kitkat24

Fergus Fergus Fergus..... The law says that marriage is for heterosexuals. Yet, you and others would fight forever to have that changed because you claim that it is a moral imperative. Kit Kat

How can you murder a fetus? It isn't a baby. It is a mass of tissues. It is just a ball of cells. It has no human value to it. It is not murder. If it is murder when killed by a doctor shooting a gun, then it is murder by the doctor with the forceps. It is not a law school debate. It is about if it is a baby or a human being or if it is not a baby or not a human being. It is either a baby worthy of life, or not a baby and not worthy of life. You cannot have it both ways. Besides the fact that if a woman has money (the almighty DOLLAR to give to the mutimillion dollar abortion mill industry then it is OK, yet let her give birth at 30 weeks at home to a live baby and if she dumps it into the trash it is murder. :angryfire What defining moment makes it a baby sometimes, and not at other times.

OK, I got one for ya... Let's consider this ethical dilemma, since Fergus commented on abortion again. A woman is 32 weeks pregnant. She has an abortion scheduled for today. On her drive to the abortion clinic, she is struck by a drunk driver and the "fetus" -- "mass of tissues" --- "ball of cells" -- is killed. The now not pregnant woman escapes with minor contusions, requiring over-night care for observation at the hospital. Should the drunk driver be charged with murder? Or, since she was driving to the abortion appointment, should he be charged with drunk driving and sent home with chemical dependency treatment? hmmmmm? I get tired of this debate being off limits. If it is not unethical, and it is nothing to get worked up over, and it is simply the law, then why not discuss it rationally and intently? The above scenario could be entirely TRUE and for all I know has most likely happened before. Kitkat

If you look at the MDH website it will show the statistics about why our TB, and MDR-TB has risen. MN has a high Somali immigrant population. This population has a high rate of TB and multi-drug resistant TB. We treat our immigrants and our refugee population for free, as TB is a true public health threat to all Americans. This is the case for Minnesota, the stats are on MN Dept of Health Web site. kitkat

America will have a difficult time coping, just as will NHS, Canada (SARS), and Australia. We would all have a very difficult time coping with pandemic flus. MDH holds pandemic influenza tabletops to practice, as we all expect another pandemic influenza (that come along every 30 or so years, last one being 1918). I do not think any healthcare system can fully prepare for that or bioterrorism. We also have the PUSH package from CDC and they are putting plans in place now at MDH to attempt to deal with public health threats.

P.S. Fergus, TB programs at MDH are free. We treat free and we perform DOT, which is the WHO and CDC standard for drug resistant, multiple-drug resistant TB. So, I do not think you know enough about MDH's TB treatment programs. Drugs free, treatment free.... for TB. Hey, I can rhyme too! Yowsa !

Fergus, Fergus, Fergus.... I am not saying the US is perfect. We have our problems. Canada has problems. Australia has problems. The NHS has problems. For the most part, the complaints sound similar and then other complaints are different. The problem is that there are problems in YOUR systems too. Yet, nobody can tell me exactly why their problems are any less significant than ours. Because, in fact, they are not less significant. Canadians do not want to pay more taxes, right Fergus? Yet, the only way to decrease waiting lists is to put more tax dollars into the system. This concept seems easy to understnad to me. Interestingly as well, when I post a conservative, supported post you call it insignificant. However, all of your posts and others posts and all of the pro-universal healthcare "opinions" are supposed to be fully trusted and believed. Why should we rid ourselves of our problems do adopt universal care problems? Kitkat

So, for the record: If I have money and I go pay a doctor to kill the fetus inside of my uterus: The doctor is protected by law. He gets MONEY to rid my body of the fetus. However, if that SAME doctor shoots ME killing the baby in my uterus then it is murder. I see, the law is perfectly clear. Interesting concept....

The Constitution says that we are to provide for the common defense: e.g. Military. The Constitution does not say that we are to provide free healthcare insurance to everybody. I do not know more than our founding fathers, and I do not think that we should change the constitution. Kitkat

The Libertarian Party's Legislative Program Health Care & Health Costs Twenty years ago, health care was a $42 billon per year industry. Today, health care costs Americans more than $2 billion per day, more than 14% of our Gross Domestic Product. These soaring costs are putting enormous financial pressures on American businesses, forcing thousands of small businesses to reduce or drop benefits for their employees. Moreover, health care costs are an increasing burden to already strained family budgets. At the same time, nearly 35 million Americans lack health insurance. The only health care reforms that are likely to have a significant impact on America's health care problems are those that draw on the strength of the free market. The Libertarian Party has developed a comprehensive proposal for health care reform that will reduce health care costs, while extending access to care. Our five-point plan is as follows: Establish Medical Savings Accounts. One key to controlling health care costs is strengthening the role of the individual health care consumer. As part of this process, an individual should be exempted from taxes on money deposited in a Medical Savings Account (MSA), in the same way that he currently pays no taxes on deposits to an IRA. Money could be withdrawn from an MSA without penalty to pay medical expenses. This would increase consumer responsibility, while increasing access and controlling costs. Restructure tax policy. As a second consumer-based reform, taxes should be restructured to establish equity in the treatment of employer-provided health insurance, individually purchased health insurance, and out-of-pocket medical expenses. All health care expenditures should be 100% tax deductible. This will add a measure of fairness to current tax policies that penalize the self-employed, part-time workers, and employees of small businesses, while subsidizing health care for the most affluent in our society. Deregulate the health care industry. There should be a thorough examination of the extent to which government policies are responsible for rising health costs and the unavailability of health care services. America can help lower health care costs and expand health care access by taking immediate steps to deregulate the health care industry, including elimination of mandated benefits, repeal of the Certificate-of-Need program, and expansion of the scope of practice for non-physician health professionals. Replace the FDA. The Food and Drug Administration is clearly an unnecessary burden on the American health care system. There is no evidence that agency offers Americans any real protection, but there is massive evidence that it is causing great harm -- driving up health care costs and depriving millions of Americans of the medical care they need. The agency should be abolished and replaced with voluntary certification by a private-sector organization, similar to the way Underwriters Laboratories certifies electrical appliances. Privatize Medicare and Medicaid.The current Medicare and Medicaid systems have clearly failed. Costs are skyrocketing. Patients are receiving second rate care. And, providers are being shortchanged. The time is ripe for drastic reform. The federal government should begin to restructure the system to give Medicaid and Medicare recipients more flexibility to purchase private health insurance.

February, 2004 CEOs Deserve What They Make by Elan Journo As millions of Americans watch the New England Patriots take on the Carolina Panthers, every minute of the game will be scrutinized, from all angles and with action replays. But, amid the cheers of victory and cries of disappointment, you won't hear a whisper of complaint from fans about the players' multi-million dollar salaries--$3.8 million on average for starting quarterbacks, and far more to exceptional players. No one doubts that the players have earned it, that the MVPs are indispensable to their teams, that it is morally proper to reward achievement. But that spirit of justice disappears by springtime, when corporations file their financial statements. It is then that we learn how much America's CEOs got paid last year. In a ritual now sadly as commonplace as Super Bowl parties, CEOs are annually reviled as overpaid fat-cats. Astonished at pay packages as large as that of Dell Inc.'s Michael Dell--America's third-highest paid CEO in 2003--people ask themselves: "How can the work of a paper-pusher be worth $82 million a year?" The answer is that successful CEOs are as indispensable to their companies as Super Bowl winning quarterbacks are to their teams. They earn their rewards. How big an influence can one man have on the fortunes of the entire corporation? Consider the impact of Jack Welch on General Electric. Before his tenure as CEO, the company was a bloated giant, floundering under its own weight. Splintered into dozens of distinct and inefficient business units, GE was scarcely making a profit. Welch turned it around. He streamlined and reorganized the company's operations and implemented a sound business strategy yielding more than $400 billion worth of shareholder wealth. In business, as in football, success requires long-range thinking. But CEOs must project a game plan in terms not merely of a single game or season, but of years and decades. A biotechnology company, for example, may spend 15 years and billions of dollars developing a new cancer-fighting medicine. Success is impossible without the business acumen of its CEO. For years before a marketable product exists, he must raise sufficient capital to sustain the research. What long-term business model will attract venture capital? Should the company accept partial short-term sponsorship from a large drug manufacturer in exchange for a modest royalty on the drug in the future--or risk going it alone and possibly running out of funds? It is on such decisions that a company's success is made--and lives of cancer patients may depend. In order to be successful in the long range, the CEO's strategy must encompass countless factors. He must devise a game plan to grow the business in the face of competitors, not only from its own league, but from all the leagues in the world. The CEO calls the plays, but for a team of tens (and sometimes hundreds) of thousands of workers. All of the actions of every employee and every aspect of the business must be coordinated and integrated to produce the cars, computers or CAT scanners that yield profits to the company. It is the CEO who is responsible for that integration. To successfully steer a corporation across the span of years by integrating its strengths toward the goal of creating wealth, requires from the CEO exceptional thought and judgment. Excellent CEOs are as rare as NFL-caliber quarterbacks. And in the business world, every day is the Super Bowl. There is no off-season or respite from the need to perform at one's peak. Given the effect a CEO can have on a company's success, we can understand why their compensation packages can be so high. One way employers (like team owners) reward excellence is through bonuses. For many CEOs, bonuses amount to a large portion of their earnings. And as with quarterbacks, the CEO's pay package is calculated with an eye on the competition. Companies pay millions of dollars to a valuable CEO, one who they judge will produce wealth for the shareholders, in part so he will not be hired away by a competitor. Americans can see with their own eyes the merits of star quarterbacks. Though the efforts of CEOs are not televised on Monday Night Football, their achievements are just as real and have a profound benefit to all our lives. Just as we admire a quarterback's athletic prowess and understand the importance of rewarding him accordingly; so we should learn to appreciate the work of successful CEOs and recognize that they too deserve every penny of their salaries. _____________________________________________________________________________________ Elan Journo is a writer for the Ayn Rand Institute in Irvine, Calif. The Institute promotes the philosophy of Ayn Rand, author of Atlas Shrugged and The Fountainhead.

