  I love this one.  The first half of the objection is easily dismissed: there have been roughly a dozen or cases of voter fraud—a dozen—since 2000.  The second half is trickier, but quickly falls apart. Having a deceased person’s name on the registration list is only a problem if a) someone knows that the person’s name is there and b) someone decides to impersonate the dead person.  And it just ain’t happenin’.  What all those deceased people are actually doing is not voting.  That’s because they’re, well, deceased.  Where’s the fraud there? Sloppy bookkeeping, I’ll grant you.  But fraud?

    This battle, though it should be over, is not. So what can you do?  A few things:

    First, if you want to vote, don’t stay home.  That may sound overly simplistic, but it means making sure that you’re properly registered, that you have ID if you need it, and that you’re willing—if necessary—to put up with some inconvenience and delay in order to cast your ballot. And please, please, please, PLEASE vote! The phrase “important mid-term” is NOT an oxymoron. This election is a chance to set the stage for the remainder of Obama’s presidency and the 2016 elections. There are many, many qualified moderate Republicans running and many, many thoughtful Democrats. Go to the polls. Elect these people. Send the crazies home.

    Second, do not leave the polling station without voting.  Even if you are challenged, you can and must vote, even if it means using a provisional ballot, or signing an affidavit, or filling out a form in order to do so. And get the name of the person who challenged you.

    Finally, know your rights.  Visit for up-to-the-minute information on voter ID issues, or contact them at 866-Our-Vote.  Don’t be afraid to call them straight from the polls if you need to—they will have staff ready to answer your questions and defend your rights. They have been and are still there for one reason only: Election Protection.

    Ultimately, though, it’s got to be about you.  This is your country, your right.  If you want it badly enough, then let nothing deter you.  And all of us should want it badly enough…


    We're All as we Lie

    I fear we’ve lost, you and I, that it’s over.

    The front page of this past Sunday’s New York Times carried the story that screamed our death knell. Entitled “Democrats Lean Heavily on PACS in Coordinated Push to Counter G.O.P.” (and providing large graphics in varying shades of red and blue), the authors, Parker and Confessore, tell a story of special interests and their special-interest money battling over who gets to control the next Congress. And you know what? I’m not sure it matters anymore, because the money controls them, which means the money controls us.

    Take a look at these numbers; as we wind towards Election Day, the Republican-supporting PACS and SuperPACS are running roughly 10,000 ads a week. Of these, roughly a fifth are Koch-related spots, while more than thirty-five percent are coming from American Crossroads & Co. At the same time the Democrat-supporting groups are cresting at around 5,000 ads each week, with about a third coming from unions.

    I feel sooooooo represented, don’t you?

    For the last couple of years many (including myself) have been fighting hard against dark money, light money, grey money, front money, dirty money—all the kinds of money that influence politics. (I even once went after Oprah Winfrey for donating an outsized amount of cash to a local election in Stockton, California—for which I took some serious s**t.) As much as we fight, though, the money keeps flowing, ad after ad after ad after ad, filling our heads and (sadly) our guts.

    The problem, of course, is that it’s all lies. The facts may be there but the meaning… well, that’s all lies.

    Check that. I take it back. That’s not the problem. It doesn’t matter if it’s all lies. The problem is that people believe the lies.


    Why haven’t we all figured it out yet? It’s lying liars laying lying lies. Over and over. And over. Oh, I know: OUR guys aren’t lying; it’s THERE guys who are lying. We’re good. They’re not. White hats over here, thank you, we shout at the prop man just offstage.

    Sorry: it’s bull.

    Lying. Liars. Lying lies.

    Why is it we are more discerning when listening to toothpaste ads than when listening to political ads? Why do we have no trouble accepting that Tide and All are really pretty much the same, but insist that Scott Brown is a jerk while Jeanne Shaheen is the Second Coming?

    So I have a plan. But first, a brief digression—

    I’ve never been much of one for self-help, new-age-y things. Astrology, I’m convinced, is no more than our pattern-making atavism at work, and crystals, though very pretty, are just rocks. There are no Secrets, nor will a fruit cleanse do anything positive for your intestinal tract.

    But then there are affirmations. Affirmations are little words and phrases you say to yourself over and over and over again. You can write them down, think them, or (and this is apparently best) say them aloud. It’s almost as if you’re re-training your brain to believe differently than it does today through nothing more than repetition of a simple idea, a mantra of sorts. Turns out that’s exactly what you’re doing, and (unlike crystals and astrology and Secrets) there’s actually science to prove it. Neurons change. Remap. Actually rethink themselves as new thoughts.

    So here’s the plan. I’m going to start speaking aloud every time I see a PAC ad, every time I see a politician “approving this message,” every time a talking head shows me a skewed chart telling me things are better/worse/different/the same as it ever was. And here’s what I’m going to say:

    It’s a lie.

