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Republican Healthcare Plan Fails the ‘Jimmy Kimmel Test’
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This week the Senate Republican leadership unveiled its Obamacare replacement plan. Like its House counterpart, the misnamed Senate plan retains most of Obamacare’s core features.

Both the House and Senate plans allow states to obtain waivers providing relief from some Obamacare mandates, although the waivers in both bills are too restrictive to be of much value. For example, the Senate’s bill does not allow states to have waived two of Obamacare’s most destructive mandates — guaranteed issue and community ratings.

The healthcare debate is dominated by emotional rhetoric about how government-run healthcare is necessary to protect the vulnerable. For example, in May, Jimmy Kimmel Live host Jimmy Kimmel delivered a touching monologue about his newborn son’s open-heart surgery. Mr. Kimmel ended his monologue with a plea to retain Obamacare so all children can obtain life-saving treatment. After the monologue became a national sensation, many suggested that any Obamacare replacement plan be judged by a “Jimmy Kimmel test.”

Every decent human being supports a healthcare system that ensures children have access to medical care. However, this does not mean every decent person should support government-run healthcare. In fact decent people should oppose all forms of nationalized medicine.

Government intervention in healthcare distorts the marketplace with mandates, subsidies, and price controls. As is the case with any goods or services, price controls in healthcare result in shortages and even price increases as providers look for ways to offset their losses caused by the controls. This is why many Americans have seen their health insurance premiums skyrocket under Obamacare.

Government-run healthcare can be deadly. Anyone who doubts this should consider the case of Laura Hillier, an 18 year-old Canadian who passed away from leukemia while on a government medical treatment wait list. This is one of many horror stories from Canada, and other countries with nationalized healthcare, of individuals who died while waiting for their turn to receive medical treatment.

One need not look to Canada to find casualties of government intervention in healthcare. In 2013 Sarah Murnaghan, a ten-year-old cystic fibrosis patient, almost died because of federal rules forbidding children her age from receiving organ transplants. Public outcry eventually forced the government to allow Sarah to receive the transplant, but how many Sarahs have died because of government organ transplant rules?

The Jimmy Kimmel test is a valid way to evaluate healthcare proposals. However, there should also be a Laura Hillier or Sarah Murnaghan test forbidding adoption of a new healthcare system that increases healthcare costs, creates healthcare shortages, or allows government to deny anyone access to healthcare.

The free market meets all these tests. In a free market, doctors voluntarily donate their time to help those in need, while private charities and churches fund charity hospitals and clinics. Such a system flourished in the days before Medicaid and Medicare, and would quickly return if the welfare state is eliminated.

Congress should be working to repeal all federal interference in healthcare, including by shutting down the Food and Drug Administration (FDA). The FDA raises the cost of medicine, denies Americans access to effective treatments, and prevents individuals from learning about cost-effective ways to improve their health.

Unfortunately, a Congress that so quickly abandons its promise to repeal and replace Obamacare will not restore free-market healthcare — or otherwise reduce the welfare-warfare state — unless forced to do so by an economic crisis or demands from a critical mass of pro-liberty Americans.

(Republished from The Ron Paul Institute by permission of author or representative)
 
• Category: Ideology • Tags: Health Care, Obamacare, Republican Party 
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  1. Cyrano says:

    To use an example of a Canadian dying while on a waiting list for treatment for leukemia as proof that the Canadian Health Care system is inferior is laughable. Even the best health care systems in the world can’t save every patient. Most of the civilized world has government run health care systems. That’s the only way to go.

    The US thinks that they have a better idea. They want to find a way where in providing health care to their citizens someone gets to make money. You see, not everything is about capitalism. Health care is not about making money. It’s about saving people’s lives.

    In the civilized world, no one profits from the health care. People pay taxes and the government runs the health care. In the US they simply loath the idea to let a fine capitalist enterprises such as the insurance companies go out of business. That’s why their health care is 3 times more expensive than any other 1st world country and 3 times worse than any of them.

    Read More
    • Replies: @jtgw
    You might be interested in this:

    https://randomcriticalanalysis.wordpress.com/2016/11/06/us-life-expectancy-is-below-naive-expectations-mostly-because-it-economically-outperforms/
    , @Chris Mallory
    Here are the wait times for surgery in 2016, in Canada:
    Wait times (in weeks) by procedure in 2016:

    Plastic surgery: 25.9
    Gynecology: 18.8
    Ophthalmology: 28.5
    Otolaryngology: 22.7
    General surgery: 12.1
    Neurosurgery: 46.9
    Orthopedic surgery: 38.0
    Cardiovascular: 8.4
    Urology: 16.2
    Internal Medicine: 12.9
    Radiation Oncology: 4.1
    Medical Oncology: 3.7

    I had two general surgeries last year here in the US, both took place in under a week.

    Several years ago, I had my gall bladder taken out. It was done next day. Talking to a person from Canada with the same problem, their wait was 3 months.
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  2. Adam S1 says:

    The “free market” wants me dead.

    First the free market has decided that a mid-50 year old with a good engineering degree had to be kicked out of a job he did well in favor for 20-somethings from overseas who will work cheaper.

    Next, the free market said I had to pay incredible amounts for health-insurance. Igoring what I had already paid for decades, the free market decided that my next insurance policy had to have premiums so high that they would cover the costs of all the health care that a mid-50s person with pre-existing conditions would likely incur. Which meant is was unaffordable.

    The only reason I am alive today is the Expanded Medicaid part of Obamacare … which happens to be the one part that has been popular, while the psuedo-free-market parts that benefit big insurance corps have been very unpopular.

    So, the message to me from Republicans right now is simply …. “DROP DEAD”. That’s litterally what they are telling me. That’s what the Republicans are telling any of the non-billionaires, the “poor people” that Donald Trump doesn’t want to hear about, in the country. And the whole argument behind “DROP DEAD” is a lot of idealogy about the wonders of a Free Market. I guess I’m supposed to support that idealogy even from the grave.

    I’m guessing that “DROP DEAD” is not going to prove to be a popular platform on which to run in the next few years. The Democrats might counter by continuing their platform of “We love bankers and we really want nuclear war”, which might actually make the following elections close. But if it turns into a race of “DROP DEAD” vs a pro-life, “WE WANT YOU TO LIVE” messages, the the Republicans are going to get slaughtered.

