Steve Lunetta: In search of elusive compromise

By Steve Lunetta

Last update: Wednesday, June 14th, 2017

Aren’t you fed up with this by now?

We seem to have become so narrowly focused and polarized in our views that real and important change does not happen.

“My way or the highway” appears to be the thinking of many of us. How did we get this way? The Congress of the United States of America was itself a compromise creating two houses to balance the interests of large and small states.

Was it exactly what each side wanted? Nope. But each one got a little and was satisfied to move forward.

This represented a huge improvement over a single-house form of government and was a triumph for the idea that compromise could forge great success in human governance.

But triumph has been elusive for us Americans in one area: health care.

We can’t seem to agree on health care programs. In 2010, Obamacare (the Affordable Care Act or ACA) was passed without a single Republican vote in support. Recently, the AHCA (the American Health Care Act of 2017) was passed without a single Democratic vote.

C’mon, Congress! This is not acceptable! You must learn to work together and create a compromise piece of legislation that benefits the majority of the American people.

You cannot adhere so closely to your philosophical mantras that true compromise is not attainable.

The Democratic ACA was signed into law but is being swept aside by a Republican-controlled Congress and White House.

So what will happen in the future? Even if the Republican AHCA is signed into law, four years later, if the Democrats control Congress (and current trends say they will), the AHCA will be swept aside for yet another program.

Does this make any sense?

No; it’s pure foolishness, this continuous cycle of creating health plans and then destroying them when another group with a new philosophy occupies positions of power.

These groups are set in place by a fickle American people who can’t seem to decide what flavor of tooth paste to buy in the store, let alone a fair and just health care system.

Something has to change.

Perhaps Congress can try compromise? And I am not referring to the cynical horse-trading that Washington, D.C., typically practices (which greatly resembles bribery).

I mean looking at an issue, determining where gaps in philosophy exist, and then negotiating to close the gaps.

For example, Obamacare forced the states to create their own exchanges, effectively limiting risk pools to the size of the state – California has a large risk pool while New Hampshire’s would be much smaller.

Some folks have suggested breaking down state barriers to allow more interstate commerce. Others like me support a nationwide risk pool.

How about a compromise? Set up “regional risk pools” where several large states and small states get together to mitigate risk.

OK, I am no insurance expert. I have no idea if that would even work. What I am illustrating is the idea of a compromise. Neither side gets exactly what it wants but a middle road is obtained that both sides can live with.

What about the area of tort reform? Surely trial lawyers will vehemently oppose any change to the current system, as it represents a huge amount of business for their industry. Also, trial lawyers are significant campaign donors.

What if tort reform was enacted but “softened” to allow trial lawyers to replace this income with other areas of legal practice? What about a graduated level of tort reform enacted over a five-year period?

Again, this could represent a compromise versus draconian sweeping tort reform in just one year.

As in the concept of consensus, each side would be required to actively support the decision. This would prevent later back-stabbing by clever political operatives (of which we see a great deal recently).

Compromise is a lost art these days. Maybe teachers can begin teaching it in schools as part of a core curriculum? Before they take it into the classroom, teachers could practice on our elected leaders in Washington.

Let’s create a health care system that we all can live with that does not change every four years.

Steve Lunetta is a resident of Santa Clarita and is hopeful that our leaders can find a path forward. He can be reached at slunetta63@yahoo.com.

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Steve Lunetta: In search of elusive compromise

Aren’t you fed up with this by now?

We seem to have become so narrowly focused and polarized in our views that real and important change does not happen.

“My way or the highway” appears to be the thinking of many of us. How did we get this way? The Congress of the United States of America was itself a compromise creating two houses to balance the interests of large and small states.

Was it exactly what each side wanted? Nope. But each one got a little and was satisfied to move forward.

This represented a huge improvement over a single-house form of government and was a triumph for the idea that compromise could forge great success in human governance.

But triumph has been elusive for us Americans in one area: health care.

We can’t seem to agree on health care programs. In 2010, Obamacare (the Affordable Care Act or ACA) was passed without a single Republican vote in support. Recently, the AHCA (the American Health Care Act of 2017) was passed without a single Democratic vote.

C’mon, Congress! This is not acceptable! You must learn to work together and create a compromise piece of legislation that benefits the majority of the American people.

You cannot adhere so closely to your philosophical mantras that true compromise is not attainable.

The Democratic ACA was signed into law but is being swept aside by a Republican-controlled Congress and White House.

So what will happen in the future? Even if the Republican AHCA is signed into law, four years later, if the Democrats control Congress (and current trends say they will), the AHCA will be swept aside for yet another program.

Does this make any sense?

No; it’s pure foolishness, this continuous cycle of creating health plans and then destroying them when another group with a new philosophy occupies positions of power.

These groups are set in place by a fickle American people who can’t seem to decide what flavor of tooth paste to buy in the store, let alone a fair and just health care system.

Something has to change.

Perhaps Congress can try compromise? And I am not referring to the cynical horse-trading that Washington, D.C., typically practices (which greatly resembles bribery).

I mean looking at an issue, determining where gaps in philosophy exist, and then negotiating to close the gaps.

