Editore"s Note
Tilting at Windmills

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June 8, 2006

'A SHARED SOCIAL RESPONSIBILITY'....Whenever the issue universal health care comes up, near the top of the list of conservative talking points is concern about government "interfering" with health care. As it turns out, it may not be such a scary concept after all.

The federal government should guarantee that all Americans have basic health insurance coverage, says a committee set up by Congress to find out what people want when it comes to health care.

"Assuring health care is a shared social responsibility," says the interim report of the Citizens' Health Care Working Group, a 14-member committee that went to 50 communities and heard from 23,000 people.

Sens. Ron Wyden (D-Ore) and Orrin Hatch (R-Utah) agreed in 2003 to create a congressionally-backed panel to work outside DC to find out what Americans actually want from the health care system. Apparently, people said they want universal coverage, guaranteed by the federal government.

To which I respond: of course they do. The existing system costs too much and offers too little to too few people. Since the Clinton plan fell apart in 1994, the country has seen no practical changes, except services cost more and there are more uninsured Americans. A single-payer, universal system -- services are provided by a private healthcare system, but financed by the government -- has to be more appealing than the status quo.

This gets back to something Kevin and I were discussing a few months ago: when it comes to the broader political debate over healthcare, those on the left who support a single-payer system don't have to worry about changing the public's mind -- they're already there. The vast majority of the country actually wants the federal government to spend more money on health care.

As for this specific Wyden/Hatch committee, the next step in the process is a 90-day public comment period, followed by a response from the Bush White House, and then five congressional committee hearings. I'm not optimistic -- "socialized medicine" still strikes some people as scary, for reasons I don't understand -- but it should be interesting.

Steve Benen 9:15 PM Permalink | Trackbacks | Comments (94)

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Comments

"Socialized medicine" is bad.

"Socialized roads," however, not so bad.

Over to you, wingnuts...

Posted by: craigie on June 8, 2006 at 9:21 PM | PERMALINK

Sounds like a bunch of commie crap to me.

Posted by: nuttylittlenut nut on June 8, 2006 at 9:27 PM | PERMALINK


If I don't want to use the roads, I don't have to buy the gasoline where the taxes fund the interstate highway construction. Here's a novel idea: pay for your own damn visits to the doctor for the sniffles instead of consistently running to the government teat in order to get others to pay for the things you're not successful enough to fund on your own.

Posted by: RW on June 8, 2006 at 9:44 PM | PERMALINK

http://www.go08.org/

Posted by: captain freud on June 8, 2006 at 9:44 PM | PERMALINK

Craigie-- Roads are a public good. Healthcare is not. Because I have no illusions that you've even heard of Paul Samuelson, I'll even link you to wikipedia's very basic primer on the subject: http://en.wikipedia.org/wiki/Public_good

By your logic, everything should be paid for by the government. "If not socialized roads.... why not socialized computers???". The public/private good dichotomy is the most workable framework of what the government should pay for.

Why I oppose a government takeover of medicine: I, like many Americans, choose not to have health insurance. I had it for years, and never used it. If I get sick, I'll pay cash. Because I'm in good health, this is a smart bet. I'd rather use my money on other things.

Most of my colleagues choose to get health insuurance. That's fine; it's their choice to bet against themselves. However, just because that choice is popular with some doesn't mean it should be forced on me.

Why is it that liberals will stand up for the right of a woman to kill her unborn baby, but not my right to decline to be insured? I don't want health insurance. I don't want to pay for somebody else's health insurance. If somebody else has different spending priorities, good for them. Economic freedom is important too, and democrats are increasingly determined to erode it.

Posted by: American Hawk on June 8, 2006 at 9:53 PM | PERMALINK

Here's a novel idea: pay for your own damn visits to the doctor for the sniffles instead of consistently running to the government teat in order to get others to pay for the things you're not successful enough to fund on your own.

So, if you get cancer, and you're not "successful" enough to have a job with adequate insurance, or any insurance, you(or your "unsuccessful" children) deserve to die? Because you're not "successful" enough?

Not sure what type of inbreeding program produces such thought patterns, but it's disturbing. Thankfully, more intelligent heads appear to be prevailing.

Posted by: American on June 8, 2006 at 9:58 PM | PERMALINK

Yes, and it comes with a 12% VAT tax on all purchases. Was that part of the survey?

If people understood the damage caused by unregulated shoe lace usage and sales, they would want more federal regulation of that industry.

These studies are never blind.

Posted by: Matt on June 8, 2006 at 9:59 PM | PERMALINK

American Hawk, so if you get cancer and incur $200K in costs, or if you're in a car accident and incur $100K in costs, who's going to pay your bills? You??? Hardly. You'll rely on the rest of us to pay your way out of your problem. That's the same consideration we all want.

Posted by: Rufus on June 8, 2006 at 10:02 PM | PERMALINK

' Socialized roads," however, not so bad. '

you picked he wrong example craigie.

Socialized roads were funded on a pay per use gas tax, they criss crossed the nation with the rise in the autoobile resulting in enormous (though maybe short term) productivity gains.

You are advocating a 12% VAT tax to pay for a 5% productivity improvement on 15% of the GDP, or a total .75% productivity improvement. Nothing compared to the national highway system.

Posted by: Matt on June 8, 2006 at 10:02 PM | PERMALINK

"Socialized roads were funded..."

By income taxes, and are about 50% subsidized even today. The gas tax doesn't come close.

Posted by: jefff on June 8, 2006 at 10:06 PM | PERMALINK

"but not my right to decline to be insured?"

Because, of course, you will immediately run to the health care system to take care of your health problems and you will likely not be able to pay for them, particularly as you grow older.

Sheesh...can we get some smarter monkeys, please? The ones we have are just phoning it in with idiotic talking points that have been discredited and debunked decades ago.

Posted by: PaulB on June 8, 2006 at 10:09 PM | PERMALINK

Who says government funded health care will cost more? Be worse? Isn't the system bad enough, now, to justify trying a different approach?

By the way, anyone who thinks he or she is paying the entire bill--even in a fee for service setting--is wrong. Medical schools are subsidized. Hospitals are subsidized. Labs are subsidized. Etc.

Posted by: Mark on June 8, 2006 at 10:14 PM | PERMALINK

American Hawk, so if you get cancer and incur $200K in costs, or if you're in a car accident and incur $100K in costs, who's going to pay your bills? You??? Hardly. You'll rely on the rest of us to pay your way out of your problem. That's the same consideration we all want.

