A　Potter, In Mashiko, Japan

: Exploring the Concept of Single Payer

2009-08-26T17:24:31Z

Today's message is in honor of Sen. Edward M. Kennedy who told us,

"For all those whose cares have been our concern, the work goes on, the cause endures, the hope still lives, and the dream shall never die."

Journal of Health Politics, Policy and Law

August 2009

Special Issue: Exploring the Concept of Single Payer

Single Payers, Multiple Systems: The Scope and Limits of Subnational Variation under a Federal Health Policy Framework

By Carolyn Hughes Tuohy, University of Toronto

Neither Obama nor any other major contender for the presidency in 2008 proposed a universal single-payer ( 1cMedicare for All 1d) model. The Obama proposal for a new public plan, to be offered in parallel with regulated private plans through a National Health Insurance Exchange modeled on the Federal Employees Health Benefits Program (FEHBP), would indeed represent a distinctive American hybrid, but it would not be a single-payer system. By definition, a government plan is not "single payer" if it competes with other insurers in offering comprehensive coverage. This is not merely a definitional issue, however: it has critically important implications for the economic and political dynamics of the system. Economically, competition between public and private insurers raises potentially crippling problems of risk selection requiring a regulatory framework that has so far eluded even those European jurisdictions with much longer experience with the regulation of social and private insurance. Politically, such a competitive framework renders the arena much more pluralistic and volatile 14 and effective regulation therefore much more difficult 14 than does a pure single-payer model with its central axis of profession-state accommodation.

In 2009, the colliding waves of hope, generated by the election of Barack Obama, and fear, generated by global financial turmoil, may produce (a paradigm shift in U.S. health care policy and a paradigm shift in the political landscape). At the very least, it seems inevitable that they will yield a larger governmental role in the health care arena. The shape of the resulting hybrid, and whether that hybrid has any room for a single-payer element, is much less clear.

http://jhppl.dukejournals.org/cgi/reprint/34/4/453

Comment: The fact that the entire August issue of the Journal of Health Politics, Policy and Law is devoted to exploring single payer certainly indicates that the concept has not died within the policy community.

Although a majority (but by no means all) of the political community dismisses single payer as not being politically feasible, much of the policy community accepts it as a feasible policy approach that would bring affordable health care to everyone. Even those opposed based on ideology understand clearly the feasibility of single payer from the policy perspective. Otherwise why would the opponents of reform keep insisting that policies that improve our health care financing would inevitably lead to a single payer system?

togeika @ 2009-04-07T20:29:00

2009-04-08T00:29:49Z

Mobile post sent by togeika using Utterli. Replies. mp3

Bamboo Things At Mashiko Hardware.

2009-02-27T21:40:25Z

Kanjiro Kawai's Kiln Altars and my Daruma "Kiln God."

2009-01-31T18:25:08Z

Hachiko Monogatari Movie Synopsis

2009-01-30T18:38:35Z

Hachiko is why I got my first Akita dog Taiko and why I have Kintaro today.

Military-Industrial Complex Speech

2009-01-30T14:09:13Z

"In the councils of government, we must guard against the acquisition
of unwarranted influence, whether sought or unsought, by the
militaryindustrial complex. The potential for the disastrous rise of
misplaced power exists and will persist.

We must never let the weight of this combination endanger our
liberties or democratic processes. We should take nothing for granted.
Only an alert and knowledgeable citizenry can compel the proper
meshing of the huge industrial and military machinery of defense with
our peaceful methods and goals, so that security and liberty may
prosper together. " --, Dwight D. Eisenhower, 1961
full text:

http://coursesa.matrix.msu.edu/~hst306/documents/indust.html

Adam Smith The Theory of the Moral Sentiments 1759

2009-01-25T20:09:48Z

The father of Capitalism did not see it in the eutopian way we do today. Capitalism is simply an amoral financial system. It is not a philosophy of life. --Lee