For example, Obamacare forced the states to create their own exchanges, effectively limiting risk pools to the size of the state – California has a large risk pool while New Hampshire’s would be much smaller.

Some folks have suggested breaking down state barriers to allow more interstate commerce. Others like me support a nationwide risk pool.

How about a compromise? Set up “regional risk pools” where several large states and small states get together to mitigate risk.

OK, I am no insurance expert. I have no idea if that would even work. What I am illustrating is the idea of a compromise. Neither side gets exactly what it wants but a middle road is obtained that both sides can live with.

What about the area of tort reform? Surely trial lawyers will vehemently oppose any change to the current system, as it represents a huge amount of business for their industry. Also, trial lawyers are significant campaign donors.

What if tort reform was enacted but “softened” to allow trial lawyers to replace this income with other areas of legal practice? What about a graduated level of tort reform enacted over a five-year period?

Again, this could represent a compromise versus draconian sweeping tort reform in just one year.

As in the concept of consensus, each side would be required to actively support the decision. This would prevent later back-stabbing by clever political operatives (of which we see a great deal recently).

Compromise is a lost art these days. Maybe teachers can begin teaching it in schools as part of a core curriculum? Before they take it into the classroom, teachers could practice on our elected leaders in Washington.

Let’s create a health care system that we all can live with that does not change every four years.

Steve Lunetta is a resident of Santa Clarita and is hopeful that our leaders can find a path forward. He can be reached at slunetta63@yahoo.com.

About the author

Steve Lunetta

Steve Lunetta

Raging, far-centrist conservative moderate with a slightly tongue-in-cheek humorist approach.

  • lois eisenberg

    “In search of elusive compromise”
    Steve you out did yourself with this opinion column **
    Must give you an A+ for this one.
    Hope that Uncle Earl approves ???

    • Anthony Breznican

      Who is Uncle Earl?

      • Brian Richards

        Why are you involving yourself in a conversation between Gil and Lois?

        • Anthony Breznican

          I’m not interjecting nastiness, as you do. I asked her to clarify.

          • Brian Richards

            Well, a simple explanation might be that Earl is the author’s uncle, although in today’s world “he” could be the authors aunt or daughter or one of 78 different genders they have these days on planet progressive!

          • Anthony Breznican

            You’ve got a great act. Solid comedy like that is hard to come by.

          • lois eisenberg

            Maybe that is why there was no response about my fabulous Aunt.

          • lois eisenberg

            Anthony don’t knock yourself out with the interjection of nastiness.
            The interjecting nasterners are much better than they used to be.
            That is their game plan to ridiculed, demean and be nasty **

            Anthony befog I forget HAPPY FATHER’S DAY ****

          • Anthony Breznican

            That’s very sweet of you. Thank you! Should be a nice weekend.

        • Ron Bischof

          That’s different, Brian! 😀

        • Gil Mertz

          I blissfully have them both blocked so I can’t see their hateful blather.

      • lois eisenberg

        Anthony you would have to ask Steve ****
        He always mentions his Uncle Earl**
        Uncle Earl is either real or fictitious **
        I tried to fix up Uncle Earl with my fabulous Aunt but never got
        a response ****
        As far as I’m concerned he lost out ***

        • Anthony Breznican

          Ha ha, got it. 🙂

    • Steve Lunetta

      He does, Lois!

  • Gil Mertz

    The challenge for Republicans with Obamacare is that it’s such a toxic issue. This was poison for the Democratic Party which cost them both Houses of Congress and enormous state seats. No party has ever lost so much since Nixon. No one wants to step on that landmine and for good reason, but compromise would be the best approach. Shared credit and shared blame.

    And I respectfully disagree that current trends are showing the GOP losing control of Congress. The horrific behavior of Democrats and their media allies is not winning the hearts of voters. I think they’re digging themselves deeper with their hatred for anyone who is different from them. And we know about eight Democratic Senators that are pretty vulnerable in 2018. I’m not seeing much from the GOP Congress to cheer about so far but I think they’ll keep their majorities in Congress. So DO something!!!

    • Anthony Breznican

      This much is true: Tea Party fury over the ACA definitely cost Democrats seats. But now, the majority of Americans are in favor of Obamacare and want it to be fixed, not destroyed. (I guess they really did have to find out what was in it, as Nancy Pelosi said.)

      If you’re worried about toxic issues, you might want to consider the poison your party is currently drinking — and forcing down the throats of the rest of the country:

      https://fivethirtyeight.com/features/trump-is-tempting-fate-on-health-care/

    • Steve Lunetta

      Gil- this is an excellent comment. We disagree but you make cogent points that are worthy of consideration.
      I think the Republicans must deliver on either health care or immigration reform. A victory in one area will give them a fighting chance in the next election. Victory in both will probably let them keep control. If they go 0 for 2, hello Pelosi….

      • lois eisenberg

        I say Hello to Pelosi ***

  • Brian Baker

    “… if the Democrats control Congress (and current trends say they
    will),”

    Back in October “current trends” at the time were solidly showing that the Pantsuit Woman was going to be President. Look how that turned out.

    There’s an old joke that goes like this: What’s a camel? It’s a horse built by a committee. The point being that “compromise” isn’t always a solution to an issue. In fact, it’s often vastly overrated, especially when you’re talking about core principles.

