The basic problem is that the American people have gotten used to high-tech, all-everything health care, under the illusion that they don't have to pay for it and that it's always better for them. Politicians are unwilling to force voters and donors to give up that sort of system, even the parts that are ineffective.

Sorta kinda close. But not quite.

The "basic problem" of health care costs is that the consumer is not the customer. The consumer's employer, or the government, is the customer. Our current private system, a "temporary" and "emergency" schizophrenic tax scheme dating back to World War II, has created a foggy maze in which the consumer simply cannot make informed decisions — because the information required to make those decisions is muddled, obfuscated or downright withheld from them.

Under such a system (which, incidentally, is also the proximate cause of our inflated "number of uninsured" statistics), is it any wonder that, as Brooks puts it, "the American people have gotten used to high-tech, all-everything health care, under the illusion that they don't have to pay for it"?

But where Brooks falls short is the innuendo that the "illusion" is somehow the American people's fault. It is not. It is the result of a 60-year government policy of disrupting and complicating what really should be a very simple business.

No health care socialist I'm familiar with is willing even to acknowledge, let alone attempt to answer, this very simple question: Why do we have these cost-driven problems in health insurance — and only in health insurance?

There is no inflation crisis in automobile insurance, or homeowners insurance, or life insurance. Other insurance industries may be regulated (that's another blogpost), but they are still basically private. The consumer is also the customer — and the providers compete for their business — directly and fiercely (how long can you go before seeing a car insurance commercial on television?).

If we were to scrap the absurd system of making health insurance tax-advantaged for employers but not employees (i.e., either tax it all equally, or exempt it all equally), then employers would exit the "health insurance middleman" business (which, incidentally, would lower their human resources cost — which in turn means higher wages, lower prices and higher profits). Employees, armed with larger paychecks and smaller benefits packages, would become not only the consumer but also the customer — and would be directly courted by the health insurers. And the same kind of intense price and service competition that we see in the "GEICO v. Allstate v. Progressive" wars would also take place in health insurance.

To a health care socialist, the only viable response to this proposal is, "Oh the horror!"

There's more to the story, of course: Medicare, ER open-door rules, legacy costs of existing programs and other entanglements would also have to be addressed. Point conceded.

But the core debate will continue to be futile, "angels on the head of a pin" parlor room (and committee chamber) chit-chat unless and until the root cause of the "basic problem" — the entirely artificial and entirely unnecessary government-spawned dichotomy between "consumer" and "customer" that underlies our failing health care leviathan — is at least on the agenda, if not at the top of it.

If the first step is admitting you have a problem, then surely the second step is figuring out what the problem actually is. Especially the "basic" problem.

Previously:
–Socialized Medicine Archive

I once countered, in a throwaway post, that even government-run lotteries are technically an affront to liberty because a government-run lottery would crowd out private lotteries. People who want to go into the lottery business have a natural right to do so without having to compete with the government.

Guess I shouldn't have thrown that post away after all:

In a White House news conference, Mr. Obama dismissed as "not logical" the suggestion that a public plan, which is intended to create more competition and therefore act as a brake on the rise of health insurance costs, would undermine the private insurance market.
…
He brushed aside concerns that a government plan would drive private insurers out of business.

"If private insurers say that the marketplace provides the best quality health care, if they tell us that they're offering a good deal, then why is it that the government — which they say can't run anything — suddenly is going to drive them out of business?" Mr. Obama said. "That's not logical."

Not logical?

The federal government is, by definition, exempt from federal business taxes. (Is it "logical" to speak of the government taxing itself?)

The federal government can, and often does, exempt itself from most federal (and all state) business regulations.

The federal government can, and often does, acquire property (e.g., for office buildings) via eminent domain, wherever it likes, for whatever price it chooses to pay.

And, most importantly, the federal government can, and often always does, run operating deficits ad infinitum via its unique ability to borrow unimaginable sums of money, at uniquely favorable terms.

But, according to the president, to suggest, despite all this, that a government-run health care insurance option would not cripple — perhaps outright destroy — the private companies trying to compete with it is "not logical"?

President Obama is either a liar or an idiot. And he's not an idiot.

(Via F.E.E. Blog.)