Rufus: That's my problem, not yours. I'll sign a form declaring that I'll never rely on a dollar of government healthcare, so long as I don't have to pay for any of it. Deal?

Posted by: American Hawk on June 8, 2006 at 10:16 PM | PERMALINK

Hey hawk, so you get in an accident on the way home and injure your brain even more than its current state; who should pick up the tab while you take a Florida nap?

Posted by: nuttylittlenut nut on June 8, 2006 at 10:21 PM | PERMALINK

Never mind the social responsibilty part of it. How does it make sense to perpetuate a health care system that costs more to maintain than single-payer systems (like Canada), and yet produces the same or poorer medical outcomes as single-payer systems?

We pay more and get less. But by God, it's better than having "socialized medicine."

Please get over it. It's just a term.

Posted by: abi on June 8, 2006 at 10:22 PM | PERMALINK

Two words: Veterans' Affairs. Our military vets have socialized health care, run by our government. Bob Dole, in his 1996 presidential campaign, bragged about how good it was for him (and purposefully misled by implying it was the same healthcare everyone had).

If universal health care is such a horrible thing we should be hearing calls for the complete elimination of the VA. Or maybe it's time to go the other way, and reduce the wasted dollars in our economy by providing universal coverage.

Posted by: Puppethead on June 8, 2006 at 10:24 PM | PERMALINK

nuttylittlenut nut -- Doubtless, they would bill me. When I buy things, I pay for them. Why does that concept elude the posters in this thread? Are you all used to walking into stores, demanding items, and confidently asserting that the government would/should pick up the tab? Man, I need to live in liberalland. Everything is free!!!!!!!

Posted by: American Hawk on June 8, 2006 at 10:28 PM | PERMALINK

Speaking as one who believes that the Constitution created a federal government with limited powers, what would be the constitutional basis for a law that establishes a national health care system?

I do not think that the commerce clause would apply because the delivery of health care does not really involve interstate commerce. Given that one can assume that the Founders never assumed or otherwise intended that the federal government would be the sole health care provider to the nation, what gives Congress the power to act in such a manner?

Posted by: Chicounsel on June 8, 2006 at 10:28 PM | PERMALINK

Chicounsel-- There would be ways to make universal healthcare constitutional. I suspect you're right that the commerce clause argument would be unavailing. In the Lopez line of authority, the court has been extremely skeptical of strained arguments about what is and is not welfare.

However, congress has the power to spend for the "general welfare", which is how medicare and other programs are justified now. The spending power is a distinct one, not merely a means to enforce the others. The easiest way would be to give the money to the states, conditioned on them spending it on healthcare. And despite their reputation, the SCOTUS is extremely reluctant to strike down legislation.

Of course, just because its constitutional doesn't mean it's a good idea.

Posted by: American Hawk on June 8, 2006 at 10:34 PM | PERMALINK

Sorry, no deal, wingnuts.

Public health IS a public good, and because of the way our health-care system is set up, "public" health extends so deep into the individual's health that there's almost no point in distinguishing between them.

"American Hawk" is the most ludicrous, of course. If s/he's seriously injured in a car accident, say, the system will provide emergency care, to at least the point of stabilization. That's the most expensive kind of medicine. And I'm quite sure that, for all his/her bluster, if s/he had serious injuries, or a life-threatening condition of any kind, s/he'd be sitting in an ED just as scared as anyone else.

And as for the silly argument about roads, quite apart from the fact that the gas tax pays, and paid, for only a fraction of the roads that exist, and overlooking entirely the gigantic indirect subsidies that the personal auto enjoys (anyone think we'd be spending $6 billion a month in Iraq if it weren't for the fact that our gasoline comes from that part of the world?), your health DOES in fact affect me, in multiple and material ways. The consequences of your getting the "sniffles" (as though that were as much as a tiny fraction of what we spend health care money on) is that your productivity goes down, you consume health-care resources for which you do not pay (see comments upthread about research, facility costs, etc.), and you are contagious. Individual health IS a public concern, and is properly treated, at least in part, as a public good.

Oh, and then there's the moral part. We'll let that go too, but I gotta say, I'm always amazed at how conservatives who set themselves up as the arbiters of moralism are happily willing to screw the unfortunate, no doubt in the name of "efficiency" or something.

I have an idea for you "self-reliant" types: go live in a cave somewhere. Don't use public sewer or water systems, don't take advantage of publicly-funded research or public facilities of any kind (parks, county hospitals, non-toll roadways), see whether you can survive -- much less make a living -- and if you can, keep your taxes.

We're better off without you anyway.

Posted by: bleh on June 8, 2006 at 10:37 PM | PERMALINK

.."By income taxes, and are about 50% subsidized even today."

Jeff, I need a reference and I will be convinced.

Posted by: Matt on June 8, 2006 at 10:44 PM | PERMALINK

Maybe Hawk just needs a lesson in what a "society" is, or what the role of "politics" is. Look up those two definitions and throw in the true teachings of Christ and most of the Right has a problem.

Posted by: nuttylittlenut nut on June 8, 2006 at 10:47 PM | PERMALINK

"..hearing calls for the complete elimination of the VA. "

I been bitching to the wingnuts about this for years. Wingnuts are simply socialists of another stripe.

--------------------

Let me repeat a proposed spiel about this.

First, use federal manadates to simplify the insurance programs to three or four major coverage groups. Do this first, as step one, to let the medical offices simpifly and rationalize the private insurance system.

Second, notify the public that full nationalization will require a VAT tax, be honest.

If you meet these two steps, then you can talk about productivity gains from nationalization. But, be honest, this is about productivity gains, nothing else, and that will generally mean rationing by government.

Posted by: Matt on June 8, 2006 at 10:50 PM | PERMALINK

Hawk:

Under the scheme that you described, would Congress have the authority to prohibit people, doctors and hospitals from having the ability to go outside the system? If not, then it would be just another welfare program. If so, then that would represent a loss of personal and economic freedom that would have to have some constitional justification.

After all, even though Congress had the power to spend, it still required a constitutional amendment to gain the power to tax incomes. Perhaps advocates of a government run health care system should propose an amendment that would expressly enpower the federal government to establish such a system

Posted by: Chicounsel on June 8, 2006 at 10:56 PM | PERMALINK

TROLL FEEDING CONTINUES!