    I’m reminded (and here comes not only another digression, but an admission of age) of the tail end of Alice’s Restaurant, the Arlo Guthrie story-song that detailed his anti-war experiences (along with some stuff about illegally dumping a bunch of garbage on Thanksgiving Day). As Arlo winds up the story, he’s trying to get everybody to realize just how stupid war is, and he does it this way:

    You may be in a similar situation, and if you’re in a situation like that there's only one thing you can do and that's walk into…wherever you are, just walk in say "You can get anything you want, at Alice's restaurant." And walk out….

    And then it builds, two people sing, then three, and it continues to build:

    Can you, can you imagine fifty people a day, I said fifty people a day walking in, singing a bar of Alice's Restaurant, and walking out. And friends they may think it's a movement….

    And so, with a proper nod to Arlo Guthrie’s wonderful idea, I ask you to join me. ‘Cause, folks, we are in a similar situation. And if, the next time a PAC ad comes on the television, one person stands up and says “It’s a lie,” well, then good for that person. But if two people do it, or three, or fifty….. Hell, if we ALL stand up next time we see a PAC ad and say “It’s a lie,” shout “IT’S A LIE,” and we do it over and over again, well, folks, then that’s not only a movement but it’s a whole new way of thinking, a whole reprogramming of our brains, and pretty soon, maybe pretty soon, they’ll all realize they can’t just buy us so easily…..


    This is NOT an Essay About GMOs…

    If I wanted to put together a list of the most contentious political issues in the United States, the ones that stick in our craw, that get to us like slits of bamboo slipped underneath tender fingernails, then GMOs would certainly be near the top. Not quite as high on the list as guns, climate change, or abortion, perhaps, but certainly well above air and water pollution, or even corporate greed.

    To be clear: I’m not referring to what the most people are talking about; I’m referring to those topics that seem to lead us towards a complete loss of sanity and logic, that get our motors running so hot that steam pours from busted radiators. And I’m saying that GMOs are one ‘em. One that gets our goat, big time.

    For some time now I’ve felt that the GMO debate was the one where everything seemed upside down somehow, where conservatives actually had some facts on their side and the more left-leaning among us were the ones having trouble with emotional responses and cognitive dissonance, spending most of the time arguing with buzzwords (the favorite being “Monsanto!” spoken with the exclamation point and expressed with a knowing sneer), while people in the middle seemed to think that perhaps, while the jury was out, we might just want to err on the side of caution and at least let people know what they were ingesting, to give them the choice.

    But now more science is in—peer-reviewed science that, at least on the surface (so far) seems remarkably fair. That science, while perhaps not at the level of certainty that surrounds climate change, seems at a level high enough to begin to suspect (perhaps more than suspect) that GMOs are just fine, thank you. Not really harmful at all.

    Now before you stop reading right at this point and head down into the comments section for some amygdala-driven tirade, I’ll ask you to review the title of this essay.

    A study just released (you can read the abstract here) is the most comprehensive yet, covering twenty-nine years of data and tracing the effects of GMO feed through our food supply, from crop to animal to us:

    Globally, food-producing animals consume 70 to 90% of genetically engineered (GE) crop biomass. This review briefly summarizes the scientific literature on performance and health of animals consuming feed containing GE ingredients and composition of products derived from them….Data on livestock productivity and health were collated from publicly available sources from 1983, before the introduction of GE crops in 1996, and subsequently through 2011, a period with high levels of predominately GE animal feed.

    And the findings?

    These field data sets representing over 100 billion animals following the introduction of GE crops did not reveal unfavorable or perturbed trends in livestock health and productivity. No study has revealed any differences in the nutritional profile of animal products derived from GE-fed animals. Because DNA and protein are normal components of the diet that are digested, there are no detectable or reliably quantifiable traces of GE components in milk, meat, and eggs following consumption of GE feed.

    Twenty-nine years of data. 100 billion animals.  This, by the way, is on top of the thousands of studies which have landed firmly on the GMO side of the scales. GMOs are, according to the Genetic Literacy Project, one of the “most analyzed subjects in science.”

    But, as I’ve said twice now, this essay isn’t about GMOs. It’s about this question: 

    Do you believe it?

    If this were climate science, we might say that we’re close to that 97% rate of acceptance: an overwhelming amount of science all arrives at the same place.

    But do you believe it?

    If you don’t, why not?

    There’s plenty of evidence to support the idea that we need to hold on to our beliefs and ideologies, our “isms,” if you will and that, even in the face of overwhelming evidence to the contrary we will still velcro ourselves to those beliefs, hooking our thoughts together defensively by the thousands rather than allowing our conclusions—right or wrong—to be ripped from us. The more liberal in our society are often quite comfortable denigrating conservatives who clings to beliefs about the need for more guns, or more abstinence, or less welfare support—all in the face of statistics that belie those beliefs. And, frankly, the denigration is deserved; facts and science matter. They matter the most. But if so, does it work the other way? Will liberals who have clung to their beliefs about GMO dangers “eat their own dog food,” as it were, and concede they were wrong because the facts and the science say so?  