So, the Peterson guy should not be convicted of TWO murders then, right? Laci is the ONLY HUMAN BEING that was murdered in your estimation? Cuz, Peterson killed his wife and that eight month old tissue in her uterus, or fetus, or cell ball..... or whatever you decide you want to call it. So, he should only be charged with one murder then, right? How many sick abortion clinic stalkers/murderers have their been that have killed pregnant women (of whom I believe should be imprisoned for life)? Can you assign a number to them? Cuz, in MN alone we have over 14,000 abortions each and every year with the number rising. And, I did not switch the topic, just for the record.....

Fergus, So you would suggest spending BILLIONS of dollars to change to a system that you can not convince anybody of, with any significant statistics is any better than what we have, and may in fact be worse. You can find bad outcomes in the US. I can find similar stories throughout ALL of the universal healthcare systems. Why change to your bad stories? It doesn't make sense. I did not say that it could turn out worse. I am saying it is worse or just as bad. That does not sound like something to change to. When you guys have a great system with all of your problems fixed, you all let me know and I'd agree to advocate change. How long have all of your systems been in play? Haven't you all figured out how to fix it yet? Why not? I know... they need more money, huh? Until then, forget it. Kitkat

Building a Culture of Character by Matthew Spalding, Ph.D., Don Eberly, Samuel Gregg, and Joseph Loconte Heritage Lecture #755 August 6, 2002 | | Character and the Destiny of Free Government Matthew Spalding The remarkable generation that built this great nation led a daring revolution against the strongest military power in the world. They declared American independence based on self-evident truths, asserted a new ground of political rule in the sovereignty of the people, and launched an experiment in self-government. Through a carefully written constitution that limits power and secures rights while allowing for change through its own amendment, they created an enduring framework of republican government that allows their posterity to enjoy the many blessings of liberty. Yet for all of their accomplishments, they could not guarantee the success of their handiwork. As he departed the Constitutional Convention, Benjamin Franklin was asked if the framers had created a monarchy or a republic. "A republic," he famously replied, "if you can keep it." In the end, Franklin and the other founders knew full well that it would always be up to future generations to keep alive what they had created. "The preservation of the sacred fire of liberty, and the destiny of the republican model of government," George Washington observed in his First Inaugural Address, "are justly considered as deeply, perhaps as finally, staked on the experiment entrusted to the hands of the American people." The success of the American experiment in self-government ultimately depended not on the precision of our laws, the strength of our economy, or the extent of our military power but on the character of our citizenry. The American Founders knew that one of the greatest bulwarks of our character as a self-governing people is our limited government. Limited government is necessary to protect liberty and what we today call civil society, what President Bush has called our communities of character--families, churches, volunteer organizations, schools. But they also knew, following political thinkers back to Plato and Aristotle, that law played a key role in the formation of character, as it shaped the habits and mores of citizens. As a result, although they recognized the need for government to take account of man's self-interest and not rely too much on virtue, they designed laws that would encourage certain virtues and good habits of government. Consider the Constitution. The separation of powers and the system of checks and balances thwarts governmental despotism and promotes responsibility in public representatives. The legitimate constitutional amendment process allows democratic reform at the same time that it elevates the document above the popular passions of the moment, thereby encouraging deliberation and patience in the people. The law inspires caution and encourages mutual checks in our representatives and thereby confines them to their constitutional responsibilities and prevents a spirit of encroachment by government. The people learn from the law-making process to curb their own passions for immediate political change and abide by the legitimate legal process. The demands of good public policy cause the people to be moderate and circumspect. Good opinions in the people, and good government, have a complementary effect on politics. Nevertheless, the Founders did not believe that the new institutional arrangements were sufficient by themselves to define and maintain the type of character necessary for republican government. They knew that a constitution, no matter how well constructed, did not remove the need for good citizens and sound morals. At the end of the American Revolution, James Madison wrote for Congress an Address to the States that concludes with a warning that still rings true: [T]he citizens of the United States are responsible for the greatest trust ever confided to a political society. If justice, good faith, honor, gratitude and all the other qualities which ennoble the character of a nation and fulfill the ends of government be the fruits of our establishments, the cause of liberty will acquire a dignity and lustre, which it has never yet enjoyed, and an example will be set, which cannot but have the most favourable influence on the rights of Mankind. If on the other side, our governments should be unfortunately blotted with the reverse of these cardinal virtues, the great cause which we have engaged to vindicate, will be dishonored and betrayed; the last and fairest experiment in favor of the rights of human nature will be turned against them; and their patrons and friends exposed to be insulted and silenced by the votaries of tyranny and usurpation. Hence Franklin's second clause: a republic, if you can keep it. Republican government was possible only if the private virtues needed for civil society and self-government remained strong and effective. The civic responsibility and moderation of public passion also requires the moderation of private passion through the encouragement of individual morality. And the best way to encourage morality is through the flourishing of religion and the establishment of traditional moral habits. "Of all the disposition and habits which lead to political prosperity," Washington wrote in his Farewell Address, "Religion and morality are indispensable supports." Religion and morality aid good government by teaching men their moral obligations and creating the conditions for decent political life. Thomas Jefferson, the great defender of rights and liberty, put it bluntly when he said that the American people "are inherently independent of all but the moral law." And when it came to politics proper, the demands of character are all the more challenging. George Washington, in his First Inaugural address, argued that the constitutional arrangements of republican government depended on virtue and character in the people in general and in our leaders in particular. Making only a passing reference to the Constitution, Washington focused instead on "the talents, the rectitude, and the patriotism"--that is, the character--of those selected to devise and adopt the laws. It is here--and not in the institutional arrangements or measures themselves--that he saw the "surest pledges" of wise policy. The individual character of the representative was the best guarantee that "the foundation of our national policy will be laid in the pure and immutable principles of private morality." The simple lesson is that there was no radical distinction--as there is today--between private morality and public character. These realms, private and public, are fundamentally connected and intertwined. Only if we can govern ourselves--restraining our individual passions and wants--can we as a people be capable of self-government. Moral character--understood as the ability to restrain the passions and maintain good habits--is necessary for the preservation of free government, and hence the safety and happiness of the American people. It is this sense that self-government and the governing of one's own passions necessarily precedes free government. At the same time, civil society requires free government (by which I mean the political process by which equal citizens rule and are ruled in turn) because it not only allows and encourages but also provides the stage for and spotlights the fully developed moral character. It is in the nature of man to be political, which is to say that the rational and communicative nature of man requires relationships with others--from families and friendships to active participation in the political community--for the perfection of the human virtues. But it is the connection between limited, constitutional government and a thriving civil society that is key. Each needs the other, and neither can survive on its own. Together--and only together--is one able to build, or in our case rebuild, a culture of character. This understanding of things, which is encapsulated in the Declaration of Independence, generally held from the time of the Founding through the 19th century. It was toward the end of the 19th century, during what is referred to as the Progressive Era, that it was replaced by a different view. In the minds of the new thinkers this shift marked the end of the old order and the birth of a new republic. The Constitution was alleged to be a reactionary document designed to thwart democratic principles and opinion; the progressives wanted to reinvent the old Constitution as "a living document" capable of change, growth, and adaptation. Their objective was to transform the old constitutional system into a genuine democratic instrument of liberal social reform. What does this have to do with the question of character? The shift from a constitutional system of limited government to an administrative system for the sake of progressive social policy also entails a shift from an emphasis on the moral character of individual citizens to the evolving ideals of the social community. In the old system, character was needed to moderate the passions of human nature and dampen their influence, thereby allowing for deliberate self-government and the thriving of civil society. But with the new system, there is little concern with moral character and little worry about emancipating the passions. This is for two reasons. First, progressive liberalism is built upon the philosophy of moral relativism and thus rejects distinctions between good and bad; the moral virtues--those habits and perfections that implied a distinction between virtue and vice, right and wrong--are relegated to the realm of private opinion and personal values. And second, the problems caused by "bad character" are to be solved--or more precisely overcome--by more democracy, more progress, and more government. It is no longer the purpose of government to restrain the passions and secure unalienable natural rights. Free government comes to mean the value-free pursuit of self-realization, and the new purpose of government is to assure an even expanding notion to civil rights and government entitlements. The progressive argument in favor of replacing the old order (including the old morality) with a liberal state oriented toward social progress has been overwhelmingly successful, and has transformed our politics and our character. Governing has become obscure, incomprehensible, and at the same time petty and small-minded, inviting and encouraging interest groups instead of deliberation and responsibility. The current system encourages habits and forms a character incompatible with republican government by feeding entitlements rather than checking the narrowest passions of self-interest. More important is the effect the new view has had on our understanding of moral character. According to the new version, an unbreachable wall separates private character (which is personal, and value-laden) and public character (which is political, and socially oriented). And there are new value-neutral virtues, such as toleration, empathy, and sincerity. There is a deeper problem as well. Not only does progressive liberalism deny a substantive role for morality in public life, but the extended reach of the state has forced traditional morality--the ground of the old idea of character--into a smaller and smaller private sphere. The sharp distinction between public and private, accompanied by the expansion of the governmental sphere points toward the privatization of morality. If all values are relative, and freedom now means liberation of the human will, it is hard to see any restraints on individual choice. The effect that this combination of things has had on education, religion, and the family--with the rise of illegitimacy and the breakdown of marriage--has been devastating. All is not despair, however. There is reason for some optimism. Gertrude Himmelfarb and Charles Murray--our greatest social observers, who have been skeptical about our accomplishments to date in effecting moral recovery--both point to fragmentary evidence of moral improvement. Murray, for example, has pointed to what he calls "the partial restoration of traditional society" --that is, the return to traditional moral viewpoints that began to be rejected in the 1960s. Specifically, he has called attention to evidence pointing to a rise in educational standards, the onset of a religious revival, and a return to traditional sexual and marital behaviors. Himmelfarb agrees that a reaction is taking place against what she regards as the "dominant ethos" of moral permissiveness. And the reaction--the return toward more traditional, less permissive morality--is taking place "among young people who will shape the culture of the future." The revival of a culture of character is assuredly the greatest task we face today. Looking ahead, if we wish to proactively rebuild a culture of character and not merely wait for trends to turn our way, we must reject the core principles and moral relativism of progressive liberalism. We must also restore the argument of the American Founders that it takes both the workings of limited government and the proper dispositions and habits of the people to form good government and good character. This means that we must break down the administrative state so as to rebuild constitutional government, on the one hand, and actively encourage the revival of the true institutions of civil society--families, churches, and schools--so as to rebuild the moral character of our citizens, on the other. Although it was at a terrible cost, the events of September 11 dealt a significant blow to the philosophy of moral relativism. It is hard to deny that there is evil in the world, and that there is good. Perhaps this moment of resolve can be transformed into a new era of responsibility and the revival of the American character. We must never forget, especially at times like these, that the "preservation of the sacred fire of liberty, and the destiny of the republican model of government," as