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Why do we need universal healthcare?


Zguy28

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JMS I did a little research on France's healthcare system. Of course the first thing that I found is that there seems to be little litigation in that country. So I can absolutely see how a system without legal accountability could drastically reduce cost.

Of course THAT system will never happen here in the U.S. purely based upon this difference.

I was unable to determine what the cost of this system is with reference to levies and taxes. But it does seem as though the employer is responsible for the collection of that tax. It is also a reason why business is reluctant to hire based upon this cost.

Thoughts?

Why is there not much healthcare related litigation in France?
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I can certainly see and am well aware of the evils of big government.

I would respectfully point out that you are unwilling to consider this fact in your assessment of universal health care in the U.S. Your unwillingness to be objective and intellectually honest about this hurts your case. :2cents:

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Proof is what I need right now. Can you do it without using data from the WHO?

Yeah if you want information on the Healthcare industry compared internationally, why in the world would you quote "The World Health Organization" ?

I am talking about quality and cost. Considering the nature of this country and the sheer number of people that we have in relationship to, say, France.

We are talking about per capta costs which are not positively effected by increasing the population. Scales of economy actually reduce costs significantly per capita for larger populations.

As for Costs... from an Ameircan non profit associated with an insurance company.. the Kaiser family foundation..

Healthcare cost per capita 2003 by country.

figure-1.gif

Healthcare as a percentage of GNP

ex-4.gif

Note that the WHO has the US spending significantly more per capita and doesn't compare the US with our 300 million population with Luxenbourg who only has 480,000 citizens.

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Why is there not much healthcare related litigation in France?
Google pointed me to an interesting link:

Up until 2002, France's malpractice system looked more or less like the United States'. Patients brought their cases to court and then either settled with the doctor/hospital/malpractice insurance company, or received an award. There were two main differences. First, France had no caps on malpractice awards -- if the judge or jury thought you deserved 600 million Euro because your child had cerebral palsy, you could get it [you probably weren't, because most of those jackpot awards come from jury trials, and your right to a trial by jury is not as great in Europe as it is here]. Second, there are several small differences that made it slightly harder for patients to win a case -- the plaintiff's burden of proof is slightly higher, the standard of care that doctors were required to provide was slightly lower, and statute of limitations on tort claims was shorter. There were also no review boards, arbitration panels, or mediation panels, which some states have established to try and act as gatekeepers to lessen the case load on civil courts and remove truly nuisance claims. But the actual legal system looked much like ours.

But this is no longer the way things work. In response to rising malpractice premiums, France has moved to a Scandinavian compensation system (I'll explain why it's called "Scandinavian" whenever Ezra covers the Swedish health care system). Under the French implementation of the Scandinavian system, wronged patients bring claims before their regions' government-appointed review board which is responsible for determining if compensation is in order and, if so, how much. For a patient to get paid, the board does not have to find the doctor at fault, or that medical negligence caused whatever pain and suffering the patient is experiencing. Money for patient relief comes from a national compensation fund, which presumably gets its cash either from a dedicated tax insurance premium placed on doctors and hospitals, or from general fund revenues. The closest analogy to this sort of system in the United States would be workers' compensation funds that many states run. The goal of such systems is not to find fault or establish causation as much as it is to provide a bit of compensation to workers who are injured on the job.

http://www.electoral-math.com/archive/200504/20050420.html

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Yeah if you want information on the Healthcare industry compared internationally, why in the world would you quote "The World Health Organization" ?

I do not necessarily trust their information. Could you find other research. I spent a little time while looking a France and was unable to get this information. If not that is OK.

Edit, thanks I see those graphs are not WHo graphs.

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JMS,

I can see the point you are trying to make. But the cause/effect connection does not fly in my opinion. All you have done is proven the U.S. to be the rich country among those being ranked. Alongside this high per capita cost should also be the wealth per capita. Only then would you see a fair assessment of this meaningless number in isolation.

If finding out that the USA is a rich country virtue its ability to pay then this exercise would have been worth the effort. Good man. :)

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That same system guarantees service EVEN IF YOU CAN NOT PAY. What more "downward" pressure do you need?

And we do not need universal coverage because

(1) Because it will cost twice that of our current system.

Well. . .i was actually in the midst of typing up a reply to Portis' ludicrous pile of :pooh: but in the midst of the reply, I saw the Pwnage JMS did on him. . .

