Let’s factor in personal responsibility to health insurance reform

For all the Republican backlash about “government intervention” in the health insurance industry (not health care- as the two have little in common)- how about we add in some new rules to cut health care costs considerably?

These comments from the ultra-conservative David Frum on the September 2nd American Public Radio show Marketplace are right on the money:

DAVID FRUM: How much does health care matter, really? The numbers suggest that for most of us individual behaviors matter more than anything doctors do.

The U.S. spends 60 percent more of national income on health care than the other advanced countries. Yet American life expectancy ranks below Italy’s and Portugal’s.

Let me suggest four simple actions to extend and improve American life and save hundreds of billions of dollars.

  1. Everybody wear a seatbelt. Even now, one-fifth of American motorists go unbelted. The National Highway and Traffic Safety Administration projects that more than 1,600 lives could be saved and more than 22,000 serious injuries prevented every year if Americans wore their seat belts as often as Germans and Brits do.
  2. Smokers: please quit. One-fifth of Americans currently smoke, and almost 9 million Americans suffer a smoking-related disease. We spend $75 billion per year treating those who will die from smoking. Those who live will incur costs of tens of billions more.
  3. Everybody lose weight. Obesity is not nearly as lethal as smoking, but its health consequences are much more costly — about one health dollar in nine for everything from type 2 diabetes to premature hip and joint disease.
  4. Above all: If you’re a woman of childbearing years, please: take extra care of yourself. Our infant mortality statistics are awful, worse than Cuba’s.

It’s these infant deaths that pull down American life expectancy overall. Once Americans reach 65, American life expectancy ranks a respectable 9th in the world.Why so many infant deaths? The shockingly high American incidence of premature birth: about one baby in eight. And the most important causes of premature birth are controllable: smoking during pregnancy, drinking, drugs, maternal overweight, and sexually transmitted diseases.

via Four simple steps to health care reform | Marketplace From American Public Media.

So if we were to put our money on us- as the right wing always wants to do, like fund our own retirements (of course by investing in stocks that can tank)- and manage our own health care (dictated by our employers and big firms)- lets put it on you:

In a motor vehicle accident and not wearing a seat belt, or on a motorcycle without proper safety equipment? No coverage- it shows a disrespect to the others in your health insurance group.

You smoke- no coverage for any smoking related issues – no coverage. It’s out of pocket, or suffer. You chose to smoke.

Diabetes and you’re overweight? No coverage until you lose weight. Obesity surgery- you’re on your own.

Have a preemie and you smoked, did drugs, were too fat etc- you pay the full load, or agree to sterilization to gain coverage.

Yes, let’s hear it for personal responsibility- it will solve all problems.

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23 Responses

  1. Robert Vigh September 9, 2009 / 1:04 pm
    I think we should all watch the Demolition man again, that is what this post makes me think about. Lets outlaw fast food and cussing.

    On a serious note, public options and programs by placing the financial burden across all of society always begin to bring the idea that “since you are on my dime, I get to limit your freedoms”.

    Dangerous water to tread in.

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  2. Larkin September 9, 2009 / 2:30 pm
    Honest to God, David, no one is going to elect you as long as you sport these kinds of dangerous, totalitarian notions. Please, man, think before you type! 
     
    I’d like to see local police respond to Failure to Yield. (Don’t even get me started on speeding through construction zones.) Everywhere you drive, you see people “merging” (barging) onto major streets from parking lots, driveways, side streets– as if the stop sign there is merely a suggestion. (Even a stoplight doesn’t make them pause if they’re turning right, and sometimes not even then. I’ve taken to looking left and right carefully before proceeding when the light turns green.)  
     
    People DIE because of these lousy driving habits. Why won’t law enforcement do anything about it?  Think of the income it would generate, and the money it would save in terms of lives and property damage.  We don’t even have to write new legislation, we just have to enforce the laws we have. 

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  3. David Esrati September 9, 2009 / 3:05 pm

    @Larkin- I just love it when people can’t quite tell I’m being sarcastic. This is my response to all who talk about how health care for others isn’t their problem, since they are fine. Or, that the system works. Or that the private sector has a solution.

    Although- I strongly believe in the motor vehicle safety parts- you are dumb enough to drive without a seatbelt or ride a motorcycle without a helmet- I think we should let Darwin run his course.