American Hawk: Doubtless, they would bill me.

How are they going to collect while you take a Florida nap?

When I buy things, I pay for them. Why does that concept elude the posters in this thread?

Oh, you'll pay for it. In fact payment will be demanded at the point of a gun (isn't that how the liberloonies describe it?).

Man, I need to live in liberalland. Everything is free!!!!!!!

Apparently you already live there. Don't you know that W's tax cuts pay for themselves?

Posted by: alex on June 8, 2006 at 10:57 PM | PERMALINK

Matt,

You basically described the Clinton health care proposal. It was all about simplified management and paying for it from a shared risk pool.

But instead today we have soaring health costs and companies that are going into bankruptcy because they can't afford to provide it for their employees. Meanwhile the employees are losing more and more of their stagnant wages to health care, which is the leading cause of personal bankruptcy.

Posted by: Puppethead on June 8, 2006 at 10:58 PM | PERMALINK

Based on bleh's big blue marble logic, all of us and all that we do is interconnected and therefore of "public concern" and a "public good", so best to have every minute personal decision (like how to treat those sniffles that so effect bleh) funded, and of course regulated, by the government. It's just that type of thinking that puts the socialized in socialized medicine and scares the s/hit out of a great many people.

Posted by: Ultra Mega Mega Man on June 8, 2006 at 11:06 PM | PERMALINK

Oh, come on - The United States can't afford universal health care coverage! Instead, we need to keep spending $2 billion of our children's money every week in Iraq, blowing things up and killing innocent people. Get your priorities straight, Steve!!!

Posted by: Stephen Kriz on June 8, 2006 at 11:09 PM | PERMALINK

It's a pity that Hilary's idea of universal health care for US was so much ahead of her time; had she triumphed, we probably wouldn't be in the straits we're in now. And, who knows, she might have remained an idealist instead of a "political prostitute" she's become.

As for Amrican Hawk's "If I get sick, I'll pay cash"... You might not be able to, sweetheart; you may *have to* go to the ER and throw the costs back to us all.

A while back, my stepdaughter came here (from another state), with her little boy, for a week. During their visit, he got sick. As is usual with small children, the onset was fast and scary, so we started phoning all the doctors in the phone book (not many; it's a small town). NONE would agree to see him. Not on the insurance (mine didn't work, because he wasn't on my "plan"; hers wouldn't work, because they were insured with a "plan" which didn't operate in my state), and not when we promised to pay cash. Don't know why; maybe the doctors'records didn't have the option to charge the full price instead of a co-payment/insurance reimbursement "standard".

Universal health care would have made getting sick outside of your "catchment area" a piece of cake (I, my son and my husband have all had reasons to use the Eurpean models of health care; they may not be as excellent as the top tier of US care, but who can afford the top tier in US?)

As several people have pointed out, a single, but big payer has more clout to negotiate the price of medicine than an individual (hower Hawkish) does -- vide the Veterans Administration or Medicare.

Posted by: libra on June 8, 2006 at 11:15 PM | PERMALINK

Dear little Hawkie, stamping his widdle foot and shaking his widdle fist, writes: "Doubtless, they would bill me."

Why yes, Hawkie, they will. And when you are wholly unable to pay, which is usually the case for something like e.g., cancer, guess who foots the bill? Why, the rest of us! Whodathunkit.

"When I buy things, I pay for them."

Unless, of course, it's catastrophic health care, which you cannot afford, which is why we have this thing called insurance, which is also not affordable to far too many people, which is why the concept of universal health care is so popular to the majority of Americans. You see, Hawkie, dear, the thing about "liberal land" is that it's enormously popular. People like living here with the rest of us. You should join us someday.

" I'll sign a form declaring that I'll never rely on a dollar of government healthcare, so long as I don't have to pay for any of it. Deal?"

Sorry, dear, but I'm afraid that it's no deal. You see, your party has this "culture of life" thing which means that it won't let you die and it won't let you not accept health care, even if it has to be shoved down your throat in a feeding tube.

Isn't Hawkie fun?

Posted by: PaulB on June 8, 2006 at 11:19 PM | PERMALINK

UMMM wrote: "so best to have every minute personal decision (like how to treat those sniffles that so effect bleh) funded, and of course regulated, by the government."

LOL.... Like I said, can we get some smarter monkeys? These have forgotten how to reason.

Posted by: PaulB on June 8, 2006 at 11:21 PM | PERMALINK

The key word there is "basic" care. Stitched, casts, pain pills, anti-biotics, shots...

Push that and this should get rolling pretty good.

Posted by: aaron on June 8, 2006 at 11:25 PM | PERMALINK

Any of you goofballs think Candidate Hilary is going to lead this charge??

Posted by: Down goes Frazier on June 8, 2006 at 11:26 PM | PERMALINK

Down goes Frazier wrote: "Any of you goofballs think Candidate Hilary is going to lead this charge??"

If she runs for president, she will undoubtedly have a health care campaign plank, probably an incremental one along the line of Kerry's rather than the universal solution she proposed years ago.

Posted by: PaulB on June 8, 2006 at 11:37 PM | PERMALINK

We used to get actual arguments against universal health care, but now all we get is inane bullshit from a few deadenders. i guess the argument is truly lost, Righties. Maybe you'll do better with the estate tax.

Oh wait, sorry...

Posted by: craigie on June 8, 2006 at 11:37 PM | PERMALINK

the insurance companies will never ever allow a single payer system funded by tax dollars to come into existence. They make ZILLIONS siphoning off much needed health care dollars to pay mid level and low level paper pushing idiots whose job it is to stand in between you and your much needed health care. The industry employes lawyers to dream of new ways to deny coverage for health care you THOUGHT you were entitled too.

What a fucking racket. They will never allow anything so mundane as human need to stand in the way of their ill-gotten profits.

Posted by: mablex on June 8, 2006 at 11:52 PM | PERMALINK

You wingnuts forgot about infectuous diseases.

If you deny health care to the poor until they are on death's door, they'll breed up antibiotic-resistant tuberculosis and other equally pleasant critters, and those bugs will then infect you.

Posted by: Joe Buck on June 9, 2006 at 12:01 AM | PERMALINK

I wonder how the posters on this list would respond if their lives were treated as cheaply as they appear to treat the lives of the uninsured.

