The government does not do everything right.
The preceding sentence was perhaps the least contestable sentence in the history of column writing. But now for the heresy some would like to ignore: sometimes, the government does do things right.
If you are an American who is paying attention (and just by the fact that you are reading this column, you are presumably the latter), you are aware that the current system of health care in this country is floundering. The costs of employer-based health insurance are crippling American businesses, even putting them at a competitive disadvantage in a globalized market. In addition, 47 million Americans do not have health insurance at all, most because it is too expensive and/or their employers are not or cannot help pay for it. This means that there are American families who are one medical situation away from both bankrupting themselves and shifting their health costs onto taxpayers or doctors.
Even those that have health insurance are not thrilled with what they’ve got. Premiums and deductibles seem too high, choice feels restricted, and there is the haunting knowledge that insurance companies have every financial incentive to cover as little as it can get away with.
In sum, the system is disabling employers that pay for health care, leaving those with coverage unsatisfied, and failing to cover millions. All of this may be acceptable if Americans were receiving superior health treatment with better outcomes that people living under other health systems. Largely, however, Americans are not as measured in terms of criteria like life expectancy and infant mortality.
Amidst this wreck are a few programs that do better than the system of private insurers now dominant in our system. Those programs, including Medicare, health care for veterans, and health coverage for poor children, are run by the government. And, at least as compared to the private insurers, the government is doing it right.
Yet this week, as President Bush was presented with an expansion of the popular and successful state children’s health insurance program, or S-CHIP, he found an opportunity to use the fourth veto of his administration. S-CHIP was originally envisioned to cover children in poor families. The program has been successful and as it came up for reauthorization, a bipartisan coalition in Congress agreed on a significant expansion so that it could reach even more of the 9 million American children living without health insurance. Members of Congress are now scrambling to gather the votes needed to override the President’s veto and salvage S-CHIP.
Why is the President so adamantly opposed to the expansion of S-CHIP, an expansion many in his own party support? It presumably is not because he thinks poor children should not be insured. It also is not because he thinks S-CHIP is ineffective. The President proposed his own expansion of the program, albeit a much smaller expansion than what Congress agreed to. The motivation for the veto was in fact precisely the opposite – S-CHIP is very effective. It is so effective and satisfying – like Medicare – that it makes it look as though health care can be successful even without private insurers. It looks as though the government is doing something right.
The President sees S-CHIP expansion as a step along the way toward government-funded health insurance for all Americans. In this, he is correct: the expansion does provide government coverage to more Americans. Where the President is wrong is that this is a bad thing.
In the private market, when one entity does something better than another, it is rewarded with market share. The same should be true where, as here, the government is doing a better job at covering Americans and providing them with coverage for quality health care than is private insurance. S-CHIP is targeted at covering those that private insurers have overlooked or refused to cover. If, based on its effectiveness, it picks up a few families who drop their own private insurance, that is simply the market’s way of punishing private insurers.
The fact is that even if President Bush’s veto is overridden, the United States is not converting to single-payer health insurance anytime soon. None of the major presidential candidates have proposed a plan that goes so far. Where the United States is going it toward a more effective system of coverage by expanding a program that works. Effectiveness is precisely what the market ought to reward, even where it is the government that is doing something right.
Showing posts with label Health Care. Show all posts
Showing posts with label Health Care. Show all posts
October 05, 2007
December 18, 2006
Spirit of the Holidays
Part of my relationship with my mother requires that I hear a large amount of information that I hardly care about. I receive all sorts of news – good and bad – about people that I do not know, cannot remember, or never will meet. Maybe this is part of every son’s relationship with his mother.
So, a few months ago, when my mom began our conversation with “D, I just heard the worst story,” I immediately settled into my feign-interest mode. My mom then went on to tell me about an employee of the florist she works with as part of her event planning business who had been having terrible headaches and had repeatedly been put off by doctors claiming they were too busy to see him or perform the necessary tests. She told me that had any one of us – the relatively privileged and well-connected – had a similar malady, we would have had no trouble getting an appointment and diagnosis from the doctor, but because this person was poor and black and had no health insurance, he kept running into obstacles that were potentially threatening his life.
The man has since been diagnosed with a malignant brain tumor. He can no longer work. He certainly cannot afford his medical care. His family who depended on him is now taking care of him, making sacrifices in every way imaginable.