Washington reminds us, are staked on the experiment entrusted to our hands. How we proceed, as a people and as a nation, will largely determine our future and the fate of free government. Matthew Spalding is the director of the B. Kenneth Simon Center for American Studies at The Heritage Foundation. The Role of Civil Society in shaping Character Don Eberly I think we're making a certain amount of headway in helping people understand again the animating first political principles of the American experiment. I don't know that we have made much headway in helping them appreciate the role that sentiments and mores and attitudes and habits had in the design of our Founders. In their minds it was not just important that we had a constitutional government; it was very, very important in their eyes that we had, and should continue to have, a thriving civil society focused on human freedom. But that freedom was understood to be fairly narrow. It wasn't something that came easy, and it took a tremendous amount of work. It was not a matter of debate during that time period: freedom required character and virtue. Hence, the famous reply of Benjamin Franklin: "A republic, if you can keep it." Now there's a message we should take to our generation. Wherever you're coming from politically in America, I think it's fair to say that people do care about freedom. But I think we ought to start talking about the demands and the obligations and the personal responsibilities that are required to preserve freedom. We must create, or perhaps we should say recreate, a culture of character. John Adams once said that the Constitution was made for a moral and religious people and is wholly inadequate for any other. The question for our time is not only how do you sustain character but also how do you recover it if it is lost? From the very first American settlement, this work of maintaining character was done--and I maintain that the work of recovering this character will be done--by civil society. America succeeded early on because it created a culture that expected, encouraged, and rewarded virtue and character. Indeed, the first institutions built on the frontier after the land was cleared were schools and churches. Mary Ann Glendon of Harvard often says that if history teaches us anything, it is that American constitutional government cannot be taken for granted. Our political order is dependent upon conditions that are more or less cultural in nature, having to do mostly with character. If we're concerned about character--and we certainly are--we must take a deep interest in character-shaping institutions. Character is not something simply that we inhale from the air. It is not something that we teach; it's not just about pedagogy. Character must be cultivated through formative institutions. In fact, if we had time we could get into research on early child development having to do with conscience formation. We as a society are obsessed with freedom of conscience but we have very little idea about the cultivation of conscience. Conscience formation, for example, which requires real institutions to be functioning. Families. Fathers. Functioning schools. Places of worship. Neighborhood groups that care about safety and order and standards. Role models and moral exemplars in the culture and so on. Alexis de Tocqueville is the person among many observers of American life who really did understand exactly the unique moral principles of America, the founding generation, and how they would be or were being, during his period of observation, carried forward on the American scene. He was also a great student of social history. His great observation was that Americans of all ages, all stages in life, and all types of dispositions are forever forming associations of a thousand different types: religious, moral, serious, futile, very general, very limited, immensely large, and very minute. Americans combined to found seminaries, build churches, distribute books. (He was even imagining at the time the Heritage Foundation being built someday!) Hospitals, prisons, and schools took shape this way. If they wanted to proclaim a truth or propagate some feeling by the encouragement of a great example, Americans formed an association. These associations, Tocqueville argued, were absolutely indispensable. All other forms of social and political progress depended upon these unique voluntary associations not only because they served to meet thousands of local practical and charitable needs and help moralize communities when such activity was encouraged, but also because they were little schools of citizenship, and thus helped in the formation of our democratic character. It was in the forming of voluntary associations that we developed our civic habits and defined our character. This is an idea that Tocqueville borrowed in part at least from Edmund Burke, who said that the "little platoon" which we belong to in society is the first link in the chain by which we proceed toward a love of our country and of mankind generally. We start with our love and our loyalty to the little platoon, out of which grows our sense of service and our sense of duty toward persons in the immediate sphere of our lives--such as our own families and in our neighborhoods and local communities. This sense of duty extends to the love of mankind and love of country. These little associations and institutions literally cultivate the kind of habits and sentiments that I think the American Founders were talking about. Burke went on to say that these subdivisions are actually partnerships, not just between those who are living but between those who are living, those who are dead, and those who are yet to come. They are the spiritual, moral, and political communities--the little transmission belts, if you will--that are absolutely essential to the preservation of our system. I want to be practical about this. Far from being anti-politics, I understand politics as a very noble calling. Citizenship entails important formal political responsibilities. But in a well-ordered society, the lawmaking function is peripheral to much of the pulsing life of society. Too many in our generation have assumed that to improve society, one must first turn to politics, meaning parties, interest groups, coalitions, and the lawmaking process. I recognize that this is part of the answer. But if the big issues of our time have to do with values, attitudes, habits, and beliefs, we will be more concerned about the shape of our character-shaping institutions. In regard to the institutions of civil society, government should concern itself mostly with doing no harm, and where appropriate, empowering other non-governmental institutions to do their jobs better. In my opinion, the greatest model of how civil society can be brought to bear upon one of the most difficult political problems of the time can be seen in the example of William Wilberforce, the British Member of Parliament who successfully campaigned over the course of 40 years to fully eradicate the slave trade. At the time, the slave trade traversed the globe and was as large as today's defense industry. It was ferociously defended by numerous economic sectors that profited from it and permitted by the general moral laxity of the time. The times were characterized by high rates of crime, drunkenness, and general disregard for standards. Public confidence in laws was at an all-time low, and there was widespread political corruption. Wilberforce knew that government action against slavery was impossible short of a massive shift in the moral attitudes and habits of the people, so he set forth two great objects: reforming the manners and morals of the people and abolishing the slave trade. A strategy for reformation that started with lawmaking was guaranteed to fail. Wilberforce was merely acknowledging what others in history had observed. Law has an instructive and very influential role in the course of a culture, but laws to a very large extent are a reflection of the culture. Law, in the end, is downstream from the culture. When the mores shift, the laws almost inevitably shift along with them. Edmund Burke said that manners are more important than laws because upon manners in great measure the laws depend. Plato said, give me the songs of a nation--it matters not who writes the laws. We must conclude, as Wilberforce concluded, that if we are going to change law, we must go upstream to the tributaries of moral beliefs and conduct. In doing so we must understand that this work will not be done by the state but will be done by various voluntary associations within civil society. Over the course of three decades, William Wilberforce personally founded and participated in as many as 67 voluntary associations aimed at the reform of manners and morals. It was his work and the work of those like him that resulted in one of the most dynamic chapters in the history of voluntary reform societies. The President in his campaign declared his desire to bring about changes in social policy grounded in the idea that, in dealing with poverty, we ought to go first to the neighborhood healers. We ought to learn first from those front-line anti-poverty workers who understand how to treat the poor--body, mind, and soul--and who understand how to use neighborhood-based solutions. These people understand that to experience genuine transformation, individuals must be restored as persons and restored once again in relationship to their family, neighborhood, community, and places of worship. Our goal is to reverse the pattern of the prior half century, moving away from the top-down rule-driven bureaucratic approach to one that actually learns from, and is instructed by, and which seeks to capture these transforming elements in the communities of America. The Administration is now involved in the early stages of a major overhaul of how we promote international economic development by developing the fruits of civil society in other countries. For too long, our policies abroad were yielding the same failed dependency-producing results that our policies at home had been producing. Just two weeks ago the President unveiled something called the Millennium Compact, which will bring dramatically new terms and conditions for our programs abroad. First of all, we will withdraw aid from governments that are corrupt and simply refuse to reform themselves. In all too many cases, our own policies perpetuate rather than reverse corruption, and this is a very, very serious problem. We must also link economic progress to democratization and good governance. Our policies should encourage prosperity by increased trade, open markets, increased direct private investment, and expanded entrepreneurship, but they must also advocate American democratic values, the rule of law, open and accountable government, and human rights. In order to do this we need to bypass bureaucracies and international technocrats and work with citizens and local community-building groups--including faith-based organizations--to build local capacity around the world, shifting our emphasis away from what we can do for people to what people can and want to do for themselves. We must treat people as partners in their own development. Every person, every community and every country has untapped capacity--and transformative powers. The rule of voluntary associations must guide our thinking as we look at social policy today, both at home and abroad. American history is filled with remarkable success stories, and this heritage of voluntary action offers important insights into how we might promote cultural renewal. Private voluntary organizations form the very basis of America's remarkable capacity to renew itself. Our policy should be to unleash that capacity to renew our country and revive freedom around the world. Don Eberly is Senior Counselor for International Civil Society at the U.S. Agency for International Development. Liberty and Moral Ecology: The Nexus of Truth Samuel Gregg When it comes to reflecting upon questions such as culture and its implications for the political order, most contemporary commentators continue to be dwarfed by the perennial genius of the 19th century philosopher and French Catholic aristocrat, Count Alexis de Tocqueville. For much of the 20th century, the unique insight of Tocqueville into the importance of culture for a free society was overshadowed by those three great masters of the hermeneutics of suspicion: Karl Marx, Friedrich Nietzsche, and Sigmund Freud. In more recent years, however, more have begun to recognize that those who are genuinely interested in seeing freedom prevail would be wise to look to Tocqueville's writings on American democracy as well as his reflections on ancien régime France. In these works, we find more than just a sophisticated analysis of the particular problems confronting two quite different societies. Instead, we begin to recognize that it is culture rather than economics that will determine whether freedom will prevail or wither, for, as Cardinal Jean-Marie Lustiger of Paris once observed, it is culture rather than economics that rules the world.1 Perhaps the most telling evidence of the centrality of culture for a free society is provided by those societies that, for many years, were decidedly unfree. Between 1933 and 1939, Germany's moral culture was transformed from one profoundly marked by a Judeo-Christian ethic to one in which there was relatively little resistance to attempts to exterminate entire categories of people. The fact that German law actually forbade many of the actions of the Nazi regime--ranging from its deadly euthanasia and eugenics programs, to the infamous 1941 Commissar order, to the moral catastrophe of Auschwitz--did little to prevent the regime from pursuing such policies. The slow but gradual changes in the moral-cultural environment in which Germans moved, lived, and had their being made real the possibility of such barbarism.2 Likewise, we know that 70 years of Communism profoundly affected the moral ecology of many European nations. For the most damaging aspect of Communism was not economic. It was not even political. Instead, the greatest damage was moral. How do we know this? Part of the answer lies in reflecting upon some of the mistaken presumptions of those Westerners who traveled to Eastern Europe in the early 1990s, confident that the road to the free society lay in the rapid privatizing of industries, the protection of private property, and the establishment of rule of law. In hindsight, we now know that such ideas reflected a certain blindness to Communism's damage to the moral ecology of these nations. The establishment of rule of law, private property, and market exchange are part of the way to the free society. But they cannot and do not suffice in themselves. Indeed, in several former Communist countries, it is not the free economy that reigns, but rather the black market. The rule of law is routinely flouted, organized crime flourishes, and private property rights remain uncertain. In no way can these be called free societies. They border, in fact, upon being kleptocracies. The question thus arises: How do we develop a moral ecology appropriate for a free society? Do we simply expect it to evolve spontaneously from nowhere, or is a more pro-active role needed? To finish reading this article: http://www.heritage.org/Research/PoliticalPhilosophy/HL755.cfm © 1995 - 2004 The Heritage Foundation

