Shame.

So, of course you should go read Steven Brill’s excellent article on health care price gouging. Or maybe you shouldn’t. It’s very long. Not everybody has to be a fucking policy intellectual, or even au courant in the “public affairs” covered by Time. You don’t have to read much (or, God forbid, write) about policy to be a good person and a good citizen.

But citizenship does carry burdens. Like this:

By the time Steven D. died at his home in Northern California the following November, he had lived for an additional 11 months. And Alice had collected bills totaling $902,452. The family’s first bill — for $348,000 — which arrived when Steven got home from the Seton Medical Center in Daly City, Calif., was full of all the usual chargemaster profit grabs: $18 each for 88 diabetes-test strips that Amazon sells in boxes of 50 for $27.85; $24 each for 19 niacin pills that are sold in drugstores for about a nickel apiece. There were also four boxes of sterile gauze pads for $77 each. None of that was considered part of what was provided in return for Seton’s facility charge for the intensive-care unit for two days at $13,225 a day, 12 days in the critical unit at $7,315 a day and one day in a standard room (all of which totaled $120,116 over 15 days). There was also $20,886 for CT scans and $24,251 for lab work.

Does Alice have neighbors? Does she have friends? Where were they, what did they — and by that I mean we in some earnest and patronizing way — do about this?

The burden of citizenship is to share in, and hold people to account for, the injustices experienced by our neighbors. Alice was fucking ripped off to the tune of any semblance of economic and financial security she might ever have had at the very moment that her husband was dying of cancer. This is beyond awful. This is mortal sin in any religion worth the name. This is pure evil.

Our problem is not a matter of shitty policy arrangements. We have plenty of those. Whatever. Policy is a third-order pile of bullshit. Our problem is that it is a sick excuse for a society when this sort of ass-rape is relegated by custom and practice into the sphere of the “private”, the sort of bureaucratic struggle one quietly hires professionals to deal with and hides as much as possible from friends and coworkers. Ass-rape of the more literal sort is also a private affair, in the first order. We insist upon it being public, because a society whose customs tolerated the maintenance of its first-order privacy would be a miserable, detestable place in which the powerful quietly ass-raped the powerless and were never held to account. The difference between literal ass-rape and what happened to Alice and Steven D. is not that ass-rape is criminal while health-care price-gouging, although regrettable, is not. To say that is to confuse cause for effect. Literal ass-rape is criminal because we-the-people as a broad-based mass are disgusted by it and insist upon it being a public and criminal matter rather than a quiet tragedy and struggle. When we hear about a Joe Paterno who overlooks this requirement, we literally hound the motherfucker to death. Perhaps unfairly, in any particular case — pitchforks are simultaneously sharp and blunt instruments! The sheer fear of which is why the powerful create laws. But where laws aren’t there, the pitchforks must always be. A society that expects laws to substitute for, rather than channel, public outrage, is a society not long for this world in any form worthy of the name. Outrage and shame are primary.

As soon as you delve into the policy wonkery in cases like this, you are submitting to a conspiracy by the powerful against the many. The greater the sphere of disagreeable things that are “complicated”, the more it is possible to construct intricate and inscrutable bureaucracies to “arbitrate”. There will be think-tanks and policy papers, funded by people who are well-meaning (in a narrow, idiotically un-self-aware way) but very rich and powerful. The conclusions of which will be earnest and carefully researched but confined to a window not very upsetting to the very rich and powerful. Undoing the ability of plutocrat hospital “CEOs”, or bankers or lobbyists or whatever, to continue the sort of ass-rape to which their lifestyles have grown accustomed will not be on the table. A good society depends on an active public, first and foremost. A society that has allowed the predations of the powerful to become purely private matters mediated via “markets”, courts, academies, and bureaucracies, that has delegated “activism” to a mostly protected professional class, is nothing more than a herd hoping that today it is somebody else who will be slaughtered.

Is that who we are?

Update History:

  • 22-Feb-2012, 8:50 p.m. PST: “economical economic“; “while although regrettable”; “its it being”; “that laws will to substitute”
 
 

53 Responses to “Shame.”

  1. Jesse S. writes:

    Amen.

