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"is_initial_load": true, "is_authenticated": false, "timestamp": "2009-12-18_17:26:52", "remote_domain": "", "page": 1, "is_moderator": false, "display_username": "", "points": null, "subscribe_on_post": 2, "moderator_can_edit": false, "is_remote": false, "is_verified": false, "missing_perm": "locked"}, "realtime_paused": false, "posts": {"11635203": {"up_voted": false, "ip": "", "has_replies": false, "message": "\"Krugman is extremely left wing when it comes to fiscal/economic issues\"<br><br>Well to the left (far left of the public, like a left-wing Dem or even playing with Green-dom).  Part of where he appears at any time (what words he chooses) depends on the lib Dem point of view on the issue of the moment about which he wants to contribute.<br><br>Krugman is like other \"economists\" notably in the Northeast who are well left of the public and routinely mix their economics with politics.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-23_13:52:13", "killed": false, "user_key": "DLS", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11577870": {"up_voted": false, "ip": "", "has_replies": false, "message": "I'm not talking about government inefficiencies gobbling up cost savings (was that an item you were expecting from a script?  because I never mentioned it).  I'm saying that at least some of the reasons that other single-payer systems are cheaper might not apply to the U.S. case, specifically that some of their cost savings have resulted BECAUSE we are a for-profit system.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_15:57:36", "killed": false, "user_key": "JasonArvak", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11580956": {"up_voted": false, "ip": "", "has_replies": false, "message": "Starley, you need food too, even more urgently.  The free market does a great job of supplying it, with good quality and in tremendous variety, without gouging anyone.<br><br>In fact, it's countries that try to control the food market that end up with bread lines and even mass starvation.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_17:37:47", "killed": false, "user_key": "Dr_J", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": 11580467, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11577373": {"up_voted": false, "ip": "", "has_replies": false, "message": "We can see that single payer systems currently implemented are cheaper. The insurance industry's own study shows their cost plus profit to be 17% and Medicare 5% and headed down. The items private insurance spends on that Medicare doesn't are detailed by the physician I quoted. They don't include the subsidies granted to the employer-insured at the expense of the privately insured, which as I noted, is an increased burden on employees of small businesses who are the major source of new jobs. Could government inefficiencies gobble up the12% savings for Medicare-style coverage? Perhaps, but to date, the government programs, including yours, pay less per patient despite higher risk populations (elderly, for example)..", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_15:41:17", "killed": false, "user_key": "GreenDreams", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 1, "author_is_creator": false, "is_realtime": false}, "11578404": {"up_voted": false, "ip": "", "has_replies": false, "message": "Starleys: \"Dr J. This link gives per capita costs for healthcare.\"<br><br>Starley, the <a href=\"http://www.nytimes.com/interactive/2008/09/04/business/20080907-metrics-graphic.html?th&emc=th\" rel=\"nofollow\">US spends more per capita</a> for everything: clothing, recreation, alcohol, you name it, so it's no surprise the same is true for health care.  And even spending more on shoes, we're probably not nearly as fashionably shod as the Italians, but that doesn't mean the government should take over Nike. <br><br>\"My concern however is we cannot sustain this level.\"<br><br>Like I say, that's exactly my concern as well.  Even without the effects of the recession, costs are going up by 5% a year, and it's not like we're getting 5% healthier a year.  Costs have come unhinged from value delivered, and we need reform that will hook them back together.<br><br>\"I do agree with the single payer system however. It allows for universal coverage and contract providers who would compete to provide care and allow for better oversight by a unified authority.\"<br><br>My concern is that's more or less what we have today.  Medicare and private plans *do* attempt to get better deals out of providers by setting rates they feel are aggressive.  As a result, not every doctor accepts every insurance plan (including Medicare), because they're not always willing to take what is being offered.  <br><br>But Medicare and private insurers all have limited leverage over the providers. They can't help anyone without a decent number of doctors signed up, so at the end of the day they pay whatever's Usual, Reasonable and Customary--which is to say whatever the providers vote they should be paid.  And they pass the cost on to us, whatever it might be.<br><br>This competitive process is broken two important ways.  First, it only happens once a year when these contracts are up for renewal, so it happens at a very high level and everyone forgets about any sort of cost competition the rest of the year.  Second, it happens on the basis of price per treatment, not price per outcome.  Medicare and Blue Cross have no idea if you actually feel better from that $10K worth of tests and treatments you got, so providers are competing on the basis of the quantity they can deliver, not the quality.  This is where reform needs to focus: making sure we're paying for what we really want.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_16:15:24", "killed": false, "user_key": "Dr_J", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": 11571588, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11547181": {"up_voted": false, "ip": "", "has_replies": true, "message": "Is clean water and sewage a right?  Is clean food?  What about safe playgrounds?  Good schools?  Are those rights or accessories?  <br><br>This is why I'm hesitant to label healthcare a \"right\" because \"rights\" are a loaded word.  At the same time, I'm baffled by anyone who seems to think our healthcare system is \"teh awesomest thing.\"  <br><br>And the \"I don't want my tax money pay for blah the blah\" isn't even a strawman, it's a Burning Man.  There are literally thousands upon thousands of programs people don't want their tax dollars going to, yet off they go anyway.  I don't understand why we can have Goldman Sachs rolling around in piles of government issued money but when it comes to healthcare, people just trot out the tired \"let 'em die!\" argument.  Why this issue more than any other?  What makes people yawn for paying tax money to corporations or unions or politicians or shitty schools and roads and stupid wars but when you're paying for someone else's X-ray, suddenly the world flips upside down?", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_02:04:20", "killed": false, "user_key": "Lit3Bolt", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 1, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 3, "author_is_creator": false, "is_realtime": false}, "11543087": {"up_voted": false, "ip": "", "has_replies": false, "message": "Well, Kathy, I think I see his point.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-21_22:56:45", "killed": false, "user_key": "Dr_J", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11580467": {"up_voted": false, "ip": "", "has_replies": true, "message": "You need an MRI. Without it you will possibly die.  Want to negotiate?", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_17:21:20", "killed": false, "user_key": "starleys", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 1, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11572489": {"up_voted": false, "ip": "", "has_replies": false, "message": "How much of the truly breakthrough innovation (the non-pen1s pill kind) has come from the \"market\" versus research funded by government grants? I'd like to see statistics on that.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_14:30:07", "killed": false, "user_key": "ChrisWWW", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11559480": {"up_voted": false, "ip": "", "has_replies": true, "message": "Our high cost private insurance, disapproving treatment and claims for financial gain, and excessive co-payments are the leading cause of citizen bankruptcies, loss of homes and retirements, and lack of treatment.  This is the greatest threat to our economy and quality of life, greater than the change required in going to a one payer system. <br> <br>I have travelled to several countries with one payer/government medicine and have been surprised at the positive attitude towards the system. The waiting times described in emergency rooms etc were actually less than what I have experienced in the US. They found it horrifying that in the US that the uninsured or unable to pay could be pushed back on the streets once stabilized without follow-up treatment. Waiting for treatment seems better than no treatment for lingering diseases such as cancer, heart disease, high blood pressure, diabetes, TB, when you can\u2019t afford to pay.    <br><br>Waiting occurs in both private and one pay systems but treatment rates appear to be higher when profit is taken out as the primary motivator.  Who has the ability to shop or discuss prices when you are in the middle of a medical emergency?  Medical treatment is not a free market when your life or a loved one\u2019s is in the balance.  Why must so many choose between life and poverty?  Do I die because my company no longer needs my services and I no longer have or can afford medical coverage?  And once I am ill and lose coverage, who will cover me?  <br><br>In our private system, fewer and fewer businesses and individuals can afford the premiums for even more limited coverage and still maintain resources necessary for their daily survival.  Do I pay rent, put gas in my car, pay my electric or buy insurance?  Do I purchase raw materials for manufacturing, pay for transport, or offer health insurance?  It can be as bad as a choice between food and medication.  These are real choices made by individuals and industry every day.  It is a choice between survival today vs survival tomorrow.  And realistically, we must survive today in order to meet tomorrow.<br><br>The lower per capita cost, greater longevity and higher birth survival rates indicate in objective statistics based on the purpose of healthcare insurance that public/one payer is performing better than private insurance.  Having seen the success of the basically one pay public system in place for the US military, veterans, congress, government employees, the poor (Medicaid), and senior citizens (Medicare), I am highly in favor of extending this same coverage, a universal Medicare, to all our middle class citizens, middle aged individuals, the unemployed and other ineligible groups.  A universal one payer system would give a better spread of the risk that will increase for all individuals as they grow older.  It would significantly increase availability, reduce costs and level out premiums.  Surprisingly it could be done at less than we are currently spending.  It would simply be more efficient.  <br><br>Finally, surveys of other countries one payer systems show better results on a per capita basis for half the money currently being spent in the USA.  The lack of availability through high cost as risk increases results in indirect euthanasia of those who can\u2019t afford coverage through failure to provide treatment.  I really would enjoy having the coverage congress enjoys but would deny the rest of us.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_11:21:32", "killed": false, "user_key": "starleys", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 1, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 2, "author_is_creator": false, "is_realtime": false}, "11581498": {"up_voted": false, "ip": "", "has_replies": false, "message": "<blockquote>Are you a real doctor?</blockquote><br><br>And now we see the inevitable final degeneration -- questioning the dissenters' personal integrity:  Anyone who disagrees with you must be lying even about <em>who they are</em>.<br><br>The thread started so well and overcame so many obstacles along the way.  Then, Kathy, you chose to kill it with viciousness and misrepresentation.  Nice job.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_17:54:27", "killed": false, "user_key": "JasonArvak", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11582032": {"up_voted": false, "ip": "", "has_replies": false, "message": "\"an overlapping system of co-ops rather than a single national system -- even the public options could compete with each other\"<br><br>It also dispels, or at least could ameliorate some of, the apprehension so much of the public has with total government (federal) control, which even many Dems at least acknowledge, which is why Sibelius and others have mentioned the multiple co-op alternative (not necessarily overlapping or competing -- a similar scheme that is avoided because those in Washington want control and the left also disfavors it is to have the state governments provide or at least fully control health care rather than having the federal government do it -- I cannot recall when any mention of having the state governments administer or form their own health care programs has entered contemporary discussion.  So many look immediately to Washington even though it should be last rather than first as a party to become involved, traditionally.)<br><br>The public currently (a majority, 69% in a recent poll, which passes the real-world observation test) is nervous about the extent to which the federal government has extended and deepened its reach into the economy and people's lives.  Much of the public is already concerned about deficit and debt and federal finance.  Note that the current health care effort in Congress (far from \"Medicare for All,\" obviously) lacks cost information and specifics on how to pay for it (much of the public would be willing to pay for more public health care, according to recent polling data).<br><br>Of course, the more childish, militant folks will instinctively reject and attack anything other than 100% federal health care as \"a compromise\" (more honest and revealing would be something like \"lack of complete faith and belief in the cause, without the slightest hesitation, question, or thought whatsoever\").", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_18:13:36", "killed": false, "user_key": "DLS", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11576412": {"up_voted": false, "ip": "", "has_replies": false, "message": "Jason, there is no reason private industry could or would not compete in a one payer system.  Some of the largest pharmacutical companies are in Europe.  New and innovative products are constantly coming into the market and they would not develop if there were not a market with most modern countries having a one payer system.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_15:12:06", "killed": false, "user_key": "starleys", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11581533": {"up_voted": false, "ip": "", "has_replies": false, "message": "<i>The free market does a great job of supplying it, with good quality and in tremendous variety, without gouging anyone.</i><br><br>Can you take me to your planet, Dr_J? It sounds like a great place to live.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_17:55:37", "killed": false, "user_key": "kathykattenburg", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 1, "author_is_creator": false, "is_realtime": false}, "11544671": {"up_voted": false, "ip": "", "has_replies": false, "message": "Tell you what, how about the taxpayer pay my mortgage?  That's the plan I expect to see, and I'm quite willing to discuss potential problems with it, but the bottom line is that's really what I insist on.  And please don't suggest compromises to me, because I've *already* compromised.  I should really have a much larger place than I do.  The average home in Canada is, like, twice the size of mine, and it's even cheaper!<br><br>Don't I sound open-minded?", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_00:00:15", "killed": false, "user_key": "Dr_J", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11553895": {"up_voted": false, "ip": "", "has_replies": false, "message": "Kathy,<br><br>Thank you for responding with a respectful tone.  Let's see if we can maintain it in spite of the efforts of SteveK to coopt it into his apparent personal vendetta against me.  BTW, it is not true that you are not able to comment at PoliGazette and that has not been the case for a long time.<br><br>As for the content of your response, I would note that I agree that some reform is necessary, but I object to the purist, no-compromise approach implied by your original headline and reinforced by many others on your side of the issue, most notably Paul Krugman in today's NYT.  He specifically and in detail rejects all debate and compromise, insisting on a purely public option.<br><br>Also, you and other advocates of public health care do not address key issues of rationing problems found in other health care systems.  The fact that our current system falls short in providing care does not mean that those flaws in other systems are meaningless.  In building a reform package, shouldn't we try to correct BOTH the defects in our current system AND the defects in other models?  Why does it have to be reduced to ideological \"win\" and \"lose\"?  Yet that is exactly what you and Krugman and so many others on the liberal side seem to do with it -- reduce it to an ideological zero-sum game.  (The fact that such a Manichean worldview is shared by some on the other side of the aisle shouldn't constitute an excuse for the behavior.)<br><br>It is also disappointing that most on the liberal side refuse to address questions about how public/private \"competition\" could work given that the government can use its power to tip the tables and drive the private options out of business.  The public plan would be subsidized by the taxpayers (thus concealing costs while not removing them) while the private plans have to answer to shareholders.  The government can also operate with a deficit while the private programs cannot, again presenting the appearance of lower costs while in reality merely competing unfairly.<br><br>It is also distressing to see that compromise ideas like Conrad's idea for health care co-ops are simply ignored or dismissed out of hand.  People like Krugman see compromise as an evil in and of itself.  Such attitudes are not conducive to a thorough debate about various alternatives.<br><br>My bottom line is that I am NOT a purist on this.  I concede at the outset that rescission is a travesty and that lack of available coverage for tens of millions is not a viable situation.   If I could be persuaded that a public option would be efficient and comprehensive, I would be willing to support it.  I've actually got a much more personal attachment to this problem area than would be comprehensible to some commenters immediately above me on this thread.  But all I'm asking for is that liberals set aside their desire to \"score a win\" long enough to actually debate the complexities of the issue thoroughly and perhaps even question some of their own assumptions.  Is that really too much to ask from the dominant political force in the country right now?", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_09:05:56", "killed": false, "user_key": "JasonArvak", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11578478": {"up_voted": false, "ip": "", "has_replies": false, "message": "Don't worry. I'm sure our government will find a way to make a health care system that stifles innovation and is more expensive than the one we have now.<br><br>The only thing that we will definitely get better is access.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_16:17:44", "killed": false, "user_key": "ChrisWWW", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11560047": {"up_voted": false, "ip": "", "has_replies": false, "message": "EEllis,<br>What about that money funneled through AIG? What about the fact <a href=\"http://www.smirkingchimp.com/thread/22413\" rel=\"nofollow\">Goldman Sachs pretty much caused the damn recession by itself</a>.<br><br>JasonArvak,<br>Rationing is a part of our health care system now. Unless you have unlimited funds to pay for medical care, you will eventually hit the limit of what your insurance will pay for, or what the hospital is willing to give you without insurance. And it will only get worse and worse if we don't fix the system, because costs are spiraling out of control.<br><br>And to be perfectly honest, I don't give a rats @ss if the competition is fair or not. The goal is better, cheaper health care, not a free marketeers wet dream. <br><br>CO,<br>The plan costs more in the short term, but saves money in the long run. That's why it's worth pursuing.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_11:41:06", "killed": false, "user_key": "ChrisWWW", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": 11548128, "depth": 0, "points": 6, "author_is_creator": false, "is_realtime": false}, "11560562": {"up_voted": false, "ip": "", "has_replies": true, "message": "ChrisWWW, from first-hand experience, I know better about the limits of health care coverage than you can possibly know.  I also know the virtues of a system that allows rapid access to treatment for conditions where time is an important factor.  I would hate to see the virtues sacrificed just because concerns about reform are dismissed out of hand with breezily hateful stereotypes like \"a freemarketeers wet dream\".  It should be possible to set aside ideological combat in the interests of pragmatism, shouldn't it?<br><br>My latest efforts to do that are here:  <a href=\"http://www.poligazette.com/2009/06/22/lessons-from-military-health-care/\" rel=\"nofollow\">http://www.poligazette.com/2009/06/22/lessons-f...</a><br><br>Please note that I am not in favor of the status quo and I take seriously the need for reform and in particular expansion of coverage.  I am dubious about purist proposals because I think they are willfully ignorant of potential problem areas and I think compromising approaches offer the potential to acknowledge and deal with the inevitable trade-offs rather than simply demonizing the issue into \"good guys\" and \"bad guys\" like you seem prone to do.<br><br>Maybe...just maybe, treating cancer patients in a timely and effective manner is more important that bashing \"free marketers\" or \"socialists\".<br><br>There is also no evidence I am aware of that shifting the costs to the government will reduce them.  In fact, basic economics says that if you make it cheaper for individuals, they will demand more of it.  Thus, the most likely direction for costs under a single-payer system is upward UNLESS you use the exact same kinds of cost controls that insurance companies do (limiting access) OR you impose arbitrary limits (rationing).  Are you prepared to discuss details, or only make sweeping statements&gt;", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_11:58:52", "killed": false, "user_key": "JasonArvak", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 1, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11576083": {"up_voted": false, "ip": "", "has_replies": true, "message": "<blockquote>BTW, your attack on the Nobel Prize process is an insult to the many brilliant people who have earned them.</blockquote><br><br>See, and here I thought that awarding Nobel Prizes to Al Gore and Paul Krugman as a way of lashing out at Bush was the REAL insult to the many brilliant people who have ACTUALLY earned them.<br><br>And my point about tradeoffs was never presented as a defense of the status quo, which you would have noticed if you actually read them before I called you out on scripting.  I've consistently maintained that the tradeoffs can be mitigated, but that doing so requires admitting to their existence first and stopping the practices of romanticizing single-payer systems and demonizing everyone who questions their flaws.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_15:01:46", "killed": false, "user_key": "JasonArvak", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 1, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11581556": {"up_voted": false, "ip": "", "has_replies": false, "message": "More poison from Kathy.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_17:56:30", "killed": false, "user_key": "JasonArvak", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11578997": {"up_voted": false, "ip": "", "has_replies": false, "message": "Very complicated.  How do you measure results and establish rates?  In this area I ask for suggestions.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_16:34:02", "killed": false, "user_key": "starleys", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11576951": {"up_voted": false, "ip": "", "has_replies": true, "message": "Jason - curious.  Why do you feel equipment would be different from Pharm?<br>jwest.  Explain more on your savings plan.  I'm not clear.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_15:28:09", "killed": false, "user_key": "starleys", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 1, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11575928": {"up_voted": false, "ip": "", "has_replies": false, "message": "\"script-driven, gross logical fallacy, you should not be so shallow in your thinking\"<br>You know, you're the one who said \"Thank you for responding with a respectful tone. Let's see if we can maintain it.\" How about a bit of civility in our discussion. I'm not an idiot and am not treating you as one.<br><br>I'm not following a script. I'm responding directly to your points about \"trade-offs,\" which I think are exaggerated, and can be minimized. I quoted the doctor to show how some within the profession see the need for change. By quoting physicians, polls, public health professionals and even defending a respected economist you were deriding, I remind readers that it is not some fringe cadre of bloggers driving the call for change. (oh, and BTW, your attack on the Nobel Prize process is an insult to the many brilliant people who have earned them.)", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_14:56:45", "killed": false, "user_key": "GreenDreams", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 1, "author_is_creator": false, "is_realtime": false}, "11577979": {"up_voted": false, "ip": "", "has_replies": false, "message": "Jason,<br>Now be fair, you did say that it would be a \"underperforming bureaucratic nightmare.\" <br><br>Good discussion by the way.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_16:01:32", "killed": false, "user_key": "ChrisWWW", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11711612": {"up_voted": false, "ip": "", "has_replies": false, "message": "Wow. That's an impressive persecution complex Jason's got there. :-)", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-24_23:18:27", "killed": false, "user_key": "kathykattenburg", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 1, "author_is_creator": false, "is_realtime": false}, "11553920": {"up_voted": false, "ip": "", "has_replies": false, "message": "<i>Is clean water and sewage a right? Is clean food? What about safe playgrounds? Good schools? Are those rights or accessories</i><br><br>Most of those items are human rights, if you think about them a little differently. Potable water is a human right, yes. I don't know what you mean by \"clean sewage,\" exactly, but certainly destroying sewage processing plants in war is a human rights violation, because it's destroying a people's means of survival. \"Unsafe playgrounds\" is a sort of reductio ad absurdum way of referring to people's right to be free of random violence and crime. So I guess if you have hypothetical playgrounds where all the play equipment is booby-trapped, or constructed to explode, it could get to be a violation of the human rights of children who used the playground.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_09:07:01", "killed": false, "user_key": "kathykattenburg", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11575938": {"up_voted": false, "ip": "", "has_replies": false, "message": "I am currently out of the office and will not be checking e-mail.<br><br>I will reply to your message as soon as I return.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_14:57:14", "killed": false, "user_key": "starleys", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": 11572216, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11575939": {"up_voted": false, "ip": "", "has_replies": false, "message": "I am currently out of the office and will not be checking e-mail.<br><br>I will reply to your message as soon as I return.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_14:57:15", "killed": false, "user_key": "starleys", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": 11572631, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11581072": {"up_voted": false, "ip": "", "has_replies": false, "message": "<blockquote>Which means, in practice, a continuation of exclusionary coverage practices. </blockquote><br><br>Wow, is that ever a misrepresentation of my advocacy.  I propose that the public option (implemented through an overlapping system of co-ops rather than a single national system -- even the public options could compete with each other) be paid for by the government for those who cannot pay for it themselves or that the value of that option be given as a voucher to supplement the purchase of private insurance.  And I would contend that the practice of rescission should be closely regulated to stop the abuses of the practice and ensure that even for those thus removed there exists a backup public option.<br><br><blockquote>How much slower do you want to go, Jason?</blockquote><br><br>Well not being forced to meet an artificial deadline of October 15 would be a start, Kathy.  Perhaps we could actually, you know, HAVE A DEBATE?<br><br><blockquote>I guess as many times as you stop reading from your \"public health care is evil\" script.</blockquote><br><br>See, now you're not even trying to be honest, Kathy.  I never said anything of the kind and have repeatedly and specifically endorsed reform.  I only want it done in a way that pays attention to potential flaws and tradeoffs.<br><br>But apparently you prefer a Manichean world where only good and evil are options.  Very sad.  You are proving valid the criticisms in my original post on this subject -- your approach is purist, intolerant, and fundamentally dishonest towards dissenters.<br><br>I suggest that the disconnect is the result of you seeing what you want to see -- an enemy to be demonized and fought -- rather than a discussant.  And that is your common problem -- an incapability to tolerate disagreement even in tiny amounts without immediately assuming it is an extreme case of absolute moral dysfunction on the other side.<br><br>Its your site so, of course, you get the last word.  But I will close my participation here by saying that my position is that a public option is a useful PART of a potential reform package, but that we need to avoid the incautious and intemperate approach of purists lest we suffer from the unforeseen consequences of their intellectual laziness.<br><br>I would invite those who want to continue the discussion without good-versus-evil rhetorical excesses to PoliGazette threads like: <a href=\"http://www.poligazette.com/2009/06/22/lets-have-a-real-health-care-debate/\" rel=\"nofollow\">http://www.poligazette.com/2009/06/22/lets-have...</a>", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_17:41:26", "killed": false, "user_key": "JasonArvak", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11543407": {"up_voted": false, "ip": "", "has_replies": false, "message": "Uhhh, surprise!", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-21_23:18:11", "killed": false, "user_key": "kathykattenburg", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 2, "author_is_creator": false, "is_realtime": false}, "11634844": {"up_voted": false, "ip": "", "has_replies": false, "message": "\"the assertion that a single payer (or public option) system might not save anything\"<br><br>I've never said that.  There are up-front savings and it's logical to assume that Medicare for All would be \"streamlined\" compared to what we have now.  But there won't be a permanent cap or brake on the costs, because the demographics (aging of the population) and increasing expense of improvements in medical treatments will force costs upward.  \"Wellness\" emphasis that goes beyond the well-known preventive care will not achieve miracles, and there are limits, anyway, to what people should be expected or worse, required [compelled] to do in the name of wellness or prevention, or what restrictions, taxes that aim at medical-related social engineering, or prohibitions people should be subjected to.  Wellness at the cost of too much freedom or quality of life ends up being the well-meaning equivalent of keeping the very elderly and sick (near death) alive at an effort that some routinely argue is not justified, and in fact is inappropriate.<br><br>Food for thought...", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-23_13:43:53", "killed": false, "user_key": "DLS", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11635361": {"up_voted": false, "ip": "", "has_replies": false, "message": "\"I would agree that mammograms and all other preventative screening tests should be covered for everyone that does not have private insurance by a government health care plan.\"<br><br>But then you run into a serious problem.  What you say (and other examples I can think of) appeal wonderful in theory, but you'll find that in many cases, the tests, for example, have been considered by people already in the government(s) and rejected as not cost-effective.<br><br>This is something to keep in mind as the scope of public health care grows (as it is likely to do).", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-23_13:55:24", "killed": false, "user_key": "DLS", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11572905": {"up_voted": false, "ip": "", "has_replies": false, "message": "Jason, I've responded to your points, except the MRI issue. This is a bit of a red herring. The TOTAL MRI equipment industry in the US is $700 million. We probably have enough of them, but even if we were talking about the taxpayer buying them for hospitals, which we're not, it's not as big a budget item as you seem to believe. As I pointed out above, by cutting our cost by LESS than half, we could avoid virtually all the issues you raise with current single payer systems.<br><br>Like you, I would support a public OPTION with competition from the private sector. Those of you who believe the current system will serve you better can have it. The market will decide if its market can be sustained. And by the way, you didn't respond to MY point. The for-profit model is in trouble, as unemployment rises, fewer employers can afford to cover their employees, and the economic downturn drives insurance customers to cheaper plans. I read that UnitedHealth has lost 9 million customers since September. The numbers of customers downgrading their coverage was not reported. Will we bail them out when they suggest to legislators that they are \"too big to fail?\"", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_14:40:50", "killed": false, "user_key": "GreenDreams", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11580080": {"up_voted": false, "ip": "", "has_replies": false, "message": "Jason,<br><br>On the MRI example, they are expensive because of the inefficiencies and cost shifting built into the current system.<br><br>In my system, before someone agrees to receive an MRI, they would know the average cost and the cost of the last 10 similar MRI\u2019s done in their zip code (or adjoining zip codes if not enough have been performed locally).  Now it becomes a matter of cost versus benefit.<br><br>On the provider side, the MRIs are high dollar sales until the free market kicks in.  A scan that someone used to charge $8000 for will drop substantially when customers start saying no.  Now the payment on the million dollar machine is due and monthly revenues don\u2019t add up.  Time to lower the price to increase the volume.  The operators who lower it the most, provide the best service for the best price will thrive.<br><br>Look for commercials like this:<br><br>\u201cHi folks, I\u2019m Earl Schieb and I\u2019ll scan any body, any color, for only $49.95.  That\u2019s right folks, if you can walk it, roll it or drag it into any one of 16 metro locations, I\u2019ll scan that body in our new, exclusive GE machines while you wait.\u201d  <br><br>Never underestimate the power of the free market.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_17:07:54", "killed": false, "user_key": "jwest", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": 11578724, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11582134": {"up_voted": false, "ip": "", "has_replies": false, "message": "\"we don't have a competitive private health care system, we have a bloated semi-public/semi-private system in which providers compete very little and on the wrong things\"<br><br>The scope of this statement of yours encompasses much, much more than merely health care, of course.<br><br>And now we have Gummint Motors.  Even die-hard Detroiters fear this will become one hell of a wreck.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_18:16:50", "killed": false, "user_key": "DLS", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11561148": {"up_voted": false, "ip": "", "has_replies": false, "message": "JasonArvak.  I researched and found that timely and effective treatment predominates in the one payer systems.  Priority is given to most serious cases.  Unfortunately, in the US no treatment may be recieved if you can't meet co-pay or don't have insurance to cover the cost of prescriptions required.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_12:17:38", "killed": false, "user_key": "starleys", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": 11560562, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11579583": {"up_voted": false, "ip": "", "has_replies": false, "message": "Every Doctor a Specialist:<br><br>This healthcare plan was designed by first asking how a person would want their medical treatment delivered, as opposed to simply wondering how to fund the existing practices.  By looking at the problem from a blank slate, savings can be designed into the system.<br><br>One of the first is the primary contact.  When someone is sick, the last thing they should need to do is drag themselves to an inconvenient office filled with other sick people in order to spend 3 minutes with a hurried doctor who is most likely going to order tests or refer them to a specialist. <br><br>A higher quality and less expensive alternative is for a Advanced Degree Nurse (ADN) with 6 years experience as an RN and 18 months advance training, to come to the home of the patient.  This ADN would have the patient\u2019s and the patient\u2019s family\u2019s medical history and be able to see, hear, smell and possibly taste the environment the patient is in.  This ADN would be trained (and have the experience) to listen to patients and ask the questions needed (in the manner needed) to draw out a full description of what the symptoms are.  ADNs would be equipped with portable devises for routine tests and be able to transmit this data to whatever specialist (or diagnostician) the ADN deems appropriate.  <br><br>What this method does is use lower-cost personnel to better perform a function now being done by highly paid doctors.  It saves the patient time and trouble, prevents cross contamination with other patients, exposes environmental factors to aid in diagnosis and eliminates an entire category of cost by bypassing the general practitioner to go directly to a specialist.  <br><br>Specialists would thrive in an atmosphere of free market healthcare.  Physicians could hyperspecialize to the point that developing new efficient procedures and facilities geared toward specific illnesses and injuries would bring higher profits for the provider and better quality of service to the customer.  If a doctor spends his life treating one specific thing, he will become very good at that one thing.  He may franchise his specific knowledge to allow others in different areas benefit from his expertise.  This brings efficiencies that would be inconceivable in the normal healthcare model we live in today.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_16:52:10", "killed": false, "user_key": "jwest", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11597507": {"up_voted": false, "ip": "", "has_replies": false, "message": "Kathy: \"Well, that's an interesting idea.\"<br><br>Well, maybe this is the disconnect going on.  My position has never been that we shouldn't help the poor.  It's that we should split health care reform into two problems and address them separately:<br><br>1. Building an efficient system of doctors, hospitals, drug companies, regulators, etc that can deliver the maximum health per dollar spent.<br>2. Providing financial help to people who can't afford #1.<br><br>The way to do #1 is a free-market system where competition forces all the players to work hard to deliver results, while minding the dollars being spent.  It should be built around consumer choice, demanding transparency from providers, and should not be controlled by big bureaucratic gatekeepers like today's system is.<br><br>The way to do #2 is by writing checks, or giving tax rebates, or issuing vouchers, or I'm sure other approaches would work fine too.  The only requirement is whatever we do must not micromanage the providers by dictating prices or policies, but should let them stay focused on goal #1: maximum health per dollar spent.<br><br>We have to do both of these things.  We can't just do #2, because today that group consists of darn near everyone, more than we can subsidize.  We also can't just do #1, because we'd leave darn near everyone high and dry without coverage.  But we shouldn't try to consider them the same problem, because we'll end up with a solution that meets neither need very well.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_22:19:16", "killed": false, "user_key": "Dr_J", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": 11583698, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11578566": {"up_voted": false, "ip": "", "has_replies": false, "message": "It is also worth remembering that private health insurance is effectively subsidizing Medicare.  Many providers make up ground on services that they provide at a loss to Medicare by increasing billing amounts to non-Medicare patients.  This de facto subsidy would disappear under a single-payer system.  While that is not necessarily a bad thing, it could wind up being bad if the result was either to significantly raise the costs beyond what we thought (based on current Medicare) would be the cost of certain services OR if the disappearance of the way to make up losses wound up forcing providers to simply no longer provide services for which Medicare did not pay enough.  The first scenario would undermine the projected cost savings of a single-payer system and the second scenario would undermine the goal of universal access to all areas of health care.<br><br>This is the kind of thing I think too many liberals fail to do - consider the complex interactive nature of the system.  They seem prone to overly simplistic assumptions.  Slowing down enough to actively seek out problems and concerns is needed to avoid critical errors in designing reform.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_16:20:30", "killed": false, "user_key": "JasonArvak", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11582153": {"up_voted": false, "ip": "", "has_replies": false, "message": "Now wait.  We have an interesting situation.  I still like one payer for cost effectiveness and universal coverage.  But think of an effective process.<br><br>Go to Doctor or trained RN for diagnosis at fixed charge  He recommends treatment plan or referral to specialist.  Referal department locates most cost effective sources.  Treatment is given.<br><br>If patient select another source then insurance only pays what original cost would have been.<br><br>This is simply a giant hmo nationwide and basically the same service we had in the military.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_18:17:19", "killed": false, "user_key": "starleys", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11583698": {"up_voted": false, "ip": "", "has_replies": true, "message": "<i>We should help people get health care by simply sending them a check.</i><br><br>Well, that's an interesting idea.<br><br><i>And then if, based on the database, you decide to play the odds, you've got an extra $200 to spend on liquor and gigolos.</i><br><br>Okay, you definitely have a better sense of humor than Jason.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_19:07:45", "killed": false, "user_key": "kathykattenburg", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 1, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11565289": {"up_voted": false, "ip": "", "has_replies": false, "message": "<i>For example, one defect with single-payer health systems is that they have fewer MRI machines available because there is simply no incentive to invest in equipment for FUTURE demand. ...</i><br><br>That emphasis on \"investing in\" equipment for future demand translates also into doctors and hospitals buying the newest, latest, most cutting edge equipment. That is one reason health care costs are through the roof and continuing to climb.In a capitalistic marketplace health care system, health care providers have a powerful incentive to do this: It allows them to charge more money.<br><br>Of course, there are always trade-offs anytime a system is changed, but with the condition health care is in in the U.S., both in terms of costs and in terms of access, I really think there's no direction to go in but up.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_13:11:35", "killed": false, "user_key": "kathykattenburg", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11581675": {"up_voted": false, "ip": "", "has_replies": false, "message": "Posted to PoliGazette thread:<br><br><strong>UPDATE 6/22 5pm:</strong> Well, Kathy Kattenburg's respectfulness didn't manage to last the day before she returned to the purist approach of misrepresenting and demonizing all opposition.  This is the dysfunction that seems likely to continue to plague the health care debate in this country -- self-righteous purists who believe in win-at-all-costs actively destroying debate from the left and know-nothing purists refusing to even offer debate from the far right.  Meanwhile, the moderate majority stuck in the middle can look forward to paying the higher tax bills for a poorly designed system built on ideology rather than analysis.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_18:00:20", "killed": false, "user_key": "JasonArvak", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11555056": {"up_voted": false, "ip": "", "has_replies": false, "message": "Actually, the UN Convention on Economic and Social Rights (to which the United States is a signatory) includes the right to be free from random violence and crime as a \"human right\".<br><br>The key problem, of course, is as it is with most \"human rights\" -- the practical problems of how best to implement them in practice.  No one believes that government action can be perfect in all areas (i.e. there will always be crime) nor does any serious analyst contend that government action is always the best mechanism (for example, freedom of the press doesn't require government to provide all the media outlets nor would that be a functional way to honor the right (except, of course, if you really love Hugo Chavez)).<br><br>Thus, the question of whether it is a \"human right\" is really semantic.  The issue is how best to implement a functional and efficient system that fixes the problems in the status quo while avoiding the flaws in other systems.  Conservatives often err in failing to see the problems in the status quo.  Liberals often err by failing to see the flaws in other systems.  Only by having a greater tolerance for debate and discussion can these errors be avoided.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_09:32:26", "killed": false, "user_key": "JasonArvak", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11570417": {"up_voted": false, "ip": "", "has_replies": false, "message": "Jason and Dr J<br>Enjoyed your replies.  Appreciate well thought out responses.  Dr J.  Your point on cancer survival rates was very accurate and led to further research.  When accidents/fatal injuries are deleted from survival rates the US actually has a HIGHER longivity rate than other countries.  76.9 years.  <br><a href=\"http://politicalcalculations.blogspot.com/2007/09/natural-life-expectancy-in-united.html\" rel=\"nofollow\">http://politicalcalculations.blogspot.com/2007/...</a><br><br>My concern however is we cannot sustain this level.  Recent increases in unemployment have moved more and more people away from available coverage.  The latest figure is 56 million without insurance.I am in that situation.  And I don't believe employers are going to be willing to continue to foot the bill.<br><br>I do agree with the single payer system however.  It allows for universal coverage and contract providers who would compete to provide care and allow for better oversight by a unified authority.  It is not necessarily socialism.  And Jason, don't forget that there will always be inovation looking to make a buck on that large money available in the industry.  Dr J.  You are right, someone will always be there to make a profit.  And having better equipment will make contract providers more competitive.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_14:04:56", "killed": false, "user_key": "starleys", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11576563": {"up_voted": false, "ip": "", "has_replies": false, "message": "Jason,<br><br>Your description of Krugman was the most accurate I\u2019ve ever seen on this website.<br><br>As someone who is just a smiggen right of center, I favor a hybrid healthcare system using both free market and socialized elements, with the complete elimination of health insurance.<br><br>On the free market side, I believe in individual health savings accounts (subsidized for the needy) that would provide a dignified means for everyone to purchase whatever healthcare they choose to buy.  The individual would have the power to pick their doctor, procedures and tests.  <br><br>This type of capitalistic system has been proven to be the best method of delivery on every imaginable service and healthcare would be no different.  I envision a time when advanced degree nurses (ADN) would come to your home to listen to your symptoms, take tests, observe your surroundings and spend the amount of time necessary to get a good idea of what the problem is.  Then, using their medical knowledge, these ADNs would transmit their findings and speak with the appropriate medical specialty necessary for the situation.  Cost savings plus better service \u2013 how good does this get?<br><br>The medical savings accounts would be linked to a debit card that pays instantly after each procedure.  Cost information is automatically entered into a database for cost comparison in your area over the internet.  At the point of sale (the doctor\u2019s office for example), when you swipe your debit card for payment, the average cost in your area would be shown along with the last 10 similar procedures with the physician\u2019s name and price.  Medical savings accounts would be funded up to $8000 per individual.  There would be a $7000 \u201cdonut hole\u201d between the point that the base savings account is depleted and the socialized catastrophic plan kicks in.<br><br>As to the socialized plan, the only reason I propose this method for the upper catastrophic end is so that government can impose some end-of-life limits on heroic efforts when the quality or quantity of life is not significantly extended by these hyper-expensive procedures.<br><br>Only government, in its dehumanizing, bureaucratic form can set the limits that need to be set.<br><br>Of course there is much more, but this is enough for one comment.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_15:17:09", "killed": false, "user_key": "jwest", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": 11576083, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11578615": {"up_voted": false, "ip": "", "has_replies": false, "message": "Starleys,<br><br>This plan was first put together in the early \u201890s to counteract HillaryCare.<br><br>First off, it recognizes that the main ingredient missing from either a government single-payer or a private insurance run operation is the dignity of managing your own healthcare.  Whether an uncaring bureaucrat or a greedy insurance employee, the emphasis is not on caring for you, but denying anything that costs money.<br><br>Back in the \u201890s, the percentage of the healthcare budget that went into clerical and billing matters exceeded 22%.  Most was centered at the provider to substantiate claims for payment and to maintain documentation in case of litigation.  A vast majority of this cost would be eliminated by customers paying via debit cards from medical savings accounts (MSAs).  <br><br>MSAs could be individually, employer or government funded, depending on the individual.  Once an MSA hit the $8000 minimum in one year, anything over that amount can be withdrawn for any purpose.  So, an employer could encourage employees to spend carefully on healthcare by paying a certain amount into the account each year, regardless if the account was at it\u2019s minimum or not, thus allowing the employee the choice of taking a \u201cbonus\u201d or leaving the greater amount in the account.<br><br>There is a \u201cdonut hole\u201d designed into the system to encourage prudent spending.  This allows first-dollar payments out of the account all the way up to the $8000 balance, but allows for an additional $7000 of unfunded expenses to accumulate before the government catastrophic plan kicks in.  The $7000 is paid through the credit function of the MSA debit card, and is repaid either by the individual or through tax refund or earned-income tax credits.  As stated, this \u201chole\u201d is for the purpose of inflicting a measured amount of pain for excessive (even if necessary) use.  Illness needs to be monetarily as well as physically painful to keep it something to be avoided.<br><br>Mentioned in an earlier post was the need for the socialized single payer catastrophic portion of the plan to place limits on services based on the type of procedure and the age and physical condition of the recipient.  The vast majority of healthcare dollars are spent trying to keep the dying from dying 6 months sooner.  By using government to play the \u201cbad guy\u201d in making the decisions of how old, what is reasonable and what is not, the healthcare crisis could easily be solved.  <br><br>Next:  Why every doctor should be a specialist.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_16:22:12", "killed": false, "user_key": "jwest", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": 11576951, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11634435": {"up_voted": false, "ip": "", "has_replies": false, "message": "\"2. Providing financial help to people who can't afford #1.\"<br><br>Vouchers (for health care only, even without monetary value, but denoting what the person can receive) -- the alternative is to end all such assistance programs of all kinds (not only health care) and just give people cash (even a \"guaranteed minimum income\" or \"basic income guarantee,\" to use the two favorite terms that describe this concept and objective).  The simplicity is appealing, as well as the termination of so many counter-productive and harmful programs and bloated bureaucracies.  (AFSCME and other organizations would never want the programs ended, but expanded instead, in addition to the income entitlement.)<br><br>* * *<br><br>\"Haggling is actually the sign of a market inefficiency.\"<br><br>I'm not sure.  The potential is always there, as no two people or parties are alike, and moreover, we're seeing an upswing in haggling (the ability of buyers to negotiate prices downward, to be more specific here), which is a sign of a continued downward movement, decline, recession, depression, you name it.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-23_13:34:58", "killed": false, "user_key": "DLS", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11571465": {"up_voted": false, "ip": "", "has_replies": false, "message": "Single-payer systems perform well at much lower cost. it's not hard to find cases of the system breaking down with either for profit or nonprofit care, so the point is which works the best most of the time. It has been estimated that many of the problems with single-payer systems, including waiting times would vanish if these countries paid a little more, but still far less than we pay. Jason disparages Paul Krugman, a Nobel prize-winning economist who favors a single-payer system and has the economic background to know what he's talking about. Doctors also favor it, by a margin of 59% to 32%. Commenting on the statistics by the World Health Organization, the Director of what is arguably our leading medical institution made this statement.<br><br>\"The US should be particularly concerned about these findings,\" says Gerard Anderson, director of the Bloomberg School of Public Health at Johns Hopkins University in Baltimore. \"If I'm spending twice as much, I'd expect to have the better outcomes.\"<br><br>A practicing physician describes why he favors public health care, and he probably sums it up better than I can:<br><br><a href=\"http://www.burlingtonfreepress.com/article/20090613/OPINION/906130301/My-Turn--A-doctor-s-view-on-single-payer-care\" rel=\"nofollow\">A doctor explains</a>.<br><blockquote>A few years ago, after crossing the midway point in my career, I decided that I had seen too many bankruptcies, too many mortgage foreclosures, too many financial crises to remain silent on the health care issue. I have seen too many patients deluged with bills after beginning cancer treatment, too many patients forgo treatment of high blood pressure, diabetes and other problems of major public health significance because they simply couldn't afford it.<br></blockquote>He also points out how the uninsured pay others' bills without getting any care for themselves.<blockquote>Uninsured Americans pay taxes for federal, state and municipal employees, veterans, the military, prisoners, the Indian Health Service, the homeless, the community health centers, the renal failure program, Medicare, Medicaid. But after paying for all those groups to have health coverage, they themselves have nothing. This is one of the greatest injustices in our health care system. In a single-payer system, everyone pays in -- as we do for the above groups, but then every single citizen has health insurance.</blockquote><br>The current system disadvantages small businesses and their employees.<br><blockquote>The vast majority of small businesses in the United States do not provide health coverage to their employees because they can't afford it. The United States is the only developed country that systematically discriminates against the owners and employees of small businesses in this way. This is completely dysfunctional. Single-payer health care would provide coverage to all citizens -- period. This allows everyone to work in the job that suits them best, without having the least concern about health coverage -- as occurs in every other developed country. With no exceptions, countries with government-run health care plans are the most efficient -- they waste less money on advertising, administration, extravagant salaries, etc. They provide the best outcomes, longer life expectancy, lower infant mortality and, with only a few exceptions, they are enormously popular with the people they serve. In every one of those countries, no one is left out -- everyone is insured from cradle to grave, there are no bankruptcies or foreclosures related to health costs, and the cost to business and government is on average half what we pay per capita in the United States.<br></blockquote><br>Finally, those who oppose changes in our insurance mediated health care system he will soon be arguing for or against taxpayer bailouts of health insurance companies. I suppose one way we could back into a single-payer system is to buy their stock when they crash. <b>14,000 Americans </b>are losing their coverage <b>every day</b>, and of course, insurance companies are losing 14,000 customers every day.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_14:18:24", "killed": false, "user_key": "GreenDreams", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 3, "author_is_creator": false, "is_realtime": false}, "11581715": {"up_voted": false, "ip": "", "has_replies": false, "message": "\"Note that a public option is already a step down from [100% public, federal]. A public option is already a compromise. \"<br><br>True.  But there's nothing sacred about 100% public (federal) nor is that what we \"should\" be doing; it is an issue of what we want.  Also, if you're negative, you again don't see things clearly or correctly (a Left common fault).  The correct thing to note is that a public option is an incrementalist tactic (which is not clever or deceptive, but is openly transparent), attempted by those firmly in favor of public health care, to condition the public to encounter and even experience public health care, for the public is wary of loss of rights and choices under a 100% government system, as it is wary overall of the current growth of the federal government and its encroachment into the economy and people's lives (without suffient effort or attention being paid to finance this and the rest of the government properly, an additional widespread concern).<br><br>* * *<br><br>\"I am someone who does believe that health care is a human right.\"<br><br>It is not a human right, despite how often you or Physicians for a National Health Plan may state this.<br><br>If you want to make it a (federal) entitlement (most people don't want to waste time or involve complexity and disparity arising from having the state governments do this, which is the logical and constitutionally faithful way to do this), and you can convince Congress to create this entitlement (say, extend Medicare to everyone), fine, but at least be honest about it, not emotive or incorrect about it.<br><br>\"Is clean water and sewage a right? Is clean food? What about safe playgrounds? Good schools? Are those rights or accessories?\"<br><br>None of these are rights.  Nor is something I saw in an activist book about the evil automobile and the lack of sufficient (to the activists) provision of alternatives to people -- they said that there is a \"right\" [sic] to transport.  There is no such right to any of these things (including health care).  If we want to provide it by government to people, that is a separate thing altogether.<br><br>* * *<br><br>\"childish rants of the intellectual midget / hack JasonArvak\"<br><br>Gee, Steve, I see you're abusing others for no reason, too, as well as continuing to engage in effective mirror talk.<br><br>* * *<br><br>\"purist, no-compromise approach implied by your original headline and reinforced by many others on your side of the issue, most notably Paul Krugman in today's NYT\"<br><br>Krugman is a Dem hack, simply adding fuel to the fake-\"Crisis!\" fire now, on cue, to support Obama and the Dems in Congress, among other things.<br><br>\"Purist\" actually is elegant and attractive in its simplicity and (assuming existing programs would be used) relying on something already extant rather than inventing something new.  But \"no-compromise\" is out of order, out of line, given it's driven by errors, misconceptions in many cases, emotions rather than facts (it is a lefty position), and even childishness.  Incrementalism is the logical way to go, which is why the Dems have done what they've done with S-CHIP in the past and are trying now with the \"public option\" (hardly leaving the private sector in a fairly competitive position -- the proponents know what they're doing).<br><br>I've said it before and can say it again -- it's smarter and more effective than what the whining lefties have done and what they're doing now (mumbling and bumbling).  Why not start by expanding Medicare to children (in addition to likely taking Medicaid into Medicare and relieving the states of this burden fully)?  Going for children appeals to many people's emotions as well as constitutes the classic age-based \"pincer\" strategy.  (Incrementalism at its utmost eventually provides for everyone but the taxpaying middle class, which then will demand they enjoy the benefits as well and consequently, demand the universality the lefties are often too ambitious, impatient, or premature to attain fully from the start of their efforts.)<br><br>But that (again) is too smart and not childishly impatient or emotive enough for most of the activists.<br><br>* * *<br><br>\"I am just saying we should take care to acknowledge the trade-offs and other issues that will affect any reformed system.\"<br><br>Aside from trying to show time after time that the current state of federal entitlement programs is set to fail, I've also tried time after time [sigh] to make it clear to people (who can't see or don't wish to, in case it conflicts with their unrealistic dreams) that if we went from private to public we'd exchange one set of problems for another.  There will still be an intermediary who will be interfering with decision-making, too.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_18:01:52", "killed": false, "user_key": "DLS", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11577109": {"up_voted": false, "ip": "", "has_replies": false, "message": "GreenDreams,<br><br>I do not agree with your assumption that criticism of another person's argument constitutes disrespect.  If you want to see real personal disrespect, scroll up to read what SteveK wrote about me and about which you had no complaint.  I haven't written anything even remotely similar to that, even when I was lambasting Kathy's original post on health care.<br><br>I also do not agree that single-payer systems can be assumed to be cost-savers.  As I have pointed out before, the cost savings enjoyed by many single-payer systems now come about at least in part because the for-profit system in the U.S. is provided an unintended subsidy and because the governments implementing those systems impose rationing and other controls that may not be acceptable to American consumers.  So we can't just jump to the conclusion that single-payer implementation in the U.S. would lead to the same cost savings.  We have to look more closely and evaluate other alternatives, like Kent Conrad's proposal for health insurance co-ops modeled on co-ops for other critical commodities and services.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_15:32:51", "killed": false, "user_key": "JasonArvak", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11582743": {"up_voted": false, "ip": "", "has_replies": false, "message": "I would agree that mammograms and all other preventative screening tests should be covered for everyone that does not have private insurance by a government health care plan.<br><br>I would say, however, that there are many different ways to implement such a provision, ranging from full-on single-payer health care, to regional co-ops, to vouchers for the purchase of private coverage.<br><br>Debating the differences and possible permutations among such a range of choices won't meet the \"NOW!\" demand nor would the outcome be emotionally satisfying to purists and those motivated only by beating the other side.  But it would result in a much better system for everyone.<br><br>I can see why you of all people would be against that, Kathy.  Without an ideological enemy to hate, life to you just doesn't seem worth living.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_18:34:53", "killed": false, "user_key": "JasonArvak", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11697956": {"up_voted": false, "ip": "", "has_replies": false, "message": "<blockquote>Jason, your demonizing of \"the left\", which from your blog, appears to be your style, is ironic, especially as you seem fond of demonizing lefties for demonizing righties. We actually could have a rational discussion, but we're so polarized that it always seems to degenerate into something like this. Too bad.</blockquote><br><br>GreenDreams, I do criticize lefties strongly but I don't think I demonize them. (I think the difference lies in not making direct attacks against their character even if I do criticize their behavior.  As can be seen above as well as broadly throughout this site and throughout the left-leaning blogosphere, direct character attacks BY leftists AGAINST non-leftists are pretty much a routine and acceptable response to any disagreement.  But any criticism, no matter how mild, BY non-leftists AGAINST leftists is considered intolerable.  Also, the fact that you had no complaint about the most vicious personal assault on this entire thread undermines your legitimacy here.) <br><br> And I would love to have a rational debate among alternatives and moving towards a compromise on health care.  But as long as people like Kathy keep inserting into the debate their presumption that anyone who disagrees with them or even doubts their purist demands for a second is not only wrong but a <em>bad person</em>, I don't think that is likely.  Asking conservatives and moderates to compete on a rhetorical playing field that is intentionally and dramatically rigged against them is unreasonable.<br><br>Unfortunately, people like Kathy have no reason to alter their openly vicious rhetoric as long as their fellow liberals and leftists remain silent about it while at the same time criticizing the other side any time it puts so much as a rhetorical toe out of line.  As long as their preferred audience continues to support their rigging the game, they will eagerly continue to rig it and, apparently, believe themselves to be laudable for doing so.<br><br>But please don't ask me to smile and love it.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-24_16:19:31", "killed": false, "user_key": "JasonArvak", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11635088": {"up_voted": false, "ip": "", "has_replies": false, "message": "\"care for our citizens\"<br><br>Note the correct meaning of that word \"care\" here means specifically, \"provide medical care,\" not anything more general or broad and subject to being a rationale for all kinds of entitlements as well as a way of satisfying feelings or cravings some might have.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-23_13:49:06", "killed": false, "user_key": "DLS", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11576628": {"up_voted": false, "ip": "", "has_replies": false, "message": "starleys,<br><br>Again, I would remind you that the economics of innovation work differently with regards to pharmaceuticals versus medical technology like scanners and other advanced testing equipment.  Also, infrastructure investment is a different issue from innovation.  But I can agree that it would be possible to design the system in such a way as to maintain incentives.  Doing so will require that purists stop their headlong rush long enough to actually pay attention to the issue, however.  And so far, even on this thread, the number willing to make even that tiny concession appears very, very small.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_15:18:48", "killed": false, "user_key": "JasonArvak", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11564346": {"up_voted": false, "ip": "", "has_replies": true, "message": "<i>Thus, the question of whether it is a \"human right\" is really semantic. The issue is how best to implement a functional and efficient system that fixes the problems in the status quo while avoiding the flaws in other systems.</i><br><br>Okay, but the point is that whether one views access to health care as a human right or a commodity to be bought and sold for profit affects how one views the solutions as well. If the goal is to make a profit, that precludes a public option. If the goal is to deliver quality, affordable health care to every American citizen, a public <b>option</b> is essential, and a fully nationalized, universal, publicly funded system is optimal.<br><br>My brother has lived in Canada for over 30 years, and although he acknowledges the problems with the Canadian health care system, he still prefers it to the American profit-motivated model. If he has an emergency in the middle of the night, for example, he knows he can go to his local hospital in Winnipeg, be treated, and not have to worry about being billed. Yes, he may have to wait, but he <b>will</b> get the health care services he needs without mortgaging his entire financial future. <br><br>By contrast, when I slipped on ice this past winter while walking my dog and injured one of my knees so badly that the next day I could not walk or stand up, I went to a local ER and was given excellent care.... and then, about a week later, I received about half a dozen separate invoices for the services I had used, adding up in total to over $3,000. I can't pay that. And by the way, I had to wait for quite a long time in the ER waiting room, too, before I was seen. <b>And</b> I was billed for thousands of dollars that I have no way of paying.<br><br>Moreover, Canada's health care system is not the only nationalized, universal health care system in the world, as you obviously know. Opponents of universal health care in the U.S. always point to Canada because it has problems, but they never point to France, or Germany, or the Scandinavian countries, where single-payer works very well. Even in England, which is also sneered at by opponents of single-payer, if you or I, as Americans, go to England on vacation or business and fall sick or have a medical emergency, we can walk into any hospital, wherever in England we are, and be treated <b>at no cost.</b> A British citizen visiting the U.S. cannot do that.<br><br>One more anecdote from my brother: A few years ago, he and his partner were in Europe, and Meaghan developed a serious urinary tract infection while in The Netherlands. That may not sound very dire, but UTIs can go from zero to 360 in a very short period of time, and when they do, they are excruciatingly painful and can have major health consequences if not treated promptly. That's what happened to Meaghan. It was at night, and within a matter of minutes it was a full-blown emergency. Dave told me that from the time they knew they had to get to a doctor, fast, and the time they were walking out of the doctor's office with Meaghan having been treated, feeling much better, and with the medication she needed in hand, about two and a half hours passed. The medication cost the equivalent of about $10, but that was because as non-citizens they were not actually enrolled in the health care system. That was the only expense associated with the medical care Meaghan received.<br><br>Try making that happen in the United States if you are not wealthy or upper-middle-class. I dare you.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_12:43:25", "killed": false, "user_key": "kathykattenburg", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 1, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11582781": {"up_voted": false, "ip": "", "has_replies": false, "message": "Kathy: \"I don't have the $200 to spend on a mammogram, though. So finding out from a database that it's recommended at my age (which I didn't need a database to tell me, anyway) doesn't help me. \"<br><br>Ah, but it does.  We should help people get health care by simply sending them a check.  That's a much better way for government to be involved.  And then if, based on the database, you decide to play the odds, you've got an extra $200 to spend on liquor and gigolos.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_18:36:22", "killed": false, "user_key": "Dr_J", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": 11582319, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11565387": {"up_voted": false, "ip": "", "has_replies": false, "message": "Why are we too stupid to do public health care?  I've lived in a couple of different European countries that do it very well.  I have received great health care in those countries.  Why are they so much better at it than us?  <br><br>If we can provide health care in the same way we provide for national defense, I believe we can have one of the best public health care systems in the world.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_13:15:05", "killed": false, "user_key": "shannonlee", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 1, "author_is_creator": false, "is_realtime": false}, "11635020": {"up_voted": false, "ip": "", "has_replies": false, "message": "\"As to the points about 'rights,' I have avoided using that term, though others did. Rather, it's a public policy decision about whether or not we will care for our citizens.\"<br><br>Absolutely.  There is no \"right\" [sic] to this (nor to so many other things that in practice are claims on others' time, labor, and money).  It is merely a decision to create an entitlement, that word being fully sound not only legally but conceptually.<br><br>A significant fraction strongly want public health care, and plenty among the many who are wary of too much government and loss of freedom (and privacy, etc.) would still look to it as a default alternative if everything else seems worse or intolerable eventually.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-23_13:47:25", "killed": false, "user_key": "DLS", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11578189": {"up_voted": false, "ip": "", "has_replies": false, "message": "I said it <em>could become</em> an \"under-performing bureaucratic nightmare\" if we failed to pay attention to flaws as well as virtues.  For example, if we fail to account for disincentives to equipment investments, what is a problem for a few hundred patients in Canada could wind up being a problem for many thousands in the United States.  The size and complexity of our society means that errors could be compounded in their impact.<br><br>My goal is to try to slow people down enough to get a good reform program that addresses all the issues as much as is possible, not to block all reform.  I think those who respond to me with the assumption that I am just reading from an anti-reform script keep running off the rails with their responses.  Having personally and intensely experienced both the virtues AND the flaws of our current health care system over the past year, I find myself outside the prepared scripts of both left and right on this issue.  And I am frustrated by the unwillingness of both left and right (with only a couple exceptions among the commenters, pretty much only the left is well represented on this site) to break out of their scripts.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_16:08:59", "killed": false, "user_key": "JasonArvak", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11565903": {"up_voted": false, "ip": "", "has_replies": false, "message": "<blockquote>Okay, but the point is that whether one views access to health care as a human right or a commodity to be bought and sold for profit affects how one views the solutions as well. If the goal is to make a profit, that precludes a public option. If the goal is to deliver quality, affordable health care to every American citizen, a public option is essential, and a fully nationalized, universal, publicly funded system is optimal.</blockquote><br><br>I disagree, not because I want to see \"profit\" being made, but because a \"fully nationalized, universal, publicly funded system\" has not always shown itself able to actually provide what it promises.  Instead, rationing combined with under-investment in equipment has often served to make the system into an underperforming bureaucratic nightmare that denies effective treatments to many people who need it.<br><br>I'm prepared to consider a public option in a competitive system provided that competition is actually maintained.  Competition could serve to prevent the growth of bureaucratic dysfunction that happens in a single-payer system as well as maintaining incentives for investment in research and equipment.   If, however, the public \"option\" really becomes a \"mandate\" through the manipulation of government coercion that drives real competition out, those advantages would be lost and we would wind up with another false-promise of universal coverage.<br><br><blockquote>Okay, but the point is that whether one views access to health care as a human right or a commodity to be bought and sold for profit affects how one views the solutions as well. If the goal is to make a profit, that precludes a public option. If the goal is to deliver quality, affordable health care to every American citizen, a public option is essential, and a fully nationalized, universal, publicly funded system is optimal.</blockquote><br><br>That sounds fine when the \"wait\" is a few hours in a well-triaged emergency room, but when the \"wait\" is months for an MRI scan or a radiation treatment program that prevents metastasis for cancer (which is the area of my recent experience with the health care system), it is much more serious and consequential and potentially life-threatening.  The satisfaction of those using a routine-care system is of little comfort to those with life-threatening conditions for whom \"a little wait\" is potentially the entire ball game.<br><br>I am thankful that the \"profit-based\" system that we have ensured rapid access for my wife that saved her life.  I am resistant, I think understandably, to proposals that might sacrifice that in order to chase the vision of universal primary care.  I'd prefer to slow down a bit and see if we can't find a way to get both.  I do, however, understand the nightmare of billing and fighting with insurance companies.  But I don't want to throw the baby out with the bathwater by being hasty and inattentive to the problems and trade-offs that we know exist in public health care options.  (My most recent post on PG deals with the public health care system that has existed in the U.S. for decades: military health care.)<br><br><blockquote>Moreover, Canada's health care system is not the only nationalized, universal health care system in the world, as you obviously know. Opponents of universal health care in the U.S. always point to Canada because it has problems, but they never point to France, or Germany, or the Scandinavian countries, where single-payer works very well. Even in England, which is also sneered at by opponents of single-payer, if you or I, as Americans, go to England on vacation or business and fall sick or have a medical emergency, we can walk into any hospital, wherever in England we are, and be treated at no cost. A British citizen visiting the U.S. cannot do that.</blockquote><br><br>I concede the virtues of those systems, but I ask you to concede the concerns as well.  Access is a virtue, particularly with regards to emergency care.  But all the systems you mention struggle with the same problems of lack of availability for time-sensitive tests and treatment programs like MRI, radiation, and chemotherapy.  I'm not suggesting that we adopt the infantile \"anything Europe does sucks\" attitude of the far right, but I also think we shouldn't romanticize those systems by pretending they are problem-free.  Paying close attention to their problems might help us design a system that mitigates some of them.<br><br>P.S.  I also know about treatment for UTIs and can testify from first-hand experience that rapid and effective treatment was also available for that condition in the United States -- Minnesota specifically.  Once again, I remind you that I am not ignorant of the virtues of other health care systems and I am not opposed to trying to model what does work in those cases.  But I am opposed to blindly embracing them without first trying to acknowledge their flaws and find ways to mitigate them wherever possible.  Perhaps if you could take a minute to acknowledge that I am not, in fact, an apologist for the status quo, we could find more productive common ground in discussing BOTH pluses and minuses.<br><br>Finally, I state from first-hand experience that you are flatly wrong that \"we have no where to go but up\".  The U.S. system is not completely deficient in all categories.  Exaggerating the problem to make the picture appear completely bad may be politically effective, but I don't think it is a good foundation from which to design reform.  Good reform takes note of what pieces work well as well as what pieces work badly.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_13:29:00", "killed": false, "user_key": "JasonArvak", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": 11564346, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11570744": {"up_voted": false, "ip": "", "has_replies": false, "message": "<b>an underperforming bureaucratic nightmare that denies effective treatments to many people who need it.</b><br><br>Jason,<br>That describes our health care system very well. <br><br>Our health care outcomes, on the whole, are not any better, and often times worse than in countries with universal coverage. What we pay, however, is nearly double what some of these other countries pay.<br><br>So again... we pay more and don't get better outcomes. There are fringe cases for rare and difficult to treat diseases where our system performs admirably. But I'm not sure how that can possibly outweigh the concerns of the millions who are uninsured and the millions more who are under insured.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_14:10:02", "killed": false, "user_key": "ChrisWWW", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "12715325": {"up_voted": false, "ip": "", "has_replies": false, "message": "Personally I would have preferred the Insurance Companies, Hospitals, Drug companies would have been willing to make health care affordable rather spend 1 trllion dollars we don't have. But guess what folks it's this thing called greed! So now we have to look at another alternative. If the private sector rather risk going under becuase of pending profit margins than so be it!  I guess that means some CEO will not be able to purchase his yacht!", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-07-15_17:32:13", "killed": false, "user_key": "charity01", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11557725": {"up_voted": false, "ip": "", "has_replies": false, "message": "Since the poll was taken while intentionally hiding its price tag, I'm neither surprised by its results nor convinced of its accuracy. Let's run a NYT poll on this statement and see what the results are........<br><br>According to our preliminary assessment, enacting the proposal would result in a net increase in federal budget deficits of about $1.0 trillion over the 2010-2019 period. When fully implemented, about 39 million individuals would obtain coverage through the new insurance exchanges. At the same time, the number of people who had coverage through an employer would decline by about 15 million (or roughly 10 percent), and coverage from other sources would fall by about 8 million, so the net decrease in the number of people uninsured would be about 16 million or 17 million.<br><br>Add that to the budget deficit already incurred for the non-stimulus package and let's see how the voters vote in 2010.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_10:19:53", "killed": false, "user_key": "casualobserver", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11578206": {"up_voted": false, "ip": "", "has_replies": false, "message": "<i>duplicate deleted</i>", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_16:09:34", "killed": false, "user_key": "JasonArvak", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11581793": {"up_voted": false, "ip": "", "has_replies": false, "message": "Kathy there's no reason we shouldn't have a big, publicly accessible database of medical outcomes, just like we do for census results.  Put in your age and other relevant information, and it will tell you the average outcomes of everyone who did or didn't do X or Y.  At your age it will probably tell you a mammogram is a good idea, without you having spent $200 and two hours on a consult.<br><br>But if your point is that mammograms cost too much, we're on the same page.  The cure for that is competition.<br><br>PhD.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_18:04:59", "killed": false, "user_key": "Dr_J", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": 11581328, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11578724": {"up_voted": false, "ip": "", "has_replies": true, "message": "Actually, MSAs sound really good until you see your first bill for an MRI.  That alone would eat an entire MSA.  After seeing the billed price of cancer treatments (which is, of course, completely and totally unrelated to the amount actually paid by insurance companies or the government), I lost all interest in MSAs as a realistic response to health care problems.  Basically, providers use any money coming from individuals as a \"cash cow\" from which to extract the maximum possible and make up for losses incurred by the artificial price controls forced on them by the government and insurers.<br><br>We really don't have any idea how much health care services would cost because it is not possible to account for the interactive effects of cross-billing, false \"discounts\", concealed surcharges, etc.  Part of any comprehensive design of a health care system has to be a system of accounting rules so we even know what we are talking about.  And that is one area where Medicare is part of the problem, not the solution to the problem.<br><br>BTW, the issue of \"personal choice\" is a bit of a red herring.  Other than primary care physician, you don't have any real choice in health care providers, as the referral system walks you step by step.  And when it is a critical issue, availability is much more determinate than choice.  We were lucky to get one of the best oncologists around, but not because we were able to do any investigation and choice.  It just happened that he was the one with an opening.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_16:25:34", "killed": false, "user_key": "JasonArvak", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 1, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11576685": {"up_voted": false, "ip": "", "has_replies": false, "message": "jwest, please feel free to also join the discussion on Poligazette.  <br><br><a href=\"http://www.poligazette.com/2009/06/22/lets-have-a-real-health-care-debate/\" rel=\"nofollow\">http://www.poligazette.com/2009/06/22/lets-have...</a>", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_15:20:27", "killed": false, "user_key": "JasonArvak", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11582319": {"up_voted": false, "ip": "", "has_replies": true, "message": "<i>At your age it will probably tell you a mammogram is a good idea, without you having spent $200 and two hours on a consult.</i><br><br>I don't have the $200 to spend on a mammogram, though. So finding out from a database that it's recommended at my age (which I didn't need a database to tell me, anyway) doesn't help me. <br><br>I do get $200 a month in food stamps, though. So if I can find someone who will agree to let me buy their groceries with my Families First card and pay me back in cash, I can get a mammogram. Of course, I won't eat until the next month,but that's all part of the dignity of choices.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_18:21:45", "killed": false, "user_key": "kathykattenburg", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 1, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 2, "author_is_creator": false, "is_realtime": false}, "11600254": {"up_voted": false, "ip": "", "has_replies": true, "message": "Jason, your demonizing of \"the left\", which from your blog, appears to be your style, is ironic, especially as you seem fond of demonizing lefties for demonizing righties. We actually could have a rational discussion, but we're so polarized that it always seems to degenerate into something like this. Too bad.<br><br>Nicera, I brought up Krugman and did not ever imply he is \"beyond reproach\". So many straw men here. I also mentioned a couple doctors, the WHO, and glad to cite others if you want. My point is independent of your opinion of Krugman. It is that experts in relevant fields think nonprofit health care is a sensible and timely idea, most of the public wants it (convenient dismissals of the NYT poll are irrelevant. Other polls show the same thing), and most doctors want it (again, according to multiple polls.)<br><br>To the concept of competition, in terms of patients negotiating down costs or going elsewhere, I'm surprised anyone thinks that would work. Patients are not really in a position to negotiate with doctors or hospitals, even if they didn't need care urgently. Additionally, that idea that we could chisel down costs with savvy patients holding the purse strings, is in stark contrast to the assertion that doctors won't accept lower payment e.g. from Medicare (though 97% of docs do take new Medicare patients). Then we have the idea of using less expensive care givers, further reducing the income of doctors. Also kinda reminds me of the cynical 70s era joke, \"cut your employee expense by a third. Hire women.\" <br><br>We also have the assertion that a single payer (or public option) system might not save anything (\"we can't assume the savings\") but yet doctors are shifting costs to insured patients because Medicare doesn't pay enough. (BTW, Medicare pays about 19% less. Think we could negotiate any lower than that?) <br><br>In my own experience it isn't true that docs can shift costs, thus \"subsidizing\" the Medicare patients, but I'm open to evidence. My doctor takes Medicare patients (ahem. I'm not one of them). A close friend who's a physician doesn't. My own doctor is not allowed by insurance companies to charge more than the doc who has no Medicare patients. I frankly don't believe hospitals are allowed to either, but please enlighten me with something credible if so.<br><br>As to the points about \"rights,\" I have avoided using that term, though others did. Rather, it's a public policy decision about whether or not we will care for our citizens. That's hardly a new or progressive idea. It's strictly caveman. The health of every tribe member was considered essential to the success of the tribe. That concept of taking care of our own *for our own good* is as ancient as we are. Perhaps with some military background people could understand the idea of not leaving someone behind, even if it costs us, inconveniences us, or even presents a mortal risk to us.<br><br>Don't get all touchy Jason. These comments are general and not from some script or aimed at you. Sheesh.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-23_00:14:37", "killed": false, "user_key": "GreenDreams", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 1, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 1, "author_is_creator": false, "is_realtime": false}, "11565291": {"up_voted": false, "ip": "", "has_replies": false, "message": "Fraudulent poll.  The CBS/NYT poll was exposed over the weekend for having a dramatically left-leaning sampling, and there fore cannot be trusted... much like one cannot trust the NYT or CBS.<br>172 million Americans have health insurance, and 70% of those rate it as good to excellent.  It's very hard to swallow that all those people are going to \"vote\" to destroy what they have.<br>As for reform: getting the government out of medical care is a good start.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_13:11:36", "killed": false, "user_key": "GerSan", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11571588": {"up_voted": false, "ip": "", "has_replies": true, "message": "Dr J.  This link gives per capita costs for healthcare.  Even though the longevity issue is relatively equal, the costs are almost double.  <a href=\"http://www.infoplease.com/ipa/A0934556.html\" rel=\"nofollow\">http://www.infoplease.com/ipa/A0934556.html</a>", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_14:19:20", "killed": false, "user_key": "starleys", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 1, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11639176": {"up_voted": false, "ip": "", "has_replies": false, "message": "Good comments, DLS. When the fight is over, regardless of what happens, we still have to deal with the major reason for cost increases. We have a high cost burden for end of life procedures that place a major part of an individual's lifelong medical care cost in the last few months of life, plus we have only a few % of individuals who incur especially high costs. Clearly we will need to set some limits, and that will be harder and more contentious even than who pays, which is the focus of the current fight.<br><br>As for prevention, through lifestyle or other incentives, we could do much there. I think most are not aware of how poorly we do in this area. In the US, we have only 4 preventive medicines available over the counter: fluoride toothpaste, sunscreen, seasickness prevention and aspirin. There is actually a 5th, formerly ulcer medicines, now approved for \"indigestion prevention.\" When we talk about \"preventive medicine\" we usually mean early disease detection (mammograms, prostate check, cholesterol testing). The realm of preventive medicines is relatively unexplored, except in the dietary supplement world.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-23_15:29:15", "killed": false, "user_key": "GreenDreams", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11564939": {"up_voted": false, "ip": "", "has_replies": false, "message": "Starley, our system definitely needs reform, but I simply don't believe the numbers you laid out.  I don't believe the \"better results for half the costs\" statistics, which are disputed in a number of different directions.  Our cancer survival rates are better than Europe's.  We don't have the queues-as-a-way-of-life that are routine other places.  Many statistics around death rates tend to be collected differently in different countries, and it's difficult to compare apples to apples.  <br><br>Most importantly, I haven't seen any data to suggest that more socialized countries have licked the problem of costs going up 5% every year.  What I've read suggests the opposite, that they can contain them for a few years only at the expense of giving people less care than they want, and the cost creep continues.  There are a bunch of ways we can help the uninsured, and we must.  But this problem looks harder to solve and more deadly over the long run.  It's what keeps me up at night.<br><br>A few other areas of factual dispute:<br><br>1.  What we have is a private system.  It's not, it's part private, part public, and heavily shaped by rules the government has set up.  If you want to compare a socialized system against a free market one, ours cannot serve as an example of the latter.<br><br>2. A single-payer system would take the profit out of the equation.  Not at all, it would just take it out of insurance companies, and they're only 20% of the industry.  Doctors and hospitals would still be making profits on the quantity rather than the quality of treatments they provide.<br><br>3. Medicare for all would be cheaper than what we're currently spending.  Medicare is the Bernard Madoff of health care funding, producing very pleasing results provided you don't look at the liabilities it's accruing.  It's cheaper only because the government is deferring the bills for our children and grandchildren to pay.  This is not a recipe for a responsible, sustainable system.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_13:01:37", "killed": false, "user_key": "Dr_J", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": 11559480, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11596686": {"up_voted": false, "ip": "", "has_replies": false, "message": "Wow.  It's been a couple of years before we've had a comment thread this long.  Sadly, I think I stopped reading after comment #30.  As much as these heated exchanges amuse me, I thought I would offer a few words of caution.<br><br>1) Let's not confuse \"positive\" freedoms with \"negative\" freedoms.  \"Negative\" freedoms are based on the classic liberal interpretation of \"rights\"--that is--the freedom to not have others coercing you into doing something or forcibly preventing you from doing something.  \"Positive\" freedoms are a much newer concept and based upon the rather progressive notion that some things are so important, that people are entitled to these things, even if it comes at the expense of someone else.<br><br>When someone argues that \"healthcare is a human right\" it's important to get past the feel good rhetoric and decipher exactly what that person is implying.  To the extend that everyone has to right to health care without someone else forcibly preventing them from obtaining it--that's an example of \"negative freedom\", and I doubt that anyone would argue against this right.  But to the extent that everyone is entitled to health care, even if it means forcing others to pay for that person's health care--that's an example of \"positive freedom\", and that is a far more debatable point.<br><br>Personally, I don't think it's intellectually consistent that call something a \"right\" or a \"freedom\" when it calls for violating someone else's rights.<br><br>2) On Krugman being a Nobel Prize Winning Economist and therefore beyond reproach.  I'm not going to question Krugman's intelligence or knowledge of economics, but Krugman is not by any stretch of the imagination a balanced source on economics.  As others as pointed out above, Krugman is extremely left wing when it comes to fiscal/economic issues, and by that, I mean he unapologetically supports Keynesian economic theory as well more expansive government in the economic arena.<br><br>3) Good intentions do not necessarily make for good political policies, and even those programs proposed by those individuals with the most sincere of intentions end up having negative unforeseen consequences.  Government programs rarely cost what politicians say they will--they always end up costing more.  So before you start criticizing those for who oppose univesal health care/single-payer health insurance/public health care or any other flavor of government involvement in the health insurance arena, I suggest you come up with a way to pay for it.<br><br>4) Arguing that public health care will \"compete\" with private health care is not the most accurate way of painting this new proposal.  Public health insurance--by its very nature of being controlled by the government--will have overwhelming advantages over private insurance companies such that private insurers will never be able to truly \"compete\" with it.  For one thing, since the government is not concerned with making a profit (as evidenced by our nation's mounting debt), it can mandate price controls for public health care and set prices as low as it wishes.  Private insurers, on the other hand, have to make a profit in order to stay in business and therefore cannot set prices below a set amount.  Under such a situation, no private insurer would be able to compete with public insurance on a level playing field.<br><br>5) Before we go name calling bloggers at other blogs whom we don't agree with, I suggest we have a firm footing from which to do so.  Don't get me wrong, there are jerks, liars, and partisan hacks out their in the blogosphere that ought to be called out.  But before we start calling people \"intellectual midgets\" I suggest we ask ourselves whether our comment passes one simple test test--that is, i.e. is this negative characterization of another blogger so important that it's worth risking the reputation of TMV?", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_21:49:45", "killed": false, "user_key": "nicrivera", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11581328": {"up_voted": false, "ip": "", "has_replies": true, "message": "<i>This problem has largely been solved in every other industry, by simply freeing consumers to make decisions about where money gets spent, and where necessary standardizing disclosures so they have the info they need to make them.</i><br><br>Do you know where I could find the necessary standardizing disclosures to free me to make a decision about whether I should spend my money paying my rent or getting a mammogram? <br><br>Are you a real doctor?", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_17:49:42", "killed": false, "user_key": "kathykattenburg", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 1, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 1, "author_is_creator": false, "is_realtime": false}, "11572631": {"up_voted": false, "ip": "", "has_replies": true, "message": "Those statistics are really hard to come by because ideology twists all the available study.  I believe it likely that in pharmaceuticals, the government funds a huge part of the truly innovative research (variations on Viagra don't count) especially after 9/11.  But in the area of medical technology and particularly in the investment in equipment, the government does not play a large role and that is a facet that we really need to examine carefully before throwing away too much of our current system.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_14:35:08", "killed": false, "user_key": "JasonArvak", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 1, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11634587": {"up_voted": false, "ip": "", "has_replies": false, "message": "\"experts in relevant fields think nonprofit health care is a sensible and timely idea\"<br><br>Many in academia (\"experts\") are more liberal than the public and form a liberal community; I would look at doctors, and others who are actual _providers_.<br><br>Many of the providers are ready to go to public health care, to simplify and ease paperwork as contrasted with what they face with the insurance companies.<br><br>They also want the lawsuit-abuse problem corrected, but I doubt a Dem administration will correct this.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-23_13:38:18", "killed": false, "user_key": "DLS", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11552157": {"up_voted": false, "ip": "", "has_replies": false, "message": "Excellent post Kathy. <br><br>It's refreshing to see someone able to counter the childish rants of the intellectual midget / hack JasonArvak. His claim of your having a \"no-discussion-tolerated\" attitude is a joke... particularly since his primary tool in any debate he's losing is to ban the individual that disagrees with him. The man is a coward and a fool.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_08:16:10", "killed": false, "user_key": "SteveK", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11574181": {"up_voted": false, "ip": "", "has_replies": false, "message": "The MRI is an example of a type of issue (medical equipment availability), it is not in and of itself the entire issue. (I was stunned to learn how many different types of scanners there are, and that is just one small area of medical technology.)  I know it to be a serious problem in the Canadian system (the best analogue in terms of geographic infrastructure challenges that would face a U.S. single-payer system) and it would have to be addressed in any decent reform package rather than, as you do, simply blown off as ideologically inconvenient.<br><br>And as I have REPEATEDLY said, I do not support the current system.  Geez.  How many times do I have to repeat it before you will stop reading off your script?", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_14:46:12", "killed": false, "user_key": "JasonArvak", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11576750": {"up_voted": false, "ip": "", "has_replies": false, "message": "Ok, Jason, I'll start by extending a bit of the respect you are unable to show me. I respect your willingness to come over here to TMV to add to our discussion, which has been going on for months now. Perhaps you believe all my points are directed at you, but that's not the case. This post begins with quotes from you blasting single-payer proponents like Kathy. You point out shortcomings of the proposed alternative; I point out shortcomings of the current system. Both are important in balancing \"trade offs.\" <br><br>We have commenters here who take the position that no one should pay for anyone else's health care. I for one do not mind that I have supported your health care for the 15 years you were in the service, nor do I object to contributing to a system that deals with our health care crisis in what I consider to be a pragmatic, cost-effective way. I do not consider a single-payer system to be a panacea, but we need to achieve savings, and the most wasteful costs, in my opinion, are the excessive costs of private insurance, its damage to small businesses including my own, and its propensity to deny payment and exclude those who need it the most.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_15:22:33", "killed": false, "user_key": "GreenDreams", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 1, "author_is_creator": false, "is_realtime": false}, "11601339": {"up_voted": false, "ip": "", "has_replies": false, "message": "\"Patients are not really in a position to negotiate with doctors or hospitals, even if they didn't need care urgently.\"<br><br>Consumers are in no better a position to negotiate with grocery stores or oil companies or airlines.  But grocery stores compete aggressively on price and quality.  Oil is a competitive, efficient commodity.  You don't even have to talk to an airline to shop for the best flights and prices, just go to a search engine that lets you choose.  A far cry from anything available to us for health care.<br><br>Haggling is actually the sign of a market inefficiency.  If people don't have good information about what the real market clearing price is, they test each other to try to find one.  Doing it can be expensive, too--for example a strike may go on for weeks as both sides try to figure out where the real bottom line is, during which both labor and management are losing a lot of money.  Provide a stable, transparent market, though, and no one has to bother.<br><br>And there's no paradox in the notion that competition could force prices down when price caps don't.  Shifting costs onto someone who won't notice is much easier than finding more efficient ways to work.  No one will do the second until they've exhausted the first.  But the elasticity is there if they work at it.  Lord knows prices have had no trouble stretching upwards.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-23_00:47:33", "killed": false, "user_key": "Dr_J", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": 11600254, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11597245": {"up_voted": false, "ip": "", "has_replies": false, "message": "Just to correct the record and protect the innocent, I will point out that the only person who threw around the direct personal attacks like \"intellectual midget\" in no way is an indication of TMV's reputation.  He is not a TMV contributor or administrator.  And TMV's actual administrators were very helpful in addressing this problem.  I have no complaints about TMV's reaction to this situation and I think it would be very unfair to taint them with the over-the-top statements of a mere commenter.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_22:08:26", "killed": false, "user_key": "JasonArvak", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11554762": {"up_voted": false, "ip": "", "has_replies": false, "message": "Lit3: \"Why this issue more than any other?\"<br><br>Because the economics of health care are different.  Welfare pays the few at the bottom by taxing those at the top, and everyone comes a bit closer to average.  <br><br>Health care is different because the *average* is too high, so bringing everyone closer to it doesn't help.  *Everyone* is paying too much.  It doesn't matter how aggressively you tax your neighbor to pay your doctor bills, they'll be taxing you back just as hard to pay theirs.  Redistributing costs until everyone's bills are below average works only in Lake Woebegone.<br><br>The only way to make progress against that average is by improving cost efficiency.  We need to shrink the role of these so-called insurance companies (private or public) that act as big gatekeepers to our medical care and are not accountable for value for money.  Consumers need to take control back.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_09:29:17", "killed": false, "user_key": "Dr_J", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": 11547181, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11579639": {"up_voted": false, "ip": "", "has_replies": true, "message": "<i>Instead, rationing combined with under-investment in equipment has often served to make the system into an underperforming bureaucratic nightmare that denies effective treatments to many people who need it.</i><br><br>Which is an excellent description of the system we have now in the U.S. for everyone who lacks health insurance and does not have the discretionary income to pay for health care out of pocket.<br><br><i>I'm prepared to consider a public option in a competitive system provided that competition is actually maintained.</i><br><br>Which means, in practice, a continuation of exclusionary coverage practices. \"Competition\" in this context does not mean that private insurers will be increasing coverage and access to meet the high standard of care provided by a public option. It means that the public option will be lowering its own standard of care so as not to be more attractive to consumers than what they can get from the private insurers. \"Competition\" in practice means that doctors will choose higher paying private practice over treating patients in a public option, unless the government agrees to pay the same amount those doctors can get in private practice.<br><br><i>I am thankful that the \"profit-based\" system that we have ensured rapid access for my wife that saved her life.</i><br><br>Of course you are, and it's entirely understandable that you would be. But would your wife have had that rapid access if she or you did not have health insurance and/or the ability to pay on your own? Would you be as thankful if your wife or your sister or daughter were one of those cancer patients who couldn't get treatment because the charity care clinic closed?<br><br><i>I also know about treatment for UTIs and can testify from first-hand experience that rapid and effective treatment was also available for that condition in the United States -- Minnesota specifically.</i><br><br>Yes, yes, yes! if you have the money or the insurance!<br><br><i>Perhaps if you could take a minute to acknowledge that I am not, in fact, an apologist for the status quo, we could find more productive common ground in discussing BOTH pluses and minuses.</i><br><br>I haven't said or (I think) implied that you are an \"apologist\" for the status quo. But I do wonder what you mean when you say things like \"I'd prefer to slow down a bit and see if we can't find a way to get both (both universal primary care and top-flight crisis medical care for those who are insured or can afford it).\" I don't understand what you mean by \"slow down a bit.\" The problems we have with health care delivery, access, coverage, and costs in this country have been with us for all of my adult life (I will be 59 on July 4), and getting steadily worse. How much slower do you want to go, Jason?<br><br><i>And as I have REPEATEDLY said, I do not support the current system. Geez. How many times do I have to repeat it before you will stop reading off your script?</i><br><br>I guess as many times as you stop reading from your \"public health care is evil\" script.<br><br>Everything you warn against in a public health care system or option -- bureaucratic dysfunction, rationing, not enough and outdated medical equipment, waiting months or years for treatment (or not getting treatment at all) -- <b>is already happening</b> in our \"competitive,\" private, for-profit health care system. So when you keep warning aginast public health care while simultaneously saying you don't support the current system, there is something of a disconnect for the listener (at least in my case).", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_16:53:44", "killed": false, "user_key": "kathykattenburg", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 1, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11546579": {"up_voted": false, "ip": "", "has_replies": false, "message": "You sound like someone who does not believe that health care is a human right. I am someone who does believe that health care is a human right.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_01:22:25", "killed": false, "user_key": "kathykattenburg", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 5, "author_is_creator": false, "is_realtime": false}, "11580380": {"up_voted": false, "ip": "", "has_replies": false, "message": "Kathy: \"Everything you warn against in a public health care system or option -- bureaucratic dysfunction, rationing, not enough and outdated medical equipment, waiting months or years for treatment (or not getting treatment at all) -- is already happening in our \"competitive,\" private, for-profit health care system.\"<br><br>That's because we don't have a competitive private health care system, we have a bloated semi-public/semi-private system in which providers compete very little and on the wrong things.  <br><br>Starley: \"Very complicated. How do you measure results and establish rates? In this area I ask for suggestions.\"<br><br>This problem has largely been solved in every other industry, by simply freeing consumers to make decisions about where money gets spent, and where necessary standardizing disclosures so they have the info they need to make them.  This doesn't happen today, because patients are not really customers.  You can find dramatically more information to decide where to go for dinner than where to go for surgery.  How broken is that?", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_17:18:37", "killed": false, "user_key": "Dr_J", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": 11579639, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11577311": {"up_voted": false, "ip": "", "has_replies": false, "message": "starleys,<br><br>Equipment is different from pharmaceuticals because providers purchase them at different points.  Pharmaceuticals are purchased pretty much as-needed in both for-profit and non-profit systems.  Thus, matching demand is relatively easy.  Equipment, however, is purchased in for-profit systems in expectation of future demand and in non-profit systems only to meet current demand.<br><br>In a single-payer system, this plays out in ways that causes the incentives for innovation to differ as well.  Pharmaceuticals can still be developed in expectation of future demand because that demand will develop automatically and the purchase cost will be recovered in short order.  But a new piece of equipment won't appear on the government's reimbursement schedules for months or years and even then will be at a rate that will be unlikely to reimburse the much larger purchase cost until that piece of equipment has been used hundreds or thousands of times.<br><br>What that has resulted in in systems like Canada is a general reluctance of providers to invest in enw equipment at all.  Knowledge of this reluctance serves to discourage innovators from developing new equipment because they doubt whether a market for that equipment will emerge in sufficient timeframe to recoup their investment.<br><br>Now, I think there are ways to adjust to this phenomenon, but doing so requires admitting that the problem exists, something which purists seem loathe to do.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_15:38:56", "killed": false, "user_key": "JasonArvak", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11548128": {"up_voted": false, "ip": "", "has_replies": true, "message": "Goldman Sachs already payed back every dime of cash it took. <br><br>For the record I was against the bailout", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_03:04:59", "killed": false, "user_key": "EEllis", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 1, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 1, "author_is_creator": false, "is_realtime": false}, "11564001": {"up_voted": false, "ip": "", "has_replies": false, "message": "As I have repeatedly said, I am aware of the access problems in the U.S. system.  I agree that something should be done to fix the system.  I am just saying we should take care to acknowledge the trade-offs and other issues that will affect any reformed system.<br><br>For example, you say \"priority is given to most serious cases\", but it is important to note that \"priority\" is a small comfort if the total number of just the \"most serious cases\" exceeds the available supply of equipment.  For example, one defect with single-payer health systems is that they have fewer MRI machines available because there is simply no incentive to invest in equipment for FUTURE demand and government budgets are designed only to address CURRENT demand (and are often subject to budget cuts on top of that as well).  The result is that even that subset of \"serious cases\" who need MRI scans (to locate their tumors or check for metastasis) often have to wait months or even years.  <br><br>Now this is an issue that would be possible to address, perhaps by including provisions in the system to allow for providers to invest in equipment based on future demand instead of just present-day compensation rates.  But in order to address such issues, we have to first admit they exist, something which single-payer purists have thus far been loathe to do with their \"no compromise allowed\" Manichean approach.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_12:32:49", "killed": false, "user_key": "JasonArvak", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11578355": {"up_voted": false, "ip": "", "has_replies": false, "message": "I think the primary focus comes down to funding and its impact.  Mr. GreenDreams is accurate that Medicare is more cost effective than private in spite of the  fact Medicare deals with solely the highest risk health groups.  This tends to support the contention that single payer is less expensive regardless of environment.  In addition, a lot of major strides have been made in geriatric treatment originating in the competitive market.  However, Jason, you should realize by now I am not a purist.  I expect competitive contracts even in a one payer system for services and suppliers to be evaluated for both. cost and effectiveness.<br>By the way, Mr GreenDreams, I think the days of employer provided health insurance are coming to an end regardless of which way health insurance goes.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_16:13:33", "killed": false, "user_key": "starleys", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 0, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}, "11572216": {"up_voted": false, "ip": "", "has_replies": true, "message": "<blockquote>And Jason, don't forget that there will always be inovation looking to make a buck on that large money available in the industry.</blockquote><br><br>Only if we keep those elements in our system in some form.  If we follow the prescriptions of purists, we will strip out all possibility of making a buck in favor of comprehensive cost controls and bureaucratic mandates that prohibit moving outside the system.  Single-payer systems intrinsically involve this since no one exists except the single payer -- the government -- which sets the rates of compensation as low as possible, too low to leave any room for risk-taking through innovation.<br><br>As I have said (and the more script-driven commenters above insist on ignoring no matter how many times I say it), I am open to some major reforms including a public option that functions in a <em>genuinely</em> competitive system.  But I think ignoring the problems of other systems and the virtues of our own in favor of an ideology-driven approach is a serious mistake in spite of its obvious emotional satisfactions for a few.<br><br>P.S. I disparage Paul Krugman because he is intellectually dishonest in acknowledging and responding to arguments he disagrees with and because his Nobel Prize is a sham granted for ideological reasons rather than as a recognition of any genuine accomplishment.  Your attempt to appeal to his authority is a gross logical fallacy.  You would be better off actually responding to my points instead of trying to blow them off by waving Krugman at me.<br><br>The question of why we pay so much is not easily answered by simply believing a single-payer system would magically solve it all.  The fact is that the U.S. for-profit system currently functions as an unintended subsidy for other systems in a variety of areas including medical technology and pharmaceuticals.  If the U.S. moved to a single-payer model, we would not necessarily get to join in that artificial subsidy since we can't simultaneously subsidize and be subsidized.  Also, lifestyle issues and infrastructure requirements make the U.S. a complex case.  So you should not be so shallow in your thinking about potential cost-savings.", "is_last_child": false, "can_reply": false, "down_voted": false, "real_date": "2009-06-22_14:26:54", "killed": false, "user_key": "JasonArvak", "has_been_anonymized": false, "edited": false, "author_is_moderator": false, "from_request_user": false, "votable": true, "date": "5 months ago", "approved": true, "num_replies": 1, "is_first_child": false, "email": "", "parent_post_id": null, "depth": 0, "points": 0, "author_is_creator": false, "is_realtime": false}}, "integration": {"receiver_url": "http://themoderatevoice.com/disqus-blank.html", "theme": 4, "reply_position": true, "disqus_logo": false}, "timer": {"timer_url": "http://localhost:8005", "thread_id": "22540631", "user_id": "anonymous", "forum_id": "2724", "hash": 8008126346623733909}, "thread": {"total_posts": 0, "paginate": false, "per_page": 0, "slug": "poll_shows_most_americans_want_public_health_care", "num_pages": 1, "days_alive": 0, "realtime_paused": true, "id": 22540631, "num_posts": 93, "closed": true, "queued": false, "killed": false}, "reactions_limit": 10, "context": {"show_reply": false, "use_fb_connect": true, "forum_facebook_key": "8e626a1cbe92745e5f4435bb28791555", "use_yahoo": false, "subscribed": false, "use_twitter_signin": true, "use_openid": false, "realtime_speed": 5000}, "reactions_start": 0, "settings": {"debug": false, "disqus_url": "http://disqus.com", "media_url": "http://media.disqus.com"}, "media_url": "http://media.disqus.com"};
	/* */ this.jsonData.cookie_messages = {"user_created": null, "post_has_profile": null, "post_twitter": null, "post_not_approved": null}; this.jsonData.session = {"url": null, "name": null, "email": null}; /* */