Australia's Public Health Care System The following 'typical' patient case descriptions By your Senates OWN admission this is a TYPICAL patient case description: Joan's throat Joan, a nineteen year old young adult is suffering from a sore throat and after a number of days of discomfort and aspirins discover she cannot swallow and goes to the Emergency department of a public hospital for treatment. She is admitted for two days and treated with antibiotics for swollen tonsils and suspected Quinsy as a public patient at no resulting cost to her. Before being released she is seen by the hospital specialist who warns that if her tonsils again become swollen or infected again she will need to have them removed. Several weeks later while visiting another city, Joan's tonsils again become swollen and so visits a medical clinic where the general practitioner (GP) prescribes a course of antibiotics to control the infection until she can visit her own local GP. The GP refers Joan to an Ear Nose and Throat (ENT) specialist who prescribes another course of antibiotics. After the course of antibiotics her tonsils become inflamed again causing the specialist to recommend surgical removal of the tonsils while classifying the patient as Non-Urgent (category 3). Wait times for category 3 public patient awaiting tonsil removal in a public hospital was estimated between 12 and 24 months. Alternatively, Joan has the option of paying around $2000 to have the specialist remove the tonsils in a private hospital within the next four weeks. Joan began to evaluate her options of risking any side effects of drugs and antibiotics treatment for over a year, or borrowing money for an early operation knowing the private hospital cost and extra billing and balance of the Medicare benefits amounted to an patient out-of-pocket expense (the gap) would amount to approximately $1000. So, Australia separates those who can pay privately and those who cannot and get STUCK waiting. This really is a good respresentation of my point. This does not happen here. We don't have lists to wait that determine whether or not your condition is a priority.....

My point with the post from your Senate (?), is that these are problems currently identified in your system in Australia. You guys haven't worked out all the problems. How long have you had socialized medicine? Why trade our problems, which do not seem to be as bad, for socialized medicine problems? The point is to have your tonsils removed is a problem in Australia. It is not here in the US. They would not treat you with antibiotics for a year (so you don't die of sepsis) while you wait on a list because your tonsils are not a priority. I know that the post was because your country is trying to fix their PROBLEMS. It was actually an exerpt from a more liberal state of mind (Liberal in the US meaning left wing and not conservative), yet it still IDENTIFIES problems in your system. The next step is they say, "MORE MONEY WILL FIX IT". So, more tax dollars get put into the system and it never does get fixed. More money never fixes the problem, yet liberals sream for more more more and more money. kitkat

Amen, and Amen !

I have never seen a gun walk up to a person and shoot him. A fetus is a baby. A baby is a human being. An abortion kills a fetus. Thus..... Lacy and Conner? I guess then Scott Peterson really only murdered ONE person, that being Lacy. Conner did not exist?

YOU said: I say the piece is crap I say: It is a great piece written by a person that actually lives in the body of a disabled person. You say: The disabled historically confuse their right to live with any needed assitance for free with the terminally ill person's right to die. I say: People with disabilities do not confuse their right to live (separate issue), with the assistance they need to live independently (separate issue). I say as well: It is the health care community and the general public that confuses a persons right to refuse further healthcare treatment with a person with a disabilities right to life. Terri Schiavo is a prime example of bioethitists, doctors, and nurses, and the public confusing right to die, or right to refuse treatment, with a person with a disabilities right to be alive. Terrie Schiavo was NOT TERMINALLY ILL. She had a NO CODE status for 12 YEARS. So, the removal of her G tube was making a decision to end her life that she was living. If she had a no code status for 12 years of life, maintained her own blood pressure, and was alive and breathing on her own, then she was not terminally ill. Had her heart stopped, they would not have coded her for 12 years. Had she stopped breathing (she had no tracheostomy any longer) she would not have been intubated. Get the picture? The media and bioethitists called her terminally ill and in a persistant vegetative state. She was a person with a disability. Then, people go onto making this mistake: People think that because they would not want to live in a long term care facility, and because they would want to choose death over disability that others would choose the same. This is the other issue of confusing QUALITY OF CARE with QUALITY OF LIFE. And, it speaks VOLUMES about how people perceived a person that has a disability. Kitkat

