Well, Michael Moore IS fat.

Socialized Medicine oh my god Bin Laden strikes again.The terrorists are doing there best to bring socialized medicine to bring us to our knees.When will they stop the next thing you Al Queda will wan to strike us with fair taxing.Oh my god the poor chidren.

....declines in employer-sponsored insurance coverage.

Wait till the decline in employer-sponsored employment...

Every year under W, the poverty rate has increased until this year. More Bush, more poverty. Nearly 1 in 5 kinds in this country live in poverty.

Unlike Al, I find this shameful. Truly shameful.

Ah Kevin you libruls will just have to wait in line for your goverment apponted hip replacment.

There are two aspects to government-provided health care, which should be evaluated separately.

1. Should the US provide adequate resources so that poor people can get appropriate medical care?

2. Should free-enterprise medical care be replaced with a government program?

On #1, I think the US is rich enough to provide medical care to poor people, one way or another. My preferred method would be for local governments to operate walk-in clinics to directly provide this care.

On #2, I want the bureaucrats to keep their hands off my medical care. Private enterprise health care isn't perfect, but chances are a government bureaucracy would be worse.

Come to think of it, Michael Moore is rather fat. What's up with that?

Fat liberals who wash their hands have longer waits for hip replacements.

ex-liberal, you're confusing the issue.

I find it difficult to believe that as much as this issue gets discussed, both on this blog and elsewhere, a basic confusion remains: we're talking about government-supported health insurance coverage, not actual medical care services provided by the government.

ex-liberal: ...but chances are a government bureaucracy would be worse

Why? Who is to say it wouldn't be better?

I find it difficult to believe that as much as this issue gets discussed, both on this blog and elsewhere, a basic confusion remains:

I don't.

We still lead the world in only a few sectors of manufacturing -- transport aircraft, and straw men.

Nearly 70% of the straw men used in political arguments worldwide are US made.

I am optimistic that if China ever fully democratizes the possibilities for the export of US-made straw men for use in Chinese political arguments are virtually limitless.

ex-lib: Should the US provide adequate resources so that poor people can get appropriate medical care?

Let me rephrase: Should the US ensure that everyone has access to a basic level of health insurance coverage?

This is not a question that can be "evaluated." You either answer 'yes' or 'no'.

As far as waiting for care is concerned, Canadians may wait longer than Americans or they may not. No one actually knows! There are waiting periods in both America and Canada for lots of different medical care. The difference is that in Canada they record (and publish) information on the length of the waiting periods; in America we do not keep track of such things.

No, Chinese-made straw men are very nearly as good and cost only 20% as much. The US market will be flooded. We need to protect our domestic straw-man industry now! Only illegal immigrants should be able to make straw men for use in America!

Well, Kevin, none of those 47 million is a non poor retired person, and that is primarily for whom our political culture operates, and it was primarily your political party which provided the major impetus for our political culture to move in that direction. Until people from your political party frankly acknowledge that this demographic has very little reason to support the reforms you support, given they experience comparatively little rationing, even relative to to other non-poor retired living in the health care regimes you favor, and devises a way to address this fact, your chances of succeeding in your advocacy approximates zero.

No, Chinese-made straw men are very nearly as good...

I beg to differ. I got laughed out of the comments at Yglesias' over at the Atlantic trying to sidetrack a health-policy argument by averring that Yao Ming is tall.

Didn't do dick. (g) Michael Moore is fat, there's your real deal....

Ah, Kevin.

So poverty actually declines, and the liberals still complain. I'm not surprised though.

