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Feeling No Pain

by: Paul Krugman  |  Visit article original @ The New York Times

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Former President Bill Clinton. (Photo: Getty Images)

    My first reaction to Bill Clinton's convention speech was sheer professional jealousy: nobody, but nobody, has his ability to translate economic wonkery into plain, forceful English. In effect, Mr. Clinton provided an executive summary of the new Census report on income, poverty and health insurance - but he did it so eloquently, so seamlessly, that there was no sense that he was giving his audience a lecture.

    My second reaction was that in Mr. Clinton's speech - as in the speeches by Hillary Clinton and Joe Biden (this column was filed before Barack Obama spoke on Thursday night) - one heard the fundamental difference between the two parties. Democrats say and, as far as I can tell, really believe that working Americans are getting a raw deal; Republicans, despite occasional attempts to sound sympathetic, basically believe that people have nothing to complain about.

    As it happens, the numbers support the Democrats.

    That Census report gives a snapshot of the economic status of American families in 2007 - that is, before the financial crisis started dragging the economy down and the unemployment rate up. It's a given that 2008 will look much worse, so last year was as good as it will get in the Bush years. Yet working-age Americans had significantly lower median income in 2007 than they did in 2000. (The elderly, whose income is supported by Social Security - the program the Bush administration tried to kill - saw modest gains.) Meanwhile, poverty was up, and health insurance - especially the employment-based insurance on which most middle-class Americans depend - was down.

    But Republicans, very much including John McCain and his advisers, don't believe there's a problem.

    Former Senator Phil Gramm made headlines, and stepped down as co-chairman of the McCain campaign, after he described America as a "nation of whiners." But how different was that remark, really, from Mr. McCain's own declaration that "there's been great progress economically" - progress that's mysteriously invisible in the actual data - during the Bush years? And Mr. Gramm, by all accounts, remains a key economic adviser to Mr. McCain.

    Last week John Goodman, an influential figure in Republican health care circles, explained that we shouldn't worry about the growing number of Americans without health insurance, because there's no such thing as being uninsured. After all, you can always get treatment at an emergency room. And Mr. Goodman - he's the president of the National Center for Policy Analysis, an important conservative think tank, and is often described as the "father of health savings accounts," a central feature of the Bush administration's health policy - wants the next president to issue an executive order prohibiting the Census Bureau from classifying anyone as uninsured. "Voilà!" he says. "Problem solved."

    The truth, of course, is that visiting the emergency room in a medical crisis is no substitute for regular care. Furthermore, while a hospital will treat you whether or not you can pay, it will also bill you - and the bill won't be waived unless you're destitute. As a result, uninsured working Americans avoid visiting emergency rooms if at all possible, because they're terrified by the potential cost: medical expenses are one of the prime causes of personal bankruptcy.

    Mr. Goodman has in the past, including in an op-ed for The Wall Street Journal, described himself as an adviser to the McCain campaign on health policy. The campaign now claims that he is not, in fact, an adviser. But it's a good bet that Mr. McCain's inner circle shares Mr. Goodman's views.

    You see, Mr. Goodman's assertion that lack of health insurance is no problem precisely echoed what President Bush said a year ago: "I mean, people have access to health care in America. After all, you just go to an emergency room." That's because both men - like Mr. Gramm - were just saying in public what modern Republicans say when they talk to each other. Despite attempts to feign sympathy, the leaders of today's G.O.P. fundamentally feel that Americans complaining about their economic and health care difficulties are, well, just a bunch of whiners.

    And that, ultimately, even more than their policy proposals, is what defines the difference between the parties.

    It's true that elected Democrats are often too cautious - and too beholden to major donors - to be as progressive as the party's activists would like. But even in the face of a Republican Congress, Mr. Clinton succeeded in pushing forward policies, like the State Children's Health Insurance Program, that did a lot to help working families.

    And what one sees on the other side is a total lack of empathy for and understanding of the problems working Americans face. Mr. Clinton, famously, felt our pain. Republicans, manifestly, don't. And it's hard to fix a problem if you don't even think it exists.

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The Goodman comment , an oft

The Goodman comment , an oft stated position of the Cheney/Bush regime, is a typical locution for a self-styled fascist potentate. They strut about, chin forward like Mussolini, bellow and snap, crush bones, and make it all sound homey on tv. Time for some overdue anti-fascism!

throw the bums out!

throw the bums out!