	
	this.curPageId = 'dsq-comments';

	this.frames = {};
};

var disqus_popup_reference = null;

if(typeof DsqLocal == 'undefined') {
	DsqLocal = {};
}



/**
 * Dsq.Strings: UI strings
 */
Dsq.Strings = new function() {
	this.ADD_NEW_COMMENT = "Add New Comment";
	this.LOG_INTO_DISQUS = "Log into DISQUS";
	this.USE_MEDIA = "Use Media";
	this.LOGOUT = "Logout";
	this.SHARING_OPTIONS = "Sharing options";
	this.SHARE_ON = "Share on";
	this.TWEET_THIS_COMMENT = "Tweet this comment";
	this.SHARE_ON_NEWSFEED = "Share on news feed";
	this.SEND_UPDATE_TO_YAHOO = "Send update to Yahoo!";
	this.REBLOG_ON = "Reblog on";
	this.CONFIGURE_OPTIONS = "Configure options";
	this.POST_AS = "Post as";
	this.SORT_BY = "Sort by";
	this.SUBSCRIBE_BY_EMAIL = "Subscribe by email";
	this.SUBSCRIBE_BY_RSS = "Subscribe by RSS";
	this.POPULAR_NOW = "Popular now";
	this.BEST_RATING = "Best Rating";
	this.NEWEST_FIRST = "Newest first";
	this.OLDEST_FIRST = "Oldest first";
	this.HIGHLIGHTED = "Highlighted";
	this.UNSUBSCRIBE = "Unsubscribe";
	this.REQUIRED = "Required";
	this.OPTIONAL = "Optional";
	this.YOU_ARE_COMMENTING_AS_A = "You are commenting as a";
	this.LOGIN_BELOW = "Login below";
	this.PLEASE_LOGIN_BELOW_TO_COMMENT = "Please login below to comment.";
	this.SUBSCRIBE_TO_ALL_COMMENTS_BY_EMAIL = "Subscribe to all comments by email";
	this.DO_NOT_SUBSCRIBE_TO_COMMENTS = "Do not subscribe to comments";
	this.REALTIME_UPDATING_IS = "Real-time updating is";
	this.ENABLED = "enabled";
	this.PAUSED = "paused";
	this.PAUSE = "Pause";
	this.RESUME = "Resume";
	this.SHOW = "Show";
	this.JUST_NOW = "Just now";
	this.REPLY = "Reply";
	this.EDIT = "Edit";
	this.FLAG = "Flag";
	this.MODERATE = "Moderate";
	this.CANCEL = "Cancel";
	this.REPLYING_TO = "Replying to";
	this.REPORT_MISSING_REACTIONS = "Report missing reactions";
	this.POST_A_COMMENT = "Post a comment";
	this.FLAG_INAPPROPRIATE_COMMENT = "Flag inappropriate comment";
	this.FLAGGED = "Flagged";
	this.NO = "No";
	this.YES = "Yes";
	this.NEVER_MIND = "Never mind";
	this.ARE_YOU_SURE_YOU_WOULD_LIKE_TO_REPORT_THIS_COMMENT_TO_A_MODERATOR = "Are you sure you would like to report this comment to a moderator";
	this.THIS_WILL_FLAG_COMMENTS_FOR_MODERATORS_TO_TAKE_ACTION = "This will flag comments for moderators to take action";
	this.TO_RATE_PLEASE_LOG_IN = "To rate, please log in";
	this.JUST_A_MOMENT = "Just a moment...";
	this.GUEST = "Guest";
	this.NAME = "Name";
	this.EMAIL = "Email";
  this.WEBSITE = "Website";
  this.SETTINGS = "Settings";
  this.MODERATOR_OPTIONS = "Moderator options: ";
  this.MODERATE_OPTIONS = "Moderate Options";