This is ugly business. They’re quoting a doctor who specializes in pancreatic and gastrointestinal surgery as saying (1) that it’s common for someone who had the cancer Jobs had to subsequently get cancer in their liver; (2) that liver transplants are not proven to help in such cases; and (3) obtaining a liver transplant in such cases is therefore controversial because it's taking a liver that could otherwise have been put to better use by someone with some other type of liver ailment. There is no other way to read this than as an implication that Steve Jobs may have gotten a liver that should have gone to someone else.

"This is ugly business." By which we mean:

–That there are not now, nor will there ever be, enough livers for everybody?

–That this will always be the case, no matter how much money, especially other people's money, is thrown at the problem?

–That choices therefore have to be made, and that health care resources therefore have to be rationed — just like every other good and service throughout the rest of the economy?

–That the only real question is therefore who gets to make the choices, for whom, and by what standard?

I guess economics is not only the dismal science, but also the ugly science too.

Via Kevin, MD.

And what, exactly, is the "it" that Ms. Kelley "unfairly" can't take advantage of now?

The Obama administration rushed to include a health care safety net for laid-off workers in the recently signed stimulus bill, but has not told employers exactly how to make it work.

As a result, tens of thousands of jobless people could wait months before getting help paying for health insurance that their employers previously had covered.
…
Employers are waiting for instructions from the Labor Department and the Internal Revenue Service on how to put the program into place. Both agencies posted some information online Thursday.

Until employers get the guidance they need and notify potentially eligible ex-employees, most workers will not apply for the new benefit. Many probably will not know it exists.
…
An IRS spokesman said the agency is moving as fast as it can.

Put aside the precedent questions of whether COBRA subsidies are a legitimate function of government (or, for that matter, whether COBRA itself is even constitutional). Put aside the question of whether it's fair to require employers to bear the added costs of trying to track down former employees, calculate their new entitlements and administer an entire new benefit regime for them.

Just focus for a moment on Ms. Kelley. She brings an understandable sense of urgency to the issue as a result of her financial situation and lengthy litany of ailments. Point conceded. But does she also get to hurl such an indignant attitude back at those trying to help her (with other people's money, of course)?

This is an entirely new entitlement, requiring an entirely new bureaucratic apparatus impacting multiple government departments, and an entirely new administrative burden on private employers. President Obama signed the stimulus package a mere 12 days ago.

And what does Ms. Kelley have to say about it? Not "thank you." But "it's totally unfair."

This is the entitlement mentality: Be offered an inch, demand a yard. Receive an entitlement, demand that it be immediately increased. Receive an increase, complain that it's all happening too slow. Too much is never enough.

Here's another quote(*) of the day — or of a somewhat longer period:

A democracy cannot exist as a permanent form of government. It can only exist until the voters discover that they can vote themselves money from the Public Treasury. From that moment on, the majority always votes for the candidate promising the most benefits from the Public Treasury with the result that a democracy always collapses over loose fiscal policy always followed by dictatorship.

The passage goes on to note that the average duration of great civilizations has been around 200 years. The Framers had hoped to exceed that limit precisely by not exceeding the limits of legitimate government in the first place, and by trying to ensure that their new nation would not be a true (i.e., mob-controlled) democracy.

As Ms. Kelley so succinctly notes: in more ways than one, Americans are living not just on borrowed money but also on borrowed time.

Full Disclosure: I myself will likely qualify for this program, and unapologetically intend to take full advantage of it. Accepting a modest entitlement clawback, after paying well over $400,000 in federal taxes over the past ten years, is hardly hypocritical. I have never considered martyrdom to be a libertarian virtue.

Which raises the entirely understandable question, the legacy of Buck v. Bell notwithstanding, of what if anything the government can or ought do about her.

Some observers, for instance, have no problem whatsoever with a Holmesian tax-based eugenics solution:

On the Internet, bloggers rained insults on Suleman, calling her an "idiot," criticizing her decision to have more children when she couldn't afford the ones she had, and suggesting she be sterilized.

"It's my opinion that a woman's right to reproduce should be limited to a number which the parents can pay for," Charles Murray [not the American Enterprise Institute scholar] wrote in a letter to the Los Angeles Daily News. "Why should my wife and I, as taxpayers, pay child support for 14 Suleman kids?"

That reasoning almost sounds downright libertarian — there is never a right to mooch off others, and a child is hardly a legitimate "public good" warranting government financing.

But the Cato Institute's Michael Cannon stands athwart:

Those responses are a predictable consequence of government charity. They reflect the same selfish rationale that the Church of Universal Coverage uses to argue for eliminating your right to choose health insurance. If somebody is abusing generosity, the appropriate response is not to take away their rights but to take away the generosity.