Posted by: Fellow on June 9, 2006 at 12:18 AM | PERMALINK

mablex, you put your finger right on it. We maintain a redundant, inefficient system because it benefits healthcare corporations, to the detriment of millions of Americans. And these corporations have actually managed to convince the me-firsters that they'd pay more under a single-payer system.

Posted by: abi on June 9, 2006 at 12:19 AM | PERMALINK

"I'm not optimistic -- 'socialized medicine' still strikes some people as scary"

Then call it what Corporate America calls it: Self Insurance.

A large chunk of the Fortune 100 kicked the health insurance companies to the curb years ago, and discovered how much cheaper it was to self-insure.

So, we just follow Corporate America's lead and have the country self-insure itself. Who needs those bloated, greedy, price-gouging insurance companies anyway ?
.

Posted by: VJ on June 9, 2006 at 12:23 AM | PERMALINK

Jesus Fuck but there are a lot of fucking YOYO's here aren't there?

Posted by: angryspittle on June 9, 2006 at 12:25 AM | PERMALINK

A single-payer, universal system -- services are provided by a private healthcare system, but financed by the government -- has to be more appealing than the status quo.

It isn't financed by the government, it's financed by taxpayers. the plans generally lose when it becomes obvious that the taxpayers will not in fact pay for "universal coverage" but impose limits and diverse other complications.

Posted by: republicrat on June 9, 2006 at 12:30 AM | PERMALINK

Goddamn are some folks fucking bone crushing stupid.

Who the fuck do you think the government is?

Posted by: angryspittle on June 9, 2006 at 12:35 AM | PERMALINK

Governmental health care? what a bunch of BS, and I'm a liberal Democrat. Why sotp there? Why not enter the food market, and declare food to be a universal right, have the taxpayers take over the payment for food, but still have it be privately owned grocery stores. Uhhuh. That would never work, and people instinctively recognize that. The challenge is to make medicine affordable enough, and that will happen when it is deregulated. no more quaota on medical students, or residents. That would instantly increase the competition, drive down the prioces (but also quality..can't have it all), and voila, no taxpayer money was needed. Of course, msot people will be able to afford the equivalent of fast food, with some able to afford Filet Mignon at The Canlis. BUt wait, that's the American Way.

Posted by: chris on June 9, 2006 at 12:39 AM | PERMALINK

Using the market for food as a model for healthcare is appealing, but wrong. Sure, it's possible to be hungry and go to McDonald's and then not be hungry, but that kind of multi-tiered model doesn't really exist in medicine. You are sick, and you want to be well. That's it. It's pretty binary. What's the fast food equivalent of getting better? Only one leg falls off?

Posted by: craigie on June 9, 2006 at 12:44 AM | PERMALINK

I had surgery on my hand 2 months ago. It cost about $4000 for out-patient surgery. I have news for you American Hawk and all you other Free Market Fundamentalists: the actual cost my insurance company paid was about $6000 because of all the mark-ups for the uninsured. So the uninsured get to pay what they can (maybe nothing at all) but I have to pay for myself PLUS them. How is that not a tax?

"Why is it that liberals will stand up for the right of a woman to kill her unborn baby, but not my right to decline to be insured?" American Hawk
In case you haven't noticed, but the unborn need care in the womb AND after they're born. It costs money something which you seem to value more than life. And when it comes to declining insurance, I'm sure there are people who can afford it but decline the coverage. But what about those that don't have the money to pay for it? Are they are there own? If they can't afford it then they don't get healthcare and die?

Posted by: T2005 on June 9, 2006 at 12:51 AM | PERMALINK

It costs money something which you seem to value more than life.

Bingo.

Posted by: craigie on June 9, 2006 at 12:59 AM | PERMALINK

For the last 25 years I've lived in a country (Japan) that blessedly has universal health care. Not free by any means--we pay quite high premiums based on income--and as others have noted, it may not be first tier in all cases, but it's available to everyone. I would hate to go back to the primitive "system" (chaos is a system, right?) advocated by American Hawk, where the "liberty" of a few cave-dwelling individuals is valued above the liberty of all.

Posted by: Hokuto on June 9, 2006 at 1:17 AM | PERMALINK

This gets back to something Kevin and I were discussing a few months ago: when it comes to the broader political debate over healthcare, those on the left who support a single-payer system don't have to worry about changing the public's mind -- they're already there. The vast majority of the country actually wants the federal government to spend more money on health care.

It obviously does not follow from the premise that most Americans want the government to provide a higher share of funding for health care that most Americans want single-payer health care.

Not that these polls mean much with respect to actual, real-world reform proposals, anyway. What people say they support in the abstract, and what they will actually support when a real meat-and-potatoes reform proposal is put in front of them are two very different things. Given the many plausible risks of any single-payer reform--rationing, waiting lists, higher budget deficits--risks that are certain to be extensively advertized and strongly emphasized by the opponents of such reform, the political battle will be enormous. Clinton's Health Security Act proposal, which was not single-payer and left the country's existing private health insurance and delivery systems largely intact, was actually a relatively small reform compared to any single-payer proposal, and even that went down in flames.

Posted by: GOP on June 9, 2006 at 1:18 AM | PERMALINK

Using the market for food as a model for healthcare is appealing, but wrong. Sure, it's possible to be hungry and go to McDonald's and then not be hungry, but that kind of multi-tiered model doesn't really exist in medicine.

So, we reform the health system to make it more "multi-tiered," more like the markets for other essential goods and services such as food, housing and clothes. But in fact health care is already very market-oriented, in both funding and provision. The fact that we don't rely on the government to fund or provide the other necessities of life does seem to undermine rather strongly the claim that we should rely on the government to fund or provide health care.

You are sick, and you want to be well. That's it. It's pretty binary.

You are hungry, and you want to be fed. You are cold, and you want to be sheltered. You are naked, and you want to be clothed. Those seem pretty "binary," too. But we don't rely on the government for them.

Posted by: GOP on June 9, 2006 at 1:27 AM | PERMALINK

Out of sight out of mind, right GOP? Good for you and your sand loving head.

Posted by: nutty little nut nut on June 9, 2006 at 1:36 AM | PERMALINK

I can grow food, buils a fire, make clothing, how I'm going to perform that heart surgery seems a little trickier.

