tag:blogger.com,1999:blog-3484251241397688762.comments2023-03-23T08:58:32.154-04:00The Citizen PostJed Eastmanhttp://www.blogger.com/profile/08555575861510514218noreply@blogger.comBlogger200125tag:blogger.com,1999:blog-3484251241397688762.post-91078842880632311902008-12-20T17:28:00.000-05:002008-12-20T17:28:00.000-05:00Good job, Jed.I read both articles you suggested, ...Good job, Jed.<BR/>I read both articles you suggested, and don't see anything to criticize the President Elect for so far.<BR/><BR/>I don't agree with the arguments the gentleman made about education. It's too early to tell whether Obama is forgetting his commitment to education. When the patient is dying from heart failure, you need to get his heart beating again before you give him food. He may be starving, but that won't kill him nearly as fast as his failed heart.Eric Eastmanhttps://www.blogger.com/profile/16113183953874631955noreply@blogger.comtag:blogger.com,1999:blog-3484251241397688762.post-63584387341609188902008-11-17T22:10:00.000-05:002008-11-17T22:10:00.000-05:00You didn't mention it, but I would like to bring u...You didn't mention it, but I would like to bring up Obama's role in the auto industry bailout. I voted for Obama, and am now quite disappointed that this is one of his first executive actions. It was apparent in the last weeks of the campaign that a bailout was inevitable, given that both McCain and Obama supported it.<BR/><BR/>A few arguments for a bailout:<BR/><BR/>It is an opportunity to make the US a world leader in the auto industry again. We (the taxpayers) can rebuild it from scratch and make sure they produce what the market desires.<BR/><BR/>Unemployment could jump to seven or eight percent in a very short amount of time if we allow them to collapse, the many companies that leach off of the industry would die, and we would probably further lower GDP.<BR/><BR/>If US car companies are gone, we wouldn't be able to buy parts for the millions of American cars on the road, the resale values would approach zero. It would be like flooding the market with Yugos.<BR/><BR/>A few arguments against a bailout:<BR/><BR/>Economics 101: there are limited resources in the US, and when those resources are allocated inefficiently productivity slows. US Auto companies are highly inefficient and they are eating up resources that could be used in much better ways.<BR/><BR/>We need the innovation and enthusiasm that comes with new companies. With the bloated auto industry that doesn't have to be profitable because it gets help from the government, it is impossible for a new company to compete.<BR/><BR/>If we bail out car companies, won't other industries demand money from Uncle Sam? Where do we draw the line?<BR/><BR/>We tried this in the 70's. It didn't work.<BR/><BR/>Congress isn't smart enough to write a good bailout package.<BR/><BR/><BR/>Here is a good article in the WSJ: <A HREF="http://online.wsj.com/article/SB122669746125629365.html?mod=todays_us_weekend_journal" REL="nofollow">Just Say No to Detroit</A>Joshhttps://www.blogger.com/profile/04955762434842115023noreply@blogger.comtag:blogger.com,1999:blog-3484251241397688762.post-62401229650143510762008-11-14T11:13:00.000-05:002008-11-14T11:13:00.000-05:00Also on the horizon:"Well, the first thing I'd do ...Also on the horizon:<BR/><BR/>"Well, the first thing I'd do as president is, is sign the Freedom of Choice Act. [Applause.] That's the first thing that I'd do."<BR/><BR/>-AlAl and Jennyhttps://www.blogger.com/profile/17433807100193935793noreply@blogger.comtag:blogger.com,1999:blog-3484251241397688762.post-79178385727115449192008-11-14T10:58:00.000-05:002008-11-14T10:58:00.000-05:00From the article, it unfortunately sounds like edu...From the article, it unfortunately sounds like education reform is taking a back seat.<BR/><BR/>Also, it seems like health care reform may continue forward regardless of the costs to the country. (Mr. Obama did promise to sign health care reform into effect before the end of his first term--sans condition.) Senator Baucus (Montana) has released a plan that will completely cover all the uninsured, requiring everyone in the US to have health insurance.<BR/><BR/>I haven't read the bill yet. I don't know how the government will ensure that everyone is covered, but it will be expensive. If a government subsidized HMO is offered at the same time it is required for all to have health insurance, more than likely the NHE will be offered to all levels of income.