.... I want the bureaucrats to keep their hands off my medical care...ex-lax at 2:13 PM

In the meantime, they are also Holding Kids Hostage
By BOB HERBERT
Published: August 28, 2007
....the Bush administration’s latest effort to thwart the expansion of the popular Children’s Health Insurance Program. Governors in several states are trying to include more youngsters from the lower rungs of the middle class and have vowed to fight the president on this issue.
Acting during a Congressional recess, and making a distinct effort to stay beneath the radar of the news media, the administration enacted insidious new rules that make it much harder for states to bring additional children under the umbrella of the program, known colloquially as CHIP.
The program is popular because it works. It’s cost effective and there is wide bipartisan support for its expansion. But President Bush, locked in an ideological straitjacket, is adamant in his opposition.
In addition to the new rules drastically curtailing the ability of governors to expand local coverage by obtaining waivers from the federal government, the president has threatened a veto of Congressional efforts to fund a more robust version of the overall program....

IMHO, the most interesting bit from this morning's news conference on the Income/Poverty/Health Ins. report was the hollowness of the increase in median household income (from $47,845 in 2005 to $48,201 last year).

You see, the median incomes of full-time, year-round workers actually dropped by about 1%, but the number of workers per household increased by enough to make up the difference, and then some.

So household income is going up because more of us are working for less, and the 'more of us' part is, in this case, the bigger factor.

Big whoop.

It's like Si Kahn once sang about President Reagan:

Without our unions and the E.R.A.
we will all have twice the jobs at half the pay.

ex-liberal, you're confusing the issue.

I find it difficult to believe that as much as this issue gets discussed, both on this blog and elsewhere, a basic confusion remains: we're talking about government-supported health insurance coverage, not actual medical care services provided by the government.

"ex-liberal" is perfectly aware of this fact. "ex-liberal" is "confusing the issue" on purpose. His purpose here is to insult Kevin and his readers by posting -- not just false right-wing bullshit; that's all the Bush cultists have -- but obviously false right wing bullshit. "ex-liberal"'s very handle is an insulting lie.

The bad faith of the "government-provided health care" line must have given "ex-liberal a special sick thrill. Why Kevin's moderator(s) tolerates "ex-liberal"'s psychodrama is a mystery.

Based on consulting my Canadian relatives, yes, there are waiting lines, and they are growing longer. But Canada's investment in health care is about half per capita what the US does. If Canada spent 20 or 30% more, they'd probably have very few waiting lines -- and still be a lot cheaper than the US.

Secondly - the choice isn't between a "free market" and the "government" ... it's between the "insurance company regulated" system we have now and a "government regulated" system. There is NO FREE MARKET in health care to speak of, for the simple reason that when you have a heart attack you don't get 3 bids on the surgery and take the lowest one. Consumers are not participants in a "free market" in any real sense. Oh, we have some choices, to be sure, but not those in an competitive free market.

Finally, we do have a government regulated health care system, it's called Medicare and it is much MORE effecient than the "free market" portion of the health care field.

As ususal, Republicans have exactly zero real arguments other than "I've got mine, screw the poor."

If poverty lowers while uninsured increases than I conclude one of two things:

1) Medical insurance is overvalued or
2) The data is fixed.

So, kevin is advised to fix the data to demonstrate, not invalidate, his theory.

It could be that poverty is falling because the poor are dying off!

JM: we're talking about government-supported health insurance coverage, not actual medical care services provided by the government.

The fact that the government is paying allows them unlimited ability to regulate. Take Medicare, for example. The bureaucratic rules control what a doctor can charge, what is or is not covered, conditions of treatment, etc.

When the government provides health insurance, that money comes from you and me. I will be eleigible of Medicare in a month, so I will use it. However, since I'm still working, I pay into Medicare. The amount I pay in is probably more than what I will take out. In any event, all Medicare is doing for me is taking some money away and giving some money back, but with lots of complicated rules and restrictions.

Dan: Who is to say [a government bureaucracy] wouldn't be better?

I read so much criticism of George Bush on this site. Would you want George Bush to design and control your health care? Bush ought to be better than most at designing a system, since he has a Harvard MBA.

Even if a government health system were set up by highly qualified people, politics inevitably intervenes. Furthermore, over time, many political structures more and more benefit the government employees who operate them. E.g. the US Post Office would be in big trouble if private companies were allowed to deliver mail.