Adam Smith
The Theory of the Moral Sentiments
1759

The poor man's son, whom heaven in its anger has visited with ambition, when he begins to look around him, admires the condition of the rich. He finds the cottage of his father too small for his accommodation, and fancies he should be lodged more at his ease in a palace. He is displeased with being obliged to walk a-foot, or to endure the fatigue of riding on horseback. He sees his superiors carried about in machines, and imagines that in one of these he could travel with less inconveniency. He feels himself naturally indolent, and willing to serve himself with his own hands as little as possible; and judges, that a numerous retinue of servants would save him from a great deal of trouble. He thinks if he had attained all these, he would sit still contentedly, and be quiet, enjoying himself in the thought of the happiness and tranquillity of his situation. He is enchanted with the distant idea of this felicity. It appears in his fancy like the life of some superior rank of beings, and, in order to arrive at it, he devotes himself for ever to the pursuit of wealth and greatness. To obtain the conveniencies which these afford, he submits in the first year, nay in the first month of his application, to more fatigue of body and more uneasiness of mind than he could have suffered through the whole of his life from the want of them. He studies to distinguish himself in some laborious profession. With the most unrelenting industry he labours night and day to acquire talents superior to all his competitors. He endeavours next to bring those talents into public view, and with equal assiduity solicits every opportunity of employment. For this purpose he makes his court to all mankind; he serves those whom he hates, and is obsequious to those whom he despises. Through the whole of his life he pursues the idea of a certain artificial and elegant repose which he may never arrive at, for which he sacrifices a real tranquillity that is at all times in his power, and which, if in the extremity of old age he should at last attain to it, he will find to be in no respect preferable to that humble security and contentment which he had abandoned for it. It is then, in the last dregs of life, his body wasted with toil and diseases, his mind galled and ruffled by the memory of a thousand injuries and disappointments which he imagines he has met with from the injustice of his enemies, or from the perfidy and ingratitude of his friends, that he begins at last to find that wealth and greatness are mere trinkets of frivolous utility, no more adapted for procuring ease of body or tranquillity of mind than the tweezer-cases of the lover of toys; and like them too, more troublesome to the person who carries them about with him than all the advantages they can afford him are commodious. There is no other real difference between them, except that the conveniencies of the one are somewhat more observable than those of the other. The palaces, the gardens, the equipage, the retinue of the great, are objects of which the obvious conveniency strikes every body. They do not require that their masters should point out to us wherein consists their utility. Of our own accord we readily enter into it, and by sympathy enjoy and thereby applaud the satisfaction which they are fitted to afford him. But the curiosity of a tooth-pick, of an ear-picker, of a machine for cutting the nails, or of any other trinket of the same kind, is not so obvious Their conveniency may perhaps be equally great, but it is not so striking, and we do not so readily enter into the satisfaction of the man who possesses them. They are therefore less reasonable subjects of vanity than the magnificence of wealth and greatness; and in this consists the sole advantage of these last. They more effectually gratify that love of distinction so natural to man. To one who was to live alone in a desolate island it might be a matter of doubt, perhaps, whether a palace, or a collection of such small conveniencies as are commonly contained in a tweezer-case, would contribute most to his happiness and enjoyment. If he is to live in society, indeed, there can be no comparison, because in this, as in all other cases, we constantly pay more regard to the sentiments of the spectator, than to those of the person principally concerned, and consider rather how his situation will appear to other people, than how it will appear to himself. If we examine, however, why the spectator distinguishes with such admiration the condition of the rich and the great, we shall find that it is not so much upon account of the superior ease or pleasure which they are supposed to enjoy, as of the numberless artificial and elegant contrivances for promoting this ease or pleasure. He does not even imagine that they are really happier than other people: but he imagines that they possess more means of happiness. And it is the ingenious and artful adjustment of those means to the end for which they were intended, that is the principal source of his admiration. But in the languor of disease and the weariness of old age, the pleasures of the vain and empty distinctions of greatness disappear. To one, in this situation, they are no longer capable of recommending those toilsome pursuits in which they had formerly engaged him. In his heart he curses ambition, and vainly regrets the ease and the indolence of youth, pleasures which are fled for ever, and which he has foolishly sacrificed for what, when he has got it, can afford him no real satisfaction. In this miserable aspect does greatness appear to every man when reduced either by spleen or disease to observe with attention his own situation, and to consider what it is that is really wanting to his happiness. Power and riches appear then to be, what they are, enormous and operose machines contrived to produce a few trifling conveniencies to the body, consisting of springs the most nice and delicate, which must be kept in order with the most anxious attention, and which in spite of all our care are ready every moment to burst into pieces, and to crush in their ruins their unfortunate possessor. They are immense fabrics, which it requires the labour of a life to raise, which threaten every moment to overwhelm the person that dwells in them, and which while they stand, though they may save him from some smaller inconveniencies, can protect him from none of the severer inclemencies of the season. They keep off the summer shower, not the winter storm, but leave him always as much, and sometimes more exposed than before, to anxiety, to fear, and to sorrow; to diseases, to danger, and to death.

