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Healthcare in the U.S.!

poop876

I know there has been many topics on the issue of Health care System in the U.S., but let me share a little story that my family just faced.

It is cheaper for somebody to fly to Europe, have a surgery done regardless if you are covered or not in the U.S.

My sister was just diagnosed with some kind of kidney, gallbladder problems few weeks ago. She was hospitalized for a week and they discharged her only to come back to the hospital to have her gallbladder and some stones removed.

She thought it would be covered by the employers insurance, but apparently they will not be covering it, surgery, medical stay, emergency etc. The bills only for those couple of days are ridiculous.

She needs to have the surgery done regardless, so we calculated and made an appointment in Europe this week. The cost to have the surgery done, her plane ticket and other costs are going to be around $3000 +/-. Having it done here would be more than that with copay and good health coverage.

Am I the only one that thinks there is something wrong with the system????

I know there is a lot of people arguing against the reforms, but until you are facing the dilemma yourself when it comes to medical bills, insurance etc. you have no idea what the hell you are talking about.

I'm just angry and wanted to share this little 'American dream' with open minded people.

Cheers!

 
Apr 25, 10 1:52 pm
sameolddoctor

Wasn't the fucking AIA also opposing the reforms?

Apr 25, 10 2:19 pm  · 
 · 
Janosh

Nope. They didn't take a position on the bill. They did however issue a document noting the aspects of the bill that would have consequences (positive and negative) for the architecture profession.

And: yes, the system is totally f-ed.

Apr 25, 10 3:23 pm  · 
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Bench

If you haven't yet seen Michael Moore's "Sicko" I highly recommend it. Although its incredibly biased, like all his other films, its still quite an eye opener in the comparisons between other countries and the US. I can vouch that the portion of the film where his parents reveal that they would never go visit the USA (they live in Canada) without buying their own insurance is accurate of the majority of Canadians; I personally don't know anyone who wouldn't do that. Vive le Canada!

Apr 25, 10 3:52 pm  · 
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Purpurina

Here they want you to spend everything that you have or don't have, to fix you up! If don't have it, oh well...just go home to die early.

I think you are right in finding other alternatives, you can even be surprised in how participative the docs can be. Good luck.

Apr 25, 10 4:14 pm  · 
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poop876

I was just talking to a friend of mine and I told her the situation and her response was "oh, that's scary, they don't have good medical equipment and medicine there". It just tells you how people are brainwashed by the propaganda. Its very sad.

Most powerful country in the world can't even compare to other countries when it comes to serve in the health interest of their own people.

Ben,
my uncle has some kind of heart condition and he never comes to the U.S., because he knows if he gets stuck in a hospital in the states he will never be able to pay of the medical debt.

Purina,
my sister was lucky that she had an alternative. She had an alternative to go somewhere else to get the necessary treatment, but how about millions that don't have that option, or don't know of any other alternatives.

Apr 25, 10 4:27 pm  · 
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Purpurina

Poop

You are totally right, I want to see how this reform is really going to help people in a practical way. I am sure that so far the reform didn’t go deep enough. We need to keep pressing for positive results.

Just completing my previous post...
…Although there are good docs that live up to good ethics and treat people right independently of race, gender and economic status. But unfortunately not everybody get the access.

Apr 25, 10 4:46 pm  · 
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Purpurina

Another thing that you can do with people here is to share a good experience with docs and treatments abroad.

Apr 25, 10 4:52 pm  · 
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binary

I have thought about moving to canada due to the b.s. in the states. I have a good amount of friends that are sick/need xrays/mri's/etc but they can't afford it.... I need some work done myself, but don't have the means to cover it and the b.s. insurance that I do have doesn't cover anything (hence why I'm thinking of dropping them soon)

Apr 25, 10 5:16 pm  · 
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bowling_ball

I'm repeating myself but it's relevant: your wacky medical (insurance) system is the one thing that would/will keep me from moving or even working in the US.