    Read More
    • Replies: @dearieme
    "the free market said I had to pay incredible amounts for health-insurance": why any American labours under the misapprehension that there's a free market in health care in the US beats me.
    , @mukat

    So, the message to me from Republicans right now is simply …. “DROP DEAD”.
     
    Your assessment of the GOP's message is right.

    But you have a naive view of your favored party's message. It's true message is particularly relevant to you. It says, and I quote "KYS, WHITE MAN"

    , @anarchyst
    Wait till your heirs have to give your property to the government after you "pass on". The dirty little secret about Medicaid, is that the government has "first dibs" on any property left by a Medicaid recipient, ahead of legal heirs...in order to pay for the Medicaid program. There "ain't no free lunch"...
  3. jtgw says:
    @Cyrano
    To use an example of a Canadian dying while on a waiting list for treatment for leukemia as proof that the Canadian Health Care system is inferior is laughable. Even the best health care systems in the world can’t save every patient. Most of the civilized world has government run health care systems. That’s the only way to go.

    The US thinks that they have a better idea. They want to find a way where in providing health care to their citizens someone gets to make money. You see, not everything is about capitalism. Health care is not about making money. It’s about saving people’s lives.

    In the civilized world, no one profits from the health care. People pay taxes and the government runs the health care. In the US they simply loath the idea to let a fine capitalist enterprises such as the insurance companies go out of business. That’s why their health care is 3 times more expensive than any other 1st world country and 3 times worse than any of them.

    Read More
  4. @Cyrano
    To use an example of a Canadian dying while on a waiting list for treatment for leukemia as proof that the Canadian Health Care system is inferior is laughable. Even the best health care systems in the world can’t save every patient. Most of the civilized world has government run health care systems. That’s the only way to go.

    The US thinks that they have a better idea. They want to find a way where in providing health care to their citizens someone gets to make money. You see, not everything is about capitalism. Health care is not about making money. It’s about saving people’s lives.

    In the civilized world, no one profits from the health care. People pay taxes and the government runs the health care. In the US they simply loath the idea to let a fine capitalist enterprises such as the insurance companies go out of business. That’s why their health care is 3 times more expensive than any other 1st world country and 3 times worse than any of them.

    Here are the wait times for surgery in 2016, in Canada:
    Wait times (in weeks) by procedure in 2016:

    Plastic surgery: 25.9
    Gynecology: 18.8
    Ophthalmology: 28.5
    Otolaryngology: 22.7
    General surgery: 12.1
    Neurosurgery: 46.9
    Orthopedic surgery: 38.0
    Cardiovascular: 8.4
    Urology: 16.2
    Internal Medicine: 12.9
    Radiation Oncology: 4.1
    Medical Oncology: 3.7

    I had two general surgeries last year here in the US, both took place in under a week.

    Several years ago, I had my gall bladder taken out. It was done next day. Talking to a person from Canada with the same problem, their wait was 3 months.

    Read More
    • Replies: @Cyrano
    The quality of a national health care system is judged based on how many people have access to it and then the quality of the health care itself once you have an access to it. No one argues that US has high quality hospitals and technology and medical science and all that. The argument is how many people have access to it and how much does it cost. Do you catch my drift son? In terms of accessibility, Cuba has better health care system than US. The quality of the health care itself is irrelevant if you can’t access it because you don’t qualify.
    , @anarchyst
    Canada has first-rate medical professionals and hospitals, BUT their "single-payer" system suffers from long wait times for procedures. The same procedures are available in the USA with much shorter wait times.
    It is a loosely-guarded secret that Canadian provinces have contracted with American border hospitals to take cases that simply cannot wait. In addition, many Canadian public officials come to the USA for treatment, something not available to most ordinary Canadian citizens.
    Until recently, it was illegal for Canadians to seek healthcare services outside official channels. Thankfully, the Canadian Supreme Court put a stop to that. Supplemental private health insurance is now available, and is widely used. Canadians get to pay for the "public system" as well as having the ability to purchase healthcare insurance, if they want faster service.
    In the public system, if a hospital runs out of funding before the end of the fiscal year, they close their doors.
    A number of years ago, a Canadian hospital was utilizing its CAT scanner for veterinarians to diagnose animal problems while humans were forced to wait for their procedures. You see, the veterinarians paid CASH to the hospital for access to the CAT scanner.
    The Canadian system works as well as it does because of the much smaller Canadian population. Most of the Canadian population lives within one-hundred miles of the U S border.
  5. dearieme says:
    @Adam S1
    The "free market" wants me dead.

    First the free market has decided that a mid-50 year old with a good engineering degree had to be kicked out of a job he did well in favor for 20-somethings from overseas who will work cheaper.

    Next, the free market said I had to pay incredible amounts for health-insurance. Igoring what I had already paid for decades, the free market decided that my next insurance policy had to have premiums so high that they would cover the costs of all the health care that a mid-50s person with pre-existing conditions would likely incur. Which meant is was unaffordable.

    The only reason I am alive today is the Expanded Medicaid part of Obamacare ... which happens to be the one part that has been popular, while the psuedo-free-market parts that benefit big insurance corps have been very unpopular.

    So, the message to me from Republicans right now is simply .... "DROP DEAD". That's litterally what they are telling me. That's what the Republicans are telling any of the non-billionaires, the "poor people" that Donald Trump doesn't want to hear about, in the country. And the whole argument behind "DROP DEAD" is a lot of idealogy about the wonders of a Free Market. I guess I'm supposed to support that idealogy even from the grave.

    I'm guessing that "DROP DEAD" is not going to prove to be a popular platform on which to run in the next few years. The Democrats might counter by continuing their platform of "We love bankers and we really want nuclear war", which might actually make the following elections close. But if it turns into a race of "DROP DEAD" vs a pro-life, "WE WANT YOU TO LIVE" messages, the the Republicans are going to get slaughtered.

    “the free market said I had to pay incredible amounts for health-insurance”: why any American labours under the misapprehension that there’s a free market in health care in the US beats me.