  // Thread moderator actions
  this.CLOSE_THREAD = "Close thread";
  this.OPEN_THREAD = "Open thread";
  this.REMOVE_THREAD = "Remove thread";
  this.RESTORE_THREAD = "Restore thread";
  this.ACTIONS = "Actions";
};
// Dsq.Strings

/**
 * Dsq.FmtStrings: functions that return interpolated UI strings
 */
Dsq.FmtStrings = new function() {
	// Seems we have to use named interpolation for Django to translate. Investigate more.
	this.LOGGED_IN_AS = function(username) {
		return Dsq.Utils.interpolate('Logged in as %(username)s', {username:username});
	};

	this.LOGOUT_FROM = function(disqus) {
		return Dsq.Utils.interpolate('Logout from %(disqus)s', {disqus:disqus});
	};

	this.SHOWING_COMMENTS_FULL = function(total, num) {
		if (num === 1) {
			return Dsq.Utils.interpolate("Showing <span id='dsq-num-posts'>%(num)s</span> of <span id='dsq-total-posts'>%(total)s</span> comment", {num:num, total:total});
		} else {
			return Dsq.Utils.interpolate("Showing <span id='dsq-num-posts'>%(num)s</span> of <span id='dsq-total-posts'>%(total)s</span> comments", {num:num, total:total});
		}
	};

	this.SHOWING_COMMENTS_WITHOUT_PAGINATION = function(num) {
		if (num === 1) {
			return Dsq.Utils.interpolate("Showing <span id='dsq-num-posts'>%(num)s</span> comment", {num:num});
		} else {
			return Dsq.Utils.interpolate("Showing <span id='dsq-num-posts'>%(num)s</span> comments", {num:num});
		}
	};

	this.NUMBER_OF_COMMENTS = function(num) {
		return Dsq.Utils.interpolate(
			(num == 1
				? '%(num)s comment'
				: '%(num)s comments'
			), {num:num});
	};

	this.NUMBER_OF_LIKES = function(num) {
		return Dsq.Utils.interpolate(
			(num == 1
				? '%(num)s like'
				: '%(num)s likes'
			), {num:num});
	};

	this.NUMBER_OF_POINTS = function(num) {
		return Dsq.Utils.interpolate(
			(num == 1
				? '%(num)s point'
				: '%(num)s points'
			), {num:num});
	};
};
// Dsq.FmtStrings





Dsq.CSRF_TOKEN = 'a2d140c59df8cd4ce27a20e0829cacd8';
Dsq.COMMENTS_RE = /(<li.*?id="?dsq-comment-(\d+)"?.*?>)((?:.|\s)*?)(<\/li>)/gim;
Dsq.POST_RE = /(<div.*?id="?dsq-comment-header-(\d+)"?.*?>)((?:.|\s)*?)(<\/div>)\s*(<div.*?class="?dsq-comment-body"?.*?>)((?:.|\s)*)(<\/div>)/gim;
Dsq.POST_BODY_RE = /\s*(<div.*?id="?dsq-comment-message-(\d+)"?.*?>)((?:.|\s)*)(<\/div>)/gim;
// HACK: Safari ends with "-->" while other browsers end with "--&gt;" as expected.
Dsq.MEDIA_POST_RE = /&lt;!--\[(.*?)\]--(?:>|&gt;)/gim;



var FragmentPacket = function(reader, writer, writer_url, is_child, receiveCallback) {
	var that = this;
	this.reader = reader;
	this.writer = writer;
	this.writer_url = writer_url;

	this.is_child = is_child || false;
	this.receiveCallback = receiveCallback;

	this._lastHash = null;

	this._accumMsg = '';

	this._lastSeqno = 0;

	this.MAX_DATA_LEN	= 1024;

	this.WAIT_TIME		= 10;

	this.READY		= 0x1;
	this.WRITING	= 0x2;
	this.FIN		= 0x4;
	this.ACK		= 0x8;

};

FragmentPacket.prototype.createListener = function() {
	var that = this;
	var listener = function() {
		that.recv();
	};
	return window.setInterval(listener, 10);
};

FragmentPacket.prototype.log = function(msg) {



};

FragmentPacket.prototype.recv = function() {
	var hash;
	if (/MSIE/.test(navigator.userAgent)) {

		hash = this.reader.name;
	} else {

		var hashIndex = this.reader.location.href.indexOf('#');
		if (hashIndex == -1) {
			return;
		}
		hash = this.reader.location.href.substring(hashIndex+1);
	}
	var flags = parseInt(hash.substring(0, 4), 10);
	var seqno = parseInt(hash.substring(4, 24), 10);
	var data  = hash.substring(24);

	if (this._lastHash !== hash) {
		this._lastHash = hash;
		this.log('recv: ' + hash);

		this.log(' flags: ' + flags);
		this.log(' seqno: ' + seqno + ' len: ' + hash.substring(4, 24).length + ' (' + hash.substring(4, 24) + ')');
		this.log(' data: ' + data + ' len: ' + data.length);

		this._lastSeqno = seqno;

		if (flags & this.WRITING) {
			this._accumMsg += data;
			this.sendFlag(this.ACK, seqno);
			if (flags & this.FIN) {
				this.log('recv finished: ' + decodeURIComponent(this._accumMsg));
				this.receiveCallback(decodeURIComponent(this._accumMsg));

				this._accumMsg = '';

				this.sendFlag(this.READY | this.ACK, this._lastSeqno);
			}
		}
	}

	return {
		flags: flags,
		seqno: seqno,
		data: data
	};
};

FragmentPacket.prototype.sendRawPacket = function(packet) {
	if (/MSIE/.test(navigator.userAgent)) {
		this.writer.name = packet;
	} else {

		this.writer.location.href = this.writer_url + '#' + packet;
	}

};

FragmentPacket.prototype.sendFlag = function(flag, seqno) {
	this.sendRawPacket(this._zerofill(flag, 4) + this._zerofill(seqno, 20));
};

FragmentPacket.prototype.send = function(msg) {
	this._send(0, encodeURIComponent(msg));
};

FragmentPacket.prototype._send = function(packetNum, msg) {
	var that = this;
	var recvBuf = this.recv();

	if (packetNum === 0) {

		if (!(recvBuf.flags & this.READY)) {
			this.log('client is not ready, waiting...');
			window.setTimeout(function() { that._send(packetNum, msg); }, this.WAIT_TIME);
			return;
		}
	} else {

		if (!( (recvBuf.flags & this.ACK) && (recvBuf.seqno === this._lastSeqno) )) {
			this.log('waiting for ack from client...');
			window.setTimeout(function() { that._send(packetNum, msg); }, this.WAIT_TIME);
			return;
		} else {
			this.log('received ack: ' + this._lastSeqno + ' ' + recvBuf.seqno);
		}
	}

	var flags = this.WRITING;
	var num_packets = Math.ceil(msg.length / this.MAX_DATA_LEN);
	this.log('num_packets: ' + num_packets);

	if (num_packets === packetNum) {

		this.log('message successfully sent!');
		this.sendFlag(this.READY | this.ACK, this._lastSeqno);
		return true;
	}

	this._lastSeqno++;

	if (packetNum == num_packets-1) {
		flags |= this.FIN;
	}

	var data = msg.substring(packetNum * this.MAX_DATA_LEN, (packetNum+1) * this.MAX_DATA_LEN);
	var packet = this._zerofill(flags, 4) + this._zerofill(this._lastSeqno, 20) + data;

	this.log('sending raw packet: ' + packet);
	this.sendRawPacket(packet);

	return this._send(packetNum + 1, msg);
};

FragmentPacket.prototype._zerofill = function(num, width) {
	var retval = num.toString();
	var retval_len = retval.length;
	for (var i = 0; i < width - retval_len; i++) {
		retval = '0' + retval;
	}
	return retval;
};

var PostMessagePacket = function(receiver, receiveCallback, id, receiverId) {
	var that = this;
	this.receiver = receiver;
	this.receiveCallback = receiveCallback;
	this.id = id;


	this.receiverId = receiverId;
};

PostMessagePacket.prototype.createListener = function() {
	var that = this;

	var listener = function(e) {

		if (!that.id) {
			that.id = e.data;
			return;
		}


		var id = e.data.split(';')[0];
		if (id !== that.id) {
			return;
		}
		var data = e.data.substring(e.data.indexOf(';') + 1);

		that.receiveCallback(data);
	};

	if (typeof window.attachEvent == 'function') {
		window.attachEvent('onmessage', listener);
	} else if (typeof window.addEventListener == 'function') {
		window.addEventListener('message', listener, false);
	} else {
		throw new Error('No method found to create event listener for PostMessagePacket.');
	}
};

PostMessagePacket.prototype.send = function(msg) {



	var needs_reget = false;
	try {
		if (typeof this.receiver.id == 'undefined' || typeof this.receiver.postMessage == 'undefined') {
			needs_reget = true;
		}
	} catch(e) {


	}
	if (needs_reget && typeof this.receiverId != 'undefined') {
		this.receiver = document.getElementById(this.receiverId).contentWindow;
	}

	var packet;
	if (!msg) {

		packet = this.id;
	} else {
		packet = this.id + ';' + msg;
	}
	this.receiver.postMessage(packet, '*');
};

PostMessagePacket._last_unique_id = null;
PostMessagePacket._get_unique_id = function() {
	var id = (new Date()).getTime();
	if (id == PostMessagePacket._last_unique_id) {
		id++;
	}
	PostMessagePacket._last_unique_id = id;
	return id.toString();
};

var JsonRpc = function() {

	this.ids = {};

	this.objectToJSON = function(obj) {
		var json = '';
		var results = [];

		if (obj === undefined || obj === null) {
			return 'null';
		}

		switch (obj.constructor) {
			case Object:
				for (var property in obj) {
					if (obj.hasOwnProperty(property)) {
						results.push(this.objectToJSON(property) + ': ' + this.objectToJSON(obj[property]));
					}
				}
				json = '{' + results.join(', ') + '}';
				break;
			case Array:
				for (var i = 0; i < obj.length; i++) {
					results.push(this.objectToJSON(obj[i]));
				}
				json = '[' + results.join(', ') + ']';
				break;
			case Number:
			case Boolean:
				json = obj.toString();
				break;
			case String:

				var specialChars = {'\b': '\\b', '\t': '\\t', '\n': '\\n', '\f': '\\f', '\r': '\\r', '\\': '\\\\'};

				json = obj.replace(/[\x00-\x1f\\]/g, function(match) {
					var ch = specialChars[match];
					return ch ? ch : '\\u00' + match.charCodeAt().toPaddedString(2, 16);
				});

				json = '"' + json.replace(/"/g, '\\"') + '"';
				break;
			default:

				json = 'null';
				break;
		}

		return json;
	};

	this.createHandler = function(send_func, registered_funcs) {
		var that = this;
		var handler = function(message) {

			try {
				var rpc = eval('(' + message + ')');
			} catch(e) {
				alert('bad JSON: ' + message);
				return;
			}
			if (rpc.method) {

				if (!registered_funcs[rpc.method]) {
					return;
				}

				var retval = registered_funcs[rpc.method].apply(null, rpc.params);
				if (rpc.id) {
					var response = {
						result: retval,
						error: null,	// TODO
						id: rpc.id
					};
					send_func(that.objectToJSON(response));
				}
			} else if(rpc.result) {

				if (!that.ids[rpc.id]) {
					return;
				}

				that.ids[rpc.id](rpc.result);
				delete that.ids[rpc.id];
			}
		};
		return handler;
	};

	this.execute = function(send_func, method, params, response_callback) {
		response_callback = response_callback || null;
		var id = (response_callback) ? (new Date()).getTime() : null;

		var request = {
			method: method,
			params: params,
			id: id
		};

		send_func(this.objectToJSON(request));

		if (id) {
			this.ids[id] = response_callback;
		}
	};
};
JsonRpc = new JsonRpc();

var ParentMessenger = function(childUrl, receiverUrl, container, receiveCallback) {


	if (navigator.userAgent.indexOf('Safari') >= 0 && parseInt(navigator.userAgent.substring(navigator.userAgent.indexOf('Version/') + 8), 10) == 3) {
		throw new Error("unsupported.");
	} else if (window.opera) {
		throw new Error("unsupported.");
	}



	if (!receiverUrl &&
		navigator.userAgent.indexOf('Gecko') >= 0 &&
		parseFloat(navigator.userAgent.slice(navigator.userAgent.indexOf('rv:') + 3, navigator.userAgent.indexOf('rv:') + 6)) < 1.9) {
		throw new Error("unsupported.");
	}


	if (/msie/i.test(navigator.userAgent) && !/opera/i.test(navigator.userAgent)) {


		if (document.domain == window.location.hostname) {
			receiverUrl = '';
		}
	}

	var that = this;
	this.childUrl = childUrl;
	this.receiverUrl = receiverUrl;
	this.container = container || document.body;

	this.packetHandler = null;


	this._ready = false;
	this._error = false;


	var _createReceiverForFragmentPacket = function() {

		that.receiver = document.createElement('iframe');
		that.receiver.src = receiverUrl;
		that.receiver.id = 'receiver_' + (new Date()).getTime();
		that.receiver.name = that.receiver.id;

		that.receiver.frameBorder = '0';
		that.receiver.frameSpacing = '0';
		that.receiver.style.borderStyle = 'none';

		var receiver_onload = function() {
			var receiver = document.getElementById(that.receiver.id).contentWindow;

			try {
				receiver.document.body.innerHTML = '';
			} catch(e) {

				that._error = true;
			}
			receiver.document.body.style.padding = '0px';
			receiver.document.body.style.margin = '0px';

			var child = receiver.document.createElement('iframe');
			child.id = 'child';
			child.name = 'child';
			child.src = that.childUrl;

			child.frameBorder = '0';
			child.frameSpacing = '0';
			child.style.borderStyle = 'none';
			child.style.width = '100%';
			child.style.height = '100%';
			receiver.document.body.appendChild(child);

			that.child = receiver.document.getElementById('child').contentWindow;
			that.receiver = receiver;

			that.packetHandler = new FragmentPacket(that.receiver, that.child, that.childUrl, false, receiveCallback);

			that._listener = that.packetHandler.createListener();

			that.packetHandler.sendFlag(that.packetHandler.READY, 0);

			that._ready = true;
		};

		that.receiver.onreadystatechange = function() {
			if (this.readyState == 'complete') {
				receiver_onload();
			}
		};

		that.receiver.onload = receiver_onload;







		if (Dsq.Utils.ie) {
			if (that.container.clientWidth === 0) {

				var _waitForWidth = function() {
					if (that.container.clientWidth > 0) {
						Dsq.Utils.fixIframesIE(that.container.id);
					} else {
						window.setTimeout(_waitForWidth, 100);
					}
				};
				_waitForWidth();

				that._once = false;
				that.receiver.onresize = function() {
					if (!that._once) {
						Dsq.Utils.fixIframesIE(that.container.id);
					}
					that._once = true;
				};
			}
		}

		that.container.appendChild(that.receiver);
	};


	var _createReceiverForPostMessage = function() {

		var receiver_onload = function() {

			that.packetHandler.send();
			that._ready = true;
		};

		var id = PostMessagePacket._get_unique_id();
		var receiverId = 'child_' + id;


		ParentMessenger['_receiver_onload_' + receiverId] = receiver_onload;

		that.container.innerHTML += '<iframe ' +
			'src="' + childUrl + '" ' +
			'id="' + receiverId + '" ' +
			'name="' + receiverId + '" ' +
			'onload="ParentMessenger._receiver_onload_' + receiverId +'();" ' +
			'></iframe>';

		that.receiver = document.getElementById(receiverId).contentWindow;
		that.packetHandler = new PostMessagePacket(that.receiver, receiveCallback, id, receiverId);
		that._listener = that.packetHandler.createListener();
	};

	if (typeof window.postMessage == 'function') {
		_createReceiverForPostMessage();
	} else {
		_createReceiverForFragmentPacket();
	}

};

ParentMessenger.prototype.sendMessage = function(message) {
	var that = this;
	if (!this._ready) {

		window.setTimeout(function() { that.sendMessage(message); }, 10);
		return;
	}
	this.packetHandler.send(message);
	return true;
};

Dsq.NewFrames = function(url) {
	this.url = url;
};

Dsq.NewFrames.prototype.init = function(onFailure) {
	var that = this;

	try {
		this.messenger = new ParentMessenger(this.url, Dsq.jsonData.integration.receiver_url, this.container, this.receive_callback);
	} catch(e) {
		if (typeof onFailure == 'function') {
			onFailure();
		}
	}

	if (typeof onFailure == 'function') {
		var iId = window.setInterval(function() {
			if (typeof that.messenger == 'undefined') {
				window.clearInterval(iId);
				return;
			}
			if (that.messenger._ready) {
				window.clearInterval(iId);
			} else if (that.messenger._error) {
				window.clearInterval(iId);
				onFailure();
			}
		}, 10);
	}
};

Dsq.NewFrames.prototype._execute = function(method, args, callback) {
	var that = this;
	if (typeof that.messenger == 'undefined') {
		return false;
	}
	JsonRpc.execute(
		function(msg) { that.messenger.sendMessage(msg); },
		method,
		args || [],
		callback);
	return true;
};

Dsq.ReplyFrame = function(container, parent_post_id) {
	var that = this;
	this.container = container;
	this.parent_post_id = parent_post_id;

	var sendFunc = function(msg) {

		Dsq.Debug.log('Dsq.ReplyFrame.sendFunc');
		that.messenger.sendMessage(msg);
	};


	var postComment_onSuccess = function(response) {
		Dsq.jsonData.posts[response.message.id] = response.message.post_meta;
		if (!Dsq.jsonData.users[response.message.post_meta.user_key]) {
			Dsq.jsonData.users[response.message.post_meta.user_key] = response.message.user_meta;
		}


		var reply_position = (typeof(disqus_insert_wrt_sort) == 'undefined' 
			? (Dsq.jsonData.forum.reply_position ? -1 : null) 
			: (Dsq.jsonData.request.sort == 2 ? null : -1));
		
		if (response.message.post_meta.approved) {
			Dsq.Post.insert(response.message.post_meta.parent_post_id || reply_position, response.message.id, response.message.post_meta.message);
		}

		Dsq.Templates.postComment_onSuccess(response, parent_post_id, response.message.id);
	};

	var postComment_onFailure = function(response) {
		Dsq.Popup.popModal(response.message, 'Error');
		Dsq.Templates.postComment_onFailure(response, parent_post_id, response.message.id);
	};

	var editComment_onSuccess = function(response) {
		var post_id = parent_post_id;
		var message = Dsq.$('dsq-comment-message-' + post_id);
		
		message.innerHTML = response.message;
		Dsq.Templates.toggleEdit(post_id);
		Dsq.Templates.setLoadingButton(false);
	};
	
	var editComment_onFailure = function(response) {
		var post_id = parent_post_id;
		
		Dsq.Popup.popModal('Sorry, there was an error editing this comment.', 'Edit Error');
		Dsq.Templates.toggleEdit(post_id);
		Dsq.Templates.setLoadingButton(false);
	};

	var getUserByEmail_onSuccess = function(response) {
		var msg = response.message;
		var fields = Dsq.Templates.getFormFields(parent_post_id);

		if (msg.username) {

			Dsq.Templates.lightboxAuthenticate(parent_post_id, 'login', {
				'username': msg.username,
				'display_name': msg.display_name,
				'avatar_url': msg.avatar_url,
				'verified': msg.verified,
				'email': fields.email.value
			});
		} else {

			Dsq.Templates.lightboxAuthenticate(parent_post_id, 'register');
		}
	};

	var validateAuth_onSuccess = function(response, auth_choice) {
		Dsq.Templates.postComment(parent_post_id, null, true, auth_choice);
	};

	var validateAuth_onFailure = function(response, auth_choice) {
		var pid = parent_post_id ? '-' + parent_post_id : '';
		var msg = response.message;

		if (auth_choice == 'register') {
			var fields = ['email', 'username', 'password'];

			for (var i = 0; i < fields.length; i++) {
				var field = fields[i];
				var errorDiv = Dsq.$('dsq-' + field + '-errors' + pid);

				if (msg[field]) {
					errorDiv.innerHTML = msg[field];
				} else {
					errorDiv.innerHTML = '';
				}
			}
		} else if (auth_choice == 'login') {
			Dsq.$('dsq-lightbox-errors' + pid).innerHTML = '<p>We couldn\'t log you in. Please verify your login.</p>';
		}
		
		Dsq.Templates.setLoadingButton(false);
	};

	this.receive_callback = JsonRpc.createHandler(sendFunc, {
		'postComment.onSuccess': postComment_onSuccess,
		'postComment.onFailure': postComment_onFailure,
		'editComment.onSuccess': editComment_onSuccess,
		'editComment.onFailure': editComment_onFailure,		
		'getUserByEmail.onSuccess': getUserByEmail_onSuccess,
		'validateAuth.onSuccess': validateAuth_onSuccess,
		'validateAuth.onFailure': validateAuth_onFailure,
		'reload': function() { window.location.reload(); }
	});

	this.url = Dsq.Urls.REPLY +
		'?' + (new Date()).getTime() +
		'&f=themoderatevoice' +
		'&t=poll_shows_most_americans_want_public_health_care' +
		'&ff=' + Dsq.Thread.ff +
		'&default_text=' + encodeURIComponent(disqus_default_text) +
		'&ifrs=' + encodeURIComponent(disqus_iframe_css);
	if (this.parent_post_id) {
		this.url += '&parent_post=' + this.parent_post_id;
	}
};

Dsq.ReplyFrame.prototype = new Dsq.NewFrames(Dsq.ReplyFrame.url);

Dsq.ReplyFrame.prototype.post = function(author_name, author_email, author_url, authenticate, sharing_services, subscribe) {
	this._execute('postComment', [author_name, author_email, author_url, authenticate, sharing_services, subscribe]);
};

Dsq.ReplyFrame.prototype.edit = function(post_id, message) {
	this._execute('editComment', [post_id, message]);
};

Dsq.ReplyFrame.prototype.setState = function(parent_post_id, depth) {
	this._execute('setState', [parent_post_id, depth]);
};

Dsq.ReplyFrame.prototype.getUserByEmail = function(email) {
	this._execute('getUserByEmail', [email]);
};

Dsq.ReplyFrame.prototype.validateAuth = function(auth_choice, email, username, password) {
	this._execute('validateAuth', [auth_choice, email, username, password]);
};

Dsq.ReplyFrame.prototype.authenticateFacebook = function(session, forum_url) {
	this._execute('authenticateFacebook', [session, forum_url]);
};

	Dsq.Facebook = function() {
	var that = this;

	var handleSessionData = function(session) {

		var forum_url = Dsq.jsonData.forum.url;




		if (typeof disqus_facebook_forum != 'undefined') {
			forum_url = disqus_facebook_forum;
		}
		Dsq.frames.reply_0.authenticateFacebook(session, forum_url);
	};

	var onLogin = function() {
		FB.Connect.getSignedPublicSessionData(handleSessionData);
	};

	this.login = function() {
		FB.Connect.requireSession(onLogin, true);
	};
};
Dsq.Facebook = new Dsq.Facebook();


	






Dsq.Themes = {};

Dsq.Themes.narcissus = new function() {
	this.addPostContainer = 'dsq-form-area';
	this.textareaContainer = 'dsq-textarea-wrapper';



	
	this.header = function() {
		var comments_count, total_posts, num_posts;
		var html = '';
		var missing_perm_tmpl;

		if (Dsq.jsonData.request.missing_perm) {
			missing_perm_tmpl = Dsq.Templates.missingPermissions();
			if (missing_perm_tmpl) {
				html += '<div class="dsq-missing-permissions">' + missing_perm_tmpl + '</div>';
			}
		}

		total_posts = Dsq.jsonData.thread.total_posts;
		num_posts = Dsq.jsonData.thread.num_posts;

		if (total_posts) {
			comments_count = Dsq.FmtStrings.SHOWING_COMMENTS_FULL(total_posts, num_posts);
		} else {
			comments_count = Dsq.FmtStrings.SHOWING_COMMENTS_WITHOUT_PAGINATION(num_posts);
		}

		html += ' \
		<div id="dsq-comments-title"> \
			<h3>' + comments_count + '</h3> \
		</div> \
		';

		html += ' \
		<div class="dsq-options"> \
			<span class="dsq-item-sort">'
				+ Dsq.Strings.SORT_BY + ' \
				<select id="dsq-sort-select" onchange="Dsq.Thread.sortBy(this.value);"> \
					<option value="hot" ' + (Dsq.jsonData.request.sort == 4 ? 'selected="selected"' : '') + '>' + Dsq.Strings.POPULAR_NOW + '</option> \
					<option value="best" ' + (Dsq.jsonData.request.sort == 3 ? 'selected="selected"' : '') + '>' + Dsq.Strings.BEST_RATING + '</option> \
					<option value="newest" ' + (Dsq.jsonData.request.sort == 2 ? 'selected="selected"' : '') + '>' + Dsq.Strings.NEWEST_FIRST + '</option> \
					<option value="oldest" ' + (Dsq.jsonData.request.sort == 1 ? 'selected="selected"' : '') + '>' + Dsq.Strings.OLDEST_FIRST + '</option> \
				</select> \
				&nbsp; \
			</span> \
			<span class="dsq-subscribe-email"> \
				<img src="http://media.disqus.com/images/embed/email.png" style="width:12px;height:12px;vertical-align:middle"> \
				<span id="dsq-subscribe">'
					+ (Dsq.jsonData.context.subscribed
						? '<a href="#" onclick="Dsq.Thread.subscribe(0); return false">' + Dsq.Strings.UNSUBSCRIBE + '</a>'
						: '<a href="#" onclick="Dsq.Thread.subscribe(1); return false">' + Dsq.Strings.SUBSCRIBE_BY_EMAIL + '</a>')
				+ '</span> \
			</span> \
			<span class="dsq-subscribe-rss" style="width:12px;height:12px;vertical-align:middle"> \
				<img src="http://media.disqus.com/images/embed/bullet-feed.png" alt="" /> \
				<a href="http://themoderatevoice.disqus.com/poll_shows_most_americans_want_public_health_care/latest.rss">' + Dsq.Strings.SUBSCRIBE_BY_RSS + '</a> \
			</span> \
		</div> \
		';

		
		

		return html;

	};
	
	this.footer = function() {
		var html = '';

		html += Dsq.Templates.pagination();

		
		
			html += Dsq.Templates.realtime();
			html += Dsq.Templates.showThreadSettings();
			html += Dsq.Templates.postBox();

		html += Dsq.Templates.reactions();

		
			html += Dsq.Templates.trackbacks();
		


		if (Dsq.jsonData.request.is_global_moderator) {
 			html += ' \
				<div class="dsq-global-moderator-extras">'
					+ '<strong>shortname:</strong> ' + Dsq.jsonData.forum.url
					+ '<strong>thread id:</strong> ' + Dsq.jsonData.thread.id
					+ '<strong>thread slug:</strong> ' + Dsq.jsonData.thread.slug
				+ '</div> \
			';
		}

		return html;
	};
	
	this.realtime = function() {
		var html = '';
		
		if (Dsq.jsonData.realtime_enabled) {
			html += '<div id="dsq-realtime-options" class="dsq-options">'
					 + Dsq.Strings.REALTIME_UPDATING_IS + ' <strong id="dsq-realtime-status" style="text-transform: lowercase">' + Dsq.Strings.ENABLED + '</strong>. \
					 <a href="#" id="dsq-realtime-toggle" style="text-transform: capitalize"></a> \
					</div>';
		}

		if (!Dsq.jsonData.forum.streaming_realtime) {
			html += ' \
				<div style="display: none" id="dsq-realtime-alert" class="dsq-realtime-alert"><span id="dsq-realtime-queued"></span> <a href="#" id="dsq-realtime-show"></a></div> \
			';
		}
		
		return html;
	};

	this.showThreadSettings = function() {
		if (!Dsq.jsonData.request.is_moderator) {
			return '';
		}

		html = '<div id="dsq-thread-settings" class="dsq-thread-settings">' + Dsq.Strings.MODERATOR_OPTIONS;
		html += '<a href="#" onclick="Dsq.Thread.showSettings(); return false;">' + Dsq.Strings.SETTINGS + '</a>';
		html += '<a href="#" onclick="Dsq.Thread.showModeratorActions(); return false;">' + Dsq.Strings.MODERATE + '</a>';
		if (Dsq.jsonData.forum.reactions_enabled && Dsq.jsonData.reactions.length === 0) {
			html += '<a href="#" onclick="Dsq.Reaction.reportMissingReactions(); return false;">'
						+ Dsq.Strings.REPORT_MISSING_REACTIONS
						+ '</a>';
		}
		html +='</div>';

		return html;
	};

	this.postBox = function(post_id, use_fallback_iframe) {


		var html;
		var display_sharing_options = Dsq.jsonData.request.is_authenticated;

		if (!Dsq.jsonData.request.is_authenticated && Dsq.jsonData.forum.disqus_auth_disabled && !Dsq.jsonData.forum.allow_anon_post) {
			return '';
		}
		
		if (Dsq.jsonData.request.is_remote) {


			if (!Dsq.jsonData.request.sharing.hasOwnProperty(Dsq.jsonData.request.remote_domain)) {
				display_sharing_options = false;
			}
		}
		
		if (post_id) {
			var _meta = Dsq.jsonData.posts[post_id];
			var userData = Dsq.jsonData['users'][_meta.user_key];				
		}
		
		var pid = post_id ? '-' + post_id : '';

		var _requestUserInfo = function() {
			var html;



			var user_has_email = false;

			html = '<div class="dsq-request-user-info"> <!-- // If authenticated --> \
				<a href="' + Dsq.jsonData.settings.disqus_url + Dsq.Urls.LOGOUT + '?ctkn=' + Dsq.CSRF_TOKEN + '" class="dsq-request-user-logout">' + Dsq.Strings.LOGOUT + '</a> \
				<table> \
					<tr> \
						<td rowspan="2">'
							+ (!Dsq.jsonData.forum.disqus_auth_disabled ? '<a href="' + Dsq.jsonData.settings.disqus_url + Dsq.Urls.REQUEST_USER_PROFILE + '">' : '')
								+ '<img src="' + Dsq.Urls.REQUEST_USER_AVATAR + '" width="48" height="48" class="dsq-request-user-avatar">'
							+ (!Dsq.jsonData.forum.disqus_auth_disabled ? '</a>' : '')
						+ '</td> \
						<td class="dsq-request-user-name">'
								+ (Dsq.jsonData.request.is_remote
									 ? '<span class="dsq-badge-small dsq-badge-' + Dsq.jsonData.request.remote_domain + '">' + Dsq.jsonData.request.remote_domain + '</span>'
									 : (Dsq.jsonData.request.is_verified
											? '<span class="dsq-badge-small dsq-badge-verified">Verified</span>'
											: '<span class="dsq-badge-small dsq-badge-registered">Registered</span>'))
							+ (!Dsq.jsonData.forum.disqus_auth_disabled ? ' <a href="' + Dsq.jsonData.settings.disqus_url + Dsq.Urls.REQUEST_USER_PROFILE + '">' : '') 
								+ Dsq.jsonData.request.display_username 
							+ (!Dsq.jsonData.forum.disqus_auth_disabled ? '</a>' : '')
							+  (Dsq.jsonData.request.is_remote && user_has_email ? ' <small>(<a href="#" onclick="Dsq.Popup.remoteAccountSettings(); return false;">change settings</a>)</small>' : '')
							+  (!Dsq.jsonData.request.is_remote && !Dsq.jsonData.forum.disqus_auth_disabled ? ' <small>(<a href="' + Dsq.jsonData.settings.disqus_url + '/profile/info/" target="_blank">change name</a> or <a href="' + Dsq.jsonData.settings.disqus_url + '/profile/avatar/" target="_blank">picture</a>)</small>' : '')
						+ '</td> \
					</tr> \
					<tr> \
						<td class="dsq-request-user-stats"> \
							<span><big>' + Dsq.jsonData.request.comments_count + '</big> ' + (Dsq.jsonData.request.comments_count == 1 ? 'comment' : 'comments') + '</span> \
							<span><big>' + Dsq.jsonData.request.likes_count + '</big> ' + (Dsq.jsonData.request.likes_count == 1 ? 'like' : 'likes') + '</span> \
							<span><big>' + Dsq.jsonData.request.points + '</big> ' + (Dsq.jsonData.request.points == 1 ? 'point' : 'points') + '</span> \
						</td> \
					</tr> \
				</table> \
			</div> \
			';
			return html;
		};

		var _loginOptions = function() {
			var html;
			html = ' \
			<div class="dsq-authenticate"> \
				<p class="dsq-autheneticate-copy">'
				+ (Dsq.jsonData.forum.allow_anon_post
					? Dsq.Strings.YOU_ARE_COMMENTING_AS_A + ' <a class="dsq-help" title="Click for more information" href="#" onclick="Dsq.Popup.helpBadges(); return false">Guest</a>. ' + Dsq.Strings.OPTIONAL + ': ' + Dsq.Strings.LOGIN_BELOW + '.'
					: Dsq.Strings.REQUIRED + ': ' + Dsq.Strings.PLEASE_LOGIN_BELOW_TO_COMMENT + '.')
				+ '</p> \
				<ul class="dsq-login-buttons">'
					+ (!Dsq.jsonData.forum.disqus_auth_disabled ? '<li class="dsq-login-button"><a href="#" onclick="Dsq.Popup.login(); return false"><img src="http://media.disqus.com/images/themes/narcissus/login-disqus.gif" /></a></li>' : '')
					+ (Dsq.jsonData.context.use_fb_connect ? '<li class="dsq-login-button"><a href="#" onclick="Dsq.Facebook.login(); return false;"><img src="http://media.disqus.com/images/themes/narcissus/login-facebook.gif" /></a></li>' : '')
					+ (Dsq.jsonData.context.use_twitter_signin ? '<li class="dsq-login-button"><a href="#" onclick="Dsq.Twitter.startTwitterConnect(); return false"><img src="http://media.disqus.com/images/themes/narcissus/login-twitter.gif" /></a></li>' : '')
					+ (Dsq.jsonData.context.use_openid ? '<li class="dsq-login-button"><a href="#" onclick="Dsq.OpenID.requestURL(); return false" ><img src="http://media.disqus.com/images/themes/narcissus/login-openid.gif" /></a></li>' : '')
					+ (Dsq.jsonData.context.use_yahoo ? '<li class="dsq-login-button"><a href="#" onclick="Dsq.Yahoo.startYahooConnect(); return false"><img src="http://media.disqus.com/images/themes/narcissus/login-yahoo.gif" /></a></li>' : '')
				+ '</ul> \
			</div> \
			';
			return html;
		};

		if (!Dsq.jsonData.context.show_reply) {


			if (!Dsq.jsonData.request.is_authenticated) {



				return '<div id="dsq-form-area" style="display:none"><div id="dsq-textarea-wrapper"></div></div>' + _loginOptions();
			} else {
				return '';
			}
		}

		html = ' \
		<div id="' + (post_id 
			? 'dsq-reply-post-' + post_id
			: 'dsq-new-post')
		 	+ '" class="dsq-post-area"> \
			<div class="dsq-dc-logo"> \
				<a href="http://disqus.com/comments" target="_blank"><img src="http://media.disqus.com/images/themes/narcissus/disqus-logo.png"></a> \
			</div>'
			+ (post_id 
				? '<h3>' + Dsq.Strings.REPLYING_TO + ' ' + userData.display_name + '</h3>'
				: '<h3>' + Dsq.Strings.ADD_NEW_COMMENT + '</h3>')
			+ (Dsq.jsonData.request.is_authenticated 
				? _requestUserInfo()
				: _loginOptions() )
			+ '<div id="dsq-form-area' + pid + '">'
			+ '<div class="dsq-textarea"> \
				<div class="dsq-textarea-wrapper" id="dsq-textarea-wrapper' + pid + '"></div> \
			</div>'
			+ (!Dsq.jsonData.request.is_authenticated
			? ' \
			<div class="dsq-post-fields"> \
				<table> \
					<tr> \
						<td class="dsq-post-fields-left"><div class="dsq-input-wrapper"><input id="dsq-field-name' + pid + '" type="text" value="' + (disqus_def_name ? disqus_def_name : (Dsq.jsonData.session.name ? Dsq.jsonData.session.name : Dsq.Strings.NAME + '" class="dsq-placeholder')) + '" onfocus="Dsq.Templates.handlePlaceholder(event, this, \'name\')" onblur="Dsq.Templates.handlePlaceholder(event, this, \'name\')" /></div></td> \
						<td class="dsq-post-fields-right"><div class="dsq-input-wrapper"><input id="dsq-field-website' + pid + '" type="text" value="' + (Dsq.jsonData.session.url ? Dsq.jsonData.session.url : Dsq.Strings.WEBSITE + ' (' + Dsq.Strings.OPTIONAL.toLowerCase() + ')" class="dsq-placeholder') + '" onfocus="Dsq.Templates.handlePlaceholder(event, this, \'website\')" onblur="Dsq.Templates.handlePlaceholder(event, this, \'website\')" /></div></td> \
					</tr> \
					<tr> \
						<td class="dsq-post-fields-left"><div class="dsq-input-wrapper"><input id="dsq-field-email' + pid + '" type="text" value="' + (disqus_def_email ? disqus_def_email : (Dsq.jsonData.session.email ? Dsq.jsonData.session.email : Dsq.Strings.EMAIL + '" class="dsq-placeholder')) + '" onfocus="Dsq.Templates.handlePlaceholder(event, this, \'email\')" onblur="Dsq.Templates.handlePlaceholder(event, this, \'email\')" /></div></td> \
						<td class="dsq-post-fields-right"> \
							<div class="dsq-subscribe"> \
								<a href="#" onclick="Dsq.Templates.chooseSubscribe(' + post_id + '); return false" class="dsq-subscribe-menu"><span id="dsq-subscribe-select' + pid + '">' + (Dsq.jsonData.request.subscribe_on_post ? Dsq.Strings.SUBSCRIBE_TO_ALL_COMMENTS_BY_EMAIL : Dsq.Strings.DO_NOT_SUBSCRIBE_TO_COMMENTS) + '</span> <small>&#9660;</small></a> \
								<ul class="dsq-panel" id="dsq-subscribe-menu' + pid + '"> \
									<li><a href="#" onclick="Dsq.Templates.setSubscribe(2, this, ' + post_id + '); return false">' + Dsq.Strings.SUBSCRIBE_TO_ALL_COMMENTS_BY_EMAIL + '</a></li> \
									<li><a href="#" onclick="Dsq.Templates.setSubscribe(0, this, ' + post_id + '); return false">' + Dsq.Strings.DO_NOT_SUBSCRIBE_TO_COMMENTS + '</a></li> \
								</ul> \
								<input id="dsq-subscribe-on-post' + pid + '" type="hidden" value="' + Dsq.jsonData.request.subscribe_on_post + '" /> \
							</div> \
						</td> \
					</tr> \
				</table> \
			</div>'
			: '')
			+ '<div class="dsq-post-footer"> \
				<div class="dsq-sharing-options" ' + (!display_sharing_options ? 'style="display:none;"' : '') + '> \
					<button type="button" class="dsq-button-small" onfocus="document.getElementById(\'dsq-post-button' + pid + '\').focus();"><span>' + Dsq.Strings.SHARING_OPTIONS + ' <small>&#9660;</small></span></button> \
					<div class="dsq-panel"> '
						+ (Dsq.jsonData.request.sharing.twitter !== undefined
								&& Dsq.jsonData.request.sharing.twitter.enabled === true
							? '<div><input type="checkbox" id="dsq-sharing-twitter' + pid + '"'
								  + (Dsq.jsonData.request.sharing.twitter.auto === true ? 'checked=true' : '') + '/> \
									<label for="dsq-sharing-twitter' + pid + '">' + Dsq.Strings.SHARE_ON + ' Twitter</label> \
								 </div>'
							: '')
						+ (Dsq.jsonData.request.sharing.facebook
								&& (Dsq.jsonData.request.sharing.facebook.enabled === true ||
										(Dsq.jsonData.request.is_remote && Dsq.jsonData.request.remote_domain == 'facebook'))
							? '<div><input type="checkbox" id="dsq-sharing-facebook' + pid + '"'
									+ (Dsq.jsonData.request.sharing.facebook.auto === true ? 'checked=true' : '') + '/> \
									<label for="dsq-sharing-facebook' + pid + '">' + Dsq.Strings.SHARE_ON + ' Facebook</label> \
								 </div>'
							: '')
						+ (Dsq.jsonData.request.sharing.yahoo !== undefined
								&& Dsq.jsonData.request.sharing.yahoo.enabled === true
							? '<div><input type="checkbox" id="dsq-sharing-yahoo' + pid + '"'
									+ (Dsq.jsonData.request.sharing.yahoo.auto === true ? 'checked=true' : '') + '/> \
									<label for="dsq-sharing-yahoo' + pid + '">' + Dsq.Strings.SHARE_ON + ' Yahoo!</label> \
								</div>'
							: '')
						+ (Dsq.jsonData.request.sharing.tumblr !== undefined
								&& Dsq.jsonData.request.sharing.tumblr.enabled === true
							? '<div><input type="checkbox" id="dsq-sharing-tumblr' + pid + '"'
									+ (Dsq.jsonData.request.sharing.tumblr.auto === true ? 'checked=true' : '') + '/> \
									<label for="dsq-sharing-tumblr' + pid + '">' + Dsq.Strings.SHARE_ON + ' Tumblr</label> \
								 </div>'
							: '')
						+ (Dsq.jsonData.request.sharing.wordpress !== undefined
								&& Dsq.jsonData.request.sharing.wordpress.enabled === true
							? '<div><input type="checkbox" id="dsq-sharing-wordpress' + pid + '"'
									+ (Dsq.jsonData.request.sharing.wordpress.auto === true ? 'checked=true' : '') + '/> \
									<label for="dsq-sharing-wordpress' + pid + '">' + Dsq.Strings.SHARE_ON + ' Wordpress</label> \
								 </div>'
							: '')
						+ (Dsq.jsonData.request.sharing.movabletype !== undefined
							  && Dsq.jsonData.request.sharing.movabletype.enabled === true
							? '<div><input type="checkbox" id="dsq-sharing-movabletype' + pid + '"'
									+ (Dsq.jsonData.request.sharing.movabletype.auto === true ? 'checked=true' : '') + '/> \
									<label for="dsq-sharing-movabletype' + pid + '">' + Dsq.Strings.SHARE_ON + ' Movable Type</label> \
							   </div>'
							: '')
						+ (Dsq.jsonData.request.sharing.typepad !== undefined
							  && Dsq.jsonData.request.sharing.typepad.enabled === true
							? '<div><input type="checkbox" id="dsq-sharing-typepad' + pid + '"'
									+ (Dsq.jsonData.request.sharing.typepad.auto === true ? 'checked=true' : '') + '/> \
								  <label for="dsq-sharing-typepad' + pid + '">' + Dsq.Strings.SHARE_ON + ' TypePad</label> \
							   </div>'
							: '')
						+ '<div><a href="' + Dsq.jsonData.settings.disqus_url + '/profile/connections/" target="_blank" class="dsq-configure-options">' + Dsq.Strings.CONFIGURE_OPTIONS + '</a></div>'
					+ '</div> \
				</div>'
				+ '<button type="button" class="dsq-button" id="dsq-post-button' + pid + '" onclick="Dsq.Templates.postComment(' + post_id + ', this, false)"><span>' + Dsq.Strings.POST_AS + ' '
				+ (Dsq.jsonData.request.display_username
					? Dsq.jsonData.request.display_username
					: Dsq.Strings.GUEST)
				+ '</span></button>'
				+ (post_id
					? '<button type="button" class="dsq-button" id="dsq-cancel-button' + pid + '" onclick="Dsq.Post.toggleReply(' + post_id +', this)"><span>' + Dsq.Strings.CANCEL + '</span></button>'
					: '')
			+ '</div>'
			+ '</div>' // end dsq-form-area
		+ '</div> \
		';
		
		return html;
	};




	this.appendPost = function(post_id) {
		var html = '<div id="dsq-append-post-' + post_id + '"></div>';
		return html;
	};

	this.postPrependHeader = function(post_id) {
		var html;
		var _meta = Dsq.jsonData.posts[post_id];
		var userData = Dsq.jsonData['users'][_meta.user_key];
		