  2. bob j93 writes:

    can we have a profanity warning?

  3. Vladimir writes:

    We sell our labour and not our conscience. I don’t really understand how anyone can work for a place that treats people this way. And thanks for the last paragraph. Things like that aren’t said enough.

  4. Mikael writes:

    Steve,

    Thank you! Thank you for tirelessly improving and moving our societal discourse forward. Per your lead, we the people are society, and hence if we don’t collectively establish what’s acceptable and what’s unacceptable, no one will.

    Kudos!

  5. Kate writes:

    I don’t get why people put up with this stuff
    It’s everywhere
    Hospitals are a disgrace

  6. Justin Cidertrades writes:


    Steven D. died

    Thank you Steve Randy Waldman for saying what we all should have said. I have merely one criticism toward your blurb. You should have used even stronger but more phatic words. Those malefactors deserve worse words than you and I could conjure. To be practical :

    All of us should discuss this sort of thing with our children and our communities. Our lawyers do have a license to steal; our doctors, a license to kill. Both doctor and lawyer are small potatoes compared to our elected officials.

    Don’t get mad, Steven!

    Get even!

    Get better medical science from more sincere practitioners within medical tourism countries. Each of us should have a plan. Should rehearse the plan. Be strike. Be ready to move out on a moments notice for our medical needs. In the meantime we should keep our rogue politicians under constant surveillance and critical scrutiny. It has become our top priority by their own flamboyant high handedness and sinister sadism.

    Parenthetically, thanks for inventing “Immaculate Deflation”! Would you subscribe also to immaculate disinflation? One thing for sure — cost-overrun gets more inflated every day. And remember, *America the Beautiful has received your message. We have our ears on. Knowing that you can sleep well tonight.*

  7. Ina writes:

    You expressed very eloquently what a lot of us feel but don’t know what to do about it. I wish you could galvanize people on other media also, to reach as broad an audience as possible.

  8. esb writes:

    You ask “is that who we are.”

    Of course the answer is “yes, that is who we are.”

    We are a people who, after learning that the Bush/Cheney duo had conquered another country for either no real reasons or specious reasons, returned the monsters to office in 2004.

    So why is it a surprise that we permit our near neighbors to be disinvested (or raped) of their net worths in ways such as you describe?

    The proper question is “why are we the people that we are?”

    I believe the answer to that question is that we are not actually a people in the traditional sense of the word at all. We are a collection of individuals and descendants of individuals who came to this spot on Earth for one primary purpose, to attempt to become rich.

    Bill Kristol, I conclude, is correct in his opinion that America is an ideology.

    The ideology is greed, the ultimate celebration of self.

  9. AllanW writes:

    “Is that who we are?”

    Yes. The evidence is before your eyes and in your article. But it doesn’t have to be that way; each one of us can choose each and every day whether we are willing to take the time and effort to counter these anti social, anti communitarian, anti egalitarian forces. The circumstances you describe (and many more) are only composed of an accumulation of unchecked decisions and actions taken by fellow members of society.

    If we’re smart we can check the little, close-to-home ones without too much effort and by so doing gain the confidence and backing of those around us who think similarly which can enable us to take on the bigger ones a little further afield. Success breeds success but it only starts will an effort of will.

  10. Dan Kervick writes:

    Bravo Steve,

    I just read this one out loud to my wife.

    When President Obama introduced his health care plan to Congress, he said “I am not the first President to take up this cause, but I am determined to be the last.”

    Can anybody really believe that he will be the last president to take up the cause of health care reform? Let us at least hope he is not!

  11. stone writes:

    Is there something particular about health care that prevents proper price competition? Computers and even to some extent food seem to be supplied in great abundance at wonderfully low cost by the “greed powered” system. Why do we get such a great deal when we buy a computer and yet the USA provides such a raw deal for health care? Perhaps people only come to consume health care when they are at their most vulnerable and least savvy? People know what they want with computers but no-one has a clue what they want with health care other than the best of the best at any cost???
    I’m in the UK where we have a whole different set of health care issues.