    What if the Founders had tried to find a “compromise” with King George? Look how well Chamberlain’s “compromise” with Hitler turned out. There’s the Missouri Compromise of 1820, which ended with a little dispute called the Civil War.

    The plain fact is that some differences are so fundamental that there’s no compromise possible.

    Once again you’re trying to rationalize your support for socialized medicine. This time you’ve taken a couple of the proposals that I and others like me have made – medical tort reform and the removal of state barriers to product sales – and proposed that there be some “compromise”
    to modify them to fit into the mold of socialized medicine, completely ignoring the fact that those proposals are made to provide a stark alternative to having the government involved in health care at all. That wouldn’t be a compromise on the part of free-market advocates; agreeing to such a proposal would amount to waving the white flag of abject surrender. It would render those proposals moot and meaningless.

    On top of all of that, we have the historical record which clearly shows that over the past half century at least, any ground the left gains through “compromise” doesn’t end the debate on an
    issue. It merely becomes the starting point for their next set of demands. It’s slow suicide by conservatives and Republicans.

    The final truth is that what you’re trying to do is very akin to trying to be a little bit pregnant. In reality, you either are or you ain’t. You support government-run healthcare, which is
    socialized medicine, whether or not you want to admit it. I, and people like me, don’t. It’s that simple and fundamental.

    • Brian Richards

      Funny how it’s always expected that Repubs should compromise, notwithstanding the author’s point.

      • Brian Baker

        Yes, exactly. All “compromise” always starts with conservatives yielding major ground.

        Another great example: the Simpson-Mazzoli act of 1986, signed into law by Reagan, which was the big “compromise” that was promised to end all debate on the issue of illegal aliens forever with that one tiny grant of blanket immunity for 3 million illegals, in return for which there would be strict border control, employer verification, and no more talk of immunity.

        Here we are, thirty years later, and the debate is harsher than ever.

        • Anthony Breznican

          Republicans are horrible at compromise. Obamacare included many provisions that were actually Republican positions, but the idea of cooperating with a Democratic president was anathema to the GOP. They added more than 160 amendments, then claimed the amendments were only “technical.” Then they spent seven years trying to repeal it, with a plan that only makes the uninsured crisis worse. (But hey — juicy tax cut.)

          It would be so, so nice if voters from your side would stop whining so much about compromise. You never bend. You just break the rest of the country.

          http://www.salon.com/2010/02/23/hcr_amendments/

          Six Republican Ideas Incorporated into ACA
          http://voices.washingtonpost.com/ezra-klein/2010/02/five_compronises_in_health_car.html

          • Brian Baker

            My “side”? What side would that be, kid, since I’m not a Republican?

            I consider them only slightly less odorous than the Dem/socialists.

          • Anthony Breznican

            Well pick a lane, Chief! (I like this “Kid” and “Chief” thing we have going, don’t you? Or did you want “Pops”? I feel like you never clarified.)

          • Brian Baker

            You made the accusation, kid. And just like always, your MO seems to be to quickly scramble into irrelevancies and obfuscations.

            Come back when you grow up. You’re nothing but a pestiferous child.

          • Anthony Breznican

            I love how irascible you are, Pops! We make a great team!

          • Brian Baker

            Proving how out of touch with reality you are.

          • Anthony Breznican

            Are you saying we’re not best friends? But… the affectionate nicknames! Pops, say it ain’t so!

          • Brian Richards

            Are you in need of a friend Anthony? If you ask me nicely, I’ll consider it.

          • Anthony Breznican

            I know – the two of YOU could be friends! The Two Brians! But which would be the irascible one? I’m sure you guys could sort it out.

          • Brian Richards

            I would be honored to have Baker as a friend. If I had you as a friend, I would get a dog. But the offer still stands Anthony, if you need a friend, just ask.

          • Anthony Breznican

            That’s generous (albeit it strange.) If you want friends, tone down the hostility.

          • Brian Richards

            Never mind. I don’t want friends as I have many of them. Just thought I would try to help you out a bit. You seem angry and lonely.

          • Anthony Breznican

            LOL. sure.

          • Ron Bischof
  • Ron Bischof

    “Something has to change.”

    Agreed. The Feds need to get out of national regulation of medical services mandates and financing, Steve.

    • Anthony Breznican

      I’m sure this man would be glad to hear that you think expanding health coverage and ensuring the safety and well-being of millions is not what America should stand for. (That’s for all the other developed nations of the world, not us. No sir!)

      Lifelong Republican to Speaker Ryan: Obamacare saved my life.

      http://www.cnn.com/2017/01/12/politics/audience-member-paul-ryan-town-hall-obamacare/index.html

      • Brian Richards

        Lifelong Republican, (not really), to Speaker Ryan: Obamacare cost me $50,000.00!

        • Anthony Breznican

          What makes you say he’s not?

          • Ron Bischof

            You didn’t pause to comprehend what Brian wrote. Reread it until you do.

          • Anthony Breznican

            Perhaps he shouldn’t phrase things incomprehensibly.

          • Ron Bischof

            You seem to be the one with the comprehension issue. Brian was clearly “writing” to Speaker Ryan about his personal “saved” story.