Joe: "Come to think of it, Michael Moore is rather fat. What's up with that?"

Two words: Burger King.

Wait till the decline in employer-sponsored employment...
Posted by: Davis X. Machina on August 28, 2007 at 2:09 PM

Excellent point. Geez, if we are at such record unemployment levels now... imagine what that is going to look like when employers start to lay off people. Not only that, but the trend towards hiring temporary professional help to weasel out of paying health benefits is going to increase dramatically in the next economic slowdown, not to mention smaller employers abandoning their employees health benefits altogether when it is clear they won't quit because they can't find another job easily. Only when the system collapses will anything get done.

Ben: "It could be that poverty is falling because the poor are dying off!"

Or perhaps, similar to the way our government now factors the rate of inflation, we no longer include certain statistics in gauging the overall poverty rate -- you know, trivial stuff like the rates and levels of income, or the cost of food, health care, energy and housing, all of which can only serve to hopelessly cloud the real issue that people need to know here, which is that rates of inflation and poverty are down.

You know ex liberal you should really call yourself ex-had-a-brain.I'm so tired of you lame assholes using the postal service as some kind of poster child for expensive ineptitude. It's not. End of story. As far as most government agencies they're only as good as the people who run them. Case in point George Bush. The gov't has done a pretty shitty job of things since his crew of inept dickweeds have been in charge.

For-profit health care has collapsed if you think of how it underserves the needs of the American people. But if you think of the money that is made everything is going along swimmingly.

So, questions:

Did poverty rates lower due to an increase in wages or employment?
(according to the government, neither of these budged)

...Or did they lower because the definition of poverty fell below families' income?

Math problem: take the infant mortality rate of the US (6.37/1000) and subtract from that the infant mortality rate of Canada (4.63/1000). That gives 1.74 excess deaths per 1000 live births, assuming we aspire to merely be 23rd best in this metric. That is, for every 4000 live births in this country, 7 babies die that would not die if they had been born in Canada (or 22 other countries; Canada's merely middling good).

Now multiply that excess death rate, times the (roughly) 4 million babies born each year in the US. (Your answer should be about 7000 excess infant deaths per year).

Kevin forgot the always reliable "ethnic composition" of the US, when doing cross-country healthcare outcome comparisons. It goes: We have more poor immigrants and an intractable poor ethnic underclass (you know who). Leaving these groups out and we have pretty good outcomes.

Apropos this and the post below about health care for LA cafeteria workers I am reminded that when people perceive that resources are scarce and unfairly distributed the commandment to "love thy neighbor" becomes much more difficult.

There's a a Russian peasant story illustrating this:

Fyodor and Ivan lived as neighbors for years. One day, by great good fortune and no little luck, Ivan acquired a young goat. A young female goat in foal. Ivan and his family were overjoyed and offered to share goat milk and cheese with Fyodor and his family. While Fyodor thanked Ivan for this, secretly he was consumed by envy.

All day, everyday, Fyodor complained to his wife about Ivan's good fortune. She became so tired of his constant moaning that she approached the village wise woman who made her a lucky amulet. Fyodor refused his wife's gift for a long time, but finally, grudgingly, used the amulet, and lo and behold a wood spirit appeared. A beautiful wood spirit with a beautiful gift,
"One wish, Fyodor! Anything, Fyodor! But only one!"

Now it was Fyodor who was overjoyed. Good fortune for him! He did not hesitate an instant,
"Kill Ivan's goat."

Sigh.
Beggar-thy-neighbor, indeed.
When we list the current ruling Republican's sins let us not forget the selfishnes, inequality of income and opportunity and closing hope of the future when a better future has always been an American hallmark, that has made Fyodors so common here.

Or, my favorite quote about conservatives:
The conservative is engaged in one of man's oldest exercises: the search for a moral justification for selfishness.
-JK Galbraith

Sigh.