Posted by: nutty little nut nut on June 9, 2006 at 1:38 AM | PERMALINK

If she runs for president, she will undoubtedly have a health care campaign plank, probably an incremental one along the line of Kerry's rather than the universal solution she proposed years ago

Yeah, I think Hillary learned her lesson in that humiliating defeat. The only politically viable kind of health care reform is modest, incremental change. Guaranteeing health insurance for all children might be a good first step.

Posted by: GOP on June 9, 2006 at 1:40 AM | PERMALINK

I can grow food, buils a fire, make clothing

Can you? That's nice. Somehow, though, I suspect that like everyone else who isn't Grizzly Adams, you probably do rely on grocery stores, clothing stores, power companies, and other market suppliers to provide you with these necessities, just as you would most likely rely on a privately-employed surgeon to perform your heart surgery, so you don't seem to have much of a point.

Posted by: GOP on June 9, 2006 at 1:50 AM | PERMALINK

"Oh, and then there's the moral part."

followed shortly by...

"I'm always amazed at how conservatives who set themselves up as the arbiters of moralism..."

rofl.

Posted by: a on June 9, 2006 at 3:52 AM | PERMALINK

The righty-tighties are bothered to the point of obsession that their contributions to the general good might benefit someone unworthy. "Why should I help you"?, they ask, mindless of the help that the generations before them have given us.

Mean-spirited, short-sighted, selfish, greedy are synonyms for conservatism in our era.

Posted by: bad Jim on June 9, 2006 at 4:07 AM | PERMALINK

People who hate the idea of government hate the idea of them... Well, what would Freud (or Groucho Marx) say?

Posted by: Kenji on June 9, 2006 at 5:01 AM | PERMALINK

Republicans claim that government doesn't work, and whenever they're in power they prove it.

Posted by: bad Jim on June 9, 2006 at 5:03 AM | PERMALINK

In respone to American Hawk:

The response I prefer to American Hawk's position is not to point out that he likely will rely on government subsidies should he incur catstrophic medical costs. Rather, it is to challenge his key assumption. His assumption holds that if he could effectively promise not to rely on government subsidized health care, the government would commit a moral wrong should it force him to contribute taxes to a system of universal health care. On the contrary, even assuming that he could effectively promise never to participate in government assisted healthcare, he should nonetheless be required to pay a tax in support of the government provided healthcare program. The argument goes like this:

We each have a duty to help our fellow Americans realize certain basic goods like healthcare. This duty of course is limited. We need not sacrifice everything to provide our fellows with such basic goods, but certain limited sacrifices are morally required. With a modest tax imposed on each of us, we can provide a fairer, cheaper and more health-promoting system of healthcare. Paying a modest tax to ensure universal health care is precisely the sort of limited sacrifice for the sake of ensuring our fellow Americans basic goods that is morally required of each of us. Moreover, and this is a further assumption, the government does no wrong in imposing a tax in service of moral requirements such as this. Also relevant is that should such a healthcare scheme be enacted, it will be the result of a democratic decision-making. This democratic imprimatur further justifies governmental imposition of a modest tax to fund the provision of this basic good. So, in short, American Hawk (as would each of us) would be morally required to contribute to a scheme of universal health care were one in place. Moreover, the government, particularly, a democratic one, would be jusiified in taxing him in service of such a scheme. American Hawk is mistaken to think otherwise.

SS

Posted by: SS on June 9, 2006 at 5:36 AM | PERMALINK

The way I look at it - I am a Christian first and an American second. Christ admonished us to care for the sick, clothe the naked and feed the hungry. It really doesn't matter to me, in the final analysis, what the U.S. Constitution or Republicans or Democrats say about it.

Providing health care to those who need it is a moral issue, not a political one.

Posted by: Stephen Kriz on June 9, 2006 at 6:59 AM | PERMALINK

We already have universal healthcare guaranteed by the government. It's called Medicare, and the people are overwhelmingly for it.

Unfortunately, it's only universal for a particular age group.

Put the question to the people: If you're against "socialized medicine," are you in favor of giving up your or your parent's Medicare coverage?

Posted by: xtalguy on June 9, 2006 at 8:31 AM | PERMALINK

How do those who are against governmental involvement feel about Tricare?

Posted by: liz on June 9, 2006 at 8:37 AM | PERMALINK

The key word there is "basic" care. Stitched, casts, pain pills, anti-biotics, shots...

Push that and this should get rolling pretty good.
Posted by: aaron

Which is the way Medicare was supposed to work, remember? Next stop titanium hip replacements for 92 year olds with advanced Alzheimers...

And before you decide to jump up and down on me: that's a factual example. The neighbor in question died 16 months later of heart failure.

And ya'll are gonna have to choose: vastly expanded immigration or health care for all. Can't have both. Mass immigration spells the end of virtually every social welfare program which has so far managed to continue under GOP 'compassion'.

Posted by: CFShep on June 9, 2006 at 8:38 AM | PERMALINK

These really are stupid trolls.

When we let private enterprise build the roads, it failed totally. As with air travel, the roads simply wouldn't exist if they depended on user fees. The tax on fuel comes nowhere close to paying for the roads.

The same is true of agriculture. Left to private enterprise, the system crashed. By the 1930s you had the Dust Bowl, the soil of the south was used up and couldn't grow crops anymore, and the "markets" were so messed up that no farmer could make a living.

Today we have the biggest system of subsidies and the biggest production of crops in the world. Whenever you buy beef, grain or milk you're buying a socialist product- that's why high cholesterol foods are so cheap in the grocery store.

By now we know the American people support universal coverage for healthcare. The problem right now is the "opinion makers" who think they can continue to bamboozle people, and the solution is to master the facts and make it plain to them that the game is over.

Posted by: serial catowner on June 9, 2006 at 8:40 AM | PERMALINK

GOP,

In the areas of food, shelter and clothing it is a safe bet that you will not suddenly be hit with a $400,000 expense. Your expenses in those other areas are predictable and limited. In health care this is not true. This is why health insurance is such a valuable thing. We on the left also believe that the fundamental role of government, providing security, is in essential character, an insurance operation. Government pools the resources of the general population to provide security where it is needed when it is needed. Government is, by its nature, ideally situated to provide insurance. So, given the extreme value of health insurance, the natural role of government in providing insurance, and the great shared social responsibility we have, we on the left support UHC.

Posted by: MSR on June 9, 2006 at 8:47 AM | PERMALINK

As a matter of fact, we don't have to choose between expanded immigration and prosperity. History has made it plain that a flood of immigrants creates prosperity.