Damn great posts JMS, you hit the nail on the head.

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I would respectfully point out that you are unwilling to consider this fact in your assessment of universal health care in the U.S. Your unwillingness to be objective and intellectually honest about this hurts your case. :2cents:

So by not building in "the government is the root of all evil" into any discussion; I am intellectually dishonest. I hurt my case?

Portisizzle, I think it's you who hurt your own case and worse your otherwise notable ability to grasp complex arguments, by failing to see government corruption and incompetence is only one evil in a world full of evil.

That balance and moderation are more important than strict adherance to a code. That intelligence and reason are more versitile and realiable protection than blind dogma to harmful excesses be them public or private..

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JMS,

I can see the point you are trying to make. But the cause/effect connection does not fly in my opinion. All you have done is proven the U.S. to be the rich country among those being ranked. Alongside this high per capita cost should also be the wealth per capita. Only then would you see a fair assessment of this meaningless number in isolation.

If finding out that the USA is a rich country virtue its ability to pay then this exercise would have been worth the effort. Good man. :)

Well the point is to establish the relationship between the cost of American healthcare and the service we recieve.

We pay the most by almost 2-1. And the service we recieve is ranked 37th behind Costa Rica on a few other third world countries, as well as the rest of the industrialized world.

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So by not building in "the government is the root of all evil" into any discussion; I am intellectually dishonest. I hurt my case?

Portisizzle, I think it's you who hurt your own case and worse your otherwise notable ability to grasp complex arguments, by failing to see government corruption and incompetence is only one evil in a world full of evil.

That balance and moderation are more important than strict adherance to a code. That intelligence and reason are more versitile and realiable protection than blind dogma to harmful excesses be them public or private..

Blind dogma?

First you can not prove, nor is any politician that is running for office has in his/her platform, the possibility of cutting the cost to the consumer in half. lets deal with this and then we can move to the next assertion that you think WILL happen of the government gets their grubby paws on this system.

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Well the point is to establish the relationship between the cost of American healthcare and the service we recieve.

We pay the most by almost 2-1. And the service we recieve is ranked 37th behind Costa Rica on a few other third world countries, as well as the rest of the industrialized world.

I am sorry are you ignoring the wealth of the US in comparison to Costa Rica or are you just being dense for the sake carrying this argument?

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JMS I did a little research on France's healthcare system. Of course the first thing that I found is that there seems to be little litigation in that country. So I can absolutely see how a system without legal accountability could drastically reduce cost.

Litigation fee's are not a significant factor in our healthcare system. Neather are doctor fees. Those are red herrings thrown out by the industry to distract from the real issues.

The problem is out of control costs of hospital related fee's and how those ever increasing fee's feed the industries profits.

Of course THAT system will never happen here in the U.S. purely based upon this difference.

I was unable to determine what the cost of this system is with reference to levies and taxes. But it does seem as though the employer is responsible for the collection of that tax. It is also a reason why business is reluctant to hire based upon this cost.

Thoughts?

There are lot's of other costs which hurt employment in Canada and European countries. I think the inability to fire employee's is a significant one.

American businesses actually are strong allies for revising the healthcare system in this country. Cause it would save them huge money, and give them relief to costs which have been growing at double the rate of inflation for thirty years.

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I do not necessarily trust their information. Could you find other research. I spent a little time while looking a France and was unable to get this information. If not that is OK.

Edit, thanks I see those graphs are not WHo graphs.

Christ Portis, just admit it, you are DEAD WRONG on this issue, and you have been put to school by JMS. He answered every single one of your "problems" and showed you WHY it was wrong.

You see, here is the difference between liberals and republicans, or even independents and republicans or libertarians and republicans. . .or hell, I should just say here is the problem with republicans. . .

Other people look at the information and base their opinions on the facts, numbers and raw data, and try to come to a rational conclusion based on said data. Republicans, like Portis, will either ignore data when it is contrary to their opinion without offering anything to back their point, or say "I don't believe the data". . .I love that one.

People like JMS and myself actually abhor government regulation and love free market systems, but ALSO (and this is a key point) can recognize when a system is broken, and take steps to fix it. A republican will, on the other hand, as Portis has so gracefully done in this thread, claim that getting away from a monopolistic system will be disastrous for America and will bury us into the ground, when EVERY SINGLE PIECE OF DATA shows a broken system that if it continues along the same path WILL bury us.