I'm sympathetic to Cannon's point, but I don't think socialized medicine is the best analogy.

The problem with socialized medicine is precisely that it is not "generosity." A person who pays Medicare and other taxes over an entire working career and then tries to recoup those extractions via government health care is hardly the recipient of "generosity" (cf., my flagship post on the subject).

The better analogy for Suleman isn't Medicare but Medicaid, which is the truly "generous" (i.e., humane, classical liberal) safety net program. There is no contradiction whatsoever in simultaneously demanding that Medicare have relatively few restrictions but that Medicaid can have far more, since only the latter can truly be called "generous."

A key component of the obfuscation machine undergirding the entitlement state is the relentless quest to confuse a truly social safety net and omnipresent government control for its own sake, a/k/a Kip's Law. Libertarians must be ever vigilant and avoid getting lost in the fog of "who pays for whom."

—

Going back to Suleman, there is another basis for government intervention in her case, one that is truly libertarian: protecting the rights of the children.

One more time: Children are not chattel, and there is no such thing — even in Libertopia — as a plenary right to raise children in a negligent, dangerous or unhealthy manner or environment. Libertarianism is all about protecting rights, especially rights that one cannot defend oneself. Surely that extends to rescuing children from incompetent, dangerous or abusive parents.

The devil is undeniably in the details — what, exactly, constitutes "negligent, dangerous or unhealthy"? Tough question. No dispute there.

But there are certain easy cases, certain asymptotic extremes that, when viewed properly, prove not only the viability but the exclusive viability of the "kiddie libertarianism" model of governemnt interventionism in childrearing.

Banning (medically unnecessary) infant circumcision, which no true libertarian can rationally oppose, is one example. Rescuing the FLDS/YFZ children from their incestuous, psychopathic custodians was another.

And, yes, the Octo-Bimbo is, sadly, yet another.

Previously:
–Children's Rights versus Parents' Rights: Case Studies

Since it was created more than 10 years ago, the Children's Health Insurance Program has been a lifeline for millions of children whose parents work full time and don't qualify for Medicaid, but through no fault of their own don't have — and can't afford — private insurance. For millions of children who fall into that gap, CHIP has provided care when they're sick and preventive services to help them stay well. This legislation will allow us to continue and build on these successes.

Of course, even if one takes as a given that it is either proper or moral to do good works with funds you seize from others by force, the subsequent question still remains: If there is a "Medicaid gap," then why not just expand Medicaid? Why establish an entirely new entitlement and bureaucracy?

The answer of course is one of perception, and delusion. SCHIP is packaged and marketed as a middle-class entitlement. Lower middle class, perhaps, but middle class nonetheless.

Medicaid, on the other hand, is the dole. And the Prime Taboo of Politics is that no middle class entitlement must ever be allowed to hint of being the dole (cf., Social Security).

So instead of the simple and straightforward approach — expand Medicaid — the politicians craft an entire new middle class entitlement, that it can expand without any fear of stigma from those voters whose support the politicians are trying to buy.

I exposed this fraudulent packaging of SCHIP expansion back in September 2007:

—

No wonder class warriors such as John Edwards and Barack Obama are so incensed. Just look at the absolute squalor now spreading across America:

Lori and Steven Siravo earn $56,000 a year and say they can't afford health insurance.

They consider themselves lucky to live in New Jersey, where the family's income isn't too high to qualify their 16-year-old daughter, Carlie, for U.S. government-subsidized coverage under the State Children's Health Insurance Program.
…
Steven, 49, drives a Chevrolet Caprice Classic that's almost 20 years old, and she drives a 5-year-old Chevy Monte Carlo. The above-ground pool out back is 17 years old, bought when "we had money" before Carlie was born, Lori said.

The one luxury is a full-size pinball machine Steven bought for his wife on her 40th birthday.

The family's monthly bills consume most of their take-home income. Pulling out her checkbook, Lori said there's the mortgage ($1,500), utilities ($743), phones and Internet service ($200), car insurance and gasoline ($205), property taxes ($230), basic cable television ($48), food ($600) and credit-card payments ($325) on an outstanding $11,000 balance. That's $46,212 a year, not including clothes, school books and extra-curricular activities for Carlie.
…
There's also $352 a month on a home-equity loan the Siravos took out to send Carlie to a private Catholic high school.