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  4. Larkin September 9, 2009 / 4:13 pm
    LOL, social darwinism. We comment on it daily it seems. 
     
    Don’t make the mistake of overestimating the intelligence of the electorate . . . though in this case, your sarcasm went over my head, Robert’s too, apparently. It’s probably best not to joke about taking away people’s freedoms (or choosing to exclude them from benefits based on their choices, even though THAT IS EXACTLY what PRIVATE HEALTH INSURANCE companies do right now.) as the right wing mob mentality already has visions of us lining up to sing “March of the Volunteers.” 
     
    How are things shaping up for Urban Nights?

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  5. John Ise September 9, 2009 / 4:27 pm
    Stats and more stats (from Salon.com)…

    Healthcare, American style
    We spend far more per person than other wealthy nations, but we’re less healthy. What’s wrong with this picture?
    By Gabriel Winant

    Sep. 08, 2009 |

    President Obama is set to address Congress to try to haul healthcare reform from the thicket it’s caught in. Presumably, he’ll seek to remind elected officials — and more important, perhaps, viewers at home — of just how bad it is out there, and how important it is that reform not be allowed to die yet again.

    As a reference guide for those watching the end stages of the president’s toughest fight, Salon has gathered some of the key statistics. Obviously, healthcare, and its associated economic and policy debates, have complexity far beyond what a list of statistics can show. Still, the following data, ranging from insurance coverage to public opinion to legislative politics to health outcomes, paint a fair picture of the state of medicine in America.

    Insurance coverage

    Americans insured through employer (2007): 159,311,384 (53.4 percent)
    Americans insured individually (2007): 14,541,782 (4.9 percent)
    Americans insured through Medicaid (2007): 39,296,423 (13.2 percent)
    Americans insured through Medicare (2007): 36,155,452 (12.1 percent)
    Americans otherwise on public insurance (2007): 3,253,122 (1.1 percent)
    Americans uninsured: 45,657,193 (15.3 percent)
    (Source: Kaiser Family Foundation)

    Americans uninsured at the time of President Clinton’s reform proposal: Approximately 37 million
    (Source: Fox News)

    Number of health insurance company mergers in past 13 years: Over 400
    Percentage of state health insurance markets that are “highly concentrated” under Department of Justice guidelines: 94
    Percentage increase in profits at 10 of the country’s largest insurers, 2000 to 2007: 428
    (Source: Health Care for Americans Now)

    Political landscape
    Democratic senators for a public option: 45
    Democratic senators against a public option: 1
    Democratic senators open to a deal: 13
    Vacancies: 1
    Republican senators against a public option: 38
    Republican senators for a public option: 0
    Republican senators open to a deal: 2
    (Sources: Open Left; Wall Street Journal)

    Percentage of poll respondents in favor of “President Obama’s plan to reform healthcare”: 48
    Percentage in opposition: 51
    Percentage who believe that problems with healthcare system “will eventually affect most Americans”: 65
    Percentage who think most Americans “will continue to get good care”: 32
    Percentage who would “feel more secure” with current healthcare system: 52
    Percentage who would “feel more secure” with President Obama’s proposal: 44
    Percentage in favor of “a public health insurance option administered by the federal government that would compete with plans offered by private health insurance companies”: 55
    Percentage opposed: 41
    (Source: CNN)

    Amount spent by the healthcare industry daily on lobbying: At least $1.4 million
    (Source: Washington Post)

    Health spending and outcomes
    Average health insurance premium for family coverage in 1999: $5,791
    Average health insurance premium for family coverage in 2008: $12,680
    (Source: Kaiser Family Foundation)

    National per capita spending on healthcare, 2007
    United States: $7,290
    Norway: $4,763
    Switzerland: $4,417
    Luxembourg: $4,162
    Canada: $3,895
    Austria: $3,761
    France: $3,601
    Germany: $3,588
    Netherlands: $3,527
    Belgium: $3,462
    OECD average: $2,964

    Life expectancy for these nations, 2006
    United States: 78.1
    Norway: 80.6
    Switzerland: 81.7
    Luxembourg: 79.4
    Canada: 80.7
    Austria: 79.9
    France: 80.7
    Germany: 79.8
    Netherlands: 79.8
    Belgium: 79.5