You can still like a free market, think that it is a great thing, but also recognize that there are tragic downfalls of a free market. It is called being rational and understanding the nuances of the world. It is what separates me from a republican such as Portis, as I will actually change my mind on a topic or an issue if evidence comes up to the contrary. I will let my decision be made by the evidence, not frame the evidence around my politics. There is a definite difference in politics, thought, and actual understanding of real world situations occur outside the republican party. They occasionally get it right, but heck a broken clock is right twice a day too. . .and in this case, as is the case in almost all of their arguments, they are dead wrong.

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Canada has always had very high gas prices on top of several other heavily taxed items to help pay for their government programs.

Can you imagine the outrage when we are paying $5.00+ for a gallon of gas, on top of increased income and sales taxes.

Our gas tax does not fund the healthcare program. Our higher income tax and sales tax rates do. Even with the government reducing our federal sales tax, I still pay 14% tax on almost every purchase (6% federal, 8% provincial). I dont know how Albertans help pay for their healthcare since they do not have a provincial tax and only pay 6% in federal taxes on most purchases.

I also am taxed at about 22-25% of my income, depending where it falls after I add in my deductions.

When all is said and done, middle income Canadians pay out close to 50% of their income in taxes. So I dont have enough money to afford that new Hummer with spinners, but I can get drunk and jump off my roof and break every bone in my body and not have to pay a dime to get fixed. I consider it a fair trade.

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I am sorry are you ignoring the wealth of the US in comparison to Costa Rica or are you just being dense for the sake carrying this argument?

I don't understand your discussion point. Are you saying because the US is wealthy and more developed it's harder to provide healthcare services?

Costa Rica ranks just ahead of the United States in service provided independent of cost by the World Health Organization..

http://www.photius.com/rankings/healthranks.html

1 France

2 Italy

3 San Marino

4 Andorra

5 Malta

6 Singapore

7 Spain

8 Oman

9 Austria

10 Japan

11 Norway

12 Portugal

13 Monaco

14 Greece

15 Iceland

16 Luxembourg

17 Netherlands

18 United Kingdom

19 Ireland

20 Switzerland

21 Belgium

22 Colombia

23 Sweden

24 Cyprus

25 Germany

26 Saudi Arabia

27 United Arab Emirates

28 Israel

29 Morocco

30 Canada

31 Finland

32 Australia

33 Chile

34 Denmark

35 Dominica

36 Costa Rica

37 United States of America

So I don't understand why are you bringing up price? The United States outspends by nearly 2-1 or more every other nation on that ranking.

Other than Luxenburg with their 400,000 population, which we still outspend but not by 2-1 rather 2-3.

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I must be dense.. because I don't understand your discussion point.

Costa Rica ranks just ahead of the United States in service provided independent of cost by the World Health Organization..

http://www.photius.com/rankings/healthranks.html

1 France

2 Italy

3 San Marino

4 Andorra

5 Malta

6 Singapore

7 Spain

8 Oman

9 Austria

10 Japan

11 Norway

12 Portugal

13 Monaco

14 Greece

15 Iceland

16 Luxembourg

17 Netherlands

18 United Kingdom

19 Ireland

20 Switzerland

21 Belgium

22 Colombia

23 Sweden

24 Cyprus

25 Germany

26 Saudi Arabia

27 United Arab Emirates

28 Israel

29 Morocco

30 Canada

31 Finland

32 Australia

33 Chile

34 Denmark

35 Dominica

36 Costa Rica

37 United States of America

So why are you bringing up price?

Please JMS, we all understand the 37 number. It's been covered. Here are some arguments against gov't healthcare. Please tell me again why this is a good idea. I've posted it twice without a response from you. Why not try again right!


