Originally Posted by JohnMc82

Nope, no refund. I did get a letter from my insurer stating that I wouldn't be eligible for one! Really just an early warning that premiums will be heading up (again.)

Who could have guessed that forcing Americans to buy a product from profit-driven providers would cause the price of that product to go up?!

Wow, premiums going up - what shocking news. Yawn.

It's a little more complicated than that and you know it. What was the projection before ACA and what will it be once it is fully in-effect? No one actually knows since it hasn't gone into effect, but you would be hard press to find any credible analysis forecasting that the curve will steepen as a result of the ACA.

Also, it is nothing but bumper sticker mentality to promote the "forcing Americans" hysteria (does that come with freedom fries?) when credible analysis shows that the top end of estimates puts those likely to actually pay the penalty at 2% of the population. My money is on it being even less - while vocal, I'm pretty sure the Libertarians so blinded by ideology (or not thinking straight due to too many freedom fries) as to go against their own self interest is a pretty small group - for example, I think the Mises website gets far less than 0.01% of the population. Since I’m sure Rani has always been covered and JDG is already on the govt teat, why we might be down to just you and Justin – unless someone talks some sense to your Mrs. - there are the kids to think about.

Originally Posted by Justin '77

Ditto to that here. Oh well...

But...but...
Health insurance is the same thing as health care! I mean, that's why everyone was happy to get forced to pay for the first, and nobody even cared to talk about the second?

Right?

Ah, no. You might want to educate yourself and actually read some of the law's provisions -

http://www.healthcare.gov/law/timeline/full.html

I realize Libertarians like to keep it real simple ("bad govt, bad"), but really, don't you find the ignorance just a tad embarrassing at times?

Originally Posted by JohnMc82

Yeah and let me tell you about those great deals! It is about $150 a month for the pleasure of being a healthy 30 year old, and if I did get sick or in to some kind of accident I'd quickly be on the hook for another $700 a month.

Any sick person can easily come up with $850 a month, right? Problem solved, then! I wonder why idiot America isn't happy with this great deal the lobbyists cooked up.

$150 dollars a month, even if true (I doubt it) is not going to buy the catheders for your hospital stay, freeloader.

And $700 a month, which is obviously an exaggeration, is $8400 in a year - that would be burned up in less than a week's stay in a hospital with any serious illness or accident.

I'm tired of paying for you free riders.

Stay off motorcycles, don't get sick and maybe quite eating so many freedom fries!

Originally Posted by The Rani

This is America, dammit. If it don't cost a lot, it ain't worth nothing.

Spoken like a true American health provider of today!

Originally Posted by Deb C

US Medicine: We Can Do Better Than This

by Dave Dvorak, MD

How much will this cost?” he asks. It’s the question at the heart of any business transaction: Is this new car, this plane ticket, this iPad worth the asking price?

But the man sitting before me is not a customer in an automobile showroom or an electronics store. He is my patient in the emergency department, and he is weighing whether to undergo the chest CT scan I have just recommended.

“I’m uninsured,” he says. “I lost my health coverage when I got laid off from my job three years ago. This is all coming out of my pocket.”

An ex-smoker in his late 40s, he has been coughing up increasing amounts of bloody sputum over the past month. What began as occasional, tiny red flecks has progressed to thick crimson streaks he can no longer ignore.

“I can only give you an estimate,” I say, “but I’m guessing a chest CT scan plus the radiologist’s fee will run in the neighborhood of $2,000.”

Like most emergency physicians, I have catalogued in my brain an endless litany of precise numbers—physiologic parameters, normal lab values, weight-based drug doses. But when it comes to knowing the costs of the myriad tests, medications and treatments that I routinely order for patients, I can offer little more than a rough estimate.

“I was afraid you’d say something like that,” he says. “I figured CT scans don’t come cheap.” He sighs quietly. “I’m raising my 8-year-old daughter on a pretty lean budget.” He looks thin in his hospital gown and a shade pale, a few days of graying stubble on his chin.

“But I’ve been worried about this for too long,” he says. “I know I need to have it.”

An hour later, I am seated at my computer scrolling through digital CT images while the radiologist on the phone describes the findings.

“In the hilum of the left lung there is a 4.5 centimeter lesion very likely to represent malignancy,” she says. My gaze falls on the irregularly shaped white mass, its tiny tentacles invading the delicate latticework of the surrounding lung tissue.

