Michael Moore's "SiCKO"

chico8

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My point obviously was that the French system is grossly flawed, and clearly not the model towards which we should be striving.

There are so many problems with your statement it's not even funny. First off, the French have undoubtedly the best health system in continental Europe. Doctors even make housecalls. You know why, because it's cheaper than having a patient come to the emergency room in an ambulance for minor problems.

Was France remiss in not having sufficient cooling rooms? No doubt about that but the biggest problem was societal, not a problem inherent in the French social health system. Too many old people left at home alone while their kids went on summer holidays. I wonder what the true number of heat related elderly deaths in the US is?

The only hope for health care to reach the broadest number of people for the least cost is through socializing it. You can look at any form of European health care, and you'll find that all are superior to those of the US. Not least because most are heavily involved in preventative care and since the government foots the bill for such things as obesity and smoking, the food and tobacco lobbies do poorly there.

Your praise of capitalistic based health care is based on jingoism and ignorance of efficient health care.

Good luck when you find yourself in the clutches of the SYSTEM, it will eat you alive.
 

STYLYUNG

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Don't let anyone tell you that Michael Moore doesn't have political partizanship in mind with his latest diatribe. His latest, "Sicko" was shown pre-release last Saturday, June 16th, in the small town of Bellaire, Michigan, in a two-screened theatre as a fund raiser for the Antrin County (Michigan) Democratic Party. He has a second home somewhere in that area.
 

Blocko

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Not just funding, but a popularist economic idealogy that's been proven wrong as a formal logical system :wink:.

Warning, oversimplification follows.:smile:

The question is why are some nations with socialised systems moving toward more econo-centric models? - Money, right. Funding through taxation in increasingly insufficient to support the existing systems. This means they cannot continue to deliver what's needed.

Why are costs rising? Presumably a combination of several factors; the increased cost of medicine, ever more complex systems and the basic providing professional care. Part of the increased costs are the pricing policies of major pharmceutical companies some is simply reflecting increased demand from both new treatments and aging populations.

If socialised medicine is to remain socialised then it needs to be funded properly. This means tax revenues must either increase, supplemented or the system replaced. The last option leads us straight into the maw of insurance based provision, which it seems clear only works for those who can afford it. That number is falling and more and more people no longer have proper access to medical care as they should, and depend more on the safety nets. This is the root cause of this thread.

Of course the argument could be made that those who can afford insurance should do so thus leaving more of the remaining tax sourced services availible to those who can't. That sounds great in theory, well not really but it instantly provides a multi-tier system. Before we know it we're back at square one, those that can afford it get it, those that can't don't, or don't get what they need. Again, the root cause of this thread.

So why are tax revenues not raised? Simple, policitical inertia and fear. People won't elect or re-elect political parties which would raise taxes to a level where they would support the level of service people demand. Politicians are spineless, thinking only of re-election. People demand first rate medical care but are evidently unwilling to contribute more tax to fund it. They don't want to pay inflated profit driven insurance premiums either. They want their cake and eat it.:rolleyes:

I'm not an economics expert but it seems to me that it would almost certainly cost less to pay a little extra income tax than said profit driven insurance premiums. The problem seems to be, many are too shortsighted, too greedy or simply too stupid to realise it.
 

Blocko

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Or you could just present a loaded-language false trichotomy of oversimplified discrete options to make the option you support seem best :wink:. Are you sure you aren't a propagandist?

That normal business tends to a high budget is no absolute truth, a successful business offering premium services might, but the whole argument for free market capitalism is that profit drives efficiency. It isn't efficient for a company offering average or basic service (or a company that isn't so successful) to maintain a high budget, or for that matter a high level of quality.

In a profit taking system, the business is necessarily tiered to each level of affordability by quality (to reap maximum profit). Not everyone has scruples about cutting corners if their customer has no choice to buy a better level of service. There are very detailed equations for cost benefit analysis to make sure that a standard of quality higher than what is absolutely necessary to make the largest profit.

The buyers on the market at any one time don't have perfect information. That means the market can not always respond to quality issues (and if they do so, it will take time). A big problem in healthcare, where lack of perfect information means you're dead before the market can react.

Of course you can address this lack of quality with a bureaucracy (regulations, standards and even subsidies) and by having interested professionals.

There are only a few ways to run anything.