    Read More
  6. Cyrano says:
    @Chris Mallory
    Here are the wait times for surgery in 2016, in Canada:
    Wait times (in weeks) by procedure in 2016:

    Plastic surgery: 25.9
    Gynecology: 18.8
    Ophthalmology: 28.5
    Otolaryngology: 22.7
    General surgery: 12.1
    Neurosurgery: 46.9
    Orthopedic surgery: 38.0
    Cardiovascular: 8.4
    Urology: 16.2
    Internal Medicine: 12.9
    Radiation Oncology: 4.1
    Medical Oncology: 3.7

    I had two general surgeries last year here in the US, both took place in under a week.

    Several years ago, I had my gall bladder taken out. It was done next day. Talking to a person from Canada with the same problem, their wait was 3 months.

    The quality of a national health care system is judged based on how many people have access to it and then the quality of the health care itself once you have an access to it. No one argues that US has high quality hospitals and technology and medical science and all that. The argument is how many people have access to it and how much does it cost. Do you catch my drift son? In terms of accessibility, Cuba has better health care system than US. The quality of the health care itself is irrelevant if you can’t access it because you don’t qualify.

    Read More
    • Replies: @jtgw
    Do those Canadians waiting months for treatments have "access"? What good is "access" if you die while waiting for treatment?
    , @Chris Mallory
    Anyone showing up at an ER will be treated.

    I am not your son.

    As for Cuba, Air Havana is ready when you are.


    A 3month wait for a minor surgery isn't what I would call access, more like torture.
  7. Dr Paul doesn’t need a magic wand to turn this pickle back into a cucumber. He has an invisible hand.

    Read More
  8. jtgw says:
    @Cyrano
    The quality of a national health care system is judged based on how many people have access to it and then the quality of the health care itself once you have an access to it. No one argues that US has high quality hospitals and technology and medical science and all that. The argument is how many people have access to it and how much does it cost. Do you catch my drift son? In terms of accessibility, Cuba has better health care system than US. The quality of the health care itself is irrelevant if you can’t access it because you don’t qualify.

    Do those Canadians waiting months for treatments have “access”? What good is “access” if you die while waiting for treatment?

    Read More
    • Replies: @Cyrano
    You are right man, millions are dying in Canada on the waiting lists, unlike US where they just flourish.
  9. @Cyrano
    The quality of a national health care system is judged based on how many people have access to it and then the quality of the health care itself once you have an access to it. No one argues that US has high quality hospitals and technology and medical science and all that. The argument is how many people have access to it and how much does it cost. Do you catch my drift son? In terms of accessibility, Cuba has better health care system than US. The quality of the health care itself is irrelevant if you can’t access it because you don’t qualify.

    Anyone showing up at an ER will be treated.

    I am not your son.

    As for Cuba, Air Havana is ready when you are.

    A 3month wait for a minor surgery isn’t what I would call access, more like torture.

    Read More
    • Replies: @Cyrano
    Don't worry, you don't qualify to be my son. I was just being generous. As for Air Havana - at least I am allowed to fly there, unlike some countries that are so democratic they decide where their citizens should be allowed to go . If you are happy with the health care in your country - stay there, I know that millions don't share your opinion.
  10. KenH says:

    If Rand Paul and some other critics on the right are to be believed, and I trust Rand’s opinion on this, it’s only a marginal improvement over Obamacare. It’s still being debated so I’m hopeful Rand can force some needed changes into it that would strip it of more Obamacare mandates and inject some free market mechanisms into it to drive down costs.

    or otherwise reduce the welfare-warfare state — unless forced to do so by an economic crisis or demands from a critical mass of pro-liberty Americans.

    The critical mass of pro-liberty Americans are invariably white European and since they are shrinking while every other third world, big government supporting racial group is growing, don’t expect this to become a reality.

    Read More
  11. However, there should also be a…test forbidding…a…healthcare system that…allows government to deny anyone access to healthcare.

    Sounds great. How about changing “government” to “insurance companies?” Why is it OK for companies to do what it is so tyrannical for governments to do? Is the suffering any different?

    Read More
    • Replies: @jtgw
    The fact that no government can guarantee care to everyone should put to rest the idea that there can be a "right to healthcare." Yes, we can sympathize with those who need care but either can't afford it or are denied it for some other reason (like government rationing), but that doesn't change the fact that they never had a right to care in the first place. Healthcare is a service just like any other. It costs something to produce and costs are determined by supply and demand just like anything else being produced and traded.

    I'm more sympathetic to pragmatic approaches that recognize that healthcare is not an inalienable right but who still think it's a good thing to have and who want to maximize access and provision. It then becomes possible to look at the problem rationally and not emotionally. At this point, I would say the most important thing to recognize is that healthcare itself has a pretty small effect on life expectancy and other health outcomes, at least in the developed world. Lifestyle choices matter much, much more, e.g. not smoking, eating healthily, taking regular exercise, etc. As it happens, not everyone wants to do that; they want to smoke or eat junk food or sit on the couch and watch TV. Lots of Americans do that, in fact, which is a big reason why Americans have worse health outcomes than you'd expect based on how much they spend on healthcare (which is actually predicted by how rich Americans are; see here).
  12. Cyrano says:
    @Chris Mallory
    Anyone showing up at an ER will be treated.

    I am not your son.

    As for Cuba, Air Havana is ready when you are.


    A 3month wait for a minor surgery isn't what I would call access, more like torture.

    Don’t worry, you don’t qualify to be my son. I was just being generous. As for Air Havana – at least I am allowed to fly there, unlike some countries that are so democratic they decide where their citizens should be allowed to go . If you are happy with the health care in your country – stay there, I know that millions don’t share your opinion.

    Read More
    • Replies: @Chris Mallory
    Thankfully, the US is not a democracy.

    Nice to see you admit that you are not an American.


    Now , run along and try to convince someone else that Canada matters.
  13. Cyrano says:
    @jtgw
    Do those Canadians waiting months for treatments have "access"? What good is "access" if you die while waiting for treatment?

    You are right man, millions are dying in Canada on the waiting lists, unlike US where they just flourish.

    Read More
    • Replies: @jtgw
    You don't necessarily have to die while waiting. A long wait time can adversely impact your health in several ways, e.g. if you have to wait long for cancer treatment, that allows the cancer to progress further, shortening your long-term life span.