“Unfortunately, it gets worse,” the radiologist says. “There are also multiple scattered smaller lesions throughout both lungs, highly suspicious for metastases.”

There was a time during medical school and residency when I regarded abnormal clinical and radiographic findings with intrigue. I remember the excitement of hearing my first heart murmur. Of palpating a thyroid nodule. Of visualizing an ovarian mass on pelvic ultrasound.

But after years of clinical practice and countless patient encounters, I now find it difficult to view abnormal findings separately from the human lives they affect. I see an elderly woman’s hip X-ray, knowing that the fracture line coursing through the femoral neck likely spells the end of her days of independent living. A peculiar bright patch lighting up in the brain’s left hemisphere on an MRI scan signifies that a man will no longer be able to grasp a pen or a coffee mug in his right hand, will never again be able to speak a meaningful word to his family.

I hang up the phone, my eyes lingering on the CT images, the sinister white lung mass and its small-but-ominous satellites. And I am aware of their significance—that a middle-aged man will not live to see his daughter’s wedding.

I return to the patient’s room and sit down on the bedside stool. Before I speak, I feel his gaze upon me, anxiously searching my face for any subtle indication of the words to come.

“I’m sorry to have to give you this news,” I say, “but your CT scan shows findings concerning for lung cancer. It’s possibly spread to both lungs.”

He stares ahead, unblinking, his facial pallor seemingly more apparent. After a few moments, he speaks.
“On some level, I was expecting something really bad like this,” he says. “But, of course, you always hope that everything will turn out fine.”

My mouth, having grown dry, lacks the appropriate words to console him in this moment of utter sorrow. So I put a hand on his arm.
“I’ll talk to our on-call oncologist,” I tell him. “We’ll figure out a plan for you.”

He waits patiently until I return to his room once more, armed with an action plan.

“The oncologist is going to admit you to the hospital and start the workup,” I explain. “He’ll order a PET scan to see if there’s been spread to other parts of the body. Then they’ll do a biopsy of that main lesion in your lung to determine the best treatment options—whether it be radiation, chemotherapy or some combination of the two.”

A long period of silence follows, time for my patient to process the information I have conveyed. I anticipate forthcoming questions.
“I suspected that you’d want to do all those things,” he says, finally. “But I’ve already been thinking this through, and I’ve decided that I’m going to have to pass on your recommendations.”

It is not a reply I was expecting. “Why is that?” I ask. “As I said before, I’ve got no health insurance,” he says. “But there’s one thing I do have—my house. And it’s fully paid for. I guess I’m not willing to mortgage it—and ultimately lose it—to pay off endless medical bills. My house is the only thing…” His voice trails off.

After a pause, he continues. “My house is the only thing I’ll have to leave my daughter when I’m gone.”
Tears have gathered in the corners of his eyes. I offer him a box of tissues, and he takes one.

We sit together in a room in a modern emergency department in a rich country, a land where highly trained specialists confidently wield the newest technologies and expensive pharmaceuticals. But these treasures are not accessible to all, for ours is also a land where private health insurance is bought and sold as a commodity. Ours is a system known to shake down sick people for money they don’t have. Ours is the only wealthy democracy that fails to guarantee health coverage to all of its citizens.
Just as it is failing now.

He looks down at his watch. “Thanks for all you’ve done. I really appreciate it. But I’ve gotta leave now,” he says. “I have to go pick her up from school.”

As I watch him reach behind his neck to untie his hospital gown, I can’t help but feel that we owe him so much more. I can’t help but feel that we—health care providers, hospital administrators, insurance company executives, politicians, all those who strenuously fight the changes that our system desperately needs—we all have failed him.

I can’t help but feel that we are better than this.

This article first appeared in the July 2012 issue of Minnesota Medicine.

© 2012 Minnesota Medical Association

I had tears when I read this -- it is the story of my older sister and only brother, two ex-smokers who succumbed to lung cancer while in their early to mid 50s.

That said, lung cancer is probably a poor example. Both my siblings had excellent insurance and excellent care. My brother's life was probably a few months shorter thanks to him suffering a relatively rare, but not unheard of complication from one of the chemo drugs, Avastin. In my sister's case, none of the chemo or radiation slowed down the growth of her tumors. In any case, after being diagnosed with Stage 4 lung cancer, it is rare for people to live beyond 2 years, care or no care. The father in the story would get, perhaps, a couple of extra months through chemo if he's typical.