Michael Cannon is a senior fellow with the National Center for Policy Analysis in Dallas. Executive Summary No. 509 February 5, 2004 In 1992 Gov. Bill Clinton of Arkansas unseated incumbent President George H. W. Bush in part by tapping voter dissatisfaction with the rising cost of health insurance and the growing number of Americans without health insurance. Despite a massive legislative campaign directed by then-first lady Hillary Rodham Clinton, the Clinton administration's sweeping proposal to increase federal control over the health care sector languished and eventually died in Congress. Today, with health insurance costs once again rising at double-digit rates and the number of uninsured Americans at a new high, the Democratic candidates for president have lined up their own health insurance reform proposals. The major candidates are Army Gen. Wesley Clark (ret.), former governor of Vermont Howard Dean, Sen. John Edwards (NC), Sen. John Kerry (MA), Rep. Dennis Kucinich (OH), Sen. Joe Lieberman (CT), and Rev. Al Sharpton. Before leaving the race, Rep. Richard Gephardt (MO) also put forward a major health care proposal. Unfortunately, the candidates' health plans reflect the same misconceptions as and rely on approaches similar to those of the failed Clinton health plan. Like the Clinton health plan, they misdiagnose what ails the health care sector; would attempt to direct the provision of health care from Washington, DC, through increased taxes, government spending, and bureaucratic control; and would magnify the perverse incentives created by past government interventions. Like that of the Clinton health plan, their response to the use of unconstitutional government power in the health care sector is to wield even more unconstitutional power. The five major candidates (Clark, Dean, Edwards, Kerry, and Lieberman) would take incremental steps toward a government-run health care system. The two long-shot candidates in the race (Kucinich and Sharpton) take a more aggressive approach, calling for an immediate government takeover. Although Sen. Hillary Rodham Clinton (D-NY) disappointed many Democratic Party faithful by forgoing a race for president this year, judging by the health care proposals of the current field, her influence is being clearly felt. Mrs. Clinton Has Entered the Race The 2004 Democratic Presidential Candidates' Proposals to Reform Health Insurance by Michael F. Cannon Introduction Americans endure rising health care costs, diminished access to health care, and high levels of frustration as a direct result of health insurance being among the most government- dominated sectors of the U.S. economy. Instead of a market where health care providers and patients benefit each other and society by pursuing their self-interest, government involvement in health insurance markets has given America a system that substitutes waste for economy, rising prices for affordability, and bureaucratic dictates for consumer choice. In a free market, consumers and producers make voluntary exchanges that benefit both parties. In a genuinely free market, consumers motivated by their own self-interest will naturally make decisions that reward the most efficient producers, while punishing inefficiency and high prices. As a result, producers search for less costly ways of meeting consumer needs. In that environment, prices convey information. They signal to consumers the cost to society of providing various products at different points in time. To producers, prices convey information about what consumers want, helping them identify activities useful to consumers and avoid unwanted activities. Over time, this process makes an ever-increasing number of products, of ever-increasing quality, available to an ever-larger number of consumers. In America's health care sector, government blocks the market process by hiding prices from patients, thus encouraging patients to consume more care and demand less value. This denies patients information on how their actions affect others, a necessary component of controlling costs and eliminating waste. At the same time, it denies producers information about what consumers value most. Rather than let producers be guided by prices that reflect consumer preferences, government distorts prices or sets them arbitrarily. This encourages producers to pursue lawmakers' preferences instead of consumers'-- and to lobby for prices that reflect their own preferences. Denied the necessary information, consumers and producers are less able and willing to circumvent waste, inefficiency, and high prices. Controlling health care costs and improving patient satisfaction require reforms that bring consumers' preferences to the fore by removing government's preferences --by deregulating health insurance and restoring incentives for patients to demand value. The health plan proposed by President Clinton in 1993 would have taken America in the opposite direction. Government would have encouraged patients to consume more medical care and demand even less value, sending more distorted signals to producers through greater use of price controls. The information necessary to promote health care quality and eliminate waste would have been even more severely restricted. Although the details of their proposals differ, the Democratic candidates for president in 2004 are all basically following the approach of the Clinton health plan. They would expand "coverage" with vast subsidies and mandates, encouraging Americans to consume even more medical care. And they would empower others--employers, insurers, and government bureaucrats--to tell consumers when they have had enough. The candidates' plans reflect a consensus among many observers that rising health care costs must be remedied with additional regulations and subsidies, that the problem of millions of Americans who lack insurance must be addressed by doing whatever expands "coverage." That is understandable. Many people who would like to purchase health insurance find it priced beyond their means, and once one is "covered" many medical expenses are passed on to someone else. This analysis is a misdiagnosis of the problem. Health care costs and the number of uninsured continue to rise, not for lack of government, but because too much government has crippled the normal market processes that make health care of everimproving quality available to an ever-larger share of the population. The candidates' pro- posals would add even more government to the mix. How much more? Between 2005 and 2013, the candidates' proposals would cost anywhere from $591 billion (Edwards) to $6.268 trillion (Kucinich). To put this in perspective, consider that the prescription drug entitlement, recently enacted as part of Medicare reform and considered the largest new government program since the Great Society, is estimated to cost only $410 billion1 (Figure 1). Financing any of the proposals would require the next president to repeal all of the tax cuts enacted in 2003 ($140 billion from 2005 to 2013) and a significant portion of the tax cuts enacted in 2001 ($1 trillion from 2005 to 2011).2 The U.S. Department of the Treasury estimates that repealing the 2001 and 2003 tax cuts would raise taxes an average of $1,544 for more than 100 million Americans and cost a married couple with an income of $40,000 and two children $1,933 annually.3 At least two of the proposals would require further tax increases. The proposals are likely to cost much more than projected and would add to an already growing burden on taxpayers. Cost projections have repeatedly and famously underestimated future spending on government health programs and other entitlements. 4 Gail Wilensky, who administered Medicare and Medicaid for President George H. W. Bush, said of the new Medicare prescription drug benefit: If history is any guide, it will cost more than we think. . . . Not because people are deliberately low-balling the estimates, but because we have never been able to correctly estimate the cost of a new benefit, and this one is much bigger than most. For example, when Medicare was enacted, hospital costs were projected to be $9 billion in 1990. Actual spending in 1990 was more than $66 billion.6 There is no reason to believe the costs of the candidates' health insurance proposals will be lower than projected; there is ample reason to believe they will be higher. Government spending on those proposals would compound the enormous budgetary pressures of existing federal entitlements. The present value of the future fiscal imbalance of Medicare and Social Security alone is Between 2005 and 2013, the candidates' proposals would cost anywhere from $591 billion (Edwards) to $6.268 trillion (Kucinich). estimated to be more than $43 trillion before the new prescription drug benefit is added.7 Under current law (again before adding the cost of the new Medicare benefit), Social Security, Medicare, and Medicaid will consume nearly 80 percent of federal spending by 2040.8 In addition to placing new duties on taxpayers, the candidates' health proposals would make existing obligations greater by subjecting Medicare and Medicaid to greater medical inflation. The cost of those proposals, however, would go well beyond federal outlays. Each would impose hidden costs on employers and workers and lead to greater state government spending. The costs include dampened economic growth resulting from higher tax rates. People who oppose the influence of money in the political process will find much to dislike about the candidates' health insurance proposals. Each would increase government control over the health care sector and with it the amount of money spent to influence how government exerts that control. By conservative estimates, health care interests spent more than $600 million on political contributions and lobbying activities in the 2001-02 election cycle.9 Health professionals make the second highest contributions to congressional campaigns. 10 Health care groups ranked second in terms of dollars spent on lobbying activities in 2000.11 The health care industry's interest in government is a direct result of government's influence over the health care sector. Under any of the candidates' proposals, health care regulation would increase and with it political contributions and lobbying activities of health care interests. Finally, the candidates' proposals would expand the federal government's power far beyond what the Constitution grants. Fidelity to the Constitution requires reducing federal power over the health care sector. A positive agenda for improving America's health care system would focus, not on the candidates' paper guarantee of "coverage," but on restoring the market processes that make health care of ever-improving quality available to an ever-greater share of the population. Remembering the Clinton Health Security Act In 1993 a Clinton administration task force, directed by First Lady Hillary Clinton, devised and proposed a sweeping reorganization of America's health care sector. The Clinton health plan would have increased government controls and exacerbated trends of rising costs and waning consumer sovereignty. Under the Clinton Health Security Act, the power of individuals to make countless choices about their health care would have been handed over to government, and the few remaining market mechanisms that contain costs and promote quality would have been lost. The federal government would have compelled all Americans to buy health coverage, dictated what type of coverage they would receive and where they would "purchase" it, set prices for coverage and medical services, and encouraged states to form their own single-payer health care systems. Commenting on the Clinton health plan, The Economist wrote, Not since Franklin Roosevelt's War Production Board has it been suggested that so large a part of the American economy should suddenly be brought under government control.12 Though it might have left some private health insurance companies standing, the Clinton health plan would have let government direct the financing of medical care to such an extent that America could no longer have been said to have a private health care system. Rising costs, diminishing quality, and rationing of care would have been exacerbated in the United States as they have been under other socialized health systems. Notable features of the Clinton health plan follow. Compelled Behavior The most draconian aspect of the Clinton health plan was its mandates on individuals and employers. The federal government would have compelled Americans to purchase health insurance whether they wanted it or not, forced employers to pay 80 percent of the cost, and subsidized premiums for low-income individuals and small employers. The option to decline health insurance coverage would have become a right no American could exercise, and health insurance "premiums" a tax few could avoid. In 1993 David Rivkin of the American Enterprise Institute commented on the unconstitutionality of the individual mandate: In the new health care system, individuals will not be forced to belong because of their occupation, employment, or business activities--as in the case of Social Security. They will be dragooned into the system for no other reason than that they are people who are here. If the courts uphold Congress's authority to impose this system, they must once and for all draw the curtain on the Constitution of 1787 and admit that there is nothing that Congress cannot do under the Commerce Clause. The polite fiction that we live under a government of limited powers must be discarded --Leviathan must be embraced.13 Standard Benefits Package The federal government would have controlled the coverage citizens received. A National Health Board would have been vested with the responsibility and power to make billions of decisions that consumers would otherwise have made for themselves. That panel of "experts" would have dictated what types of health insurance Americans would purchase, how much they would pay in premiums, and how much could be spent on health care nationwide. The board would have been charged with constructing a package of health benefits that all Americans would have had to purchase. Creating a one-size-fits-all standard benefits package ignores the fact that there is no "right" package of benefits. Individuals have different preferences when it comes to