            Perhaps your knee-jerk ideological predilections preclude you from reading accurately.

          • Anthony Breznican

            Nah, it was a poorly written comeback. Anyway, once again you feel the need to resort to ad hominem attacks against me as a way to bully a fellow commenter. Yawn.

          • Brian Richards

            If only I knew a successful author that could help me write more comprehensibly.

          • Anthony Breznican

            First, you need to have something worth saying. I seldom see you post anything insightful about any of the topics. It’s just attack, attack, attack other commenters.

          • Brian Richards

            That was insightful.

          • Ron Bischof

            Touché!

      • Ron Bischof

        Appeals to emotion and bandwagon fallacies aren’t substitutes for rational debate on policies. Anecdotes or a series of anecdotes ≠ data.

        As I previously outlined in another post, you’re employing a successful tactic of the Left, telling stories that tug on our hearts to enable policies that are destructive when employed at the macro level. It’s designed leverage emotion and avoid critical thinking.

        We’ve already seen your static data “model” that presumes CA won’t use their block Medicaid grant effectively.

        • Anthony Breznican

          Yes, because leaders should take into account the human beings who are impacted by these policies. People who are indifferent, arrogant, egotists tend not to care about such things.

          • Ron Bischof

            Non-responsive to what I wrote. I know the game and am experienced in debate, Mr. Breznican.

            I’m not riding your hamster wheel to nowhere. You’re certainly welcome to continue.

            https://www.youtube.com/watch?v=Mh-YoKUmnyM

          • Anthony Breznican

            If you are experienced, why are you so bad at this?

            Oh, should I be careful? Are you going to get mad and google me for more personal information to use for taunts?

          • Ron Bischof

            Actually, you’re projecting again. It is you who demonstrates inexperience.

            If you would set aside your ego and leftist talking points for a moment, you might learn to be more effective at argumentation and avoid being schooled publicly by forum participants.

            I’ll provide you a couple of pointers to illustrate what you engaged in:

            https://yourlogicalfallacyis.com/appeal-to-emotion

            https://yourlogicalfallacyis.com/bandwagon

          • Anthony Breznican

            Ha ha ha… and here’s Risible Ron, crossing the high-bar to achieve a new condescension record, besting his own all-time high score. Congratulations!! 🏅

          • Ron Bischof
          • Gary Bierend

            Help me out Ron, how many time has Tony Claimed Victory! in this thread? It’s hard to keep up.

          • Ron Bischof

            I stopped counting but you’ve definitely called the consistent pattern of behavior, Gary. PN, GO, CV it is!

            Even when he’s successfully rebutted chapter and verse with references, he can’t help himself. It’s just the way he’s wired.

            At this point, all we can do is point and laugh because he’s not a serious person.

          • Gary Bierend

            Just enjoy the show, it’s like a dog eating peanut butter.

          • Gil Mertz

            Keep in mind, he still thinks Hillary won the election.

          • Anthony Breznican

            Not the election, just the majority of Americans. But no, that’s not the White House. Pretty fierce opposition growing, thought, having close to two-thirds of the nation against you. Eager for 2018 – and for Mueller’s report. Then I guess we’ll see, won’t we?

          • Anthony Breznican

            I see this is a link about ad hominem attacks, which is literally your last resort every time you get stuffed. Grow up, dude. The macho act is tired. And stick to the topics at hand.

          • Sloan Norwich

            “Literally” it’s his last resort?
            I really think I must report –
            You’d be better served
            With a better retort.

          • Brian Baker

            “Grow up, dude… And stick to the topics at hand.”

            There’s so much irony there, I wouldn’t even know where to begin.

          • Anthony Breznican

            Oh, your little nicknames and put-downs… those are signs of maturity?

  • Anthony Breznican

    It’s true, something has to change. But look at which party is trying to get more people health care coverage and which is trying to take it away. In our district, CA-25, and estimated 77,000 people will lose coverage. Tens of millions nationally will do the same. Compromise is wonderful, but in and of itself, that’s not a necessary goal. I have been an independent my whole life, voting for Democrats as well as Republicans, but now it’s clear that Democrats are the ones advocating for positive change.

  • Phil Ellis

    I think the threshold question should be – Is health care a proper issue for federal legislation. And, if so, what is its proper role.

    • Anthony Breznican

      Fair enough. But you could also ask, should government be concerned with employment? We’re either a society or we’re not. America is great because it says the individual matters, but there are some things that make it better for everyone if we work together – infrastructure, defense, economy, the environment, and health & wellness are prime examples.

      • Brian Richards

        Nobody said the government shouldn’t be concerned about an issue. The issue is what degree should the federal government run healthcare. You seem to think that based on the success of the VA, the federal government’s involvement should leap from a few million to 350 million people. How many examples of federal government failure do you need? College? We want everyone to go to college and we make loan qualification easy. So what happens? The cost of college skyrockets. Housing! We want everyone to won their own home and we make qualification easy. So what happens? The housing market collapses and we’re stuck bailing out lenders. By the way, these are bipartisan caused problems. Based on the success of those two endeavors, lets go for it all and tackle the 4 trillion dollar healthcare industry. Lets make it easy for everyone to get healthcare and lets make it cheap, although borrowing money from the Chinese will not be cheap one day. What could possibly go wrong?