		html = ' \
		<table> \
			<tr> \
				<td id="dsq-header-avatar-' + post_id + '" class="dsq-header-avatar" onmouseover="Dsq.Post.dropProfile(' + post_id + ')"> \
					<a id="dsq-avatar-' + post_id + '" class="dsq-avatar" href="' + userData.url + '" onclick="Dsq.Popup.popProfile(' + post_id + '); return false;">'
					+ (Dsq.jsonData.forum.show_avatar
					? '<img src="' + Dsq.jsonData.users[_meta.user_key].avatar + '" alt="" />'
					: '')
				+ '</a> \
				</td> \
				<td class="dsq-comment-header-meta"> \
		';

		
		return html;
	};
	
	this.postAppendHeader = function(post_id) {
		var _meta = Dsq.jsonData.posts[post_id];
		var html;
		var parent_display_name = '';
		
		if(_meta.parent_post_id) {

			var _parent_meta = Dsq.jsonData.posts[_meta.parent_post_id];

			if (_parent_meta) {
				var parentUserData = Dsq.jsonData['users'][_parent_meta.user_key];
				parent_display_name = parentUserData.display_name;
			}
		}

		html = ' \
		<img src="http://media.disqus.com/images/themes/narcissus/moderator.png" class="dsq-moderator-star" title="Moderator" /> \
		<span class="dsq-comment-header-time"><a href="#comment-' + post_id + '" onclick="Dsq.Popup.permalink(' + post_id + ')" title="Permalink">' + (_meta.is_realtime ? Dsq.Strings.JUST_NOW : _meta.date) + '</a></span> '
		+ (_meta.parent_post_id && parent_display_name
			? '<a href="#comment-' + _meta.parent_post_id + '" title="Jump to comment">in reply to ' + parent_display_name + '</a>'
			: '')
		+ '</td> \
		<td id="dsq-like-pts-' + post_id + '" class="dsq-comment-header-likes">'
		+ (_meta.points
			? _meta.points + Dsq.Utils.pluralize(_meta.points, ' person', ' people') + ' liked this.'
			: '')
		+ '</td> \
		</tr> \
		</table> \
		';
		return html;
	};

	this.preBody = function(post_id) {
		var html = '';
		return html;
	};

	this.postFooter = function(post_id) {
		var html;
		var _meta = Dsq.jsonData.posts[post_id];
		if(_meta.killed || !_meta.approved) { return ''; }
		
		html = ' \
		<div class="dsq-comment-footer" id="dsq-comment-footer-' + post_id + '"> \
			<div class="dsq-comment-footer-left">'
				+ (Dsq.jsonData.request.is_moderator || Dsq.jsonData.request.is_global_moderator
					? '<a href="#" onclick="Dsq.Templates.moderateOptions(' + post_id+ '); return false">' + Dsq.Strings.MODERATE + '</a>'
					: '')
				+ '<a href="#" id="dsq-post-report-' + post_id + '" class="dsq-post-report" onclick="Dsq.Post.report(' + post_id + ', false); return false;">' + Dsq.Strings.FLAG + '</a> \
			</div> \
			<div class="dsq-comment-footer-right">'
				+ (_meta.votable 
					? '<span id="dsq-like-' + post_id + '" class="dsq-like">'
					+ (!_meta.up_voted
						? '<button type="button" class="dsq-button-small" onclick="Dsq.Post.rate(this, ' + post_id + ', 1)" >Like</button>'
						: 'You liked this.&nbsp;&nbsp;')
					+ '</span>'
					: '')
				+ (_meta.can_reply && !_meta.has_replies && _meta.from_request_user
					? '<button type="button" class="dsq-button-small dsq-post-edit" onclick="Dsq.Post.edit(this, ' + post_id + ')" >' + Dsq.Strings.EDIT + '</button>'
					: '')
				+ (_meta.can_reply
					? '<span class="dsq-comment-footer-reply" id="dsq-comment-footer-reply-' + post_id + '" onclick="Dsq.Post.toggleReply(' + post_id +', this)"> \
						<button type="button" class="dsq-button-small">' + Dsq.Strings.REPLY + '</button> \
						<button type="button" class="dsq-comment-footer-reply-tab">' + Dsq.Strings.REPLY + '</button><span></span> \
					</span>'
					: '')
			+ '</div> \
		</div> \
		';
		
		return html;
	};



	
	this.showRetweets = function(id, limit, element_id /* Optional */) {
		var source, html = '';

		for (var i = 0, reaction; reaction = Dsq.jsonData.reactions[i]; i++) {
			if (reaction.id === id) {
				source = reaction.retweets;
			}
		}

		if (source) {
			if (limit === 0) {
				limit = source.length;
			}

			for (var j = 0; j < limit; j++) {
				var rt = source[j];
				html += '<a href="' + rt.url + '">' + rt.author_name + '</a>'	+ ((j === (limit - 1)) ? '.' : ', ');
			}
		}

		if (element_id === undefined) {
			return html;
		}

		var element = document.getElementById(element_id);
		element.innerHTML = html;
		return element;
	};

	this.showMoreReactions = function(reactions, has_more, start, limit) {
		var link = document.getElementById('dsq-show-more-reactions');
		var container = link.parentNode;
		container.removeChild(link);

		for (var i = 0, reaction; reaction = reactions[i]; i++) {
			var el = Dsq.Templates.generateReactionHTML(reaction);
			if (el) {
				container.innerHTML += el;
			}
		}

		if (has_more) {
			var d = Dsq.jsonData.settings.disqus_url;
			var f = Dsq.jsonData.forum.url;
			var t = Dsq.jsonData.thread.id;
			var s = start;
			var l = limit;

			var handler = 'Dsq.Utils.execScript(\'' + d + '/forums/' + f + '/more_reactions.js?t=' + t + '&s=' + s + '&l=' + l + '\', true); return false;';
			container.innerHTML += '<li id="dsq-show-more-reactions" class="dsq-show-more-reactions"><button type="button" class="dsq-button-small" onclick="' + handler + '">Show more reactions</button></li>';
		}
	};

	this.generateReactionHTML = function(reaction) {
		if (reaction.body === null || reaction.body == '') {
			return;
		}

		if (reaction.author_name === '') {
			reaction.author_name = '&nbsp;';
		}

		if (reaction.url === '') {
			reaction.url = reaction.get_service_url;
		}

		var item = '<li class="dsq-comment dsq-reaction" id="dsq-reaction-' + reaction.id + '">'
			+ '<div class="dsq-comment-header"> \
			<table> \
			<tr> \
			<td class="dsq-header-avatar"> \
			';

		if (reaction.author_url && reaction.author_url !== '') {
			item += '<a target="_blank" href="' + reaction.author_url +'" class="dsq-avatar">';
		}

		if (reaction.avatar_url && reaction.avatar_url !== '') {
			item += '<img src="' + reaction.avatar_url + '"/>';
		} else {

			item += '<img src="' + Dsq.jsonData.media_url + '/images/noavatar92.png"/>';
		}

		var service_icon = (reaction.get_service_name == 'trackback' || reaction.get_service_name == 'pingback' ? 'rss' : reaction.get_service_name.replace(' ', ''));
		item += (reaction.author_url && reaction.author_url !== ''
				? '</a>'
				: '')
			+ '</td>'
			+ '<td><cite class="dsq-comment-cite">' + reaction.author_name + '</cite> <span class="dsq-comment-header-time">' + reaction.date_created + '</span></td>'
			+ '<td class="dsq-comment-header-likes"></td>'
			+ '</tr></table></div>' // end dsq-comment-header
			+ '<div class="dsq-reaction-header" \
				<table> \
					<tr> \
						<td class="dsq-reaction-header-left">'
							+ '<img class="dsq-service-icon" src="' + Dsq.jsonData.media_url + '/images/reactions/services/' + service_icon + '.png" />'
							+ ' From <a class="dsq-service-name" target="_blank" href="' + reaction.url + '">' + reaction.get_service_name + '</a> '
							+ 'via <a href="' + reaction.source_url + '">' + (reaction.source == 'backtype' ? 'BackType' : 'UberVU') + '</a>'
						+ '</td>'
						+ '<td class="dsq-reaction-header-right">';

			if(reaction.retweets) {
				var num_retweets = reaction.retweets.length;
				if (num_retweets > 0) {
					if (num_retweets == 1) {
						item += 'One more retweet from <a href="' + reaction.retweets[0].url + '">'  + reaction.retweets[0].author_name + '</a>';
					} else {
						item += (num_retweets + ' more retweets from ');
						item += '<span id="dsq-reaction-retweets-' + reaction.id + '">';
						var n_tweets = (num_retweets > 3) ? 3 : num_retweets;
						item += Dsq.Templates.showRetweets(reaction.id, n_tweets);
						if (n_tweets != num_retweets) {
							item += '</span> <a onclick="Dsq.Templates.showRetweets(' + reaction.id + ', 0, \'dsq-reaction-retweets-' + reaction.id + '\');'
								+ 'this.parentNode.removeChild(this); return false;" href="#">Show all</a>';
						}
					}
				}
			}	
			item += '</td></tr> \
			</table> \
			</div>' // end dsq-reaction-header
			+ '<div class="dsq-comment-body"> \
				<div class="dsq-comment-message">' + reaction.body + '</div>'
			+ '</div> \
			<div class="dsq-comment-footer"> \
				<div class="dsq-comment-footer-left"> \
				</div>'
				+ (Dsq.jsonData.request.is_moderator || Dsq.jsonData.request.is_global_moderator 
					? ' \
					<div class="dsq-comment-footer-right"> \
						<button type="button" class="dsq-button-small dsq-hide-reaction" onclick="Dsq.Reaction.hide(' + reaction.id + ')">Hide</button> \
					</div>'
					: '')
			+ '</div>'
		item += '</li>'; /* Reaction HTML ends */
		return item;
	};

	this.reactions = function() {
		var html, reaction;

		if (Dsq.jsonData.reactions === undefined || Dsq.jsonData.reactions.length === 0) {
			return '';
		}

		html = '';
		for (var i = 0; reaction = Dsq.jsonData.reactions[i]; i++) {
			var item = Dsq.Templates.generateReactionHTML(reaction);
			if (item) {
				html += item;
			}
		}

		if (Dsq.jsonData.has_more_reactions) {
			var d = Dsq.jsonData.settings.disqus_url;
			var f = Dsq.jsonData.forum.url;
			var t = Dsq.jsonData.thread.id;
			var s = Dsq.jsonData.reactions_start;
			var l = Dsq.jsonData.reactions_limit;

			var handler = 'Dsq.Utils.execScript(\'' + d + '/forums/' + f + '/more_reactions.js?t=' + t + '&s=' + s + '&l=' + l + '\', true); return false;';
			html += '<li id="dsq-show-more-reactions" class="dsq-show-more-reactions"><button type="button" class="dsq-button-small" onclick="' + handler + '">Show more reactions</button></li>';
		}

		return '<h3 id="dsq-reactions-title" class="dsq-h3-reactions">Reactions</h3><ul id="dsq-reactions" class="dsq-reactions">' + html + '</ul>';
	};
	
	this._popupGeneric = function(content) {
		return ' \
		<div class="dsq-popup-container"> \
			<table> \
				<tbody> \
					<tr> \
						<td class="dsq-popup-tl"></td><td class="dsq-popup-b"></td><td class="dsq-popup-tr"></td> \
					</tr> \
					<tr> \
						<td class="dsq-popup-b"></td> \
						<td class="dsq-popup-body"> \
							<div class="dsq-popup-content"> \
								<div class="dsq-popup-title"> \
									<button type="button" class="dsq-button-small" style="float:right" onclick="Dsq.Popup._closePopup(null, true)">Close</button>'
									+ content['header'] 
								+ '</div>'
								+ content['body']
							+ '</div> \
							<div class="powered-by"><a href="http://disqus.com/comments/">Powered by <img src="http://media.disqus.com/images/embed/disqus-logo.png" alt="Disqus Comments" style="margin-bottom:-5px" /></a></div> \
						</td> \
						<td class="dsq-popup-b"></td> \
					</tr> \
					<tr> \
						<td class="dsq-popup-bl"></td><td class="dsq-popup-b"></td><td class="dsq-popup-br"></td> \
					</tr> \
				</tbody> \
			</table> \
		</div> \
		';
	};



	
	this.chooseSubscribe = function(post_id) {

		var pid = post_id ? '-' + post_id : '';
		var menu = Dsq.$('dsq-subscribe-menu' + pid);
		
		menu.style.display = menu.style.display == 'block' ? 'none' : 'block';
		
	};
	
	this.setSubscribe = function(value, el, post_id) {

		var pid = post_id ? '-' + post_id : '';
		var input = Dsq.$('dsq-subscribe-on-post' + pid);
		var select = Dsq.$('dsq-subscribe-select' + pid);
		var menu = Dsq.$('dsq-subscribe-menu' + pid);
		
		select.innerHTML = el.innerHTML;
		input.value = value;
		this.chooseSubscribe(post_id);
	};
	
	this.getFormFields = function(post_id) {

		var fields = {};
		var pid = post_id ? '-' + post_id : '';
		var name = Dsq.$('dsq-field-name' + pid);
		var email = Dsq.$('dsq-field-email' + pid);
		var website = Dsq.$('dsq-field-website' + pid);
		var username = Dsq.$('dsq-field-username' + pid);
		var password = Dsq.$('dsq-field-password' + pid);

		fields = {
			'name': name,
			'email': email,
			'website': website,
			'username': username,
			'password': password
		}
		
		return fields;
	}
	
	this.validateFields = function(post_id) {
		
		if(Dsq.jsonData.request.is_authenticated) { return true; }
		
		var fields = Dsq.Templates.getFormFields(post_id);
		
		var nameField = fields.name;
		var websiteField = fields.website;
		var emailField = fields.email;
		
		websiteField.value = (websiteField.value == Dsq.Templates.placeholder['website']) ? '' : websiteField.value;
		
		var v = [{

			validator: Dsq.Validators.name,
			value: nameField.value
		}, {

			validator: Dsq.Validators.email,
			value: emailField.value
		}, {

			validator: Dsq.Validators.url,
			value: websiteField.value
		}];
		
		return Dsq.Validators.validate(v, function(e) { Dsq.Popup.popModal(e, 'Oops...') } );
	};
	
	this.checkExistingUser = function(post_id) {
		var fields = Dsq.Templates.getFormFields(post_id);		
		Dsq.Popup.loading(post_id);
		
		if (post_id) {
			Dsq.frames['reply_' + post_id].getUserByEmail(fields.email.value);
		} else {
			Dsq.frames['reply_0'].getUserByEmail(fields.email.value);
		}
	};

	this.validateAuth = function(el_clicked, post_id, auth_choice) {
		var fields = Dsq.Templates.getFormFields(post_id);
		var email = fields.email ? fields.email.value : '';
		var username = fields.username ? fields.username.value : '';
		var password = fields.password ? fields.password.value : '';
		
		Dsq.Templates.setLoadingButton(el_clicked, post_id);
		
		if (post_id) {
			Dsq.frames['reply_' + post_id].validateAuth(auth_choice, email, username, password);
		} else {
			Dsq.frames['reply_0'].validateAuth(auth_choice, email, username, password);
		}
	};

	this.lightboxUpdateEmail = function(post_id, new_email) {
		var fields = Dsq.Templates.getFormFields(post_id);
		fields.email.value = new_email;
	};

	this.lightboxAuthenticate = function(post_id, auth_choice, auth_data) {
		var title, body;
		var pid = post_id ? '-' + post_id : '';

		if(typeof(auth_data) == 'undefined') {
			var auth_data = Dsq.Templates.getFormFields(post_id);
		}

		d = auth_data;

		switch(auth_choice) {
			case 'register':
				var suggestedUsername = d.name.value.replace(/[^a-zA-Z0-9-]/g,'').toLowerCase();
			
				title = Dsq.jsonData.forum.allow_anon_post ? 'Optional:' : 'Required:';
				title += ' Register a <img src="http://media.disqus.com/images/embed/disqus-profile.png" alt=Disqus Profile" />';

				body = ' \
				<ul class="dsq-lightbox-register-reasons"> \
				<li>Verify your comments</li> \
				<li>Edit and delete comments</li> \
				<li>Manage comments and replies</li> \
				</ul> \
				';

				body += ' \
				<div class="dsq-lightbox-auth-fields"> \
					<table> \
						<tr> \
							<td>Email</td> \
							<td><input type="text" value="' + d.email.value + '" onchange="Dsq.Templates.lightboxUpdateEmail(' + post_id + ', this.value)" /><div id="dsq-email-errors' + pid + '"></div></td> \
						</tr> \
						<tr> \
							<td>Username</td> \
							<td><input id="dsq-field-username' + pid + '" type="text" value="' + suggestedUsername + '"/><div id="dsq-username-errors' + pid + '"></div></td> \
						</tr> \
						<tr> \
							<td>Password</td> \
							<td><input id="dsq-field-password' + pid + '" type="password" /><div id="dsq-password-errors' + pid + '"></div></td> \
						</tr> \
					</table> \
					<div class="dsq-lightbox-switch-auth"><a href="#" onclick="Dsq.Templates.lightboxAuthenticate(' + post_id + ',\'login\'); return false">Login instead</a></div> \
				</div> \
				<div id="dsq-lightbox-errors' + pid + '" class="dsq-lightbox-errors"></div> \
				<div class="dsq-lightbox-submit"> \
					<div class="dsq-lightbox-auth-post"><button type="button" class="dsq-button" onclick="Dsq.Templates.validateAuth(this, ' + post_id + ',\'' + auth_choice + '\')">Register and Post comment</button></div>'
					+ (Dsq.jsonData.forum.allow_anon_post
						? '<div class="dsq-lightbox-auth-skip"><button type="button" class="dsq-button-small" onclick="Dsq.Templates.postComment(' + post_id + ', this, true)">Just post as a Guest</button></div>'
						: '')
				+ '</div> \
				';
				break;
			case 'login':
				title = Dsq.jsonData.forum.allow_anon_post ? 'Optional:' : 'Required:';
				title += ' Login to your <img src="http://media.disqus.com/images/embed/disqus-profile.png" alt=Disqus Profile" />';
				body = '';
				
				if(d.avatar_url) {
					body += '<div class="dsq-lightbox-recognized"><table><tr>';
					body += '<td><img src="' + d.avatar_url + '" alt="" /></td>';
					body += '<td><span class="dsq-badge ' + (d.verified ? 'dsq-badge-verified' : 'dsq-badge-registered') + '">' + (d.verified ? 'Verified' : 'Registered') + '</span></td>';
					body += '<td>Hey <strong>' + d.display_name + '</strong>, is that you? Login below to claim this comment.';
					body += '</tr></table></div>';
				}

				body += ' \
				<div class="dsq-lightbox-auth-fields"> \
					<table> \
						<tr> \
							<td>Username or Email</td> \
							<td><input id="dsq-field-username' + pid + '" type="text" value="' + (d.avatar_url ? d.username : '') + '" /></td> \
						</tr> \
						<tr> \
							<td>Password <a href="http://disqus.com/forgot" target="_blank">(cannot log in?)</a></td> \
							<td><input id="dsq-field-password' + pid + '" type="password" /></td> \
						</tr> \
					</table> \
					<div class="dsq-lightbox-switch-auth"><a href="#" onclick="Dsq.Templates.lightboxAuthenticate(' + post_id + ',\'register\'); return false">Register instead</a></div> \
				</div> \
				<div id="dsq-lightbox-errors' + pid + '" class="dsq-lightbox-errors"></div> \
				<div class="dsq-lightbox-submit"> \
					<div class="dsq-lightbox-auth-post"><button type="button" class="dsq-button" onclick="Dsq.Templates.validateAuth(this, ' + post_id + ',\'' + auth_choice + '\')">Login and Post comment</button></div>'
					+ (Dsq.jsonData.forum.allow_anon_post
						? '<div class="dsq-lightbox-auth-skip"><button type="button" class="dsq-button-small" onclick="Dsq.Templates.postComment(' + post_id + ', this, true)">Just post as a Guest</button></div>'
						: '')
				+ '</div> \
				';
				break;
			default:
				break;
		}
		Dsq.Popup.lightbox(body, title, post_id);
		Dsq.$('dsq-field-username' + pid).focus();
	};
	
	this.buttonsToRestore = [];
	this.setLoadingButton = function(btn, post_id) {
		var pid = post_id ? '-' + post_id : '';
		if (btn) {

			var loadingBtn = document.createElement('button');
			loadingBtn.id = btn.id + '-loading';
			loadingBtn.innerHTML = '<img src="http://media.disqus.com/images/loading-lite.gif" alt="" /> ' + Dsq.Strings.JUST_A_MOMENT;
			loadingBtn.className = btn.className + ' dsq-post-loading';
			btn.parentNode.appendChild(loadingBtn);
			btn.style.display = 'none';
			var cancelBtn = Dsq.$('dsq-cancel-button' + pid);
			if(cancelBtn) { cancelBtn.style.display = 'none'; this.buttonsToRestore.push(cancelBtn); }
			this.buttonsToRestore.push(btn);
		} else {

			var buttons = this.buttonsToRestore;
			for(var i = 0; i < buttons.length; i++) {
				buttons[i].style.display = 'inline';
				Dsq.Utils.deleteNode(Dsq.$(buttons[i].id + '-loading'));
			}
		}
		
	};

	this.postComment = function(post_id, el_clicked, force, auth_choice) {
		var append_id = post_id ? '-' + post_id : '';
		var fields = Dsq.Templates.getFormFields(post_id);

		if (Dsq.Templates.validateFields(post_id)) {

			if (!Dsq.jsonData.request.is_authenticated && !force &&
				((!Dsq.Utils.readCookie('skipped_auth') && !disqus_skip_auth && !Dsq.jsonData.forum.disqus_auth_disabled) || !Dsq.jsonData.forum.allow_anon_post)) {
				Dsq.Templates.checkExistingUser(post_id);
				return false;
			}
			var params = [];
			if (!Dsq.jsonData.request.is_authenticated) {
				params.push(fields.name.value,
					fields.email.value,
					fields.website.value);

				if (auth_choice == 'login' || auth_choice == 'register') {
					params.push({
						auth_choice: auth_choice,
						username: fields.username.value,
						password: fields.password.value,
						email: fields.email.value
					});
				} else {
					params.push(null);
				}

				params.push(null /* sharing options */, Dsq.$('dsq-subscribe-on-post' + append_id).value);
			} else {
				var service_checked = function(name) {
					var el = Dsq.$('dsq-sharing-' + name + append_id);
					return (el !== null && el.checked === true) ? '1' : '0';
				};
				params.push(null, null, null, null, {
					tw: service_checked('twitter'),
					fb: service_checked('facebook'),
					tr: service_checked('tumblr'),
					wp: service_checked('wordpress'),
					mt: service_checked('movabletype'),
					tp: service_checked('typepad'),
					yh: service_checked('yahoo')
				});
			}

			var frame = Dsq.frames['reply_' + (post_id ? post_id : 0)];
			frame.post.apply(frame, params);

			if (el_clicked) {
				Dsq.Templates.setLoadingButton(el_clicked, post_id);
			}
			
			if (force) {
				Dsq.Utils.createCookie('skipped_auth', true);	
			}
			
		} else {
			return false;
		}
	};

	this.editComment = function(el_clicked, post_id) {
		var edited_message = Dsq.$('dsq-edit-textarea-' + post_id).value;

		Dsq.Templates.setLoadingButton(el_clicked, post_id);
		Dsq.frames['edit_' + post_id].edit(post_id, edited_message);
	};

	this.toggleEdit = function(post_id) {
		var body = Dsq.$('dsq-comment-body-' + post_id);
		var message = Dsq.$('dsq-comment-message-' + post_id);

		if (!Dsq.Post.stateEditToggled[post_id]) {


			message.style.display = 'none';
			if (Dsq.$('dsq-edit-' + post_id)) {
				Dsq.$('dsq-edit-' + post_id).style.display = 'block';
			} else {

				var edit_area = document.createElement('div');
				edit_area.id = 'dsq-edit-' + post_id;
				edit_area.className = 'dsq-edit dsq-textarea';
				edit_area.innerHTML = ' \
				<div class="dsq-textarea-wrapper"> \
					<textarea class="dsq-edit-textarea" id="dsq-edit-textarea-' + post_id + '">' + message.innerHTML + '</textarea> \
				</div> \
				<div class="dsq-save-edit"> \
					<button type="button" onclick="Dsq.Templates.editComment(this, ' + post_id + ')" class="dsq-button-small">Save Edit</button> \
				</div> \
				<div id="dsq-edit-iframe-' + post_id + '" style="display: none"></div> \
				';

				body.appendChild(edit_area);

				if (!Dsq.frames['edit_' + post_id]) {
					var _meta = Dsq.jsonData.posts[post_id];
					Dsq.frames['edit_' + post_id] = new Dsq.ReplyFrame(Dsq.$('dsq-edit-iframe-' + post_id), post_id);
					Dsq.frames['edit_' + post_id].init();
					Dsq.frames['edit_' + post_id].setState(post_id, _meta.depth);
				}
			}
		} else {

			message.style.display = 'block';
			Dsq.$('dsq-edit-' + post_id).style.display = 'none';
		}
		
		Dsq.Post.stateEditToggled[post_id] = !Dsq.Post.stateEditToggled[post_id];
	};
	
	this.edit = function(el, post_id) {

		Dsq.Templates.toggleEdit(post_id);
	};

	this.toggleReply = function(post_id, button) {
		
		if(!this.stateReplyToggled[post_id]) {

			if (Dsq.$('dsq-reply-post-' + post_id)) {
				Dsq.$('dsq-append-post-' + post_id).style.display = 'block';
			} else {
				Dsq.$('dsq-append-post-' + post_id).innerHTML = Dsq.Templates.postBox(post_id);
				var container = Dsq.$('dsq-textarea-wrapper-' + post_id);
				if (!Dsq.frames['reply_' + post_id] && container) {
					var _meta = Dsq.jsonData.posts[post_id];
					Dsq.frames['reply_' + post_id] = new Dsq.ReplyFrame(container, post_id);
					Dsq.frames['reply_' + post_id].init(function() {

						Dsq.$('dsq-append-post-' + post_id).innerHTML = Dsq.Templates.postBox(post_id, true);
						Dsq.$('dsq-form-area-' + post_id).innerHTML = '';

						var theme = (typeof disqus_frame_theme == 'undefined') ? 'default' : disqus_frame_theme;
						Dsq.Iframes.showReplyIframeInContainer(Dsq.$('dsq-form-area-' + post_id), post_id, {theme: theme});

					});
					Dsq.frames['reply_' + post_id].setState(post_id, _meta.depth);
				}
			}
			Dsq.$('dsq-append-post-' + post_id).className = 'dsq-append-post';
			Dsq.$('dsq-comment-footer-reply-' + post_id).className = 'dsq-comment-footer-reply-active';
			
		} else {

			Dsq.$('dsq-append-post-' + post_id).style.display = 'none';
			Dsq.$('dsq-append-post-' + post_id).className = '';
			Dsq.$('dsq-comment-footer-reply-' + post_id).className = 'dsq-comment-footer-reply';
		}
		
		this.stateReplyToggled[post_id] = !this.stateReplyToggled[post_id];

		if(Dsq.Utils.ie && this.stateReplyToggled[post_id]) {

		}

		Dsq.Events.fire(Dsq.Events.REPLY_IFRAME_TOGGLED, {
			postId: post_id,
			opened: this.stateReplyToggled[post_id]
		});
	};
	
	this.moderateOptions = function(post_id) {
		var _meta = Dsq.jsonData.posts[post_id];
		var userData = Dsq.jsonData['users'][_meta.user_key];
		
		if(!Dsq.jsonData.request.is_moderator && !Dsq.jsonData.request.is_global_moderator) { return false; }

		var html;
		
		html = ' \
		<div class="dsq-moderate-options"> \
		<table>'
		+ (_meta.email ? '<tr><td>Email</td><td>' + _meta.email + '</td></tr>' : '')
		+ (_meta.ip ? '<tr><td>IP address</td><td>' + _meta.ip + '</td></tr>' : '')
		+ '<tr> \
			<td>Actions</td> \
			<td><ul>'
			+ (Dsq.jsonData.request.moderator_can_edit
				? '<li><a href="#" onclick="Dsq.Post.edit(this, ' + post_id + '); Dsq.Popup._closePopup(null, true); return false;">Edit Comment</a></li>'
				: '')
			+ '<li><a href="#" onclick="Dsq.Post.removePost(' + post_id + ', 1); Dsq.Popup._closePopup(null, true); return false;">Delete Comment</a></li> \
			<li><a href="#" onclick="Dsq.Post.reportSpam(' + post_id + '); Dsq.Popup._closePopup(null, true); return false;">Mark Spam</a></li> \
			<li><a href="#" onclick="Dsq.Popup.blacklist(' + post_id + '); return false">Block User</a></li> \
			</ul></td> \
			</table> \
		</div> \
		';
		
		html += '<p>Go to the full <a href="http://disqus.com/comments/moderate/" target="_blank">moderate panel</a> for more options.</p>';
		
		return Dsq.Popup.popModal(html, 'Moderate Options', post_id);
	};
	
	this.placeholder = {
		'class': 'dsq-placeholder',
		'name': Dsq.Strings.NAME,
		'email': Dsq.Strings.EMAIL,
		'website': Dsq.Strings.WEBSITE + ' (' + Dsq.Strings.OPTIONAL.toLowerCase() + ')'
	};
	
	this.handlePlaceholder = function(evt, el, key) {
		var placeholder = Dsq.Templates.placeholder[key];
		var className = Dsq.Templates.placeholder['class'];
		
		switch(evt.type) {
			case 'focus':
				if(el.value == placeholder) {
					el.value = '';
					el.className = '';
				}
				break;

			case 'blur':
				if(el.value == '') {
					el.value = placeholder;
					el.className = className;
				}
				break;
			default:
				break;
		}
	};
	
	this.paginate = function(page, el_clicked) {

		var extra_params = '';

		if(typeof disqus_per_page != 'undefined') {
			extra_params += '&per_page=' + disqus_per_page;
		}
		if(typeof disqus_sort != 'undefined') {
			extra_params += '&sort=' + disqus_sort;
		}

		Dsq.$('dsq-pagination').innerHTML += '<img src="http://media.disqus.com/images/loading-small.gif">';
		
		if(el_clicked) {
			Dsq.Templates.setLoadingButton(el_clicked);
		}
		
		Dsq.Utils.execScript('http://disqus.com/forums/themoderatevoice/thread.js'
			+ '?slug='	+ 'poll_shows_most_americans_want_public_health_care'
			+ '&p='		+ page
			+ extra_params);
	};
	
	
	this.rate = function(el, id, vote) {


		if(Dsq.jsonData.request.is_authenticated || Dsq.jsonData.forum.allow_anon_votes) {
			if(vote == 1) {
				Dsq.$('dsq-like-' + id).innerHTML = '<img src="http://media.disqus.com/images/loading-small.gif">';
			}
			Dsq.Utils.execScript('http://disqus.com/forums/themoderatevoice/vote.js'
				+ '?post_id='    + id
				+ '&vote='        + vote);
		} else {
			Dsq.Popup.login('To rate, please log in');
		}
	};

	this.voted = function(post_id, points, vote) {

		Dsq.$('dsq-like-pts-' + post_id).innerHTML = points + Dsq.Utils.pluralize(points, ' person', ' people') + ' liked this.';

		if(vote) {
			Dsq.$('dsq-like-' + post_id).innerHTML = 'You liked this.&nbsp;&nbsp;';
		}
	};




	this.postComment_onSuccess = function(response, parent_post_id, post_id) {
		var approved = response.message.post_meta.approved;

		if (parent_post_id) {
			Dsq.Post.toggleReply(parent_post_id);
		}

		Dsq.Popup._closePopup(null, true);
		
		if (approved) {
			Dsq.Post.incrementPostCount();
			Dsq.Post.outlineComment(post_id);
		} else {			
			var unapproved_msg = 'Thanks for posting!\
	 Your comment must be approved by a moderator before appearing here.\
			';
			Dsq.Popup.popModal(unapproved_msg, 'Comment awaiting approval', post_id);
		}

		var sharing_results = response.message.sharing_results;
		var sharing_errors = '';
		for (var service in sharing_results) {
			if (sharing_results.hasOwnProperty(service) === true) {
				if (sharing_results[service].error === true) {
					sharing_errors += service + ', ';
				}
			}
		}

		if (sharing_results.facebook && sharing_results.facebook.callback) {
			FB.ensureInit(function() {
				FB.Connect.streamPublish('', sharing_results.facebook.attachment);
			});
		}

		if (sharing_errors !== '') {
			var message = 'Your comment was posted, but there were errors sharing with the following connections: ';
			message += sharing_errors.replace(/,\s$/, '');
			message += '<p><a href="' + Dsq.jsonData.settings.disqus_url + '/profile/connections" target="_blank">Configure your connections here</a></p>'
			Dsq.Popup.popModal(message, 'Sharing options');
		}

		Dsq.Templates.setLoadingButton(false);
	};

	this.postComment_onFailure = function(response, parent_post_id, post_id) {

		Dsq.Templates.setLoadingButton(false);
	};
};




// TODO: It might be faster to use string methods to find all <li (...) </li> blocks and pass to Dsq.PostHandler manually.
Dsq.CommentsHandler = function(str, head, post_id, content, tail, offset, s) {
	var prepend_post = Dsq.Templates.prependPost(post_id);
	var append_post = Dsq.Templates.appendPost(post_id);

	content = content.replace(Dsq.POST_RE, Dsq.PostHandler);
	Dsq.Templates.postLoopCounter++;
	head = Dsq.Templates.Filters.commentContainer(post_id, head);
	return prepend_post + head + content + tail + append_post;
};

Dsq.PostHandler = function(str, h_head, post_id, h_content, h_tail, b_head, b_content, b_tail, offset, s) {
	var prepend_header = Dsq.Templates.postPrependHeader(post_id);
	var append_header = Dsq.Templates.postAppendHeader(post_id);
	var prepend_body = Dsq.Templates.preBody(post_id);
	var append_body = Dsq.Templates.postBody(post_id);
	var append_footer = Dsq.Templates.postFooter(post_id);

	b_content = b_content.replace(Dsq.POST_BODY_RE, Dsq.PostBodyHandler);
	return h_head + prepend_header + h_content + append_header + h_tail + b_head + prepend_body + b_content + append_body + b_tail + append_footer;
};

Dsq.PostBodyHandler = function(str, head, post_id, content, tail, offset, s) {
	content = Dsq.Templates.Filters.commentContent(post_id, content);
	return head + content + tail;
};

Dsq.MediaPostHandler = function(str, args, offset, s) {
	args = args.split(' ');
	if(args[0] == 'seesmic') {
		return '<br />' + Dsq.Templates.mediaSeesmic(args[1], args[2]);
	}
	return '';
};


/**
 * Shorcuts
 */
Dsq.$ = function(element) { return document.getElementById(element); };
Dsq.$b = document.body || document.getElementsByTagName('body')[0];


/**
 * Dsq.Debug: Logging functions.
 */

Dsq.Debug = new function() {this.log=function(s){};this.profile=function(f){if(typeof f == 'function')return f();else return eval(f);};};


/**
 * Dsq.Urls: URL paths
 */
Dsq.Urls = new function() {
	this.LOGIN = '/profile/login/';
	this.LOGOUT = '/logout/';
	this.REPLY = 'http://themoderatevoice.disqus.com/poll_shows_most_americans_want_public_health_care/reply.html';
	this.REQUEST_USER_PROFILE = '/AnonymousUser/';
	this.REQUEST_USER_AVATAR = 'http://media.disqus.com/uploads/forums/2724//avatar92.jpg';
};
// Dsq.Urls

/**
 * Dsq.Validators: Validation for form fields
 */
Dsq.Validators = new function() {
	this.VALID_EMAIL_RE = /^[a-z0-9\-\_\+]+(\.[a-z0-9\-\_\+]+)*\@(([a-z0-9\-\_\+]+(\.[a-z0-9\-\_\+]+)*)+\.[a-z]{2,}|([0-9]+\.){3}[0-9]+)$/i;
	this.name = function(name) {
		var error = false;

		if(typeof Dsq.Templates.placeholder !== 'undefined' &&
		   name == Dsq.Templates.placeholder.name) {
			error = true;
		}
		if(name.length <= 1) {
			error = true;
		}

		if(error) {
			return "Please enter a name to comment.";
		} else {
			return true;
		}
	};
	this.email = function(addr) {
		if(Dsq.Validators.VALID_EMAIL_RE.test(addr)) {
			return true;
		} else {
			return "Please enter a valid email to comment.";
		}
	};
	this.url = function(addr) {
		if(!addr || addr.indexOf('.') != -1) {
			return true;
		} else {
			return "Please check your website URL (this field is optional).";
		}
	};

	this.validate = function(bulk_validation, failure_callback) {
		failure_callback = failure_callback || function(e){ alert(e); };

		for(var i = 0; i < bulk_validation.length; i++) {
			v = bulk_validation[i];
			ret = v.validator(v.value);
			if(ret !== true) {
				failure_callback(ret);
				return false;
			}
		}
		return true;
	};
};

/**
 * Dsq.Utils: Generic utility functions.
 */
Dsq.Utils = new function() {
	this.ie = /msie/i.test(navigator.userAgent) && !/opera/i.test(navigator.userAgent);
	this.ie7 = (document.all && !window.opera && window.XMLHttpRequest) ? true : false;
	this.ie6 = (!window.XMLHttpRequest) ? true: false;
	this.webkit = navigator.userAgent.indexOf('AppleWebKit/') >= 0;
	this.gebiFromElementCollectionCache = {};
	this._styleSheet = null;

	this.gebiFromElement = function(el, id, tag) {
		// This only method only helps IE.
		if(!this.ie) {
			return Dsq.$(id);
		} else {
			var cacheKey = el.id + '-' + tag;
			tag = tag || 'div';
			if(typeof this.gebiFromElementCollectionCache[cacheKey] != 'undefined') {
				collection = this.gebiFromElementCollectionCache[cacheKey];
			} else {
				collection = el.getElementsByTagName(tag);
				this.gebiFromElementCollectionCache[cacheKey] = collection;
			}

			for(var i = 0; i < collection.length; i++) {
				if(collection[i].id == id) {
					return collection[i];
				}
			}
			return null;
		}
	};

	this.execOnReady = function(func) {
		var node = document.createElement('document:ready');
		try {
			node.doScroll('left');
			func();
			node = null;
		} catch(err) {
			setTimeout(function() { Dsq.Utils.execOnReady(func); }, 10);
		}
	};


	// Courtesy of http://www.quirksmode.org/js/cookies.html
	this.createCookie = function(name,value,days) {
		if (days) {
			var date = new Date();
			date.setTime(date.getTime()+(days*24*60*60*1000));
			var expires = "; expires="+date.toGMTString();
		}
		else var expires = "";
		document.cookie = name+"="+value+expires+"; path=/";
	};

	this.readCookie = function(name) {
		var nameEQ = name + "=";
		var ca = document.cookie.split(';');
		for(var i=0;i < ca.length;i++) {
			var c = ca[i];
			while (c.charAt(0)==' ') c = c.substring(1,c.length);
			if (c.indexOf(nameEQ) == 0) return c.substring(nameEQ.length,c.length);
		}
		return null;
	};

	this.eraseCookie = function(name) {
		Dsq.Utils.createCookie(name,"",-1);
	};

	this.deleteNode = function(node) {
		if(node) {
			this.deleteChildren(node);
			if(typeof node.outerHTML != 'undefined') { node.outerHTML = ''; }
			else if(node.parentNode) { node.parentNode.removeChild(node); }
			delete node;
		}
	};

	this.deleteChildren = function(node) {
		if(node) {
			for(var x = node.childNodes.length-1; x >= 0; x--) {
				var childNode = node.childNodes[x];
				if(childNode.hasChildNodes()) { this.deleteChildren(childNode); }
				if(typeof childNode.outerHTML != 'undefined') { childNode.outerHTML = ''; }
				else node.removeChild(childNode);
				delete childNode;
			}
		}
	};

	this.findPos = function(obj) {
		var curleft = 0;
		var curtop = 0;
		if (obj.offsetParent) {
			do {
				curleft += obj.offsetLeft;
				curtop += obj.offsetTop;
			} while (obj = obj.offsetParent);
		}
		return [curleft,curtop];
	};

	this.getWindowSize = function() {
		var windowWidth = -1;
		var windowHeight = -1;

		if(typeof(window.innerWidth) == 'number') { //Non-IE
			windowWidth = window.innerWidth;
			windowHeight = window.innerHeight;
		} else if(document.documentElement) { // IE 6+ in 'standards compliant mode'
			windowWidth = document.documentElement.clientWidth || document.body.clientWidth;
			windowHeight = document.documentElement.clientHeight || document.body.clientHeight;
		}

		return [windowWidth, windowHeight];
	}

	this.getScrollPos = function() {
		var scrollWidth, scrollTop;

		if(document.documentElement && (document.documentElement.scrollTop || document.documentElement.scrollWidth)) {
			scrollWidth = document.documentElement.scrollWidth;
			// IE is weird here.  If no doctype is provided, document.body.scrollTop is 0,
			// otherwise document.documentElement.scrollTop is 0.
			scrollTop = document.documentElement.scrollTop || document.body.scrollTop;
		} else if(document.body.scrollTop && document.body.scrollWidth) {
			scrollWidth = document.body.scrollWidth;
			scrollTop = document.body.scrollTop;
		}

		return [scrollWidth, scrollTop];
	}

	this.addEventListener = function(instance, eventName, listener) {
		var listenerFn = listener;
		if (instance.addEventListener) {
			instance.addEventListener(eventName, listenerFn, false);
		} else if (instance.attachEvent) {
			listenerFn = function() {
				listener(window.event);
			};
			instance.attachEvent("on" + eventName, listenerFn);
		} else {
			throw new Error("Event registration not supported");
		}
		return {
			instance: instance,
			name: eventName,
			listener: listenerFn
		};
	};

	this.removeEventListener = function(event) {
		var instance = event.instance;
		if (instance.removeEventListener) {
			instance.removeEventListener(event.name, event.listener, false);
		} else if (instance.detachEvent) {
			instance.detachEvent("on" + event.name, event.listener);
		}
	};

	this.fixIframesIE = function(id) {
		var disqusThread = Dsq.$(disqus_container_id);
		var iframes = disqusThread.getElementsByTagName('iframe');

		if(id) {
			var container = Dsq.$(id);
		} else {
			var container = Dsq.$('dsq-content');
		}

		for(i = 0; i < iframes.length; i++) {
			if (container) {
				iframes[i].style.width = container.offsetWidth;
			}
		}
	};

	this.getElementsByClassName = function(oElm, strTagName, strClassName) {
	/* Credit: Jonathan Snook [http://www.snook.ca/jonathan], Robert Nyman [http://www.robertnyman.com] */
		var arrElements = (strTagName == "*" && oElm.all)? oElm.all : oElm.getElementsByTagName(strTagName);
		var arrReturnElements = new Array();
		strClassName = strClassName.replace(/\-/g, "\\-");
		var oRegExp = new RegExp("(^|\\s)" + strClassName + "(\\s|$)");
		var oElement;
		for(var i = 0; i < arrElements.length; i++) {
			oElement = arrElements[i];
			if(oRegExp.test(oElement.className)) {
				arrReturnElements.push(oElement);
			}
		}
		return (arrReturnElements);
	};

	this.postToUrl = function(url, post_data, opt_redirect) {
		var form = document.createElement('form');
		var iframe_container = document.createElement('div');
		var id = 'dsq-temp-iframe-' + (new Date()).getTime();

		form.method = 'POST';
		form.action = url;
		if (!opt_redirect) {
			form.target = id;
		}
		iframe_container.innerHTML = '<iframe style="display:none" name="' + id + '" id="' + id + '"></iframe>';

		for(var key in post_data) {
			if(post_data.hasOwnProperty(key)) {
				var input = document.createElement('input');
				input.name = key;
				input.type = 'hidden';
				input.value = post_data[key];

				form.appendChild(input);
			}
		}

		Dsq.$b.appendChild(iframe_container);
		Dsq.$b.appendChild(form);
		form.submit();
	};

	// Strips integer id from id of element in the form ('some-id-###')
	this.extractId = function(e) {
		var chunks = e.id.split('-');
		if(chunks.length <= 1) {
			return 0;
		} else {
			var retval = parseInt(chunks[chunks.length-1]);
			return !isNaN(retval) ? retval : null;
		}
	};

	this.getStyle = function(el, styleProp) {
		if(el.currentStyle) {
			var y = el.currentStyle[styleProp];
		} else if(window.getComputedStyle) {
			var y = document.defaultView.getComputedStyle(el, null).getPropertyValue(styleProp);
		}

		if(y == 'transparent' || y == '') {
			this.getStyle(el.parentNode, styleProp);
		} else {
			return y;
		}
	};

	this.execScript = function(url, append_qs, container) {
		var script = document.createElement('script');
		append_qs = typeof append_qs == 'undefined' ? true : append_qs;
		container = container || Dsq.container;

		if(append_qs) {
			var j = (url.indexOf('?') >= 0) ? '&' : '?';
			url += j + (new Date()).getTime();
		}
		script.type = 'text/javascript';
		script.charset = 'UTF-8';
		script.src = url;
		container.appendChild(script);
		return script;
	};

	this.pluralize = function(num, singular, plural) {
		return (num != 1) ? plural || 's' : singular || '';
	};

	this.getRequestParams = function(queryString /* optional */) {
		var pairs, tuple;
		var params = {};

		queryString = queryString || window.location.search.substring(1);
		pairs = queryString.split('&');

		for (var i = 0, pair; pair = pairs[i]; i++) {
			tuple = pair.split('=');
			params[tuple[0]] = (tuple[1] || true);
		}

		return params;
	};

	this.addCssRule = function(selector, styleText, index) {
		var stylesheet;
		index = index || 0;

		if(!this._styleSheet) {
			var styleEl = document.createElement('style');
			document.getElementsByTagName('head')[0].appendChild(styleEl);
			this._styleSheet = styleEl.sheet;
			if(!this._styleSheet) {
				// IE does not like our newly created stylesheet.
				this._styleSheet = document.styleSheets[document.styleSheets.length-1];
			}
		}
		stylesheet = this._styleSheet;

		if(stylesheet.insertRule) {
			var ruleText = selector + ' { ' + styleText + ' }';
			if(index == -1) {
				index = stylesheet.cssRules.length;
			}
			stylesheet.insertRule(ruleText, index);
		} else if(stylesheet.addRule) {
			stylesheet.addRule(selector, styleText, index);
		}
	};

	this.forEachIn = function(obj, callback) {
		for(var key in obj) {
			if(obj.hasOwnProperty(key)) {
				callback(key, obj[key]);
			}
		}
	};

	this._interpolateGlobalContext = {
		// values that get used a lot and are global to the request
		'profile_url': Dsq.Urls.REQUEST_USER_PROFILE,

		'disqus_url': Dsq.jsonData.settings.disqus_url,
		'media_url': Dsq.jsonData.settings.media_url,
		'request_username': Dsq.jsonData.request.username,
		'request_display_username': Dsq.jsonData.request.display_username,
		'forum_name': Dsq.jsonData.forum.name
	};

	this.renderFromContextStack = function(key, contexts) {
		// Returns the first instance of `key` in the array of objects `contexts` or else ''
		for (var i=0; i<contexts.length; i++) {
			if (contexts[i][key] !== undefined) {
				return String(contexts[i][key]);
			}
		}
		throw new Error('key ' + key + ' not found in context');
	};

	var that = this;
	this.interpolate = function(fmt, opt_localContext) {
		// Interpolate `fmt` named-format string with an assumed global context.
		// Based on `interpolate` in django.views.i18n
		var contextStack = [opt_localContext || {}, that._interpolateGlobalContext];
		return fmt.replace(/%\(\w+\)s/g, function(match){
			return that.renderFromContextStack(match.slice(2,-2), contextStack);
		});
	};

	this.stripTags = function(s) {
		// Removes HTML tags from `s`
		return s.replace(/(<([^>]+)>)/g,"");