  12. jsn writes:

    Stone,
    Yes there is something about healthcare: there is no organic correlation between who has a health issue and who has money to pay to treat it. Without first distributing the means to pay evenly enough that anyone with a health need can fund that need a market can not exist for medical services. That abundant food comes to your vendor both because of societal efforts to see to it that it is produced and distributed and societal efforts to see to it that everyone who wants food has access to some means to pay for it. Then there is labeling of foods for nutritious content. etc.

    Food is a public good that does not automatically distribute itself so the public has agreed to make it available through a series of market interventions. Healthcare should be the same.

  13. Steve,

    Thank you for expressing that, and with the raw, unfiltered emotion behind it as well.

    Couldn’t have been said better.

  14. Disillusionedliberal writes:

    Is that who we are? Yes. I only repeat the earlier answer from others for emphasis because this point needs to be beaten into every progessive activist, pundit, and politican. You can’t fix the problems in America until you fix the problem with Americans. Stop pretending America is a generous and compassionate society. The first step is admitting you have a problem.

  15. Morgan Warstler writes:

    Good Kee-Ryst, this is unhelpful.

    Menu shopping is super easy to achieve. HSAs work CATEGORICALLY. No one should ever be allowed to discuss health care if they haven’t admitted HSAs work.

    There are three issue here, all of which we can live with:

    1. High end care, CT scans and the like, are not for the have-nots. XRAYs are fine. This is the one thing the left will always have to accept: Yesterdays tech is for the people who pay in less.

    2. Don’t allow price gouging on retailable supplies, but expect to see real higher costs exposed elsewhere, this is GOOD, because it aids in the real price shopping, the actual treatments delivered.

    3. Force all entities to publish all procedure codes and costs in machine readable format. Then, get out of the way, over night in everything but emergency room situations, HSAs will drive costs of care down.

    There’s no reason to be emotional about this stuff. It isn’t confusing. I have now price shopped on two different non-electable surgical procedures, but I’m able to do the research that 99.9% don’t know how to do.

    There is an internet for a reason, people need to start relying on it exclusively to solve our problems.

  16. 4randyh writes:

    The summary I get from your rant is the healthcare system rips us off because we and our friends let it by not hold every detail of charges in review. Most of the problem wil be moot because of the ACA and it’s REDUCTION in life extending services. I think transparency to the extreme is a step in the right direction. As an example Hosptials.com or Clinicswire.com where we could shop and compare institutions cost and effectiveness.Now that we have been further hoodwinked into having more Government intervention, the quality will be less the cost not so much.
    As an aside, #8 esb had me ROFLMAO when through some bizarre time warp Bush/Cheney was interjected into our healthcare mess. Sorry my friend Trial Lawyers, Insurance companies, Doctors and now Obama/Pelosi own this mess in that order. In 2014 the last group supplants the first.

  17. Dr No writes:

    I hate hearing stories like this. They boil my blood. However, why are some procedures and supplies so fucking expensive? It’s not always the greedy CEO and doctors looking for more coin. Hospitals treat almost everyone, even if they cant pay. That $77 box of gauze helps to offset the homeless alcoholic with the mallory weiss tear. Unfortunately those with any ability to pay are often the ones to get ass raped the hardest.

  18. Randy writes:

    Steve, you say that citizenship carries burdens, and also ask whether Alice has neighbors and friends. But isn’t the most important conversation between Alice and Steven D? Stage IV cancer should not come as a complete surprise to a smoker. When you quoted from the article, you skipped the “[Steven] kept saying he wanted every last minute he could get, no matter what.” How unbelievably selfish of him! Whether medical care is obscenely expensive — and I do not take issue with any part of your assessment — or subsidized and (presumably) inexpensive, this guy is going to go, and soon. The courageous choice for Alice and Steven should have been for one of them to say, “I will not burden my family by compounding the mistake of an entire life of smoking by leaving them a gigantic bill.” The system you criticize demands suckers for its profits, just like any other unethical con. Don’t participate.

  19. Luke writes:

    I hate to (always have to) be the resident socialist, but yes, this is who we are as a capitalist society. Living in a society which doesn’t put its common humanity first and foremost, above all else, but instead private property rights and self-survival, this is exactly what people become. Whoever it was that quoted Bill Kristol was right. This is very much so who we are, and unless we talk about our existential source, then we’ve got no right to see this scenario as anything other than the way it’s supposed to be.