    Number of practicing physicians in these nations, per 1,000 people, 2007
    United States: 2.43
    Norway: 3.86
    Switzerland: 3.85
    Luxembourg: 2.87
    Canada: 2.18
    Austria: 3.75
    France: 3.37
    Germany: 3.50
    Netherlands: 3.93
    Belgium: 4.03

    Percentage of population classified as obese, 2006

    United States: 34.3
    Norway: 9.0 (2005)
    Switzerland: 8.1 (2007)
    Luxembourg: 20.4
    Canada: 15.4 (2007)
    Austria: 12.4
    France: 10.5
    Germany: 13.6 (2005)
    Netherlands: 11.3
    Belgium: 12.4 (2004)

    Diabetes deaths per 100,000 people, 2005

    United States: 20.3
    Norway: 10.1
    Switzerland: 10.8
    Luxembourg: 7.4
    Canada: 18.4 (2004)
    Austria: 27.1
    France: 10.9
    Germany: 16.2
    Netherlands: 15.8
    Belgium: 15.1 (1999)

    Cancer deaths per 100,000 people, 2005

    United States: 157.9
    Norway: 159.4
    Switzerland: 138.7
    Luxembourg: 153.9
    Canada: 169.0 (2004)
    Austria: 157.0
    France: 165.6
    Germany: 159.3
    Netherlands: 180.8
    Belgium: 183.2 (1999)

    Heart attack deaths per 100,000 people, 2005

    United States: 37.9
    Norway: 49.0
    Switzerland: N/A
    Luxembourg: 35.8
    Canada: 41.5 (2004)
    Austria: 44.1
    France: 21.4
    Germany: 46.3
    Netherlands: 41.0
    Belgium: 47.7 (1999)

    Infant mortality, deaths per 1,000 live births, 2006

    United States: 6.7
    Norway: 3.2
    Switzerland: 4.4
    Luxembourg: 2.5
    Canada: 5.0
    Austria: 3.6
    France: 3.8
    Germany: 3.8
    Netherlands: 4.4
    Belgium: 3.7

    (Source: Organisation for Economic Co-operation and Development)

    Amenable mortality rate, preventable deaths per 100,000 people, 2002-2003

    United States: 110
    Norway: 80
    Switzerland: N/A
    Luxembourg: N/A
    Canada: 77
    Austria: 84
    France: 65
    Germany: 90
    Netherlands: 82
    Belgium: N/A

    (Source: The Commonwealth Fund)

    Estimated number of deaths in the United States from lack of health insurance, 2006: 22,000

    (Source: The Urban Institute)

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  6. Larkin September 9, 2009 / 5:15 pm
    One of the best things I’ve seen on health care yet. (Check it out, it’s funny.)
     
    http://snipurl.com/rpqat   [www_funnyordie_com] 

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  7. Jeffrey September 9, 2009 / 8:36 pm
    Healthcare, American style
    We spend far more per person than other wealthy nations, but we’re less healthy. What’s wrong with this picture?

    What else would you expect? You have a large number of people who don’t live a healthy lifestyle. The diabetic who eats an extra large piece of cake knowing they can just up there insulin later. The heavyweight who gets the “Jazzy 511” so he or she can travel down the snack aisle and buy chips.

    People take the easy way out, face it. If given the option to take a pill (health care expense) or do some type of activity and it would solve ones problems most will take the pill. It is no wonder why healthcare, per capita is higher.

    I learned early on in life that you get nothing for free. Teachers didn’t give A’s because they liked you, you got an A, because you studied and busted your hump to get it. Neighbors didn’t give me money just because I didn’t have as much as the next kid. They gave me money when I came to collect for delivering the newspaper to there door. Now all of this has changed – People want something for nothing and there are people out there who are willing to give them something for nothing, but those giving don’t have enough to give so they want to take from others.

    Time to pay the piper – (here’s my rant) if you receive a government check and are physically able to work, put them to work. We should get some work out of them since they are employed by the government. A business wouldn’t pay someone for doing nothing? Want to sit at home and wait for the check to arrive, its not, if you’re not working. No jobs? I can look outside and see several jobs that can be done with nothing more than a trash bag and a broom. Drug test? You work for me, test negative get a check. You want FREE health care (we all know it’s not free)? Work for it if you are able.