Apr 25, 10 5:39 pm  · 
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poop876

also a response that I recently got...

'but Canadians and Europeans pay 40% tax'....in the U.S. you pay tax, and you pay ridiculous insurance premiums, only to pay even more on the end. I'd rather pay higher tax but know that I CAN go to a doctor WITHOUT fear of huge medical bills that could potentially ruin me.

I've lived in Europe for 16 years before moving back to the U.S., although I really like it in the U.S. and don't plan returning back, I have regrets more and more and will probably be changing my mind about going back.

My parents even think about when retiring, selling their house and moving to Europe because they are afraid of retiring in the system that we currently have. They want to be able to enjoy their retirement, something that most people in the U.S. can't do. From when you start working the U.S. the talk is always about retiring and saving money for retirement, 401Ks, IRAs, social security, medicaid and bills for retirement homes....

Ahhhh, I'm going to have a glass of wine on this fine Sunday afternoon...

Cheers!

Apr 25, 10 5:51 pm  · 
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zen maker

My friend is from Israel, and he says, they had universal healthcare for many years already, not only its free, they can even call doctors to come to their home if something wrong for free too... USA is a great country but a bit spoiled.

Apr 25, 10 7:43 pm  · 
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jakethesnake

Doctor's are greedy. Pharmaceutical companies are greedier. Insurance companies are run by devils(lawyers). It is more profitable to keep someone sick. It should be changed to the hypocritical oath.


Columbia and Argentina also offer GREAT healthcare. My american friends that visit Buenos Aires on the regular schedule appointments with dentists and surgeons for years. No problems yet. Costa Rica is also a good one.

Apr 25, 10 8:19 pm  · 
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jakethesnake

^ sorry, that should be COLOMBIA not COLUMBIA... damn GSAAP!

Apr 25, 10 8:19 pm  · 
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mantaray
It is cheaper for somebody to fly to Europe, have a surgery done regardless if you are covered or not in the U.S.

This has always been my personal "ace in the hole" as well. I will fully absolutely do this, with anything short of emergency service. This was part of my health-care strategy during the many years I spent without any insurance at all, because I work in an industry with a high amount of small firms and self-employed practitioners, none of whom can afford to carry coverage for their employees. Yay architecture.

Also, whatever friend thought that Europe doesn't have good health care is... well, sadly ignorant. France for one is rated higher than the US, and I don't think they're the only country like that...

Apr 26, 10 10:26 pm  · 
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Bench

Couldn't find a better source but this seems to be accurate from what Ive read.

http://en.wikipedia.org/wiki/WHO%27s_ranking_of_health_care_systems

Apr 26, 10 11:32 pm  · 
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aquapura

poop - I'm sorry to hear about your sister but you don't tell any details about why her insurance coverage will not pay for her treatment in the US. All the horror stories about the evil insurance companies never have any details - just the tired "they won't pay" line.

Well, for every story like yours there are thousands of people that have very expensive medical procedures paid by insurance every day. I can name numerous friends and family members that have received excellent care in the USA all paid by insurance, less co-pays and deductibles.

My spouse had orthoscopic surgery a couple years back. Total bills were in excess of $10k and all we had to pay was the insurance co-pay of $20. What's telling is that between diagnosis and surgery she had emmigrated from BC Canada where she was already on a waiting list. In the states the surgery was scheduled two weeks out. Her perspective is that the quality of the care is the same between countries but the system in the US is far superior for access to care. She hears the same complaints that are common in this thread and simply warns people, the grass is not always greener.

I don't mean to make the system in the States sound perfect because people do fall through the cracks, your sister included. Without good insurance coverage it can be very expensive. Then again, other countries aren't perfect either. Medical tourism is a rapidly growing industry and quite frankly, a lot of foreigners come to the USA for treament too. It's important to take it all into perspective.

Apr 27, 10 8:57 am  · 
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poop876

It was a 'preexisting' condition, because she had gallbladder stones. A person develops these stones over time, so there is no way of finding out that you have some condition, until you start feeling it.