health insurance, just as they do when it comes to doctors, cars, and clothes. Imposing the same coverage on everyone means many people will be forced to purchase benefits they do not want. For example, the Clinton health plan would have required Americans to buy coverage for elective abortions.14 Declining unwanted, government-mandated benefits today can be difficult. It may involve dropping coverage, changing jobs, or even moving to another state. However, any of those is easier than passing a new federal law or leaving the country, which is what would have been necessary under the Clinton health plan. Insofar as a standard benefits package forces consumers to buy benefits they otherwise would not, it encourages them to consume more care to obtain some value for the money they would rather have spent elsewhere. In addition to the National Health Board, the Clinton plan would have impaneled a National Quality Management Council to develop standards of quality coverage and care. All health plans would have been required to comply with the council's quality guidelines. In effect, the council would have substituted its judgments about quality for those of more than 250 million consumers. It is certain that such a panel's judgments would have delivered quality in some instances and failed in others. Patients adversely affected by the council's judgments, however, would not have had the option of avoiding them. Care could have been delivered only according to the council's guidelines. Price Controls The National Health Board would have set prices and spending levels for the entire health care sector. No health insurance premium could have exceeded the average for a geographic area by more than 20 percent. Many observers predicted this price control would health plan's premiums would have been the same for everyone--young and old, healthy and sick--within a politically determined geographic area. Forcing people with below-average needs to subsidize those with above-average needs would have stimulated demand among both groups. The former would have wanted to get the most value for their forced contributions, and the cost of coverage and care for the latter would have been dramatically lowered. The board also would have controlled spending nationwide by drafting global budgets that dictated how much could be spent on medical care in a certain geographic area. Global budgets in other nations have invariably led to rationing of care.15 Health Alliances Another feature of the Clinton health plan was "managed competition": government would bring together private insurers and consumers in an artificial marketplace, much like the Federal Employees' Health Benefits Plan. The Clinton health plan would have created state-based "regional health alliances" to serve everyone within a geographic area, with the exception of those working for certain large employers. The alliances would have been operated by state governments or quasi-governmental agencies and would have been responsible for enforcing the dictates of the National Health Board and the National Quality Management Council. Individuals would have been automatically enrolled in their regional health alliance and in some instances automatically assigned to a plan. Although consumers could have chosen among a few health plans, those options would have been heavily restricted by a standard benefits package, price controls, and other regulations. Moreover, third-party payment and other perverse incentives would have been intensified. The alliances would have created a semblance of competition, but without the economizing incentives that come from allowing risk-based insurance pricing or letting consumers decide how to spend their health care dollars. Consumers would have continued to pay a small fraction of the cost of the medical care they consumed, encouraging them to demand more care but less value. Community rating would have encouraged consumption but discouraged healthy behavior. Not every American would have been forced into a regional health alliance. Certain large employers would have been allowed to operate their own alliances, though they would have been required to conform to the same benefits, pricing, and quality standards and would have faced other incentives to join a regional alliance. The Clinton health plan also would have encouraged states to launch single-payer health care programs, under which the state would finance medical care for everyone within its borders. Interestingly, federal employees, including members of Congress and many of those who drafted the Clinton health plan, would have been excluded from regional alliances for four years after the first Americans were forced to enroll. Had the regional alliances not met the planners' expectations, that would have granted politically powerful federal workers enough time to carve themselves out of the alliances permanently. Higher Taxes The Clinton health plan would have resulted in a massive tax increase. The Clinton administration initially estimated its health plan would save taxpayers money, though few people believed that prediction. As one observer noted at the time: [V]irtually all of the perverse incentives of the current system are to be left in place, while the Administration is expanding coverage for the millions who are uninsured. This amounts to a stimulation of demand, combined with a constriction of supply. This is akin to turning up the heat on a pressure cooker, while clamping down on the lid. At some point, the lid will blow and the costs of the system will skyrocket in bigger deficits and even higher taxes. Under heavy criticism, the Clinton administration was forced to admit the program would cost taxpayers an additional $700 billion over five years, and some observers maintained it would cost significantly more in higher tax revenue and lower economic growth.17 An Incremental Approach The Clinton health plan was so massive in scope that it collapsed of its own weight. Since its defeat, supporters of greater government control over the health care sector have focused on incremental rather than wholesale measures. As President Clinton told a group of supporters in 1997: I'm glad I tried to do the health care plan. . . . Now that what I tried to do before won't work, maybe we can do it in another way. That's what we've tried to do, a step at a time, until eventually we finish this.18 One of those steps already has been taken. Internal documents from the Clinton administration's health care task force reveal the group considered a number of options for phasing in "universal coverage" starting with children. Phasing in full government control first for children and then later for adults was discussed with the task force by a senior aide to Sen. Edward Kennedy (D-MA), a longtime advocate of a single-payer system.19 In 1997, with the help of Senator Kennedy, the Clinton administration created the State Children's Health Insurance Program, which expanded government financing of health care to cover more low-income children. The 2004 Democratic presidential candidates' proposals would take the next several steps down this road. 2004: The Democratic Presidential Candidates Many features of the Clinton health plan have resurfaced in the health platforms of the Democratic candidates for president in 2004: expanding government health programs; individual and employer mandates; a standard benefits package; government quality standards; price controls; health insurance subsidies; exemption of federal workers from rules that govern others; and higher taxes, both explicit and hidden. One ostensible difference is the proposal to use tax credits to expand insurance coverage (Clark, Dean, Edwards, Kerry, Lieberman). Although tax credits have the potential to curb third-party payment and improve consumer choice through a more equitable distribution of the tax subsidy for health insurance, the tax credits proposed by the candidates would do little more than subsidize greater consumption of health care. The five leading candidates (Clark, Dean, Edwards, Kerry, Lieberman) would expand government control over the health care sector incrementally and subsidize health insurance with refundable tax credits. The two long shots (Kucinich and Sharpton) would go well beyond even the Clinton health plan and establish a nationwide single-payer system. Features Common to All Plans Higher Taxes, Hidden Taxes. The costs of all of the plans for which cost estimates are available would far outstrip the cost of the recently enacted Medicare prescription drug benefit. The least expensive plan (Edwards) would cost a projected 40 percent more in 2013. The most expensive proposal (Kucinich) would cost nearly 17 times as much.20 The cost estimates are likely to understate actual government outlays and do not account for additional hidden costs. Financing any of the candidates' proposals would require the next president to repeal all of the tax cuts enacted in 2003 ($140 billion from 2005 to 2013) and a significant portion of the tax cuts enacted in 2001 ($1 trillion from 2005 to 2011).21 All of the candidates have endorsed repealing a significant portion of those tax cuts. Some propose additional tax increases. Kucinich would impose a 7.7 percent payroll tax to finance a single-payer system. Expanding Government Programs. Each candidate would expand the reach of government health programs. Even the incremental expansions of Medicaid and SCHIP proposed by some candidates (e.g., Dean) rival the cost of the new Medicare prescription drug benefit. The expansions would increase the "entitlement" attitude toward health care and diminish private-sector coverage. Again, the proposals of the five leading candidates would crowd out private health insurance by as much as 50 percent of the proposed expansions. 22 The proposals of Kucinich and Sharpton would crowd out the entire private health insurance industry. Price Controls. Each candidate would expand the reach of government price controls by expanding government programs at the expense of private-sector coverage. Government-determined prices would be imposed on more transactions, and the share of prices set by private payers would shrink. In proposals containing health alliances (see below), premiums would be community rated, creating a disincentive for younger and healthier risks, attracting more expensive risks, and putting taxpayers on the hook for the costs of adverse selection. Standard Benefits Packages. Each proposal would give government greater power to dictate the type and level of health benefits consumers would receive. This most obviously would occur in government programs, but candidates who would preserve a private health insurance market would mandate that consumers purchase governmentordained benefits. Some would require certain types of coverage and measures of quality, while others would prescribe appropriate deductibles and copayments. Features Common to Some Plans Individual and Employer Mandates (Clark, Dean, Edwards, Kucinich, Lieberman). Forcing consumers to do what government wants is particularly detrimental to the goal of determining what consumers want. Several candidates would either compel certain individuals to obtain coverage or compel employers to provide coverage for some or all workers. The mandates would be enforced by various tax penalties. Automatic Enrollment and Government Monitoring of Insurance Status (Clark, Dean, Edwards, Kerry, Lieberman). Several candidates would set up procedures to enroll individuals automatically in government health programs or monitor their insurance status, or both. Status would be monitored through schools, the Internal Revenue Service, or other government agencies. Candidates proposing single-payer systems (Kucinich and Sharpton) have not specifically addressed these issues. Cato Policy Analysis No. 509 February 5, 2004 Mrs. Clinton Has Entered the Race: The 2004 Democratic Presidential Candidates' Proposals to Reform Health Insurance by Michael F. Cannon Michael Cannon is a senior fellow with the National Center for Policy Analysis in Dallas. -------------------------------------------------------------------------------- Executive Summary In 1992 Gov. Bill Clinton of Arkansas unseated incumbent President George H. W. Bush in part by tapping voter dissatisfaction with the rising cost of health insurance and the growing number of Americans without health insurance. Despite a massive legislative campaign directed by then-first lady Hillary Rodham Clinton, the Clinton administration's sweeping proposal to increase federal control over the health care sector languished and eventually died in Congress. Today, with health insurance costs once again rising at double-digit rates and the number of uninsured Americans at a new high, the Democratic candidates for president have lined up their own health insurance reform proposals. The major candidates are Army Gen. Wesley Clark (ret.), former governor of Vermont Howard Dean, Sen. John Edwards (NC), Sen. John Kerry (MA), Rep. Dennis Kucinich (OH), Sen. Joe Lieberman (CT), and Rev. Al Sharpton. Before leaving the race, Rep. Richard Gephardt (MO) also put forward a major health care proposal. Unfortunately, the candidates' health plans reflect the same misconceptions as and rely on approaches similar to those of the failed Clinton health plan. Like the Clinton health plan, they misdiagnose what ails the health care sector; would attempt to direct the provision of health care from Washington, DC, through increased taxes, government spending, and bureaucratic control; and would magnify the perverse incentives created by past government interventions. Like that of the Clinton health plan, their response to the use of unconstitutional government power in the health care sector is to wield even more unconstitutional power. The five major candidates (Clark, Dean, Edwards, Kerry, and Lieberman) would take incremental steps toward a government-run health care system. The two long-shot candidates in the race (Kucinich and Sharpton) take a more aggressive approach, calling for an immediate government takeover. Although Sen. Hillary Rodham Clinton (D-NY) disappointed many Democratic Party faithful by forgoing a race for president this year, judging by the health care proposals of the current field, her influence is being clearly felt. Full Text of Policy Analysis No. 509 (PDF, 26 pgs, 163 Kb)