    I have worked hard for what I have earned, nothing has been given to me. I guarantee, like many others, there will be a fight if someone tries to take it.

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  8. Larkin September 9, 2009 / 9:40 pm
    I wish you Jeffreys would identify yourselves, because one of you is brilliant and the other is, well, the less said the better,  and it would be nice to know which one is posting. 
     
    P.S. To whichever Jeffrey this is, some people don’t have to “bust their hump” for an A. They’re just that bright. 

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  9. Brilliant September 9, 2009 / 10:23 pm
    Thanks for the “brilliant” accolade. I like the tag so much I changed my name. I feel so much better about myself now. Your right some dont have to put in extra time or effort (bust their hump) to achieve an A in school. By your comments I assume you didnt have any problem getting an ‘A’, since you are so bright, (edited by publisher…)

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  10. David Esrati September 9, 2009 / 10:50 pm

    @Brilliant- standing rule- don’t call each other names-

    and- we may have to work something different- because we have too many “Jeff’s” on this site…

    stick with Brilliant and we’ll be fine.

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  11. Brilliant September 10, 2009 / 6:44 am
    Come on Dave, you edited that? What name calling? It was no more a suggestion than what Larkin used in “one of you is brilliant and the other is, well,”. It’s your blog and you run it how you will.

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  12. David Esrati September 10, 2009 / 10:34 am

    @Brilliant- look, I’m not perfect- and I’ve been considering installing a moderation package so you can moderate- but that requires signing in and accounts- etc.

    Just stick to calling me names please- and just embarrass other commentators with your brilliance.

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  13. Robert Vigh September 10, 2009 / 6:00 pm
    I agree with Brilliant. Only difference, Brilliant may be content with “get this check do this work”, while I am more of “you get nothing, go earn it, then I dont have to think about it”.

    Healthcare summary Hurdles:

    #1) Convince me it is ok to steal from one person to give to another.
    #2) Convince me that it is not economic disaster offering something for nothing.
    #3) Convince me it improves services and cost by lowering Supply and increasing Demand.
    #4) Convince me that is moral to take from producers, give to looters and waste a societies resources.
    Nationalized healthcare pretty much loses the philosophical, economical, ethical and moral debate.

    Larkin, I am making an assumption that you disagree, but why do so in that particular manner? Brilliant made a perfectly legitimate (emotional with logic) post about how one feels when they are taken advantage of. Let me summarize:

    Brilliant:
    I feel taken advantage of and I dont like it.
    Larkin:
    Shutup, you are worthless.
    Brilliant:
    Stolen from and told to shut up by the enabler, why you …… (Flag thrown by David, 10 yard penalty)

    Point being, try defending your position. I’ll go a few rounds and Ill even give you perceived advantage: I got alot of F’s in highschool.

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  14. David Esrati September 10, 2009 / 6:28 pm

    1) Robert- we’ve been stolen from to do much stupider things- like invade Iraq, bail out AIG and pay big bonuses to morons.

    2) Where are they saying offer health coverage for nothing? Everything I’ve read says you pay. Everyone pays- just like they do now- either with skyrocketing costs to cover the “uninsured”- or with less than adequate care.

    4) we give lousy health care on demand now- supposedly. You don’t seem to understand the idea that preventative health care is much cheaper than reactive.

    I’m not following you on #3- how are we “lowering supply” and “increasing demand”?

    and- last but not least- we could take all the paper pushers in insurance companies and give them jobs as nurses and doctors- we’d be much better off.

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  15. Gene September 10, 2009 / 6:37 pm
    The Thomas Hayden Church thing was funny, but the kept using the word free. They do not have free health care in Canada. Why do they keep saying that?

    Larkin, can you, the writer, define the word “free” as used in that video? How is it “free?”

    THC chews gum while drinking wine, you do the math.

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  16. Larkin September 10, 2009 / 10:04 pm
    I don’t know Gene. It was free when I lived there. Did we pay through the nose to Canada Revenue? Well, sure. 
     