I have rarely seen my mom so passionate and compassionate about something. She was obviously upset that this man was suffering and angry that he was not being properly taken care of. And I know what happens when my mom gets angry.
Over the next couple of months, my mom did something amazing. Heroic even.
Rather than simply allowing this man to continue unaided, she, along with the two florists the man had worked for, took it upon herself to make a difference in his life. She acted on her compassion. She decided that she would not wait for someone to help this man – why wait, she concluded, when she could help him herself?
This holiday season, my mom, along with the two florists, has led a campaign to gather money for this man and his family – to be used for Christmas presents or food or health care. Their effort raised over $1,500, an amount that was matched by Target. Thanks to these efforts - efforts that were not required and that were undertaken without knowing how they would turn out - this man and his family will have the opportunity for a relatively pleasant Christmas during this most difficult of times for them.
She reported that the man was in tears as he thanked her. “I didn’t know there were people who would just give like this,” he sobbed. There were tears in my mom’s eyes as she relayed the story to me.
What my mom did is inspiring. It means far more than any of the gifts she and my dad got for me or my wife or my daughter. It captures the spirit of charity that should be at the heart of this season, during which we have the opportunity to reach out and help those not as fortunate as ourselves. And perhaps most inspiring, it shows what happens when people act. It is so easy to simply criticize and ponder the ills of the world. It is far more difficult to act. But it is only when people act out of compassion for others or passion for making a difference that things change.
Thank you, Mom, for living this lesson this holiday season.
So, a few months ago, when my mom began our conversation with “D, I just heard the worst story,” I immediately settled into my feign-interest mode. My mom then went on to tell me about an employee of the florist she works with as part of her event planning business who had been having terrible headaches and had repeatedly been put off by doctors claiming they were too busy to see him or perform the necessary tests. She told me that had any one of us – the relatively privileged and well-connected – had a similar malady, we would have had no trouble getting an appointment and diagnosis from the doctor, but because this person was poor and black and had no health insurance, he kept running into obstacles that were potentially threatening his life.
The man has since been diagnosed with a malignant brain tumor. He can no longer work. He certainly cannot afford his medical care. His family who depended on him is now taking care of him, making sacrifices in every way imaginable.
I have rarely seen my mom so passionate and compassionate about something. She was obviously upset that this man was suffering and angry that he was not being properly taken care of. And I know what happens when my mom gets angry.
Over the next couple of months, my mom did something amazing. Heroic even.
Rather than simply allowing this man to continue unaided, she, along with the two florists the man had worked for, took it upon herself to make a difference in his life. She acted on her compassion. She decided that she would not wait for someone to help this man – why wait, she concluded, when she could help him herself?
This holiday season, my mom, along with the two florists, has led a campaign to gather money for this man and his family – to be used for Christmas presents or food or health care. Their effort raised over $1,500, an amount that was matched by Target. Thanks to these efforts - efforts that were not required and that were undertaken without knowing how they would turn out - this man and his family will have the opportunity for a relatively pleasant Christmas during this most difficult of times for them.
She reported that the man was in tears as he thanked her. “I didn’t know there were people who would just give like this,” he sobbed. There were tears in my mom’s eyes as she relayed the story to me.
What my mom did is inspiring. It means far more than any of the gifts she and my dad got for me or my wife or my daughter. It captures the spirit of charity that should be at the heart of this season, during which we have the opportunity to reach out and help those not as fortunate as ourselves. And perhaps most inspiring, it shows what happens when people act. It is so easy to simply criticize and ponder the ills of the world. It is far more difficult to act. But it is only when people act out of compassion for others or passion for making a difference that things change.
Thank you, Mom, for living this lesson this holiday season.
November 20, 2006
Protecting Our Most Vulnerable
In the twelve months since last Thanksgiving, I've added one very small (but growing every day) thing to be thankful about. For almost ten months now, I've been the proud dad of a beautiful baby girl. So far, my wife and I have been extremely lucky -- our daughter is a great and easy kid and she has been healthy and happy thus far. It is this that I am most thankful for this year.
But even as lucky as we have been, raising a child is difficult work. For those of you who are parents, I'm not telling you anything you don't already know. For those who are not parents, the difficulty and incredible sense of responsibility of child rearing cannot be fully understood until you are staring down at a tiny, helpless human being and you know that it is now your job to turn her into an independent person. The process is filled with joy, but it requires patience, sacrifice, and careful attention to the details through which babies send us signals about their health, hunger, and happiness.