<BR/><BR/>I think this will cause everyone to drop their health insurance (me included--if I'm going to pay taxes for it and I can get it for cheap, I'm going to get it), place a fantastic burden on the government and the program will be abandoned. A similar situation happened in Hawaii.<BR/><BR/>Once again, I haven't read the bill. I'm leaving out of town again and don't have much time to sift through its nuances. I could be wrong. But I'm not for reforming health care regardless of cost. Baucus' plan sounds bad.<BR/><BR/>-AlAl and Jennyhttps://www.blogger.com/profile/17433807100193935793noreply@blogger.comtag:blogger.com,1999:blog-3484251241397688762.post-36031443825586174612008-11-14T10:46:00.000-05:002008-11-14T10:46:00.000-05:00I don't know if the fall in the US performance in ...I don't know if the fall in the US performance in math and language is related to the teachers.<BR/><BR/>Mr. Obama's plan seems to focus on replacing the current teachers, pay them more, and expect more (vague). Also he promises to make sure that individuals can 'afford' a college education if they 'commit' to serving the community or country (once again vague).<BR/><BR/>I submit that there is more of a value problem in the US. Many individuals and families no longer value education as it once was valued in the US. I don't forsee any effective government approach on this front.<BR/><BR/>I am for increasing teachers' salary. They are truly underpaid, underresourced government workers. I will sign up for that tax increase.<BR/><BR/>I don't know if targeting the price of college is an effective goal. There exist myriad scholarships and affordable community college opportunities. FAFSA already covers quite a bit.<BR/><BR/>I am for an increase in teachers pay and encouraging college education. I don't think that any of Obama's changes target the real problem, however.<BR/><BR/>-AlAl and Jennyhttps://www.blogger.com/profile/17433807100193935793noreply@blogger.comtag:blogger.com,1999:blog-3484251241397688762.post-37581559532583861622008-11-13T12:38:00.000-05:002008-11-13T12:38:00.000-05:00In Gallup polls since 1944, only about 20% of the ...In Gallup polls since 1944, only about 20% of the public has supported the current system of awarding all of a state’s electoral votes to the presidential candidate who receives the most votes in each separate state (with about 70% opposed and about 10% undecided). The recent Washington Post, Kaiser Family Foundation, and Harvard University poll shows 72% support for direct nationwide election of the President. This national result is similar to recent polls in Vermont (75%), Maine (71%), Arkansas (74%), California (69%), Connecticut (73%), Massachusetts (73%), Michigan (70%), Missouri (70%), North Carolina (62%), and Rhode Island (74%). In short, the public believes that the candidate that receives the most votes should get elected.mvymvyhttps://www.blogger.com/profile/07860792846652677912noreply@blogger.comtag:blogger.com,1999:blog-3484251241397688762.post-37046521784095291282008-11-13T12:21:00.000-05:002008-11-13T12:21:00.000-05:00When presidential candidates campaign to win the e...When presidential candidates campaign to win the electoral votes of closely divided battleground states, such as in Ohio and Florida, the big cities in those battleground states do not receive all the attention, much less control the outcome. Cleveland and Miami certainly did not receive all the attention or control the outcome in Ohio and Florida in 2000 and 2004. <BR/>Under a national popular vote, every vote is equally important politically. There is nothing special about a vote cast in a big city. When every vote is equal, candidates of both parties know that they must seek out voters in small, medium, and large towns throughout the state in order to win the state. A vote cast in a big city is no more valuable than a vote cast in a small town or rural area. <BR/>Another way to look at this is that there are approximately 300 million Americans. The population of the top five cities (New York, Los Angeles, Chicago, Houston and Philadelphia) is only 6% of the population of the United States and the population of the top 50 cities is only 19% of the population of the United States. Even if one makes the far-fetched assumption that a candidate won 100% of the votes in the nation’s top five cities, he