1. Interest. This is the realm of the hobbiest. Low budget, wide range of quality.
2. Profit. Normal business; supply and consumption of skilled services, etc. High budget, tendency to high quality.
3. Bureaucracy. The socialist dream. High budget, wide range of quality.

Take your pick.
 

B_NineInchCock_160IQ

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I agree with you that he is a proven liar and should be viewed with skepticism, but SO IS EVERYONE ELSE!

oh come on Zora, are you really that unfamiliar with what the word "proof" means? You had a hard time grasping that in the Clinton thread.

and BD, be serious... that model you threw out for different healthcare systems was *grossly* oversimplified and biased. You can do better than that.
 

B_big dirigible

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There are so many problems with your statement it's not even funny. First off, the French have undoubtedly the best health system in continental Europe. Doctors even make housecalls. You know why, because it's cheaper than having a patient come to the emergency room in an ambulance for minor problems.

Was France remiss in not having sufficient cooling rooms? No doubt about that but the biggest problem was societal, not a problem inherent in the French social health system. Too many old people left at home alone while their kids went on summer holidays. I wonder what the true number of heat related elderly deaths in the US is?
That's why I included the quote. I didn't determine that it was a failure of the French health care system; that was a French diagnosis.

You can look up the number of heat related elderly deaths in the US, but be prepared for disappointment. We take care of our ancestors; we don't breezily assume that they're the government's problem, like old tires piled by the side of the road.
The only hope for health care to reach the broadest number of people for the least cost is through socializing it. You can look at any form of European health care, and you'll find that all are superior to those of the US. Not least because most are heavily involved in preventative care and since the government foots the bill for such things as obesity and smoking, the food and tobacco lobbies do poorly there.
Hmmm, imagine that. They're all superior. And inexpensive. You'll pardon my skepticism. If they were really inexpensive, we'd be doing the same. But they're not, the costs are simply sloshed somewhere else. The secret of socialism, I suppose.
Your praise of capitalistic based health care is based on jingoism and ignorance of efficient health care.
Listen, squid, nothing that I say is based on ignorance. If I don't know what I'm talking about, I move on to something else. I don't chime in on these threads just to impress someone like you. And I really don't want to hear a Eurosuckup whine about "jingoism".
Good luck when you find yourself in the clutches of the SYSTEM, it will eat you alive.
I am in its clutches. It's the only reason I'm here today. I'd have died ten years ago without it.
 

B_big dirigible

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and BD, be serious... that model you threw out for different healthcare systems was *grossly* oversimplified and biased. You can do better than that.
To which model do you refer? I've tossed out a couple. All are necessarily simplified. They must be, if the essential features are to be grasped by anyone but policy junkies.

In any case, I'm not trying to type out an entire "Health Care for Dummies" here. I'm not qualifed to do so, and have little interest in the subject. Like most males, I only think of health care when something's bleeding and I can't stop it with duct tape. But I can spot a couple of the more obvious bullshit leaks in a thread like this, and try to plug them.
 

B_big dirigible

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Or you could just present a loaded-language false trichotomy of oversimplified discrete options to make the option you support seem best :wink:. Are you sure you aren't a propagandist?
Are you?
That normal business tends to a high budget is no absolute truth, a successful business offering premium services might, but the whole argument for free market capitalism is that profit drives efficiency.
Not so. Some things become more efficient. But at heart isn't not an efficient system at all. How can it be efficient to have two companies making essentially identical washing machines? The duplication of effort is complete, from manufacture through retail distribution.

The bald statement that profit drives efficency is such a gross oversimplification that there's little truth even buried in it.
In a profit taking system, the business is necessarily tiered to each level of affordability by quality (to reap maximum profit). Not everyone has scruples about cutting corners if their customer has no choice to buy a better level of service. There are very detailed equations for cost benefit analysis to make sure that a standard of quality higher than what is absolutely necessary to make the largest profit.
You can rely on the equations, or you can rely on the competition.
The buyers on the market at any one time don't have perfect information.
If they're relying on Michael Moore for their infomation, that's certainly so.
That means the market can not always respond to quality issues (and if they do so, it will take time). A big problem in healthcare, where lack of perfect information means you're dead before the market can react.
Are you trying to argue that a bureaucracy will react with more alacrity? Color me skeptical.
Of course you can address this lack of quality with a bureaucracy (regulations, standards and even subsidies) and by having interested professionals.
But as I briefly outlined above, it's not at all obvious that a blizzard of bureaucratic regulations result in increased quality. They give the paperwork industry a boost, for sure. The tremendous growth in the ratio of paperwork shufflers to actual medical workers in health care facilities of all sizes is approaching crisis proportion. No patient was ever helped by filling out forms. This is not all government's fault, of course - the insurers are probably the major offenders. But a socialized system necessarily runs on paper.