Not that any of our trolls have actually read any history.

Posted by: serial catowner on June 9, 2006 at 8:48 AM | PERMALINK

When are the better trolls going to arrive with their higher class of bullshit? You know, stuff like "if we have universal health insurance companies will stop innovating" and "wait lists in Canada" and the sort of garbage that takes more than half a thought to debunk?

This "poor people should be allowed to die" stuff can hardly even be called trolling - it's more like simple confession from the right-wing id.

Posted by: S Ra on June 9, 2006 at 9:00 AM | PERMALINK

>>As a matter of fact, we don't have to choose between expanded immigration and prosperity. History has made it plain that a flood of immigrants creates prosperity.

Bullshit. And quite beside the point, which is single payer health care - a proposition I've supported all along. The current systems which singles out only certain classes causes vast distortions.

"There are many victims in the illegal immigration saga, foremost among them blue collar American workers who are besieged from all sides. The right wing disdainfully views them as mere fodder for the corporate juggernaut. The left wing empathizes with employees angst while sacrificing their interests at the altar of political correctness. Trapped in a thirty-five year trend of falling real wages, working class Americans are steadily losing ground. To make matters worse, whenever workers bemoan the pernicious effects of illegal immigration they are smeared as being nativist, as though demanding a fair wage in exchange for hard work somehow reveals malice."

David Podvin http://www.smirkingchimp.com/

Posted by: CFShep on June 9, 2006 at 9:08 AM | PERMALINK

Not to interfere with the regularly-scheduled name calling, but there's an interesting proposal in my state at www.commonsensehealthplan.org.

Posted by: A Georgian on June 9, 2006 at 9:17 AM | PERMALINK

It is truly a shame that this board is so filled with Leftish vitriol. In many ways, the Democrats have a reasonable and even compelling argument - although not without elements that should give all of us pause.

For every argument in favor of the "Shared Social Responsibility" advocated in this article, however, there are two or three gratuitous slams ("Wingnut," "Not that you trolls read history", etc). If you want to win this argument my first advice is simply to grow up (Not counting you, SS, I liked your arguments very much).

Also, keep in mind that there are some pretty well-established costs that you must honestly address. As long as you retreat to "greedy corporations" (as if Government is perfect?), straw-man arguments (all "rightys" are greedy, heartless bastards), etc. then you appear to be trying to just change the subject.

As long as you come off this way, I simply don't trust you to be making a real argument rather than simply living in a bubble. Remember, this same kind of "shared social responsibility" argument was made in favor of housing projects that turned out to be huge errors - locking the populations being served into ghettos with spiraling crime rates, a near-total destruction of the family, falling educational achievements and a host of other social ills. I'm old enough to remember when those who opposed these programs were ostracized in much the same way as the Dems on this board are trying to intimidate and marginalize those who offer reservations about a single-payer system.

How are we to know that, for all your bluster, arrogance and intimidation, that this isn't simply a replay of other liberal policy failures? How do we know that this will instead follow in the footsteps of past liberal successes? I'm not a Liberal so convince me - don't yell at me!

Posted by: WildMonk on June 9, 2006 at 10:01 AM | PERMALINK

WildMonk - Yes, but...

Every attempt in the last six decades to provide universal health coverage in the U.S. has been torpedoed by a coalition of Republican and corporate interests. This has been accomplished primarily by highly-orchestrated and massively funded propaganda campaigns, filled with distortions, scare tactics, and obfuscation.

I'd love to have a civil debate on this, but the other side seems determined not to allow that to happen.

Every other industialized country provides universal coverage. None of them would dream of going back. The American people want it by a large margin. But we continue to be denied universal health care because of a minority which is willing to pour seemingly endless resources into making sure it doesn't happen. I ask you, how are we supposed to deal with this?

Posted by: Virginia Dutch on June 9, 2006 at 10:18 AM | PERMALINK

Why is it that liberals will stand up for the right of a woman to kill her unborn baby, but not my right to decline to be insured? I don't want health insurance. I don't want to pay for somebody else's health insurance. If somebody else has different spending priorities, good for them. Economic freedom is important too, and democrats are increasingly determined to erode it.
Posted by: American Hawk

Another dishonest post by Chickenhawk. Do you work for a corporation, Chickenhawk? If so (or for any company with over 50 employees), the only way you can opt out of company-subsidized health insurance is to prove that you are insured elsewhere. Guess why, Chickenhawk? Because companies don't want their employees to get sick and spend an inordinate amount of time out of work.

I suspect you are a liar, Chickenhawk, or a fool (well, we already know the latter is true). If you are working and not covered by insurance, you are a dumber bastard than I gave you credit for. Kudos, that's quite an accomplishment.

Of course, the likelihood is that you are not working, but living in your mother's basement and sponging off of her healthcare.

Posted by: MeLoseBrain? on June 9, 2006 at 10:33 AM | PERMALINK

In 1992 the Dems had the WH and the congress and Hillary was hard at work on putting together such a program. The program collapsed primarily because of the weight of the costs associated with it.

I currently don't have any healthcare and fortunately don't require much. I personally do not want a UHC system in that I don't want to pay for others healthcare needs and I don't want them to have to pay for mine. I could, however, see the need for a universal catastrophic health care system, helping patients cover extensive care needs. Which really is already being done indirectly.

Posted by: Jay on June 9, 2006 at 10:37 AM | PERMALINK

Guaranteeing health insurance for all children might be a good first step.
Posted by: GOP

What??? And how do you do that without the government becoming involved? Jesus, that's the situation we're trying to address. Granted, many solutions posited here may not be viable, but at least we're trying to solve a problem. You guys want the market to take care iof everything and then miraculously expect all children to be insured. I'd honestly like to know how you propose to do it.

Posted by: MeLoseBrain? on June 9, 2006 at 10:49 AM | PERMALINK

Which really is already being done indirectly.
Posted by: Jay

I didn't know so many wingnuts went uninsured! The problem with your concept, Jay, is that "extensive care needs" are the most expensive to provide. That is the entire rationale for UHC, to get people to take care of a problem before it becomes a huge problem. Prevention is a lot less expensive than actual care.

And you're saying that the current system works? Try telling that to GM.