I am an underpaid,

I am an underpaid, under-insured citizen. After bi-weekly deduction for health care, I must still pay very high deductibles before insurance payments kick in. Even then, I am responsible for a significant portion of many bills. I have areas in my mouth that require serious attention, but I cannot afford -- even on a payment plan (which charges 22% interest) -- the cost of necessary treatment. I simply cannot afford the several thousands of dollars I'd have to pay OUT OF POCKET after insurance paid their "reasonable and customary" fees ONLY up to $1500 per year. In addition, I cannot afford the wellness visits of any sort. I'm over 50, and should have regular checkups and cancer screenings. Yet I can't afford the tests they say I should have. I haven't seen a doctor in more than three years, because I cannot afford to. These are all reasons I will not vote for McCain. He has NO idea the trials and tribulations so many of us face on a daily basis. Not surprising from one who divorced his first wife so he could marry into even more money. Enjoy your 7 homes, sir. I can barely afford a 1-room apartment in the bad part of town. And can't afford a band-aid for a small cut.

"Let them go to the

"Let them go to the emergency room" will go down in history alongside "Let them eat cake."

Here's the side of our

Here's the side of our disease-promotion system that many Democrats seem to think people are too oblivious to get. If harm-reduction from the present broken system is not addressed before expanding said system, we will get more excess disability, side-effect issues (so often addressed with more drugs and more side-effects), and more chronic, refractory obesity and emotional dysfunction. We also need to get rid of the amazingly harmful drug war (Prohibition), first.

OK, it's a fantasy, I know

OK, it's a fantasy, I know that. But imagine McCain and the rest of the emergency room ideologues having a heart attack, some of them being hauled off to the emergency room while others are simply ignored, being hurriedly "stabilized", waiting untold hours for further treatment, being told they cannot be admitted because they have inadequate or no insurance, being trundled off to one of the few "public" hospitals where they share a four- or six-person room with a demographically correct group of patients, having overworked and underpaid staff provide them what minimal attention time allows, waiting interminably for access to limited equipment or repair of broken equipment, and being discharged early because someone worse off than they needs the bed, and as a going away present, getting a bill that they can't possibly pay. My question is whether such an experience would open these folks' eyes to the reality of medical care in the US. My suspicion is that the experience would make not one whit's difference to any of them, since they are convinced, like all fanatics, that they and only they have possession of the truth, the whole truth, and nothing but the truth. So, unlike Krugman, I don't think the problem is that McCain et al have "a total lack of empathy for and understanding of the problems working Americans face," since having the understanding and empathy would make no difference. It is rather that they will not, maybe even cannot, leave the hermetically sealed, warm, and comfy cocoon spun over recent decades by con artists and neo-con artists. Seems to me in days of yore, people who could not distinguish between fantasy and reality were sequestered to prevent harm to themselves and others, and, if they were lucky or rich, provided with treatment in hopes of alleviating their inability to cope with reality. But these are the days of "mainstreaming", of dumping unprovided for emotionally and mentally disturbed people on the street to "integrate" them. You do-gooders, bleeding hearts, liberals, and others beyond the pale of neo-con righteousness need to check reality. "Mainstreaming" has worked so well that one of those deluded crazies might just get hisself elected President.

The United States of America

The United States of America seems to have all the money in the world for weapons to kill people but no plan to keep its own citizens well taken care of. It is surreal that the American people have put up with the status quo as long as they have and keep paying. THROW THE BUMS OUT!!!!!!!!!!!!! The hospitals are flush with cash, look behind the scenes of organizations like PARTNERS and Kaiser Permanente, see what car your physician (if you have one) drives and where he/she lives, count the staff the physicians employ which is why there is a nursing shortage in hospitals and see the palaces they have built for their HEALTH MONOPOLIES under the pretense of having every service under one roof. That ought to explain some things. Let us not forget the insurance industry, the pharmaceutical industry who via their lobbies twist arms of lawmakers and the fact that most law-makers are/were professional lawyers. There are a lot of areas that need to be cleaned-up, reigned-in and reformed. It is going to be a big job but one that is long overdue. By the way, when was the last time you ever met a poor or even middle-class doctor?????? Yes, they study and work hard but they also play hard. The rest of us just work hard to keep up not with expenses for the yacht club but the regular bills.

So now we have $30,000 per

So now we have $30,000 per person debt to pay for the unnecessary war and handouts to wealthy friends. If an individual took out that kind of credit we'd have something to say. What this means is that this administration has created a burden for generations to come. It makes repairing infrastructure instead of applying bandaids and all the other costly things we need to do nearly impossible. And I think this was done intentionally. The legacy will live on.

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