I know a physician who had his narcotics in a cabinet with a lock. He never locked it; the key was kept in the lock. He did that because the bureaucracy had mandated that narcotics be kept in a cabinet with a lock, not that the cabinet be kept locked. He did what the bureaucracy required; everything else he did according to his own professional judgement.

The interesting thing is that even the bureaucracy itself thought that he was doing things the right way, despite them. Whenever he had occasion to dispose of narcotics he'd call the relevant agency, and they'd tell him to flush them. They never sent anyone out to supervise. They knew his record; he wasn't overprescribing narcotics, he wasn't using them himself, he wasn't selling them into the black market. So, if they knew that he wasn't a problem, why did the bureaucrats try to dictate how he did something simple, like store them in a cabinet? While a trivial case, it is symptomatic - and hardly a formula for efficiency.
 

B_big dirigible

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Errm, I know. That's why I said, oversimplification follows. It helps to read before engaging keyboard.
Here's a hot tip - it takes some particularly dim types years to figure this out - if you try to lecture me on a point of snark, you're likely to end up with tooth marks in your ass. OF COURSE I saw the fuckin' "oversimplification alert". Your problem wasn't oversimplification. I was pointing out that you'd misrepresented the topic grotesquely. That ain't no oversimplification, that's an error.
You should go on Mastermind. Chosen specialist subject - the blatantly (yet oversimplified) obvious.:biggrin1:
You're the self-proclaimed Oversimplification King, not me.
Seriously, that may be the case, generally (or specifically) in the US healthcare system, I've never had cause to avail myself of it so I can't say. The situation in the UK is far from being so cut and dried, though, sadly it seems to be headed that way.
That's why I put my location in my profile. All I know about the UK system is that a relative who lives there always has his non-emergency care done when he's back in the US. He apparently simply can't get it done there on a schedule that doesn't involve years. Or so he says, I have no way to check that myself. And that's why I've said nothing about the UK system. If all I can do here is parrot rumor, I won't bother.
Some of my friends work in medicine, some here in the UK others overseas, some are doctors, some not and conversations with them over the years is, in part, where I formed and reformed some of my views on this.
And where do you think my information comes from? Watching Oprah?
One or two would agree with some or all of what you say, one or two would say it was almost entirely round objects and misses or ignores the root causes. Most would, I suspect, like myself think that the truth is a somewhere in between. The consequences of excessive specialisation is usually high on the list of pet hates when the topic comes up.
I believe I included that. That's the business of one doctor referring the patient to another. Back in the dark ages, an unspecialized country doctor could handle most of that stuff. The occasional exception doesn't falsify that. We've always had specialists. But were weren't always all specialists.
The thing is, I agree you, at least in part. I disagree that it need be so and none of this alters the basic premise of what's been said by me, or others; that decent healthcare in the US and elsewhere is becoming increasingly unaffordable and thus inaccessible.
I'm only doing a few specific things in this thread. I'm disputing what I understand to be Moore's quasi-religious claim that France is an ideal. I'm calling BS on claims that the poor are "denied" health care in any way. And I'm expressing skepticism, justified by specific reasons, that the bureaucratic solution is a solution at all.

There a far more things I'm not arguing in this thread. I'm not arguing that things are great, and I'm not saying that they're getting better or worse.
The reasons are simple - people are unwilling or unable to pay for it. It really is that simple.

The reasons why they can't or won't are of course many and various, but primarily fall into the categories of self interest and unreasonable expectation of all concerned.
And those are factors which are handled in the commercial world every day. People behave that way in all transactions for goods and services. These concerns do not by themselves imply that government intervention is necessary or even desirable.
Your cynical observations while typically erudite seem intended to largely sidestep that simple truth.
A reluctance to put faith in simple answers to complex problems is not cynicism.
 

ClaireTalon

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I don't see a problem with using Michael Moore's movies as one more piece of half-true information that you can mix in with the rest of your half-true information from other sources and ultimately form an opinion.

I hope that was only a joke.