Read that again: Apparently "poverty in America" now means having "only" two cars, "only" basic cable, "only" an above-ground pool and "only" a private education. Oh, and "only" one pinball machine.

If that's your (deprived) lifestyle, then you are, to SCHIP apologists, "poor" and in need of health insurance welfare underwritten by other people's taxes.

This is what Democrats decry as "poverty in America." These are the people to whom President Bush is being "cruel" by threatening a veto of SCHIP expansion. These are the miserable, contemptible, utterly hopeless forty-something whiner-brats who lay claim to other people's income, insisting that — their words — "life is stressful enough without worrying about your health."

Or, apparently, worrying about being middle-class leeches on other taxpayers.

Just to be clear, this family is not "uninsurable." They have access to typical, ordinary private health insurance. They choose, however, to opt — immorally if not irrationally — to enroll in SCHIP for less than one-third the cost of private, middle-class health insurance. Behold "enlightened" socialized medicine schemes — corrupting otherwise reasonable people into becoming welfare bums.

Madness. Sheer madness.

—

Back to the present, Tax Policy Blog explains how the SCHIP expansion: (1) entices families who do in fact have private health insurance to abandon it for "not the dole" government health insurance, and (2) reflects a unapologetically broken campaign promise by President Obama not to raise taxes on anyone making under $250,000 per year. "Change we can believe in"?

Previously:
–Should We Worry About SCHIP Mission Creep?
–Is SCHIP Analogous to Public Schools?

Reduce and eliminate health disparities? How about we eliminate gay, lesbian and bisexual behavior? Perhaps the Department of Health, Governor and Legislature should create strategies to reduce the number of gays, lesbians and bisexuals. That would solve this health crisis.

But don't you dare call him a "bigot," right?

The basis for Dr. Swier's prescription — let's call it "Operation Gas Chamber" — is a report prepared for the government of Massachusetts titled, "A Health Profile of Massachusetts Adults by Sexual Orientation Identity" (PDF – 30 pages). From the summary:

A growing body of research indicates that health disparities exist between gay/lesbian/bisexuals and heterosexuals. For the first time, population-based estimates of sexual orientation differences in adult health are available in the Commonwealth of Massachusetts. … Most (97.1%) self-identified as heterosexual or straight, while 1.9% identified as gay, lesbian or homosexual, and 1.0% as bisexual.

Results suggest that sexual orientation differences exist with respect to access to health care, overall health status, cancer screening, chronic health conditions, mental health, substance use including tobacco smoking, sexual health, and violence victimization. While gay/lesbian/homosexual adults evidenced poorer health and greater risk than straight/heterosexuals across several health domains, poorer health was observed most often for bisexuals.

The health profile of gay/lesbian/homosexual residents was poorer than that of heterosexual/straight residents on: self-reported health; disability-related activity limitation; asthma; current and past tobacco smoking; anxious mood; 30-day binge drinking and substance use; and lifetime sexual assault victimization.

I'm not sure what the connection is, if any, between sexual orientation and asthma. But I'm sure Dr. Swier can concoct one if he tries hard enough.

But let's look at some of the other findings. First and foremost, Dr. Swier obviously didn't read past the report's summary, because he neglects to mention that almost all the differences between straights and gays are not statistically significant. Details, details…

Gays, we are told, have less access to health care (but, again, not by a statistically significant amount). What exactly does that have to do with "lifestyle choices"? I can imagine a gay, lesbian or bisexual having inferior access to health care because they've been disowned by their family. Or because they're unemployed, underemployed or self-employed due to discrimination in the workforce. Or because they're not welcome at hospitals or clinics run by religious charities. In any case, what bizarre leap of logic enables a physician to conclude that less access to health care is the patient's fault?

As for cancer screening, I hope neither you nor Dr. Swier jumped to any conclusions when you read that "differences exist," because actually the statistical difference is in the other direction: Gay men are more likely to screen for colorectal cancer than straight men and lesbians are more likely to have regular mammographies than straight women. Go figure.

Same for sexual health: The report finds that gays, lesbians and bisexuals are far more likely than heterosexuals to practice safe sex and get regularly tested for HIV. This is a damnable behavior — how?

Lastly, is Dr. Swier really suggesting that gays should be blamed for the fact that they are more likely to encounter "violent victimization"? (Note: The difference was only statistically significant for random violence; there is no statistically significant difference regarding domestic violence.)