This morning she had the gallbladder removed and total cost for the surgery was ca. $1000 because she is not a resident of that country, if she was it would have been covered with no out of pocket costs.

Regardless what the 'details' are, a powerful country like the U.S. should take care of its citizens. Why would you look for an excuse why the insurance company should not be paying for something like this. It should be very simple, you pay for your insurance, and they should be paying for your medical bills. If I'm paying for something, then I should be expecting something in return, right? Why would insurance companies accept insurance payments if they will deny coverage on the end? Can we demand our money back, since we are not getting any service for the money?

Even if the insurance paid for her treatment, chances are that the copay and deductibles would be higher than the above mentioned amount.

I'm just saying that it is really sad that you pay tax, insurance premiums in the most powerful country where you are a citizen, yet you have to rely on services in a different country that has nothing to do with you, that is sometimes laughed at by people, yet they welcome you with open arms to help others...

We will be fighting the insurance company once she returns, but we could not wait for it, so we found an alternative.

Apr 27, 10 9:10 am  · 
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wurdan freo

You're right. The US does not protect its citizens.

It does not allow you uncensored access to the internet.

It does not provide for you the greatest military in the world to protect the everyday freedoms you take for granted.

It does not provide for you the chance to start from zero and make the most out of any opportunity.

It does not provide for you the right to life, liberty and the pursuit of happiness... (or lawsuits).

It does not provide the choice to wake up everyday and live your life as you see fit.

Maybe the problem with healthcare is not that everyone is not covered by insurance or that pre existing conditions are not covered. Maybe the problem is that healthcare costs are too expensive. Why is that not the target of everyone's anger? Why can't we go to the doctor and before we enter the clinic, see his menu of services and the costs for them? A free market approach to healthcare would drive down prices and make us less dependent on health insurance to pay for our care. But who ultimately would be against that?

I hope your sister is recovering well.

Apr 27, 10 10:04 am  · 
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poop876

Why take it literally...and that is not what I was saying when it comes to protection.

And yes, the cost has been the topic of this if you read it, but there is something wrong with the system if many people can't afford it. So something needs to be done...

Menu when you go to a doctor? Its not like you are getting a happy meal or just fries!!! Its your health, so regardless of the 'menu' you need to get that happy meal to be healthy.

if you can't afford health, screw the internet....
if you can't afford health, no army is helping me...
if you can't afford health, how do I start from zero....
if you can't afford health, how and I happy
if you can't afford health, I wake up to be sick again...

that has nothing to do with the protection I'm talking about....

cost is the issue here!

Apr 27, 10 10:14 am  · 
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aquapura
Why would you look for an excuse why the insurance company should not be paying for something like this.

I'm not looking to excuse the insurance company in your example. All too often the stories come out as "I'm the victim" where in my personal experience those w/out insurance and/or some non-payment story aren't telling the whole truth, i.e. didn't pay premium, quit job that had health coverage, etc. Not always the case but it happens and the insurance company is an easy target when they aren't to blame.

It should be very simple, you pay for your insurance, and they should be paying for your medical bills. If I'm paying for something, then I should be expecting something in return, right? Why would insurance companies accept insurance payments if they will deny coverage on the end? Can we demand our money back, since we are not getting any service for the money?

The problem I see is that people simply do not understand the nature of what insurance is - pooled risk. The state requires me to carry liability insurance on my car. Well, I've never been in an accident or caused any damage with my vehicle. Should the company return all my premiums paid? No, because they've been used to pay out claims for those that did have claims. Thanks to my good "risk" they reward me by charging lower premiums. Health insurance is technically no different.

A pre-existing condition that isn't disclosed to the insurance company factors into their risk ratings and technically speaking isn't fair to the others insured by the company as someone is "gaming" the system. I'm no doctor so I can't comment on your example, but that's the nature of the business. If they deny payment due to a pre-existing condition I would think that premium payments should be refunded, but asking for your money back just because you haven't "used" the insurance is a different story.