  20. [...] But, God, I’d really like to do something, to answer the call of this author who rightly excoriates this country’s corrupt medical industry. “Pitchforks” is the symbol for the threat of violence we must constantly offer to the [...]

  21. Peter K. writes:

    @ 10

    yeah sure it’s all Obama’s fault like everything else.

    Off topic, first time I’ve seed the Fed confirm this:

    “When the economy grows stronger, the Fed plans to sell some of its vast holdings of Treasury and mortgage-backed securities. The Fed also plans to pay banks to leave some money on deposit with it to limit the pace of new lending.”

    http://www.nytimes.com/2013/02/23/business/fed-officials-debate-banks-losses-once-economy-mends.html

  22. Great post as usual. Great website–I’ve learned so much from this website, and your various articles, that I find it slightly embarrassing.

    I think what I take away from this post is confirmation that we need some kind of integrated approach to understanding human society. The anal rape analogy actually, I think, is not an analogy, in the sense that these are independent phenomena that happen to align nicely for explanatory purposes. These matters are not independent phenomena; they are two perspectives on the same thing.

    To make the world less anti-human, I think we need to delve more deeply into what it means to be human, the good, bad, ugly, etc. There used to be a time, I think, when people at least made gestures toward developing social understanding from an evolutionary perspective; the project never really got off the ground, it would seem, except as a foil to reinforce preformed racial prejudices. But I think a more nuanced consideration of these matters, alongside with a more honest consideration of the role of media and the arts in reinforcing the most vile attacks on the individual and his family, might bring consciousness more in line with reality.

    Maybe this comment isn’t clear. All the bourgeois pie-in-the-sky theorizing that spews forth from the academic and intellectual community can actually obscure the fact that humanity and human relations really are complicated, just not in the ways these monied folk, representatives of representations, tend to portray them. That lady really was anally raped, perhaps. And financial derivatives really are excrement; likewise, postmodernism really does instantiate a derivative form of thought. And on the weekend, when thousands of Americans have their heads hung over toilet bowls, recycling the contents of their wine glasses, their vomit really does reflect… I’m not sure exactly, this discussion is rather nauseating! Anyway, the truth is not platonic and pure; it’s covered in blood, semen, and other bodily fluids, and getting over the shame one experiences at the sight of it is, I think, an important step toward constructing a new society and a new culture.

  23. Tex C writes:

    >>Is that who we are?>>

    Of course it’s not who we should be, but it may be whom we default to if we keep this crime in the private sphere.

    What your well-intentioned post lacks is action items. What is the best way to focus and amplify the voices of the many victims of these crimes? Without a viable answer, these victims voices are just muffled like the din of a crowd between innings of a sold-out baseball game where the last place home team is getting clobbered again.

  24. AllanW writes:

    Action Items;

    “The circumstances you describe (and many more) are only composed of an accumulation of unchecked decisions and actions taken by fellow members of society. If we’re smart we can check the little, close-to-home ones without too much effort and by so doing gain the confidence and backing of those around us who think similarly which can enable us to take on the bigger ones a little further afield. Success breeds success but it only starts will an effort of will.”

    1. Pick any item you see happening near where you live. Of any sort. Think about how to counter, stop or thwart its next instance. If you need to involve other people to make your action effective, find them and get them to help you.

    2. Once successful, work out how to keep that one from recurring and move onto the next example.

    3. Repeat as long as necessary.

    My point being that you can do something yourself, you don’t need to wait for permission or guidance, you can work with others to make it more effective or happen quicker and there are many who live near you now who will take the chance to get involved if start the ball rolling. You don’t have to do it all and all of the time but there is no substitute for the initial will to action; that needs to come from you.

  25. Johannes Yohighness writes:

    Le vice et la vertu sont des produits comme le vitriol et le sucre.
    Acid merely burns your tongue, but sugar could give you diabetes. Tell me something!