Using sources that mix 50 % truth with 50 % lies, fakes and falsehood is very dangerous for opinion making: Who guarantees you that the 50 % of truth from each source complement each other? Use reliable, reputable sources if you want to form an opinion.

Back on the original subject. I have put a little thought in this, and couldn't come up with one single person in my circle of acquaintances who has complaints about the US health care and insurance system. As an employee of *DING DONG ATCHOO* I profit from a health insurance plan, as do many of my other acquaintances. I also know another former crew member of mine who started his own one-man construction business, mostly interior, who doesn't complain about the lack of federally-funded health insurance, and would have to stem the costs of medical treatment and loss of earnings in case of an injury. I also think I remember a poll that showed a majority of US citizens thinking the same.
 

Blocko

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You can look up the number of heat related elderly deaths in the US, but be prepared for disappointment. We take care of our ancestors; we don't breezily assume that they're the government's problem, like old tires piled by the side of the road.

Because no one in the US piles their parents into a home to rot with only a regular government payment just because those damn commie foreign types do, by jingo!

Hmmm, imagine that. They're all superior. And inexpensive. You'll pardon my skepticism. If they were really inexpensive, we'd be doing the same. But they're not, the costs are simply sloshed somewhere else. The secret of socialism, I suppose.

No, the "secret" of state enterprise is:
  • Spreading cost impact over time and over a wide group of people who all have need of a service (Cost leveling). Insurance is another way to do this (but it has it's own problems).
  • Reducing redundancy by using regulation instead of competition to keep prices low and service standards high.
  • Using a large buying power to prevent price gouging.
  • Profits aren't bad, but in the case of a necessary universal service they are inefficient (a simple evolutionary search simulation shows this) as they put a cost burden on general society.
These things do not guarantee a low cost, it's up to citizens to hold their government accountable to manage cost well and make it affordable to all in a way that doesn't create unsustainable debt or hardship. State enterprise is far more dependent on democracy to function well than private capitalism is (which is one reason why communism is a bad idea).

It's not a good solution for everything, especially not as an idealogical absolute, but it does have its practical uses. So far, water, police, fire, military, schooling and health have all been successfully run by nation states.

Choose the best solution for the job, not idealogical claptrap full of logic holes.

Listen, squid, nothing that I say is based on ignorance. If I don't know what I'm talking about, I move on to something else. I don't chime in on these threads just to impress someone like you. And I really don't want to hear a Eurosuckup whine about "jingoism".

To be fair, I thought his comment was a bit out of line. But so is your jingoism :wink:.

I am in its clutches. It's the only reason I'm here today. I'd have died ten years ago without it.

I know people who would've died here without the state health safety net. There are many saviours to be thankful for.
 

B_big dirigible

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Because no one in the US piles their parents into a home to rot with only a regular government payment just because those damn commie foreign types do, by jingo!
So tell me - your vast knowledge of the United States and its citizenry comes from where, exactly? Or is this just another good old ignorant LPSG smear?
No, the "secret" of state enterprise is:
  • Spreading cost impact over time and over a wide group of people who all have need of a service (Cost leveling). Insurance is another way to do this (but it has it's own problems).
  • Reducing redundancy by using regulation instead of competition to keep prices low and service standards high.
  • Using a large buying power to prevent price gouging.
  • Profits aren't bad, but in the case of a necessary universal service they are inefficient (a simple evolutionary search simulation shows this) as they put a cost burden on general society.
All benefits honored more in the breach than in the practice. Mere theory never lowered anyone's insurance premiums.

These things do not guarantee a low cost, it's up to citizens to hold their government accountable to manage cost well and make it affordable to all in a way that doesn't create unsustainable debt or hardship. State enterprise is far more dependent on democracy to function well than private capitalism is (which is one reason why communism is a bad idea).
Another marvelous solution which can't possibly happen. We can't get the government to do something which almost everybody actually agrees on. The chances of enforcing anything complex or controversial are approximately zero. It's a waste of time to even suggest it.
It's not a good solution for everything, especially not as an idealogical absolute, but it does have its practical uses. So far, water, police, fire, military, schooling and health have all been successfully run by nation states.
These services have all also been successfully run by private organizations.
Choose the best solution for the job, not idealogical claptrap full of logic holes.
And you are going to choose the best solution, how? With your own ideological claptrap? Your own feeble logic? Or with Michael Moore's ideology or logic, perhaps. That would save the effort of coming up with your own.
To be fair, I thought his comment was a bit out of line. But so is your jingoism :wink:.
The meaning of the fine old British word jingoism is something you might profitably look up.
 