All that said, if health care is paid through health insurance premiums or by gov't through taxpayers, the fact remains that someone has to pay for it. Health care is not free anywhere in the world. All your complaints seem somewhat moot since the new health care bill will likely fundamentally change the whole insurance/health care setup we currently have in the USA. Time will tell if the changes will be for the better or worse.


Apr 27, 10 10:55 am  · 
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ManBearPig

The trouble with pooled risk is that in the case of healthcare, every one of us will, by the time they die, use more than they put in measured in real dollars. The insurance companies take the transfer the money from the young and healthy to the old or sick vis-a-vis massive payouts from their investments. The insurance companies are huge investors on Wall St. The last decade they took a beating and the payouts are growing way too fast to keep up with.


Obviously, this system is akin to a ponzie scheme where the population at the young end must keep growing to keep it liquid. There needs to be a wholesale reduction in costs, something like industrialized medicine.

Apr 27, 10 11:07 am  · 
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FrankLloydMike

This is so spot on:

'but Canadians and Europeans pay 40% tax'....in the U.S. you pay tax, and you pay ridiculous insurance premiums, only to pay even more on the end. I'd rather pay higher tax but know that I CAN go to a doctor WITHOUT fear of huge medical bills that could potentially ruin me.

We, for a fact, pay more money for less health care here than most industrialized countries. We do not pay as much of it in taxes, but in enormous insurance premiums, co-pays, and so on. On top of this, there is no guarantee of health care or that we will be appropriately covered. Thus, on top of paying more for less, we live with the stress of obtaining and maintaining health insurance. The same is true of higher education funding, etc. I would very gladly pay significantly higher taxes if things like college tuition and health care were provided at little or no out-of-pocket cost.

wundan's little diatribe of inaccurate platitudes about how everything in the US is perfect and any failure to do well financially or say not die as a result of being denied insurance, shows how successful corporate America has been in convincing us that the government (made up of us) can't do anything better than profit-driven executives. For whatever it's flaws, the goal of socialized medicine is to preserve the health and wellness of the public; the goal of private insurance companies is to make a profit for its investors. There's more to freedom than a military circle-jerk... there's freedom to obtain an education, to receive medical treatment, freedom from want and fear. For all our talk of personal freedoms, we don't have those things in America. We have freedom of corporations to make a profit. Tax me more and provide me better services. I'll sleep better at night.

Apr 27, 10 3:22 pm  · 
 · 
aquapura
The trouble with pooled risk is that in the case of healthcare, every one of us will, by the time they die, use more than they put in measured in real dollars

True, but most people drop off of private insurance late in life and go on gov't medicare, excluding medigap coverage. So if health insurance is for families and working age adults assesment of the risk should be easier to price. Even if you argue that private health insurance is basically a defacto money manager pocketing interest the net end game is the same, minimize risk.

I'm by no means an expert on health insurance but I've talked to enough "old timers" to know that basic health care in the 60's and prior was 100% on a fee-for-service basis. My feeling is that insurance, or a safety net, should only be necessary for catastrophic instances. We can debate if this should be covered privately with individual insurance premiums or covered under a tax funded public plan. However, for the common cold I think one should "cough" up the cost of the doctor visit, pardon the pun.

Apr 27, 10 4:12 pm  · 
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wurdan freo

A friend of mine has been living in Panama for several years. I recently visited him and asked him what kind of health insurance he gets down there. He told me that he had no health insurance, but it didn't matter. He broke his leg about a year ago and had to go to the emergecy room. It got reset and put in a cast for $150. He leg is perfectly fine now.