	};

	this.assert = function(b) {
		if (!b) {
			throw new Error('Assertion error.');
		}
	};

};
// Dsq.Utils

/**
 * Dsq.Popup: Popup helper functions.
 */
Dsq.Popup = new function() {
	this.timeHide = new Array();
	this.timeShow = new Array();
	this.activePopup = {};
	this.profileCache = {};
	this.statusCache = {};

	this.showTimer = function(post_id) {
		// clear the hide timer
		clearTimeout(this.timeHide[post_id]);

		// start the timer
		if(!Dsq.Popup.profileIsOn && !Dsq.Thread.adminIsOn) {
			this.timeShow[post_id] = setTimeout("Dsq.Popup.popProfile(\"" + post_id + "\")", 400);
		}
	};

	this.hideTimer = function(post_id) {
		// clear the show timer
		clearTimeout(this.timeShow[post_id]);
	};

	this.updateProfile = function(username) {
		// Callback from /embed/profile.js
		if (this.statusCache[username]) {
			var statusEl = Dsq.$('dsq-profile-status-' + username);
			statusEl.innerHTML = this.statusCache[username];
			statusEl.style.display = 'block';
		}

		if (this.profileCache[username]) {
			var _cache = this.profileCache[username];

			var _genhtml = function(text) { return '<span><big>' + text + '</big></span>'; };
			var _no_comments = _genhtml(Dsq.FmtStrings.NUMBER_OF_COMMENTS(_cache.comments_count));
			var _no_likes = _genhtml(Dsq.FmtStrings.NUMBER_OF_LIKES(_cache.likes_count));
			var _no_points = _genhtml(Dsq.FmtStrings.NUMBER_OF_POINTS(_cache.points));

			var statsEl = Dsq.$('dsq-popup-profile-user-stats-' + username);
			statsEl.innerHTML = '';

			if (Dsq.jsonData.users[username].registered) {
				statsEl.innerHTML = _no_comments + _no_likes;
			}
			statsEl.innerHTML += _no_points;

			var activeSites = '';
			for (var i = 0; i < _cache.active_sites.length; i++) {
				var site = _cache.active_sites[i];
				activeSites += '<li><a href="' + site.url + '"> \
					<img src="' + site.favicon + '"/ width="16" height="16"/></a>\
					<a href="' + site.url + '">' + site.name + '</a></li>';
			}
			if (activeSites !== '') {
				Dsq.$('dsq-popup-profile-active-sites-' + username).innerHTML = activeSites;
			} else {
				Dsq.$('dsq-popup-profile-active-sites-' + username).innerHTML = 'This site.';
			}

			var moderatedSites = '';
			for (var i = 0; i < _cache.moderated_sites.length; i++) {
				var site = _cache.moderated_sites[i];
				moderatedSites += '<li><a href="' + site.url + '"> \
					<img src="' + site.favicon + '"/ width="16" height="16"/></a>\
					<a href="' + site.url + '">' + site.name + '</a></li>';
			}
			if (moderatedSites !== '') {
				Dsq.$('dsq-popup-profile-moderated-' + username).innerHTML = moderatedSites;
			} else {
				Dsq.$('dsq-popup-profile-moderated-wrapper-' + username).innerHTML = '';
			}
		}

		// Reposition popup after full HTML is rendered
		if(Dsq.Popup.activePopup && Dsq.Popup.activePopup.el) {
			Dsq.Popup.initPopup(Dsq.Popup.activePopup.el, Dsq.Popup.activePopup.id, Dsq.Popup.activePopup.type);
		}

	};

	this.showCookieMsgs = function() {
		var title = '';
		var message = '';
		var numAlerts = 0;

		Dsq.Utils.forEachIn(Dsq.jsonData.cookie_messages, function(k, v) {
			if (!v) return;

			switch(k) {
				// Cookie: Twitter
				case 'post_twitter':
					if (v === 'error') {
						title = 'Twitter Error!';
						message += '<li id="dsq-msg-twitter-error">Oops, we couldn\'t tweet this comment. Please check your <a href="http://disqus.com/account/services">account settings</a>.</li>';
					} else {
						var _msg = v.split(':');
						title = 'Tweeted!';
						message += '<li id="dsq-msg-twitter-success">Your comment was successfully tweeted. <a href="http://twitter.com/' + _msg[0] + '/status/' + _msg[1] + '">Click here to view the tweet</a>.</li>';
					}
					break;
				// Cookie: Unapproved Post
				case 'post_not_approved':
					title = 'Comment awaiting approval by a moderator';
					message += '<li id="dsq-msg-post-not-approved">Your comment must be approved by a moderator before appearing here.</li>';
					break;
				// Cookie: Profile Found
				case 'post_has_profile':
					title = 'Use your existing commenter profile';
					message += '<li id="dsq-msg-post-has-profile">You have just posted your commment as a <span class="dsq-badge-guest">Guest</span>, but you may already have a <span class="logo-disqus">Disqus</span> Profile.<br /><br /><a href="http://disqus.com/claim">Log in and claim this comment!</a></li>';
					break;
				case 'user_created':
					var _data = v.split(':');
					title = 'Profile created!';
					message += '<li id="dsq-msg-user-created">You have just created a <span class="logo-disqus">Disqus</span> Profile, the best way to claim, manage, and track your comments all over the web. \
					<br /><br />A confirmation is being sent to <strong>' + _data[1] + '</strong>. Please check for this email in order to verify your profile. \
					<ul class="dsq-list-tick"> \
						<li>Your username is <strong>' + _data[0] +'</strong>. <a href="http://disqus.com/people/' + _data[0] + '/" target="_blank">Click here to view your public profile</a>.</li> \
						<li>Be sure to set your profile picture, as well as connect your <span class="dsq-badge-facebook">Facebook</span> and <span class="dsq-badge-twitter">Twitter</span> accounts. <a href="http://disqus.com/account/" target="_blank">Click here for account settings</a>.</li> \
					</ul> \
					</li>'
					break;
				default:
					break;
			}
			numAlerts++;
		});

		if(numAlerts > 1) {
			message = '<ul class="dsq-list-bluebullet">' + message;
			message += '</ul>';
			title = 'Thanks for posting!';
		}
		if(numAlerts > 0) {
			if(typeof(disqus_cookie_msgs) == 'function') {
				disqus_cookie_msgs(message, title);
			} else {
				Dsq.Popup.popModal(message, title);
			}
		}
	};

	this.helpBadges = function(post_id) {
		var html = ' \
			<ul class="dsq-popup-help"> \
				<li><span class="dsq-badge dsq-badge-verified">Verified</span> has a <span class="logo-disqus">Disqus</span> Profile with a confirmed email address.</li> \
				<li><span class="dsq-badge dsq-badge-registered">Registered</span> has a <span class="logo-disqus">Disqus</span> Profile, but has not yet confirmed his or her email address.</li> \
				<li><span class="dsq-badge dsq-badge-guest">Guest</span> is not logged in with any account and has not claimed his or her comments.</li> \
				<li class="dsq-help-otheraccts">Other accounts</li> \
				<li><span class="dsq-badge dsq-badge-facebook">Facebook</span> is using his or her Facebook profile via Facebook Connect.</li> \
				<li><span class="dsq-badge dsq-badge-twitter">Twitter</span> is using his or her Twitter profile via Twitter Sign-in.</li> \
				<li><span class="dsq-badge dsq-badge-openid">OpenID</span> is using his or her OpenID.</li> \
			</ul> \
		';

		this.popModal(html, 'Help: Types of Commenters', post_id);
		return;
	};

	this.permalink = function(post_id) {
		var header = 'Link to this comment';
		var body = '<strong>You are anchored to</strong>:<br />' + document.location.protocol + '//' + document.location.host + document.location.pathname + document.location.search + '#comment-' + post_id;

		this.popModal(body, header, post_id);
	};

	this.login = function(header, body) {
		var h = header || 'Login or Register';
		var b = body || '';
		b += Dsq.Templates.frameLogin({id: 'dsq-popup-login'});
		b += '</iframe>'; // HACK: Sometimes there is something funky with the IFRAME SRC that causes no end tag
		this.popModal(b, h, null, true, 'dsq-popup-login');
	};

	this.blacklist = function(id) {
		var _meta = Dsq.jsonData.posts[id];
		var userData = Dsq.jsonData['users'][_meta.user_key];
		var title = 'Add to Blacklist';
		var message = ' \
		Adding this person to the blacklist will block him or her from commenting on this site. Check the following types that you would like to add to the blacklist:'
		+ (userData['registered'] ?
			'<div class="dsq-blacklist-option"> \
				<input id="dsq-blacklist-username" type="checkbox" checked> \
				<label for="dsq-blacklist-username"><strong>Username</strong>: ' + userData['username'] + '</label> \
			</div>'
			: '')
		+ (_meta.email ?
			'<div class="dsq-blacklist-option"> \
				<input id="dsq-blacklist-email" type="checkbox" checked> \
				<label for="dsq-blacklist-email"><strong>Email address</strong>: ' + _meta.email + '</label> \
			</div>'
			: '')
		+ '<div class="dsq-blacklist-option"> \
			<input id="dsq-blacklist-ip" type="checkbox" onclick="Dsq.$(\'dsq-blacklist-ip-warning\').style.display=\'block\'"> \
			<label for="dsq-blacklist-ip"><strong>IP address</strong>: ' + _meta.ip + '</label> \
		</div> \
		';

		message += ' \
			<p id="dsq-blacklist-ip-warning" style="display:none">	\
				Note: Blocking this person\'s IP address may also unintentionally prevent others, who share his/her IP address, from commenting on this site. \
				This may include people who are sharing the same computer, living in the same house, or using the same Internet provider. Only block an IP address as a last resort. \
			</p> \
		';

		message += ' \
			<p style="text-align:center"><button type="button" onclick="Dsq.Post.blockUser(' + id + '); this.disabled=true; this.innerHTML=\'Just one moment...\'">Add to Blacklist</button></p> \
		';

		Dsq.Popup.popModal(message, title);
	};

	this.remoteAccountSettings = function() {
		var body = '';
		// Set up IFrame.
		var params = {};
		var base_url = 'http://disqus.com/forums/themoderatevoice/_auth/embed/remote_settings/';
		var attributes = {id: 'dsq-popup-account-settings'};
		if (typeof disqus_frame_theme != 'undefined') {
			params['theme'] = disqus_frame_theme;
		}

		body = Dsq.Templates._frameGeneric(base_url, params, attributes);
		this.popModal(body, 'Account Settings', null, true, 'dsq-popup-account-settings');
	};

	this.popModal = function(message, title, post_id, use_listener, extra_classes) {
		var container = document.createElement('div');
		var header, body;

		Dsq.Popup._closePopup(null, true);

		if(typeof(title) == 'undefined') { title = ''; }
		if(typeof(use_listener) == 'undefined') { use_listener = true; }

		if(post_id) {
			container.id = 'dsq-popup-message-' + post_id;
		} else {
			container.id = 'dsq-popup-message';
		}

		header = title;
		body = message;

		container.innerHTML = Dsq.Templates.popupModal(header, body);
		Dsq.Popup.initPopup(container, post_id, 'message', extra_classes);
		if(use_listener) {
			Dsq.Popup.popupListener = Dsq.Utils.addEventListener(document, 'mouseup', Dsq.Popup._closePopup);
		}
	};

	this.popAlert = this.popModal;

	this.loading = function(post_id) {
		var title = Dsq.Strings.JUST_A_MOMENT;
		var body = '<div style="text-align:center; padding: 5px 0 10px 0"><img src="http://media.disqus.com/images/loading.gif" alt="" /></div>'
		Dsq.Popup.lightbox(body, title, post_id);
	};

	this.lightbox = function(message, title, post_id) {
		// Wraps Dsq.Popup.popModal

		var overlay = document.createElement('div');
		overlay.id = 'dsq-overlay';
		overlay.className = 'dsq-overlay';
		Dsq.$b.appendChild(overlay);
		
		Dsq.Popup.popModal(message, title, post_id, false, 'dsq-lightbox');
	};

	this.popProfile = function(post_id, userKey) {
		var post = Dsq.jsonData['posts'][post_id];
		if (post && post.has_been_anonymized) {
			Dsq.Popup.popModal('This message was anonymized by its previous owner.', 'Anonymized', post_id);
			return;
		}

		if(post_id) {
			userKey = Dsq.jsonData['posts'][post_id].user_key;	
		}
		var userData = Dsq.jsonData['users'][userKey];
		var elId = 'dsq-popup-profile-' + userKey;
		var container = document.createElement('div');

		if(this.activePopup.el) {
			this._closePopup(null, true);
			if(this.activePopup.linkClicked) {
				this.activePopup.linkClicked = false;
				return;
			}
		}

		container.id = elId;
		container.innerHTML = Dsq.Templates.popupProfile(userKey);

		this.initPopup(container, post_id, 'profile');
		this.popupListener = Dsq.Utils.addEventListener(document, 'mouseup', this._closePopup);

		if(!this.profileCache[userKey]) {
			Dsq.Utils.execScript('http://disqus.com/embed/profile.js'
				+ '?username=' + userKey
				+ '&anon=' + (userData['registered'] ? 0 : 1)
				+ '&f=' + Dsq.jsonData['request'].forum);
		} else {
			this.updateProfile(userKey);
		}
	};

	this._closePopup = function(e, force) {
		var activePopup = Dsq.Popup.activePopup.el;
		var id = Dsq.Popup.activePopup.id;
		var link = 'dsq-avatar-' + id; // HACK: Specific to profile toggle target

		// HACK: This event should be gone if there is no active popup.
		if(!activePopup) {
			return;
		}
		if(force || !Dsq.Popup.isClicked(e, activePopup.id)) {
			// TODO: This is breaking iE?
			if(Dsq.Popup.popupListener) {
				Dsq.Utils.removeEventListener(Dsq.Popup.popupListener);
			}
			
			// Kill overlay
			var overlay = Dsq.$('dsq-overlay');
			if(overlay) { Dsq.Utils.deleteNode(overlay); }
			
			try {
				Dsq.Utils.deleteNode(activePopup);
			} catch(e) {
				// HACK: IE6 throws an error when using deleteNode() with a node containing a <table> in the html.
				activePopup.parentNode.removeChild(activePopup);
			}
			Dsq.Popup.activePopup = {};
		}

		if(!force && Dsq.Popup.isClicked(e, link)) {
 			Dsq.Popup.activePopup.linkClicked = true;
		}

	};

	this.initPopup = function(popup, post_id, type, extra_classes) {
		popup.className = 'dsq-popup dsq-popup-' + type + ' ' + (extra_classes ? extra_classes : '');
		if(Dsq.Utils.ie6 || Dsq.Utils.ie7) {
			// HACK: We can't modify the body before it's ready, so we need
			//       to use an IE-safe "DOMReady" workaround before loading
			//       our popup.
			Dsq.Utils.execOnReady(function() {Dsq.$b.appendChild(popup); });
		} else {
			Dsq.$b.appendChild(popup);
		}

		popup.style.display = 'block';

		var xPos = (Dsq.Utils.getWindowSize()[0] - popup.offsetWidth) / 2;
		var yPos = (Dsq.Utils.getWindowSize()[1] - popup.offsetHeight) / 2;

		if(Dsq.Utils.ie6) {
			yPos += Dsq.Utils.getScrollPos()[1];
		}

		popup.style.left = xPos + 'px';
		popup.style.top = yPos + 'px';

		Dsq.Popup.activePopup = {
			'el' : popup,
			'id' : post_id,
			'type': type,
			'linkClicked' : false
		};
	};

	this.isClicked = function(e, id) {
		var t = e.target || e.srcElement;
		while(t && t.parentNode) {
			if(t.id == id) {
				return true;
			}

			t = t.parentNode;
		}
		return false;
	};
};
// Dsq.Popup

/**
 * Dsq.Templates
 */
Dsq.Templates = new function() {
	/*
	 * Counter keeping track of the number of posts iterated over.
	 */
	this.postLoopCounter = 0;
	this.filters = {};
	this.addPostContainer = 'dsq-post-add';
	this.textareaContainer = 'dsq-post-add';

	this.registerTemplate = function(name, func) {
		this['$$_' + name] = func;

		if(typeof DsqLocal.Filters != 'undefined'
		&& typeof DsqLocal.Filters[name] == 'function') {
			// Push filters to this.filters to unify code.
			this.filters[name] = this.filters[name] || [];
			this.filters[name].push(DsqLocal.Filters[name]);
		}

		this[name] = function() {
			var ret;

			if(typeof DsqLocal.Templates != 'undefined'
			&& typeof DsqLocal.Templates[name] == 'function') {
				ret = DsqLocal.Templates[name].apply(this, arguments);
			}

			if(ret === undefined) {
				ret = this['$$_' + name].apply(this, arguments);
			}

			if(this.filters[name]) {
				var args = [ret];

				args.push.apply(args, arguments);
				for(var i = 0; i < this.filters[name].length; i++) {
					ret = this.filters[name][i].apply(this, args);
				}
			}

			return ret;
		};
	};

	this.registerFilter = function(name, func) {
		this.filters[name] = this.filters[name] || [];
		this.filters[name].push(func);
	};

	/**
	 * Dsq.Templates.Filters
	 */
	this.Filters = new function() {
		this.commentContainer = function(post_id, s) {
			var _meta = Dsq.jsonData.posts[post_id];
			var classes = [];
			if(Dsq.jsonData.request.page > 1) {
				classes.push('dsq-append');
			}

			//
			// Extra classes used for custom themes
			//

			if(_meta.depth) {
				classes.push('dsq-comment-child', 'dsq-depth-' + _meta.depth, 'dsq-parent-is-' + _meta.parent_post_id);
			}


			//

			if(_meta.author_is_creator) {
				// TODO: We need to deprecate the "special" class since it is not properly prefixed.
				classes.push('special', 'dsq-special');
			}
			if(_meta.author_is_moderator) {
				classes.push('dsq-moderator');
			}
			classes.push(['dsq-odd', 'dsq-even'][Dsq.Templates.postLoopCounter % 2]);

			s = s.substring(0, s.lastIndexOf('>'));
			return s + ' class="dsq-comment ' + classes.join(' ') + '" style="margin-left:' + _meta.depth*30 + 'px">';
		};

		this.commentContent = function(post_id, s) {
			var _meta = Dsq.jsonData.posts[post_id];
			if (_meta.killed) {
				return '<em>Comment removed.</em>';
			} else if (!_meta.approved) {
				return '<em>This comment was flagged for review.</em>';
			}

			s = s.replace(Dsq.MEDIA_POST_RE, Dsq.MediaPostHandler);
			return s;
		};
	};

	//
	// Thread
	//
	// TODO: These need to be stripped of all Django template tags.

	this.authPost = function() {
		if (!Dsq.jsonData.context.show_reply) {
			return '';
		}
		var result = [];
		result = result.concat([
				'<div id="dsq-auth"',
						Dsq.jsonData.integration.reply_position ? 'class="dsq-auth-bottom"' : '',
						'>',
					'<div class="dsq-by">',
						'<a href="http://disqus.com" target="_blank">',
							(Dsq.jsonData.integration.disqus_logo ?
								Dsq.Utils.interpolate('<img src="%(media_url)s/images/embed/by-disqus.png" alt="discussion by DISQUS">') :
								Dsq.Utils.interpolate('<img src="%(media_url)s/images/embed/dsq-button-120x19.png" alt="discussion by DISQUS">')
							),
						'</a>',
					'</div>',
					'<div class="dsq-auth-header">',
						'<h3 id="dsq-add-new-comment" class="dsq-h3-addcomment">',
								Dsq.Strings.ADD_NEW_COMMENT,
						'</h3>',
						'<div id="dsq-login">',
						(!Dsq.jsonData.request.is_authenticated && Dsq.jsonData.forum.allow_anon_post
								? '<p class="dsq-login-message" id="dsq-login-message">You are commenting as a <a class="dsq-help" title="Click for more information" href="#" onclick="Dsq.Popup.helpBadges(); return false">Guest</a>. You may select one to log into:</p>'
								: '')
		]);
		if (!Dsq.jsonData.request.is_authenticated) {
			result = result.concat([
							Dsq.Utils.interpolate(
								'<a id="dsq-login-toggle" href="%(disqus_url)s%(login_url)s?next=article:%(thread_id)s" onclick="Dsq.Popup.login(); return false"><img class="dsq-login-icon" src="%(media_url)s/images/dsq-profile-btn.png" title="%(log_into)s" alt="%(log_into)s"/></a>',
								{login_url: Dsq.Urls.LOGIN, thread_id: Dsq.jsonData.thread.id, log_into: Dsq.Strings.LOG_INTO_DISQUS}
								),
							'&nbsp; ',
							(Dsq.jsonData.context.use_fb_connect ?
								'<div id="dsq-fbc-login" onlogin="DisqusFbcParentController.onLogin()" size="medium" background="light" length="short" style="display:inline; margin-right:7px"></div>' :
								''
							),
							(Dsq.jsonData.context.use_twitter_signin ?
								Dsq.Utils.interpolate(
									'<div id="dsq-twitter-login" class="dsq-twitter-login" onclick="Dsq.Twitter.startTwitterConnect();" style="display:inline; cursor: pointer"><img src="%(media_url)s/images/twitter-signin-short.png" style="margin-right:7px" /></div>', {}) : ''),
							(Dsq.jsonData.context.use_openid ?
								Dsq.Utils.interpolate(
									'<div id="dsq-openid-login" class="dsq-openid-login" onclick="Dsq.OpenID.requestURL();" style="display:inline; cursor:pointer;"><img src="%(media_url)s/images/openid-login-button.png"/></div>', {}
								) : '')
			]);
		}
		result = result.concat([
						'</div>', // dsq-login
					'</div>', // dsq-auth-header
					'<div id="dsq-authenticated" class="dsq-authenticated" ',
						Dsq.jsonData.request.is_authenticated ? 'style="display:block"' : '',
						'>',
						'<div class="dsq-authenticated-pic">',
								Dsq.Utils.interpolate('<a href="%(url)s" title="%(request_display_username)s">' +
																			'<img class="dsq-post-avatar" src="%(avatar_url)s" alt="" /></a>',
																			{avatar_url: Dsq.Urls.REQUEST_USER_AVATAR,
																			url: (Dsq.jsonData.request.is_remote
																					 ? Dsq.jsonData.request.url
																					 : Dsq.jsonData.settings.disqus_url + Dsq.Urls.REQUEST_USER_PROFILE) }),
						'</div>',
						'<div class="dsq-authenticated-info">',
							'<ul>',
								'<li>',
									(Dsq.jsonData.request.is_remote
										? Dsq.FmtStrings.LOGGED_IN_AS(
												Dsq.Utils.interpolate('<a href="%(url)s" title="%(request_display_username)s">%(request_display_username)s</a>', {url:Dsq.jsonData.request.url})
										  )
										: Dsq.FmtStrings.LOGGED_IN_AS(
												Dsq.Utils.interpolate('<a href="%(disqus_url)s%(profile_url)s" title="%(request_display_username)s">%(request_display_username)s</a>')
											)
									),
								'</li>',
								'<li class="logout">',
									(!Dsq.jsonData.request.is_remote
										? Dsq.Utils.interpolate('<img class="dsq-login-icon" src="%(media_url)s/images/dsqicon12.png" alt="%(logged_in_as)s"/>&nbsp',
											{logged_in_as: Dsq.FmtStrings.LOGGED_IN_AS(Dsq.jsonData.request.display_username)})
										: ''),

									(!Dsq.jsonData.request.is_remote
										? Dsq.Utils.interpolate('<a href="%(disqus_url)s%(logout_url)s?ctkn=%(csrf_token)s" title="%(logout_from_disqus)s">',
											{logout_url: Dsq.Urls.LOGOUT, csrf_token: Dsq.CSRF_TOKEN, logout_from_disqus: Dsq.FmtStrings.LOGOUT_FROM('DISQUS')})
										: ((Dsq.jsonData.request.remote_domain == 'twitter')
												? Dsq.Utils.interpolate('using Twitter (<a href="%(disqus_url)s%(logout_url)s?ctkn=%(csrf_token)s" title="Logout">Logout</a>)',
												 {logout_url: Dsq.Urls.LOGOUT, csrf_token: Dsq.CSRF_TOKEN})
												: ((Dsq.jsonData.request.remote_domain == 'openid')
													 ? Dsq.Utils.interpolate('using OpenID (<a href="%(disqus_url)s%(logout_url)s?ctkn=%(csrf_token)s" title="Logout">Logout</a>)',
													 {logout_url: Dsq.Urls.LOGOUT, csrf_token: Dsq.CSRF_TOKEN})
													 : ''
													)
											)
									),

									(!Dsq.jsonData.request.is_remote ? Dsq.FmtStrings.LOGOUT_FROM('<span class="logo-disqus">DISQUS</span>') : ''),
									'</a>',
								'</li>',
							'</ul>',
						'</div>',
					'</div>'
		]);
		if (Dsq.jsonData.context.use_fb_connect) {
			result = result.concat([
					'<div id="dsq-fbc-authenticated" class="dsq-authenticated">',
						'<div id="dsq-fbc-profilepic" class="dsq-authenticated-pic" uid="loggedinuser" type="FB.XFBML.ProfilePic" size="square" facebook-logo="true"></div>',
						'<div class="dsq-authenticated-info">',
							'<ul>',
								'<li>',
									'Logged in as <span id="dsq-fbc-name" uid="loggedinuser" type="FB.XFBML.Name" linked="true" useyou="false"></span>',
								'</li>',
								'<li class="logout">using Facebook Connect <a href="#" onclick="javascript:DisqusFbcParentController.logout();return false;">(Logout)</a></li>',
							'</ul>',
						'</div>',
					'</div>'
			]);
		}
		result = result.concat([
				'</div>', // dsq-auth
				'<div id="dsq-toolbar-items">',
				'</div>'
		]);
		result = result.concat([
					//
					//
					//
				((!Dsq.jsonData.forum.allow_anon_post && !Dsq.jsonData.request.is_authenticated) ?
					// Needs to be translated:
					('<p id="dsq-no-anon-msg">Required: Please log into <span class="logo-disqus">Disqus</span> ' +
					(Dsq.jsonData.context.use_fb_connect ? 'or connect with Facebook ' : '') +
					(Dsq.jsonData.context.use_twitter_signin ? 'or sign in with Twitter ' : '') +
					(Dsq.jsonData.context.use_openid ? 'or sign in using OpenID ' : '') +
					Dsq.Utils.interpolate('to comment on <strong>%(forum_name)s</strong>.</p>')) :
					''
				),
				'<div id="dsq-post-add"></div>',
				'<div style="margin:10px 0">',
				((Dsq.jsonData.forum.use_media) ?
						'<a href="#" id="dsq-media-link" onclick="Dsq.Post.showMenu(this, false, \'media\'); return false">' + Dsq.Strings.USE_MEDIA + ' <small>&#9660;</small></a>' :
						''),
				'</div>'
		]);
		return result.join('');
	};


	this.header = function() {

		var html = '\<h3 id="dsq-comments-count" class="dsq-h3-commentcount">\
	 <span id="dsq-num-posts">93</span> Comments\
	 &nbsp;\
	 <span class="dsq-item-feed">\
	 <a href="http://themoderatevoice.disqus.com/poll_shows_most_americans_want_public_health_care/latest.rss"><img src="http://media.disqus.com/images/embed/bullet-feed.png"></a>\
	 </span>\
	 </h3>\
	 <div id="dsq-options" style="margin:15px 0">\
	 <span class="dsq-item-sort">\
	 Sort by\
	 <select id="dsq-sort-select" onchange="Dsq.Thread.sortBy(this.value);">\
	 <option value="hot" selected="selected">Popular now</option>\
	 <option value="best" >Best Rating</option>\
	 <option value="newest" >Newest first</option>\
	 <option value="oldest" >Oldest first</option>\
	 </select>\
	 &nbsp;\
	 </span>\
	 <span class="dsq-item-cp"><a href="http://themoderatevoice.disqus.com/poll_shows_most_americans_want_public_health_care/">Community Page</a>&nbsp;&nbsp;&nbsp;</span>\
	 <span class="dsq-item-subscribe">\
	 <img src="http://media.disqus.com/images/embed/email.png" style="width:12px;height:12px;vertical-align:middle">\
	 <span id="dsq-subscribe">\
	 <a href="#" onclick="Dsq.Thread.subscribe(1); return false">Subscribe by email</a>\
	 </span>\
	 </span>\
	 </div>\
	 <div id="dsq-alerts">\
	 <p>Comments for this page are closed.</p>\
	 </div>\
		';

		

		
		if (Dsq.jsonData.request.is_moderator) { 
			html = ' \
			<div class="dsq-alert-message dsq-upgrade-message"> \
				<strong>Disqus upgrade available.</strong> Hi ' + Dsq.jsonData.request.display_username + ', this message is being displayed to you because you are a moderator of this site. <a href="#" onclick="Dsq.$(\'dsq-upgrade-message\').style.display=\'block\';this.style.display=\'none\';return false">Click here for details.</a> \
				<div style="display:none; margin-top:10px;" id="dsq-upgrade-message"> \
					A new theme is available with added features. <a href="http://disqus.com/comments/settings/' + Dsq.jsonData.forum.url + '/?p=customize">To change your theme, click here</a> and choose the theme Narcissus. \
					If you do not upgrade, you are missing out on features such as: real-time commenting, new sign-in integrations, and an upgrade interface. \
					<strong>This message will automatically go away in one week.</strong> \
				</div> \
			</div> \
			' + html; 
		}
		return html;
	};

	this.footer = function() {
		var html = Dsq.Templates.pagination();

		
			html += Dsq.Templates.authPost();
		

		html += Dsq.Templates.reactions();

		
			html += Dsq.Templates.trackbacks();
		

		return html;
	};

	this.pagination = function() {
		var html = '';
		
		if (Dsq.$('dsq-pagination')) { Dsq.$('dsq-pagination').innerHTML = ''; }
		if (!Dsq.jsonData.thread.paginate) { return ''; }

		//
		// TODO: num_paginator still uses the template tag for pagination, 
		// 		while append_paginator does it all in JavaScript.
		//		This should all be in JavaScript.
		//

		if (Dsq.jsonData.thread.num_pages > 1 && Dsq.jsonData.request.page < Dsq.jsonData.thread.num_pages) {
			html = ' \<a class="dsq-paginate-append-text" href="#" onclick="Dsq.Thread.paginate(Dsq.jsonData.request.page + 1, this); return false">Show more comments...</a>\
	 <button type="button" class="dsq-button-small dsq-paginate-append-button" onclick="Dsq.Thread.paginate(Dsq.jsonData.request.page + 1, this);">Load more comments</button>\
			';
		}
		
		if (Dsq.$('dsq-pagination')) {
			Dsq.$('dsq-pagination').innerHTML = html;
			return '';
		} else {
			return '<div id="dsq-pagination" class="dsq-pagination">' + html + '</div>';
		}
	};

	this.trackbacks = function() {
		var html = '';

		if(typeof DsqLocal != 'undefined' && DsqLocal.trackback_url && DsqLocal.trackbacks) {
			var trackbacks = DsqLocal.trackbacks;
			var trackback_url = DsqLocal.trackback_url;
		} else {
			var trackbacks = [
			
			
			];
			var trackback_url = 'http://themoderatevoice.disqus.com/poll_shows_most_americans_want_public_health_care/trackback/';
		}

		html += '<div class="dsq-item-trackback">Trackback URL&nbsp;&nbsp;<input class="dsq-trackback-url" onclick="this.select()" readonly="true" value="' + trackback_url + '"></div>';

		if(trackbacks.length) {
			html += '<ul id="dsq-references">'
			for(var i = 0; i < trackbacks.length; i++) {
				var trackback = trackbacks[i];
				html += '<li><cite><a href="' + trackback.author_url + '" rel="nofollow">' + trackback.author_name + '</a></cite> \
						<p class="dsq-meta">' + trackback.date + '</p> \
						<p class="dsq-content">' + trackback.excerpt + '</p></li>';
			}
			html += '</ul>';
			html = '<h3 class="dsq-h3-trackbacks">Trackbacks</h3>' + html;
		}

		return html;
	}

	this.showRetweets = function(id, limit, element_id /* Optional */) {
		var source, html = '';

		for (var i = 0, reaction; reaction = Dsq.jsonData.reactions[i]; i++) {
			if (reaction.id === id) {
				source = reaction.retweets;
			}
		}

		if (source) {
			if (limit === 0) {
				limit = source.length;
			}

			for (var j = 0; j < limit; j++) {
				var rt = source[j];
				html += '<a href="' + rt.url + '">' + rt.author_name + '</a>'	+ ((j === (limit - 1)) ? '.' : ', ');
			}
		}

		if (element_id === undefined) {
			return html;
		}

		var element = document.getElementById(element_id);
		element.innerHTML = html;
		return element;
	};

	this.showMoreReactions = function(reactions, has_more, start, limit) {
		var link = document.getElementById('dsq-show-more-reactions');
		var container = link.parentNode;
		container.removeChild(link);

		for (var i = 0, reaction; reaction = reactions[i]; i++) {
			var el = Dsq.Templates.generateReactionHTML(reaction);
			if (el) {
				container.innerHTML += el;
			}
		}

		if (has_more) {
			var d = Dsq.jsonData.settings.disqus_url;
			var f = Dsq.jsonData.forum.url;
			var t = Dsq.jsonData.thread.id;
			var s = start;
			var l = limit;

			var handler = 'Dsq.Utils.execScript(\'' + d + '/forums/' + f + '/more_reactions.js?t=' + t + '&s=' + s + '&l=' + l + '\', true); return false;';
			container.innerHTML += '<li id="dsq-show-more-reactions"><a href="#" onclick="' + handler + '">Show more reactions</a></li>';
		}
	};

	this.generateReactionHTML = function(reaction) {
		if (reaction.body === null || reaction.body == '') {
			return;
		}

		if (reaction.author_name === '') {
			reaction.author_name = '&nbsp;';
		}

		if (reaction.url === '') {
			reaction.url = reaction.get_service_url;
		}

		/* Reaction HTML begins */
		var item = '<li class="dsq-reaction" id="dsq-reaction-' + reaction.id + '">'
			+ '<div class="dsq-reaction-header">'
			+ '<div class="dsq-header-avatar">';

		if (reaction.author_url && reaction.author_url !== '') {
			item += '<a target="_blank" href="' + reaction.author_url +'">';
		} else {
			item += '<a target="_blank" href="#" onclick="return false;">';
		}

		if (reaction.avatar_url && reaction.avatar_url !== '') {
			item += '<img src="' + reaction.avatar_url + '"/>';
		} else {
			item += '<img src="' + Dsq.jsonData.media_url + '/images/noavatar32.png"/>';
		}

		var service_icon = (reaction.get_service_name == 'trackback' || reaction.get_service_name == 'pingback' ? 'rss' : reaction.get_service_name.replace(' ', ''));
		item += '<img class="dsq-service-icon" src="' + Dsq.jsonData.media_url + '/images/reactions/services/' + service_icon + '.png"/>'
			+ '</a></div>'
			+ '<cite><span>' + reaction.author_name + '</span></cite>'
			+ '<span class="dsq-header-meta"><a class="dsq-header-time">' + reaction.date_created + '</a></span>'
			+ '</div><div class="dsq-reaction-body">'
			+ '<div class="dsq-reaction-message">' + reaction.body + '</div>'
			+ '<div class="dsq-reaction-footer">From <a class="dsq-service-name" target="_blank" href="' + reaction.url + '">' + reaction.get_service_name + '</a> '
			+ 'via <a href="' + reaction.source_url + '">' + (reaction.source == 'backtype' ? 'BackType' : 'UberVU') + '</a>'
			+ (Dsq.jsonData.request.is_moderator || Dsq.jsonData.request.is_global_moderator ? '&nbsp;&bull;&nbsp;<a class="dsq-hide-reaction" href="#" onclick="Dsq.Reaction.hide(' + reaction.id + '); return false;">Hide</a>' : '') + '</div></div>';

		if(reaction.retweets) {
			var num_retweets = reaction.retweets.length;
			if (num_retweets > 0) {
				item += '<div class="dsq-reaction-retweets">';
				if (num_retweets == 1) {
					item += 'One more retweet from <a href="' + reaction.retweets[0].url + '">'  + reaction.retweets[0].author_name + '</a>';
				} else {
					item += (num_retweets + ' more retweets from ');

					item += '<span id="dsq-reaction-retweets-' + reaction.id + '">';
					var n_tweets = (num_retweets > 15) ? 15 : num_retweets;
					item += Dsq.Templates.showRetweets(reaction.id, n_tweets);

					if (n_tweets != num_retweets) {
						item += '</span> <a onclick="Dsq.Templates.showRetweets(' + reaction.id + ', 0, \'dsq-reaction-retweets-' + reaction.id + '\');'
							+ 'this.parentNode.removeChild(this); return false;" href="#">Show all</a>';
					}
				}
				item += '</div>';
			}
		}

		item += '</li>'; /* Reaction HTML ends */
		return item;
	};

	this.reactions = function() {
		var html, reaction;

		if (Dsq.jsonData.reactions === undefined || Dsq.jsonData.reactions.length === 0) {
			return '';
		}

		html = '';
		for (var i = 0; reaction = Dsq.jsonData.reactions[i]; i++) {
			var item = Dsq.Templates.generateReactionHTML(reaction);
			if (item) {
				html += item;
			}
		}

		if (Dsq.jsonData.has_more_reactions) {
			var d = Dsq.jsonData.settings.disqus_url;
			var f = Dsq.jsonData.forum.url;
			var t = Dsq.jsonData.thread.id;
			var s = Dsq.jsonData.reactions_start;
			var l = Dsq.jsonData.reactions_limit;

			var handler = 'Dsq.Utils.execScript(\'' + d + '/forums/' + f + '/more_reactions.js?t=' + t + '&s=' + s + '&l=' + l + '\', true); return false;';
			html += '<li id="dsq-show-more-reactions"><a href="#" onclick="' + handler + '">Show more reactions</a></li>';
		}

		return '<h3 class="dsq-h3-reactions">Reactions</h3><ul id="dsq-reactions" class="dsq-reactions">' + html + '</ul>';
	};
	
	this.missingPermissions = function() {
		return '	<p>Comments for this page are closed.</p>\n';
	};

	//
	// Post
	//

	this.prependPost = function(post_id) {
		var html = '<div id="comment-' + post_id + '"></div>';
		return html;
	};

	this.appendPost = function(post_id) {
		var html = '<div id="dsq-comment-reply-' + post_id + '"></div>';
		return html;
	};

	this.postPrependHeader = function(post_id) {
		var _meta = Dsq.jsonData.posts[post_id];
		var userData = Dsq.jsonData['users'][_meta.user_key];

		var _includeServices = function() {
			var userServices = Dsq.Post.getUserServices(null, post_id);
			var html = '';
			var hiddenThreshold = 3; // Define # of services to show before stuffing them in hidden div

			for(var i = 0; i < userServices.length; i++) {
				html +=
				(i == hiddenThreshold
					? '<li id="dsq-drop-hidden-' + post_id +'" class="dsq-drop-hidden"><ul>'
					: '')
				+ '<li class="dsq-drop-services"> \
					<a class="dsq-service-' + userServices[i].name.toLowerCase() + '" href="' + userServices[i].url + '" target="_blank"> \
						<img src="' + Dsq.jsonData.media_url + '/images/embed/services/' + userServices[i].name.toLowerCase() + '.png" alt="' + userServices[i].name.toLowerCase() + '">'
					+ userServices[i].name
					+ '</a> \
				</li>';
			}

			if(i >= hiddenThreshold) {
				html += '</ul></li> \
				<li id="dsq-drop-more-' + post_id + '" class="dsq-drop-more"><a href="#" onclick="Dsq.Post.dropProfileMore(this, '+ post_id + '); return false"><small>&#9660;</small></a></li> \
				';
			}
			return html;
		};

		return ' \
			<div class="dsq-header-avatar" id="dsq-header-avatar-' + post_id + '" onmouseover="Dsq.Post.dropProfile(' + post_id + ')"> \
				<a id="dsq-avatar-' + post_id + '" class="dsq-avatar" href="' + userData.url + '" onclick="Dsq.Popup.popProfile(' + post_id + '); return false;">'
			+ (Dsq.jsonData.forum.show_avatar
				? '<img src="' + Dsq.jsonData.users[_meta.user_key].avatar + '" alt="" />'
				: '')
			+ '</a>'
			+ '</div> \
		';
	};

	this.postAppendHeader = function(post_id) {
		var _meta = Dsq.jsonData.posts[post_id];

		return ''
			+ (_meta.author_is_moderator
				? '<img class="dsq-mod-star" src="http://media.disqus.com/images/bullet-star.png" title="Moderator" alt="" />'
				: '')
			+ '<span class="dsq-header-meta"> \
				<a id="dsq-time-' + post_id + '" class="dsq-header-time" href="#comment-' + post_id + '" title="Permalink">' + _meta.date + '</a> \
			</span>';
	};

	this.preBody = function(post_id) {
		return '';
	}

	this.postBody = function(post_id) {
		// TODO: Deprecate flagging conditional
		var _meta = Dsq.jsonData.posts[post_id];
		return ''
			+ (_meta.edited
				? '<p class="dsq-editedtxt">(Edited by a moderator)</p>'
				: '')
			;
	};

	this.postFooter = function(post_id) {
		// TODO: Use media should be conditional
		var _meta = Dsq.jsonData.posts[post_id];
		if(_meta.killed) { return ''; }

		return ' \
			<div class="dsq-comment-footer" id="dsq-comment-footer-' + post_id + '"> \
				<div id="dsq-points-' + post_id + '" class="dsq-likedtxt">'
				+ (_meta.points
					? _meta.points + Dsq.Utils.pluralize(_meta.points, ' person', ' people') + ' liked this comment.'
					: '')
				+ '</div>'
				+ '<ul class="dsq-comment-options dsq-list-style">'
				+ (_meta.votable
					? '<li class="dsq-list-first dsq-rate" id="dsq-rate-cont-' + post_id + '">'
					+ (!_meta.up_voted
						? '<a href="#" onclick="Dsq.Post.rate(this, ' + post_id + ', 1); return false;">Like</a>'
						: 'You liked this.') + '</li>'
					: '')
				+ '<li class="dsq-report' + (!_meta.votable ? ' dsq-list-first' : '') + '" id="dsq-post-report-' + post_id + '"><a href="#" class="dsq-post-report" onclick="Dsq.Post.report(' + post_id + ', false); return false;">Report</a></li> \
				</ul> \
				<ul class="dsq-list-style">'
				+ (_meta.can_reply
					? '<li class="dsq-list-first"><a href="#" id="dsq-reply-link-' + post_id +'" onclick="Dsq.Post.toggleReply(this, ' + post_id +'); return false;">Reply</a></li>'
					: '')
				+ (_meta.can_reply && !_meta.has_replies && _meta.from_request_user
					? '<li id="dsq-edit-el-' + post_id + '"><a id="dsq-edit-link-' + post_id + '" href="#" onclick="Dsq.Post.edit(this, ' + post_id + '); return false;">Edit</a></li>'
					: '')
				+ '<li class="' + (!_meta.can_reply ? 'dsq-list-first' : '') + '" id="dsq-more-el-' + post_id + '"><a id="dsq-more-link-' + post_id + '" href="#" onclick="Dsq.Post.showMenu(this, ' + post_id + ', \'more\'); return false">More <small>&#9660;</small></a></li>'
				+ (Dsq.jsonData.forum.use_media
					? '<li id="dsq-media-el-' + post_id +'" style="display:none"><a id="dsq-media-link-' + post_id + '" href="#" onclick="Dsq.Post.showMenu(this, ' + post_id + ', \'media\'); return false">Use Media <small>&#9660;</small></a></li>'
					: '')
				+ '</ul>'
				+ '<div id="dsq-reply-bar-' + post_id + '" class="dsq-reply-bar" style="display:none"> \
						<div id="dsq-reply-bar-items-' + post_id + '" class="dsq-reply-bar-items"> \
						</div> \
						<div id="dsq-reply-bar-auth-' + post_id + '" class="dsq-reply-bar-auth"> \
							 \
								 \
									<a href="#" class="dsq-help dsq-reply-req-opt" title="You must log into an account in order to comment on The Moderate Voice" onclick="Dsq.Popup.helpBadges(); return false">Required:</a> \
								 \
								<img class="dsq-login-icon" src="http://media.disqus.com/images/dsq-favicon-16x16.png" alt="" /> \
								<a id="dsq-reply-login-' + post_id + '" href="http://disqus.com/profile/login/?next=article:22540631" onclick="Dsq.Popup.login(); return false">Login</a> \
								 \
									&nbsp;or&nbsp; \
									<img class="fb_login_image" src="http://static.ak.fbcdn.net/images/fbconnect/login-buttons/connect_light_small_short.gif" alt="Facebook Connect"/> \
									<a href="#" onclick="FB.Connect.requireSession(DisqusFbcParentController.onLogin); return false;">Connect</a> \
								 \
								&nbsp;or&nbsp; \
									<img src="http://media.disqus.com/images/twitter-signin-icon.png" alt="" /> \
									<a href="#" onclick="Dsq.Twitter.startTwitterConnect(); return false">Sign-in</a> \
								 \
								 \
							 \
						</div> \
					</div> \
					<div id="dsq-reply-' + post_id + '"></div> \
			</div> \
		';
	};

	//
	// Iframes
	//

	this._makeAttributes = function(attributes) {
		// Makes a tag attributes string out of an object.
		// Caller is responsible for making sure nothing needs to be escaped.
		var result = [];
		for (key in attributes) {
			result.push(' ' + key + '="' + attributes[key] + '"');
		}
		result = result.join('');
		return result;
	};

	this._frameGeneric = function(base_url, params, attributes) {
		if(typeof(disqus_callback_params) == 'undefined') {
			disqus_callback_params = '';
		}

		var default_params = {
			// TODO: These should be moved to Dsq.jsonData.
			'f'				: 'themoderatevoice',
			't'				: 'poll_shows_most_americans_want_public_health_care',
			// Do we need encodeURIComponent here?
			'ifrs'			: encodeURIComponent(disqus_iframe_css),
			'to_redirect'	: encodeURIComponent(window.location),
			'cbp'			: disqus_callback_params,
			'ff'			: Dsq.Thread.ff,
			'fc'			: Dsq.Thread.fc,
			'ac'			: Dsq.Thread.ac,
			'default_text'	: disqus_default_text
		};

		base_url += '?' + (new Date()).getTime();
		// Add params to default_params.
		if(params) {
			for(var key in params) {
				if(params.hasOwnProperty(key)) {
					default_params[key] = encodeURIComponent(params[key]);
				}
			}
		}
		// Build querystring.
		for(var key in default_params) {
			if(default_params[key] && default_params.hasOwnProperty(key)) {
				base_url += '&' + key + '=' + default_params[key];
			}
		}

		return [
			'<iframe marginwidth="0" marginheight="0" hspace="0" vspace="0" frameborder="0"',
			(' allowtransparency="true" src="' + base_url + '"'),
			this._makeAttributes(attributes),
			'</iframe>'].join('');
	};

	this.frameLogin = function(opt_attributes) {
		var params = {};
		var base_url = 'http://disqus.com/embed/login.html';
		var attributes = opt_attributes || {};
		attributes['class'] = 'dsq-post-login';

		if(typeof disqus_frame_theme != 'undefined') {
			params['theme'] = disqus_frame_theme;
		}
		return this._frameGeneric(base_url, params, attributes);
	};

	this.frameReply = function(post_id, extra_params, attributes) {
		// Returns the HTML for a reply iframe. Called by Dsq.Iframes.setReplyIframeToContainer
		var _meta = (typeof post_id != 'undefined') ? Dsq.jsonData.posts[post_id] : false;
		var base_url = Dsq.Urls.REPLY;
		var params = {
			'def_email'		: disqus_def_email,
			'def_name'		: disqus_def_name
		};
		if(extra_params) {
			for(var key in extra_params) {
				if(extra_params.hasOwnProperty(key)) {
					params[key] = extra_params[key];
				}
			}
		}
		if(_meta) {
			params['parent_post'] = post_id;
		}
		if(typeof disqus_per_page != 'undefined') {
			params['per_page'] = disqus_per_page;
		}
		if(typeof disqus_frame_theme != 'undefined') {
			params['theme'] = disqus_frame_theme;
		}
		if(Dsq.jsonData.request.is_authenticated) {
			attributes['class'] += '-authenticated';
		}
		return this._frameGeneric(base_url, params, attributes);
	};

	this.frameEdit = function(post_id) {
		var _meta = (typeof post_id != 'undefined') ? Dsq.jsonData.posts[post_id] : false;
		var base_url = 'http://disqus.com/embed/edit.html';
		var params = {
			'p' : post_id
		};
		return this._frameGeneric(base_url, params, {'class': 'dsq-post-edit', 'name': 'dsq-edit_' + post_id + '-frame'});
	};