    1. There isn't a single government agency or division that runs efficiently; do we really want an organization that developed the U.S. Tax Code handling something as complex as health care? Quick, try to think of one government office that runs efficiently. The Department of Transportation? Social Security Administration? Department of Education? There isn't a single government office that squeezes efficiency out of every dollar the way the private sector can. We've all heard stories of government waste such as million-dollar cow flatulence studies or the Pentagon's 14 billion dollar Bradley design project that resulted in a vehicle which when struck by a mortar produced a gas that killed every man inside. How about the U.S. income tax system? When originally implemented, it collected 1 percent from the highest income citizens. Look at it today. A few years back to government published a "Tax Simplification Guide", and the guide itself was over 1,000 pages long! This is what happens when politicians mess with something that should be simple. Think about the Department of Motor Vehicles. This isn't rocket science--they have to keep track of licenses and basic database information for state residents. However, the costs to support the department are enormous, and when was the last time you went to the DMV and didn't have to stand in a long line? If it can't handle things this simple, how can we expect the government to handle all the complex nuances of the medical system?

    2. "Free" health care isn't really free since we must pay for it with taxes; expenses for health care would have to be paid for with higher taxes or spending cuts in other areas such as defense, education, etc. There's an entitlement mentality in this country that believes the government should give us a number of benefits such as "free" health care. But the government must pay for this somehow. What good would it do to wipe out a few hundred dollars of monthly health insurance premiums if our taxes go up by that much or more? If we have to cut AIDS research or education spending, is it worth it?

    3. Profit motives, competition, and individual ingenuity have always led to greater cost control and effectiveness. Government workers have fewer incentives to do well. They have a set hourly schedule, cost-of-living raises, and few promotion opportunities. Compare this to private sector workers who can receive large raises, earn promotions, and work overtime. Government workers have iron-clad job security; private sector workers must always worry about keeping their jobs, and private businesses must always worry about cutting costs enough to survive.

    4. Government-controlled health care would lead to a decrease in patient flexibility. At first glance, it would appear universal health care would increase flexibility. After all, if government paid for everything under one plan, you could in theory go to any doctor. However, some controls are going to have to be put in to keep costs from exploding. For example, would "elective" surgeries such as breast implants, wart removal, hair restoration, and lasik eye surgery be covered? Then you may say, that's easy, make patients pay for elective surgery. Although some procedures are obviously not needed, who decides what is elective and what is required? What about a breast reduction for back problems? What about a hysterectomy for fibroid problems? What about a nose job to fix a septum problem caused in an accident? Whenever you have government control of something, you have one item added to the equation that will most definitely screw things up--politics. Suddenly, every medical procedure and situation is going to come down to a political battle. The compromises that result will put in controls that limit patient options. The universal system in Canada forces patients to wait over 6 months for a routine pap smear. Canada residents will often go to the U.S. or offer additional money to get their health care needs taken care of.

    5. Patients aren't likely to curb their drug costs and doctor visits if health care is free; thus, total costs will be several times what they are now. Co-pays and deductibles were put in place because there are medical problems that are more minor annoyances than anything else. Sure, it would be nice if we had the medical staff and resources to treat every ache and pain experienced by an American, but we don't. For example, what if a patient is having trouble sleeping? What if a patient has a minor cold, flu, or headache? There are scores of problems that we wouldn't go to a doctor to solve if he had to pay for it; however, if everything is free, why not go? The result is that doctors must spend more time on non-critical care, and the patients that really need immediate help must wait. In fact, for a number of problems, it's better if no medical care is given whatsoever. The body's immune system is designed to fight off infections and other illnesses. It becomes stronger when it can fight things off on its own. Treating the symptoms can prolong the underlying problem, in addition to the societal side effects such as the growing antibiotic resistance of certain infections.

    6. Just because Americans are uninsured doesn't mean they can't receive health care; nonprofits and government-run hospitals provide services to those who don't have insurance, and it is illegal to refuse emergency medical service because of a lack of insurance. While uninsured Americans are a problem in regards to total system cost, it doesn't mean health care isn't available. This issue shouldn't be as emotional since there are plenty of government and private medical practices designed to help the uninsured. It is illegal to refuse emergency treatment, even if the patient is an illegal immigrant.

    7. Government-mandated procedures will likely reduce doctor flexibility and lead to poor patient care. When government controls things, politics always seep into the decision-making. Steps will have to be taken to keep costs under control. Rules will be put in place as to when doctors can perform certain expensive tests or when drugs can be given. Insurance companies are already tying the hands of doctors somewhat. Government influence will only make things worse, leading to decreased doctor flexibility and poor patient care.