    I have something of an idea as to what the responses will be like, and I’ll probably write a follow-up on this topic in a week or so.  In the meantime, I ask you to ask yourself: How important is fact, is science, when it challenges your “isms?”


    Is it Time for Single-Issue Voting?

    I find myself this morning strangely sympathizing with those who cast their votes simply on the basis of whether or not a candidate agrees with them on one single issue.

    It wasn’t a position I ever expected to consider. The idea of basing one’s entire decision on a single issue, a narrow thread, seemed always to me the height of obstinance, a flavor of stubborn that I find thoroughly unpalatable. It is always, I believe (perhaps with equal stubbornness) necessary to look at all of a candidate’s beliefs.

    Clearly, some of those issues will be more important to me, to you, than others will. The last few years, for example, have me peering through a jeweler’s loupe at where a candidate stands on gun control, and in years past I have pendulumed from voting rights to economics to war to climate change—all issues that, along with much of the country at the time, weighed heavily on my decision. Still, I always looked for the balance, with no single concern serving as a litmus test.

    That may change this time around.

    For the longest time a number of organizations—from Stephen Colbert’s SuperPAC (Americans for a Better Tomorrow, Tomorrow) to CoffeePartyUSA have shown us that the corrupting influence of money in politics beats all, standing as the Goliath to every voter’s David but, unlike the biblical underdog, continuing to win. Money, dark and light, flows to all compass points, flooding us with special-interest ideologies while politicians, concerned more with their next election than those who elected them, spend inordinate amounts of time simply raising money for additional campaigns.

    One organization—Mayday—is this time taking a far more active role than any have in the past and, in doing so, has made us aware of candidates that until recently had barely blipped the radar screens.

    Founded by Lawrence Lessig, the Roy L. Furman Professor of Law and Leadership at Harvard Law School, director of the Edmond J. Safra Center for Ethics at Harvard University, and founder of Rootstrikers, Mayday is a full-on political action committee, or PAC, and makes no effort to hide the fact that its purpose is to promote candidates who are taking active stances against the overwhelming taint that is money-in-politics. (True to its mission, it reveals a great deal about its own donor base.)

    The money-in-politics issue is of supreme importance to me, one of two that have driven most of my political thinking, speaking, and writing over the last few years (the other being hypocrisy in political coverage), and so when I saw that first flyer from Mayday in support of Jim Rubens, I paid attention.

    Until I saw the flyer I had no idea Jim Rubens was running for the Senate, nor even who he was. My vote was firmly in the Scott Brown camp, a moderate Republican we New Hampshirites inherited from Massachusetts. Brown is the kind of Republican we need more of in Washington, someone who (though he stays just far enough right to gain the needed baseline popularity), is much more of a traditional Republican, having decidedly moderate leanings.

    Mayday, however, has a different idea. Of Rubens Mayday says: “Jim Rubens is the only Republican running for Senate who puts our issue front and center.” The organization then goes on to ask that we “Help Republicans send their party a message: voters care about corruption.”

    This voter does. Definitely. And that brings forth my conundrum. You see, there is much about Jim Rubens that I don’t like, issues that—aside from money in politics—would almost certainly have given me no reason to consider his candidacy. He has, for example, received an “A+” rating from the NRA, and he pledges to oppose gun registration, any bans on “so-called assault weapons,” or any limits on magazine capacity. He also espouses a fiscal policy that comes from the Ron Paul playbook (“The Federal Reserve Board controls the interest rates we receive and pay and prints money out of thin air, enabling Congress [to] perpetuate unsustainable deficit spending.”), gives broad support to charter schools and “family privacy” regarding education, and refers to the “crisis along our southern border” as a “crisis of the President’s own creation,” arguing that we need to send those kids back. On the other hand, he accepts global warming (and its man-made origins), believes that gay marriage in New Hampshire is a “settled issue” and one he respects, and believes we should avoid further intervention in the Middle East.

    A mixed bag, to be sure, but definitely to the right of Scott Brown.

    Ahh… but then there’s this, from Rubens’ website and part of a nine-point “Political Reform Agenda”:

    [I support requiring] all campaign contributions and expenditures of all types and to all entities engaged in electioneering and lobbying to be reported in realtime in an easily searchable public database.

    And this:

    [I support enacting] a public elections financing system for candidates voluntarily opting out of the current private money system. Allow voters to use a portion of their own taxes to fund the campaigns of their choice. Each two years, every citizen 18 years and older is given a $50 tax rebate check assignable to and spendable only by candidates for Congress or President.  

    He then promises that:

    If elected, after my time in office, I pledge not to accept any position lobbying for or against legislation in Washington.

    And so I’m torn. This guy is saying all the things I want to him to say on the issue that is most important to me. And yet he isn’t the candidate that aligns most purely with my own personal beliefs, some of them almost as key. So what do I do? Do I use the litmus test? Do I give Rubens my vote because he’s taking the brave step of abandoning corruption? Do I vote on this one, single issue? 

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