    Does insulin make you hunger for sugar? Does your licensed scientific professional assistant prescribe insulin? Insulin equivalent, colourful little pill that releases insulin? Does the pill give you hunger? Hunger cause you to gain weight gain? Does the increment of weight then increment your diabetes? Or does your licensed assistant prescribe exercise, calorie restriction, and weight loss? Do you keep running, biking, and living on fresh spinach? Or do you get lazy then get hooked on insulin? Go blind within a baker’s dozen of years from diabetes? Did a great prophet once say, “is not mocked. Whatsoever a man” exercises shall he reap?

    Imprecisely, but gave us a hint. Tomorrow morning, go for 4 minute run! Tomorrow afternoon go for a 4 minute bike ride. No! Not on you gas-hog, Dummy. On your peddle-bike. Remember :

    health and happiness for the asking
    ethanol restriction benediction
    prayer with fasting, everlasting

    You are my people, Populace.

    Gimme 5 push-ups, My People!

    Gimme 5
    !

    ☻☺☻☺☻☺☻☺☻☺☻

  26. Mattia Landoni writes:

    I just wanted to link to this episode of the Colbert Report where the CEO of the Game Show Network talks very insightfully about health care.

  27. Dan Kervick writes:

    Peter, I didn’t say health care was Obama’s fault. I just said there is no way that Obama’s health care reform should (or likely will) be the end of presidential initiative in health care reform. It was a bit silly of him to even suggest that is the case.

  28. David Merkel writes:

    Hey, friend. I view this a little differently. I believe that billing for the critically ill should be constrained, and that charges beyond a threshold (say like $50,000) would have to be approved by the payor (who should employ an insurance adjuster). That might mean that the sick one moves to a hospice, which is the proper solution.

    This also has implications for what should happen to Medicare. Downplay radical treatment. Play up palliative care near death. Do not try heroic solutions unless the expected lifespan is long if it works.

  29. [...] Randy Waldman has an amazing (but very profane) rant about the state of the healthcare system, keying off of Steven Brill’s epic cover story for [...]

  30. c smith writes:

    “A society that has allowed the predations of the powerful to become purely private matters mediated via “markets”, courts, academies, and bureaucracies, that has delegated “activism” to a mostly protected professional class, is nothing more than a herd hoping that today it is somebody else who will be slaughtered.”

    A true market (not one co-opted by the hospitals, doctors, drug and medical supply firms) could reduce costs and increase care by cutting through all the BS rules with regard to “minimum” standards of care. You’re exactly right that all the garbage policy-wonkery is nothing more than a smokescreen for the monopoly providers trying to maintain their hold on the so-called “market”.

  31. The complication is by design: first you have to convince people that the complication is necessary, and then they spend the rest of their time bickering over the details. We have hundreds of thousands of pages of laws on medical practice. Since when did the bureaucrats in Washington become such experts in health care? The complications are meant to hide corruption. It’s time to wipe our slates clean and start over – but the people doing the ass raping aren’t going to allow for that.

  32. praxis22 writes:

    @2 You have a case where somebody is charged almost a million Dollars to die of cancer, and you worry about profanity?

    That would be funny if it wasn’t tragic.

  33. [...] “The burden of citizenship is to share in, and hold people to account for, the injustices experienced by our neighbors. Alice was fucking ripped off to the tune of any semblance of economic and financial security she might ever have had at the very moment that her husband was dying of cancer.” -Shame [...]

  34. Barry Parr writes:

    I don’t need to read the article, because it will only make me feel furious and helpless.

    However, I’m grateful that Brill wrote this and Time published it, because the folks who read Time for news and analysis need to read this sort of thing again and again, apparently.

  35. KarenJ writes:

    Morgan Warstler writes:
    1. High end care, CT scans and the like, are not for the have-nots. XRAYs are fine. This is the one thing the left will always have to accept: Yesterdays tech is for the people who pay in less.
    ———————
    I’m sorry, I can’t even get through the rest of your anti-leftist rant, because the above is just so much horsepucky.