This week, my thankfulness stretches even deeper as I realize I live in the city with the highest infant mortality rate among the sixty largest American cities. In Memphis, 14 of 1,000 infants die before they reach their first birthday. That's more than double the national average. More human beings die in Memphis as infants than from homicides. In some of the poorest areas of Memphis, the rate is four times the national average. Even though these children live in the most medically-sophisticated country in the world, a child born in these areas has about the same chance of reaching its first birthday as the average child born in several third world countries.
While infant mortality is often viewed as a medical statistic, it is more properly understood as a symptom of deeper social failures. The U.S. has more neonatologists and neonatal intensive care beds per capita than Australia, Canada, and Great Britain, but has a higher infant mortality rate than these countries. The problem is not that we lack the doctors or facilities. Infant mortality risks begin well before a pregnant mother reaches a hospital. They begin the moment a woman becomes pregnant and the U.S. -- Memphis, in particular -- has done a poor job of delivering information and services to the pregnant women whose children are most at risk.
The characteristics most highly correlated with an increased risk of infant mortality are poverty, lack of education, lack of access to health care, and a mother's use of alcohol, tobacco or other drugs while pregnant. Many mothers do not see a doctor during the entire term of their pregnancy until they enter the hospital for labor. They neglect a visit to the doctor because they do not have health insurance or they dont know that regular visits during pregnancy are important or they cannot get time off from their employer or a thousand other reasons. Even if our health care system removes these barriers in theory, many women are still paralyzed by them in reality. This lack of early and regular prenatal care puts infants at a disadvantage even before they enter the world.
As a society, we should be alarmed that in a country where we are capable of achieving medical miracles, so many of our fellow citizens do not have access to the information or health care needed to give their children the best opportunity to survive. Even in the best of circumstances, raising a healthy child is a difficult task. To avoid making it even more difficult, we must do better at getting information to pregnant women that will allow them to have safer pregnancies and births, and we must remove barriers these women feel toward seeing physicians early and often during their pregnancies and during a child's earliest months. We will not reach every pregnant woman and we'll never eliminate the tragedy of infant mortality, but we must do better at protecting our most vulnerable.
But even as lucky as we have been, raising a child is difficult work. For those of you who are parents, I'm not telling you anything you don't already know. For those who are not parents, the difficulty and incredible sense of responsibility of child rearing cannot be fully understood until you are staring down at a tiny, helpless human being and you know that it is now your job to turn her into an independent person. The process is filled with joy, but it requires patience, sacrifice, and careful attention to the details through which babies send us signals about their health, hunger, and happiness.
This week, my thankfulness stretches even deeper as I realize I live in the city with the highest infant mortality rate among the sixty largest American cities. In Memphis, 14 of 1,000 infants die before they reach their first birthday. That's more than double the national average. More human beings die in Memphis as infants than from homicides. In some of the poorest areas of Memphis, the rate is four times the national average. Even though these children live in the most medically-sophisticated country in the world, a child born in these areas has about the same chance of reaching its first birthday as the average child born in several third world countries.
While infant mortality is often viewed as a medical statistic, it is more properly understood as a symptom of deeper social failures. The U.S. has more neonatologists and neonatal intensive care beds per capita than Australia, Canada, and Great Britain, but has a higher infant mortality rate than these countries. The problem is not that we lack the doctors or facilities. Infant mortality risks begin well before a pregnant mother reaches a hospital. They begin the moment a woman becomes pregnant and the U.S. -- Memphis, in particular -- has done a poor job of delivering information and services to the pregnant women whose children are most at risk.
The characteristics most highly correlated with an increased risk of infant mortality are poverty, lack of education, lack of access to health care, and a mother's use of alcohol, tobacco or other drugs while pregnant. Many mothers do not see a doctor during the entire term of their pregnancy until they enter the hospital for labor. They neglect a visit to the doctor because they do not have health insurance or they dont know that regular visits during pregnancy are important or they cannot get time off from their employer or a thousand other reasons. Even if our health care system removes these barriers in theory, many women are still paralyzed by them in reality. This lack of early and regular prenatal care puts infants at a disadvantage even before they enter the world.