    I didn’t say anything to “Brilliant.”  I just suggested that there are too many Jeffs on this board.  I think it’s useful to identify oneself expecially when you have strong opinions. My posts only carry my first name, but it does link to my blog. To be fair, I realize that one of the Jeffs links their posts to his blog and I guess that’s as good a way as any to tell them apart. Unless there are three. Or four. 
     
    I certainly didn’t tell anyone they were worthless (I’m far too liberal to ever do such a thing, just ask Gene) . . . but merely reminded the poster that not everyone struggles with achievement– and having words put in my mouth by others really isn’t appreciated, thanks all the same.  

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  17. Gene September 11, 2009 / 8:38 am
    well, if that is what you call free, then you must define “consensual sex” as “no, no, no, no, no, nooooooooooo” – only when you put in forty or fifty more “no”s then it has crossed the line.

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  18. Larkin September 11, 2009 / 12:14 pm
    Gene, would you say that your use of roadways is free? Would you say that public school is free? Would you consider that snow removal from the streets is free? What about military defense? Hiking in the National Forests? The streetlights that illuminate your block?
     
    If you want to take a position that none of these things are free because we pay taxes and the taxes support various public works, fine.  But none of those things have user based fees (though over the road truckers might argue that because diesel fuel is more highly taxed they pay a user based fee). You don’t have to pay each night when they turn on the lights. You don’t have to pay to stroll through Riverscape. You don’t have to pony up before the snowplow will come down your street. 
     
    Thus, too is the Canadian Health Care system. Canadian citizens contribute to the system though taxation. In my opinion they gat a better return for their investment than we do. Some truly socialized countries like Sweden pay an enormous amount of tax,but they also get enormous returns too.  Everyone in Canada is covered for health care, whether they make enough money to pay income tax, whether they are retired and no longer pay income tax.  
     
    God forbid you fell down in the street in Toronto with a heart attack or seizure, or because someone dropped a flower pot on your head from their balcony — or mauled by a grizzly bear — you would be treated for free too, having never contributed a dime to their health care system.  That’s free enough for me. 
     
     

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  19. Gene September 11, 2009 / 12:44 pm
    So then you can not define the word free, and evidently have no idea what the word free means. Free health care if I go to Canada, great, while 30 million people pay for me. Real free for those 30 million. You just are a typical liberal who defines words for your own benifit, and you certainly can’t do math. :)

    Free enough for you – ahh, what? My point is that the word free as it pertains to health care is the biggest lie ever said. I does not make sense. It should never be used. We need to understand (especially those who do not contribute to society) that things in life are never free, someone has to work for it. The welfare recipient can say he gets a free check, but go ask the workers down the street if it free to them.

    Call it what it is – socialism and high way robbery for the most part. Canada has a Stivers, why don’t you move there? And if I had a brain tumor I certainly rather be here than there……… a year on a waiting list is not my idea of free.

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  20. Larkin September 11, 2009 / 1:28 pm
    Actually Gene, as a former landed immigrant and a person with a guaranteed income (through retirement) I am welcome to return to Canada at any time, and I do consider it from time to time.  If I had a brain tumour, I would certainly go, as I have a neurological pre-existing condition here that prevents me from getting health insurance AT ANY PRICE.  So I can go to Canada and get treatment, or stay here and die . . .  Hm, which one I should I choose, I wonder . . . 
     
    As far as there being a Stivers there, well of course there are schools with performing arts curriculum. My concern was that Julian would be at a great disadvantage having had a less than stellar beginning in an American rural school. 
     
    You didn’t answer my questions. Do you consider your use of the roadways “free” ? Using your “logic,” its clear that you don’t. But that’s disingenuous. Most people would consider those things “free,” even if they are funded with tax dollars. The problem with you Gene is that when someone pokes holes in your flimsy arguments, you lash back with a bit of nastiness and personal attack. Of course I know what “free” is– and like every other word in the English language, it does not have a single concrete definition clear of nuance and intimation. You don’t change that by insulting me. 
     