Posted by: MeLoseBrain? on June 9, 2006 at 10:53 AM | PERMALINK

The one, absolute identifier, of when a health plan becomes state socialist is this: they tell you that you will go to your assigned medical provider, only switch providers with government permission, and will never try to pay out of pocket for a better private doctor or a better course of treatment, or a quicker course of treatment.

This complete prohibition of your right to seek and pay for the best care is ground zero of socialist medicine. Without this critical proviso the government has to compete for providing services and bureaucrats hate competition.

My favorite anecdote from Canada years ago was when a veterinarian noticed that the new CAT scanner in a public hospital sat idle during the graveyard shift because the public health service did not want to pay staff a shift differential to work nights.

The Veterinarian asked for and received permission to hire his own technicians and to use the machine on animals during the night. It quickly became apparent, however, that a pet in crisis could get scanned the next day, but the most seriously sick humans were waiting in line for months to get images made.

Embarassed by this revelation making the media, the socialist health providers did what comes most naturally to them--they disallowed the Veterinarian any further use of the machine.

Once again, the costly CAT device sits idle at night. Innocent animals are dying, humans wait for weeks for the diagnosis that might save their lives, but the government does not have to be embarassed.

How much is your life worth if you are really sick, or your spouse in really sick? The pace of medical progress is incredible, but ONLY, ONLY, ONLY because there are competing health care systems in the world. Who is to judge which treatment is the best? How about you, even if you have to spend your own buck to do it.

The dirty truth about insurance in the first place is that it costs the majority of people more over the long run than if they were self-insured. Guaranteed, and no matter what is being insured. All you ever really get with insurance is a kind of forward loan if your misfortune comes along too early in your earning career.

If you are careful and lead a healthy life, you are going to pay for those who don't. But why should you arbitrarily be prevented from paying out of pocket if you are smart enough to discover a new treatment option that could work, but government is resisting it?

Posted by: Mike Cook on June 9, 2006 at 11:00 AM | PERMALINK

CFShep:"And ya'll are gonna have to choose: vastly expanded immigration or health care for all. Can't have both. Mass immigration spells the end of virtually every social welfare program which has so far managed to continue under GOP 'compassion'."

Agree 100%. I saw an article this week (in the Economist, IIRC) that compared the US and Europe on immigration. The article proposed that Europeans were having difficulties with immigration because their model provided open access to welfare benefits for immigrants but a closed labor market. The US, OTOH, provided an open labor market and restricted welfare benefits. So the US saw benefits from immigration and the Europeans saw only costs.

Posted by: PTate in MN on June 9, 2006 at 11:03 AM | PERMALINK

Why is socialism for corporations okay but not for individuals?

Posted by: PW on June 9, 2006 at 11:07 AM | PERMALINK

"Why I oppose a government takeover of medicine: I, like many Americans, choose not to have health insurance. I had it for years, and never used it. If I get sick, I'll pay cash. Because I'm in good health, this is a smart bet. I'd rather use my money on other things"

I hope you get diagnosed with cancer. Soon.

Posted by: brewmn on June 9, 2006 at 11:38 AM | PERMALINK

In 1992 the Dems had the WH and the congress and Hillary was hard at work on putting together such a program. The program collapsed primarily because of the weight of the costs associated with it.
--jay

That is simply inaccurate. The program "collapsed", due to the largest negative advertising campaign in American history ("Harry and Louise"), organized by the Health Insurance Association of America. Another example of how conservatives are masters of propaganda/opinion manipulation and getting people to vote against their own best interests. Also, not to be pedantic, but the year was 1993.

I currently don't have any healthcare and fortunately don't require much.
--jay

Consider yourself to be very lucky, my friend. You are also at great risk. One accident or an unforeseen illness and you will be financially wiped out.

I personally do not want a UHC system in that I don't want to pay for others healthcare needs and I don't want them to have to pay for mine.

I personally don't want to pay for a $450 billion war machine either, but me and my children are stuck with that bill whether we like it or not. George W. Bush and his cronies are in the pockets of defense contractors like Halliburton and the American people get stuck with the tab. I call it socialism for the wealthy. The payback from defense spending is zilch. The payback from UHC is enormous, particularly pre-natal and early childhood coverage.


I could, however, see the need for a universal catastrophic health care system, helping patients cover extensive care needs. Which really is already being done indirectly.
--jay


What do you mean it is being done "indirectly"? Do you mean by default? That is one reason that everyone's health care costs are so high - because we have uninsured people getting very sick, because they forego early treatment and preventitive care. Then, when they are very, very sick, they present at an emergency room, which is the most expensive venue, and need massive amounts of medical attention to address what may have started out as a simple malady. This is an extremely stupid way to deliver health care. So, don't call it "indirect" catastrophic coverage. Call it "stupid and short-sighted", which is what it is.

I will pray that you do not get sick or hurt.

Posted by: Stephen Kriz on June 9, 2006 at 11:39 AM | PERMALINK

I'm going to sign a form declaring that my family will never rely on a dollar of government healthcare, so long as they don't have to pay for any of it. Deal?

Granted, it may be tough for the rest of you to watch my kid go without limb-saving surgery when we get hit by an uninsured motorist, or to watch my preemie die because there's nothing more expensive than intensive care for premature infants, and hospitals want cash if you don't have insurance, and I already went into a hundred thousand dollars worth of debt to pay for the amputation of junior's mangled leg. Too bad I can't afford a prosthesis and physical therapy for him either.

But that's a sacrifice I'm willing to make so I don't have to pay for insurance or be taxed for universal health care.


Posted by: American Idiot on June 9, 2006 at 11:41 AM | PERMALINK

The inalienable right to life, enshrined in our Declaration of Independence, it would seem is not so inalienable.

If you can't afford health care, you die.
If you can't afford housing, you live in the streets.
If you can't afford food, you starve

In this post-Regan "hooray for me and screw you" world, the Land of the Free boasts:

A higher infant mortality rate than most officially recognized third world countries

The highest prison population ON EARTH

The highest imbalance between work, wages, benefits and merit between the now sharply divided classes in the USA

It is a country filled with slums, hidden and shoved away behind a facade, carefully concealed by corporate advertising and marketing otherwise known as American mass media.

The middle class will soon be gone and won't even have the status of sharecroppers anymore.

This is the third world toilet that has become the USA.

Posted by: MARBLEX on June 9, 2006 at 12:19 PM | PERMALINK

Mr. Cook, I'm an academic. Would you be so kind as to provide a verifiable citation for the story about the CAT machine and the veterinarian, please?