    8. Healthy people who take care of themselves will have to pay for the burden of those who smoke, are obese, etc. Universal health care means the costs will be spread to all Americans, regardless of your health or your need for medical care, which is fundamentally unfair. Your health is greatly determined by your lifestyle. Those who exercise, eat right, don't smoke, don't drink, etc. have far fewer health problems than the smoking couch potatoes. Some healthy people don't even feel the need for health insurance since they never go to the doctor. Why should we punish those that live a healthy lifestyle and reward the ones who don't?

    9. A long, painful transition will have to take place involving lost insurance industry jobs, business closures, and new patient record creation. A universal health plan means the entire health insurance industry would be unnecessary. All companies in that area would have to go out of business, meaning all people employed in the industry would be out of work. A number of hospital record clerks that dealt with insurance would also be out of work. A number of these unemployed would be able to get jobs in the new government bureaucracy, but it would still be a long, painful transition. We'd also have to once again go through a whole new round of patient record creation and database construction, which would cost huge amounts of both time and money.

    10. Loss of private practice options and possible reduced pay may dissuade many would-be doctors from pursuing the profession. Government jobs currently have statute-mandated salaries and civil service tests required for getting hired. There isn't a lot of flexibility built in to reward the best performing workers. Imagine how this would limit the options of medical professionals. Doctors who attract scores of patients and do the best work would likely be paid the same as those that perform poorly and drive patients away. The private practice options and flexibility of specialties is one of things that attracts students to the profession. If you take that away, you may discourage would-be students from putting themselves through the torture of medical school and residency.

    11. Malpractice lawsuit costs, which are already sky-high, could further explode since universal care may expose the government to legal liability, and the possibility to sue someone with deep pockets usually invites more lawsuits. When you're dealing with any business, for example a privately-funded hospital, if an employee negligently causes an injury, the employer is ultimately liable in a lawsuit. If government funds all health care, that would mean the U.S. government, an organization with enormous amounts of cash at its disposal, would be ultimately responsible for the mistakes of health care workers. Whether or not a doctor has made a mistake, he or she is always a target for frivolous lawsuits by money-hungry lawyers & clients that smell deep pockets. Even if the health care quality is the same as in a government-funded system, the level of lawsuits is likely to increase simply because attorneys know the government has the money to make settlements and massive payouts. Try to imagine potential punitive damages alone. When the government has the ability to spend several trillion dollars per year, how much will a jury be willing to give a wronged individual who is feeble, disfigured, or dying?

    12. Like social security, any government benefit eventually is taken as a "right" by the public, meaning that it's politically near impossible to remove or curtail it later on when costs get out of control. Social security was originally put in place to help seniors live the last few years of their lives; however, the retirement age of 65 was set when average life spans were dramactically shorter. Now that people are regular living into their 90s or longer, costs are skyrocketing out of control, making the program unsustainable. Despite the fact that all politicians know the system is heading for bankruptcy in a couple decades, no one is rushing to fix it. When President Bush tried to re-structure it with private accounts, the Democrats ran a scare campaign about Bush's intention to "take away your social security". Even though he promised no change in benefits, the fact that he was proposing change at all was enough to kill the effort, despite the fact that Democrats offered zero alternative plan to fix it. Despite Republican control of the presidency and both houses, Bush was not even close to having the political support to fix something that has to be fixed ASAP; politicians simply didn't want to risk their re-elections. The same pattern is true with virtually all government spending programs. Do you think politicians will ever be able to cut education spending or unemployment insurance?...Only if they have a political death wish. In time, the same would be true of universal health care spending. As costs skyrocket because of government inefficiency and an aging population, politicians will never be able to re-structure the system, remove benefits, or put private practice options back in the system....that is, unless they want to give up hope of re-election. With record debt levels already in place, we can't afford to put in another "untouchable" spending program, especially one with the capacity to easily pass defense and social security in cost.

[*]~

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JMS, you won me over. Good posts.

When my son was born, some doctor I've never seen before came into the post-delivery room my wife was in, said hi, looked at her chart for 20 seconds, didn't say a word and left the room. We got a bill from that person for $200.

The government needs to regulate our medical system. It is out of control.

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I must be dense.. because I don't understand your discussion point.