        • Anthony Breznican

          I would say based on the success of Medicare, that’s a program that could be expanded to a functioning single-payer system that would allow us to join other industrialized nations like England and Australia in providing broad, sustainable coverage for citizens.

          • Brian Richards

            And tell us based upon your trips to Australia and England how those programs are working out? Australia? A country with the population 3/5ths of California? What’s wrong, Lichtenstein wasn’t a good enough example? Healthcare in the UK sucks. It’s rationed and it’s denied based on your life expectancy. No thanks!

          • Anthony Breznican

            You should ask them. Or read some of the polling. Every system has problems and complaints, but none of those countries would trade their system for our Darwinian one.

          • Brian Richards

            Wrong! Foreigners from all over the planet come here for healthcare if they have the money. And I have asked them. I know plenty of Canadian and UK expats and without exception they deride their system. But I don’t expect to convince you as that would require an open mind. Yes, our system has problems and complaints but go to the UK and try to get a MRI and tell me how it works out in 6 months, if you’re lucky. Go to Canada and try to get a knee replacement and assuming they approve you because you’re not too old, tell me how that works out in a couple years. You literally know nothing about the sad state of healthcare in some of those countries.

          • Anthony Breznican

            Nah, they come here sometimes for elective surgeries or for certain specialists. This is a tired old talking point that has been discredited many times.

          • Steve Lunetta

            Anthony- I’d like to learn more about this. Can you email me? slunetta63@yahoo.com. I’m not challenging your assertion- I’d just like to know where you get this info. Thx!

          • Brian Richards

            Not sure why he couldn’t provide the same info to all of us, assuming it’s true.

          • Steve Lunetta

            No question- it would be good info to share. I’d like to see it because it sounds like good material for a column. If its legit, it contradicts a long-held talking point. If its not legit, then the talking point stands. Either way, it would be interesting to understand.

          • Anthony Breznican

            Hey Steve, I wasn’t about to spend time posting information to those trolls, but since you asked and you seem like a reasonable dude, I’m happy to talk about this.

            The claim that Canadians are in a mass exodus to the United States for health care is one that has been thrown around for a long time and it has been debunked in many places. Unfortunately, it’s one of those “big lies” — repeated often enough that some believe it by rote.

            It’s self-evident that the border hospitals in Montana, Minnesota and North Dakota are not swarmed with ailing Canadians seeking care and comfort. However, yes, some Canadians (and people from around the world) do come here for care with specialists. Just as people from around our own country travel to specific clinics, like Johns-Hopkins, for care from certain doctors.

            And if you are an extremely wealthy Canadian, certainly you could pick and choose the best doctors from around the globe to care for you. No question.

            On the whole, however, we are not a refuge for sick Canadians. The claim that you wait an eternity for a knee replacement is just false. Are there waits? Yes, and the most urgent care is prioritized. (As it is here. Anyone who has tried to schedule a doctor’s visit for a pain, only to be told yes, there’s an open spot in five weeks, knows that routine.)

            Anyway, the right-leaning Fraser Institute think tank released a study estimating that 52,000 Canadians come to the U.S. for care in 2014, a spike of 25% from the year before. Again, these were only estimates, since there isn’t a lot reliable recent date about this, and the report was widely CITED by those who wanted to discredit the Canadian system.

            One of the people who cited this study was Donald Trump, and the Washington Post fact-checked his claim (and the Fraser study) here: https://www.washingtonpost.com/news/fact-checker/wp/2016/10/11/trumps-claim-about-canadians-traveling-to-the-united-states-for-medical-care/?utm_term=.6d6ad24ec0e6

            Again, there isn’t a lot of recent data on the subject — partly because it isn’t perceived as a major issue, either in Canada or here. But in 2002, another study attempted to explore this question:

            http://content.healthaffairs.org/content/21/3/19.full.html

            It surveyed ambulance services and hospitals near the border and found that 80 percent of American medical centers saw (on average) a single Canadian per month. One. Roughly 40 percent had seen zero Canadians.

            This will sound comical but I actually have several Canadian friends (I know, I know, the old “my girlfriend is in Canada” routine,) but they find it laughable that Americans think Canadians would like to have our Darwinian-style medical coverage in their country.

            They have complaints, no doubt. This is not to celebrate the Canadian system as perfect. Wait times there sound like they could be improved. (Comparatively, it’s not like our own single-payer system, Medicare, has extraordinary wait times. This is a flaw of the medical treatment system, not the medical coverage system.)

            The AARP cited that 2002 study in its own debunking of this Canadians in Peril myth: http://www.aarp.org/politics-society/government-elections/info-03-2012/myths-canada-health-care.html

            Back to that Fraser study about 2014 showing an increase in this number — the same group put out a 2015 study, which Donald Trump did NOT choose to cite. It said roughly 45,000 Canadians (I’m rounding) went abroad for specialist care, compared to the 52,000 the year before. Still sounds like a lot, right?