Lung is hard to detect early; maybe colon or (for women) breast cancer might be a better example. People with insurance may be more willing to go through the exams and tests to find out what is wrong at an earlier stage and catch it sooner.

Originally Posted by The Rani

Really.
What makes you so sure, and what difference does that make, in the context of this discussion?

I think it can provide a little insight to know that some of those questioning the value of others having health insurance are sitting pretty with their own coverage.

And really, a medical professional without insurance? Someone that dumb would never have made it through pre-med.

Originally Posted by The Rani

Well, yeah. That's exactly my point.
The Industry shoves its crap into people's mouths, and they swallow it whole.

So if I didn't have medical insurance, that would make my comments on this thread more valid?

Yep.

Must be some term equivalent to "chicken hawk."

Originally Posted by playwrite

$150 dollars a month, even if true (I doubt it) is not going to buy the catheders for your hospital stay, freeloader.

And $700 a month, which is obviously an exaggeration, is $8400 in a year - that would be burned up in less than a week's stay in a hospital with any serious illness or accident.

I'm tired of paying for you free riders.

See, the thing is -- you're not! You're paying for the profit-margins of the health industry. The cost of actual care is so ridiculously small that 'free-riding' isn't a thing. $8400 is more than enough to pay for two months in a neonatal ICU, if we're talking abou tthe cost of care, rather than the total pricetag one dysfunctional system elects to put on it.

You should attempt to get out and learn stuff, rather than assuming that the system you know is a defining paradigm.

Originally Posted by The Rani

So you're basically saying that I'm gutless, and I want other people to go without while I get free or low-cost medical services because of my (allegedly) excellent insurance plan?
Isn't that some kind of logical fallacy? Help me out, high-school debate clubbers.

Did you miss that in high school? Let me help you out a little.

You'll notice I never said "gutless" but you suggest I did. This is putting words-in-my-mouth. There's fancy term for that, but just suffice it to say the judges really really frown on this - as such, it is usually eliminated as a tactic within your freshman year.

What I was suggesting is that those who have health insurance, and very likely have always had such insurance, cannot know what it is like on a personal level to experience the lack of having such a benefit; and yet, they want to attempt to place a value on said insurance. They can perhaps provide a perspective from a different viewpoint, such as a health provider, but they cannot provide it from the perspective of one without insurance. Those without such insurance might profit from understanding that lack of perspective from someone suggesting that they are better off within a system that doesn't provide them insurance.

A "chicken hawk" is one who has a strong opinion of going to war without every having the experience of personally going to war. They may have some perspective, such as a health provider who has dealt with war injuries, but they will not have a perspective from the experience of actually being in a combat zone. Someone going off to a combat zone might want to understand that viewpoint of the chicken hawk comes from a limited experience – gutless or otherwise.

Originally Posted by Justin '77

See, the thing is -- you're not! You're paying for the profit-margins of the health industry. The cost of actual care is so ridiculously small that 'free-riding' isn't a thing. $8400 is more than enough to pay for two months in a neonatal ICU, if we're talking abou tthe cost of care, rather than the total pricetag one dysfunctional system elects to put on it.

You should attempt to get out and learn stuff, rather than assuming that the system you know is a defining paradigm.

$8400 for two months of neonatal ICU???

Ah, I see, you're beyond private insurers, beyond pubic option, beyond single payer, beyond Medicare for everyone, you're in magic pony land where the magic ponies poop out gold nuggets to pay the hospitals!

I don't do magic ponyland.

What I do consider is the ACA's Medical Loss Ratio which limits insurers total cost recovery to 15% or 20% and that includes all their expenses, salaries, profits and dividends. And in a couple weeks, every insurer is going to have to provide a highly simplified, standardized 2-pager on exactly what they cover and the price. Neither of these things have ever been required before -just these two things alone are going to drastically change the industry.

That's reality. I return you to -




- watch out for those golden nuggets! If one lands on you, it could land you up in the hospital!

Originally Posted by JDG 66

-Playwrite's claim was that Uncle Sam should be allowed to force people to buy health insurance because not buying it forces up the cost for those who do buy it.

This shows:



...that less than 4 million PAYERS will be added to the rolls (4 million who didn't want to be part of the system).

And then he claims that I'm difficult to understand.

I should just let this go, but really, does any one know what point Glick is trying to make?

We're all saying that the likely ceiling on who will pay the penallity is about 2% of the population.