.... it was primarily your political party which provided the major impetus for our political culture to move in that direction..... Will Allen at 2:35 PM

...the US Post Office would be in big trouble if private companies were allowed to deliver mail.ex-lax at 2:57 PM

*sigh* Health Insurance. The cost of private health insurance is staggering and I am not surprised that so many people go without. Especially low-income working families in the service and retail industries. I am currently in process of switching my personal insurance from state to state. As a writer/waiter, I have no employer coverage so buy directly. I am 37 and single. In good health. No prior conditions. My monthly fee is $300+, without maternity. I can't imagine what a family would cost.

"I want the bureaucrats to keep their hands off my medical care."

Get those pesky kids off my lawn, sayeth ex-liberal! 10 crochety points right off the bat! Although, you're supposed to say, "hands out of my medicine cabinet." We'll send you the memo.

"Private enterprise health care isn't perfect, but chances are a government bureaucracy would be worse."

Ex-liberal does not travel to Canada, France, the UK, etc. very much. Ex-liberal enjoys spending 25 cents of each of his health care dollars on pointless administrative costs. Yay ex-liberal!!

Apparently, in ex-lib's parallel universe, there's no such thing as a private bureaucracy. The free market gods banished them long ago. Why, changing insurers is just like switching from Best Buy to Circuit City.

Besides, pain and suffering is just so much easier to cope with while you're waiting for pre-authorization from those efficiency experts at United Healthcare. It's nothing like what you go through at the post-office.

Love this: "the amount I pay in is more than what I take out." Gosh, I sure hope so. Because that's why they call it insurance, maybe ... because you don't *want* to be in a position to make a claim.

Except that it's not insuance for something you bought, like a house or a car. Your health is not something you "choose" to buy, especially if you're a child, or if you get saddled with anything chronic, which now becomes a "pre-existing condition."

Mike, please try to avoid feeding Will. We all suffer from exposure to thte the infectious effluvia that he issues as a result of getting such snacks--and no covered medical procedure will address it.

Long waits.My wife needs a hip replacment but at the age of 44 she will have to wait another 20 years before she can get a hip replcament.Oh, you didn't know you almost can never get a new hip before age 65.Unless you move to Canada then you only have to 6 weeks.

ex-liberal: My preferred method would be for local governments to operate walk-in clinics to directly provide this care.

I take it these clinics will provide open heart surgery, cancer treatments, emergency care after serious accidents and similar, sophisticated medical care. It will be tricky for the EMTs to figure out whether the bleeding victims should go to the free clinic or the hospital. Of course they can always be transferred later if there's a mistake.

I assume that anyone can walk in for care regardless of their income. It wouldn't be very practical to delay diagnosis and treatment while the clinic conducts background checks on the incomes and assets belonging to the families of those who walk in.

No, Mike, our political culture is increasingly a gerontocracy, which is why the cliche "third rail of American politics" is reserved for government actions which benefit non-poor retirees.

"The program is popular because it works. It’s cost effective and there is wide bipartisan support for its expansion. But President Bush, locked in an ideological straitjacket, is adamant in his opposition."- Mike

You've hit on why ALL ideologues are mentally straitjacketed: every model, paradigm, construct, map, or 'gut feeling' inevitably leaves out some variable that is usually linear and/or can be ignored, but sometimes, under some conditions, becomes non-linear and leads to chaos.

Please never allow ideologues to serve in public office again.

And don't allow them to influence public policy concern national health care or health insurance. We're all tired of this manmade chaos.

clio: "The conservative is engaged in one of man's oldest exercises: the search for a moral justification for selfishness.
-JK Galbraith"

A great quote. Interestingly, if you let "cooperation" equal the opposite of selfishness, one is intrigued to learn that scientist Martin Nowak proposes "that cooperation is one of the three basic principles of evolution. The other two are mutation and selection."

Of course, a majority of conservatives don't believe in evolution...so why should they cooperate?