Yes, it can happen any place as I did mention group homes as well. This post had nothing to do with "Male Caregivers", so the Jeddi mind trick does nothing for a debate either. I believe focusing on the two primary aspects of my comments would be best. And, also imposing your view of what I typed is not efficient for a debate either. As, I never said that people are only raped in LTC's. You know too little about "my home" life to comment and you will continue to know too little about my home to make comments. Let me review: 1. Terminal illness is not a disability. Disability does not mean you have a terminal illness. 2. Quality of care is not the same thing as Quality of life. And, if personal invective and wallowing in negative contribute nothing to a debate... they'd shut this BB down my friend. All of the positive aspects of universal healthcare have mostly been personal invective.... of which I take note of. Kit*yawn*kat

Australia's Public Health Care System The following 'typical' patient case descriptions attempt to illustrate how Australia's healthcare system is beginning to fail the average Australian in not providing adequately accessible and affordable medical and hospital services. Despite Medibank's original objective in 1974 to avoid creating a two-tiered system, Australia's healthcare system has effectively created two classes of service based upon the patient's ability to pay and placing financial burdens on the average Australian income earner and the longer waits for care from public hospitals. John's knee John is a fit and healthy sports-minded twenty-three year old who recently graduated from University, and joined a government department as a full-time casual employee. He is invited to join a departmental touch football team to play after work. He joins, pays the club membership fee (which includes basic medical insurance) and unfortunately, in his first game receives torn knee ligaments from a playing accident. Almost unable to walk the next day, he visits his doctor and is referred to an orthopaedic specialist who, after x-rays, advises arthroscopic surgery to clean up torn cartilage and fully assess possible reconstructive surgery of the knee ligaments. John is advised that he can wait for a public hospital which is likely to take several months, or pay around $2,500 for the assessment to be carried out within four week in a private hospital. He would be eligible to claim back the scheduled Medicare fees for doctors, surgeon and operational assistants from the government. With seemingly little choice, John borrows the money and undergoes the operation. Following the operation John is advised he will need a further operation for a ligament reconstruction with knee function likely to deteriorate the longer the operation is delayed. Public hospital availability would be at least 12 months but again, for around $3,500, a private hospital could be booked and the knee done within the month. John, faced with further financial debt, decides to evaluate his options. He reviewed his costs and benefits to-date to discover that the total cost of the injury (GPs, specialists, surgeons, hospital and health services) amounted to $2,600 with the Medicare benefit ($620) and insurance refund ($875 for 75% of hospital cost less a $75 deductible) totalling $1,500. The residual $1,100 is John's out-of pocket expense - representing 43% of the total cost and resulting from residual Medicare schedule fee balance("the gap"), extra billing and residual hospital costs. Joan's throat Joan, a nineteen year old young adult is suffering from a sore throat and after a number of days of discomfort and aspirins discover she cannot swallow and goes to the Emergency department of a public hospital for treatment. She is admitted for two days and treated with antibiotics for swollen tonsils and suspected Quinsy as a public patient at no resulting cost to her. Before being released she is seen by the hospital specialist who warns that if her tonsils again become swollen or infected again she will need to have them removed. Several weeks later while visiting another city, Joan's tonsils again become swollen and so visits a medical clinic where the general practitioner (GP) prescribes a course of antibiotics to control the infection until she can visit her own local GP. The GP refers Joan to an Ear Nose and Throat (ENT) specialist who prescribes another course of antibiotics. After the course of antibiotics her tonsils become inflamed again causing the specialist to recommend surgical removal of the tonsils while classifying the patient as Non-Urgent (category 3). Wait times for category 3 public patient awaiting tonsil removal in a public hospital was estimated between 12 and 24 months. Alternatively, Joan has the option of paying around $2000 to have the specialist remove the tonsils in a private hospital within the next four weeks. Joan began to evaluate her options of risking any side effects of drugs and antibiotics treatment for over a year, or borrowing money for an early operation knowing the private hospital cost and extra billing and balance of the Medicare benefits amounted to an patient out-of-pocket expense (the gap) would amount to approximately $1000.