    Anyway, you should check out the link I shared. Life expectancy in the developed world is more determined by lifestyle than by healthcare. You lengthen lifespan much more by just not smoking than by getting top-notch treatment after having already developed lung cancer. The US has lower life expectancy than many other developed countries because many of its people lead relatively unhealthy lifestyles. But Americans spend much more on health because Americans are wealthier and have more to spend, so if you just plot life expectancy against expenditures, it looks like Americans are overspending on health. Once you factor in lifestyle choices, which are largely independent of healthcare policy, the correlation disappears.

    The importance of lifestyle choices cannot be overstressed. What they essentially mean is that people are choosing fast food over long life, which they should be free to do. Not everybody thinks a long, healthy life is the most important thing in the world.
  14. @Cyrano
    Don't worry, you don't qualify to be my son. I was just being generous. As for Air Havana - at least I am allowed to fly there, unlike some countries that are so democratic they decide where their citizens should be allowed to go . If you are happy with the health care in your country - stay there, I know that millions don't share your opinion.

    Thankfully, the US is not a democracy.

    Nice to see you admit that you are not an American.

    Now , run along and try to convince someone else that Canada matters.

    Read More
    • Replies: @Cyrano
    Don't get your sense of self-importance too high. The world just about had it with you stupid f**ks. The day is not too far when the world will unite and get rid of you.
  15. jtgw says:
    @Cyrano
    You are right man, millions are dying in Canada on the waiting lists, unlike US where they just flourish.

    You don’t necessarily have to die while waiting. A long wait time can adversely impact your health in several ways, e.g. if you have to wait long for cancer treatment, that allows the cancer to progress further, shortening your long-term life span.

    Anyway, you should check out the link I shared. Life expectancy in the developed world is more determined by lifestyle than by healthcare. You lengthen lifespan much more by just not smoking than by getting top-notch treatment after having already developed lung cancer. The US has lower life expectancy than many other developed countries because many of its people lead relatively unhealthy lifestyles. But Americans spend much more on health because Americans are wealthier and have more to spend, so if you just plot life expectancy against expenditures, it looks like Americans are overspending on health. Once you factor in lifestyle choices, which are largely independent of healthcare policy, the correlation disappears.

    The importance of lifestyle choices cannot be overstressed. What they essentially mean is that people are choosing fast food over long life, which they should be free to do. Not everybody thinks a long, healthy life is the most important thing in the world.

    Read More
  16. jtgw says:
    @Elf Himself

    However, there should also be a...test forbidding...a...healthcare system that...allows government to deny anyone access to healthcare.
     
    Sounds great. How about changing "government" to "insurance companies?" Why is it OK for companies to do what it is so tyrannical for governments to do? Is the suffering any different?

    The fact that no government can guarantee care to everyone should put to rest the idea that there can be a “right to healthcare.” Yes, we can sympathize with those who need care but either can’t afford it or are denied it for some other reason (like government rationing), but that doesn’t change the fact that they never had a right to care in the first place. Healthcare is a service just like any other. It costs something to produce and costs are determined by supply and demand just like anything else being produced and traded.

    I’m more sympathetic to pragmatic approaches that recognize that healthcare is not an inalienable right but who still think it’s a good thing to have and who want to maximize access and provision. It then becomes possible to look at the problem rationally and not emotionally. At this point, I would say the most important thing to recognize is that healthcare itself has a pretty small effect on life expectancy and other health outcomes, at least in the developed world. Lifestyle choices matter much, much more, e.g. not smoking, eating healthily, taking regular exercise, etc. As it happens, not everyone wants to do that; they want to smoke or eat junk food or sit on the couch and watch TV. Lots of Americans do that, in fact, which is a big reason why Americans have worse health outcomes than you’d expect based on how much they spend on healthcare (which is actually predicted by how rich Americans are; see here).

    Read More
  17. Cyrano says:
    @Chris Mallory
    Thankfully, the US is not a democracy.

    Nice to see you admit that you are not an American.


    Now , run along and try to convince someone else that Canada matters.

    Don’t get your sense of self-importance too high. The world just about had it with you stupid f**ks. The day is not too far when the world will unite and get rid of you.

    Read More
    • Replies: @jtgw
    LOL but who will save you from Putler?
    , @Chris Mallory
    Does your government Healthcare pay for Massengill ? If so, you need a case to remove the sand that is irritating you.
  18. jtgw says:
    @Cyrano
    Don't get your sense of self-importance too high. The world just about had it with you stupid f**ks. The day is not too far when the world will unite and get rid of you.

    LOL but who will save you from Putler?

    Read More
  19. @Cyrano
    Don't get your sense of self-importance too high. The world just about had it with you stupid f**ks. The day is not too far when the world will unite and get rid of you.

    Does your government Healthcare pay for Massengill ? If so, you need a case to remove the sand that is irritating you.

    Read More
  20. MarkinLA says:

    The free market meets all these tests. In a free market, doctors voluntarily donate their time to help those in need, while private charities and churches fund charity hospitals and clinics. Such a system flourished in the days before Medicaid and Medicare, and would quickly return if the welfare state is eliminated.

    Nobody is more delusional than a libertarian. Hey Ron, how many doctors are working for free and what is stopping them from doing so now? Somehow if we have a “free market” system doctors are suddenly going to decide to donate tons of time to patients who they know can’t pay the bills. But to spite us and our less than free market system they refuse to work for free now. Yeah, that makes semse. I bet they got that from Hans-Herman Hoppe or whatever twit I was supposed to get my libertarian wisdom from.

    No system will work when hospital bills are routinely knocked down by 90% if you have insurance but you are sued for the whole amount if you don’t. No system will work when people in the US pay more for drugs and medical devices than anywhere else in the world – oh wait we pay more because we have the most free market oriented health care system in the industrialized world. So the answer to lowering prices is an even freer market. Maybe Ron can figure than one out for us as well.

    I know, I know, like all libertarians whose main thinking is pulled right from their asses, Ron thinks if you are 80% of his beloved free market then you are hopelessly screwed and that other 20% somehow miraculously fixes everything.

    Read More
    • Replies: @jtgw
    Americans pay more because they have more money to spend:

    https://randomcriticalanalysis.wordpress.com/2016/11/06/us-life-expectancy-is-below-naive-expectations-mostly-because-it-economically-outperforms/#conclusion

    Quality of healthcare has little discernible effect on health outcomes in the developed world. The RAND Corporation carried out a famous experiment forty years ago where they gave people free healthcare to see if it improved their chances; it didn't. Lifestyle choices are much better indicators of health outcomes and life expectancy. Americans paradoxically may have poorer outcomes than other developed countries because they are wealthier, meaning they have more to spend on unhealthy habits like fast food.