     

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  21. Robert Vigh September 11, 2009 / 2:54 pm
    David:
    1) I certainly agree we waste plenty. However are you saying that stupidity is justification for more stupidity?
    2) People who cannot afford to pay will be paid for by people that can. Hence, a large portion will get something for nothing. Do you disagree?
    3) Paying for people that cannot pay will increase demand. Having a government regulated health insurance will undoubtedly lead to cost control, which will limit prices on procedures, which will limt supply of Medicine to market. Requires more economics then a quick blurb, but is true.
    4) I do not think our healthcare is lousy. I think it is a little overpriced, but I purchase what is adequate for me. Furthermore, studies have shown that preventative healthcare is often more expensive. By testing for everything, it drives costs up trying to identify illness that does not exist. The best preventative healthcare is actually the original article that you quoted.

    Larkin,

    Quote: I wish you Jeffreys would identify yourselves, because one of you is brilliant and the other is, well, the less said the better, and it would be nice to know which one is posting.
    Followed by Quote: I certainly didn’t tell anyone they were worthless

    I am pretty sure I infered safely your implication of worth about Brilliants post. You contained brilliant and a contrast to brilliance with acknowledgement of less would be better. So, you did not say worthless, you in effect said: not brilliant and stop writing (paraphrased to worthless). Larkin, this is a poor defense of position.

    I believe Gene answered your questions when he stated that “nothing is free”. As roadways, snow removal, forests, military all require the use of our tax dollars and has a cost associated with them. An anarcho-capitalist could give you a good argument for making all of those things private. As a constitutional capitist, I simply believe the military should be the primary government expenditure and that is it. Public schools, roadways, snow removal etc could easily be privatized and arguments made that they would improve in service and equality. But, each of those would require a proper look. Does this also mean that you expect the performance of socialized medicine to be as good as public education? Let us all hope not.

    You attack Gene’s logic, but there was no fallacy. However your primary argument is based on the performance of other forced programs that have not been established as right nor just. You are also comparing many things which are local to a national program. Your argument has a very shaky foundation.

    Lets shrink the argument. Lets say you have a brain condition and I do not. Why should I have to work harder to support you? How do you not become the master and I the slave? Services become free to the master on the backs of the slaves. This is how you define free, by taking the freedom of others it becomes free to you.

    You go right ahead and try to overcome the first 4 sentences of the preceding paragraph. Show me the logic!

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  22. Larkin September 11, 2009 / 4:40 pm
    Bob, you bore me. 

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  23. Gene September 11, 2009 / 7:42 pm
    Not sure how I insulted you (or personally attacked you )- how?, by calling you a typical liberal. If that is insulting to you then stop being a typical liberal. You are who you are, and it was not meant as an insult or attack. If someone is short and I say they are short it is not necessarily an insult. But I can see sometimes people take it as an insult – which is what a typical liberal does a lot, which is they think everything has some hidden meaning or is meant to be negative. It was not either, you are liberal, typical of most liberals, and don’t understand that “nothing is free.” I love you, but it really was not an insult, rather an observation.

    Roads are not free. I pay a tax, as do you. What is hard to understand about that? They are not free. Never have been, never will be.

    “Most people would consider those things “free,” even if they are funded with tax dollars.” Big Deal. Most people thought the world was flat, they were………. WRONG. Most people in the USA think Christianity is an older religion that Judaism, well, again, they would be………….. WRONG. What most people think is irrelevant for most arguments. Most people eat McDonald’s – therefore is it the best burger in the world? According to your liberal logic, yes. Funny, you hate McDonald’s.

    The “you bore me” to Bob is weak. You are a writer by trade, what you thought was funny or cute makes any arguments you had worthless. It is like you took your ball and went home bc you lost the game. Yes, I expect better from you bc you are better than that. If you don’t want to engage bc you don’t like what Bob says then that makes you either apathetic or weak, and when you say that “you bore me” it makes you seem like a quitter or a self important know-it-all. You can do better. I am not trying to be mean, but really, you are better than that.

    The response you should have had in regards to my “free” and “health care” situation should have been something like this: You are right. Health care is not and can not ever be free.

    You can want national health care. I have stated I want it, in some form, and I am willing to pay for it so long as I stop paying for things that we don’t need or really don’t use. But never will it be free. Plain and simple, and when a person says “free health care” I honestly think they are too dumb to have a say in this argument. It simply is not free nor will it be free. You know it and I know it.

    Just bc the English language allows for a little interpretation should not give people a false sense of what the truth is, which is it ain’t free, so don’t say it is…….. xoxo

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