would only have won 6% of the national vote. <BR/>Further evidence of the way a nationwide presidential campaign would be run comes from the way that national advertisers conduct nationwide sales campaigns. National advertisers seek out customers in small, medium, and large towns of every small, medium, and large state. National advertisers do not advertise only in big cities. Instead, they go after every single possible customer, regardless of where the customer is located. National advertisers do not write off Indiana or Illinois merely because their competitor has an 8% lead in sales in those states. And, a national advertiser with an 8%-edge over its competitor does not stop trying to make additional sales in Indiana or Illinois merely because they are in the lead.mvymvyhttps://www.blogger.com/profile/07860792846652677912noreply@blogger.comtag:blogger.com,1999:blog-3484251241397688762.post-63127770187133830102008-11-13T12:19:00.000-05:002008-11-13T12:19:00.000-05:00The small states are the most disadvantaged of all...The small states are the most disadvantaged of all under the current system of electing the President. Political clout comes from being a closely divided battleground state, not the two-vote bonus. <BR/><BR/>Small states are almost invariably non-competitive in presidential election. Only 1 of the 13 smallest states are battleground states (and only 5 of the 25 smallest states are battlegrounds). <BR/><BR/>Of the 13 smallest states, Idaho, Montana, Wyoming, North Dakota, South Dakota, and Alaska regularly vote Republican, and Rhode Island, Delaware, Hawaii, Vermont, Maine, and DC regularly vote Democratic. These 12 states together contain 11 million people. Because of the two electoral-vote bonus that each state receives, the 12 non-competitive small states have 40 electoral votes. However, the two-vote bonus is an entirely illusory advantage to the small states. Ohio has 11 million people and has "only" 20 electoral votes. As we all know, the 11 million people in Ohio are the center of attention in presidential campaigns, while the 11 million people in the 12 non-competitive small states are utterly irrelevant. Nationwide election of the President would make each of the voters in the 12 smallest states as important as an Ohio voter. <BR/><BR/>The fact that the bonus of two electoral votes is an illusory benefit to the small states has been widely recognized by the small states for some time. In 1966, Delaware led a group of 12 predominantly low-population states (North Dakota, South Dakota, Wyoming, Utah, Arkansas, Kansas, Oklahoma, Iowa, Kentucky, Florida, Pennsylvania) in suing New York in the U.S. Supreme Court, arguing that New York's use of the winner-take-all effectively disenfranchised voters in their states. The Court declined to hear the case (presumably because of the well-established constitutional provision that the manner of awarding electoral votes is exclusively a state decision). Ironically, defendant New York is no longer a battleground state (as it was in the 1960s) and today suffers the very same disenfranchisement as the 12 non-competitive low-population states. A vote in New York is, today, equal to a vote in Wyoming--both are equally worthless and irrelevant in presidential elections. <BR/><BR/>The concept of a national popular vote for President is far from being politically “radioactive” in small states, because the small states recognize they are the most disadvantaged group of states under the current system.mvymvyhttps://www.blogger.com/profile/07860792846652677912noreply@blogger.comtag:blogger.com,1999:blog-3484251241397688762.post-90896446050363257082008-11-13T12:18:00.000-05:002008-11-13T12:18:00.000-05:00The people vote for President now in all 50 states...The people vote for President now in all 50 states and have done so in most states for 200 years. <BR/><BR/>So, the issue raised by the National Popular Vote legislation is not about whether there will be "mob rule" in presidential elections, but whether the "mob" in a handful of closely divided battleground states, such as Florida, get disproportionate attention from presidential candidates, while the "mobs" of the vast majority of states are ignored. In 2004, candidates spent over two thirds of their visits and two-thirds of their money in just 6 states and 99% of their money in just 16 states, while ignoring the rest of the country. <BR/><BR/>The