As a society, we should be alarmed that in a country where we are capable of achieving medical miracles, so many of our fellow citizens do not have access to the information or health care needed to give their children the best opportunity to survive. Even in the best of circumstances, raising a healthy child is a difficult task. To avoid making it even more difficult, we must do better at getting information to pregnant women that will allow them to have safer pregnancies and births, and we must remove barriers these women feel toward seeing physicians early and often during their pregnancies and during a child's earliest months. We will not reach every pregnant woman and we'll never eliminate the tragedy of infant mortality, but we must do better at protecting our most vulnerable.
April 21, 2006
Abstinence from Reality
Imagine you have in your hands the capability of immunizing every American woman from HPV, a sexually-transmitted disease, several strains of which are the primary cause of cervical cancer. Science has shown that by eliminating these strains of HPV, a vaccine could significantly decrease instances of cervical cancer and other illnesses resulting from HPV. What would you do?
I hope you would find a way to get that vaccine to as many women as possible -- in the US and globally -- to help decrease, even eliminate, the possibility of contracting HPV and cervical cancer.
Unfortunately, this compassionate route may not be what the people actually charged with making such decisions settle upon. Later this year, the FDA is expected to approve an HPV vaccine. However, the committee that makes recommendations regarding immunizations may not recommend the HPV vaccine for widespread use. The Bush Administration is cool to any policy -- scientific or otherwise -- that could be construed to implicitly condone premarital sex. As Senator Tom Coburn puts it, "Premarital sex is dangerous, even deadly. Let's not encourage it by vaccinating ten-year-olds so they think they're safe." How's that for a pro-life stance?
Of course, cervical cancer is also "dangerous, even deadly." In the US, 5,000 women die each year of cervical cancer. The number who die of the disease globally is nearly a quarter-million. Senator Coburn would have us ignore a tool that could decrease these numbers for fear that protecting women in this way may encourage more promiscuous behavior. Even if decreasing/eliminating the risk of HPV and cervical cancer had been shown to increase promiscuity, and it has not, are the 5,000 lives that could be saved so expendable as to be sacrificed in the name of a moral principle -- sexual abstinence before marriage -- many Americans do not even ascribe to?
By promoting abstinence as the only legitimate way to prevent STDs or unwanted pregnancy, the Bush administration has transformed health decisions that ought to be based on science into political decisions based on morality. According to researchers in various branches of the government, government scientists are being kept on a very tight political leash that inhibits the free and open inquiries required to make valuable scientific advances. This merger of science and politics has allowed the Administration to pursue its social goals -- like abstinence programs -- by using selective science. Of course, this is all perfectly consistent with the Administration's complete aversion on many topics to dissenting voices and evidence.
What about a hypothetical HIV vaccine? Certainly, a vaccine against the most deadly STD would be distributed immediately and en masse. Don't be so sure. Reginald Finger, former medical advisor to the conservative group Focus on the Family, says, "With any vaccine for HIV, disinhibition (the removal of risk or fear) would certainly be a factor and it is something we will have to pay attention to with a great deal of care." Before dismissing Finger's opinions as that of an out-of-touch ideologue, know that he sits on the very committee charged with making immunization recommendations. His stance should not be surprising as the logic is consistent -- an HIV vaccine would decrease the risks of premarital sex and thus, could lead to greater promiscuity.
There can be no question that abstinence is the most effective method of preventing STDs and unwanted pregnancies. Teaching abstinence is useful and healthy. However, there can also be no question that the majority of Americans do not practice abstinence before marriage. In fact, many Americans see premarital sex as normal and sensible, not immoral. Denying those who choose to engage in premarital sex -- an activity that, by the way, is perfectly legal -- tools that can improve their health or save their life, whether it be the HPV vaccine or education on contraception, is not a policy at all. It is the imposition of one group's morals on the health of all Americans in deliberate disregard of reality.
I invite those making the HPV vaccine recommendations to open their eyes and look beyond the political goals their bosses hope to accomplish. If they cannot, I invite them to look in the eyes of the families of any American who contracts an illness the vaccine could have prevented and explain themselves. Maybe then they would see reality.
I hope you would find a way to get that vaccine to as many women as possible -- in the US and globally -- to help decrease, even eliminate, the possibility of contracting HPV and cervical cancer.