Blocko

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So tell me - your vast knowledge of the United States and its citizenry comes from where, exactly? Or is this just another good old ignorant LPSG smear?

Having lived there of course. Being in MA, you might know Unity St. in the North End? You know, near Paul Revere mall? Or maybe that area isn't "American" enough to learn anything (or the other places I lived in the USA for that matter).

I can see why anything state related may be horror to you guys. It actually took me six weeks to get a social security number due to government cockups (they didn't have my first application on record!).

All benefits honored more in the breach than in the practice. Mere theory never lowered anyone's insurance premiums.

Except here, where they practice the theory and it does actually lower the premiums. That's if you bother to get private health insurance.

Another marvelous solution which can't possibly happen. We can't get the government to do something which almost everybody actually agrees on. The chances of enforcing anything complex or controversial are approximately zero. It's a waste of time to even suggest it.

I actually partially agree with you on this case with regards to the United States as it currently stands. There is too much inertia in the private health care juggernaut to make this fully feasible and the time cost of everyone making up their mind would probably be too much in such a critical area.

In a country that already has public health care it is feasible. Here the health responsibilities are divided by state and federal government, with hospitals being a state jurisdiction and public health refunds and private insurance rebates being federal.

Having the smaller state governments responsible for local hospital issues (e.g. Western Australia) has worked to make the health departments democractically accountable. State governments are regularly thrown out on health care issues.

Not perfect, but it works.

These services have all also been successfully run by private organizations.

Never said they haven't. Of course, when they have been private they haven't always been successfully run.

But are they currently providing affordable services to all that require it? That's the question at hand.

And you are going to choose the best solution, how? With your own ideological claptrap? Your own feeble logic? Or with Michael Moore's ideology or logic, perhaps. That would save the effort of coming up with your own.

I sincerely hope that a problem like that doesn't have a solution come from me. It should come from a much larger number of people presenting proposals to elected representatives. I sincerely hope no idealogical claptrap of any kind is involved and that decisions are balanced based on the best solution to the problem at hand. Systems should be constructed on their merit for the requirements at hand.

But then again, I'm a business/systems analyst and have clients in both public and private health, so I'm probably qualified to apply my "feeble logic" to parts of such a solution. It's interesting that people in health care are prepared to pay for my "feeble logic", isn't it?

The meaning of the fine old British word jingoism is something you might profitably look up.

Gee, I thought you might catch the allusion in the start of my first message, being that you're so intelligent and all BY JINGO. All your guns, men and money won't convince me to look it up and neither will that bellicose patriotism you hold so dear. You know, because I didn't know the word or it's history before and I'm so ignorant I choose to remain that way!

Of course, being young I don't know any history and I've never lived in countries other than my own. Hell, I've never read a book. Yes, that's it, I probably shouldn't have opinions on anything!
 

dong20

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Here's a hot tip - it takes some particularly dim types years to figure this out - if you try to lecture me on a point of snark, you're likely to end up with tooth marks in your ass.

Well, here's another; one good snark deserves another.:wink:

OF COURSE I saw the fuckin' "oversimplification alert". Your problem wasn't oversimplification. I was pointing out that you'd misrepresented the topic grotesquely. That ain't no oversimplification, that's an error.

I saw a minor rant about things that should be obvious to anyone with a double digit IQ. But little or nothing that addressed the specific points I raised, other than with oblique sarcasm or an irrelevant micro lecture about supply and demand. As for the 'grotesque' misrepresention, well of course you're entitled to your opinion. Just don't expect me to agree with you, because I don't.

You're the self-proclaimed Oversimplification King, not me.

Not so, said simplification was necessarily pre-announced lest anyone think I considered that a definitive statement, heaven forbid than anyone should of course.

That's why I put my location in my profile. All I know about the UK system is that a relative who lives there always has his non-emergency care done when he's back in the US. He apparently simply can't get it done there on a schedule that doesn't involve years. Or so he says, I have no way to check that myself. And that's why I've said nothing about the UK system. If all I can do here is parrot rumor, I won't bother.

Hardly a sound statistical sample, but then I wasn't really commenting on specifics. Like yourself I'm not well enough informed about them to do so. I was stating, in my regal simplistic manner, that to me, the ethos of insurance profit driven healthcare is wrong.