current system does NOT provide some kind of check on the "mobs." There have been 22,000 electoral votes cast since presidential elections became competitive (in 1796), and only 10 have been cast for someone other than the candidate nominated by the elector's own political party. The electors are dedicated party activists who meet briefly in mid-December to cast their totally predictable votes in accordance with their pre-announced pledges.mvymvyhttps://www.blogger.com/profile/07860792846652677912noreply@blogger.comtag:blogger.com,1999:blog-3484251241397688762.post-10232297569679235302008-11-13T12:16:00.000-05:002008-11-13T12:16:00.000-05:00After more than 10,000 statewide elections in the ...After more than 10,000 statewide elections in the past two hundred years, there is no evidence of any tendency toward a massive proliferation of third-party candidates in elections in which the winner is simply the candidate receiving the most votes throughout the entire jurisdiction served by the office. No such tendency has emerged in other jurisdictions, such as congressional districts or state legislative districts. There is no evidence or reason to expect the emergence of some unique new political dynamic that would promote multiple candidacies if the President were elected in the same manner as every other elected official in the United States. <BR/><BR/>Based on historical evidence, there is far more fragmentation of the vote under the current state-by-state system of electing the President than in elections in which the winner is simply the candidate who receives the most popular votes in the jurisdiction involved. <BR/><BR/>Under the current state-by-state system of electing the President (in which the candidate who receives a plurality of the popular vote wins all of the state’s electoral votes), minor-party candidates have significantly affected the outcome in six (40%) of the 15 presidential elections in the past 60 years (namely the 1948, 1968, 1980, 1992, 1996, and 2000 presidential elections). The reason that the current system has encouraged so many minor-party candidates and so much fragmentation of the vote is that a presidential candidate with no hope of winning a plurality of the votes nationwide has 51 separate opportunities to shop around for particular states where he can affect electoral votes or where he might win outright. Thus, under the current system, segregationists such as Strom Thurmond (1948) or George Wallace (1968) won electoral votes in numerous Southern states, although they had no chance of receiving the most popular votes nationwide. In addition, candidates such as John Anderson (1980), Ross Perot (1992 and 1996), and Ralph Nader (2000) did not win a plurality of the popular vote in any state, but managed to affect the outcome by switching electoral votes in numerous particular states.mvymvyhttps://www.blogger.com/profile/07860792846652677912noreply@blogger.comtag:blogger.com,1999:blog-3484251241397688762.post-89758500062243462562008-11-13T12:15:00.000-05:002008-11-13T12:15:00.000-05:00The present system of electing the President does ...The present system of electing the President does not "work well" because the winner-take-all rule (currently used by 48 of 50 states) awards all of a state's electoral votes to the candidate who gets the most votes in the state. Because of these 48 state laws, presidential candidates have no reason to poll, visit, advertise, organize, campaign, or worry about the concerns of voters of states that they cannot possibly win or lose. Instead, candidates concentrate their attention on a handful of "battleground" states. In 2004, 88% of the money was focused onto just 9 closely divided battleground states, and 99% was concentrated in just 16 states. Two thirds of the states, are effectively disenfranchised in presidential elections. Another effect of the winner-take-all rule is that a candidate can win the Presidency without winning the most popular votes nationwide -- something that happens in 1 in 14 elections (1 in 7 non-landslide elections).mvymvyhttps://www.blogger.com/profile/07860792846652677912noreply@blogger.comtag:blogger.com,1999:blog-3484251241397688762.post-89955380068510765452008-11-13T09:58:00.000-05:002008-11-13T09:58:00.000-05:00Good post Tyler. Let me play devil's advocate for...Good post Tyler. Let me play devil's advocate for a minute.