Barack Berry

2009-01-22T23:24:31Z

'Air and Simple Gifts' John Williams at Obama Inauguration

2009-01-21T06:20:08Z

Yo-Yo Ma , Itzhak Perlman , Anthony McGill & Gabriela Montero

Theres no one as Irish as Barack OBama- Corrigan Brothers

2009-01-21T05:28:46Z

"Air and Simple Gifts", composed by John Williams

2009-01-21T05:06:30Z

Yo-Yo Ma , Itzhak Perlman , Anthony McGill & Gabriela Montero at the Obama Inauguration

"Air and Simple Gifts", composed by John Williams

2009-01-21T05:05:08Z

Yo-Yo Ma , Itzhak Perlman , Anthony McGill & Gabriela Montero at the Obama Inauguration

KILL BANDITS!

2009-01-21T02:33:38Z

"Simple Gifts" was written by Elder Joseph

2009-01-21T00:17:53Z

Listen to Copeland here.

'Tis the gift to be simple, 'tis the gift to be free,

'Tis the gift to come down where you ought to be,

And when we find ourselves in the place just right,

'Twill be in the valley of love and delight.

When true simplicity is gain'd,

To bow and to bend we shan't be asham'd,

To turn, turn will be our delight,

Till by turning, turning we come round right.

We Are Back!

2009-01-20T15:09:04Z

Peace Is Patriotic.

2009-01-16T04:03:50Z

Interesting dream last night...

2009-01-12T05:49:34Z

I was laying on my back in my dream when I noticed an irregular heart beat. Was fluttering. Then I felt two electrical shocks in my chest and I thought, "Must be the pacemaker they just installed." My heart started beating normally after the shocks. Then I woke up. I could feel in my chest that it had just stopped fluttering and my chest was a little sore. I didnt think of it until after talking to Jean the next morning, but I created a circumstance within my dream to stop the irregular heart beat and the fiction of the pacemaker (which I really don't have), made my heart beat regular again.

I've done lucid dreaming on my own and also as a part of Tibetan initiations. It is remarkable what you can do in your dreams when you learn how to effect them.

NY TImes A 50-Year Farm Bill By WES JACKSON and WENDELL BERRY

2009-01-09T22:08:21Z

We've been reading these two guys in the Midwest for years. I am happy that they are getting Op-Eds in the New York Times. -- Lee

January 5, 2009

Op-Ed Contributors

A 50-Year Farm Bill

By WES JACKSON and WENDELL BERRY

THE extraordinary rainstorms last June caused catastrophic soil erosion in the grain lands of Iowa, where there were gullies 200 feet wide. But even worse damage is done over the long term under normal rainfall — by the little rills and sheets of erosion on incompletely covered or denuded cropland, and by various degradations resulting from industrial procedures and technologies alien to both agriculture and nature.

Soil that is used and abused in this way is as nonrenewable as (and far more valuable than) oil. Unlike oil, it has no technological substitute — and no powerful friends in the halls of government.

Agriculture has too often involved an insupportable abuse and waste of soil, ever since the first farmers took away the soil-saving cover and roots of perennial plants. Civilizations have destroyed themselves by destroying their farmland. This irremediable loss, never enough noticed, has been made worse by the huge monocultures and continuous soil-exposure of the agriculture we now practice.

To the problem of soil loss, the industrialization of agriculture has added pollution by toxic chemicals, now universally present in our farmlands and streams. Some of this toxicity is associated with the widely acclaimed method of minimum tillage. We should not poison our soils to save them.

Industrial agricultural has made our food supply entirely dependent on fossil fuels and, by substituting technological “solutions” for human work and care, has virtually destroyed the cultures of husbandry (imperfect as they may have been) once indigenous to family farms and farming neighborhoods.