    Anyway, I see in another thread you said the following:

    "We really have to get over this idea that human life is so special that it must be saved in any way possible."

    http://www.unz.com/isteve/portugal-vs-angola/#comment-1916283

    It seems only rational to apply this to the unhealthy in our own society (including perhaps yourself, since you've often complained about your own health issues and costs in these threads). Those who have nothing to contribute on net and who are merely drains on resources should be allowed to die naturally. Why should resources be diverted from the productive to the unproductive?
    , @JackOH
    "Nobody is more delusional than a libertarian." Good comment, MarkinLA.

    I like Doctors Ron and Rand, but the reality is that both have derived most of their personal incomes most of their lives from government service at taxpayer expense and from actuarial schemes, such as America's unique group health insurance and, of course, taxpayer-paid Medicare, that give people of widely varying incomes medical purchasing parity.

    Group health insurance, of course, is a compulsory, corporate-paid charity scheme widely mistaken as compensation for work, which is why it's not taxed. Its sole purpose was to block national health care, which is why no more than about 55% of the American public has ever been covered by it.

    I have yet to hear of any American so besotted by free market dogma that he's made a principled demand on his employer to be removed from group health insurance enrollment, or likewise demanded that he be removed from the Medicare roll. Does any American earning an income at or below the 50th percentile, or even the 75th percentile, think he'll exercise meaningful consumer sovereignty by competing with deep-pockets payers for health care with the chump change in his wallet, his bank account, or his home equity?

    Ron's a good guy, but his essay here is yet another example of Beltway libertarianism of political convenience.

  21. mukat says:
    @Adam S1
    The "free market" wants me dead.

    First the free market has decided that a mid-50 year old with a good engineering degree had to be kicked out of a job he did well in favor for 20-somethings from overseas who will work cheaper.

    Next, the free market said I had to pay incredible amounts for health-insurance. Igoring what I had already paid for decades, the free market decided that my next insurance policy had to have premiums so high that they would cover the costs of all the health care that a mid-50s person with pre-existing conditions would likely incur. Which meant is was unaffordable.

    The only reason I am alive today is the Expanded Medicaid part of Obamacare ... which happens to be the one part that has been popular, while the psuedo-free-market parts that benefit big insurance corps have been very unpopular.

    So, the message to me from Republicans right now is simply .... "DROP DEAD". That's litterally what they are telling me. That's what the Republicans are telling any of the non-billionaires, the "poor people" that Donald Trump doesn't want to hear about, in the country. And the whole argument behind "DROP DEAD" is a lot of idealogy about the wonders of a Free Market. I guess I'm supposed to support that idealogy even from the grave.

    I'm guessing that "DROP DEAD" is not going to prove to be a popular platform on which to run in the next few years. The Democrats might counter by continuing their platform of "We love bankers and we really want nuclear war", which might actually make the following elections close. But if it turns into a race of "DROP DEAD" vs a pro-life, "WE WANT YOU TO LIVE" messages, the the Republicans are going to get slaughtered.

    So, the message to me from Republicans right now is simply …. “DROP DEAD”.

    Your assessment of the GOP’s message is right.

    But you have a naive view of your favored party’s message. It’s true message is particularly relevant to you. It says, and I quote “KYS, WHITE MAN

    Read More
  22. jtgw says:
    @MarkinLA
    The free market meets all these tests. In a free market, doctors voluntarily donate their time to help those in need, while private charities and churches fund charity hospitals and clinics. Such a system flourished in the days before Medicaid and Medicare, and would quickly return if the welfare state is eliminated.

    Nobody is more delusional than a libertarian. Hey Ron, how many doctors are working for free and what is stopping them from doing so now? Somehow if we have a "free market" system doctors are suddenly going to decide to donate tons of time to patients who they know can't pay the bills. But to spite us and our less than free market system they refuse to work for free now. Yeah, that makes semse. I bet they got that from Hans-Herman Hoppe or whatever twit I was supposed to get my libertarian wisdom from.

    No system will work when hospital bills are routinely knocked down by 90% if you have insurance but you are sued for the whole amount if you don't. No system will work when people in the US pay more for drugs and medical devices than anywhere else in the world - oh wait we pay more because we have the most free market oriented health care system in the industrialized world. So the answer to lowering prices is an even freer market. Maybe Ron can figure than one out for us as well.

    I know, I know, like all libertarians whose main thinking is pulled right from their asses, Ron thinks if you are 80% of his beloved free market then you are hopelessly screwed and that other 20% somehow miraculously fixes everything.

    Americans pay more because they have more money to spend:

    https://randomcriticalanalysis.wordpress.com/2016/11/06/us-life-expectancy-is-below-naive-expectations-mostly-because-it-economically-outperforms/#conclusion

    Quality of healthcare has little discernible effect on health outcomes in the developed world. The RAND Corporation carried out a famous experiment forty years ago where they gave people free healthcare to see if it improved their chances; it didn’t. Lifestyle choices are much better indicators of health outcomes and life expectancy. Americans paradoxically may have poorer outcomes than other developed countries because they are wealthier, meaning they have more to spend on unhealthy habits like fast food.

    Anyway, I see in another thread you said the following:

    “We really have to get over this idea that human life is so special that it must be saved in any way possible.”

    http://www.unz.com/isteve/portugal-vs-angola/#comment-1916283

    It seems only rational to apply this to the unhealthy in our own society (including perhaps yourself, since you’ve often complained about your own health issues and costs in these threads). Those who have nothing to contribute on net and who are merely drains on resources should be allowed to die naturally. Why should resources be diverted from the productive to the unproductive?

    Read More
    • Replies: @low voltage
    Instead of making them die a slow and miserable death, why don't we make it more painless for them?

    https://www.britannica.com/event/T4-Program
    , @MarkinLA
    Why should resources be diverted from the productive to the unproductive?