<BR/><BR/>I agree that it's worked well enough in the past. I also agree that the sovereignty argument had merit at one time.<BR/><BR/>It was valid when the country was young and the states needed to be vigilant in the defense of their rights against proponents of a strong central government. But that isn't the case any more. Separation of powers is clearly spelled out now. So I believe the strongest and most used argument to keep the College is based on a fear that was real once but isn't any more.Eric Eastmanhttps://www.blogger.com/profile/16113183953874631955noreply@blogger.comtag:blogger.com,1999:blog-3484251241397688762.post-88141246218493206202008-11-12T20:48:00.000-05:002008-11-12T20:48:00.000-05:00Great post Tyler! So proud to be your uncle. :)Ser...Great post Tyler! So proud to be your uncle. :)<BR/><BR/>Seriously though, I appreciate all the points you made. As one who's usually with the "anti-EC" crowd, I was really interested to hear the arguments for keeping it. I think they're good arguments you make, and I agree with you that the current system seems to be working just fine. With plenty of other problems to fix, we might as well focus on those.<BR/><BR/>I was one of the "4" on the poll, but I think you've convinced me to change my answer!<BR/><BR/>Thanks for the post.Jed Eastmanhttps://www.blogger.com/profile/08555575861510514218noreply@blogger.comtag:blogger.com,1999:blog-3484251241397688762.post-82106467047254911452008-11-12T19:49:00.000-05:002008-11-12T19:49:00.000-05:00Good thoughts. Sometimes in the midst of the hubb...Good thoughts. Sometimes in the midst of the hubbub we forget what a miracle our democracy is.<BR/><BR/>I'm disgusted with Sean Hannity's post election attitude. Calling himself a "conservative in exile" implies a severe lack of ability to support the democratic process. <BR/><BR/>I wish people like that would move to Europe.Eric Eastmanhttps://www.blogger.com/profile/16113183953874631955noreply@blogger.comtag:blogger.com,1999:blog-3484251241397688762.post-72391735364023128962008-11-11T22:17:00.000-05:002008-11-11T22:17:00.000-05:00That is a really cool site, but he got the colors ...That is a really cool site, but he got the colors wrong! It's fun to start at the beginning and work forward. The later elections brought back memories.Eric Eastmanhttps://www.blogger.com/profile/16113183953874631955noreply@blogger.comtag:blogger.com,1999:blog-3484251241397688762.post-6210273657531071252008-11-04T11:37:00.000-05:002008-11-04T11:37:00.000-05:00I agree with Matt that this is an excellent post, ...I agree with Matt that this is an excellent post, Al. Thanks very much for all the good details and links. I'm really enjoying this discussion. There is one thing I'd like to get Al's (or anyone else's) opinion on if you don't mind.<BR/><BR/>This is part of McCain's statement on the JAMA link you posted, <EM>"the key is to put doctors and patients back in control of health care decisions."</EM> I think McCain is absolutely right, I completely agree with this statement and from your posts, it sounds like you do to (I apologize if I am mis-stating your opinion). <BR/><BR/>My question relates to a comment Matt made regarding his experience in the Navy operating under a government-run health care system. Matt said in part, <EM>"I never fought with insurance companies who wanted to deny care or coverage. If my patient needed a medicine they got it. I had to make choices that were within coverage limits but those choices were clear . . . If my patient needed a Cardiologist, Oncologist, Surgeon, whatever, they got it. The difference is, all those decisions were made by me, their primary care doctor. They were not made by their insurance company or anyone else. Only by me."</EM> <BR/><BR/>Matt's experience seems to suggest to me that, at least in this instance, government-run health care actually provided a solution to something that you and I both agree is a problem. However, I understand we may disagree on this point and I'd love to hear your thoughts.Jed Eastmanhttps://www.blogger.com/profile/08555575861510514218noreply@blogger.comtag:blogger.com,1999:blog-3484251241397688762.post-30629168042533806152008-11-04T10:43:00.000-05:002008-11-04T10:43:00.000-05:00A brief rundown compiled by Reuters(Reuters) - Tue...A brief rundown compiled by Reuters<BR/>(Reuters) - Tuesday's U.S. presidential election will be decided in about a dozen battleground states where most opinion polls show Democrat Barack Obama ahead of Republican rival John McCain.