I broke my ankle about three years ago. I went in to see a specialist and he told me that I needed surgery and in what seemed like a high pressure sales pitch told me that I needed to have it tomorrow. I had originally planned to get a second opinion. When I asked him how much it will cost he skirted around any type of answer. I would much rather have been able to get on the net and do a search for broken leg doctors. i imagine I could find all kinds of information if it was organized as such. How many of these types of operations had the doctor performed that year? Where the patients happy with their outcomes? What did he charge? How much was covered by insurance? Who else was invovled in the surgery? How much did they charge? and on and on and on. Two scenarios could evolve here. One were the better doctors charge more (which already happens) and two you could choose to go with a cheaper doctor if you wanted to. I understand not all healthservices can wait, but in my instance and in the instance of your sister it could have.

I hate that when it comes to healthcare, no body can tell me how much it is going to cost. Why not? My point was that the system is completely non-transparent and insuring everyone is not the answer. That doesn't cut the fat from the system. It does the opposite. I would rather be able to afford healthcare and pay for it my self than to have to rely on an employer or the government to subsidize insurance so that I can afford healthcare.

Poop I can see i hit a nerve with you and for that I apologize. I'm sure your family is having a tough time. I hope your sister is at least able to enjoy a little bit of her recovery in Europe.

Apr 27, 10 6:02 pm  · 
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poop876

Let's put it this way, if you are going under a knife for gallstones, it means you have an infection or its inflamed. If not treated pronto the gallbladder could rupture and it could be lethal. Just to let you know. So comparing a broken leg and that is a bit crazy.

Comparing car insurance and repayment of your premium if not involved in an accident is a bit weird. I've been in plenty of accidents, pay the premiums and never had problems getting my repairs covered.

Having health care should work the same way....only its a 'little' bit more important than having a broken bumper and getting it fixed.

If I pay for it, I should not be paying even more....that's a simple thing to do I think....I mean other countries have it, right....and they are wayyyy 'poorer' than ours.

"True, but most people drop off of private insurance late in life and go on gov't medicare, excluding medigap coverage." Wonder why? Is it because they can't afford it?

I think we all agree here that the system is not working and that our citizens are not protected the way they should. It all comes back to money and profit for insurance companies and 'others'. I guess the only thing that is the question is where do we start to improve the entire system.

Apr 27, 10 6:30 pm  · 
 · 
do2

The reason why its so expensive is because the majority of this country is getting fatter and sicker by the day... premiums go up, the need to make riskier bets for insurance goes up and we all end up paying for it. Its a sick cycle and a nasty system.

The quality of care goes down because doctors spend less time with each patient... the medical system never provides solutions to treating the root or cause of our problems, just the symptoms... we are never really cured, we just keep piling the shit on.

Its f'ed up. start eating better and taking care of yourself so the system can treat the people who really need it.

Apr 27, 10 7:18 pm  · 
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poop876

haha d02, its sad, but I believe in some of that.

Do any of you older folks remember our child hood? I for example spent most of my time playing outside, beating each other up, biking, hiking, just being very active. My parents could never get me to come inside. I was never sick and to this day I'm not (knock on the wood). I think its due to being very active that you get sick less.

Look at these kids NOW! They are always inside, always playing games etc. depression in KIDS is going up (I never even heard of that when I was a child), obesity, lack of social skills and this is just a few...but there are more.

Maybe that is the reason like do2 mentioned!!!! All those functioning countries don't have the obesity and other problems like we do....hmmm

Apr 27, 10 7:51 pm  · 
 · 
FrankLloydMike

do2, I think you're quite right about that: among several other reasons that all compound on one another, I think our unwillingness to address the widespread public health problems of things like obesity (not to mention our autocentric landscape and food standards), stress and so on is a huge contributor not only to rising health care costs, but also to our declining overall health and satisfaction with our care. It's certainly not the only reason, but it's a contributor. I also agree the medical field larger treats symptoms rather than the underlying causes. I understand some of the reasons for this, but it is very worrisome, and not to get too nutty, but I think if we were more accepting of certain alternative medicines and approaches (osteopathy, etc) being integrated into the medical system, we'd have a health care system better able to draw on multiple sources.

Apr 29, 10 12:57 pm  · 
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trace™

The AMA has done a stellar job of banishing most alternative medicines.