    Do I get to decide if you are not productive?
  23. @jtgw
    Americans pay more because they have more money to spend:

    https://randomcriticalanalysis.wordpress.com/2016/11/06/us-life-expectancy-is-below-naive-expectations-mostly-because-it-economically-outperforms/#conclusion

    Quality of healthcare has little discernible effect on health outcomes in the developed world. The RAND Corporation carried out a famous experiment forty years ago where they gave people free healthcare to see if it improved their chances; it didn't. Lifestyle choices are much better indicators of health outcomes and life expectancy. Americans paradoxically may have poorer outcomes than other developed countries because they are wealthier, meaning they have more to spend on unhealthy habits like fast food.

    Anyway, I see in another thread you said the following:

    "We really have to get over this idea that human life is so special that it must be saved in any way possible."

    http://www.unz.com/isteve/portugal-vs-angola/#comment-1916283

    It seems only rational to apply this to the unhealthy in our own society (including perhaps yourself, since you've often complained about your own health issues and costs in these threads). Those who have nothing to contribute on net and who are merely drains on resources should be allowed to die naturally. Why should resources be diverted from the productive to the unproductive?

    Instead of making them die a slow and miserable death, why don’t we make it more painless for them?

    https://www.britannica.com/event/T4-Program

    Read More
    • Replies: @jtgw
    Why not indeed? In many cases I can see it being more cost-effective and affordable to get some palliative care while waiting for nature to take its course, rather than spending exorbitant amounts on putting off the inevitable for a few miserable months or years.
  24. Munchen says:

    Does any non-American believe that there is a rational Congress and government anymore? The healthcare non-debate is just people being obstinate and forcing others to show their cards first. That might win points for them but that does nothing for the voters.
    If the world’s greatest deliberative body really lived up to its name, there would be open, honest debates about who benefits (cui bono, favorite question on UR) and who, whom (also).
    Dr. Paul, what can you do to shed light on the role played by your large pharmaceutical and insurance companies and their influence? Can you produce a scorecard showing who paid how much to lobby for which politician? How much did you take? How much is that turtle guy McConnell taking?

    Read More
  25. Munchen says:

    Also ask your son, the other Dr. Paul, since he is currently serving the public as an elected official.

    Read More
  26. jtgw says:
    @low voltage
    Instead of making them die a slow and miserable death, why don't we make it more painless for them?

    https://www.britannica.com/event/T4-Program

    Why not indeed? In many cases I can see it being more cost-effective and affordable to get some palliative care while waiting for nature to take its course, rather than spending exorbitant amounts on putting off the inevitable for a few miserable months or years.

    Read More
  27. JackOH says:
    @MarkinLA
    The free market meets all these tests. In a free market, doctors voluntarily donate their time to help those in need, while private charities and churches fund charity hospitals and clinics. Such a system flourished in the days before Medicaid and Medicare, and would quickly return if the welfare state is eliminated.

    Nobody is more delusional than a libertarian. Hey Ron, how many doctors are working for free and what is stopping them from doing so now? Somehow if we have a "free market" system doctors are suddenly going to decide to donate tons of time to patients who they know can't pay the bills. But to spite us and our less than free market system they refuse to work for free now. Yeah, that makes semse. I bet they got that from Hans-Herman Hoppe or whatever twit I was supposed to get my libertarian wisdom from.

    No system will work when hospital bills are routinely knocked down by 90% if you have insurance but you are sued for the whole amount if you don't. No system will work when people in the US pay more for drugs and medical devices than anywhere else in the world - oh wait we pay more because we have the most free market oriented health care system in the industrialized world. So the answer to lowering prices is an even freer market. Maybe Ron can figure than one out for us as well.

    I know, I know, like all libertarians whose main thinking is pulled right from their asses, Ron thinks if you are 80% of his beloved free market then you are hopelessly screwed and that other 20% somehow miraculously fixes everything.

    “Nobody is more delusional than a libertarian.” Good comment, MarkinLA.

    I like Doctors Ron and Rand, but the reality is that both have derived most of their personal incomes most of their lives from government service at taxpayer expense and from actuarial schemes, such as America’s unique group health insurance and, of course, taxpayer-paid Medicare, that give people of widely varying incomes medical purchasing parity.

    Group health insurance, of course, is a compulsory, corporate-paid charity scheme widely mistaken as compensation for work, which is why it’s not taxed. Its sole purpose was to block national health care, which is why no more than about 55% of the American public has ever been covered by it.

    I have yet to hear of any American so besotted by free market dogma that he’s made a principled demand on his employer to be removed from group health insurance enrollment, or likewise demanded that he be removed from the Medicare roll. Does any American earning an income at or below the 50th percentile, or even the 75th percentile, think he’ll exercise meaningful consumer sovereignty by competing with deep-pockets payers for health care with the chump change in his wallet, his bank account, or his home equity?

    Ron’s a good guy, but his essay here is yet another example of Beltway libertarianism of political convenience.

    Read More
    • Replies: @jtgw
    What is nationalized healthcare other than a giant group insurance scheme covering everybody?

    I would hardly call the Pauls Beltway libertarians. The latter have always looked askance at the Pauls' populism.

    Of course few people are going to voluntarily give up welfare when it's offered and we shouldn't expect them to. That doesn't make welfare a good idea. If I got enough benefits that I didn't have to work for my living, I probably would not work, or not work as much anyway. Old people use lots more healthcare than young people for obvious reasons. Politically it's impossible to make the old people save up and pay for their own care, but they really should be made to do so. This care only buys them a few extra years of life, but it's an enormous drain on the rest of the population and contributes to skyrocketing prices.
  28. Renoman says:

    I’d be interested to know the number of Americans who died because they couldn’t afford heath insurance. We have to wait here in Canada but no one is turned away, also very few wait if they are in an emergency situation. No question the wealthy can always get better service but how many can actually afford to pay for it. US hospital charges are just crazy.

    Read More
    • Replies: @jtgw
    You talk as if waiting were purely inconsequential, when it can often have significant effects on the success of the treatment. Also, by law, no one in the US can be turned away in an emergency.

    But ultimately whether Canada or the US is doing better health-wise has much more to do with lifestyle choices. White Americans outside the South actually do as well as Europeans, so it's basically down to particular American subcultures that promote unhealthy habits (similar correlations are found with e.g. violence, where if you take out blacks and Hispanics and southern whites, Americans have comparable homicide rates to Europeans).
  29. jtgw says:
    @Renoman
    I'd be interested to know the number of Americans who died because they couldn't afford heath insurance. We have to wait here in Canada but no one is turned away, also very few wait if they are in an emergency situation. No question the wealthy can always get better service but how many can actually afford to pay for it. US hospital charges are just crazy.