<BR/><BR/>* Colorado -- Nine electoral votes. The four latest polls put Obama up by between 4 and 7 points.<BR/><BR/>* Florida -- 27 electoral votes. Two new polls on Tuesday had Obama in the lead by 1 and 3 points respectively, while another recent poll gave a 1-point edge to McCain.<BR/><BR/>* Indiana -- 11 electoral votes. The Reuters/Zogby poll on Tuesday showed McCain in the lead by 5 points, although earlier polls had showed the race as a dead heat.<BR/><BR/>* Missouri -- 11 electoral votes. The race looks to be among the tightest in the country, with two new polls on Tuesday showing it a tie.<BR/><BR/>* New Hampshire -- Four electoral votes. A poll on Sunday showed Obama ahead by 11 points.<BR/><BR/>* New Mexico -- Five electoral votes. The most recent poll shows Obama ahead by 10 points.<BR/><BR/>* Nevada -- Five electoral votes. The Reuters/Zogby poll on Tuesday gave Obama a lead of 11 points.<BR/><BR/>* North Carolina -- 15 electoral votes. The two most recent polls split, one showing McCain up by 1 point and the other giving a similar lead to Obama.<BR/><BR/>* Ohio -- 20 electoral votes. The Reuters/Zogby poll on Tuesday gave Obama a narrow 2-point lead in what appears to be a very competitive race.<BR/><BR/>* Pennsylvania -- 21 electoral votes. The two latest polls show Obama up by 9 and 10 points respectively.<BR/><BR/>* Virginia -- 13 electoral votes. The Reuters/Zogby poll on Tuesday had Obama ahead by 7 points, while two other recent polls gave him a 4-point lead.<BR/><BR/>* Wisconsin -- 10 electoral votes. The three most recent polls show Obama ahead by 10, 11 and 16 points, respectively.<BR/><BR/>http://www.reuters.com/article/vcCandidateFeed2/idUSTRE49U46X20081104?pageNumber=1&virtualBrandChannel=10112&sp=true<BR/><BR/>It would be informative to see the margin of error in these polls (but like most, people don't understand the significance of it).<BR/><BR/>I'll make a prediction: the popular vote will be close and the other party will whine.<BR/><BR/>Here is a cool link to how the country looks through an electoral college lense: http://en.wikipedia.org/wiki/Image:Cartogram-2004_Electoral_Vote.gif<BR/><BR/>-AlAl and Jennyhttps://www.blogger.com/profile/17433807100193935793noreply@blogger.comtag:blogger.com,1999:blog-3484251241397688762.post-48335959530542984592008-11-04T10:09:00.000-05:002008-11-04T10:09:00.000-05:00I'm following Senator Obama's advice and taking th...I'm following Senator Obama's advice and taking the day off to vote!<BR/><BR/>(Actually I have an interview in KC tomorrow, so I'll be leaving at noon to drive there.)<BR/><BR/>I guess I am more interested in this election than those in years past. I don't think that this election really has been more intense than years past (although the candidates certainly have raised record breaking funds), more that I am become more interested in the forces that shape our nation.<BR/><BR/>Either way, I look forward to discussing the nuances of the politics that will come our way with either candidate. Hopefully most of us feel it really is just the end of a beginning rather than the beginning of an end.<BR/><BR/>-AlAl and Jennyhttps://www.blogger.com/profile/17433807100193935793noreply@blogger.comtag:blogger.com,1999:blog-3484251241397688762.post-82013255925538800332008-11-04T06:44:00.000-05:002008-11-04T06:44:00.000-05:00I'm on my way to be a poll worker. I hope we're n...I'm on my way to be a poll worker. I hope we're not disappointed by the turnout. I'm thankful for the things all of you have helped me understand through this process. Thanks again.Lucile Eastmanhttps://www.blogger.com/profile/08478968344169618845noreply@blogger.comtag:blogger.com,1999:blog-3484251241397688762.post-88975273498524517072008-11-03T23:38:00.000-05:002008-11-03T23:38:00.000-05:00I agree that medicine should really move to an ele...I agree that medicine should really move to an electronic medical record system. SLUH is terrible. Many hospitals already do this, and even some smaller family care offices. It is very expensive to start such a program--some estimate for a family office between $20,000 and $50,000. I have no problem if the government throws a bone or two toward this problem. My point was I don't think it is clear how fixing this problem will lead to cutting into the skyrocketing costs of health care.