Let us now turn to the true point of Dr. Swier's post: The notion that gays, lesbians and bisexuals "lead unhealthy lifestyles." Gays smoke more, binge drink more, are more likely to engage in substance abuse, etc. Moreover, gays must be doing something wrong, since they are more likely than straights to self-report their health as "poor" or "fair."

But as Jacob Riis demonstrated over a century ago, doesn't this reverse cause and effect? Are gays to be stigmatized because some lead such failed lives, or do some lead such failed lives because they are stigmatized?

If you are told, almost from the day you are born, that you are "wrong" or "defective" or "sick" or "sinful," then you are of course more likely to believe it, and therefore more likely to drown your problems in a self-destructive pit of tobacco, alcohol, drugs and meaningless sex. Anything to make the pain go away (and anything means anything — up to and including suicide).

If you spend every waking moment in a society that portrays an ideal that is in many respects unavailable to you, where almost every television show, movie, novel, advertisement is "not you," wouldn't you be even a little bit lore likely to suffer from mental health issues, or to have your overall health deteriorate to "fair" or even "poor" status?

(And did I mention that this is Massachusetts, the state most infected with the worst font of systematic anti-gay bigotry ever conceived — the Roman Catholic Church? Goodridge notwithstanding, living in Massachusetts can't be all that much fun for gays.)

One more statistical note: For whatever reason, the group that does show bona fide statistical differences in this study is not gay men and not lesbians, but bisexuals. I don't know what the explanation is for that (and Dr. Swier was of course too busy calling for Operation Gas Chamber to address the question either). Perhaps it's just the "Other Half" phenomenon escalated. Perhaps being caught between the "right" world and the "sick" world is the most stressful situation of all.

Via InterstateQ.

—

I have forwarded a link to Dr. Swier's vile, intellectually sloppy post to the authors of the study — at least one of whom is openly gay. I will update this post if they respond to my email. Meanwhile, here's a special Kip Clip:

Previously:
–"Libertarian" Professor: Gays "Poor Planners with Risky Lifestyles"
–Hoppe's Non-Apology for Anti-Gay Remarks

That's right — Both are scarce goods and must therefore be rationed:

With about 55,000 requests for fewer than 400 tickets to Barack Obama's inauguration, Sen. Benjamin L. Cardin's staff says he has no choice but to dispense them in a random drawing. Sen. Barbara A. Mikulski, a fellow Maryland Democrat with 35,000 inquiries of her own, made the same decision. So did Del. Eleanor Holmes Norton (D-D.C.), who has logged more than 10,000 calls. Rep. James P. Moran Jr. (D) of Northern Virginia is taking a first-come, first-served approach.

You mean that there is no such thing as a "right to an inauguration ticket"? That all the warm-fuzzy-feeling do-goodism of all the politicians in Washington can't repeal the laws of economics? Go figure.

Just don't try to do the figuring on eBay, which has banned the sale of inauguration tickets:

This is a major civic event of the time, and no one pays for their tickets, and we believe no one should be required to pay for their tickets.

That from Dianne Feinstein, the Congressional overseer of the event.

I guess eBay and Feinstein are borrowing a page from the organ donation playbook: Better to "preserve the dignity" of the event than to actually get the tickets to those who want to attend it the most (as reflected by their willingness to pay for the privilege) — just as it's supposedly better to "preserve the dignity" of competent consenting adults who might be perfectly willing to sell their organs at a profit than the alternative of, um, saving lives. (And if "dignity" is really the issue, then why not auction off the tickets, with the proceeds going to some "dignity-raising" charity? Or, just a thought, use the money to pay down the federal debt?)

To say that some things, like inauguration tickets or health care, are "too important" or "too solemn" or "too dignified" to leave to unfettered markets is all well and good. But that does not exempt the self-congratulatory who would "rise above cold and cruel capitalism" from the acknowledgement that some alternative system of rationing is always unavoidable.

Whether it's government-rationed inauguration tickets or government-rationed health care: Somebody will be deprived — and the deprivation will be on somebody's conscience.

(Via Perfect Substitute.)

Previously:
–New York May Repeal Scalping Laws

I'm sure opponents will dust off the same old slogans they have used to try to block every major advance in health care. They will call it "socialized medicine" and a "government takeover," just as they did when they opposed Medicare and the children's health program — and they are just as wrong today as they were then. Such advances are no more "socialized medicine" than is the coverage available to George W. Bush, Dick Cheney and every member of Congress, subsidized by the American taxpayer.