Is he trying to say that or something completely different?

Originally Posted by playwrite

$8400 for two months of neonatal ICU???

Ah, I see, you're beyond private insurers, beyond pubic option, beyond single payer, beyond Medicare for everyone, you're in magic pony land where the magic ponies poop out gold nuggets to pay the hospitals!

Nope. I'm multiplying the $1000 it actually cost me -- as a non-insurance sole-payer cash-paying direct-bill 'customer' -- for the week my son actually resided in an actual neonatal ICU. It's rounded a bit, but also test-included (and there were a fair number of those) so it evens out pretty well.

Numbers should, in my opinion, come from the real world if we're going to use them to talk about the real world. YMMV, of course.

Originally Posted by The Wonkette

I had tears when I read this -- it is the story of my older sister and only brother, two ex-smokers who succumbed to lung cancer while in their early to mid 50s.

That said, lung cancer is probably a poor example. Both my siblings had excellent insurance and excellent care. My brother's life was probably a few months shorter thanks to him suffering a relatively rare, but not unheard of complication from one of the chemo drugs, Avastin. In my sister's case, none of the chemo or radiation slowed down the growth of her tumors. In any case, after being diagnosed with Stage 4 lung cancer, it is rare for people to live beyond 2 years, care or no care. The father in the story would get, perhaps, a couple of extra months through chemo if he's typical.

Lung is hard to detect early; maybe colon or (for women) breast cancer might be a better example. People with insurance may be more willing to go through the exams and tests to find out what is wrong at an earlier stage and catch it sooner.

I'm so sorry about your sister and brother-in-law. Your right, lung cancer is hard to detect. Often when symptoms do appear, it's in the later stages.

The Supreme Court ruling on Obamacare: A physician’s perspective
By Ann Settgast, M.D.
Southside Pride (Minneapolis), Aug. 6, 2012

One might think I felt better at the end of that morning clinic knowing the ACA had been upheld. But, I didn’t. You see, even with the ACA in place, we have no reason to believe these two men will obtain access to care. In Minnesota, more than 250,000 will remain uninsured after the ACA’s implementation. These Minnesotans will remain invisible like the family members I describe, and some of them may die. After all, uninsurance is a risk factor for preventable death in the United States. However, this is not the only problem. Thousands more will remain underinsured. Any practicing physician can tell stories about underinsurance —we see it when recommendations we make to our insured patients are not taken because the deductible hasn’t been met or the co-pay is unaffordable. Minnesota ranks second in the nation for uptake of high-deductible plans, so underinsurance here is alive and well.

I hate to be a spoilsport while many are celebrating the Supreme Court’s decision, but the truth is, as a society, we have again sold ourselves short. Here, in this incredibly wealthy nation with vast resources, rather than actually fixing the problem, we will continue to allow patients to forgo needed care because of cost. We have still not joined other wealthy nations in recognizing health care as a human right.

It has been disheartening to hear post-ruling commentary on both sides of the ACA debate because much of it simply isn’t true. One politician actually claimed that now the U.S. was joining all other industrialized countries in finally providing universal care … but more than 20 million Americans will be uninsured if the ACA is fully enacted. I need not spell out the blatant falsehood here. I’ve also heard that now, Americans will not face medical ruin because of healthcare costs. Again, the facts simply belie the statement. The medical bankruptcy rate in Massachusetts did not budge with implementation of the mandate there. That state, now with the lowest uninsurance rate in the nation, also boasts the highest per capita costs. Forcing people to buy skimpy policies that leave them without proper access to care and vulnerable to financial ruin is not meaningful reform. Rather, it is perpetuation of our current dysfunction.

http://www.pnhp.org/news/2012/august...’s-perspective

Originally Posted by The Rani

Freeloaders???
I thought that people without health insurance were doomed to die a slow and painful death in this country.

There is before ACA and there's after 2014 ACA. With all the subsidies, up to 400% of PL (currently $43320 for an individual, $88200 for a family of four) and standardization of insurance plans, the only people not getting insurance are free riders and don't deserve much sympathy. The exception, of course, are those who were suppose to become eligible for Medicaid where their state govt screws them (likely Texas, possible Florida); I'm already involved with a group preparing to fight for them.

Originally Posted by Justin '77

Nope. I'm multiplying the $1000 it actually cost me -- as a non-insurance sole-payer cash-paying direct-bill 'customer' -- for the week my son actually resided in an actual neonatal ICU. It's rounded a bit, but also test-included (and there were a fair number of those) so it evens out pretty well.