            But as the CBC reports, this is actually just 1% of the Canadians who required a specialist. One. Percent.

            http://www.cbc.ca/news/politics/canadian-health-tourists-drop-1.3800729

            This “Canadians go the U.S. for medicine” story is a very, very old one. Here’s a report from 2009 rebutting it: http://www.denverpost.com/2009/06/04/debunking-canadian-health-care-myths/

            What I found interesting in that report was this claim: When Canadians do come to the U.S. to see a doctor, those costs are covered by the Canadian government as part of their national health care plan.

            In other words, they may come here because there is a need to see a specific specialist, but the care is still underwritten by the single-payer system. I’d be interested to learn more about that.

            Anyway, nice talking with you. Although this subject has been written about extensively, I do think you are on to something: why people continue to believe — and promote — this myth is an excellent question?

            Are they doing it maliciously, knowing it to be false, to bolster a political position? Or are they just mindlessly echoing an oft-repeated falsehood?

          • Steve Lunetta

            Very cool, Anthony! I want to read all of this. You should do a column with this info. If not, I will do it. Its too important a topic. And, your data is persuasive!

          • Anthony Breznican

            Please feel free to use as you see fit. Those are just a few examples. I enjoy your columns, so I look forward to your writing on this subject.

          • vladmir vapnik

            Included Steve could also be information related to Americans who also travel abroad to have surgeries. If you google medical tourism you can find lots of information. It isn’t just that people come to the United States who can afford to get better care. For those people the expense does not matter. They don’t also all come to the United States. There are other destinations. But there are also large numbers of people who leave the United States to have medical procedures done at a greatly reduced price. Many find they can get better care in a foreign country. What does this say about the American system if people are willing to pay for round trip tickets to a destination perhaps halfway around the world to get a service for far cheaper? This was a topic that was covered quite a bit about 10 years ago. I don’t know how much it happens now or how Obamacare influenced it or perhaps the financial crisis or strength of the US dollar. But it’s well worth researching if you’re writing an article related to people who enter the United States to get care. It sort of adds another element if people are also leaving the United States to get care.

          • Ron Bischof

            Here’s a perspective from Canada:

            “The trunk of her silver Ford Taurus was packed with everything Sharon Shamblaw needed to get through the next three months, including a pile of stationery so she could write to her three kids, Amy Poehler’s biography, and a DVD of the Chicago Blackhawks’ greatest moments leading up to their Stanley Cup victory last year.

            Shamblaw, 46, rolled up to Roswell Park Cancer Institute in Buffalo on Jan. 25, 2016, expecting to be admitted to the stem cell transplant ward the next morning for an intensive, life-saving treatment program for acute myeloid leukemia.

            That was the plan.

            Instead, the morning before she was to be admitted, doctors discovered the cancer, which had been brought into remission with several rounds of chemotherapy, had returned. The transplant was off the table. By March 30, she had just two choices: die in a semi-private room at hospital or die at home. Last week, her family rolled a hospital bed into the room she shares with her husband of 27 years.

            “I was so close,” Shamblaw said Monday from her home in St. Marys, Ont. “I believe I should be in Buffalo right now, getting ready to come home soon. I’m not ready to die.”

            Shamblaw is the latest victim in the breakdown of an essential cancer care program in Ontario hospitals, the subject of an ongoing Toronto Star investigation.

            https://www.thestar.com/news/gta/2016/04/27/sharons-story-trip-to-buffalo-for-stem-cell-transplant-came-too-late.html

          • Anthony Breznican

            What a tragic story. Heartbreaking for that family. The Star has been doing good work uncovering the problems in Ontario’s local cancer screening program.

            It’s a local problem they need to fix. In the meantime, note in that story that “The health ministry responded last fall by approving more than $100 million (U.S.) to send hundreds of Ontario patients who would have died waiting for treatment in this province to hospitals in Buffalo, Cleveland and Detroit.”

            They should also work quickly to make sure that action is being taken for patients. There will be local breakdowns in every health care system. But when it comes to the big picture, the notion that Canadians are crossing the American border in huge volumes for care is false.

          • Ron Bischof

            No one made the argument that “Canadians are crossing the American border in huge volumes”. That’s a straw man you introduced.

            Canadians in their single-payer system do in fact seek treatment in the USA. We should be intellectually curious and why that’s the case and if there’s medical services innovation produced by that system equal to that of ours.

            Here’s another Canadian reporter:

            Crossing the Border for Care
            Frustrated by long waits, some Canadians are heading to the U.S. for medical treatment.

            “To be sure, Canada’s publicly funded system provides individuals with preventative care and medical treatment from primary-care physicians along with access to hospitals and other important medical services. Universal health care is a source of collective pride in Canada, which boasts one of the highest life expectancies and lowest infant mortality rates in the world.

            However, the Canadian health-care system is far from perfect, and its shortcomings are a hot-button topic north of the 49th parallel.

            Contrary to popular belief among Americans, health care is not entirely free for Canadians. Dental, ambulance and many other services as well as prescription medications must be paid for out of pocket or they’re covered through a combination of public programs and private health insurance. About two-thirds of Canadians have such insurance.”

            https://www.usnews.com/news/best-countries/articles/2016-08-03/canadians-increasingly-come-to-us-for-health-care

          • Anthony Breznican

            Yup, that’s based on the Fraser study I mentioned. Amounts to 1% of Canadians.