First of all, note the insolence of calling governmental mission creep in socialized medicine — oops, sorry, "not at all socialized medicine" — a "major advance in health care." Where I come from, statins are a major advance in health care, vaccines are a major advance in health care, oral insulin is a major advance in health care, female surgeons are a major advance in health care. Bureaucratic command-and-control may be desirable (as if); it may be undesirable but inevitable; but it is certainly not "a major advance in health care."

More importantly, what's up with that asinine cheap shot about the health care that President Bush and Vice President Cheney receive coincident with their public office? Is Kennedy suggesting, via his irrelevant outliers, that government employees should not be covered by health insurance? Or is he just being an obnoxious jerk?

In reality, this nonsense illustrates an important point about the debate over socialized medicine — oops, sorry, "not at all socialized medicine" — namely the lie that our current system is "private" and that the supposed "failures" of our system are therefore the failures of the "private" market.

The first part of the lie, the part that is not the point of this post, is that it ignores the pesky fact that much, essentially all, of our current woes derive from government disruption of the private market, mostly through the tax code. This was the point John McCain tried, poorly, to make during the campaign: health care expenses, either direct or via insurance premiums, should either be tax deductible (or tax exempt) or they shouldn't. If they should, then they should be tax deductible (or tax exempt) regardless of who pays for it — the employer or the employee.

The second part of the lie, the part that Kennedy inadvertently highlights, is the role of government, qua employer, as a direct participant in health care and insurance: government employees

• military and civilian
• current and retired
• employees, spouses and dependents
• federal, state and local

are all already outside the private health care sector simply by being outside the private employment sector.

Tens of millions of Americans already get their health coverage from the government — even before Medicare, Medicaid, public hospitals and other interventions, all the way down to the school nurse. But still the advocates of socialized medicine — oops, sorry, "not at all socialized medicine" — insist that the current is exclusively the failure and fault of the private sector. Somehow.

If you want to argue, as a progressive or even as a classical liberal, that the faultless incompetent in our society should enjoy taxpayer-funded health care as part of a humane social safety net, then fine. But don't kvetch about how a government employee — even the president (or for that matter the senator-turned-president-elect) — gets health coverage courtesy of taxpayers. That is an obfuscatory non sequitur of the highest order.

But I'm changing tack after having read the whole piece:

More than 90 percent of nursing homes were cited for violations of federal health and safety standards last year, and for-profit homes were more likely to have problems than other types of nursing homes, federal investigators say in a report issued on Monday.

Gee, typical "greedy capitalist bastard" behavior, right? Well of course the government-run nursing homes are going to be so much better than the private facilities — just like public schools are so much better than private schools.

Reading a little further down:

The inspector general said 94 percent of for-profit nursing homes were cited for deficiencies last year, compared with 88 percent of nonprofit homes and 91 percent of government homes.

I certainly concede the arithmetic that "94 percent" is greater than "91 percent." What I do not concede, however, is that a three percentage point differential is significant. Stated differently, hyping the margin of error in your first sentence is dubious journalism at best and agenda-driven muckraking at worst.

More:

Problems included infected bedsores, medication mix-ups, poor nutrition, and abuse and neglect of patients.

Statistically speaking, a violation is a violation, without any distinction for differing magnitudes. But who would seriously suggest that a stray bedsore is no different than a case of abuse?

Bruce A. Yarwood, president of the American Health Care Association, a trade group, said … that the inspection system was broken. "It does not reliably measure quality," he said. "It does not create any positive incentives."
…
Mr. Yarwood said: "Inspectors are subjective and inconsistent. They interpret federal standards in different ways."

That wouldn't surprise me at all.

(Note also that the 94/88/91 metrics treat a facility with one violation no different statistically from a facility with 100 violations: those ratios are also nearly equal at 7.6/5.7/6.3. Bottom line: The data are not particularly robust except as fodder for a cheap shot at private enterprise.)

According to the article, there are already 1.5 million Americans living in 15,000 nursing homes (not including assisted living facilities). That number will only rise as the baby boom ages. Medicare and Medicaid cover more than two-thirds of them, at a cost to taxpayers of $75 billion per year. Those numbers will also only rise.

Something to ponder in between news reports about the ($700 billion) Wall Street bailout scramble.