"Long waits.My wife needs a hip replacment but at the age of 44 she will have to wait another 20 years before she can get a hip replcament.Oh, you didn't know you almost can never get a new hip before age 65.Unless you move to Canada then you only have to 6 weeks."

And until she is scheduled for surgery she won't show up in the wait time statistics.

Geez, I was going to thank FAUX-Lib and Will Allen for supporting my VA benefits - But, now, I am soooo scared - Have to see my great Primary Care Doctor next month - Mein Gott, whomever she may be - you mean that I will be seeing a, Gasp, Government Doctor????

But, how could the government get it sooooo right?

This comment will probably get deleted as many others have, but perhaps Drum - should he decide to be intellectually honest one day - could try to figure out what percentage of that number is foreign citizens who are here illegally.

My ultra-liberal brother-in-law, who doesn't even know what an HSA is buys all that crap about wait times in Canada. Of course, so too does the conservative brother-in-law who spouts Right Wing Talking Points (tm), but from him I'd expect it.

The Big Lie about health care in Canada has worked even on otherwise liberal people who just don't have many facts to support their view. They truly are knee-jerk liberals, because they don't react on the base of knowledge.

Somewho, other than through Michael Moore (god bless him) the word has to get out that all the propaganda about wait times in places with non-profit or single-payer health care is just baloney.

"this demographic has very little reason to support the reforms you support..."

Not true, actually. The $3,650 annual donut hole in prescription drug coverage is going to make even Medicare patients support full medical coverage.

Also, unlike followers of Ayn Rand and ReThuglicans in general, there are a whole lot of people who don't base their political support on the idea of "I've got mine so screw you."

Gandalf: Case in point George Bush. The gov't has done a pretty shitty job of things since his crew of inept dickweeds have been in charge.

That's why I don't want to let the next crew of inept dickweeds deliver shitty health care for every American.

Private health care and private insurance may sometimes be inept, but I have alternatives. I can choose my doctor, my hospital, my HMO, and my insurance company. I'm not stuck with the dickweeds.

Also, the dickweeds tend to go out of business over time.

However, once the government takes over we will have no alternatives. Furthermore, the government will continue in control no matter how inept they may be.

Just pointing out that this illuminates a particularly disgusting poison pill in Bush's current changes to the children's health insurance program.

If a state's employer-based insurance has declined 2% over the past 5 years among the target kids, then the state wouldn't be able to offer insurance to kids over 250% of poverty.

The Administration's mendacious argument is that obviously, insurance would be declining because parents were voluntarily dropping employer-based insurance for a state program. So, we'd obviously need to get rid of the state program, to get rid of this terrible destabilizing incentive.

Of course, this data puts a lie to that. It's obvious that employers are dropping people off the rolls of the uninsured, whether there's a safety net there to catch them or not. Clearly, there's an incentive there, and the incentive isn't the Chidren's Health Insurance program, it's the pile of money your company has when you're not paying for insurance anymore!

Punishing children because their parents had the bad luck to choose a company that offered benefits when they took the job, but then changed their mind...that's creepy.

"I can choose my doctor, my hospital, my HMO, and my insurance company."

Really? If you can, you're in the extremely wealthy minority.

Most of us get our insurance chosen by our jobs. We sign the forms, and we get the insurance. If we're REALLY lucky, our employers give us an option!

Then, we go to the doctors they tell us we can go to, the ones in the book. We can't choose our own doctors until we get old and go into Medicare. The evil, evil government program. Where we can all, for the first time, go to any doctor or hospital we want.

Single payer healthcare is a lot like democracy. It's the worst kind of healthcare--except for everything else.

Kevin,
I pick (h)! Your list is fairly comprehensive. I'll go with that.

Father Figure: Ex-liberal enjoys spending 25 cents of each of his health care dollars on pointless administrative costs.

Yes I do. The "pointless administrative costs" are the cost of freedom.