          • Ron Bischof

            There’s more than the Fraser study (Canadian organization as well) in the article, of course.

          • Ron Bischof

            The inherent rationing that single-payer systems entail are worth examining. Dismissing it as a “local issue” patched with emergency funding doesn’t address root causation.

          • Anthony Breznican

            Because you are a waste of research.

          • Ron Bischof

            Aww… does this mean you won’t email this critical information to Steve either?

          • Anthony Breznican

            See below.

          • Ron Bischof

            Precisely, Brian.

            My wife is a medial professional in the dental field and her office was the official one for the British Consulate for a time. They do work on A-List celebrities whose appearance is critical to their marketability.

            The NHS dental work from the UK is almost invariably appallingly low quality and must be completely redone. That of other European countries with their touted socialized medicine is rarely up to U.S. standards.

          • Ron Bischof

            Single-payer systems lead to rationing of care and price controls stifle innovation.

            https://www.policyed.org/intellections/single-payer-right-america/video

        • Ron Bischof

          Government efficiency at work:

          Trump Orders Government to Stop Work on Y2K Bug, 17 Years Later

          https://www.bloomberg.com/politics/articles/2017-06-15/trump-orders-government-to-stop-work-on-y2k-bug-17-years-later

        • Ron Bischof

          More government:

          We Could Have Had Cellphones Four Decades Earlier
          Thanks for nothing, Federal Communications Commission.

          https://reason.com/archives/2017/06/11/we-could-have-had-cellphones-f

          • vladmir vapnik

            That article is exceptionally hyperbolic in the conclusions it seems to reach.

          • Ron Bischof

            Are any of the material facts incorrect?

          • vladmir vapnik

            It isn’t as much that the information provided is incorrect so much as it is that the information missing isn’t provided. It’s quite a statement “we could have had cellphones four decades earlier”. A confluence of technologies needed to develop for that to be a viable technology, technologies that didn’t exist wouldn’t have been developed alone for such a speculative high end market.

          • Ron Bischof

            The focus of the article is Federal government regulatory ineffecies and how monopolies managed on the utility model stifle innovation.

          • vladmir vapnik

            Sure this was a good example of a failure of government. Luckily damages were mitigated by the times. We are experiencing similar issues with the FCC today with chairman Ajit Pai using his position to stifle innovation for the benefit of a single industry.

            Still the conclusions of the article are very much incorrect. It seems you posted this as evidence of something larger related to government’s role regarding technological innovation. Was this meant to implicitly argue something larger than this one instance of poor governance?

          • Ron Bischof

            Yes, it is part of a larger question on the proper role and efficacy of government.

            https://www.facebook.com/prageru/videos/1445758062133712/?pnref=story

          • vladmir vapnik

            That would be a very compelling argument for someone who doesn’t know the actual origins of those technologies. Sadly it’s a gross misrepresentation.

            Here’s a very condensed talk by someone named Alan Kay, I’m not sure if you’re familiar with him. I’d suggest watch this.

            https://www.youtube.com/watch?v=id1WShzzMCQ

          • Ron Bischof

            I’m well informed about technology and I know that Alan Kay was part of the Xerox Parc program and an early Apple investor.

            What’s your specific point?

          • vladmir vapnik

            Well if you know who is then perhaps listen to his perspective. That little video you posted is a work of fiction in that ignores the actual history.

            Speaking of Alan Kay just here’s a quick question that would help me understand your background. Do you know what Object Oriented Programming is? A flip flop, an instruction set? Do you know how these technologies were built? Von Neumann vs modified harvard architecture? Do you know what Turing complete means, or np completeness?

          • Ron Bischof

            Non-responsive to my question and you’re making your response about me.

            Why, specifically, is the video I posted about capitalism a “work of fiction”?

            No need to understand my background. Answer my question and I’ll inquire further if I need clarification.

          • vladmir vapnik

            Watch Alan Kay’s lecture. He actually participated in the invention of many of the technologies listed in your video. I don’t have time to argue with a layman, but that video was a child’s representation of this nations history and the technological innovation that was created in the latter half of the 20th century and government’s role in either providing for or stifling innovation. I’m not arguing against Capitalism. But most of what we use today is largely thanks to private public partnerships that allowed for it to be invented.

            There’s a reason Silicon Valley exists where it does and it didn’t show up in North Dakota or China. If we want to continue to be leaders and innovators well we need to know what actually works to achieve these ends.

            Here’s a good look at some achievements I suggest you look through,

            https://www.darpa.mil/about-us/darpa-history-and-timeline

            And again I invite you to watch that Stanford lecture by Alan Kay, it would be well worth your time and far more informative than the link you provided.

          • Ron Bischof

            The link I provided is specifically targeted at the layman because the majority of the population falls into this category.

            No one is arguing against public/private partnerships. However, funding ≠ technology innovation. The latter is produced by the private sector.

          • vladmir vapnik

            You’re right funding != technological innovation, perhaps as proof that DARPA in contrast to ARPA has built little due to the lack of creative vision of those that run it. Equally untrue is the statement you wrote following however. Innovation production is not solely the domain of the private sector.