<BR/><BR/>As to how Obama institutes the government into the health care crisis, his plan only provides a cheap government HMO for lower income individuals to buy. It seems to me to still be open to free market forces, yet with more government institution paid for by tax increases.<BR/><BR/>Also, the current economic difficulties are more a result of irresponsiblity of consumers and investors. I was against the bailout (although I don't understand the motivations behind it fully--of course there was the wish to avoid a recession/depression, but there is some evidence that several European nations approached the US requesting the bailout).<BR/><BR/>I don't think we can pin it on free market forces, rather it falls on unresponsible individuals giving and taking more loans than they could handle.<BR/><BR/>-Al<BR/><BR/>(Sorry once again for deleting comments. Like I said, there is not a good edit feature.)Al and Jennyhttps://www.blogger.com/profile/17433807100193935793noreply@blogger.comtag:blogger.com,1999:blog-3484251241397688762.post-44243106060764229532008-11-03T23:31:00.000-05:002008-11-03T23:31:00.000-05:00This comment has been removed by the author.Al and Jennyhttps://www.blogger.com/profile/17433807100193935793noreply@blogger.comtag:blogger.com,1999:blog-3484251241397688762.post-75947924364335777382008-11-03T22:43:00.000-05:002008-11-03T22:43:00.000-05:00Al;Excellent post.There are certainly vaguearies o...Al;<BR/>Excellent post.<BR/>There are certainly vaguearies on both sides. Obama talks a lot about decreasing cost through technology and increasing efficiency/safety. Sounds great but ENORMOUS undertaking (maybe youthful exuberance as you said). I've been working hard in my organization to get electronic prescribing going. I've been working at that for 8 months and have made little headway. I've been arguing for electronic registry and secure website/patient communication systems for the same time period to no avail. These are systems you can buy and start using tomorrow, and cornerstones of what Obama is proposing. The bureaucracy in implementation is difficult to say the least. And this is just in my organization of about 100 providers. Imagine a nationwide effort. I think some real leadership from the president could get things going though.<BR/>McCain pays lip service to improving access for people with pre-existing conditions but gives few specifics as to how. This is another enormous problem that no amount of tax break etc will solve. Nothing short of a mandate (dirty word that no republican will say) will make this problem go away. Health insurance companies are built with the express purpose of not paying for these people's health care.<BR/>I agree that the two plans are similar in some ways. And people advocating either plan can spin the numbers to make it look however they want it to look. But the plans do differ in the core philosophy that informs them. <BR/>McCain's plan wants to expand the role of market forces. Obama's plan wants to expand the role of government forces. Plain and simple.<BR/>There exists in this country a deep and abiding mistrust of government. <BR/>I have, and I think we should all have, a deep mistrust of markets and their motives as they relate to the public good. We're all currently paying the price of unrestrained market forces and all that's at stake is our stock portfolios. Why should we trust our lives to those same market forces?<BR/>There are things that government does better than markets. I guess we'll see.<BR/>Thanks again for the post, Al. Good stuff.<BR/>Matt EastmanKimhttps://www.blogger.com/profile/15327685929076683867noreply@blogger.comtag:blogger.com,1999:blog-3484251241397688762.post-14766350775534061492008-11-03T02:12:00.000-05:002008-11-03T02:12:00.000-05:00Part of my purpose in researching and writing so m...Part of my purpose in researching and writing so much is to inform you as much as it is to inform me.<BR/><BR/>These are timely topics and will undoubtedly be discussed in some of my residency interviews.<BR/><BR/>Thanks for letting me post on this forum.Al and Jennyhttps://www.blogger.com/profile/17433807100193935793noreply@blogger.comtag:blogger.com,1999:blog-3484251241397688762.post-30077927640718241272008-11-03T02:06:00.000-05:002008-11-03T02:06:00.000-05:00Alex, thanks for your comments.I’ve addressed the ...Alex, thanks for your comments.<BR/><BR/>I’ve addressed the fact that this article is not about the current situation. It is a good point, and all should be aware.