	//
	// Menus
	//

	this.menuMore = function(post_id) {
		// TODO: "Remove post" button should hide menu.
		var _meta = Dsq.jsonData.posts[post_id];
		var userData = Dsq.jsonData['users'][_meta.user_key];
		return ' \
			<li><a href="#comment-' + post_id + '" onclick="Dsq.Popup.permalink(' + post_id + ')">Link</a></li> \
			<li><a href="#" onclick="Dsq.Popup.popProfile(' + post_id + '); return false;">Profile</a></li>'
	+ (Dsq.jsonData.request.is_moderator || Dsq.jsonData.request.is_global_moderator
		? '	<li class="dsq-menu-sep"></li>' + (_meta.email ? '<li class="dsq-admin-email">' + _meta.email + '</li>' : '')
		+ '	<li class="dsq-admin-ip">' + _meta.ip + '</li> \
			<li class="dsq-menu-sep"></li>'
		+ (Dsq.jsonData.request.moderator_can_edit
			? ' <li class="dsq-admin-edit"><a href="#" onclick="Dsq.Post.edit(this, ' + post_id + '); return false;">Edit Comment</a></li>'
			: '')
		+ ' <li class="dsq-remove"><a href="#" onclick="Dsq.Post.removePost(' + post_id + ', 1); return false;">Remove Comment</a></li> \
			<li class="dsq-report-spam"><a href="#" onclick="Dsq.Post.reportSpam(' + post_id + '); return false;">Mark Spam</a></li> \
			<li class="dsq-block-user"><a href="#" onclick="Dsq.Popup.blacklist(' + post_id + '); return false">Block User</a></li>'
		: '');
	};

	this.menuMedia = function(post_id) {
		return ' \
			<li><a href="#" onclick="Dsq.Post.toggleMediaReply(this, ' + post_id + ', \'seesmic\'); return false;">Record video</a></li> \
		';
	};

	this.dropProfile = function(post_id) {
		var _meta = Dsq.jsonData.posts[post_id];
		var userData = Dsq.jsonData['users'][_meta.user_key];

		var _includeServices = function() {
			var userServices = Dsq.Post.getUserServices(null, post_id);
			var html = '';
			var hiddenThreshold = 3; // Define # of services to show before stuffing them in hidden div

			for(var i = 0; i < userServices.length; i++) {
				html +=
				(i == hiddenThreshold
					? '<li id="dsq-drop-hidden-' + post_id +'" class="dsq-drop-hidden"><ul>'
					: '')
				+ '<li class="dsq-drop-services"> \
					<a class="dsq-service-' + userServices[i].name.toLowerCase() + '" href="' + userServices[i].url + '" target="_blank"> \
						<img src="' + Dsq.jsonData.media_url + '/images/embed/services/' + userServices[i].name.toLowerCase() + '.png" alt="' + userServices[i].name.toLowerCase() + '">'
					+ userServices[i].name
					+ '</a> \
				</li>';
			}

			if(i >= hiddenThreshold) {
				html += '</ul></li> \
				<li id="dsq-drop-more-' + post_id + '" class="dsq-drop-more"><a href="#" onclick="Dsq.Post.dropProfileMore(this, '+ post_id + '); return false"><small>&#9660;</small></a></li> \
				';
			}
			return html;
		};


		var menu = '<li class="dsq-drop-showlnk"><a href="#" onclick="Dsq.Popup.popProfile(' + post_id + '); return false;">Expand &#8663;</a></li>';
		var pointsMessage = '';
		if (userData['registered']) {
			pointsMessage = 'with ' + userData['points'] + ' points (more points are better).';
		}

		if (userData['is_remote']) {
			var domain = userData['remote_domain_name'];
			menu += '<li class="dsq-drop-badge" title="' + userData['display_name'] + ' is a ' + domain + ' user ' + pointsMessage + '" onclick="Dsq.Popup.helpBadges()">';
			menu += '<span class="dsq-badge-' + domain.toLowerCase() + '">' + domain + '</span></li>';
		} else if (userData['registered']) {
			if (userData['verified']) {
				menu += '<li class="dsq-drop-badge" title="' + userData['display_name'] + ' has a verified commenter profile ' + pointsMessage + '" onclick="Dsq.Popup.helpBadges()">';
				menu += '<span class="dsq-badge-verified">Verified</span></li>';
			} else {
				menu += '<li class="dsq-drop-badge" title="' + userData['display_name'] + ' has a registered, but unverified, commenter profile ' + pointsMessage + '" onclick="Dsq.Popup.helpBadges()">';
				menu += '<span class="dsq-badge-registered">Registered</span></li>';
			}
		} else {
			menu += '<li class="dsq-drop-badge" title="' + userData['display_name'] + ' has not claimed this commenter profile." onclick="Dsq.Popup.helpBadges()"><span class="dsq-badge-guest">Guest</span></li>';
		}

		menu += _includeServices();
		return menu;
	};

	//
	// Popups
	//

	this._popupGeneric = function(content) {
		return ' \
		<div class="dsq-popup-content"> \
			<div class="dsq-popup-top"></div> \
			<div class="dsq-popup-body" class="clearfix"> \
				<div class="dsq-popup-body-padding"> \
					<div class="dsq-popup-header"> \
						<a class="dsq-close-link" href="#" onclick="Dsq.Popup._closePopup(null, true); return false"><img src="http://media.disqus.com/images/modal-close.png" alt="" /></a>'
						+ content['header']
					+ '</div>'
					+ content['body']
					+ '<div class="powered-by"><a href="http://disqus.com/comments/">Powered by <img src="http://media.disqus.com/images/embed/disqus-logo.png" alt="Disqus Comments" style="margin-bottom:-5px" /></a></div> \
				</div> <!-- padding --> \
			</div> <!-- body --> \
			<div class="dsq-popup-bottom"></div> \
		</div> \
		';
	};

	this.popupProfile = function(user_key) {
		var userServices = Dsq.Post.getUserServices(user_key, null);
		var userData = Dsq.jsonData['users'][user_key];
		var headerHtml = '';
		var bodyHtml = '';
		var content = {};

		var _includeServices = function() {
			var html = '';
			for(var i = 0; i < userServices.length; i++) {
				html +=
				(i == 0
					? '<h4>Connections</h4><ul>'
					: '')
				+ '<li> \
					<img src="' + Dsq.jsonData.media_url + '/images/embed/services/' + userServices[i].name.toLowerCase() + '.png" alt="' + userServices[i].name.toLowerCase() + '" title="' + userServices[i].name.toLowerCase() + '" /> \
					<a class="dsq-service-' + userServices[i].name.toLowerCase() + '" href="' + userServices[i].url + '" target="_blank">'
					+ userServices[i].name
					+ '</a> \
				</li>'
				+ (i+1 == userServices.length ? '</ul>' : '');
			}
			return html;
		};

		headerHtml = ' \
			<table> \
				<tr> \
					<td> \
						<a class="dsq-profile-userurl" href="' + userData.url + '"><img class="dsq-popup-profile-avatar" src="' + userData['avatar'] + '" alt="" /></a> \
					</td> \
					<td> \
						<div class="dsq-popup-profile-user"> \
							<h3>' + userData['display_name'] + '</h3> \
							<div class="dsq-popup-profile-user-stats" id="dsq-popup-profile-user-stats-' + user_key + '">Loading...</div> \
						</div> \
					</td> \
				</tr> \
			</table> \
		';

		bodyHtml = ' \
			<div class="dsq-popup-profile-state"> \
				This is a&nbsp;<span class="'
					+ (userData['registered']
						? (userData['verified']
							? ' dsq-badge-verified'
							: (userData['is_remote']
								? ' dsq-badge-' + userData['remote_domain_name'].toLowerCase()
								: ' dsq-badge-registered')
							)
							: ' dsq-badge-guest') + '">'
			+ (userData['registered']
				? (userData['verified']
					? 'Verified'
					: (userData['is_remote']
						 ? userData['remote_domain_name']
						 : 'Registered')
					)
				: 'Guest')
			+ '</span>&nbsp;commenter profile.'
			+ '&nbsp;<a class="dsq-profile-userurl" href="' + userData.url + '"><strong>View more comments </strong></a>'
			+ (!userData['points']
				? '<p class="dsq-popup-notice">If this is you, <a href="http://disqus.com/profile" target="_blank">claim it now</a> to manage your comments.</p>'
				: '')
			+ ((userData['registered'] && !userData['verified'] && (Dsq.jsonData.request.username && (Dsq.jsonData.request.username == userData['username'])) && !userData['is_remote'])
				? '<p class="dsq-popup-notice"><strong>Alert</strong>: You have not verified this account. <a href="http://disqus.com/verify">Verify it now.</a></p>'
				: '')
			+ '</div> \
			<div id="dsq-profile-status-' + user_key + '" class="dsq-popup-profile-status" style="display:none"></div> \
			<div class="dsq-popup-profile-snapshot"> \
				<table> \
					<tr> \
						<td> \
							<div id="dsq-popup-profile-active-sites-wrapper-' + user_key + '"> \
								<h4>Most active sites</h4> \
								<ul id="dsq-popup-profile-active-sites-' + user_key + '"> \
									<li>Loading...</li> \
								</ul> \
							</div> \
						</td> \
						<td>'
							+ _includeServices()
							+ '<div id="dsq-popup-profile-moderated-wrapper-' + user_key + '"> \
								<h4>Moderator of</h4> \
								<ul id="dsq-popup-profile-moderated-' + user_key + '"> \
									<li>Loading...</li> \
								</ul> \
							</div> \
						</td> \
					</tr> \
				</table> \
			</div> \
			';

		content = {
			'header': headerHtml,
			'body': bodyHtml
		};

		return this._popupGeneric(content);
	};

	this.popupReblog = function() {
		var headerHtml = '';
		var bodyHtml = '';
		var content = {};

		headerHtml = ' \
			<cite><span>Reblog this comment</span></cite> \
		';

		bodyHtml = ' \
			<div id="dsq-reblog-form" class="dsq-reblog-form"> \
			</div> \
		';

		content = {
			'header': headerHtml,
			'body': bodyHtml
		};

		return this._popupGeneric(content);
	};

	this.popupModal = function(title, message) {
		var headerHtml = '';
		var bodyHtml = '';
		var content = {};

		headerHtml = ' \
			<h3>' + title + '</h3> \
		';

		bodyHtml = message;

		content = {
			'header': headerHtml,
			'body': bodyHtml
		};

		return this._popupGeneric(content);
	};

	this.alertContent = function(name, post_id) {
		var alert = {
			'post_not_approved': {
				'title': 'Comment awaiting approval by a moderator',
				'message': 'Thanks for posting. Your comment must be approved by a moderator before appearing here.'
			},
			'post_has_profile': {
				'title': 'Use your existing commenter profile',
				'message': 'You have just posted your commment as a <span class="dsq-badge dsq-badge-guest">Guest</span>, but you may already have a <span class="dsq-badge dsq-badge-registered">Registered</span> commenter profile.<br /><br /><a href="http://disqus.com/claim">Log in and claim this comment!</a>'
			}
		};
		return alert[name] || false;
	};

	//
	// Actions
	//

	this.voted = function(post_id, points, vote) {
		// Update number of points
		Dsq.$('dsq-points-' + post_id).innerHTML = points + Dsq.Utils.pluralize(points, ' person', ' people') + ' liked this comment.';

		// Update link text
		if(vote) {
			Dsq.$('dsq-rate-cont-' + post_id).innerHTML = 'You liked this.';
		}
	};

	this.subscribed = function(status) {
		var title, message;

		if(status) {
			title = 'Subscribed!';
			message = 'You have subscribed to this comment thread. New comments will be sent directly to your email inbox, where you may read and respond by email.';
			Dsq.$('dsq-subscribe').innerHTML = ' \
				<a href="#" onclick="Dsq.Thread.subscribe(0); return false">Unsubscribe</a> \
			';
		} else {
			title = 'Unsubscribed';
			message = 'You have unsubscribed to this comment thread. New comments will no longer be sent to your email inbox.';
			Dsq.$('dsq-subscribe').innerHTML = ' \
				<a href="#" onclick="Dsq.Thread.subscribe(1); return false">Subscribe by email</a> \
			';
		}

		Dsq.Popup.popModal(message, title);

	};
	
	this.highlighted = function() {
		Dsq.Popup.popModal('This comment has been highlighted.', 'Highlighted comment');
	};

	//
	// Media
	//

	this.mediaSeesmic = function(id, thumb) {
		return ' \
			<div id="dsq-seesmic-' + id + '_preview" class="dsq-seesmic-preview"><a href="http://www.seesmic.com/video/' + id + '" target="_blank" class="see_link">&nbsp;</a> \
				<div style="display:block;width:160px; height:120px; border:none; background-image:url(http://t.seesmic.com/thumbnail/' + thumb + ')"> \
					<div id="dsq-seesmic-' + id + '_hide" class="seePlayOverlay" style="display:none;"><img onclick="see_play_video(\'' + id + '\',false)" src="http://media.disqus.com/images/seesmic/stopOverlay.png" width="50" height="50" style="cursor:pointer; cursor:hand; padding-top: 30px; padding-left: 50px" alt="" /></div> \
					<div id="dsq-seesmic-' + id + '_show" class="seePlayOverlay"><img onclick="see_play_video(\'' + id + '\',true)" src="http://media.disqus.com/images/seesmic/playOverlay.png" width="50" height="50" style="cursor:pointer; cursor:hand; border:none; padding-top: 30px; padding-left: 50px" alt="" /></div> \
				</div> \
			</div> \
			<div id="' + id + '_content" style="display:block; width:100%; padding-top:5px"></div> \
		';
	};

	//
	// Callbacks
	//

	this.postComment_onSuccess = function(parent_post_id) {
		// Increment post count
		var num_posts = Dsq.$('dsq-num-posts');
		var total_posts = Dsq.$('dsq-total-posts');
		
		if (num_posts) { 
			num_posts.innerHTML = parseInt(num_posts.innerHTML) + 1;
		}
		if (total_posts) { 
			total_posts.innerHTML = parseInt(total_posts.innerHTML) + 1;
		}
	};
};
// Dsq.Templates


/**
 * Dsq.Post
 */
Dsq.Post = new function() {
	this.openedMenu = {};
	this.menuEventListener = null;
	this.stateReplyToggled = {};
	this.stateEditToggled = {};
	this.stateRecordLink = {};

	/**
	 * Inserts a new post into the document.
	 *
	 * @param after_id {Number}	Insert a post before specified id.  If after_id
	 *							evaluates to false, then post in the front.  If
	 *							after_id is -1, post at the end.
	 */
	this.insert = function(after_id, id, message, author) {
		// Skeleton template from thread_posts.html.
		var skeleton = ' \
			<li id="dsq-comment-%(id)s"> \
				<div id="dsq-comment-header-%(id)s" class="dsq-comment-header"> \
					<cite id="dsq-cite-%(id)s" class="dsq-comment-cite"> \
						<a id="dsq-author-user-%(id)s" href="%(author_url)s" target="_blank" rel="nofollow">%(author_name)s</a> \
					</cite> \
				</div> \
				<div id="dsq-comment-body-%(id)s" class="dsq-comment-body"> \
					<div id="dsq-comment-message-%(id)s" class="dsq-comment-message">%(message)s</div> \
				</div> \
			</li> \
		';
		var _meta = Dsq.jsonData.posts[id];
		var _user_meta = Dsq.jsonData.users[_meta.user_key];
		var markup = Dsq.Utils.interpolate(skeleton, {
			id: id,
			message: message,
			author_url: _user_meta.blog,
			author_name: _user_meta.display_name
		});
		var div = document.createElement('div');
		markup = markup.replace(Dsq.COMMENTS_RE, Dsq.CommentsHandler);
		div.innerHTML = markup;

		if (after_id === -1) {
			Dsq.$('dsq-comments').appendChild(div);
		} else if (!after_id) {
			Dsq.$('dsq-comments').insertBefore(div, Dsq.$('dsq-comments').firstChild);
		} else if (Dsq.$('dsq-comment-' + after_id)) {
			// Get next node after "after_id", so we can insert before it.
			// If "after_id" is the last comment, the target node is the
			// last node.
			
			// var append_post_id = Dsq.Templates.appendPost(after_id).replace('<div id="','').replace('"></div>', '');
			var append_post_id = 'dsq-append-post-' + after_id;
			var node = Dsq.$(append_post_id);
			while (node = node.nextSibling) {
				if (!node || node.nodeType == 1) { // 1 == Node.ELEMENT_NODE
					break;
				}
			}
			if (!node) {
				node = Dsq.$(append_post_id);
			}
			node.parentNode.insertBefore(div, node);
		}
	};

	this.incrementPostCount = function() {
		
		var num_posts = Dsq.$('dsq-num-posts');
		var total_posts = Dsq.$('dsq-total-posts');

		if (num_posts) {
			num_posts.innerHTML = parseInt(num_posts.innerHTML, 10) + 1;
		}
		if (total_posts) {
			total_posts.innerHTML = parseInt(total_posts.innerHTML, 10) + 1;
		}
	}
	
	this.outlineComment = function(post_id) {
		Dsq.$('dsq-comment-' + post_id).className += ' dsq-comment-outline';
		setTimeout("(function () { Dsq.Post.clearOutlineComment(" + post_id + ") })()", 3000);
	};
	
	this.clearOutlineComment = function(post_id) {
		Dsq.$('dsq-comment-' + post_id).className = Dsq.$('dsq-comment-' + post_id).className.replace('dsq-comment-outline', '');
	};

	this.showMenu = function(el, id, name) {
		var anchorPos = Dsq.Utils.findPos(el);
		var menu = document.createElement('ul');

		if(this.openedMenu) {
			if(this.openedMenu.linkClicked) {
				this.openedMenu.linkClicked = false;
				return;
			}
		}

		switch(name) {
			case 'more':
				menu.innerHTML = Dsq.Templates.menuMore(id);
				break;
			case 'media':
				menu.innerHTML = Dsq.Templates.menuMedia(id);
				break;
			default:
				break;
		}

		// Add menu to document body
		menu.id = 'dsq-menu-' + id;
		menu.className = 'dsq-menu';
		Dsq.$b.appendChild(menu);

		// Position and show
		anchorPos[1] += 15;
		menu.style.left = anchorPos[0] + 'px';
		menu.style.top = anchorPos[1] + 'px';
		menu.style.display = 'block';

		// Set global reference
		this.openedMenu = {
			'el' : menu,
			'id' : id,
			'name' : name,
			'linkClicked' : false
		};

		// Set listener
		this.menuEventListener = Dsq.Utils.addEventListener(document, 'mouseup', this._hideMenu);
	};

	this._hideMenu = function(e) {
		var el = e.target || e.srcElement;
		var openedMenu = Dsq.Post.openedMenu.el;
		var id = Dsq.Post.openedMenu.id;

		if(!id) {
			var link = 'dsq-' + Dsq.Post.openedMenu.name + '-link';
		} else {
			var link = 'dsq-' + Dsq.Post.openedMenu.name + '-link-' + id;
		}

		if(!openedMenu) {
			return;
		}

		if(!Dsq.Popup.isClicked(e, openedMenu.id)) {
			openedMenu.style.display = 'none';
			Dsq.Utils.removeEventListener(Dsq.Post.menuEventListener);
			Dsq.Utils.deleteNode(openedMenu);

		} else {
			// Hide the menu if a link was clicked inside the menu.  We can't
			// completely remove the menu until the onclick event on the link
			// fires, but the menuEventListener will prevent multiple menus
			// from polluting the DOM.
			if(el && typeof el.href != 'undefined') {
				openedMenu.style.display = 'none';
				Dsq.Post.openedMenu.el = null;
			}
		}

		if(Dsq.Popup.isClicked(e, link)) {
 			Dsq.Post.openedMenu.linkClicked = true;
		}
	};


	this.getUserServices = function(user_key, id) {
		if(!user_key && id) {
			var _meta = Dsq.jsonData.posts[id];
			user_key = _meta.user_key;
		}
		var userData = Dsq.jsonData['users'][user_key];
		var userServices = [];

		// Keep a full list of supported services. This is the order they will display in the drop-profile.
		// Each service must have a corresponding case in _buildServiceUrl()
		var supportedServices = ['blog', 'twitter', 'facebook', 'tumblr'];

		function _buildServiceUrl(serviceName) {
			var data = userData[serviceName];
			var services = {
				blog:		function(d) { return d; },
				twitter:	function(d) { return d; },
				facebook:	function(d) { return d; },
				tumblr:		function(d) { return 'http://' + d + '.tumblr.com'; }
			};
			return services[serviceName](data);
		}

		for(var i = 0; i < supportedServices.length; i++) {
			if(userData[supportedServices[i]]) {
				var serviceUrl = _buildServiceUrl(supportedServices[i]);
				userServices.push({'name' : supportedServices[i], 'url' : serviceUrl});
			}
		}
		return userServices;
	}

	this.dropProfile = function(id) {
		var dp = Dsq.$('dsq-drop-profile-' + id);

		// IE6 needs JS to display/hide. All other browsers use CSS.
		if(dp) {
			if(Dsq.Utils.ie6) dp.style.display = (dp.style.display == 'inline') ? 'none' : 'inline';
			return false;
		} else {
			dp = document.createElement('ul');
		}

		dp.id = 'dsq-drop-profile-' + id;
		dp.className = 'dsq-drop-profile';

		if(Dsq.Utils.ie6) { dp.style.display = 'inline'; }

		var container = Dsq.$('dsq-header-avatar-' + id);
		dp.innerHTML = Dsq.Templates.dropProfile(id);
		container.appendChild(dp);
	};

	this.dropProfileMore = function(el, id) {
		var hiddenItems = Dsq.$('dsq-drop-hidden-' + id);

		hiddenItems.style.display = 'inline';
		el.parentNode.style.display = 'none';
	};

	this._updateReplyLinks = function(el, id) {
		// Update "reply / cancel" links based on state.
		var displayDict = {};

		if(id) {
			if(this.stateReplyToggled[id]) {
				el.innerHTML = 'Cancel';
				displayDict['media'] = 'inline';
				displayDict['edit'] = 'none';
			} else {
				el.innerHTML = 'Reply';
				displayDict['media'] = 'none';
				displayDict['edit'] = 'inline';
			}
		}

		for(var key in displayDict) {
			if(displayDict.hasOwnProperty(key)) {
				var	linkEl = Dsq.$('dsq-' + key + '-el-' + id),
					spacer = Dsq.$('dsq-' + key + '-spacer-' + id);

				if(linkEl) {
					linkEl.style.display = displayDict[key];
					if(spacer) spacer.style.display = displayDict[key];
				}
			}
		}
	};

	this._updateMediaLinks = function(el, id) {
		// Update "use media / cancel" links based on state.
		var appendId = (id) ? ('-' + id) : '';
		var link = Dsq.$('dsq-media-link' + appendId);

		if(this.stateRecordLink[id]) {
			link.innerHTML = 'Cancel Media';
			link.onclick = function() { Dsq.Post.toggleMediaReply(link, id); return false; };
		} else {
			link.innerHTML = 'Use Media <small>&#9660;</small>';
			link.onclick = function() { Dsq.Post.showMenu(link, id, 'media'); return false; };
		}
	};

	this.toggleReply = function(el, id) {
		// Create reply IFrame
		if (window.disqus_use_postmessage) {
			if (!this.stateReplyToggled[id]) {
				Dsq.$('dsq-reply-' + id).style.display = 'block';
				Dsq.$('dsq-reply-bar-' + id).style.display = 'block';
				// Create IFrame if it doesn't exist.
				if (!Dsq.frames['reply_' + id]) {
					var _meta = Dsq.jsonData.posts[id];
					Dsq.frames['reply_' + id] = new Dsq.ReplyFrame(Dsq.$('dsq-reply-frame-' + id), id);
					Dsq.frames['reply_' + id].init();
					Dsq.frames['reply_' + id].setState(id, _meta.depth);
				}
			} else {
				Dsq.$('dsq-reply-' + id).style.display = 'none';
				Dsq.$('dsq-reply-bar-' + id).style.display = 'none';
			}
		} else {
			// DEPRECATED
			if(!this.stateReplyToggled[id]) {
				// Reply toolbar
				Dsq.$('dsq-reply-bar-' + id).style.display = 'block';
				Dsq.Iframes.showReplyIframeInContainerIfAllowed(Dsq.$('dsq-reply-' + id), id);
			} else {
				Dsq.$('dsq-reply-bar-' + id).style.display = 'none';
				Dsq.Iframes.hideAllInContainer(Dsq.$('dsq-reply-' + id));
				if(this.stateRecordLink[id]) {
					// HACK: Cancel media before canceling self.
					this.toggleMediaReply(Dsq.$('dsq-media-link-' + id), id);
				}
			}
		}

		this.stateReplyToggled[id] = !this.stateReplyToggled[id];
		this._updateReplyLinks(el, id);

		if(Dsq.Utils.ie) { Dsq.Utils.fixIframesIE('dsq-reply-' + id); }

		Dsq.Events.fire(Dsq.Events.REPLY_IFRAME_TOGGLED, {
			postId: id,
			opened: this.stateReplyToggled[id]
		});
	};

	this.toggleMediaReply = function(el, id, xtype) {
		id = id || 0;
		if(id) {
			var container = Dsq.$('dsq-reply-' + id);
		} else {
			var container = Dsq.$('dsq-post-add');
		}

		if(!this.stateRecordLink[id]) {
			Dsq.Iframes.showReplyIframeInContainer(container, id, {xtype:xtype}, 'dsq-post-video');
		} else {
			Dsq.Iframes.showReplyIframeInContainer(container, id);
		}
		this.stateRecordLink[id] = !this.stateRecordLink[id];
		this._updateMediaLinks(el, id);

		if(Dsq.Utils.ie) { Dsq.Utils.fixIframesIE(); }
	};

	this.edit = function(el, id) {
		Dsq.$('dsq-comment-message-' + id).innerHTML = Dsq.Templates.frameEdit(id);
		el.parentNode.style.display = 'none';
		if(Dsq.Utils.ie) { Dsq.Utils.fixIframesIE('dsq-comment-message-' + id); }
	};

    this.rate = function(el, id, vote) {
		if(Dsq.jsonData.request.is_authenticated || Dsq.jsonData.forum.allow_anon_votes) {
			if(vote == 1) {
                Dsq.$('dsq-rate-cont-' + id).innerHTML = '<img src="http://media.disqus.com/images/loading-small.gif">';
            }

            Dsq.Utils.execScript('http://disqus.com/forums/themoderatevoice/vote.js'
                + '?post_id='    + id
                + '&vote='        + vote);

		} else {
			Dsq.Popup.login(Dsq.Strings.TO_RATE_PLEASE_LOG_IN);
		}
    };

	this.report = function(id, confirmed) {
		if(confirmed) {
			Dsq.Utils.postToUrl('http://disqus.com/forums/themoderatevoice/poll_shows_most_americans_want_public_health_care/post_report/', {'post_id': id});
			Dsq.Popup.popModal('Thank you. This comment has been flagged for moderator attention.', 'Successfully flagged');
			Dsq.Utils.deleteNode(Dsq.$('dsq-post-report-' + id));
		} else {
			var title = Dsq.Strings.FLAG_INAPPROPRIATE_COMMENT;
			var message = Dsq.Strings.ARE_YOU_SURE_YOU_WOULD_LIKE_TO_REPORT_THIS_COMMENT_TO_A_MODERATOR + '? \
			<br /><br /> \
			<button type="button" onclick="Dsq.Popup._closePopup(null, true)"><strong>' + Dsq.Strings.NO + '</strong>, ' + Dsq.Strings.NEVER_MIND + '</button>&nbsp;&nbsp;&nbsp;<button type="button" onclick="Dsq.Post.report(' + id + ', true);"><strong>' + Dsq.Strings.YES + '</strong>, ' + Dsq.Strings.FLAG_INAPPROPRIATE_COMMENT + '</button><br /><br />'
			+ Dsq.Strings.THIS_WILL_FLAG_COMMENTS_FOR_MODERATORS_TO_TAKE_ACTION + '. \
			';

			Dsq.Popup.popModal(message, title, id);
		}
	};



	this.showAlert = function(id, msg) {
		var msgEl = Dsq.$('dsq-comment-message-' + id);
		var alert = '<div class="dsq-comment-alert">' + msg + '</div>';

		msgEl.innerHTML = alert + msgEl.innerHTML;
	};

};
// Dsq.Post


/**
 * Dsq.Thread
 */
Dsq.Thread = new function() {
	this.fc = null;
	this.ff = null;
	this.ac = null;

	
	this.adminIsOn = false;

	
	
	

	this.hlComment = null;
	this.hlCommentClass = null;

	this.getNextComment = function(el) {
		var start_id = el.id;
		while(el = el.nextSibling) {
			if(el.id && el.id.indexOf('dsq-comment-') != -1 && el.id != start_id) {
				return el;
			}
		}
		return null;
	};

	this.getActiveCommentId = function() {
		if (document.URL.indexOf('#comment-') >= 0) {
			var anchor = document.URL.slice(document.URL.indexOf('#') + 1);
			return anchor.replace('comment-', '');
		}
		return null;
	};

	this.highlightAnchor = function() {
		var i = this.getActiveCommentId();
		if (i == null) return false;
		var id = 'dsq-comment-' + i;
		var hash = window.location.hash;

		// Toggle the hash incase the comment isn't available when the page loads
		// for WebKit-based browsers.
		if (Dsq.Utils.webkit) {
			window.location.hash = '';
			window.location.hash = hash;
		}

		this.hlComment = Dsq.$(id);
		// Adding this conditional guard pending #289
		if (!this.hlComment) {
			return;
		}
		this.hlCommentClass = this.hlComment.className;
		this.hlComment.className += ' dsq-hl-anchor';

		setTimeout("Dsq.Thread.highlightClear()", 3000);
	};

	this.highlightClear = function() {
		if (!this.hlComment) {
			return;
		}
		this.hlComment.className = this.hlCommentClass;
	};

	this.login = function(toggle) {
		// toggle id is #dsq-reply-login-[id]
		var postId;
		if(toggle.id.indexOf('dsq-reply-login') != -1) {
			postId = toggle.id.slice(16);
			var container = Dsq.$('dsq-reply-' + postId);
		} else {
			var container = Dsq.$('dsq-post-add');
		}

		if(toggle) {
			if(toggle.className == 'dsq-login-active') {
				Dsq.Iframes.showReplyIframeInContainerIfAllowed(container, postId);
				toggle.className = '';
			} else {
				Dsq.Iframes.showLoginIframeInContainer(container, postId);
				toggle.className = 'dsq-login-active';
			}
		} else {
			Dsq.Iframes.showLoginIframeInContainer(container, postId);
		}

		if(Dsq.Utils.ie) { Dsq.Utils.fixIframesIE(); }
	};


	this.paginate = function(page, el_clicked, per_page) {
		// Use extra_params to pass any override parameters that we need to persist.
		var extra_params = '';

		// "Per page" can either be overriden by providing it as an argument
		// (per-call) or setting the disqus_per_page override variable (global).
		if(typeof per_page == 'undefined') {
			per_page = null;
		}
		if(typeof disqus_per_page != 'undefined' && per_page === null) {
			per_page = disqus_per_page;
		}

		if(typeof disqus_sort != 'undefined') {
			extra_params += '&sort=' + disqus_sort;
		}
		if(per_page !== null) {
			extra_params += '&per_page=' + per_page;
		}

		Dsq.$('dsq-pagination').innerHTML += '<img src="http://media.disqus.com/images/loading-small.gif">';
		
		if(el_clicked) {
			el_clicked.style.display = 'none';
		}
		
		Dsq.Utils.execScript('http://disqus.com/forums/themoderatevoice/thread.js'
			+ '?slug='	+ 'poll_shows_most_americans_want_public_health_care'
			+ '&p='		+ page
			+ extra_params);
	};

	this.sortBy = function(sort) {
		var disqus_script = document.createElement('script');
		var disqus_date = new Date();

		if (location.hash != '') {
			location.hash = '#disqus_thread';
		}

		if(typeof(disqus_url) == 'undefined') {
			disqus_url = disqus_href;
		}
		disqus_script.type = 'text/javascript';
		disqus_script.src = 'http://disqus.com/forums/themoderatevoice/thread.js'
			+ '?slug='	+ 'poll_shows_most_americans_want_public_health_care'
			+ '&sort='	+ sort
			+ '&title='
			+ '&'		+ disqus_date.getTime();

		Dsq.$('dsq-comments').innerHTML = '<img src="http://media.disqus.com/images/loading.gif">';
		Dsq.container.appendChild(disqus_script);
	};

	this.subscribe = function(status, email) {
		// `status` is an int -- 1 to subscribe, 0 to unsubscribe
		if(Dsq.jsonData.request.is_authenticated || email) {
			// If authenticated user OR anonymous email provided

			if(email) {
				Dsq.Popup._closePopup(null, true);
			}

			Dsq.Utils.execScript('http://disqus.com/forums/themoderatevoice/subscribe.js'
				+'?status=' 	+ status
				+ '&slug='		+ 'poll_shows_most_americans_want_public_health_care'
				+ '&email=' 	+ encodeURIComponent(email));

		} else if(!email) {
			// If anonymous user and no email has been provided yet, prompt for email

			var title = 'Subscribe to this comment thread';
			var message = ' \
				New comments will be sent directly to your email inbox! \
				<div class="dsq-subscribe-submit"> \
					<p><strong>Enter your email address below.</strong></p> \
					<input type="text" id="dsq-subscribe-email"> \
					<button type="button" onclick="Dsq.Thread.subscribe(1, Dsq.$(\'dsq-subscribe-email\').value)">Subscribe</button> \
				</div> \
			';

			Dsq.Popup.popModal(message, title);
		}
	};

	this.showSettings = function() {
		if (!Dsq.jsonData.request.is_moderator) {
			return;
		}

		/* The form has to be re-designed when more options will come out. */
		var html = 'Automatically close comments after <input size="3" id="dsq-thread-days-alive" value="' + Dsq.jsonData.thread.days_alive + '" type="text" /> days. Existing comments will still be displayed.<br /><br />(Using 0 days will disable this feature)<br /><br />'
								 + '<button type="button" onclick="Dsq.Thread.updateDaysAlive();" class="dsq-button-small"><span>Save</span></button>'
								 + '<span id="dsq-thread-settings-status" class="dsq-options-status"></span>';

		Dsq.Popup.popModal(html, 'Settings');
	};

  this.showModeratorActions = function() {
      if (!Dsq.jsonData.request.is_moderator) {
          return;
      }

      var html = '<div class="dsq-moderate-options"><table><tr>' +
                 '<td>' + Dsq.Strings.ACTIONS + '</td><td><ul>';
      html += '<li><a href="#" onclick="Dsq.Thread.toggleClosed(); return false;">' +
              (Dsq.jsonData.thread.closed ? Dsq.Strings.OPEN_THREAD : Dsq.Strings.CLOSE_THREAD) +
              '</a></li>';
      html += '<li><a href="#" onclick="Dsq.Thread.toggleKilled(); return false;">' +
              (Dsq.jsonData.thread.killed ? Dsq.Strings.RESTORE_THREAD : Dsq.Strings.REMOVE_THREAD) +
              '</a></li>';
      html += '</ul></td></tr></table></div>' +
              '<p>Go to the full <a href="http://disqus.com/comments/moderate-threads/" target="_blank">moderate panel</a> for more options.</p>';
      Dsq.Popup.popModal(html, Dsq.Strings.MODERATE_OPTIONS);
  };

	this.updateDaysAlive = function() {
		  var days = Dsq.$('dsq-thread-days-alive').value;
		  var status = Dsq.$('dsq-thread-settings-status');
		  Dsq.Utils.postToUrl('http://disqus.com/forums/themoderatevoice/update_days_alive.js', {days:days,thread:Dsq.jsonData.thread.id});
		  status.innerHTML = 'Saved!';
		  window.setTimeout(function() { status.innerHTML = ''; }, 1000);
	};

  this.toggleClosed = function() {
      Dsq.Utils.postToUrl('http://disqus.com/forums/themoderatevoice/toggle_thread_closed.js', {thread:Dsq.jsonData.thread.id});
      window.setTimeout(function() { window.location.reload(); }, 500);
  };

  this.toggleKilled = function() {
      Dsq.Utils.postToUrl('http://disqus.com/forums/themoderatevoice/toggle_thread_killed.js', {thread:Dsq.jsonData.thread.id});
      window.setTimeout(function() { window.location.reload(); }, 500);
  };
};
// Dsq.Thread

Dsq.Events = function() {
	var obj = {};

	// Private
	var handlers = {};
	var getHandlers = function(event) {
		if (handlers[event] === undefined) {
			handlers[event] = [];
		}
		return handlers[event];
	};

	// Public
	// Value keys : postId, node, xtype
	obj.REPLY_IFRAME_CREATED = 1;
	// Value keys : postId, opened
	obj.REPLY_IFRAME_TOGGLED = 2;
	obj.fire = function(event, opt_value) {
		if (!event) {
			throw new Error('Unknown event');
		}
		var value = opt_value || {};
		for (var i=0; i<getHandlers(event).length; i++) {
			getHandlers(event)[i](value);
		}
	};
	obj.addHandler = function(event, callback) {
		getHandlers(event).push(callback);
	};

	return obj;
}();

/**
 * Dsq.Realtime
 */
Dsq.Realtime = new function() {
	var initialized = false;
	var interval = null;
	var last_checked = Dsq.jsonData.request.timestamp;
	var new_posts = [];
	var ongoing_request = false;
	var prev_script = null;

	function updateNewPostCount() {
		Dsq.$('dsq-realtime-alert').style.display = new_posts.length ? 'block' : 'none';

		Dsq.$('dsq-realtime-queued').innerHTML = new_posts.length
		+ ' new '
		+ Dsq.Utils.pluralize(new_posts.length, 'comment', 'comments')
		+ Dsq.Utils.pluralize(new_posts.length, ' was', ' were')
		+ ' just posted.';

		Dsq.$('dsq-realtime-show').innerHTML = '(' + Dsq.Strings.SHOW + ')';
	}

	function insertNewPosts() {
		var post_id = null;
		var after_id = Dsq.$('dsq-sort-select').value === 'oldest' ? -1 : null;

		for (var i=0; i<new_posts.length; i++) {
			post_id = new_posts[i];
			Dsq.Post.insert(after_id, post_id, Dsq.jsonData.posts[post_id].message);
			Dsq.Post.incrementPostCount();
			Dsq.Post.outlineComment(post_id);
		}
		new_posts = [];
	}

	this.enableInterval = function() {
		interval = setInterval(Dsq.Realtime.check, Dsq.jsonData.context.realtime_speed);
		Dsq.$('dsq-realtime-status').innerHTML = Dsq.Strings.ENABLED;
		Dsq.$('dsq-realtime-toggle').innerHTML = '(' + Dsq.Strings.PAUSE + ')';
	}

	this.disableInterval = function() {
		if (interval) {
			clearInterval(interval);
			interval = null;
		}
		Dsq.$('dsq-realtime-status').innerHTML = Dsq.Strings.PAUSED;
		Dsq.$('dsq-realtime-toggle').innerHTML = '(' + Dsq.Strings.RESUME + ')';
	}

	this.toggleInterval = function() {
		if (!interval) {
			Dsq.Realtime.enableInterval();
		} else {
			Dsq.Realtime.disableInterval();
		}
		return false;
	}

	this.initialize = function() {
		if (!initialized) {
			initialized = true;
			Dsq.$('dsq-realtime-toggle').onclick = this.toggleInterval;
			if (!Dsq.jsonData.forum.streaming_realtime) {
				Dsq.$('dsq-realtime-show').onclick = this.show;
				updateNewPostCount();
			}
			if (Dsq.jsonData.thread.realtime_paused) {
				Dsq.Realtime.disableInterval();
			} else {
				Dsq.Realtime.enableInterval();
			}
		}
	}

	this.show = function() {
		insertNewPosts();
		updateNewPostCount();
		return false;
	}

	this.check = function() {
		if (!ongoing_request && Dsq.jsonData.realtime_enabled) {
			if (prev_script) {
				prev_script.parentNode.removeChild(prev_script);
			}
			ongoing_request = true;
			prev_script = Dsq.Utils.execScript('http://disqus.com/forums/22540631/realtime.js?timestamp=' + last_checked);
		}
	};

	this.update = function(timestamp, posts, users) {
		ongoing_request = false;
		last_checked = timestamp;

		if (users) {
			for (var user_id in users) {
				if (users.hasOwnProperty(user_id)) {
					if (!Dsq.jsonData.users[user_id]) {
						Dsq.jsonData.users[user_id] = users[user_id];
					}
				}
			}
		}

		if (posts) {
			for (var post_id in posts) {
				if (posts.hasOwnProperty(post_id)) {
					if (!Dsq.jsonData.posts[post_id]) {
						Dsq.jsonData.posts[post_id] = posts[post_id];
						new_posts.push(post_id);
					}
				}
			}

			if (Dsq.jsonData.forum.streaming_realtime) {
				insertNewPosts();
			} else {
				updateNewPostCount();
			}
		}
	};

}();

// DEPRECATED
Dsq.Iframes = function() {
	// Different style of object from the above. Hoping to switch to this for some reason.
	var obj = {};

	// Private
	var showIframeInContainer = function(container, id, markup) {
		// Look through container for iframes, hiding them, except show one that matches id
		// If none of them matched id, create a new iframe using markup and insert it.
		// Returns the iframe node if and only if it was newly created.
		var found = false;
		for (var i=0; i<container.childNodes.length; i++) {
			var child = container.childNodes[i];
			if (child.nodeName == 'IFRAME') {
				if (child.id == id) {
					child.style.display = 'block';
					found = true;
				} else {
					child.style.display = 'none';
				}
			}
		}
		if (found) {
			return;
		}
		// The iframe wasn't found, so construct it and add it to the container.
		// Don't use innerHTML because it might reload iframes
		var div = document.createElement('div');
		div.innerHTML = markup;
		var iframe = div.childNodes[0];
		div.removeChild(iframe);
		container.appendChild(iframe);
		return iframe;
	};

	// Public
	obj.makeReplyIframeId = function(opt_postId, opt_xtype) {
		var id = 'dsq-post-add-iframe';
		if (opt_xtype) {
			id += '-' + opt_xtype;
		}
		if (opt_postId) {
			id += '-' + opt_postId;
		}
		return id;
	};
	obj.makeLoginIframeId = function(opt_postId) {
		if (!opt_postId) {
			return 'dsq-login-iframe';
		}
		return 'dsq-login-iframe-' + opt_postId;
	};
	obj.makeReplyIframeName = function(opt_postId, opt_xtype) {
		var name = 'dsq-reply-frame';
		if (opt_xtype) {
			name += '-' + opt_xtype;
		}
		if (opt_postId) {
			name += '-' + opt_postId;
		}
		return name;
	};
	obj.showReplyIframeInContainer = function(container, opt_postId, opt_extraParams, opt_className) {
		// Construct the id so we can check if it's already present.
		// Hide any other iframes we find, and show this one if it's found.
		var params = opt_extraParams || {};
		// use xtype in the id and name so we can distinguish media replies from text replies:
		var id = Dsq.Iframes.makeReplyIframeId(opt_postId, params.xtype);
		var name = Dsq.Iframes.makeReplyIframeName(opt_postId, params.xtype);
		var attributes = {
			'id': id,
			'name': name,
			'class': opt_className || 'dsq-post-reply'
			};
		var markup = Dsq.Templates.frameReply(opt_postId, opt_extraParams, attributes);
		var iframe = showIframeInContainer(container, id, markup);
		// It was newly created
		if (iframe) {
			Dsq.Events.fire(Dsq.Events.REPLY_IFRAME_CREATED, {
				postId: opt_postId,
				node: iframe,
				xtype: params.xtype
			});
		}
	};
	obj.showLoginIframeInContainer = function(container, opt_postId) {
		var id = Dsq.Iframes.makeLoginIframeId(opt_postId);
		var markup = Dsq.Templates.frameLogin({id: id});
		showIframeInContainer(container, id, markup);
	};
	obj.showReplyIframeInContainerIfAllowed = function(container, opt_postId) {
		if (Dsq.jsonData.context.show_reply) {
			obj.showReplyIframeInContainer(container, opt_postId);
		} else {
			obj.hideAllInContainer(container);
		}
	};
	obj.hideAllInContainer = function(container) {
		for (var i=0; i<container.childNodes.length; i++) {
			var child = container.childNodes[i];
			if (child.nodeName == 'IFRAME') {
				child.style.display = 'none';
			}
		}
	};

	return obj;
}();

Dsq.Twitter = new function() {
	var that = this;

	this.startTwitterConnect = function() {
		var popupParams = 'location=0,status=0,width=800,height=400';
		that._twitterWindow = window.open(Dsq.jsonData.settings.disqus_url + '/_ax/twitter/begin/', 'twitterWindow', popupParams);
		that._twitterInterval = window.setInterval(that.completeTwitterConnect, 1000);
	};

	this.completeTwitterConnect = function() {
		if (that._twitterWindow.closed) {
			window.clearInterval(that._twitterInterval);
			window.location.reload();
		}
	};
};

Dsq.Yahoo = new function() {
	var that = this;

	this.startYahooConnect = function() {
		var popupParams = 'location=0,status=0,width=800,height=400';
		that._yahooWindow = window.open(Dsq.jsonData.settings.disqus_url + '/_ax/yahoo/begin/', 'yahooWindow', popupParams);
		that._yahooInterval = window.setInterval(that.completeYahooConnect, 1000);
	};

	this.completeYahooConnect = function() {
		if (that._yahooWindow.closed) {
			window.clearInterval(that._yahooInterval);
			window.location.reload();
		}
	};
};