'I would not trust my dog, let alone my mother, to many nurses' (Filed: 29/11/2003) Millions of pounds are being pumped into our hospitals - so why are they in such chaos? For the past 11 months, Harriet Sergeant has been free to talk to management in six NHS hospitals. A patient in an NHS hospital exists in a power vacuum. Who is in charge of my health? Who is responsible and accountable for what? These are the questions that many patients are asking with increasing panic. It is a revelation to anyone spending time in a hospital to discover how little of hospital activity is actually managed. The closer you get to the patient, the less management there is. No single person appears to have the authority to oversee all the elements of a patient's care, pull them together and take responsibility for that person's wellbeing. Whether you enjoy attentive nurses, a proper diet and clean wards is simply pot luck. Nor can this arbitrary standard of care be blamed wholly on staff shortages; rather, it is a catastrophic failure of management, combined with substandard training, that has brought about a crisis in the wards. A nurse consultant who prepares hospitals for audits gave me an example of a scene that she comes across every day in the NHS. She had walked into a ward where a second-year nurse was taking care of six patients, unsupervised by a senior nurse. An old man wearing an oxygen mask was sitting in bed, staring disconsolately at a wash bowl. Next to the wash bowl lay his breakfast, uneaten, and beside that, an overflowing sputum pot. A full bottle of urine dangled beneath the bed. The nurse had left him with the wash bowl "to do what he could". No one had taught the nurse that she should clear everything away first, remove the urine bottle and then present the bowl of water. No one had taught her the purpose of nursing: to do for the sick what they cannot do for themselves. The training of nurses has promoted them further and further away from the interests of their patients. In the late 1980s, nursing turned itself into an academic profession. Nurses desiring increased status and greater parity with doctors sought to transform their training into a graduate profession. The result is "a frigging mess", according to a member of the King's Fund, a charitable foundation concerned with health. One senior staff nurse at a hospital in the West Country, who teaches at the local university, pointed out - logically enough - that the academic status of the qualification means "there has to be a lot of theory". But there is too much theory, too much emphasis on social policy and communication skills - and not enough practical work. At a London A&E department, a staff nurse who had recently qualified complained to me that her training had not prepared her at all. In 18 months of study, she had spent only one and a half hours learning how to take blood pressure and a patient's temperature. On the other hand, a whole afternoon had been devoted to poverty in Russia. "They don't prepare you for the things that matter," said the nurse. Instead, she had learnt how to approach a patient and what mannerisms to adopt. She shrugged. "If you don't know that already, then why are you becoming a nurse?" she asked rhetorically. Or, as an Irish sister of 17 years' experience put it: "No, I have never felt the lack of studying sociology. Kindness and common sense go a long way.'' The staff nurse had been astonished to discover how little anatomy or physiology her course contained. Anxious that her grasp of these essential subjects was "not as good as it could be", she approached her tutors. But they took a relaxed view. Soon, she discovered that her ignorance did not matter. Her first exam, tackled after 18 months, was multiple-choice; her final exam, at the end of two and a half years, allowed her to answer three out of six questions, and so avoid revealing her ignorance. For assignments, her tutors had set her work on social issues and ethics - including patient rights. That patients might have a right to a person qualified in how to look after them did not seem to have occurred to her teachers. She said: "Theoretically, you could go through the whole three years without anyone asking you about bed sores." She managed to qualify with only a vague knowledge of the bodies soon to be in her charge. After graduation, she recalled vividly putting on her uniform for the first time and pinning on her badge. She had looked at herself in the mirror with a sense of disbelief. "You are expected to cope with situations that you know you just can't. There is no one to ask - or they are too busy or they don't know because they are agency nurses." Another nurse recalled the shock of her own first days on the ward, with phone calls coming in from everywhere and acutely unwell patients. In one 10-minute period, she had to arrange transportation for a patient, give morphine to a man screaming for pain relief and see to another in a side room, who was dangerously short of breath. "I was on my own. I did not know which way to run, which was the most important. I remember thinking, 'Shit, I just want to get out of here'.'' She added: "I learnt more in the first three months on the job than in three years at college.'' The Irish sister had scant respect for new nurses: "They picture themselves at a computer or with a doctor on his rounds. They are horrified to discover that 90 per cent of their time is doing things for the patient. "I see nurses walk past a patient, ignoring his distress. I will not have on my ward a patient apologising because he needs to ask for care. We are dealing here with sick and vulnerable people, many of whom are dying. I aim to see them die in dignity and comfort, and for their relatives to have good memories of their last few weeks.'' The Irish sister's training had been very different - learning practical skills side-by-side with what she was studying in the classroom. She had practised washing a patient and making beds. Every three months, she had taken a three-hour exam in the morning, followed by a two-hour exam in the afternoon. "If you failed, you had one chance to repeat it - then out. You also had to go through every task observed by a nurse until you were ticked off on it." A former matron recalled being watched and criticised - "and woe betide if you got anything wrong" - while learning to wash a patient, feed him, put on a dressing and make him comfortable. "No one learns how to make a patient comfortable any more," she said sadly. Rather like the concept of hot milky drinks - which she used to offer to patients every night at eight o'clock - the idea of comfort got jettisoned in favour of social policies. Once on the ward, "a nurse took you under her wing to show you the ropes", recalled the Irish sister. Nowadays, the overseeing and training of newly qualified nurses can be overlooked. One staff nurse said that the atmosphere on her ward is so unfriendly that when "you screw up your courage to ask someone to show you a procedure, they give you a withering look''. A sister explained to me that, when a nurse asks for help, "you have to set aside half an hour to show her how to do it. If you don't give her the time, she will make a mistake. But we don't have the time.'' Thirty years ago, the newly qualified nurse knew exactly what was expected of her. In one morning, she might be asked to polish all the bed pans, or give each of the 17 patients on the ward an "up" bath. Then, when she became a senior nurse, she dressed all wounds on the ward. In the mid-1970s, task-centred care changed to client-centred care. Each nurse was allocated a group of patients for whom she did everything. "All that did was create a mountain of paperwork," said the sister. Nurses had to assess their patients, then plan their care - and all this had to be written down. It was fine if there was enough staff. But if a nurse had to cover for a colleague, she suddenly had 10 patients about whom she knew nothing. The former matron said she had heard a woman asking a nurse for a bedpan for her mother. "She's not my patient," said the nurse. The irony is that nurses thought that making their qualifications more academic would gain them the respect of consultants. This does not seem to have happened. Nearly every consultant I interviewed complained that the standards of nursing were, as one put it, "dangerously low". He added: "It's very frustrating to see our patients treated to such poor standards of care.'' A consultant anaesthetist at a London teaching hospital complained of patients arriving for operations with bed sores. On ward rounds, he frequently found himself helping patients to eat. "The catering staff slam the food down. No one bothers. Spooning food into a patient is just too demeaning for professional nurses, it seems. I always thought nurses were meant to care for patients. I might be wrong. I may have missed the plot somewhere.'' Another described the difficulty of trying to find a particular patient on a ward. Every patient is supposed to have his name above the bed. But, in some hospitals, they refuse to display the name "in case it infringes your autonomy". So the consultant found himself wandering around, trying to find his patient. "There never seems to be anyone in charge who knows anything," he said. He would try to find the patient's nurse. Then the patient's notes. "I don't often strike lucky with all three." Finally, he had to translate the nurses' diagnoses. "They refuse to use hierarchical, male-dominated medical terms, so they will not say the patient is unconscious. No, the patient has to have 'an altered state of awareness'.'' The voluntary service co-ordinator of one hospital told me a shocking story. As he was passing a room, he heard an elderly lady call urgently: "Please take me to the toilet. I have been pushing and pushing the button, but no one will come." He pointed out that only a nurse could take her and went to find one. Three were clustered about the nurses' station, listening to Radio 1 and dipping into a box of chocolates. The co-ordinator told them about the patient, adding: "Can't you hear her calling?" "Oh, she's always calling,'' they said, without moving. When he went back, he found the old lady face-down on the floor. He returned to the nurses. "You had better come now," he said. "I think she's dead." The voluntary service co-ordinator added: "That has happened more than once.'' Many of the patients I met had stories of neglect. One woman suffering from a placenta praevia found herself abandoned in a side room. No one came. No one checked her blood pressure or temperature. Her catheter was left in for three days. The toilets were all blocked up. Finally, her cousin - a qualified gynaecologist - came to visit and was so appalled that she had a showdown with the nursing staff. "I would have had better treatment in the Third World," remarked the patient. Many also told of unexpected kindness and good nursing. One woman said: "The older ones are better. The younger ones are quick to tell you: 'That's not my job' or 'That's not my patient'.'' An older nurse had taken her down to the theatre for her operation and kissed her. "It was so comforting and sweet - it made a big difference to me." But whether patients received a kiss or a reproof for "whingeing" - as one man did after a traumatic road accident - seemed entirely a matter of chance. The attitude of the nurses is of enormous importance to a patient who is helpless and totally dependent. It is bad enough being ill and in pain. To be abandoned or treated unkindly is almost insupportable. Traditionally, sister attended the ward round with the consultant. She saw her job as taking the patient's side and putting the patient's point of view. She had, after all, taken care of the patient over the past 24 hours. The loss of sister's authority means the loss not just of patient care, but also of a patient's advocate. Nursing is mainly done by young women, and there is a constant turnover and shortage of nurses - particularly at the lower grades. Until recently, the only way to gain promotion or an increase in salary was to move into management. This takes nurses and auxiliary nurses away from the patient and the practical care at which they should excel. Sir Stanley Kalms, an entrepreneur who became chairman of an NHS trust for three years, remarked: "People say nurses are angels. Well, nurses are employees who do nursing." And, like every other employee, they need managing. The "modern matron" - a new post that puts a senior nurse in charge of three or four wards - lacks the tools to manage her nurses. One former matron, now a nurse consultant in audit work, pointed out how difficult it was, for example, to discipline a nurse for incompetence. First, the busy matron or sister (who looks after one ward) has to notice what is going on - and most are too occupied to do so. Then, even if she does, discipline in the no-blame culture of the NHS is a "long-winded process". The emphasis is on being "nice" and making sure no one is blamed. She continued: "You can't bawl them out or they'll sue you for harassment." Instead, "in a nice soft voice, you have to ask if that was the way she was taught. Does she consider it appropriate care?" Modern management is meant to "nurture" its employees. So, the errant nurse is offered training, supervision and, of course, she is given another chance. This can go on for a year. "In the meantime," said the former matron, "patients are going through her hands and suffering.'' Most matrons or ward managers take the easier option and promote the incompetent "to get them out of your hair", she said. Even if the nurse is disciplined, the modern matron faces a further difficulty. Who will replace the nurse? A bad one is better than none. Trusts around the country are struggling to find the staff they need for present workloads, let alone take forward government plans. Hence, the shortage of nurses insulates the profession from the normal disciplines of working life. Nurses enter the profession to care for people. Yet their training, combined with the lack of supervision on the wards, robs them of the means to show their compassion. Those who do manage to give good care succeed despite the system, not because of it. A male modern matron with 15 years' experience in the NHS summed up a view I heard from nearly every medical person I interviewed, including many nurses themselves: "I would not trust my dog, let alone my mother, to many of them.'' The failure of management around the patient is evident in other areas. Many patients, for example, complained about the food: it was inappropriate for their age or illness (elderly people are flummoxed by pizza), it was plain bad, or it simply didn't arrive. "My family bring me sandwiches," one old lady told me. Another commented: "I just took one look at [the meal] and I said no.'' One woman had not eaten for 48 hours. "They did offer me a tea cake which had been in the fridge for months. I had to throw it away." Her nurses seemed indifferent or helpless. The NHS Magazine states that 40 per cent of adults are suffering from malnutrition on hospital wards. Many elderly patients are already malnourished on arrival, but studies show that their condition deteriorates in hospital. Malnutrition results in "substantial" morbidity and mortality, complicates illness and delays recovery as well as reducing wound-healing and increasing the risk of infection. The King's Fund estimates that this costs the NHS £226 million a year. The fact that so many elderly people are actually going hungry on our wards, unnoticed, is an appalling indictment of the NHS and the management of the wards. Essence of Care, a book distributed by the Department of Health, describes best and worst practice for patient care - from bed sores to feeding, from patient notes to incontinence. The book also categorises levels of care, beginning with "deliberately negative and offensive behaviour and attitude". These basics are what nurses 30 years ago learnt as a matter of course. These basics were nursing. Now, the Department of Health has to regulate something as fundamental to the sick person as privacy and dignity. As a member of the King's Fund said: "What state must nursing be in that the NHS should have to put this around? " The foreword by Sarah Mullally, Chief Nursing Officer, makes grim reading. Essence of Care, she writes, focuses on those "core and essential aspects of care" that matter to patients "quite rightly", yet that rarely attract the attention they should during the "quality improvement process''. You cannot help but wonder at a "quality improvement process" that fails to notice bed sores or malnutrition. Ms Mullally suggests throwing a weekly tea party at which carers and patients can "express concerns". Here, then, is our modern culture of caring. Bed sores and malnutrition alongside tea parties, and a happy experience for all concerned. There can be no doubt that the lack of management around the patient is due to matron's loss of power and the shift from the practical to the academic in nurse training. Yet this has not been recognised, let alone tackled. If the Government was serious about improving patient care, it would give hospitals the power to pay nurses a proper wage and modern matrons the power to hire, fire and reward staff. I met many dedicated sisters and nurses. But, in this situation, dedication is not enough. There is only so much difference an individual can make in a system that fails to support her. The focus of caring for the patient has been lost - and the effect on the patient is devastating. This article is an edited extract from Managing not to Manage, to be published on Tuesday by the Centre for Policy Studies. To order the full pamphlet please send a cheque for £10 to Centre for Policy Studies, 57 Tufton Street, London SW1P 3QL

Fergus I do read your posts. I believe that is your honest opinion about your system. There are too many other views that say that indeed there are problems with care and who dictates that care. What if your doctor wanted you to see a specialist, then how long would you wait? What about surgery? Other reports say different than your experience. But, I do take heed of your opinion ! Kitkat

ktwlpn, Wow, I didn't see this post. I must respond. You said: The disabled historically confuse their right to live with any needed assitance for free with the terminally ill person's right to die. end quote So, you are a historian of disability rights, eh? OK, well I think that you are suffering from loose associations here. People with disabilities rights to be alive have nothing to do with a terminally ill person's right to die peacefully. I fully support the terminally ill and home hospice. We took care of my father with hospice at home who had TERMINAL BRAIN LUNG CANCER THAT HAD SPREAD TO HIS BRAIN STEM. He was terminally ill. Here is the problem, K.T.W. LPN: Now, pay close attention: When people like Y O U confuse terminal illness with disability... ya follow? Do I see a lightbulb yet? Also, K.T.W LPN Please do not confuse quality of CARE with quality of LIFE ! That too is a common mistake. I bet that you would chose to live your life in the least restrictive, most home like setting that you can forever, am I right? Or do you want to pack up your bags and move into a long term care place right now? A few years ago there was a story of a 35 year old adult female with cerebral palsy and mental retardation living in a nursing (assistant) home/long term care facility. One day she was writhing in pain, and they discovered that this diapered, incontinent woman was in labor. She delivered a baby into a urine and feces soaked diaper. The baby lived and is being cared for by a family member. Apparently, a nurses aid was having sex with the severely disabled young woman and impregnated her. They did DNA tests and caught the man. This was testified to by the family's attorney on CSPAN. I can tell your horror story after horror story of goup home sexual and physical abuse cases. Search Lexus Nexus on the subject... And for the record, I do not equate cognitively and physically disabilities with mental illness. kitkat