<BR/><BR/>Most socialized health care systems allow for individuals to purchase and use private health insurance as well. But to work within a system, you have to follow their rules. In the UK, the NHS allows for this as you pointed out. In Canada, it is less so, but you can always drive south. In the Navy it sounds like you have to go to your assigned PCP first. Since there has been no institution of socialized medicine in the US, we can’t accurately answer that question. It was rhetorical. I was hoping others would see my point that once a system is in place, you are bound by its restrictions.<BR/><BR/>I don’t want panels of experts deciding what my care should be either. I’d rather that be between my doctor and I. But that is my choice, and you are entitled to yours.<BR/><BR/>-------------------------------<BR/><BR/>Matt, thank you for serving in the armed services. I have a great respect for individuals who dedicate their time to serving our country.<BR/><BR/>Your observations are insightful on how a well run system should work. I completely agree with you that individuals seeking care from specialists before seeing a PCP is ridiculous. Most insurance providers, however, require individuals to see their PCP before they will pay for visits to specialists.<BR/><BR/>I have some questions for you, and would appreciate your insight from serving in the VA system.<BR/><BR/>Why is the VA system outsourcing more and more of its care? Is it a funding issue or an effectiveness issue? How many of active service men are dual-users of insurance? How many of retired veterans are dual users?<BR/><BR/>The VA is not a closed medical system. Many individuals qualify for Tricare (VA health care) as well as Medicare and Medicaid, as well as have the options of private insurance. Many medical studies from the VA are confounded by the fact that there exist this population that will get some care within the system and without.<BR/><BR/>----------------------------------<BR/><BR/>Josh, sorry. I did through it in your face pretty hard.<BR/><BR/>You are correct that Big Pharma is in business to make money. So are hospitals, doctors, nurses, and even the cleaning personel. Money isn’t the only motivation, or perhaps even the biggest, in most cases. I am sorry you are so soured on Big Pharma and my resources could not convince you that they are not just working to increase shareholder value. The products they create save lives, and they donate quite a bit to other organizations to find cures.<BR/><BR/>Honestly I don’t feel pressured by Big Pharma and HMOs to make choices. If anything I feel a lack of pressure. If I knew which drugs were available to my patients in their plans, I could pick more effectively which would work the best and be affordable at the same time.<BR/><BR/>Doctors know the science well and are rarely pressured to make the wrong choice scientifically. Often they embarrass drug reps with this:<BR/><BR/>My favorite is from my family med preceptor: some rep was pushing an ARB as a 1st line treatment for HTN, the doc got fed up with it and said, “why wasn’t it in the JNC VII then?” The rep replied, “Jane who?” (Matt you’ll appreciate the humor)<BR/><BR/>The only pressure I feel is to eat their free lunch without having to talk to their reps.<BR/><BR/>As to whether or not I feel that medical care is a right, I do think that every individual should have access to care. I don’t think that means that the government should socialize medicine.<BR/><BR/>-AlAl and Jennyhttps://www.blogger.com/profile/17433807100193935793noreply@blogger.comtag:blogger.com,1999:blog-3484251241397688762.post-15583842285295205762008-11-03T00:53:00.000-05:002008-11-03T00:53:00.000-05:00I know about the fake SSN's, I was a victim and ha...I know about the fake SSN's, I was a victim and had to switch mine. I don't care that some pay sales tax. Employers need to account for them and they need to pay real taxes. Fake SSN's or whatever should be even higher penalty for them, in our country it's called identity theft or fraud, it shouldn't be something we look at and say "oh but SOME of them pay taxes" and if you're familiar with how NYC works, a lot of them don't pay sales taxes. There are so many places that don't charge tax if you pay cash- ridiculous if you ask me.akdoxeyhttps://www.blogger.com/profile/11454517304548232381noreply@blogger.com