Numbers should, in my opinion, come from the real world if we're going to use them to talk about the real world. YMMV, of course.

What you got was "special non-insured" rates. A lot of people believe their negotiated great non-insurance rate came from the goodness of the hearts of the folks running hospitals and/or from their superior negotiating skills. Yea, right.

The hospitals make up for their special non-insured rates, in large part, by charging more for those with insurance. They also have been making up for it more directly with a federal payment they get for uncompensated provided health care. Unfortunately, that federal program is going away as part of the ACA deal to expand Medicaid. That is why the hospitals are going to be lobbying hard with state governors and legislators in places like TX and FL that are toying with the idea of not accepting the Medicaid expansion. If we’re successful with getting the expansion it is not going to be because those politicians care about the poor, it’s going to be because the hospital associations got a lot of lobbying money and vicious legal/political attack dogs

In the near future, hospitals are going to be a whole lot less generous with their "special non-insured" rates even where they succeed in getting the Medicaid expansion. The rest of society is also going to be less sympathetic to the non-insured particularly as a result of the costs to everyone else being a lot more clear in the near future (ACA has requirements for hospitals to start stating those costs). Non-insured free rider is going to be quickly and greatly diminished.

Regardless, I'm glad your son got the care he needed; I hope that (God-forbid that it is needed) he or your other kids will be able to get the care in the future as well. Take a hard look at your options, the world in this regard is going to change drastically.

Originally Posted by The Rani

The Healthcare Industry thanks you for having no sympathy for those who can't afford their premiums.

You'rer making over $88K per year with a wife and two kids walking around without health insurance. You can forgo the cable plan for your plasma TV, the data plan on your iPhone, or a trip to Disneyworld and get at least the Bronze Plan. Otherwise, well, there's the Darwin Awards.

Playwrite:

What would it cost per day to have a baby in the neonatal ICU if neither the hospital nor any of those companies providing services or equipment to the hospital made a profit? Seems to me that should be the baseline. A somewhat higher price than that baseline would be warranted, perhaps, but it's worth looking at how much of the cost is profit. That shows how much room there is to drive costs down.

Originally Posted by Justin '77

Nope. I'm multiplying the $1000 it actually cost me -- as a non-insurance sole-payer cash-paying direct-bill 'customer' -- for the week my son actually resided in an actual neonatal ICU. It's rounded a bit, but also test-included (and there were a fair number of those) so it evens out pretty well.

Numbers should, in my opinion, come from the real world if we're going to use them to talk about the real world. YMMV, of course.

Is this based on the experience with your youngest son in Russia?

Originally Posted by Deb C

The Supreme Court ruling on Obamacare: A physician’s perspective
By Ann Settgast, M.D.
Southside Pride (Minneapolis), Aug. 6, 2012

One might think I felt better at the end of that morning clinic knowing the ACA had been upheld. But, I didn’t. You see, even with the ACA in place, we have no reason to believe these two men will obtain access to care. In Minnesota, more than 250,000 will remain uninsured after the ACA’s implementation. These Minnesotans will remain invisible like the family members I describe, and some of them may die. After all, uninsurance is a risk factor for preventable death in the United States. However, this is not the only problem. Thousands more will remain underinsured. Any practicing physician can tell stories about underinsurance —we see it when recommendations we make to our insured patients are not taken because the deductible hasn’t been met or the co-pay is unaffordable. Minnesota ranks second in the nation for uptake of high-deductible plans, so underinsurance here is alive and well.




http://www.pnhp.org/news/2012/august...’s-perspective

Thanks for posting this, Debs.

I plan to send Dr. Stettgast a candle. Not so much to stop her from cursing the darkness, but perhaps to shed some light on the fact that the Medicaid expansion is not a done deal in Minn. and she could actually do something about bringing single payer (Medicaid) to thousands of people in Minn. instead of continuing to whine about the lack of a universal single payer at the national level.

Don't get me wrong, I'm okay with the whining - just not when there is ACTUAL work to be done that will ACTUALLY make a difference. After she gets Minn. in the "win column" for the Medicaid expansion, then she should hold off on the whining for just a little longer and get a state exchange in place that actually has a single payer option in it. From there, I'd like to see her then try to get Minnesota to work with the Pacific Northwest states and possible the regional exchange California is considering with a number of states that if it has single payer could bring that to about 1/3 of the US population. After that, if she still wants to whine about not having a national single payer for all, then more power to her. I think by then it could very well be a moot point except in a couple of backward Red states.