Unfortunately, this compassionate route may not be what the people actually charged with making such decisions settle upon. Later this year, the FDA is expected to approve an HPV vaccine. However, the committee that makes recommendations regarding immunizations may not recommend the HPV vaccine for widespread use. The Bush Administration is cool to any policy -- scientific or otherwise -- that could be construed to implicitly condone premarital sex. As Senator Tom Coburn puts it, "Premarital sex is dangerous, even deadly. Let's not encourage it by vaccinating ten-year-olds so they think they're safe." How's that for a pro-life stance?
Of course, cervical cancer is also "dangerous, even deadly." In the US, 5,000 women die each year of cervical cancer. The number who die of the disease globally is nearly a quarter-million. Senator Coburn would have us ignore a tool that could decrease these numbers for fear that protecting women in this way may encourage more promiscuous behavior. Even if decreasing/eliminating the risk of HPV and cervical cancer had been shown to increase promiscuity, and it has not, are the 5,000 lives that could be saved so expendable as to be sacrificed in the name of a moral principle -- sexual abstinence before marriage -- many Americans do not even ascribe to?
By promoting abstinence as the only legitimate way to prevent STDs or unwanted pregnancy, the Bush administration has transformed health decisions that ought to be based on science into political decisions based on morality. According to researchers in various branches of the government, government scientists are being kept on a very tight political leash that inhibits the free and open inquiries required to make valuable scientific advances. This merger of science and politics has allowed the Administration to pursue its social goals -- like abstinence programs -- by using selective science. Of course, this is all perfectly consistent with the Administration's complete aversion on many topics to dissenting voices and evidence.
What about a hypothetical HIV vaccine? Certainly, a vaccine against the most deadly STD would be distributed immediately and en masse. Don't be so sure. Reginald Finger, former medical advisor to the conservative group Focus on the Family, says, "With any vaccine for HIV, disinhibition (the removal of risk or fear) would certainly be a factor and it is something we will have to pay attention to with a great deal of care." Before dismissing Finger's opinions as that of an out-of-touch ideologue, know that he sits on the very committee charged with making immunization recommendations. His stance should not be surprising as the logic is consistent -- an HIV vaccine would decrease the risks of premarital sex and thus, could lead to greater promiscuity.
There can be no question that abstinence is the most effective method of preventing STDs and unwanted pregnancies. Teaching abstinence is useful and healthy. However, there can also be no question that the majority of Americans do not practice abstinence before marriage. In fact, many Americans see premarital sex as normal and sensible, not immoral. Denying those who choose to engage in premarital sex -- an activity that, by the way, is perfectly legal -- tools that can improve their health or save their life, whether it be the HPV vaccine or education on contraception, is not a policy at all. It is the imposition of one group's morals on the health of all Americans in deliberate disregard of reality.
I invite those making the HPV vaccine recommendations to open their eyes and look beyond the political goals their bosses hope to accomplish. If they cannot, I invite them to look in the eyes of the families of any American who contracts an illness the vaccine could have prevented and explain themselves. Maybe then they would see reality.
April 07, 2006
A Remedy from Massachusetts
If I feel a pain in my backside, I go to the doctor and have it checked out. If it's something serious, I get it fixed, and if it's not, I stop worrying about it. I do not let the problem linger. I'm able to take preventative measures, catching potential emergencies in their early stages before they develop into more serious and expensive conditions.
I am able to do this because I have health insurance. Forty-five million Americans cannot do this because they do not.
In this land of plenty, it is an outrage that so many citizens are not covered for the medical costs to keep them healthy. Not having health insurance is both bad for one's health -- the death rate for people without health insurance is 25% higher than for people with insurance -- and bad for one's pocketbook -- the leading cause of personal bankruptcy is unpaid medical bills.
No American should be left to face this situation, yet finding a way to deliver more health coverage to Americans has rarely been a successful political endeavor -- just ask Hillary Clinton. Conservatives want to allow health care consumers more autonomy to select only the coverage they need, while liberals want the government to provide a safety net of insurance to everyone. The two visions of the problem are diametrically opposed and neither side has been willing to work with the other to solve the problem.
Until now. In Massachusetts, a conservative governor and a liberal legislature came together to develop -- believe it or not -- a reasonable compromise. Facing a loss of federal government aid if the number of uninsured citizens was not reduced, Massachusetts put together a program designed to cover 95% of the state's residents within three years. The plan confronts three distinct categories of uninsured -- the very poor, the working poor, and the not poor at all -- with three distinct solutions.