          • Ron Bischof

            You added the word “solely”. For an example of public/private partnership, Sir Tim Berners-Lee was at CERN when he prototyped hyperlinks on a NeXTcube.

            It was capitalism that made the technology ubiquitous.

          • vladmir vapnik

            I apologize if I misunderstood but that certainly seemed to be the implication. Was it not? [Technology innovation] is produced by the private sector. Is this not the sentence you intended to get across? I didn’t feel that statement should stand alone, it seems incomplete, lacking context.

            Your statements, your evidence all seem to lack a greater context. The private sector works to both create but just as often impede innovation. I’m not trying to be too judgmental here but that really was quite a terrible video you submitted. It lacks an understanding of how the technologies it praises were invented in the first place, the role “big government” played in their creation. Not only was it childishly simple, it’s conclusions it’s statements are clearly incorrect.

            The last people we should be seeking advice from in regards as to how to innovate and create technologies for the future are those who can’t even build or understand the workings or the history of the technologies that exist today.

            So P vs NP what do you think? You more on the side of P or NP?

          • Ron Bischof

            Yes, you don’t like the video, assert what I write lacks context, think innovation is dead and are a fan of big government.

            Silly, but I get it.

            Time to move on, Vlad. You’re repeating yourself.

          • vladmir vapnik

            Innovation isn’t dead, but it is in danger from small unremarkable men who can’t see very much beyond themselves, in this country at least.

            So you don’t want to talk about one of the most important unsolved questions of our era?

          • Steve Lunetta

            I think I read where Julius Caesar was presented a working model of a steam engine. He passed up on the technology. Can you imagine if the Romans had railroads? We’d all be speaking Latin today….

          • vladmir vapnik

            Leonardo da Vinci despite his brilliance was never able to make a working engine in his lifetime. He was limited by the times. I find it unlikely the Roman’s would have been able to build a very useful steam engine given the materials at their disposal, the metallurgy required to keep steam highly pressurized. But perhaps I am wrong given we still haven’t been able to figure out how to make concrete as well as they did.

            The Romans were very pragmatically minded. If they didn’t see something as useful they didn’t adopt it. They weren’t great innovators. The Greeks on the other hand sought knowledge for it’s own sake. The Romans essentially took many of their good ideas from the Greeks and put them to use. It is said however due to Archimedes penchant for inventiveness especially as it related for instruments of war, whenever the Romans saw a Greek carrying something toward them that they didn’t recognize during way they would run away.

            My point being intelligence alone isn’t worth much. Da Vinci, a man far smarter than most was unable to live up to his full potential limited by the times. A good perspective, a good outlook, is far more valuable than intelligence. The Romans lacked the best perspective. History is full of examples where we could have gone one way and were limited by our perspective and perhaps missed out on great advancement. I wrote below about Charles Babbage who is credited with inventing the first computer, though he never built one. It was a mechanical computer. He was limited by the perspective of the times. We could have perhaps had computers far earlier. Computer Science despite it’s name is neither about computers nor is it a science so the actual instrument used to do computation perhaps wouldn’t be too impeding to be useful.

            What would have happened. It’s a good question to ask. What would have happened had Christians not burned down the library of Alexandria? What would have happened had the dark ages never happened? What are the things that limit our ability to see a useful idea and use it?

            Many don’t realize it but our perspective is very wrong today. Not wholly but we are headed in the wrong direction. We’ve been riding the coattails of innovation that happened more than 30 years ago. Intel for instance has stifled a great deal of innovation in truth locking us into one perspective. We are making great advances now in certain areas that we missed out on 40 to 50 years ago. We made a great misstep in the study of artificial intelligence. Researches like Rosenblatt were cast aside by the AI community and though we are now implementing work that follows of his work on perceptrons we experienced what has been described as an AI winter because of it. We didn’t also develop the hardware that could have helped innovate so much. We now are to some degree with catching up with this with GPUs and FPGAs but we missed the boat being locked into Intel’s limited vision. We should have adopted an actor model long ago. This may all sound like greek but the point is our perspective now is allowing us much perhaps like Julius Caesar to miss out on what truly can bring a better future. Our politics leads us to abandon useful research and development. We are fighting to compete with developing nations in the worst way while abandoning a perspective that values and grows intelligence and expertise and innovation. Most misunderstand our current place as the dominant technological force due to some inherent or innate ability due to just being american. We will shortly be left behind if we don’t change our perspective and recognize we are living off the borrowed success of the past.

    • Steve Lunetta

      A great question, Phil. But, seeing as how the Feds are already involved to a very deep level, I think the philosophical question has already been answered. Government involvement is here to stay in health care, regardless of our personal feelings about it. The next question becomes: “How do we modify the system to create the best outcomes as economically as possible”?

      • Brian Baker

        Perfect illustration of surrender.

        That kinda sounds like the old (and bad) joke, “when rape is inevitable, lie back and enjoy it”.

        No thanks.

  • lois eisenberg

    OFF TOPIC, but very interesting ***
    “Attorney General Jeff Sessions might not recall anything about anything, but an American lobbyist who is paid to work on behalf of Russian interests says he attended two dinners with Sessions during the 2016 campaign”

    • Ron Bischof

      At least you recognize your post isn’t germane. That’s progress!