    I am a have-not (I live on Social Security). A year ago I had a headache that felt like the top of my head was going to blow up like a Humvee over an IED. I took 4 ibuprofen…then a Vicodin…nothing helped. It was so painful I was crying. I finally drove myself to the emergency room, where the FIRST thing they did was do a CT scan, to make sure I wasn’t experiencing a cerebral aneurysm, leaking or still intact.

    See, if I DID have an aneurysm, and being a have-not your recommended diagnostic exam would be an x-ray, I could be paralyzed, a vegetable, or dead today.

    But the CT scan ruled out an aneurysm, which allowed the ER doc to diagnose my problem as a severe migraine, for which I got an IV dose of dilaudid (standard practice). They kept me there for 4 hours, to make sure I could drive home safely — and the headache faded to manageability by then.

    I hope you have a chance someday to experience the dread of being a have-not at the mercy of “the right”, who universally seem to be soulless bastards. At least “the left” cares about the least fortunate of us.

  36. The pills, strips, and gauze are quoted at several multiples of a comparable. But they’re a couple orders of magnitude too low to budge an O($100,000) figure. I looked up the cost of a CT scanner her e http://www.beckershospitalreview.com/hospital-key-specialties/12-statistics-on-ct-scanner-costs.html and they appear to cost half a million to two million bucks. Amortised over a maximum of 10 years. So a couple thousand per scan seems like a reasonable cost-plus once you pay the people and the building as well.

    Not that anyone could afford this, mind you. I’m just saying the scan numbers seem close to cost.

    I think the “wonky” angles are fine. Are there really “bad guys” and “good guys” in this story? Or do we live in a world where everything goes wrong by default and only through judicious prudence and invention do things get better? All the standard boring stories about principal-agent and end-of-life expense seem appropriate here. Although a passion that boring policy wonkery has deadly serious consequences for real human beings also warranted.

  37. [...] See full story on interfluidity.com [...]

  38. OpenThePodBayDoorsHAL writes:

    Do not let ANYBODY tell you that America has the best possible system. I lived in France where health care is ubiquitous, excellent and cheap. And France happens to have the same productivity per capita and similar debt/deficit levels to the US. I now live in Australia and health care is a DREAM. They have “single payer” here: I call the Dr, ask for an appointment; he says “how about 2PM today”; I go, get a low-cost excellent service. I hand them a card; they put the payment through; the reimbursement is in my account within approx 1 DAY.
    But Oh No Obomba took “single payer” off the table on Day One. He made sure insurance execs could afford that second yacht and Big Pharma fatcats could get that mansion they always wanted..

  39. vlade writes:

    Steve, the sad truth is yes, this is who we are. We (humans) are just plainly not suitable to todays world, and it’s absolutely amazing how easy we’re to manipulate. Indeed, we teach our children every day “power is bad, it’s evil, do not seek power” – because we all see how people who have power misuse it. We shade the word “power” with “evil”.

    Yet all this does is open space for those who will use it like that – we hand them the power on a silver plate.

    What we SHOULD teach to our children is that no-one can have more power over you than you give them. We give power over ourselves to others – but it’s us who does it, and it’s ONLY us who can take it back (as opposed to just pass it to someone else). The ruling rule only on the sufferance of ruled (whether the ruled realise it or not). And I’m not talking about democracy, but things more fundamental. It was well shown (often by spectacular misfires) in societies all across the history, that laws that are ignored by populace cannot be enforced for any long periods of time, even by brute force. Yet we don’t seem to learn from it what the true source of power is.

    Saying “I’m powerless” in face of human action is just saying “I don’t like the consequences if I acted differently” or “I don’t really want to think about it” – which is empathically NOT the same thing as being powerless.

    It’s funny. We try to find ways to break natural laws (and I use the term here cautiously) – we don’t all go and say “I’m powerless to break speed of light”, some people will always try to figure out whether they can do something else, and are often applauded for it across history when they do succeed.

    But when it comes to our, human, transient and weak (from the perspective of universe) so-called “laws” (or customs or whatever), we say “we’re powerless” much more often and treat it as final.

  40. [...] the rest here: interfluidity » Shame. ← Businesses Dropping Insurance for Spouses, Despite Large [...]

  41. [...] Awesome Healthcare, shame and why “our problem is not a matter of shitty policy arrangements” – Steve Waldman [...]