Costa Rica ranks just ahead of the United States in service provided independent of cost by the World Health Organization..

http://www.photius.com/rankings/healthranks.html

1 France

2 Italy

3 San Marino

4 Andorra

5 Malta

6 Singapore

7 Spain

8 Oman

9 Austria

10 Japan

11 Norway

12 Portugal

13 Monaco

14 Greece

15 Iceland

16 Luxembourg

17 Netherlands

18 United Kingdom

19 Ireland

20 Switzerland

21 Belgium

22 Colombia

23 Sweden

24 Cyprus

25 Germany

26 Saudi Arabia

27 United Arab Emirates

28 Israel

29 Morocco

30 Canada

31 Finland

32 Australia

33 Chile

34 Denmark

35 Dominica

36 Costa Rica

37 United States of America

So why are you bringing up price?

I am saying compare your number against these numbers.

http://en.wikipedia.org/wiki/List_of_countries_by_GDP_%28nominal%29 What does the COST mean if you are not comparing it to the ability to afford the cost. Yes in the US it costs a lot of money. But (cue Patrick Ewings voice here) WE MAKE A LOT OF MONEY. lol

It is called being intellectually honest with yourself. This is why I do not listen the WHO hook line and sinker. Nothing wrong with being objective. Right?

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Ok I promised to not get into this but with JMS still singing the same song I have to.

What he forgets to tell everyone is in the 70's we were still the highest per capita in healthcare yet we were #1. If you look at the change in costs per country since then they have all gone up about the same.

The question is what has happened since the 70's that has made our healthcare so bad??

The answer is pretty simple, it is us. Look at the report that came out the other day regarding middle age women and the huge increase in strokes, it is related to the fact the average waist size has grown 2 inches!!!!!

Look there is a problem with our healthcare system, the infrastructure needs updating and we need to make better choices about our personal health.

Those large meals, fast food joints, setting on the couch, and the fact we are an aging country with the boomers all about to retire, there are a lot of issues right now.

Universal healtchare is not the answer though, it isn't like people see the dr anyway when they should. There was a great report on minortities and cancer rates and how religion gets in the way of their ability to see a dr early on. This lady in Atlanta had cancer so bad her tumor burst on her chest, she told the dr she had that for about 10 years and did NOTHING. She told the dr she prayed that it would go away, that lady died months later.

What we need to have is affordable healthcare for all, and push preventive medicine, instead of being a diseased nation which we are right now, we need to catch it early. This though is a compelete change in thought for many of us.

For those screaming universal healthcare look at what we have with medicare and ask yourself are you sure you want the government in control of it??? I didn't think so.

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Christ Portis, just admit it, you are DEAD WRONG on this issue, and you have been put to school by JMS. He answered every single one of your "problems" and showed you WHY it was wrong.

You see, here is the difference between liberals and republicans, or even independents and republicans or libertarians and republicans. . .or hell, I should just say here is the problem with republicans. . .

Other people look at the information and base their opinions on the facts, numbers and raw data, and try to come to a rational conclusion based on said data. Republicans, like Portis, will either ignore data when it is contrary to their opinion without offering anything to back their point, or say "I don't believe the data". . .I love that one.

People like JMS and myself actually abhor government regulation and love free market systems, but ALSO (and this is a key point) can recognize when a system is broken, and take steps to fix it. A republican will, on the other hand, as Portis has so gracefully done in this thread, claim that getting away from a monopolistic system will be disastrous for America and will bury us into the ground, when EVERY SINGLE PIECE OF DATA shows a broken system that if it continues along the same path WILL bury us.

You can still like a free market, think that it is a great thing, but also recognize that there are tragic downfalls of a free market. It is called being rational and understanding the nuances of the world. It is what separates me from a republican such as Portis, as I will actually change my mind on a topic or an issue if evidence comes up to the contrary. I will let my decision be made by the evidence, not frame the evidence around my politics. There is a definite difference in politics, thought, and actual understanding of real world situations occur outside the republican party. They occasionally get it right, but heck a broken clock is right twice a day too. . .and in this case, as is the case in almost all of their arguments, they are dead wrong.

Green, take you lesson from here.

1) How to say absolutely nothing. But do it with style and substance.

2) Include definitive "I win you lose" statement. Whether the truth to this statement is confirmed or not.

3) Provide your argument in such a way as to nearly make it impossible to respond in a reasonable way.

Classic Chrome. :D

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