Dsq.OpenID = new function() {
	var that = this;

	this.requestURL = function() {
		var message = '<table class="dsq-openid-form"><tr><td style="vertical-align:top;" rowspan="2"><img src="' + Dsq.jsonData.settings.media_url + '/images/openid-icon-100x100.png" /></td>';
		message += '<td><label for="dsq-openid-url">OpenID URL:</label></td><td><input type="text" id="dsq-openid-url" /></td></tr>';
		message += '<tr><td><label for="dsq-openid-username">Display name:</label></td><td><input type="text" id="dsq-openid-username" /></td></tr>';
		message += '<tr><td class="dsq-openid-submit" colspan="3"><input type="button" value="Sign in" onclick="Dsq.OpenID.startConnect();" /></td></tr>';
		message += "</table>";

		Dsq.Popup.popModal(message, 'Sign in using OpenID');
	};

	this.startConnect = function() {
		var isblank = function(str) {
			return /^\s*$/.test(str);
		};

		var openid_url = Dsq.$('dsq-openid-url').value;
		var username = Dsq.$('dsq-openid-username').value;

		if (isblank(openid_url)) {
			return;
		}

		var popupParams = 'location=0,status=0,width=800,height=500';
		var url = Dsq.jsonData.settings.disqus_url + '/_ax/openid/begin/' + '?url=' + encodeURIComponent(openid_url) + '&username=' + encodeURIComponent(username);
		that._openidWindow = window.open(url, 'openidWindow', popupParams);
		that._openidInterval = window.setInterval(that.completeConnect, 1000);
	};

	this.completeConnect = function() {
		if (that._openidWindow.closed) {
			window.clearInterval(that._openidInterval);
			window.location.reload();
		}
	};
};

Dsq.Reaction = new function() {
	var that = this;

	this.hide = function(id) {
		Dsq.Utils.execScript('http://disqus.com/forums/themoderatevoice/hidereaction.js?' + 'reaction_id=' + id);
	};

	this.reportMissingReactions = function() {
		if (!Dsq.jsonData.request.is_moderator || !Dsq.jsonData.forum.reactions_enabled) {
			return;
		}

		if (Dsq.jsonData.thread.queued) {
			Dsq.Popup.popModal('Your report has been received. The system will automatically search for new reactions; if any are found, they will be displayed on this comment thread.<br/><br/>Thank&nbsp;you.',
												 'Reported missing reactions');
			return;
		}

		Dsq.Utils.execScript(Dsq.jsonData.settings.disqus_url + '/forums/themoderatevoice/queueurl.js');
	};
};

Dsq.CNN = function() {
	var obj = {};

	obj.authenticate = function() {
		var url = Dsq.jsonData.settings.disqus_url + "/saml/cnn/try/";
		Dsq.Utils.postToUrl(url, {'target': document.location}, true);
	};

	return obj;
}();


if(Dsq.Utils.ie6) {
	(function() {
		DSQ_HEADER_AVATAR_RE = /<div class="dsq-header-avatar"(.*?)>/gim;
		Dsq.Templates.registerFilter('postPrependHeader', function(html, post_id) {
			// Add "onmouseout" for dsq-header-avatar for dropProfile
			// functionality since IE6 cannot use :hover.
			function _headerAvatarReplace(content, inner, _unused, html) {
				return '<div class="dsq-header-avatar" '
					+ inner
					+ ' onmouseout="Dsq.Post.dropProfile(' + post_id + ')">';
			}
			html = html.replace(DSQ_HEADER_AVATAR_RE, _headerAvatarReplace);
			return html;
		});
	})();
}









(function() {
	//
	// Load theme.  This overrides the base templates with template functions
	// from the respective themes.
	//
	if (Dsq.jsonData.integration.theme == 4) {
		var theme = 'narcissus';
		// HACK: Set variable on window to use post message.
		window.disqus_use_postmessage = true;

		
		for(var prop in Dsq.Themes[theme]) {
			if(Dsq.Themes[theme] && Dsq.Themes[theme].hasOwnProperty(prop)) {
				Dsq.Templates[prop] = Dsq.Themes[theme][prop];
			}
		}
		
		for(var prop in Dsq.Post) {
			if(Dsq.Themes[theme] && Dsq.Themes[theme].hasOwnProperty(prop)) {
				Dsq.Post[prop] = Dsq.Themes[theme][prop];
			}
		}
	}

	//
	// Register templates.  This must be done after all themes are loaded.
	//
	Dsq.Templates.registerTemplate('authPost', Dsq.Templates.authPost);
	Dsq.Templates.registerTemplate('header', Dsq.Templates.header);
	Dsq.Templates.registerTemplate('footer', Dsq.Templates.footer);
	Dsq.Templates.registerTemplate('trackbacks', Dsq.Templates.trackbacks);
	Dsq.Templates.registerTemplate('reactions', Dsq.Templates.reactions);
	Dsq.Templates.registerTemplate('prependPost', Dsq.Templates.prependPost);
	Dsq.Templates.registerTemplate('appendPost', Dsq.Templates.appendPost);
	Dsq.Templates.registerTemplate('postPrependHeader', Dsq.Templates.postPrependHeader);
	Dsq.Templates.registerTemplate('postAppendHeader', Dsq.Templates.postAppendHeader);
	Dsq.Templates.registerTemplate('preBody', Dsq.Templates.preBody);
	Dsq.Templates.registerTemplate('postBody', Dsq.Templates.postBody);
	Dsq.Templates.registerTemplate('postFooter', Dsq.Templates.postFooter);
	Dsq.Templates.registerTemplate('_popupGeneric', Dsq.Templates._popupGeneric);
	Dsq.Templates.registerTemplate('voted', Dsq.Templates.voted);
	Dsq.Templates.registerTemplate('popupProfile', Dsq.Templates.popupProfile);
	Dsq.Templates.registerTemplate('postBox', Dsq.Templates.postBox);
	Dsq.Templates.registerTemplate('pagination', Dsq.Templates.pagination);
	Dsq.Templates.registerTemplate('postComment_onSuccess', Dsq.Templates.postComment_onSuccess);

})();