  42. Carolyn Kay writes:

    Take the profit out of healthcare and the money out of politics.

  43. [...] Finance is unusual but not unique — see also health care, education, and government, together the “information asymmetry [...]

  44. [...] in the system should receive (and some shouldn’t receive any), and how of that profit is predatory. Share this:TwitterFacebookStumbleUponRedditDiggEmailPrintLike this:Like Loading… This entry [...]

  45. quixote writes:

    @32 “@2 You have a case where somebody is charged almost a million Dollars to die of cancer, and you worry about profanity?”

    Um. Yes, actually. At least for me, it got in the way of the message. It’s not really the profanity, I guess. It’s the type of profanity. After the first “ass-rape” it took me a while to come back from the tangent that went like this:

    In what way is sexual torture like a bureaucratic nightmare set up to beggar people? Why specifically *ass*rape? Is that worse than “ordinary” rape? Why? Because it could also happen to men? What happens to women isn’t bad enough?

    Okay. Take deep breath. Try to get back to the point of the piece. It didn’t take long for the second ass-rape to show up.

    Huh? Does this guy actually have no concept of what he’s saying? Is he just trying to slap me around?

    Another deep breath. Two sentences later, another slap.

    At that point, I stopped reading and scanned the comments to see whether anyone else was having similar trouble. Were there other newcomers he’d lost (I’m here from a Counterparties link) before we even got to reading what is otherwise an obviously insightful site?

    I think the thing that bothers me most in this context is that it’s totally unnecessary. Using words that mean what he’s trying to say would be more to the point, less distracting, and better writing.

  46. A friend emailed this blog to me and I have to say the article in the Times did not even touch the entirety of the problems we not only face with today’s medical industry but the legal industry as well. Rather than take the space here I would encourage everyone who reads this to go into a new website I created called Medical Malpractice Awareness.com (www.medicalmalpracticeawareness.com) and read as much as you dare take the time for. This site is about a doctor and hospital group killing my wife than going into her medical records (13) hours after the death they caused and withholding, destroying and re-writing them in a planned conspiracy of cover up. To make this far worse is today’s legal industry tells me this is legal sense the medical industry has a different set of laws versus us everyday meaningless people. So Steve Waldman used some pretty harsh words and comments and he did not even touch on the entirety of the problems we as a society have allowed. We are allowing our country to implode around us and do nothing to stop it. At what point did we allow a dollar to trump a human life?
    Dayton Smith Jr.
    Email: Dayton@medicalmalpracticeawareness.com
    (815)222-2097

  47. Tangalace writes:

    We have all seen or experienced similar stories of the deplorability of profit versus humanity. Health is essential to life; and this is why privatized medicine is not working; this is why corporate capitalism as our form of government is not compatible with democracy. It is incredibly predatory.

  48. [...] I wanted to reiterate Steve Randy Waldman’s blog post regarding our massive healthcare costs. Waldman’s post, titled “Shame,” responds to Steven Brill’s long article on healthcare costs. [...]

  49. @15 Can you be more explicit about what you did with the internet that 99.9% can’t do? It could be useful.

    I read for example on the incidental economist that EEUUses of any age can use the Medicaid website to do price comparisons.

  50. [...] Smith has asked, not entirely gently, that I reconcile differences in my outrage towards health-care chicanery and what she perceives as “a clever defense of abuses by the [...]

  51. Becky Hargrove writes:

    Looks like I missed this post, glad to have just picked up on it! Healthcare is the first area in which communities need to reclaim knowledge and skills use in more effective ways. Rather than the exclusionary formation of hospitals, there is enough in healthcare knowledge use today for all in a community to learn a part of and participate in, and the technology now being created for healthcare needs to be harnessed so that all in a community can become a part of the proceeds and no one need worry about roboticization in the future.

  52. [...] Smith has asked, not entirely gently, that I reconcile differences in my outrage towards health-care chicanery and what she perceives as “a clever defense of abuses by the [...]

  53. [...] imprescindible este durísimo post de Steve Randy Waldman. Aunque por el momento nuestro sistema sanitario está a mucha distancia del [...]