Posted by: Noel on June 9, 2006 at 12:23 PM | PERMALINK

Mike Cook: The one, absolute identifier, of when a health plan becomes state socialist is this: they tell you that you will go to your assigned medical provider, only switch providers with government permission, and will never try to pay out of pocket for a better private doctor or a better course of treatment, or a quicker course of treatment.

But is that what's actually being proposed? Or are you infering that because other countries have such strictures, we will necessarily end up with the same?

If you are careful and lead a healthy life, you are going to pay for those who don't. But why should you arbitrarily be prevented from paying out of pocket if you are smart enough to discover a new treatment option that could work, but government is resisting it?

Are you seriously suggesting that you can live a healthy lifestyle and be certain you won't get cancer?


Posted by: cyntax on June 9, 2006 at 12:48 PM | PERMALINK

That CAT scan story is a beautiful example of the kind of brain-dead argument by anecdote that the right loves so much when they try to kill any progressive initiative.

I wonder how many anecdotes I could come up with about people who suffered and died in the U.S. because they were denied proper care? If you want to look at facts, check out things like the U.S. infant mortality rate. I think we're right below Latvia. Where are the "right to life" folks on that one?

Posted by: Virginia Dutch on June 9, 2006 at 1:25 PM | PERMALINK

MSR,

In the areas of food, shelter and clothing it is a safe bet that you will not suddenly be hit with a $400,000 expense. Your expenses in those other areas are predictable and limited. In health care this is not true. This is why health insurance is such a valuable thing.

First, prices of other essential goods and services aren't predictable or limited, either. Housing prices, for example, are highly volatile. But we don't rely on the government to build or pay for our homes. Second, there are obviously many other types of large and unpredictable expenses in addition to health ones. That's why there is a market for insurance. Again, we don't rely on the government to fund or provide this in most cases. Life insurance, home insurance, car insurance and health insurance are all primarily provided by private companies, not the government.

We on the left also believe that the fundamental role of government, providing security, is in essential character, an insurance operation. Government pools the resources of the general population to provide security where it is needed when it is needed.

So are you now proposing that the government should take over the entire insurance industry, not just health insurance? I don't believe that's a position of the mainstream left.

Posted by: GOP on June 9, 2006 at 2:27 PM | PERMALINK

Virginia Dutch:

Every other industialized country provides universal coverage. None of them would dream of going back.

The U.S. also provides "universal coverage." "No insurance" does not mean "no health care" or "no access to health care." As for other countries, Canada and Britain, which are probably the two clearest examples of single-payer, government-funded national health care systems, are clearly reforming their health care systems to be more multi-tiered and market-oriented. Canadians increasingly rely on private insurance and private health care services outside the state Medicare system for their needs. Britain has a large private health care system that people who can afford it use for medical services and procedures that are not provided by the state National Health Service, or that they would have to wait a long time for under the NHS.

Posted by: GOP on June 9, 2006 at 2:47 PM | PERMALINK

Bruce Emory to American Hawk,

I hope you get diagnosed with cancer. Soon.

What a despicable excuse for a human being you are, bruce_emory@hotmail.com.

Posted by: GOP on June 9, 2006 at 2:56 PM | PERMALINK

"'Socialized medicine' is bad.

'Socialized roads,' however, not so bad."

Not to mention "socialized security" (cops and prisons) and "socialized property protection" (firemen).

Finally, there's "socialized capitalism" with deposit insurance and active protection and regulation of markets that could not operate nearly as well as they do if we had true a laissez-faire economy.

Re going without health insurance and paying cash, good luck getting admitted to a hospital. Just how high IS the credit limit on your Visa card?

Here's who I want to hear from: a wingnut with a serious chronic disease who pays cash...

Posted by: Cal Gal on June 9, 2006 at 2:57 PM | PERMALINK

'Jay' posted:

"In 1992 the Dems had the WH and the congress"

President Clinton wasn't inaugurated until January 1993.

.

"and Hillary was hard at work on putting together such a program. The program collapsed primarily because of the weight of the costs associated with it."

False.

It would have covered everyone and COST LESS. You must not be aware we already pay for all those that are uninsured, except at a higher price.
.

Posted by: VJ on June 9, 2006 at 10:00 PM | PERMALINK

'GOP' posted:

"The only politically viable kind of health care reform is modest, incremental change. Guaranteeing health insurance for all children might be a good first step."

That was already accomplished during the Clinton administration. It was called SCHIP.

Where were you, in that undisclosed cave where Cheney is now ?

.

"As for other countries, Canada and Britain, which are probably the two clearest examples of single-payer, government-funded national health care systems"

Nope.

Canada has 'Single-payer' insurance, with the physicians and other medical employees working for the private-sector. Britain has a government owned healthcare system, with the physicians and other medical employees working for the government.
.

Posted by: VJ on June 9, 2006 at 10:02 PM | PERMALINK

VJ,

That was already accomplished during the Clinton administration. It was called SCHIP.

Well, if you're happy to leave things with that "accomplishment," fine. I was under the impression that you seek additional, and much larger, reforms of the nation's health care system. As I said, the only politically viable approach is modest, incremental change. Sweeping reforms that attempt to radically alter the nation's health care funding and delivery systems are probably doomed to failure, at least for the foreseeable future.

Nope.

Yep.

Canada has 'Single-payer' insurance, with the physicians and other medical employees working for the private-sector. Britain has a government owned healthcare system, with the physicians and other medical employees working for the government.

Right. Both are "single-payer, government-funded national health care systems," as I said.

[ClintonCare] would have covered everyone and COST LESS.

You obviously don't know that.

Posted by: GOP on June 9, 2006 at 11:27 PM | PERMALINK

Mike Cook:
"The one, absolute identifier, of when a health plan becomes state socialist is this: they tell you that you will go to your assigned medical provider, only switch providers with government permission [...]"

How dare you call my HMO "socialist"?!?!? It's a perfectly American, market-oriented one, with high rates, co-payments, tons of paperwork/wasted tme on the phone trying to unscramble the problems 'n' all... The only thing it shares with socialised medicine is the difficulty of getting an appointment with a doctor quickly without resorting to a visit to ER.

Posted by: libra on June 10, 2006 at 12:20 AM | PERMALINK

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Posted by: fgdg on June 10, 2006 at 4:41 AM | PERMALINK




 

 

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