For the very poor, those living below the federal poverty level, the state will provide essentially free coverage, following a liberal model of state-provided coverage. For the working poor with incomes above the poverty level but too meager to afford health coverage, the state will pay part of their premiums on a sliding scale based on income. This is a liberal solution -- the state pays -- with a conservative slant -- only as much as you need. And for the not poor at all, a surprisingly large group of mostly young male professionals of good health who have chosen to live without health care even though they could afford it, the state will force them to pay a penalty of up to half the cost of private health insurance if they still choose to go without insurance. This is a conservative solution -- adjust incentives to adjust behavior, allowing for personal autonomy -- with a liberal slant -- get more people covered.
On the national scene, a similar compromise is less likely. Congressional Republicans, especially House members from safe seats, are intent on expanding a program of health-savings accounts -- tax-free accounts individuals can use to pay for health care -- as the solution to the problems of health insurance. Unfortunately, HSAs are of little use to those who simply cannot afford health insurance. Over 70% of uninsured Americans have family incomes under $50,000. HSAs offer these citizens nothing more than the current unaffordable system.
The Massachusetts plan remains untested and some on both sides are not sure it can be successful. I'm not one qualified to evaluate it one way or the other. But the plan is already a triumph in two senses. First, it shows that Republicans and Democrats can work together and compromise toward a common goal. And second, it shows that a common goal of the two parties is an increase in the number of Americans with affordable health insurance.
Sensible policy crafted for the benefit of the people? As hard as it may be to believe, such things can happen. At least in Massachusetts. In Washington, partisanship and stubbornness remain pains in all of our backsides -- conditions we must treat quickly. Say, in November.
I am able to do this because I have health insurance. Forty-five million Americans cannot do this because they do not.
In this land of plenty, it is an outrage that so many citizens are not covered for the medical costs to keep them healthy. Not having health insurance is both bad for one's health -- the death rate for people without health insurance is 25% higher than for people with insurance -- and bad for one's pocketbook -- the leading cause of personal bankruptcy is unpaid medical bills.
No American should be left to face this situation, yet finding a way to deliver more health coverage to Americans has rarely been a successful political endeavor -- just ask Hillary Clinton. Conservatives want to allow health care consumers more autonomy to select only the coverage they need, while liberals want the government to provide a safety net of insurance to everyone. The two visions of the problem are diametrically opposed and neither side has been willing to work with the other to solve the problem.
Until now. In Massachusetts, a conservative governor and a liberal legislature came together to develop -- believe it or not -- a reasonable compromise. Facing a loss of federal government aid if the number of uninsured citizens was not reduced, Massachusetts put together a program designed to cover 95% of the state's residents within three years. The plan confronts three distinct categories of uninsured -- the very poor, the working poor, and the not poor at all -- with three distinct solutions.
For the very poor, those living below the federal poverty level, the state will provide essentially free coverage, following a liberal model of state-provided coverage. For the working poor with incomes above the poverty level but too meager to afford health coverage, the state will pay part of their premiums on a sliding scale based on income. This is a liberal solution -- the state pays -- with a conservative slant -- only as much as you need. And for the not poor at all, a surprisingly large group of mostly young male professionals of good health who have chosen to live without health care even though they could afford it, the state will force them to pay a penalty of up to half the cost of private health insurance if they still choose to go without insurance. This is a conservative solution -- adjust incentives to adjust behavior, allowing for personal autonomy -- with a liberal slant -- get more people covered.
On the national scene, a similar compromise is less likely. Congressional Republicans, especially House members from safe seats, are intent on expanding a program of health-savings accounts -- tax-free accounts individuals can use to pay for health care -- as the solution to the problems of health insurance. Unfortunately, HSAs are of little use to those who simply cannot afford health insurance. Over 70% of uninsured Americans have family incomes under $50,000. HSAs offer these citizens nothing more than the current unaffordable system.
The Massachusetts plan remains untested and some on both sides are not sure it can be successful. I'm not one qualified to evaluate it one way or the other. But the plan is already a triumph in two senses. First, it shows that Republicans and Democrats can work together and compromise toward a common goal. And second, it shows that a common goal of the two parties is an increase in the number of Americans with affordable health insurance.
Sensible policy crafted for the benefit of the people? As hard as it may be to believe, such things can happen. At least in Massachusetts. In Washington, partisanship and stubbornness remain pains in all of our backsides -- conditions we must treat quickly. Say, in November.
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