There are similar "pointless administrative costs" in other aspects of our lives. How much more efficient would it be if the government decided what each of us should eat, what we should wear, where we should live, what we should read, etc. The government could assign each of us to living quarters. No more hassle of searching for apartments and house-hunting. The government could send us their idea of appropriate clothing, food, books, etc. That would be far more efficient than having multiple shops, advertisments, time spent deciding what to buy, etc. I imagine the saving would be well over 25%. Nevertheless, I'd rather spend the extra time and money and have the freedom to decide for myself.

P.S., the system Kevin is advocating is similar to Medicare. In practice, it's not at all clear that Medicare is efficient. Certainly its costs have far outstripped original estimates.

[persistent trolling deleted]

Under Medicare, it is not always easy now to select your own doctors because many, many, doctors will not take Medicare Patients. Under a Gov't Insurance program (single-payer) system, ALL doctors, hospital, pharmacys and ancillary services would receive payment from the same source. Then and only then could a patient have TRUE FREE CHOICE.

Why doesn't the US conduct some proof of concept seed programs? Those patients who think that the government running healthcare is a good idea can test things out, at say, Walter Reed Army Medical Center?

The "pointless administrative costs" are the cost of freedom.

Wow. That is quite the assertion. What else pays for our freedom? Price fixing? Embezzlement? How about grossly inflated salaries for hedge fund managers?

I mean, I know freedom isn't free and all, but this is ridiculous.

I still haven't heard an even half way decent rebuke of the healthcare systems in France, Germany, Italy, Spain, Denmark, Norway, the UK, or Sweden - all with public funding, most with consumer choice. The only argument against the Canadian system I have heard is that people have to wait... so... it's need based? Access is determined based on need and not wealth? Sounds fine to me. The point is, in Canada, if you need a procedure, you get it. If you want a procedure, you get it, but you might have to wait a bit. Boo hoo. In the US if you need a procedure you might get it, if you can pay, but chances are, if you're poor, you just won't. Hmmm... but wait... in the US we have the best system, because we have the highest life expectancy, the lowest infant mortality, and the best ROI for our healthcare dollars... oh wait.

Wasn't Megan McArdle just running off some numbers about how the numbers of uninsured dropped or am I wrong?

I caught a bit of the NPR business report, Market Place, on the way home from the train station, and they had a short interview with someone wingnut from Heritage or AEI, who said that most of those 47 million uninsured people are illegal immigrants, that there are actually fewer uninsured people. Ay carumba! There is absolutely nothing that wingnuts won't claim is the fault of illegal immigrants.

I know I shouldn't respond to ex-liberal but I wonder how s/he likes the current choices Americans have in suburban hardware stores, or suburban grocery shopping? Wow, what freedom we have.

In its late stage (which can last decades), capitalism is all about monopolization and consolidation. Small businesses, especially those whose products and services touch our lives most directly, have become virtually extinct, replaced with faceless, identical "big box" stores -- exactly the kind of dystopia that free-market ideologues promised to deliver us from.

It's ironic that their ideology, which is so wedded to notions of freedom, individuality, and so on, has produced so many durable systems under which our actions are less free than they have ever been, with fewer choices than we have ever had.

Two points.

First, poverty is measured against an absolute benchmark that is continually eroded by inflation. So many people still have the same absolute poverty they had a year ago even though they are above the line.

Second, while some unfortunate people have lost health care altogether, most everyone now pays from wages a substantial monthly portion of their health insurance cost. Thus, their available incomes has dropped. For me this is $300/month increased out of pocket medical insurance cost in 2 years. I would need to earn $3,600 more in salary per year to stay even.

Tracer Hand: I know I shouldn't respond to ex-liberal but I wonder how s/he likes the current choices Americans have in suburban hardware stores, or suburban grocery shopping? Wow, what freedom we have.

In its late stage (which can last decades), capitalism is all about monopolization and consolidation. Small businesses, especially those whose products and services touch our lives most directly, have become virtually extinct, replaced with faceless, identical "big box" stores -- exactly the kind of dystopia that free-market ideologues promised to deliver us from.