    You talk as if waiting were purely inconsequential, when it can often have significant effects on the success of the treatment. Also, by law, no one in the US can be turned away in an emergency.

    But ultimately whether Canada or the US is doing better health-wise has much more to do with lifestyle choices. White Americans outside the South actually do as well as Europeans, so it’s basically down to particular American subcultures that promote unhealthy habits (similar correlations are found with e.g. violence, where if you take out blacks and Hispanics and southern whites, Americans have comparable homicide rates to Europeans).

    Read More
  30. jtgw says:
    @JackOH
    "Nobody is more delusional than a libertarian." Good comment, MarkinLA.

    I like Doctors Ron and Rand, but the reality is that both have derived most of their personal incomes most of their lives from government service at taxpayer expense and from actuarial schemes, such as America's unique group health insurance and, of course, taxpayer-paid Medicare, that give people of widely varying incomes medical purchasing parity.

    Group health insurance, of course, is a compulsory, corporate-paid charity scheme widely mistaken as compensation for work, which is why it's not taxed. Its sole purpose was to block national health care, which is why no more than about 55% of the American public has ever been covered by it.

    I have yet to hear of any American so besotted by free market dogma that he's made a principled demand on his employer to be removed from group health insurance enrollment, or likewise demanded that he be removed from the Medicare roll. Does any American earning an income at or below the 50th percentile, or even the 75th percentile, think he'll exercise meaningful consumer sovereignty by competing with deep-pockets payers for health care with the chump change in his wallet, his bank account, or his home equity?

    Ron's a good guy, but his essay here is yet another example of Beltway libertarianism of political convenience.

    What is nationalized healthcare other than a giant group insurance scheme covering everybody?

    I would hardly call the Pauls Beltway libertarians. The latter have always looked askance at the Pauls’ populism.

    Of course few people are going to voluntarily give up welfare when it’s offered and we shouldn’t expect them to. That doesn’t make welfare a good idea. If I got enough benefits that I didn’t have to work for my living, I probably would not work, or not work as much anyway. Old people use lots more healthcare than young people for obvious reasons. Politically it’s impossible to make the old people save up and pay for their own care, but they really should be made to do so. This care only buys them a few extra years of life, but it’s an enormous drain on the rest of the population and contributes to skyrocketing prices.

    Read More
  31. anarchyst says:
    @Chris Mallory
    Here are the wait times for surgery in 2016, in Canada:
    Wait times (in weeks) by procedure in 2016:

    Plastic surgery: 25.9
    Gynecology: 18.8
    Ophthalmology: 28.5
    Otolaryngology: 22.7
    General surgery: 12.1
    Neurosurgery: 46.9
    Orthopedic surgery: 38.0
    Cardiovascular: 8.4
    Urology: 16.2
    Internal Medicine: 12.9
    Radiation Oncology: 4.1
    Medical Oncology: 3.7

    I had two general surgeries last year here in the US, both took place in under a week.

    Several years ago, I had my gall bladder taken out. It was done next day. Talking to a person from Canada with the same problem, their wait was 3 months.

    Canada has first-rate medical professionals and hospitals, BUT their “single-payer” system suffers from long wait times for procedures. The same procedures are available in the USA with much shorter wait times.
    It is a loosely-guarded secret that Canadian provinces have contracted with American border hospitals to take cases that simply cannot wait. In addition, many Canadian public officials come to the USA for treatment, something not available to most ordinary Canadian citizens.
    Until recently, it was illegal for Canadians to seek healthcare services outside official channels. Thankfully, the Canadian Supreme Court put a stop to that. Supplemental private health insurance is now available, and is widely used. Canadians get to pay for the “public system” as well as having the ability to purchase healthcare insurance, if they want faster service.
    In the public system, if a hospital runs out of funding before the end of the fiscal year, they close their doors.
    A number of years ago, a Canadian hospital was utilizing its CAT scanner for veterinarians to diagnose animal problems while humans were forced to wait for their procedures. You see, the veterinarians paid CASH to the hospital for access to the CAT scanner.
    The Canadian system works as well as it does because of the much smaller Canadian population. Most of the Canadian population lives within one-hundred miles of the U S border.

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  32. MarkinLA says:
    @jtgw
    Americans pay more because they have more money to spend:

    https://randomcriticalanalysis.wordpress.com/2016/11/06/us-life-expectancy-is-below-naive-expectations-mostly-because-it-economically-outperforms/#conclusion

    Quality of healthcare has little discernible effect on health outcomes in the developed world. The RAND Corporation carried out a famous experiment forty years ago where they gave people free healthcare to see if it improved their chances; it didn't. Lifestyle choices are much better indicators of health outcomes and life expectancy. Americans paradoxically may have poorer outcomes than other developed countries because they are wealthier, meaning they have more to spend on unhealthy habits like fast food.

    Anyway, I see in another thread you said the following:

    "We really have to get over this idea that human life is so special that it must be saved in any way possible."

    http://www.unz.com/isteve/portugal-vs-angola/#comment-1916283

    It seems only rational to apply this to the unhealthy in our own society (including perhaps yourself, since you've often complained about your own health issues and costs in these threads). Those who have nothing to contribute on net and who are merely drains on resources should be allowed to die naturally. Why should resources be diverted from the productive to the unproductive?

    Why should resources be diverted from the productive to the unproductive?

    Do I get to decide if you are not productive?

    Read More
  33. MarkinLA says:

    I really love this idiotic mantra “free market”. Somehow the US does not have a free market in heath care. However almost EVERY undertaking in healthcare in the US is completely voluntary. Unless you agree to a contract with somebody you can charge them anything you want.

    The only “socialized” portion of healthcare is emergency situations. And the hospital is allowed to shuffle them off to the county hospital once they are stabilized. In additon, there is money set aside to pay for the indigent. It may not be as much as the hospital and doctors want but they don’t work for free.

    No doctor is required to treat medicaid or medicare patients. No doctor is required to accept any insurance, and that includes Obamacare. These are voluntarily entered into contracts.