As for delays, I agree, the best medical care in the world is useless if you die before you receive it. By the same token it's equally useless if you die because you can't afford the insurance premiums to pay for it.

We will never agree on the ideology so I wasn't trying to change your mind, merely explaining my viewpoint which is as valid as yours. That's what this forum is about, well meant to be about, I think.

And where do you think my information comes from? Watching Oprah?

No, you mentioned a radiologist buddy, I was merely reciprocating lest you think I was an Oprah fan too.:rolleyes:

I believe I included that. That's the business of one doctor referring the patient to another. Back in the dark ages, an unspecialized country doctor could handle most of that stuff. The occasional exception doesn't falsify that. We've always had specialists. But were weren't always all specialists.

Yes, you did, and the GP is increasingly an endangered species here too, though primarily for different reasons.

I'm only doing a few specific things in this thread. I'm disputing what I understand to be Moore's quasi-religious claim that France is an ideal. I'm calling BS on claims that the poor are "denied" health care in any way. And I'm expressing skepticism, justified by specific reasons, that the bureaucratic solution is a solution at all.

I long since moved on from Moore, his arguments have more holes than Emmental. I probably shouldn't have done that but the likelihood of me watching this 'expose' are slim to none so I mostly ignored the source. What prompted me is your evident conviction that almost anything non 'private sector' is an automatic bureaucratic nightmare doomed to failure. That's more conservative cliche than substance, and more than a tad ill informed, at least from my standpoint.

There a far more things I'm not arguing in this thread. I'm not arguing that things are great, and I'm not saying that they're getting better or worse. And those are factors which are handled in the commercial world every day. People behave that way in all transactions for goods and services. These concerns do not by themselves imply that government intervention is necessary or even desirable.

Neither do said concerns imply that government intervention is unecessary or undesirable. Your faith in the 'market' to deliver equitable services such as healthcare appears too unconditional.

A reluctance to put faith in simple answers to complex problems is not cynicism.
I didn't suggest the answers were simple, they aren't. But that at least one of the root causes i.e. escalating cost, is.

Finally, to me, your comments do reflect an evident innate cynicism. No matter, so do mine.
 

SteveHd

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My cable system is offering "Sicko" via Video-on-Demand so I figure it's probably being offered by other systems as well. Anyone who's interested should check their guide.
 

pronatalist

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I would go so far to say, that in some respects, the U.S. may no longer be the best place to live. Maybe still the best place to live overall, but in government-monopoly education, corporation-controlled medical/insurance rip-off industry and such, we seem to be slipping behind. How can our medical care be the best, when most of us can't even afford it? Do we even have the fastest internet anymore?, since greedy telephone corporations refuse to run fiber optics to our homes, and claim "unfair competition" when people try to upgrade around them.

This abuse from greedy unaccountable corporations has got to stop! How can we hold corporations more accountable to the public that they ought to be serving? Watch the DVD, "the corporation" to get an eye-opener over what has gone wrong, with many corporations. Corporations are about the most undemocratic institution around, because even common stockholders are denied their stock-proportional votes. Corporate meetings are held at places far away and inconvenient, similar to a charge against King George I think in the Declaration of Independence, and so most all important economic decisions are made by rich elite power-monger who own much of the stock, who don't even live in the real world of the working poor. CEOs are like "kings" who can't be fired, because while they didn't build the company, and often care little about it, they happen to hold much of the voting stock.
 

pronatalist

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I thought it was an excellent film, and I think Michael Moore is great.

I haven't seen it yet. Should I buy it?

Michael Moore is a lunatic it seems, but I have to give him credit, for delving into topics that better, more reasonable, conservatives act like they are afraid to touch, "with a ten-foot pole." Somebody's got to talk about these things.
 

dong20

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I would go so far to say, that in some respects, the U.S. may no longer be the best place to live. Maybe still the best place to live overall, but in government-monopoly education, corporation-controlled medical/insurance rip-off industry and such, we seem to be slipping behind. How can our medical care be the best, when most of us can't even afford it? Do we even have the fastest internet anymore?, since greedy telephone corporations refuse to run fiber optics to our homes, and claim "unfair competition" when people try to upgrade around them.

It's amusing that you think it ever was or that such a 'best' place even exists. Best for you, maybe.