Clearly, our present ways of agriculture are not sustainable, and so our food supply is not sustainable. We must restore ecological health to our agricultural landscapes, as well as economic and cultural stability to our rural communities.

For 50 or 60 years, we have let ourselves believe that as long as we have money we will have food. That is a mistake. If we continue our offenses against the land and the labor by which we are fed, the food supply will decline, and we will have a problem far more complex than the failure of our paper economy. The government will bring forth no food by providing hundreds of billons of dollars to the agribusiness corporations.

Any restorations will require, above all else, a substantial increase in the acreages of perennial plants. The most immediately practicable way of doing this is to go back to crop rotations that include hay, pasture and grazing animals.

But a more radical response is necessary if we are to keep eating and preserve our land at the same time. In fact, research in Canada, Australia, China and the United States over the last 30 years suggests that perennialization of the major grain crops like wheat, rice, sorghum and sunflowers can be developed in the foreseeable future. By increasing the use of mixtures of grain-bearing perennials, we can better protect the soil and substantially reduce greenhouse gases, fossil-fuel use and toxic pollution.

Carbon sequestration would increase, and the husbandry of water and soil nutrients would become much more efficient. And with an increase in the use of perennial plants and grazing animals would come more employment opportunities in agriculture — provided, of course, that farmers would be paid justly for their work and their goods.

Thoughtful farmers and consumers everywhere are already making many necessary changes in the production and marketing of food. But we also need a national agricultural policy that is based upon ecological principles. We need a 50-year farm bill that addresses forthrightly the problems of soil loss and degradation, toxic pollution, fossil-fuel dependency and the destruction of rural communities.

This is a political issue, certainly, but it far transcends the farm politics we are used to. It is an issue as close to every one of us as our own stomachs.

Wes Jackson is a plant geneticist and president of The Land Institute in Salina, Kan. Wendell Berry is a farmer and writer in Port Royal, Ky.

On Elephant Sanctuary, Unlikely Friends

2009-01-07T20:39:56Z

New Year's Okonomiyaki

2009-01-02T14:03:09Z

For a special occasion, I broke my low-carb routine and madeokonomiyaki (Japanese pancake) on New Years Day. The first time Ivisited Kazumi in Sakai, I noticed that her okonomiyaki was yellower.So I started doubling the eggs I put in to get a similar color.

Franken Is Winning!

2008-12-19T17:44:57Z

Recount is on life. Franken is winning!

http://www.startribune.com/video/?ls1=1?elr=KArksLckD8EQDUoaEyqyP4O:DW3ckUiD3aPc:_Yyc:aUycaEacyU

web posting test

2008-12-18T16:30:40Z

test

Brave Iraqi Reporter Speaks For Us All!

2008-12-15T03:45:33Z

Dog Hero!

2008-12-08T21:51:57Z

Ever Have One Of those Days?

2008-12-02T23:00:35Z

Lost Toolbag In Space

A Potter, In Mashiko, Japan

: Exploring the Concept of Single Payer

togeika @ 2009-04-07T20:29:00

Bamboo Things At Mashiko Hardware.

Kanjiro Kawai's Kiln Altars and my Daruma "Kiln God."

Hachiko Monogatari Movie Synopsis

Military-Industrial Complex Speech

Adam Smith The Theory of the Moral Sentiments 1759

Barack Berry

'Air and Simple Gifts' John Williams at Obama Inauguration

Theres no one as Irish as Barack OBama- Corrigan Brothers

"Air and Simple Gifts", composed by John Williams

"Air and Simple Gifts", composed by John Williams

KILL BANDITS!

"Simple Gifts" was written by Elder Joseph

We Are Back!

Peace Is Patriotic.

Interesting dream last night...

NY TImes A 50-Year Farm Bill By WES JACKSON and WENDELL BERRY

A 50-Year Farm Bill

On Elephant Sanctuary, Unlikely Friends

New Year's Okonomiyaki

Franken Is Winning!

web posting test

Brave Iraqi Reporter Speaks For Us All!

Dog Hero!

Ever Have One Of those Days?

A　Potter, In Mashiko, Japan