    No pharmaceutical company or device manufacturer is required to sell their products in the US at a price they don’t like. Obamacare dinks them with a 2.3% tax. The government negotiates a price for certain items, just like insurance companies, and the companies can refuse to be part of it if they don’t think there is enough profit.

    You hear all the time about this nonsesne of “posting prices” by the doctors. Well any doctor can do that now. They don’t for the same reason that car dealers still use salesmen – they make more money.

    Just where is all this “socialism” in the US healthcare system?

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  34. What makes people think that politicians can manage health care access and delivery any better than they manage anything else?

    Read More
    • Replies: @JackOH
    js, politicians have been distorting health care markets since Medicare and Medicaid, and even before that if you want to count how the American Medical Association pretty much destroyed your local pharmacist's onetime independent scope of practice by influencing state legislatures. The prescription that might cost $15 if pharmacists were permitted prescribing authority is maybe $10 or so plus the cost and delay involved in getting a doctor's appointment.

    Group health insurance, the now super-inflated gimmick meant to block national health care, is arguably even worse. About 40% of group health insurance enrollees perform no work at all for the business that bankrolls their insurance. They're contractually qualifying dependents. Even worse, businesses routinely cannibalize their own work force through outsourcing, off-shoring, tactical shut-downs and bankruptcies, and part-timing to pay for non-workers' benefits without actually knowing what they're doing, which is de-incentivizing productive workers in favor of a sort of medical rentier class of beneficiaries..

    America's political class won't be leaving health care soon, or ever. And, group health insurance is a goner.
  35. JackOH says:
    @jacques sheete
    What makes people think that politicians can manage health care access and delivery any better than they manage anything else?

    js, politicians have been distorting health care markets since Medicare and Medicaid, and even before that if you want to count how the American Medical Association pretty much destroyed your local pharmacist’s onetime independent scope of practice by influencing state legislatures. The prescription that might cost $15 if pharmacists were permitted prescribing authority is maybe $10 or so plus the cost and delay involved in getting a doctor’s appointment.

    Group health insurance, the now super-inflated gimmick meant to block national health care, is arguably even worse. About 40% of group health insurance enrollees perform no work at all for the business that bankrolls their insurance. They’re contractually qualifying dependents. Even worse, businesses routinely cannibalize their own work force through outsourcing, off-shoring, tactical shut-downs and bankruptcies, and part-timing to pay for non-workers’ benefits without actually knowing what they’re doing, which is de-incentivizing productive workers in favor of a sort of medical rentier class of beneficiaries..

    America’s political class won’t be leaving health care soon, or ever. And, group health insurance is a goner.

    Read More
  36. anarchyst says:
    @Adam S1
    The "free market" wants me dead.

    First the free market has decided that a mid-50 year old with a good engineering degree had to be kicked out of a job he did well in favor for 20-somethings from overseas who will work cheaper.

    Next, the free market said I had to pay incredible amounts for health-insurance. Igoring what I had already paid for decades, the free market decided that my next insurance policy had to have premiums so high that they would cover the costs of all the health care that a mid-50s person with pre-existing conditions would likely incur. Which meant is was unaffordable.

    The only reason I am alive today is the Expanded Medicaid part of Obamacare ... which happens to be the one part that has been popular, while the psuedo-free-market parts that benefit big insurance corps have been very unpopular.

    So, the message to me from Republicans right now is simply .... "DROP DEAD". That's litterally what they are telling me. That's what the Republicans are telling any of the non-billionaires, the "poor people" that Donald Trump doesn't want to hear about, in the country. And the whole argument behind "DROP DEAD" is a lot of idealogy about the wonders of a Free Market. I guess I'm supposed to support that idealogy even from the grave.

    I'm guessing that "DROP DEAD" is not going to prove to be a popular platform on which to run in the next few years. The Democrats might counter by continuing their platform of "We love bankers and we really want nuclear war", which might actually make the following elections close. But if it turns into a race of "DROP DEAD" vs a pro-life, "WE WANT YOU TO LIVE" messages, the the Republicans are going to get slaughtered.

    Wait till your heirs have to give your property to the government after you “pass on”. The dirty little secret about Medicaid, is that the government has “first dibs” on any property left by a Medicaid recipient, ahead of legal heirs…in order to pay for the Medicaid program. There “ain’t no free lunch”…

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    • Replies: @Ivy
    States have their own variations on estate clawback. Remember to update your affairs by 55 or you may lock in your own nasty surprises.
  37. Ivy says:
    @anarchyst
    Wait till your heirs have to give your property to the government after you "pass on". The dirty little secret about Medicaid, is that the government has "first dibs" on any property left by a Medicaid recipient, ahead of legal heirs...in order to pay for the Medicaid program. There "ain't no free lunch"...

    States have their own variations on estate clawback. Remember to update your affairs by 55 or you may lock in your own nasty surprises.

    Read More
  38. Technomad says:

    Ever since he jumped all over that dentist for shooting that stupid lion in Zimbabwe, Jimmy Kimmel has been on my sh-t-list. Anything he is for I am almost automatically against.

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  39. You would think that Jimmy Kimmel could afford a good insurance policy for his son without using Obamacare, or possibly pay for his medical treatment out of pocket.

    The real issue over Obamacare for many people earning between $50,000 and $100,000 is that it is so expensive, and the deductibles so high, that it provides very little more than an incredibly expensive type of bankruptcy insurance. But this cost of the bankruptcy insurance is so high, that it is probably better for many people to go bankrupt, depending on the bankruptcy laws where they live. In the meantime, while waiting for a medical catastrophe, they have more money to use doctors and dentists when on vacation overseas for a fraction of the US cost.

    For example here in Florida, in bankruptcy you get to keep your home and your retirement savings accounts and pensions, which is all that many people have.

    Another factor that is hardly ever discussed is that the cost of living various hugely between different parts of the US, so Obamacare may be quite affordable in some parts, but out of the question for average families in others.

    Some kind of affordable, universal health care system, or bankruptcy insurance, would be a huge boost to the quality of life in the US, and allow many more people to be self employed or start their own businesses without facing the risk of medical related bankruptcy.

    Another side to the issue that I never see discussed is the racial one. I have a feeling that African-Americans are likely to be more affected by the demise of Obamacare and cutbacks in Medicare, but never see any analysis beyond “22 million people”. Who are the 22 million?

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