I suspect you're a lot younger than I am. In the late 1940's, there were hardly any supermarkets. My famiy shopped at a corner grocer and bought meat from a butcher where a gas flame was available so the buyer could singe the pin-feathers off the chicken. Today, my suburban Safeway is indeed faceless, but the choice of items is far greater. Ditto for Home Despot. And, specialty food stores and hardware stores are still around.

Getting back to medical care, consider the example of Lasik surgery, which has not been generally covered by insurance. This miraculous treatment has gotten better while the price has fallen from thousands to hundreds per eye in just a few years. It's a great victory for the free market.

ex-liberal: "Private enterprise health care isn't perfect, but chances are a government bureaucracy would be worse."

Every single-payer publicly-administered not-for-profit medical insurance system operated by every government of every developed nation -- including Medicare in the US -- is demonstrably better than the for-profit so-called "private enterprise" medical insurance system in the USA, both in terms of health outcomes and efficiency (value for cost).

Your claim is absurdly wrong.

ex-liberal wrote: "I want the bureaucrats to keep their hands off my medical care."

The bureaucrats of the for-profit medical insurance industry already have their hands on your medical care. And their profit incentive is to take as much money from you as possible and deliver as little value to you as possible in return.

In a CNN poll conducted earlier this year, 64 percent of respondents said the government should “provide a national insurance program for all Americans, even if this would require higher taxes”. Your view is in the minority.

Gregory is correct to point out, as he always does in response to your comments, that you are nothing but a bullshit artist.

... Those patients who think that the government running healthcare is a good idea can test things out, at say, Walter Reed Army Medical Center? --Dave!

You mean the Walter Reed Army Medical Center where the maintenance issues were the result of **gasp** OUTSOURCING TO A PRIVATE COMPANY?

Some of you people really, really don't know what the holy hell you're typing about, do you?

The whole health care debate come down to one basic question we need to ask ourselves:

Is health care a right, or a privilege?

Republicans see it as the latter, which is morally reprehensible.

. In the late 1940's, there were hardly any supermarkets.... but the choice of items is far greater. ....consider the example of Lasik surgery.... It's a great victory for the free market. ex-lax at 12:18 PM

Why not go back to the late 20s? Between 29 and 50, there was little change for rural Americans and between 29 and the immediate post war period, there was little change for urban Americans as well. It's obvious that the cliché should be "younger, wiser" because the traditional one has become dysfunctional in your case.

Lasik is not a covered medial care, it's a vanity one like butt tucks and face lifts which have also become 'better & cheaper' because more people are buying them so more doctors are getting into field. No national health care would cover vanity operations like these, so your point is nugatory.

First, poverty is measured against an absolute benchmark that is continually eroded by inflation.

No, its not. Poverty is measured against a benchmark that is tied to the consumer price index, which is the same measure used to identify inflation.

Now, different people will argue that the CPI overstates or understates inflation (my personal intuition is that it understates the impact of inflation on the lowest end of the spectrum and overstates it on the highest end, because it is a single-number measure and things like hedonic adjustments are probably small impacts, in practice, at the low end, and much bigger at the high end, but one number gets rolled into the measure for overall inflation), but it is not a static measure that ignores inflation.

It is an absolute measure, rather than a relative measure like the Gini, and there are lots of solid reasons to think that relative poverty is at least as significant, if not more, of a concern than absolute poverty, but that's a differnt issue.

Mike: Lasik is not a covered medical care, it's a vanity one like butt tucks and face lifts which have also become 'better & cheaper' because more people are buying them so more doctors are getting into field.

Mike, Lasik is phenomenal. People have their vision permanently corrected to normal in a operation that lasts a very few minutes. They can throw away their eye glasses and contact lenses.

If you think this is comparable to a butt tuck, that's your privilege. I'm very glad I had the freedom to choose Lasik without the approval of misinformed persons in some government-controlled system.

The UK delivers better health outcomes, for 100% of its population, for 40% of the cost. It's totally single-payer.