Or, I guess Dr. Stettgast could decide it’s more fun now for her to continue to blog on the Internet about something that is never going to happen and have it read by an increasingly dwindling number of diehards.

I think a lot of the Progressives in the health care policy arena need a little tough love. If there wasn’t so much at stake and so much potential, even I would join the whining. BUT, that simply is not the situation. The sooner they figure this out, the better.

Originally Posted by playwrite

What you got was "special non-insured" rates...

Actually, no. What I got was the rate the hospital bills non-indigents at. Where this happened, medical insurance is rare to the point of practically non-existent. So your 'subsidized by the insured' strawman doesn't hold.

However, it is perfectly valid to turn it around and point out that the ridiculous sums you are naming are a 'fat, rich mark' rate. It's a shame you think they represent more than just however much a bunch of greedy bastards think they can squeeze out of the system. That opinion may not be the cause of the system's woes, but it surely goes hand-in-hand with them.

Originally Posted by Brian Rush

Playwrite:

What would it cost per day to have a baby in the neonatal ICU if neither the hospital nor any of those companies providing services or equipment to the hospital made a profit? Seems to me that should be the baseline. A somewhat higher price than that baseline would be warranted, perhaps, but it's worth looking at how much of the cost is profit. That shows how much room there is to drive costs down.

I've been pretty consistent in addressing ACA issues from both the Left and the Right that I'm not too interested in dealing with hypothetical’s that, for at least our lifetimes, are never going to happen. I might entertain the possibility of the private insurers collapsing within a decade as a result of ACA's medical loss ratio coupled with single payer operating within state/regional exchanges but I think it borders on magic pony land to suggest hospitals backing away from the profit model.

Moreover, there's just too much else going on now where those issues are going to look extremely different in a few years, and just how so is not predictable. The big issues are the exchanges and, for bleeding heart Liberals like me, the Medicare expansion, but there is a ton of things rolling out over the next couple years that are going to impact I would bet nearly everyone on this board and has nothing to do with what could or should have been. The horse is dead, can’t we just stop beating the poor thing?

Originally Posted by Justin '77

Actually, no. What I got was the rate the hospital bills non-indigents at. Where this happened, medical insurance is rare to the point of practically non-existent. So your 'subsidized by the insured' strawman doesn't hold.

However, it is perfectly valid to turn it around and point out that the ridiculous sums you are naming are a 'fat, rich mark' rate. It's a shame you think they represent more than just however much a bunch of greedy bastards think they can squeeze out of the system. That opinion may not be the cause of the system's woes, but it surely goes hand-in-hand with them.

I didn't say "indigent" rate; I said "non-insured" rate. And as you agree, that is different than the "insured rate" or as you put it, the "fat, rich mark rate."

One man's certainty that it is others' greed is another man's assumption of that being the human condition and the actual fault is structural.

Regardless, the non- "fat, rich mark rate" is going bye-bye. Those with brains will adjust accordingly.

Well, at least I found you a better ride -

Originally Posted by The Rani

Golly, you sound like a Republican now.
But I think I understand the "chicken hawk" concept now. When was the last time that YOU had to choose between putting food on the table for your kids and buying them medical insurance?
Liberal "compassion" truly knows no bounds.

Ah, you're still not grasping the whole concept.

The chicken hawk wants other people to do something that he himself will not be subjected to.

I want people to have the benefits of health insurance. The ACA does that for 10s of millions of people.

Moreover, the cost is not from someone making over $88k per year having to choose between food or insurance for their kids - that is just silly. The cost is to someone making over $88K per year having to choose between their idiotic freedom fries ideology or doing the right thing for their kids. One would think the latter would fit well with these folks "family values" but then one would have forgotten that, with these folks, family values only applies to issues prior to actual childbirth.

Originally Posted by playwrite

I didn't say "indigent" rate; I said "non-insured" rate. And as you agree, that is different than the "insured rate" or as you put it, the "fat, rich mark rate."

One man's certainty that it is others' greed is another man's assumption of that being the human condition and the actual fault is structural...

You're a wordsmith... what do you call a person who, confronted with the unfamiliar, aims to explain it, rather than to understand it? I'm thinking 'ideologue' is not a bad choice for that, but I'm sure there's better.