This is a problem with the health care now and will, most likely, get worse. Most alternative practices are not covered under insurance programs (thankuflly, acupuncture seems to have gained enough demand to get at least a few visits a year). We'll have to see where things land, I guess, but I am not optimistic about widespread covered for alternative medicine.


There will be the "there's no proof!", etc., that the AMA continues to chant about (forget the centuries of practice, if it isn't born and proven in a laboratory, then it can't possible work).



I agree with the health issues. Amazing how people think giving a 2 year old a coke and plopping them in front of a tv is acceptable.

I think people have just gotten lazier and lazier. Where's the parents outside playing with the kids?

Apr 29, 10 1:48 pm  · 
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Janosh

I don't know that there is a global conspiracy against alternative medicine, rather there is a lack of investment in quantifying its benefits. When evidence of effectiveness is presented, many "alternative" treatments (massage therapy, accupuncture, St. Johns Wort, accupuncture) have been accepted by both the medical community and insurance. In the absence of proof, it would indeed be irresponsible to spend health dollars on unproven or quack remedies. The problem isn't skepticism, it is the lack of institutional will to invest in separating crap therapies from effective ones when there isn't an industry group to subsidize the work.

Apr 29, 10 4:03 pm  · 
 · 
do2

MD's have used placibo medications in this country for years and oddly enough there are many cases where it has worked, this wasn’t born in a laboratory. The brain has the ability to transform our physical health. The connection doesn’t always have to be a direct one.

I also think that alternative treatment is not something that cannot work with singular therapies, such as, massage therapy, acupuncture, St. Johns Wort... its more of a lifestyle, all inclusive.

Apr 29, 10 5:55 pm  · 
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FrankLloydMike

trace, I agree with almost everything. I disagree with this, though:

I think people have just gotten lazier and lazier. Where's the parents outside playing with the kids?

I know what you mean, and I don't disagree that people are less engaged to some degree in their health and their community, but I don't think it's a result of individual or collective laziness. There are all the typical sob stories about how hard things were "when I was your age", but to my mind, it has never been so difficult to be engaged, concerned and aware. Once you deal with your student debt, political ineptitude, corporate irresponsibility, bills, overtime and all the stress that comes with all these things, there's just such a defeated feeling among so many people. Which is a great time to pitch them the new miracle drug.

May 11, 10 1:07 pm  · 
 · 
Urbanist

yep. the healthcare system is broken. Heck, the country's broken.

and it'll stay broken until we say, enough is enough, and demand real change. We have the best schools in the world, producing the most educated, best trained, and most productive people anywhere, and we can't force our corrupt political class to fix healthcare in any meaningful way.

There was an editorial last week in an upstate NY paper, where the commentator wrote "Let God lead America from health care reform".. he said he was heartened by the sight, at some protest, of a thousand "Christian Americans" falling down in prayer, calling down the wrath of their evangelical god to stop government involvement in healthcare. A week later, all but one of the dozen or so reader comments online were supportive of this little yankee ayatollah.

Nothing's going to change until we're willing to speak up over the brutishness and ignorance that is tearing this country apart.

May 11, 10 1:26 pm  · 
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FrankLloydMike

Unfortunately, I think most of the political/policy problems we face, including the inability to achieve meaningful health care reform, is a symptom of a larger problem: our inability and unwillingness to revisit, as almost all other countries do, our system of government. There are certain things about how our government is set up that work very well, but for the most part it is the vestige of a once-innovative (but also highly compromised and flawed) multi-tiered, trifurcated 18th century republican system. If the overly revered founders couldn't agree on what the intent of their collective work was only a few years after the constitution was written, why are we still so obsessed as a country with "original intent" and adhering to a system that has been outdated for at least a century? Until we are at least willing to think about reforming the structure of our government, including removing money from politics and proportional representation, all the squabbling over individual issues will likely amount to very little.

May 11, 10 2:48 pm  · 
 · 

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