I can also remember a time when old people did not have health insurance. It was hard to watch. As luck would have it, I was on the team that developed the first, and most widely used, Medicare System. I realized how lucky I would be when I reached age 65 because I would have good health insurance. Niow I have it and it is better, by far, than the employer plans, the HMO’s, and the self-insured plans I had before Medicare.

But now the folks who are under age 65 but above age 50 are falling into the slot once occupied by us old folks. Of course they had the same problem before Medicare, except costs were not so killing. These folks are in trouble and it ain’t gonna get better.

The corruption in our national government is not new, as you accurately pointed out, but it is more dangerous. We aren’t fiddling with whether to outlaw cigarettes, which we didn’t, but we are fiddling with the very air we breath. The SCOTUS decision gives the tyranno-rulers of our world all the freedom they need to exploit every last resource we have including working people. We are fiddling with life and death for millions of people in a way that makes early death more likely than not.

You should be very concerned. Passing health insurance reform as it is now generally configured will help lots of people, but many more will be disappointed and the stranglehold of the health insurance companies on the future of our nation will be stronger. They are on their way to control of the entire medical structure. Docs will be employees. Hell, they even may control medical schools. There is no stopping their ambition. Especially with the corrupt government we now have.

On a side note, the only reason that I tend to go to doctors over the last decade and a half has been sports medicine, and I’ve tended to find it a wonderful experience–I get the vibe of, “We’re going to find what’s wrong and fix it.” I don’t care if I’m being treated like I’m on an assembly line if it’s an efficiently run one.

On the pro-side: sprinkler manufacturers, thier “experts” and some fire fighters.
On the con-side: home builders, their “experts”, and the fire alarm manufacturing industry, which has surprisingly little overlap with sprinkler manufacturers …

The science? Somewhere in the middle, but like any cost-benefit analysis, one that can be easily skewed by either side depending on initial assumptions.

Just think, there are literally ten of thousands of people fighting over this issue nationwide as you read this. I assure you, the venom spit over this last month in Harrisburg is as bad as any of the healthcare debates in Washington, except the general public doesn’t care … helps put your little healthcare concerns in perspective. As i speak, the outcome is uncertain …

As a quasi-naturalist working on the land this has a sort of beauty to my eye. It is more resilient in the face of inevitable and repeated shocks. Perhaps this is in the end an aesthetic issue. I see beauty in diversity. A mixed environment with many species at every stage of development is more pleasing to my eye than uniformity, even the ugly bits where some convulsion has just wrecked things, since I anticipate the new growth that will colonize that spot now that it is available.

Beyond that, my feeling in 2004 was that some kinds of understandings were possible across what I suspected were highly manipulated and misrepresented divides in the public sphere and the body politic. I increasingly just don’t think that, because the conversation doesn’t seem to be re-converging at any point, and in many cases, is spiralling away into a flailing mess of idee fixes which don’t seem to bear any relationship to the world as I see it. I was just talking to my very conservative mother-in-law last night and she asked me if I’d seen this man called Glenn Beck. She said she was so impressed with his detailed command over facts and evidence, that he did so much research. I just don’t know what to say any more, you know? What’s the point of disagreeing with anyone? Who is in any sense persuadable or willing to be persuaded? All that’s left is the social underpinnings of why people feel as they do, which I completely agree are important and authentic and worth taking seriously. But the proposition that there’s some communicative connection that can happen, that the content of speech and ideas isn’t *just* a projection of a habitus, that we can somehow connect the hubs and spokes of a social network and make something that links the situated knowledges of people to systematic improvements in our institutions? It just seems like a stupid thing to have ever believed that possible.

I don’t think I’ve read a comment quite so fatalistic as this from you, Tim; indeed, during the worst depths of the Bush presidency–say 2003 to 2005–you were never fatalistic: you were angry, raging in fact, and threw yourself into diagnosing and explaining (to yourself and your readers) the hows and whys of the situation as you understood it. Of course, that was years ago, and time goes by and a lot of water flows under the bridge. Still, it’s worth reflecting on why the “underlying structure of American politics” seem hopeless to you now, when apparently it didn’t so strike you even after Bush and the Republicans did well in the 2004 midterms. (There was quite a bit of fatalism in the blogosphere pack then; I remember Teresa Nielsen Hayden’s reaction: “Well, 220 years is a pretty good run for a republic.”)

I don’t deny that, as always, you eloquantly express a sensation which I–and no doubt many others who are basically comfortable with our places within the current socio-economic system(s)–have as well: the suspicion that the corruption, the inability to surmount the dominant ideological and rhetorical categorization of our political expressions, the intractability of the power of money and influence and self-interest, is simply too great to contemplate escaping. But isn’t it possible that we feel this way mostly because Obama and the move towards health care reform and much else promised something that, as much as we might wish to present ourselves as unflappable and worldly wise, nonetheless wanted to believe in, wanted to see happen? That the hopelessness of our entrenched, complex, patterns of compromise and division loom larger now, because we thought we could actually perceive a path outside of them? In which case, the Tea Partiers did much worse than merely sling mud at what started out as a well-intentioned bill.

But what I think ought to happen with the bill and what I think is going to happen is also different. Sorry if you think depression is premature. I think it’s the structural fact of the situation we find ourselves in, and the reasons go far beyond the wretched timidity of Democrats and the foul, cynical opportunism of Republicans. It wasn’t unreasonable to hope in early 2009 that things might have shifted not just at the level of leadership but in the underlying structure of American politics. It is unreasonable to hope that now.

There is a bill in Congress that would provide health insurance coverage for 30 million Americans. All it needs is for the House (which already approved a more ambitious bill) to vote on it. We are this close. It is not perfect, but it would make a real difference in the lives of many, many people in our country without health insurance and do something to make our system more rational in a myriad of small ways.

Many blogs that I read have posts up telling people to call their Congressperson and tell them to pass the bill (which I have done). Even blogs that have not been especially supportive of the Senate bill in the past. Why? Because this is it. We are either going to get something important now or we aren’t going to get anything. Because after this, it sure looks like we are in for years and years of either total gridlock or BS compromises that don’t really solve anything. It’s not time or Monday morning quarterbacking. Or griping about the Repubicans. Or depressed cynicism. There is a rare chance here to actually achieve something lasting.

In the next several weeks, either something important for the country and for millions of people without health insurance will happen or it wouldn’t. After that, whatever happens with the health care bill, I predict you will have years and years for these sort of ruminations. With which I will probably nod sadly in agreement. But now is not the time.

On a more practical note, if you’re willing to go to Philadelphia to see the doctor, I really loved my primary care doctor at Spruce Internal Medicine (which incidentally is where almost all of my friends there went, and worked out really well for all of us). Everyone I saw in the practice listened pretty well, though I have not always loved the specialists they suggested. As a bonus, their phlebotomists are awesome.