Dsq.container.className = "clearfix";
Dsq.container.innerHTML = ' \
<ul id="dsq-comments">\
	 <li id="dsq-comment-11560047">\
	 <div id="dsq-comment-header-11560047" class="dsq-comment-header">\
	 <cite id="dsq-cite-11560047" class="dsq-comment-cite">\
	 <a id="dsq-author-user-11560047" href="http://www.whyweworry.com" target="_blank" rel="nofollow">ChrisWWW</a>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11560047" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11560047" class="dsq-comment-message">EEllis,<br>What about that money funneled through AIG? What about the fact <a href="http://www.smirkingchimp.com/thread/22413" rel="nofollow">Goldman Sachs pretty much caused the damn recession by itself</a>.<br><br>JasonArvak,<br>Rationing is a part of our health care system now. Unless you have unlimited funds to pay for medical care, you will eventually hit the limit of what your insurance will pay for, or what the hospital is willing to give you without insurance. And it will only get worse and worse if we don\'t fix the system, because costs are spiraling out of control.<br><br>And to be perfectly honest, I don\'t give a rats @ss if the competition is fair or not. The goal is better, cheaper health care, not a free marketeers wet dream. <br><br>CO,<br>The plan costs more in the short term, but saves money in the long run. That\'s why it\'s worth pursuing.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11546579">\
	 <div id="dsq-comment-header-11546579" class="dsq-comment-header">\
	 <cite id="dsq-cite-11546579" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11546579">kathykattenburg</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11546579" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11546579" class="dsq-comment-message">You sound like someone who does not believe that health care is a human right. I am someone who does believe that health care is a human right.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11571465">\
	 <div id="dsq-comment-header-11571465" class="dsq-comment-header">\
	 <cite id="dsq-cite-11571465" class="dsq-comment-cite">\
	 <a id="dsq-author-user-11571465" href="http://greendreams.wordpress.com" target="_blank" rel="nofollow">GreenDreams</a>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11571465" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11571465" class="dsq-comment-message">Single-payer systems perform well at much lower cost. it\'s not hard to find cases of the system breaking down with either for profit or nonprofit care, so the point is which works the best most of the time. It has been estimated that many of the problems with single-payer systems, including waiting times would vanish if these countries paid a little more, but still far less than we pay. Jason disparages Paul Krugman, a Nobel prize-winning economist who favors a single-payer system and has the economic background to know what he\'s talking about. Doctors also favor it, by a margin of 59% to 32%. Commenting on the statistics by the World Health Organization, the Director of what is arguably our leading medical institution made this statement.<br><br>"The US should be particularly concerned about these findings," says Gerard Anderson, director of the Bloomberg School of Public Health at Johns Hopkins University in Baltimore. "If I\'m spending twice as much, I\'d expect to have the better outcomes."<br><br>A practicing physician describes why he favors public health care, and he probably sums it up better than I can:<br><br><a href="http://www.burlingtonfreepress.com/article/20090613/OPINION/906130301/My-Turn--A-doctor-s-view-on-single-payer-care" rel="nofollow">A doctor explains</a>.<br><blockquote>A few years ago, after crossing the midway point in my career, I decided that I had seen too many bankruptcies, too many mortgage foreclosures, too many financial crises to remain silent on the health care issue. I have seen too many patients deluged with bills after beginning cancer treatment, too many patients forgo treatment of high blood pressure, diabetes and other problems of major public health significance because they simply couldn\'t afford it.<br></blockquote>He also points out how the uninsured pay others\' bills without getting any care for themselves.<blockquote>Uninsured Americans pay taxes for federal, state and municipal employees, veterans, the military, prisoners, the Indian Health Service, the homeless, the community health centers, the renal failure program, Medicare, Medicaid. But after paying for all those groups to have health coverage, they themselves have nothing. This is one of the greatest injustices in our health care system. In a single-payer system, everyone pays in -- as we do for the above groups, but then every single citizen has health insurance.</blockquote><br>The current system disadvantages small businesses and their employees.<br><blockquote>The vast majority of small businesses in the United States do not provide health coverage to their employees because they can\'t afford it. The United States is the only developed country that systematically discriminates against the owners and employees of small businesses in this way. This is completely dysfunctional. Single-payer health care would provide coverage to all citizens -- period. This allows everyone to work in the job that suits them best, without having the least concern about health coverage -- as occurs in every other developed country. With no exceptions, countries with government-run health care plans are the most efficient -- they waste less money on advertising, administration, extravagant salaries, etc. They provide the best outcomes, longer life expectancy, lower infant mortality and, with only a few exceptions, they are enormously popular with the people they serve. In every one of those countries, no one is left out -- everyone is insured from cradle to grave, there are no bankruptcies or foreclosures related to health costs, and the cost to business and government is on average half what we pay per capita in the United States.<br></blockquote><br>Finally, those who oppose changes in our insurance mediated health care system he will soon be arguing for or against taxpayer bailouts of health insurance companies. I suppose one way we could back into a single-payer system is to buy their stock when they crash. <b>14,000 Americans </b>are losing their coverage <b>every day</b>, and of course, insurance companies are losing 14,000 customers every day.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11547181">\
	 <div id="dsq-comment-header-11547181" class="dsq-comment-header">\
	 <cite id="dsq-cite-11547181" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11547181">Lit3Bolt</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11547181" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11547181" class="dsq-comment-message">Is clean water and sewage a right?  Is clean food?  What about safe playgrounds?  Good schools?  Are those rights or accessories?  <br><br>This is why I\'m hesitant to label healthcare a "right" because "rights" are a loaded word.  At the same time, I\'m baffled by anyone who seems to think our healthcare system is "teh awesomest thing."  <br><br>And the "I don\'t want my tax money pay for blah the blah" isn\'t even a strawman, it\'s a Burning Man.  There are literally thousands upon thousands of programs people don\'t want their tax dollars going to, yet off they go anyway.  I don\'t understand why we can have Goldman Sachs rolling around in piles of government issued money but when it comes to healthcare, people just trot out the tired "let \'em die!" argument.  Why this issue more than any other?  What makes people yawn for paying tax money to corporations or unions or politicians or shitty schools and roads and stupid wars but when you\'re paying for someone else\'s X-ray, suddenly the world flips upside down?</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11582319">\
	 <div id="dsq-comment-header-11582319" class="dsq-comment-header">\
	 <cite id="dsq-cite-11582319" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11582319">kathykattenburg</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11582319" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11582319" class="dsq-comment-message"><i>At your age it will probably tell you a mammogram is a good idea, without you having spent $200 and two hours on a consult.</i><br><br>I don\'t have the $200 to spend on a mammogram, though. So finding out from a database that it\'s recommended at my age (which I didn\'t need a database to tell me, anyway) doesn\'t help me. <br><br>I do get $200 a month in food stamps, though. So if I can find someone who will agree to let me buy their groceries with my Families First card and pay me back in cash, I can get a mammogram. Of course, I won\'t eat until the next month,but that\'s all part of the dignity of choices.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11559480">\
	 <div id="dsq-comment-header-11559480" class="dsq-comment-header">\
	 <cite id="dsq-cite-11559480" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11559480">starleys</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11559480" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11559480" class="dsq-comment-message">Our high cost private insurance, disapproving treatment and claims for financial gain, and excessive co-payments are the leading cause of citizen bankruptcies, loss of homes and retirements, and lack of treatment.  This is the greatest threat to our economy and quality of life, greater than the change required in going to a one payer system. <br> <br>I have travelled to several countries with one payer/government medicine and have been surprised at the positive attitude towards the system. The waiting times described in emergency rooms etc were actually less than what I have experienced in the US. They found it horrifying that in the US that the uninsured or unable to pay could be pushed back on the streets once stabilized without follow-up treatment. Waiting for treatment seems better than no treatment for lingering diseases such as cancer, heart disease, high blood pressure, diabetes, TB, when you can’t afford to pay.    <br><br>Waiting occurs in both private and one pay systems but treatment rates appear to be higher when profit is taken out as the primary motivator.  Who has the ability to shop or discuss prices when you are in the middle of a medical emergency?  Medical treatment is not a free market when your life or a loved one’s is in the balance.  Why must so many choose between life and poverty?  Do I die because my company no longer needs my services and I no longer have or can afford medical coverage?  And once I am ill and lose coverage, who will cover me?  <br><br>In our private system, fewer and fewer businesses and individuals can afford the premiums for even more limited coverage and still maintain resources necessary for their daily survival.  Do I pay rent, put gas in my car, pay my electric or buy insurance?  Do I purchase raw materials for manufacturing, pay for transport, or offer health insurance?  It can be as bad as a choice between food and medication.  These are real choices made by individuals and industry every day.  It is a choice between survival today vs survival tomorrow.  And realistically, we must survive today in order to meet tomorrow.<br><br>The lower per capita cost, greater longevity and higher birth survival rates indicate in objective statistics based on the purpose of healthcare insurance that public/one payer is performing better than private insurance.  Having seen the success of the basically one pay public system in place for the US military, veterans, congress, government employees, the poor (Medicaid), and senior citizens (Medicare), I am highly in favor of extending this same coverage, a universal Medicare, to all our middle class citizens, middle aged individuals, the unemployed and other ineligible groups.  A universal one payer system would give a better spread of the risk that will increase for all individuals as they grow older.  It would significantly increase availability, reduce costs and level out premiums.  Surprisingly it could be done at less than we are currently spending.  It would simply be more efficient.  <br><br>Finally, surveys of other countries one payer systems show better results on a per capita basis for half the money currently being spent in the USA.  The lack of availability through high cost as risk increases results in indirect euthanasia of those who can’t afford coverage through failure to provide treatment.  I really would enjoy having the coverage congress enjoys but would deny the rest of us.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11543407">\
	 <div id="dsq-comment-header-11543407" class="dsq-comment-header">\
	 <cite id="dsq-cite-11543407" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11543407">kathykattenburg</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11543407" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11543407" class="dsq-comment-message">Uhhh, surprise!</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11711612">\
	 <div id="dsq-comment-header-11711612" class="dsq-comment-header">\
	 <cite id="dsq-cite-11711612" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11711612">kathykattenburg</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11711612" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11711612" class="dsq-comment-message">Wow. That\'s an impressive persecution complex Jason\'s got there. :-)</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11600254">\
	 <div id="dsq-comment-header-11600254" class="dsq-comment-header">\
	 <cite id="dsq-cite-11600254" class="dsq-comment-cite">\
	 <a id="dsq-author-user-11600254" href="http://greendreams.wordpress.com" target="_blank" rel="nofollow">GreenDreams</a>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11600254" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11600254" class="dsq-comment-message">Jason, your demonizing of "the left", which from your blog, appears to be your style, is ironic, especially as you seem fond of demonizing lefties for demonizing righties. We actually could have a rational discussion, but we\'re so polarized that it always seems to degenerate into something like this. Too bad.<br><br>Nicera, I brought up Krugman and did not ever imply he is "beyond reproach". So many straw men here. I also mentioned a couple doctors, the WHO, and glad to cite others if you want. My point is independent of your opinion of Krugman. It is that experts in relevant fields think nonprofit health care is a sensible and timely idea, most of the public wants it (convenient dismissals of the NYT poll are irrelevant. Other polls show the same thing), and most doctors want it (again, according to multiple polls.)<br><br>To the concept of competition, in terms of patients negotiating down costs or going elsewhere, I\'m surprised anyone thinks that would work. Patients are not really in a position to negotiate with doctors or hospitals, even if they didn\'t need care urgently. Additionally, that idea that we could chisel down costs with savvy patients holding the purse strings, is in stark contrast to the assertion that doctors won\'t accept lower payment e.g. from Medicare (though 97% of docs do take new Medicare patients). Then we have the idea of using less expensive care givers, further reducing the income of doctors. Also kinda reminds me of the cynical 70s era joke, "cut your employee expense by a third. Hire women." <br><br>We also have the assertion that a single payer (or public option) system might not save anything ("we can\'t assume the savings") but yet doctors are shifting costs to insured patients because Medicare doesn\'t pay enough. (BTW, Medicare pays about 19% less. Think we could negotiate any lower than that?) <br><br>In my own experience it isn\'t true that docs can shift costs, thus "subsidizing" the Medicare patients, but I\'m open to evidence. My doctor takes Medicare patients (ahem. I\'m not one of them). A close friend who\'s a physician doesn\'t. My own doctor is not allowed by insurance companies to charge more than the doc who has no Medicare patients. I frankly don\'t believe hospitals are allowed to either, but please enlighten me with something credible if so.<br><br>As to the points about "rights," I have avoided using that term, though others did. Rather, it\'s a public policy decision about whether or not we will care for our citizens. That\'s hardly a new or progressive idea. It\'s strictly caveman. The health of every tribe member was considered essential to the success of the tribe. That concept of taking care of our own *for our own good* is as ancient as we are. Perhaps with some military background people could understand the idea of not leaving someone behind, even if it costs us, inconveniences us, or even presents a mortal risk to us.<br><br>Don\'t get all touchy Jason. These comments are general and not from some script or aimed at you. Sheesh.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11581328">\
	 <div id="dsq-comment-header-11581328" class="dsq-comment-header">\
	 <cite id="dsq-cite-11581328" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11581328">kathykattenburg</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11581328" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11581328" class="dsq-comment-message"><i>This problem has largely been solved in every other industry, by simply freeing consumers to make decisions about where money gets spent, and where necessary standardizing disclosures so they have the info they need to make them.</i><br><br>Do you know where I could find the necessary standardizing disclosures to free me to make a decision about whether I should spend my money paying my rent or getting a mammogram? <br><br>Are you a real doctor?</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11581533">\
	 <div id="dsq-comment-header-11581533" class="dsq-comment-header">\
	 <cite id="dsq-cite-11581533" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11581533">kathykattenburg</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11581533" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11581533" class="dsq-comment-message"><i>The free market does a great job of supplying it, with good quality and in tremendous variety, without gouging anyone.</i><br><br>Can you take me to your planet, Dr_J? It sounds like a great place to live.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11577373">\
	 <div id="dsq-comment-header-11577373" class="dsq-comment-header">\
	 <cite id="dsq-cite-11577373" class="dsq-comment-cite">\
	 <a id="dsq-author-user-11577373" href="http://greendreams.wordpress.com" target="_blank" rel="nofollow">GreenDreams</a>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11577373" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11577373" class="dsq-comment-message">We can see that single payer systems currently implemented are cheaper. The insurance industry\'s own study shows their cost plus profit to be 17% and Medicare 5% and headed down. The items private insurance spends on that Medicare doesn\'t are detailed by the physician I quoted. They don\'t include the subsidies granted to the employer-insured at the expense of the privately insured, which as I noted, is an increased burden on employees of small businesses who are the major source of new jobs. Could government inefficiencies gobble up the12% savings for Medicare-style coverage? Perhaps, but to date, the government programs, including yours, pay less per patient despite higher risk populations (elderly, for example)..</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11575928">\
	 <div id="dsq-comment-header-11575928" class="dsq-comment-header">\
	 <cite id="dsq-cite-11575928" class="dsq-comment-cite">\
	 <a id="dsq-author-user-11575928" href="http://greendreams.wordpress.com" target="_blank" rel="nofollow">GreenDreams</a>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11575928" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11575928" class="dsq-comment-message">"script-driven, gross logical fallacy, you should not be so shallow in your thinking"<br>You know, you\'re the one who said "Thank you for responding with a respectful tone. Let\'s see if we can maintain it." How about a bit of civility in our discussion. I\'m not an idiot and am not treating you as one.<br><br>I\'m not following a script. I\'m responding directly to your points about "trade-offs," which I think are exaggerated, and can be minimized. I quoted the doctor to show how some within the profession see the need for change. By quoting physicians, polls, public health professionals and even defending a respected economist you were deriding, I remind readers that it is not some fringe cadre of bloggers driving the call for change. (oh, and BTW, your attack on the Nobel Prize process is an insult to the many brilliant people who have earned them.)</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11576750">\
	 <div id="dsq-comment-header-11576750" class="dsq-comment-header">\
	 <cite id="dsq-cite-11576750" class="dsq-comment-cite">\
	 <a id="dsq-author-user-11576750" href="http://greendreams.wordpress.com" target="_blank" rel="nofollow">GreenDreams</a>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11576750" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11576750" class="dsq-comment-message">Ok, Jason, I\'ll start by extending a bit of the respect you are unable to show me. I respect your willingness to come over here to TMV to add to our discussion, which has been going on for months now. Perhaps you believe all my points are directed at you, but that\'s not the case. This post begins with quotes from you blasting single-payer proponents like Kathy. You point out shortcomings of the proposed alternative; I point out shortcomings of the current system. Both are important in balancing "trade offs." <br><br>We have commenters here who take the position that no one should pay for anyone else\'s health care. I for one do not mind that I have supported your health care for the 15 years you were in the service, nor do I object to contributing to a system that deals with our health care crisis in what I consider to be a pragmatic, cost-effective way. I do not consider a single-payer system to be a panacea, but we need to achieve savings, and the most wasteful costs, in my opinion, are the excessive costs of private insurance, its damage to small businesses including my own, and its propensity to deny payment and exclude those who need it the most.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11565387">\
	 <div id="dsq-comment-header-11565387" class="dsq-comment-header">\
	 <cite id="dsq-cite-11565387" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11565387">shannonlee</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11565387" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11565387" class="dsq-comment-message">Why are we too stupid to do public health care?  I\'ve lived in a couple of different European countries that do it very well.  I have received great health care in those countries.  Why are they so much better at it than us?  <br><br>If we can provide health care in the same way we provide for national defense, I believe we can have one of the best public health care systems in the world.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11548128">\
	 <div id="dsq-comment-header-11548128" class="dsq-comment-header">\
	 <cite id="dsq-cite-11548128" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11548128">EEllis</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11548128" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11548128" class="dsq-comment-message">Goldman Sachs already payed back every dime of cash it took. <br><br>For the record I was against the bailout</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11543087">\
	 <div id="dsq-comment-header-11543087" class="dsq-comment-header">\
	 <cite id="dsq-cite-11543087" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11543087">Dr J</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11543087" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11543087" class="dsq-comment-message">Well, Kathy, I think I see his point.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11544671">\
	 <div id="dsq-comment-header-11544671" class="dsq-comment-header">\
	 <cite id="dsq-cite-11544671" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11544671">Dr J</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11544671" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11544671" class="dsq-comment-message">Tell you what, how about the taxpayer pay my mortgage?  That\'s the plan I expect to see, and I\'m quite willing to discuss potential problems with it, but the bottom line is that\'s really what I insist on.  And please don\'t suggest compromises to me, because I\'ve *already* compromised.  I should really have a much larger place than I do.  The average home in Canada is, like, twice the size of mine, and it\'s even cheaper!<br><br>Don\'t I sound open-minded?</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11552157">\
	 <div id="dsq-comment-header-11552157" class="dsq-comment-header">\
	 <cite id="dsq-cite-11552157" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11552157">SteveK</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11552157" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11552157" class="dsq-comment-message">Excellent post Kathy. <br><br>It\'s refreshing to see someone able to counter the childish rants of the intellectual midget / hack JasonArvak. His claim of your having a "no-discussion-tolerated" attitude is a joke... particularly since his primary tool in any debate he\'s losing is to ban the individual that disagrees with him. The man is a coward and a fool.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11553895">\
	 <div id="dsq-comment-header-11553895" class="dsq-comment-header">\
	 <cite id="dsq-cite-11553895" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11553895">JasonArvak</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11553895" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11553895" class="dsq-comment-message">Kathy,<br><br>Thank you for responding with a respectful tone.  Let\'s see if we can maintain it in spite of the efforts of SteveK to coopt it into his apparent personal vendetta against me.  BTW, it is not true that you are not able to comment at PoliGazette and that has not been the case for a long time.<br><br>As for the content of your response, I would note that I agree that some reform is necessary, but I object to the purist, no-compromise approach implied by your original headline and reinforced by many others on your side of the issue, most notably Paul Krugman in today\'s NYT.  He specifically and in detail rejects all debate and compromise, insisting on a purely public option.<br><br>Also, you and other advocates of public health care do not address key issues of rationing problems found in other health care systems.  The fact that our current system falls short in providing care does not mean that those flaws in other systems are meaningless.  In building a reform package, shouldn\'t we try to correct BOTH the defects in our current system AND the defects in other models?  Why does it have to be reduced to ideological "win" and "lose"?  Yet that is exactly what you and Krugman and so many others on the liberal side seem to do with it -- reduce it to an ideological zero-sum game.  (The fact that such a Manichean worldview is shared by some on the other side of the aisle shouldn\'t constitute an excuse for the behavior.)<br><br>It is also disappointing that most on the liberal side refuse to address questions about how public/private "competition" could work given that the government can use its power to tip the tables and drive the private options out of business.  The public plan would be subsidized by the taxpayers (thus concealing costs while not removing them) while the private plans have to answer to shareholders.  The government can also operate with a deficit while the private programs cannot, again presenting the appearance of lower costs while in reality merely competing unfairly.<br><br>It is also distressing to see that compromise ideas like Conrad\'s idea for health care co-ops are simply ignored or dismissed out of hand.  People like Krugman see compromise as an evil in and of itself.  Such attitudes are not conducive to a thorough debate about various alternatives.<br><br>My bottom line is that I am NOT a purist on this.  I concede at the outset that rescission is a travesty and that lack of available coverage for tens of millions is not a viable situation.   If I could be persuaded that a public option would be efficient and comprehensive, I would be willing to support it.  I\'ve actually got a much more personal attachment to this problem area than would be comprehensible to some commenters immediately above me on this thread.  But all I\'m asking for is that liberals set aside their desire to "score a win" long enough to actually debate the complexities of the issue thoroughly and perhaps even question some of their own assumptions.  Is that really too much to ask from the dominant political force in the country right now?</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11553920">\
	 <div id="dsq-comment-header-11553920" class="dsq-comment-header">\
	 <cite id="dsq-cite-11553920" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11553920">kathykattenburg</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11553920" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11553920" class="dsq-comment-message"><i>Is clean water and sewage a right? Is clean food? What about safe playgrounds? Good schools? Are those rights or accessories</i><br><br>Most of those items are human rights, if you think about them a little differently. Potable water is a human right, yes. I don\'t know what you mean by "clean sewage," exactly, but certainly destroying sewage processing plants in war is a human rights violation, because it\'s destroying a people\'s means of survival. "Unsafe playgrounds" is a sort of reductio ad absurdum way of referring to people\'s right to be free of random violence and crime. So I guess if you have hypothetical playgrounds where all the play equipment is booby-trapped, or constructed to explode, it could get to be a violation of the human rights of children who used the playground.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11554762">\
	 <div id="dsq-comment-header-11554762" class="dsq-comment-header">\
	 <cite id="dsq-cite-11554762" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11554762">Dr J</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11554762" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11554762" class="dsq-comment-message">Lit3: "Why this issue more than any other?"<br><br>Because the economics of health care are different.  Welfare pays the few at the bottom by taxing those at the top, and everyone comes a bit closer to average.  <br><br>Health care is different because the *average* is too high, so bringing everyone closer to it doesn\'t help.  *Everyone* is paying too much.  It doesn\'t matter how aggressively you tax your neighbor to pay your doctor bills, they\'ll be taxing you back just as hard to pay theirs.  Redistributing costs until everyone\'s bills are below average works only in Lake Woebegone.<br><br>The only way to make progress against that average is by improving cost efficiency.  We need to shrink the role of these so-called insurance companies (private or public) that act as big gatekeepers to our medical care and are not accountable for value for money.  Consumers need to take control back.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11555056">\
	 <div id="dsq-comment-header-11555056" class="dsq-comment-header">\
	 <cite id="dsq-cite-11555056" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11555056">JasonArvak</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11555056" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11555056" class="dsq-comment-message">Actually, the UN Convention on Economic and Social Rights (to which the United States is a signatory) includes the right to be free from random violence and crime as a "human right".<br><br>The key problem, of course, is as it is with most "human rights" -- the practical problems of how best to implement them in practice.  No one believes that government action can be perfect in all areas (i.e. there will always be crime) nor does any serious analyst contend that government action is always the best mechanism (for example, freedom of the press doesn\'t require government to provide all the media outlets nor would that be a functional way to honor the right (except, of course, if you really love Hugo Chavez)).<br><br>Thus, the question of whether it is a "human right" is really semantic.  The issue is how best to implement a functional and efficient system that fixes the problems in the status quo while avoiding the flaws in other systems.  Conservatives often err in failing to see the problems in the status quo.  Liberals often err by failing to see the flaws in other systems.  Only by having a greater tolerance for debate and discussion can these errors be avoided.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11557725">\
	 <div id="dsq-comment-header-11557725" class="dsq-comment-header">\
	 <cite id="dsq-cite-11557725" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11557725">casualobserver</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11557725" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11557725" class="dsq-comment-message">Since the poll was taken while intentionally hiding its price tag, I\'m neither surprised by its results nor convinced of its accuracy. Let\'s run a NYT poll on this statement and see what the results are........<br><br>According to our preliminary assessment, enacting the proposal would result in a net increase in federal budget deficits of about $1.0 trillion over the 2010-2019 period. When fully implemented, about 39 million individuals would obtain coverage through the new insurance exchanges. At the same time, the number of people who had coverage through an employer would decline by about 15 million (or roughly 10 percent), and coverage from other sources would fall by about 8 million, so the net decrease in the number of people uninsured would be about 16 million or 17 million.<br><br>Add that to the budget deficit already incurred for the non-stimulus package and let\'s see how the voters vote in 2010.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11560562">\
	 <div id="dsq-comment-header-11560562" class="dsq-comment-header">\
	 <cite id="dsq-cite-11560562" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11560562">JasonArvak</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11560562" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11560562" class="dsq-comment-message">ChrisWWW, from first-hand experience, I know better about the limits of health care coverage than you can possibly know.  I also know the virtues of a system that allows rapid access to treatment for conditions where time is an important factor.  I would hate to see the virtues sacrificed just because concerns about reform are dismissed out of hand with breezily hateful stereotypes like "a freemarketeers wet dream".  It should be possible to set aside ideological combat in the interests of pragmatism, shouldn\'t it?<br><br>My latest efforts to do that are here:  <a href="http://www.poligazette.com/2009/06/22/lessons-from-military-health-care/" rel="nofollow">http://www.poligazette.com/2009/06/22/lessons-f...</a><br><br>Please note that I am not in favor of the status quo and I take seriously the need for reform and in particular expansion of coverage.  I am dubious about purist proposals because I think they are willfully ignorant of potential problem areas and I think compromising approaches offer the potential to acknowledge and deal with the inevitable trade-offs rather than simply demonizing the issue into "good guys" and "bad guys" like you seem prone to do.<br><br>Maybe...just maybe, treating cancer patients in a timely and effective manner is more important that bashing "free marketers" or "socialists".<br><br>There is also no evidence I am aware of that shifting the costs to the government will reduce them.  In fact, basic economics says that if you make it cheaper for individuals, they will demand more of it.  Thus, the most likely direction for costs under a single-payer system is upward UNLESS you use the exact same kinds of cost controls that insurance companies do (limiting access) OR you impose arbitrary limits (rationing).  Are you prepared to discuss details, or only make sweeping statements&gt;</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11561148">\
	 <div id="dsq-comment-header-11561148" class="dsq-comment-header">\
	 <cite id="dsq-cite-11561148" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11561148">starleys</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11561148" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11561148" class="dsq-comment-message">JasonArvak.  I researched and found that timely and effective treatment predominates in the one payer systems.  Priority is given to most serious cases.  Unfortunately, in the US no treatment may be recieved if you can\'t meet co-pay or don\'t have insurance to cover the cost of prescriptions required.</div>\
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	 </li>\
	 <li id="dsq-comment-11564001">\
	 <div id="dsq-comment-header-11564001" class="dsq-comment-header">\
	 <cite id="dsq-cite-11564001" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11564001">JasonArvak</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11564001" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11564001" class="dsq-comment-message">As I have repeatedly said, I am aware of the access problems in the U.S. system.  I agree that something should be done to fix the system.  I am just saying we should take care to acknowledge the trade-offs and other issues that will affect any reformed system.<br><br>For example, you say "priority is given to most serious cases", but it is important to note that "priority" is a small comfort if the total number of just the "most serious cases" exceeds the available supply of equipment.  For example, one defect with single-payer health systems is that they have fewer MRI machines available because there is simply no incentive to invest in equipment for FUTURE demand and government budgets are designed only to address CURRENT demand (and are often subject to budget cuts on top of that as well).  The result is that even that subset of "serious cases" who need MRI scans (to locate their tumors or check for metastasis) often have to wait months or even years.  <br><br>Now this is an issue that would be possible to address, perhaps by including provisions in the system to allow for providers to invest in equipment based on future demand instead of just present-day compensation rates.  But in order to address such issues, we have to first admit they exist, something which single-payer purists have thus far been loathe to do with their "no compromise allowed" Manichean approach.</div>\
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	 </li>\
	 <li id="dsq-comment-11564346">\
	 <div id="dsq-comment-header-11564346" class="dsq-comment-header">\
	 <cite id="dsq-cite-11564346" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11564346">kathykattenburg</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11564346" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11564346" class="dsq-comment-message"><i>Thus, the question of whether it is a "human right" is really semantic. The issue is how best to implement a functional and efficient system that fixes the problems in the status quo while avoiding the flaws in other systems.</i><br><br>Okay, but the point is that whether one views access to health care as a human right or a commodity to be bought and sold for profit affects how one views the solutions as well. If the goal is to make a profit, that precludes a public option. If the goal is to deliver quality, affordable health care to every American citizen, a public <b>option</b> is essential, and a fully nationalized, universal, publicly funded system is optimal.<br><br>My brother has lived in Canada for over 30 years, and although he acknowledges the problems with the Canadian health care system, he still prefers it to the American profit-motivated model. If he has an emergency in the middle of the night, for example, he knows he can go to his local hospital in Winnipeg, be treated, and not have to worry about being billed. Yes, he may have to wait, but he <b>will</b> get the health care services he needs without mortgaging his entire financial future. <br><br>By contrast, when I slipped on ice this past winter while walking my dog and injured one of my knees so badly that the next day I could not walk or stand up, I went to a local ER and was given excellent care.... and then, about a week later, I received about half a dozen separate invoices for the services I had used, adding up in total to over $3,000. I can\'t pay that. And by the way, I had to wait for quite a long time in the ER waiting room, too, before I was seen. <b>And</b> I was billed for thousands of dollars that I have no way of paying.<br><br>Moreover, Canada\'s health care system is not the only nationalized, universal health care system in the world, as you obviously know. Opponents of universal health care in the U.S. always point to Canada because it has problems, but they never point to France, or Germany, or the Scandinavian countries, where single-payer works very well. Even in England, which is also sneered at by opponents of single-payer, if you or I, as Americans, go to England on vacation or business and fall sick or have a medical emergency, we can walk into any hospital, wherever in England we are, and be treated <b>at no cost.</b> A British citizen visiting the U.S. cannot do that.<br><br>One more anecdote from my brother: A few years ago, he and his partner were in Europe, and Meaghan developed a serious urinary tract infection while in The Netherlands. That may not sound very dire, but UTIs can go from zero to 360 in a very short period of time, and when they do, they are excruciatingly painful and can have major health consequences if not treated promptly. That\'s what happened to Meaghan. It was at night, and within a matter of minutes it was a full-blown emergency. Dave told me that from the time they knew they had to get to a doctor, fast, and the time they were walking out of the doctor\'s office with Meaghan having been treated, feeling much better, and with the medication she needed in hand, about two and a half hours passed. The medication cost the equivalent of about $10, but that was because as non-citizens they were not actually enrolled in the health care system. That was the only expense associated with the medical care Meaghan received.<br><br>Try making that happen in the United States if you are not wealthy or upper-middle-class. I dare you.</div>\
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	 </li>\
	 <li id="dsq-comment-11564939">\
	 <div id="dsq-comment-header-11564939" class="dsq-comment-header">\
	 <cite id="dsq-cite-11564939" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11564939">Dr J</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11564939" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11564939" class="dsq-comment-message">Starley, our system definitely needs reform, but I simply don\'t believe the numbers you laid out.  I don\'t believe the "better results for half the costs" statistics, which are disputed in a number of different directions.  Our cancer survival rates are better than Europe\'s.  We don\'t have the queues-as-a-way-of-life that are routine other places.  Many statistics around death rates tend to be collected differently in different countries, and it\'s difficult to compare apples to apples.  <br><br>Most importantly, I haven\'t seen any data to suggest that more socialized countries have licked the problem of costs going up 5% every year.  What I\'ve read suggests the opposite, that they can contain them for a few years only at the expense of giving people less care than they want, and the cost creep continues.  There are a bunch of ways we can help the uninsured, and we must.  But this problem looks harder to solve and more deadly over the long run.  It\'s what keeps me up at night.<br><br>A few other areas of factual dispute:<br><br>1.  What we have is a private system.  It\'s not, it\'s part private, part public, and heavily shaped by rules the government has set up.  If you want to compare a socialized system against a free market one, ours cannot serve as an example of the latter.<br><br>2. A single-payer system would take the profit out of the equation.  Not at all, it would just take it out of insurance companies, and they\'re only 20% of the industry.  Doctors and hospitals would still be making profits on the quantity rather than the quality of treatments they provide.<br><br>3. Medicare for all would be cheaper than what we\'re currently spending.  Medicare is the Bernard Madoff of health care funding, producing very pleasing results provided you don\'t look at the liabilities it\'s accruing.  It\'s cheaper only because the government is deferring the bills for our children and grandchildren to pay.  This is not a recipe for a responsible, sustainable system.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11565289">\
	 <div id="dsq-comment-header-11565289" class="dsq-comment-header">\
	 <cite id="dsq-cite-11565289" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11565289">kathykattenburg</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11565289" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11565289" class="dsq-comment-message"><i>For example, one defect with single-payer health systems is that they have fewer MRI machines available because there is simply no incentive to invest in equipment for FUTURE demand. ...</i><br><br>That emphasis on "investing in" equipment for future demand translates also into doctors and hospitals buying the newest, latest, most cutting edge equipment. That is one reason health care costs are through the roof and continuing to climb.In a capitalistic marketplace health care system, health care providers have a powerful incentive to do this: It allows them to charge more money.<br><br>Of course, there are always trade-offs anytime a system is changed, but with the condition health care is in in the U.S., both in terms of costs and in terms of access, I really think there\'s no direction to go in but up.</div>\
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	 </li>\
	 <li id="dsq-comment-11565291">\
	 <div id="dsq-comment-header-11565291" class="dsq-comment-header">\
	 <cite id="dsq-cite-11565291" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11565291">GerSan</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11565291" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11565291" class="dsq-comment-message">Fraudulent poll.  The CBS/NYT poll was exposed over the weekend for having a dramatically left-leaning sampling, and there fore cannot be trusted... much like one cannot trust the NYT or CBS.<br>172 million Americans have health insurance, and 70% of those rate it as good to excellent.  It\'s very hard to swallow that all those people are going to "vote" to destroy what they have.<br>As for reform: getting the government out of medical care is a good start.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11565903">\
	 <div id="dsq-comment-header-11565903" class="dsq-comment-header">\
	 <cite id="dsq-cite-11565903" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11565903">JasonArvak</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11565903" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11565903" class="dsq-comment-message"><blockquote>Okay, but the point is that whether one views access to health care as a human right or a commodity to be bought and sold for profit affects how one views the solutions as well. If the goal is to make a profit, that precludes a public option. If the goal is to deliver quality, affordable health care to every American citizen, a public option is essential, and a fully nationalized, universal, publicly funded system is optimal.</blockquote><br><br>I disagree, not because I want to see "profit" being made, but because a "fully nationalized, universal, publicly funded system" has not always shown itself able to actually provide what it promises.  Instead, rationing combined with under-investment in equipment has often served to make the system into an underperforming bureaucratic nightmare that denies effective treatments to many people who need it.<br><br>I\'m prepared to consider a public option in a competitive system provided that competition is actually maintained.  Competition could serve to prevent the growth of bureaucratic dysfunction that happens in a single-payer system as well as maintaining incentives for investment in research and equipment.   If, however, the public "option" really becomes a "mandate" through the manipulation of government coercion that drives real competition out, those advantages would be lost and we would wind up with another false-promise of universal coverage.<br><br><blockquote>Okay, but the point is that whether one views access to health care as a human right or a commodity to be bought and sold for profit affects how one views the solutions as well. If the goal is to make a profit, that precludes a public option. If the goal is to deliver quality, affordable health care to every American citizen, a public option is essential, and a fully nationalized, universal, publicly funded system is optimal.</blockquote><br><br>That sounds fine when the "wait" is a few hours in a well-triaged emergency room, but when the "wait" is months for an MRI scan or a radiation treatment program that prevents metastasis for cancer (which is the area of my recent experience with the health care system), it is much more serious and consequential and potentially life-threatening.  The satisfaction of those using a routine-care system is of little comfort to those with life-threatening conditions for whom "a little wait" is potentially the entire ball game.<br><br>I am thankful that the "profit-based" system that we have ensured rapid access for my wife that saved her life.  I am resistant, I think understandably, to proposals that might sacrifice that in order to chase the vision of universal primary care.  I\'d prefer to slow down a bit and see if we can\'t find a way to get both.  I do, however, understand the nightmare of billing and fighting with insurance companies.  But I don\'t want to throw the baby out with the bathwater by being hasty and inattentive to the problems and trade-offs that we know exist in public health care options.  (My most recent post on PG deals with the public health care system that has existed in the U.S. for decades: military health care.)<br><br><blockquote>Moreover, Canada\'s health care system is not the only nationalized, universal health care system in the world, as you obviously know. Opponents of universal health care in the U.S. always point to Canada because it has problems, but they never point to France, or Germany, or the Scandinavian countries, where single-payer works very well. Even in England, which is also sneered at by opponents of single-payer, if you or I, as Americans, go to England on vacation or business and fall sick or have a medical emergency, we can walk into any hospital, wherever in England we are, and be treated at no cost. A British citizen visiting the U.S. cannot do that.</blockquote><br><br>I concede the virtues of those systems, but I ask you to concede the concerns as well.  Access is a virtue, particularly with regards to emergency care.  But all the systems you mention struggle with the same problems of lack of availability for time-sensitive tests and treatment programs like MRI, radiation, and chemotherapy.  I\'m not suggesting that we adopt the infantile "anything Europe does sucks" attitude of the far right, but I also think we shouldn\'t romanticize those systems by pretending they are problem-free.  Paying close attention to their problems might help us design a system that mitigates some of them.<br><br>P.S.  I also know about treatment for UTIs and can testify from first-hand experience that rapid and effective treatment was also available for that condition in the United States -- Minnesota specifically.  Once again, I remind you that I am not ignorant of the virtues of other health care systems and I am not opposed to trying to model what does work in those cases.  But I am opposed to blindly embracing them without first trying to acknowledge their flaws and find ways to mitigate them wherever possible.  Perhaps if you could take a minute to acknowledge that I am not, in fact, an apologist for the status quo, we could find more productive common ground in discussing BOTH pluses and minuses.<br><br>Finally, I state from first-hand experience that you are flatly wrong that "we have no where to go but up".  The U.S. system is not completely deficient in all categories.  Exaggerating the problem to make the picture appear completely bad may be politically effective, but I don\'t think it is a good foundation from which to design reform.  Good reform takes note of what pieces work well as well as what pieces work badly.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11570417">\
	 <div id="dsq-comment-header-11570417" class="dsq-comment-header">\
	 <cite id="dsq-cite-11570417" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11570417">starleys</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11570417" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11570417" class="dsq-comment-message">Jason and Dr J<br>Enjoyed your replies.  Appreciate well thought out responses.  Dr J.  Your point on cancer survival rates was very accurate and led to further research.  When accidents/fatal injuries are deleted from survival rates the US actually has a HIGHER longivity rate than other countries.  76.9 years.  <br><a href="http://politicalcalculations.blogspot.com/2007/09/natural-life-expectancy-in-united.html" rel="nofollow">http://politicalcalculations.blogspot.com/2007/...</a><br><br>My concern however is we cannot sustain this level.  Recent increases in unemployment have moved more and more people away from available coverage.  The latest figure is 56 million without insurance.I am in that situation.  And I don\'t believe employers are going to be willing to continue to foot the bill.<br><br>I do agree with the single payer system however.  It allows for universal coverage and contract providers who would compete to provide care and allow for better oversight by a unified authority.  It is not necessarily socialism.  And Jason, don\'t forget that there will always be inovation looking to make a buck on that large money available in the industry.  Dr J.  You are right, someone will always be there to make a profit.  And having better equipment will make contract providers more competitive.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11570744">\
	 <div id="dsq-comment-header-11570744" class="dsq-comment-header">\
	 <cite id="dsq-cite-11570744" class="dsq-comment-cite">\
	 <a id="dsq-author-user-11570744" href="http://www.whyweworry.com" target="_blank" rel="nofollow">ChrisWWW</a>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11570744" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11570744" class="dsq-comment-message"><b>an underperforming bureaucratic nightmare that denies effective treatments to many people who need it.</b><br><br>Jason,<br>That describes our health care system very well. <br><br>Our health care outcomes, on the whole, are not any better, and often times worse than in countries with universal coverage. What we pay, however, is nearly double what some of these other countries pay.<br><br>So again... we pay more and don\'t get better outcomes. There are fringe cases for rare and difficult to treat diseases where our system performs admirably. But I\'m not sure how that can possibly outweigh the concerns of the millions who are uninsured and the millions more who are under insured.</div>\
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	 </li>\
	 <li id="dsq-comment-11571588">\
	 <div id="dsq-comment-header-11571588" class="dsq-comment-header">\
	 <cite id="dsq-cite-11571588" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11571588">starleys</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11571588" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11571588" class="dsq-comment-message">Dr J.  This link gives per capita costs for healthcare.  Even though the longevity issue is relatively equal, the costs are almost double.  <a href="http://www.infoplease.com/ipa/A0934556.html" rel="nofollow">http://www.infoplease.com/ipa/A0934556.html</a></div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11572216">\
	 <div id="dsq-comment-header-11572216" class="dsq-comment-header">\
	 <cite id="dsq-cite-11572216" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11572216">JasonArvak</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11572216" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11572216" class="dsq-comment-message"><blockquote>And Jason, don\'t forget that there will always be inovation looking to make a buck on that large money available in the industry.</blockquote><br><br>Only if we keep those elements in our system in some form.  If we follow the prescriptions of purists, we will strip out all possibility of making a buck in favor of comprehensive cost controls and bureaucratic mandates that prohibit moving outside the system.  Single-payer systems intrinsically involve this since no one exists except the single payer -- the government -- which sets the rates of compensation as low as possible, too low to leave any room for risk-taking through innovation.<br><br>As I have said (and the more script-driven commenters above insist on ignoring no matter how many times I say it), I am open to some major reforms including a public option that functions in a <em>genuinely</em> competitive system.  But I think ignoring the problems of other systems and the virtues of our own in favor of an ideology-driven approach is a serious mistake in spite of its obvious emotional satisfactions for a few.<br><br>P.S. I disparage Paul Krugman because he is intellectually dishonest in acknowledging and responding to arguments he disagrees with and because his Nobel Prize is a sham granted for ideological reasons rather than as a recognition of any genuine accomplishment.  Your attempt to appeal to his authority is a gross logical fallacy.  You would be better off actually responding to my points instead of trying to blow them off by waving Krugman at me.<br><br>The question of why we pay so much is not easily answered by simply believing a single-payer system would magically solve it all.  The fact is that the U.S. for-profit system currently functions as an unintended subsidy for other systems in a variety of areas including medical technology and pharmaceuticals.  If the U.S. moved to a single-payer model, we would not necessarily get to join in that artificial subsidy since we can\'t simultaneously subsidize and be subsidized.  Also, lifestyle issues and infrastructure requirements make the U.S. a complex case.  So you should not be so shallow in your thinking about potential cost-savings.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11572489">\
	 <div id="dsq-comment-header-11572489" class="dsq-comment-header">\
	 <cite id="dsq-cite-11572489" class="dsq-comment-cite">\
	 <a id="dsq-author-user-11572489" href="http://www.whyweworry.com" target="_blank" rel="nofollow">ChrisWWW</a>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11572489" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11572489" class="dsq-comment-message">How much of the truly breakthrough innovation (the non-pen1s pill kind) has come from the "market" versus research funded by government grants? I\'d like to see statistics on that.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11572631">\
	 <div id="dsq-comment-header-11572631" class="dsq-comment-header">\
	 <cite id="dsq-cite-11572631" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11572631">JasonArvak</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11572631" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11572631" class="dsq-comment-message">Those statistics are really hard to come by because ideology twists all the available study.  I believe it likely that in pharmaceuticals, the government funds a huge part of the truly innovative research (variations on Viagra don\'t count) especially after 9/11.  But in the area of medical technology and particularly in the investment in equipment, the government does not play a large role and that is a facet that we really need to examine carefully before throwing away too much of our current system.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11572905">\
	 <div id="dsq-comment-header-11572905" class="dsq-comment-header">\
	 <cite id="dsq-cite-11572905" class="dsq-comment-cite">\
	 <a id="dsq-author-user-11572905" href="http://greendreams.wordpress.com" target="_blank" rel="nofollow">GreenDreams</a>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11572905" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11572905" class="dsq-comment-message">Jason, I\'ve responded to your points, except the MRI issue. This is a bit of a red herring. The TOTAL MRI equipment industry in the US is $700 million. We probably have enough of them, but even if we were talking about the taxpayer buying them for hospitals, which we\'re not, it\'s not as big a budget item as you seem to believe. As I pointed out above, by cutting our cost by LESS than half, we could avoid virtually all the issues you raise with current single payer systems.<br><br>Like you, I would support a public OPTION with competition from the private sector. Those of you who believe the current system will serve you better can have it. The market will decide if its market can be sustained. And by the way, you didn\'t respond to MY point. The for-profit model is in trouble, as unemployment rises, fewer employers can afford to cover their employees, and the economic downturn drives insurance customers to cheaper plans. I read that UnitedHealth has lost 9 million customers since September. The numbers of customers downgrading their coverage was not reported. Will we bail them out when they suggest to legislators that they are "too big to fail?"</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11574181">\
	 <div id="dsq-comment-header-11574181" class="dsq-comment-header">\
	 <cite id="dsq-cite-11574181" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11574181">JasonArvak</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11574181" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11574181" class="dsq-comment-message">The MRI is an example of a type of issue (medical equipment availability), it is not in and of itself the entire issue. (I was stunned to learn how many different types of scanners there are, and that is just one small area of medical technology.)  I know it to be a serious problem in the Canadian system (the best analogue in terms of geographic infrastructure challenges that would face a U.S. single-payer system) and it would have to be addressed in any decent reform package rather than, as you do, simply blown off as ideologically inconvenient.<br><br>And as I have REPEATEDLY said, I do not support the current system.  Geez.  How many times do I have to repeat it before you will stop reading off your script?</div>\
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	 </li>\
	 <li id="dsq-comment-11575938">\
	 <div id="dsq-comment-header-11575938" class="dsq-comment-header">\
	 <cite id="dsq-cite-11575938" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11575938">starleys</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11575938" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11575938" class="dsq-comment-message">I am currently out of the office and will not be checking e-mail.<br><br>I will reply to your message as soon as I return.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11575939">\
	 <div id="dsq-comment-header-11575939" class="dsq-comment-header">\
	 <cite id="dsq-cite-11575939" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11575939">starleys</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11575939" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11575939" class="dsq-comment-message">I am currently out of the office and will not be checking e-mail.<br><br>I will reply to your message as soon as I return.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11576083">\
	 <div id="dsq-comment-header-11576083" class="dsq-comment-header">\
	 <cite id="dsq-cite-11576083" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11576083">JasonArvak</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11576083" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11576083" class="dsq-comment-message"><blockquote>BTW, your attack on the Nobel Prize process is an insult to the many brilliant people who have earned them.</blockquote><br><br>See, and here I thought that awarding Nobel Prizes to Al Gore and Paul Krugman as a way of lashing out at Bush was the REAL insult to the many brilliant people who have ACTUALLY earned them.<br><br>And my point about tradeoffs was never presented as a defense of the status quo, which you would have noticed if you actually read them before I called you out on scripting.  I\'ve consistently maintained that the tradeoffs can be mitigated, but that doing so requires admitting to their existence first and stopping the practices of romanticizing single-payer systems and demonizing everyone who questions their flaws.</div>\
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	 </li>\
	 <li id="dsq-comment-11576412">\
	 <div id="dsq-comment-header-11576412" class="dsq-comment-header">\
	 <cite id="dsq-cite-11576412" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11576412">starleys</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11576412" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11576412" class="dsq-comment-message">Jason, there is no reason private industry could or would not compete in a one payer system.  Some of the largest pharmacutical companies are in Europe.  New and innovative products are constantly coming into the market and they would not develop if there were not a market with most modern countries having a one payer system.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11576563">\
	 <div id="dsq-comment-header-11576563" class="dsq-comment-header">\
	 <cite id="dsq-cite-11576563" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11576563">jwest</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11576563" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11576563" class="dsq-comment-message">Jason,<br><br>Your description of Krugman was the most accurate I’ve ever seen on this website.<br><br>As someone who is just a smiggen right of center, I favor a hybrid healthcare system using both free market and socialized elements, with the complete elimination of health insurance.<br><br>On the free market side, I believe in individual health savings accounts (subsidized for the needy) that would provide a dignified means for everyone to purchase whatever healthcare they choose to buy.  The individual would have the power to pick their doctor, procedures and tests.  <br><br>This type of capitalistic system has been proven to be the best method of delivery on every imaginable service and healthcare would be no different.  I envision a time when advanced degree nurses (ADN) would come to your home to listen to your symptoms, take tests, observe your surroundings and spend the amount of time necessary to get a good idea of what the problem is.  Then, using their medical knowledge, these ADNs would transmit their findings and speak with the appropriate medical specialty necessary for the situation.  Cost savings plus better service – how good does this get?<br><br>The medical savings accounts would be linked to a debit card that pays instantly after each procedure.  Cost information is automatically entered into a database for cost comparison in your area over the internet.  At the point of sale (the doctor’s office for example), when you swipe your debit card for payment, the average cost in your area would be shown along with the last 10 similar procedures with the physician’s name and price.  Medical savings accounts would be funded up to $8000 per individual.  There would be a $7000 “donut hole” between the point that the base savings account is depleted and the socialized catastrophic plan kicks in.<br><br>As to the socialized plan, the only reason I propose this method for the upper catastrophic end is so that government can impose some end-of-life limits on heroic efforts when the quality or quantity of life is not significantly extended by these hyper-expensive procedures.<br><br>Only government, in its dehumanizing, bureaucratic form can set the limits that need to be set.<br><br>Of course there is much more, but this is enough for one comment.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11576628">\
	 <div id="dsq-comment-header-11576628" class="dsq-comment-header">\
	 <cite id="dsq-cite-11576628" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11576628">JasonArvak</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11576628" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11576628" class="dsq-comment-message">starleys,<br><br>Again, I would remind you that the economics of innovation work differently with regards to pharmaceuticals versus medical technology like scanners and other advanced testing equipment.  Also, infrastructure investment is a different issue from innovation.  But I can agree that it would be possible to design the system in such a way as to maintain incentives.  Doing so will require that purists stop their headlong rush long enough to actually pay attention to the issue, however.  And so far, even on this thread, the number willing to make even that tiny concession appears very, very small.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11576685">\
	 <div id="dsq-comment-header-11576685" class="dsq-comment-header">\
	 <cite id="dsq-cite-11576685" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11576685">JasonArvak</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11576685" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11576685" class="dsq-comment-message">jwest, please feel free to also join the discussion on Poligazette.  <br><br><a href="http://www.poligazette.com/2009/06/22/lets-have-a-real-health-care-debate/" rel="nofollow">http://www.poligazette.com/2009/06/22/lets-have...</a></div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11576951">\
	 <div id="dsq-comment-header-11576951" class="dsq-comment-header">\
	 <cite id="dsq-cite-11576951" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11576951">starleys</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11576951" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11576951" class="dsq-comment-message">Jason - curious.  Why do you feel equipment would be different from Pharm?<br>jwest.  Explain more on your savings plan.  I\'m not clear.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11577109">\
	 <div id="dsq-comment-header-11577109" class="dsq-comment-header">\
	 <cite id="dsq-cite-11577109" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11577109">JasonArvak</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11577109" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11577109" class="dsq-comment-message">GreenDreams,<br><br>I do not agree with your assumption that criticism of another person\'s argument constitutes disrespect.  If you want to see real personal disrespect, scroll up to read what SteveK wrote about me and about which you had no complaint.  I haven\'t written anything even remotely similar to that, even when I was lambasting Kathy\'s original post on health care.<br><br>I also do not agree that single-payer systems can be assumed to be cost-savers.  As I have pointed out before, the cost savings enjoyed by many single-payer systems now come about at least in part because the for-profit system in the U.S. is provided an unintended subsidy and because the governments implementing those systems impose rationing and other controls that may not be acceptable to American consumers.  So we can\'t just jump to the conclusion that single-payer implementation in the U.S. would lead to the same cost savings.  We have to look more closely and evaluate other alternatives, like Kent Conrad\'s proposal for health insurance co-ops modeled on co-ops for other critical commodities and services.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11577311">\
	 <div id="dsq-comment-header-11577311" class="dsq-comment-header">\
	 <cite id="dsq-cite-11577311" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11577311">JasonArvak</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11577311" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11577311" class="dsq-comment-message">starleys,<br><br>Equipment is different from pharmaceuticals because providers purchase them at different points.  Pharmaceuticals are purchased pretty much as-needed in both for-profit and non-profit systems.  Thus, matching demand is relatively easy.  Equipment, however, is purchased in for-profit systems in expectation of future demand and in non-profit systems only to meet current demand.<br><br>In a single-payer system, this plays out in ways that causes the incentives for innovation to differ as well.  Pharmaceuticals can still be developed in expectation of future demand because that demand will develop automatically and the purchase cost will be recovered in short order.  But a new piece of equipment won\'t appear on the government\'s reimbursement schedules for months or years and even then will be at a rate that will be unlikely to reimburse the much larger purchase cost until that piece of equipment has been used hundreds or thousands of times.<br><br>What that has resulted in in systems like Canada is a general reluctance of providers to invest in enw equipment at all.  Knowledge of this reluctance serves to discourage innovators from developing new equipment because they doubt whether a market for that equipment will emerge in sufficient timeframe to recoup their investment.<br><br>Now, I think there are ways to adjust to this phenomenon, but doing so requires admitting that the problem exists, something which purists seem loathe to do.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11577870">\
	 <div id="dsq-comment-header-11577870" class="dsq-comment-header">\
	 <cite id="dsq-cite-11577870" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11577870">JasonArvak</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11577870" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11577870" class="dsq-comment-message">I\'m not talking about government inefficiencies gobbling up cost savings (was that an item you were expecting from a script?  because I never mentioned it).  I\'m saying that at least some of the reasons that other single-payer systems are cheaper might not apply to the U.S. case, specifically that some of their cost savings have resulted BECAUSE we are a for-profit system.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11577979">\
	 <div id="dsq-comment-header-11577979" class="dsq-comment-header">\
	 <cite id="dsq-cite-11577979" class="dsq-comment-cite">\
	 <a id="dsq-author-user-11577979" href="http://www.whyweworry.com" target="_blank" rel="nofollow">ChrisWWW</a>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11577979" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11577979" class="dsq-comment-message">Jason,<br>Now be fair, you did say that it would be a "underperforming bureaucratic nightmare." <br><br>Good discussion by the way.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11578189">\
	 <div id="dsq-comment-header-11578189" class="dsq-comment-header">\
	 <cite id="dsq-cite-11578189" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11578189">JasonArvak</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11578189" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11578189" class="dsq-comment-message">I said it <em>could become</em> an "under-performing bureaucratic nightmare" if we failed to pay attention to flaws as well as virtues.  For example, if we fail to account for disincentives to equipment investments, what is a problem for a few hundred patients in Canada could wind up being a problem for many thousands in the United States.  The size and complexity of our society means that errors could be compounded in their impact.<br><br>My goal is to try to slow people down enough to get a good reform program that addresses all the issues as much as is possible, not to block all reform.  I think those who respond to me with the assumption that I am just reading from an anti-reform script keep running off the rails with their responses.  Having personally and intensely experienced both the virtues AND the flaws of our current health care system over the past year, I find myself outside the prepared scripts of both left and right on this issue.  And I am frustrated by the unwillingness of both left and right (with only a couple exceptions among the commenters, pretty much only the left is well represented on this site) to break out of their scripts.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11578206">\
	 <div id="dsq-comment-header-11578206" class="dsq-comment-header">\
	 <cite id="dsq-cite-11578206" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11578206">JasonArvak</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11578206" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11578206" class="dsq-comment-message"><i>duplicate deleted</i></div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11578355">\
	 <div id="dsq-comment-header-11578355" class="dsq-comment-header">\
	 <cite id="dsq-cite-11578355" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11578355">starleys</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11578355" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11578355" class="dsq-comment-message">I think the primary focus comes down to funding and its impact.  Mr. GreenDreams is accurate that Medicare is more cost effective than private in spite of the  fact Medicare deals with solely the highest risk health groups.  This tends to support the contention that single payer is less expensive regardless of environment.  In addition, a lot of major strides have been made in geriatric treatment originating in the competitive market.  However, Jason, you should realize by now I am not a purist.  I expect competitive contracts even in a one payer system for services and suppliers to be evaluated for both. cost and effectiveness.<br>By the way, Mr GreenDreams, I think the days of employer provided health insurance are coming to an end regardless of which way health insurance goes.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11578404">\
	 <div id="dsq-comment-header-11578404" class="dsq-comment-header">\
	 <cite id="dsq-cite-11578404" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11578404">Dr J</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11578404" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11578404" class="dsq-comment-message">Starleys: "Dr J. This link gives per capita costs for healthcare."<br><br>Starley, the <a href="http://www.nytimes.com/interactive/2008/09/04/business/20080907-metrics-graphic.html?th&emc=th" rel="nofollow">US spends more per capita</a> for everything: clothing, recreation, alcohol, you name it, so it\'s no surprise the same is true for health care.  And even spending more on shoes, we\'re probably not nearly as fashionably shod as the Italians, but that doesn\'t mean the government should take over Nike. <br><br>"My concern however is we cannot sustain this level."<br><br>Like I say, that\'s exactly my concern as well.  Even without the effects of the recession, costs are going up by 5% a year, and it\'s not like we\'re getting 5% healthier a year.  Costs have come unhinged from value delivered, and we need reform that will hook them back together.<br><br>"I do agree with the single payer system however. It allows for universal coverage and contract providers who would compete to provide care and allow for better oversight by a unified authority."<br><br>My concern is that\'s more or less what we have today.  Medicare and private plans *do* attempt to get better deals out of providers by setting rates they feel are aggressive.  As a result, not every doctor accepts every insurance plan (including Medicare), because they\'re not always willing to take what is being offered.  <br><br>But Medicare and private insurers all have limited leverage over the providers. They can\'t help anyone without a decent number of doctors signed up, so at the end of the day they pay whatever\'s Usual, Reasonable and Customary--which is to say whatever the providers vote they should be paid.  And they pass the cost on to us, whatever it might be.<br><br>This competitive process is broken two important ways.  First, it only happens once a year when these contracts are up for renewal, so it happens at a very high level and everyone forgets about any sort of cost competition the rest of the year.  Second, it happens on the basis of price per treatment, not price per outcome.  Medicare and Blue Cross have no idea if you actually feel better from that $10K worth of tests and treatments you got, so providers are competing on the basis of the quantity they can deliver, not the quality.  This is where reform needs to focus: making sure we\'re paying for what we really want.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11578478">\
	 <div id="dsq-comment-header-11578478" class="dsq-comment-header">\
	 <cite id="dsq-cite-11578478" class="dsq-comment-cite">\
	 <a id="dsq-author-user-11578478" href="http://www.whyweworry.com" target="_blank" rel="nofollow">ChrisWWW</a>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11578478" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11578478" class="dsq-comment-message">Don\'t worry. I\'m sure our government will find a way to make a health care system that stifles innovation and is more expensive than the one we have now.<br><br>The only thing that we will definitely get better is access.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11578566">\
	 <div id="dsq-comment-header-11578566" class="dsq-comment-header">\
	 <cite id="dsq-cite-11578566" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11578566">JasonArvak</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11578566" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11578566" class="dsq-comment-message">It is also worth remembering that private health insurance is effectively subsidizing Medicare.  Many providers make up ground on services that they provide at a loss to Medicare by increasing billing amounts to non-Medicare patients.  This de facto subsidy would disappear under a single-payer system.  While that is not necessarily a bad thing, it could wind up being bad if the result was either to significantly raise the costs beyond what we thought (based on current Medicare) would be the cost of certain services OR if the disappearance of the way to make up losses wound up forcing providers to simply no longer provide services for which Medicare did not pay enough.  The first scenario would undermine the projected cost savings of a single-payer system and the second scenario would undermine the goal of universal access to all areas of health care.<br><br>This is the kind of thing I think too many liberals fail to do - consider the complex interactive nature of the system.  They seem prone to overly simplistic assumptions.  Slowing down enough to actively seek out problems and concerns is needed to avoid critical errors in designing reform.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11578615">\
	 <div id="dsq-comment-header-11578615" class="dsq-comment-header">\
	 <cite id="dsq-cite-11578615" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11578615">jwest</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11578615" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11578615" class="dsq-comment-message">Starleys,<br><br>This plan was first put together in the early ‘90s to counteract HillaryCare.<br><br>First off, it recognizes that the main ingredient missing from either a government single-payer or a private insurance run operation is the dignity of managing your own healthcare.  Whether an uncaring bureaucrat or a greedy insurance employee, the emphasis is not on caring for you, but denying anything that costs money.<br><br>Back in the ‘90s, the percentage of the healthcare budget that went into clerical and billing matters exceeded 22%.  Most was centered at the provider to substantiate claims for payment and to maintain documentation in case of litigation.  A vast majority of this cost would be eliminated by customers paying via debit cards from medical savings accounts (MSAs).  <br><br>MSAs could be individually, employer or government funded, depending on the individual.  Once an MSA hit the $8000 minimum in one year, anything over that amount can be withdrawn for any purpose.  So, an employer could encourage employees to spend carefully on healthcare by paying a certain amount into the account each year, regardless if the account was at it’s minimum or not, thus allowing the employee the choice of taking a “bonus” or leaving the greater amount in the account.<br><br>There is a “donut hole” designed into the system to encourage prudent spending.  This allows first-dollar payments out of the account all the way up to the $8000 balance, but allows for an additional $7000 of unfunded expenses to accumulate before the government catastrophic plan kicks in.  The $7000 is paid through the credit function of the MSA debit card, and is repaid either by the individual or through tax refund or earned-income tax credits.  As stated, this “hole” is for the purpose of inflicting a measured amount of pain for excessive (even if necessary) use.  Illness needs to be monetarily as well as physically painful to keep it something to be avoided.<br><br>Mentioned in an earlier post was the need for the socialized single payer catastrophic portion of the plan to place limits on services based on the type of procedure and the age and physical condition of the recipient.  The vast majority of healthcare dollars are spent trying to keep the dying from dying 6 months sooner.  By using government to play the “bad guy” in making the decisions of how old, what is reasonable and what is not, the healthcare crisis could easily be solved.  <br><br>Next:  Why every doctor should be a specialist.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11578724">\
	 <div id="dsq-comment-header-11578724" class="dsq-comment-header">\
	 <cite id="dsq-cite-11578724" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11578724">JasonArvak</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11578724" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11578724" class="dsq-comment-message">Actually, MSAs sound really good until you see your first bill for an MRI.  That alone would eat an entire MSA.  After seeing the billed price of cancer treatments (which is, of course, completely and totally unrelated to the amount actually paid by insurance companies or the government), I lost all interest in MSAs as a realistic response to health care problems.  Basically, providers use any money coming from individuals as a "cash cow" from which to extract the maximum possible and make up for losses incurred by the artificial price controls forced on them by the government and insurers.<br><br>We really don\'t have any idea how much health care services would cost because it is not possible to account for the interactive effects of cross-billing, false "discounts", concealed surcharges, etc.  Part of any comprehensive design of a health care system has to be a system of accounting rules so we even know what we are talking about.  And that is one area where Medicare is part of the problem, not the solution to the problem.<br><br>BTW, the issue of "personal choice" is a bit of a red herring.  Other than primary care physician, you don\'t have any real choice in health care providers, as the referral system walks you step by step.  And when it is a critical issue, availability is much more determinate than choice.  We were lucky to get one of the best oncologists around, but not because we were able to do any investigation and choice.  It just happened that he was the one with an opening.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11578997">\
	 <div id="dsq-comment-header-11578997" class="dsq-comment-header">\
	 <cite id="dsq-cite-11578997" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11578997">starleys</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11578997" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11578997" class="dsq-comment-message">Very complicated.  How do you measure results and establish rates?  In this area I ask for suggestions.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11579583">\
	 <div id="dsq-comment-header-11579583" class="dsq-comment-header">\
	 <cite id="dsq-cite-11579583" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11579583">jwest</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11579583" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11579583" class="dsq-comment-message">Every Doctor a Specialist:<br><br>This healthcare plan was designed by first asking how a person would want their medical treatment delivered, as opposed to simply wondering how to fund the existing practices.  By looking at the problem from a blank slate, savings can be designed into the system.<br><br>One of the first is the primary contact.  When someone is sick, the last thing they should need to do is drag themselves to an inconvenient office filled with other sick people in order to spend 3 minutes with a hurried doctor who is most likely going to order tests or refer them to a specialist. <br><br>A higher quality and less expensive alternative is for a Advanced Degree Nurse (ADN) with 6 years experience as an RN and 18 months advance training, to come to the home of the patient.  This ADN would have the patient’s and the patient’s family’s medical history and be able to see, hear, smell and possibly taste the environment the patient is in.  This ADN would be trained (and have the experience) to listen to patients and ask the questions needed (in the manner needed) to draw out a full description of what the symptoms are.  ADNs would be equipped with portable devises for routine tests and be able to transmit this data to whatever specialist (or diagnostician) the ADN deems appropriate.  <br><br>What this method does is use lower-cost personnel to better perform a function now being done by highly paid doctors.  It saves the patient time and trouble, prevents cross contamination with other patients, exposes environmental factors to aid in diagnosis and eliminates an entire category of cost by bypassing the general practitioner to go directly to a specialist.  <br><br>Specialists would thrive in an atmosphere of free market healthcare.  Physicians could hyperspecialize to the point that developing new efficient procedures and facilities geared toward specific illnesses and injuries would bring higher profits for the provider and better quality of service to the customer.  If a doctor spends his life treating one specific thing, he will become very good at that one thing.  He may franchise his specific knowledge to allow others in different areas benefit from his expertise.  This brings efficiencies that would be inconceivable in the normal healthcare model we live in today.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11579639">\
	 <div id="dsq-comment-header-11579639" class="dsq-comment-header">\
	 <cite id="dsq-cite-11579639" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11579639">kathykattenburg</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11579639" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11579639" class="dsq-comment-message"><i>Instead, rationing combined with under-investment in equipment has often served to make the system into an underperforming bureaucratic nightmare that denies effective treatments to many people who need it.</i><br><br>Which is an excellent description of the system we have now in the U.S. for everyone who lacks health insurance and does not have the discretionary income to pay for health care out of pocket.<br><br><i>I\'m prepared to consider a public option in a competitive system provided that competition is actually maintained.</i><br><br>Which means, in practice, a continuation of exclusionary coverage practices. "Competition" in this context does not mean that private insurers will be increasing coverage and access to meet the high standard of care provided by a public option. It means that the public option will be lowering its own standard of care so as not to be more attractive to consumers than what they can get from the private insurers. "Competition" in practice means that doctors will choose higher paying private practice over treating patients in a public option, unless the government agrees to pay the same amount those doctors can get in private practice.<br><br><i>I am thankful that the "profit-based" system that we have ensured rapid access for my wife that saved her life.</i><br><br>Of course you are, and it\'s entirely understandable that you would be. But would your wife have had that rapid access if she or you did not have health insurance and/or the ability to pay on your own? Would you be as thankful if your wife or your sister or daughter were one of those cancer patients who couldn\'t get treatment because the charity care clinic closed?<br><br><i>I also know about treatment for UTIs and can testify from first-hand experience that rapid and effective treatment was also available for that condition in the United States -- Minnesota specifically.</i><br><br>Yes, yes, yes! if you have the money or the insurance!<br><br><i>Perhaps if you could take a minute to acknowledge that I am not, in fact, an apologist for the status quo, we could find more productive common ground in discussing BOTH pluses and minuses.</i><br><br>I haven\'t said or (I think) implied that you are an "apologist" for the status quo. But I do wonder what you mean when you say things like "I\'d prefer to slow down a bit and see if we can\'t find a way to get both (both universal primary care and top-flight crisis medical care for those who are insured or can afford it)." I don\'t understand what you mean by "slow down a bit." The problems we have with health care delivery, access, coverage, and costs in this country have been with us for all of my adult life (I will be 59 on July 4), and getting steadily worse. How much slower do you want to go, Jason?<br><br><i>And as I have REPEATEDLY said, I do not support the current system. Geez. How many times do I have to repeat it before you will stop reading off your script?</i><br><br>I guess as many times as you stop reading from your "public health care is evil" script.<br><br>Everything you warn against in a public health care system or option -- bureaucratic dysfunction, rationing, not enough and outdated medical equipment, waiting months or years for treatment (or not getting treatment at all) -- <b>is already happening</b> in our "competitive," private, for-profit health care system. So when you keep warning aginast public health care while simultaneously saying you don\'t support the current system, there is something of a disconnect for the listener (at least in my case).</div>\
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	 <li id="dsq-comment-11580080">\
	 <div id="dsq-comment-header-11580080" class="dsq-comment-header">\
	 <cite id="dsq-cite-11580080" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11580080">jwest</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11580080" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11580080" class="dsq-comment-message">Jason,<br><br>On the MRI example, they are expensive because of the inefficiencies and cost shifting built into the current system.<br><br>In my system, before someone agrees to receive an MRI, they would know the average cost and the cost of the last 10 similar MRI’s done in their zip code (or adjoining zip codes if not enough have been performed locally).  Now it becomes a matter of cost versus benefit.<br><br>On the provider side, the MRIs are high dollar sales until the free market kicks in.  A scan that someone used to charge $8000 for will drop substantially when customers start saying no.  Now the payment on the million dollar machine is due and monthly revenues don’t add up.  Time to lower the price to increase the volume.  The operators who lower it the most, provide the best service for the best price will thrive.<br><br>Look for commercials like this:<br><br>“Hi folks, I’m Earl Schieb and I’ll scan any body, any color, for only $49.95.  That’s right folks, if you can walk it, roll it or drag it into any one of 16 metro locations, I’ll scan that body in our new, exclusive GE machines while you wait.”  <br><br>Never underestimate the power of the free market.</div>\
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	 </li>\
	 <li id="dsq-comment-11580380">\
	 <div id="dsq-comment-header-11580380" class="dsq-comment-header">\
	 <cite id="dsq-cite-11580380" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11580380">Dr J</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11580380" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11580380" class="dsq-comment-message">Kathy: "Everything you warn against in a public health care system or option -- bureaucratic dysfunction, rationing, not enough and outdated medical equipment, waiting months or years for treatment (or not getting treatment at all) -- is already happening in our "competitive," private, for-profit health care system."<br><br>That\'s because we don\'t have a competitive private health care system, we have a bloated semi-public/semi-private system in which providers compete very little and on the wrong things.  <br><br>Starley: "Very complicated. How do you measure results and establish rates? In this area I ask for suggestions."<br><br>This problem has largely been solved in every other industry, by simply freeing consumers to make decisions about where money gets spent, and where necessary standardizing disclosures so they have the info they need to make them.  This doesn\'t happen today, because patients are not really customers.  You can find dramatically more information to decide where to go for dinner than where to go for surgery.  How broken is that?</div>\
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	 <li id="dsq-comment-11580467">\
	 <div id="dsq-comment-header-11580467" class="dsq-comment-header">\
	 <cite id="dsq-cite-11580467" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11580467">starleys</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11580467" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11580467" class="dsq-comment-message">You need an MRI. Without it you will possibly die.  Want to negotiate?</div>\
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	 <li id="dsq-comment-11580956">\
	 <div id="dsq-comment-header-11580956" class="dsq-comment-header">\
	 <cite id="dsq-cite-11580956" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11580956">Dr J</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11580956" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11580956" class="dsq-comment-message">Starley, you need food too, even more urgently.  The free market does a great job of supplying it, with good quality and in tremendous variety, without gouging anyone.<br><br>In fact, it\'s countries that try to control the food market that end up with bread lines and even mass starvation.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11581072">\
	 <div id="dsq-comment-header-11581072" class="dsq-comment-header">\
	 <cite id="dsq-cite-11581072" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11581072">JasonArvak</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11581072" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11581072" class="dsq-comment-message"><blockquote>Which means, in practice, a continuation of exclusionary coverage practices. </blockquote><br><br>Wow, is that ever a misrepresentation of my advocacy.  I propose that the public option (implemented through an overlapping system of co-ops rather than a single national system -- even the public options could compete with each other) be paid for by the government for those who cannot pay for it themselves or that the value of that option be given as a voucher to supplement the purchase of private insurance.  And I would contend that the practice of rescission should be closely regulated to stop the abuses of the practice and ensure that even for those thus removed there exists a backup public option.<br><br><blockquote>How much slower do you want to go, Jason?</blockquote><br><br>Well not being forced to meet an artificial deadline of October 15 would be a start, Kathy.  Perhaps we could actually, you know, HAVE A DEBATE?<br><br><blockquote>I guess as many times as you stop reading from your "public health care is evil" script.</blockquote><br><br>See, now you\'re not even trying to be honest, Kathy.  I never said anything of the kind and have repeatedly and specifically endorsed reform.  I only want it done in a way that pays attention to potential flaws and tradeoffs.<br><br>But apparently you prefer a Manichean world where only good and evil are options.  Very sad.  You are proving valid the criticisms in my original post on this subject -- your approach is purist, intolerant, and fundamentally dishonest towards dissenters.<br><br>I suggest that the disconnect is the result of you seeing what you want to see -- an enemy to be demonized and fought -- rather than a discussant.  And that is your common problem -- an incapability to tolerate disagreement even in tiny amounts without immediately assuming it is an extreme case of absolute moral dysfunction on the other side.<br><br>Its your site so, of course, you get the last word.  But I will close my participation here by saying that my position is that a public option is a useful PART of a potential reform package, but that we need to avoid the incautious and intemperate approach of purists lest we suffer from the unforeseen consequences of their intellectual laziness.<br><br>I would invite those who want to continue the discussion without good-versus-evil rhetorical excesses to PoliGazette threads like: <a href="http://www.poligazette.com/2009/06/22/lets-have-a-real-health-care-debate/" rel="nofollow">http://www.poligazette.com/2009/06/22/lets-have...</a></div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11581498">\
	 <div id="dsq-comment-header-11581498" class="dsq-comment-header">\
	 <cite id="dsq-cite-11581498" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11581498">JasonArvak</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11581498" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11581498" class="dsq-comment-message"><blockquote>Are you a real doctor?</blockquote><br><br>And now we see the inevitable final degeneration -- questioning the dissenters\' personal integrity:  Anyone who disagrees with you must be lying even about <em>who they are</em>.<br><br>The thread started so well and overcame so many obstacles along the way.  Then, Kathy, you chose to kill it with viciousness and misrepresentation.  Nice job.</div>\
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	 </li>\
	 <li id="dsq-comment-11581556">\
	 <div id="dsq-comment-header-11581556" class="dsq-comment-header">\
	 <cite id="dsq-cite-11581556" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11581556">JasonArvak</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11581556" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11581556" class="dsq-comment-message">More poison from Kathy.</div>\
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	 <li id="dsq-comment-11581675">\
	 <div id="dsq-comment-header-11581675" class="dsq-comment-header">\
	 <cite id="dsq-cite-11581675" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11581675">JasonArvak</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11581675" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11581675" class="dsq-comment-message">Posted to PoliGazette thread:<br><br><strong>UPDATE 6/22 5pm:</strong> Well, Kathy Kattenburg\'s respectfulness didn\'t manage to last the day before she returned to the purist approach of misrepresenting and demonizing all opposition.  This is the dysfunction that seems likely to continue to plague the health care debate in this country -- self-righteous purists who believe in win-at-all-costs actively destroying debate from the left and know-nothing purists refusing to even offer debate from the far right.  Meanwhile, the moderate majority stuck in the middle can look forward to paying the higher tax bills for a poorly designed system built on ideology rather than analysis.</div>\
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	 </li>\
	 <li id="dsq-comment-11581715">\
	 <div id="dsq-comment-header-11581715" class="dsq-comment-header">\
	 <cite id="dsq-cite-11581715" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11581715">DLS</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11581715" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11581715" class="dsq-comment-message">"Note that a public option is already a step down from [100% public, federal]. A public option is already a compromise. "<br><br>True.  But there\'s nothing sacred about 100% public (federal) nor is that what we "should" be doing; it is an issue of what we want.  Also, if you\'re negative, you again don\'t see things clearly or correctly (a Left common fault).  The correct thing to note is that a public option is an incrementalist tactic (which is not clever or deceptive, but is openly transparent), attempted by those firmly in favor of public health care, to condition the public to encounter and even experience public health care, for the public is wary of loss of rights and choices under a 100% government system, as it is wary overall of the current growth of the federal government and its encroachment into the economy and people\'s lives (without suffient effort or attention being paid to finance this and the rest of the government properly, an additional widespread concern).<br><br>* * *<br><br>"I am someone who does believe that health care is a human right."<br><br>It is not a human right, despite how often you or Physicians for a National Health Plan may state this.<br><br>If you want to make it a (federal) entitlement (most people don\'t want to waste time or involve complexity and disparity arising from having the state governments do this, which is the logical and constitutionally faithful way to do this), and you can convince Congress to create this entitlement (say, extend Medicare to everyone), fine, but at least be honest about it, not emotive or incorrect about it.<br><br>"Is clean water and sewage a right? Is clean food? What about safe playgrounds? Good schools? Are those rights or accessories?"<br><br>None of these are rights.  Nor is something I saw in an activist book about the evil automobile and the lack of sufficient (to the activists) provision of alternatives to people -- they said that there is a "right" [sic] to transport.  There is no such right to any of these things (including health care).  If we want to provide it by government to people, that is a separate thing altogether.<br><br>* * *<br><br>"childish rants of the intellectual midget / hack JasonArvak"<br><br>Gee, Steve, I see you\'re abusing others for no reason, too, as well as continuing to engage in effective mirror talk.<br><br>* * *<br><br>"purist, no-compromise approach implied by your original headline and reinforced by many others on your side of the issue, most notably Paul Krugman in today\'s NYT"<br><br>Krugman is a Dem hack, simply adding fuel to the fake-"Crisis!" fire now, on cue, to support Obama and the Dems in Congress, among other things.<br><br>"Purist" actually is elegant and attractive in its simplicity and (assuming existing programs would be used) relying on something already extant rather than inventing something new.  But "no-compromise" is out of order, out of line, given it\'s driven by errors, misconceptions in many cases, emotions rather than facts (it is a lefty position), and even childishness.  Incrementalism is the logical way to go, which is why the Dems have done what they\'ve done with S-CHIP in the past and are trying now with the "public option" (hardly leaving the private sector in a fairly competitive position -- the proponents know what they\'re doing).<br><br>I\'ve said it before and can say it again -- it\'s smarter and more effective than what the whining lefties have done and what they\'re doing now (mumbling and bumbling).  Why not start by expanding Medicare to children (in addition to likely taking Medicaid into Medicare and relieving the states of this burden fully)?  Going for children appeals to many people\'s emotions as well as constitutes the classic age-based "pincer" strategy.  (Incrementalism at its utmost eventually provides for everyone but the taxpaying middle class, which then will demand they enjoy the benefits as well and consequently, demand the universality the lefties are often too ambitious, impatient, or premature to attain fully from the start of their efforts.)<br><br>But that (again) is too smart and not childishly impatient or emotive enough for most of the activists.<br><br>* * *<br><br>"I am just saying we should take care to acknowledge the trade-offs and other issues that will affect any reformed system."<br><br>Aside from trying to show time after time that the current state of federal entitlement programs is set to fail, I\'ve also tried time after time [sigh] to make it clear to people (who can\'t see or don\'t wish to, in case it conflicts with their unrealistic dreams) that if we went from private to public we\'d exchange one set of problems for another.  There will still be an intermediary who will be interfering with decision-making, too.</div>\
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	 </li>\
	 <li id="dsq-comment-11581793">\
	 <div id="dsq-comment-header-11581793" class="dsq-comment-header">\
	 <cite id="dsq-cite-11581793" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11581793">Dr J</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11581793" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11581793" class="dsq-comment-message">Kathy there\'s no reason we shouldn\'t have a big, publicly accessible database of medical outcomes, just like we do for census results.  Put in your age and other relevant information, and it will tell you the average outcomes of everyone who did or didn\'t do X or Y.  At your age it will probably tell you a mammogram is a good idea, without you having spent $200 and two hours on a consult.<br><br>But if your point is that mammograms cost too much, we\'re on the same page.  The cure for that is competition.<br><br>PhD.</div>\
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	 </li>\
	 <li id="dsq-comment-11582032">\
	 <div id="dsq-comment-header-11582032" class="dsq-comment-header">\
	 <cite id="dsq-cite-11582032" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11582032">DLS</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11582032" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11582032" class="dsq-comment-message">"an overlapping system of co-ops rather than a single national system -- even the public options could compete with each other"<br><br>It also dispels, or at least could ameliorate some of, the apprehension so much of the public has with total government (federal) control, which even many Dems at least acknowledge, which is why Sibelius and others have mentioned the multiple co-op alternative (not necessarily overlapping or competing -- a similar scheme that is avoided because those in Washington want control and the left also disfavors it is to have the state governments provide or at least fully control health care rather than having the federal government do it -- I cannot recall when any mention of having the state governments administer or form their own health care programs has entered contemporary discussion.  So many look immediately to Washington even though it should be last rather than first as a party to become involved, traditionally.)<br><br>The public currently (a majority, 69% in a recent poll, which passes the real-world observation test) is nervous about the extent to which the federal government has extended and deepened its reach into the economy and people\'s lives.  Much of the public is already concerned about deficit and debt and federal finance.  Note that the current health care effort in Congress (far from "Medicare for All," obviously) lacks cost information and specifics on how to pay for it (much of the public would be willing to pay for more public health care, according to recent polling data).<br><br>Of course, the more childish, militant folks will instinctively reject and attack anything other than 100% federal health care as "a compromise" (more honest and revealing would be something like "lack of complete faith and belief in the cause, without the slightest hesitation, question, or thought whatsoever").</div>\
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	 </li>\
	 <li id="dsq-comment-11582134">\
	 <div id="dsq-comment-header-11582134" class="dsq-comment-header">\
	 <cite id="dsq-cite-11582134" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11582134">DLS</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11582134" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11582134" class="dsq-comment-message">"we don\'t have a competitive private health care system, we have a bloated semi-public/semi-private system in which providers compete very little and on the wrong things"<br><br>The scope of this statement of yours encompasses much, much more than merely health care, of course.<br><br>And now we have Gummint Motors.  Even die-hard Detroiters fear this will become one hell of a wreck.</div>\
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	 <li id="dsq-comment-11582153">\
	 <div id="dsq-comment-header-11582153" class="dsq-comment-header">\
	 <cite id="dsq-cite-11582153" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11582153">starleys</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11582153" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11582153" class="dsq-comment-message">Now wait.  We have an interesting situation.  I still like one payer for cost effectiveness and universal coverage.  But think of an effective process.<br><br>Go to Doctor or trained RN for diagnosis at fixed charge  He recommends treatment plan or referral to specialist.  Referal department locates most cost effective sources.  Treatment is given.<br><br>If patient select another source then insurance only pays what original cost would have been.<br><br>This is simply a giant hmo nationwide and basically the same service we had in the military.</div>\
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	 </li>\
	 <li id="dsq-comment-11582743">\
	 <div id="dsq-comment-header-11582743" class="dsq-comment-header">\
	 <cite id="dsq-cite-11582743" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11582743">JasonArvak</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11582743" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11582743" class="dsq-comment-message">I would agree that mammograms and all other preventative screening tests should be covered for everyone that does not have private insurance by a government health care plan.<br><br>I would say, however, that there are many different ways to implement such a provision, ranging from full-on single-payer health care, to regional co-ops, to vouchers for the purchase of private coverage.<br><br>Debating the differences and possible permutations among such a range of choices won\'t meet the "NOW!" demand nor would the outcome be emotionally satisfying to purists and those motivated only by beating the other side.  But it would result in a much better system for everyone.<br><br>I can see why you of all people would be against that, Kathy.  Without an ideological enemy to hate, life to you just doesn\'t seem worth living.</div>\
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	 <li id="dsq-comment-11582781">\
	 <div id="dsq-comment-header-11582781" class="dsq-comment-header">\
	 <cite id="dsq-cite-11582781" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11582781">Dr J</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11582781" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11582781" class="dsq-comment-message">Kathy: "I don\'t have the $200 to spend on a mammogram, though. So finding out from a database that it\'s recommended at my age (which I didn\'t need a database to tell me, anyway) doesn\'t help me. "<br><br>Ah, but it does.  We should help people get health care by simply sending them a check.  That\'s a much better way for government to be involved.  And then if, based on the database, you decide to play the odds, you\'ve got an extra $200 to spend on liquor and gigolos.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11583698">\
	 <div id="dsq-comment-header-11583698" class="dsq-comment-header">\
	 <cite id="dsq-cite-11583698" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11583698">kathykattenburg</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11583698" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11583698" class="dsq-comment-message"><i>We should help people get health care by simply sending them a check.</i><br><br>Well, that\'s an interesting idea.<br><br><i>And then if, based on the database, you decide to play the odds, you\'ve got an extra $200 to spend on liquor and gigolos.</i><br><br>Okay, you definitely have a better sense of humor than Jason.</div>\
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	 <li id="dsq-comment-11596686">\
	 <div id="dsq-comment-header-11596686" class="dsq-comment-header">\
	 <cite id="dsq-cite-11596686" class="dsq-comment-cite">\
	 <a id="dsq-author-user-11596686" href="http://profiles.yahoo.com/blog/OQGAGQL7ZFHS2GTUXPRIA275QY" target="_blank" rel="nofollow">nicrivera</a>\
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	 </div>\
	 <div id="dsq-comment-body-11596686" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11596686" class="dsq-comment-message">Wow.  It\'s been a couple of years before we\'ve had a comment thread this long.  Sadly, I think I stopped reading after comment #30.  As much as these heated exchanges amuse me, I thought I would offer a few words of caution.<br><br>1) Let\'s not confuse "positive" freedoms with "negative" freedoms.  "Negative" freedoms are based on the classic liberal interpretation of "rights"--that is--the freedom to not have others coercing you into doing something or forcibly preventing you from doing something.  "Positive" freedoms are a much newer concept and based upon the rather progressive notion that some things are so important, that people are entitled to these things, even if it comes at the expense of someone else.<br><br>When someone argues that "healthcare is a human right" it\'s important to get past the feel good rhetoric and decipher exactly what that person is implying.  To the extend that everyone has to right to health care without someone else forcibly preventing them from obtaining it--that\'s an example of "negative freedom", and I doubt that anyone would argue against this right.  But to the extent that everyone is entitled to health care, even if it means forcing others to pay for that person\'s health care--that\'s an example of "positive freedom", and that is a far more debatable point.<br><br>Personally, I don\'t think it\'s intellectually consistent that call something a "right" or a "freedom" when it calls for violating someone else\'s rights.<br><br>2) On Krugman being a Nobel Prize Winning Economist and therefore beyond reproach.  I\'m not going to question Krugman\'s intelligence or knowledge of economics, but Krugman is not by any stretch of the imagination a balanced source on economics.  As others as pointed out above, Krugman is extremely left wing when it comes to fiscal/economic issues, and by that, I mean he unapologetically supports Keynesian economic theory as well more expansive government in the economic arena.<br><br>3) Good intentions do not necessarily make for good political policies, and even those programs proposed by those individuals with the most sincere of intentions end up having negative unforeseen consequences.  Government programs rarely cost what politicians say they will--they always end up costing more.  So before you start criticizing those for who oppose univesal health care/single-payer health insurance/public health care or any other flavor of government involvement in the health insurance arena, I suggest you come up with a way to pay for it.<br><br>4) Arguing that public health care will "compete" with private health care is not the most accurate way of painting this new proposal.  Public health insurance--by its very nature of being controlled by the government--will have overwhelming advantages over private insurance companies such that private insurers will never be able to truly "compete" with it.  For one thing, since the government is not concerned with making a profit (as evidenced by our nation\'s mounting debt), it can mandate price controls for public health care and set prices as low as it wishes.  Private insurers, on the other hand, have to make a profit in order to stay in business and therefore cannot set prices below a set amount.  Under such a situation, no private insurer would be able to compete with public insurance on a level playing field.<br><br>5) Before we go name calling bloggers at other blogs whom we don\'t agree with, I suggest we have a firm footing from which to do so.  Don\'t get me wrong, there are jerks, liars, and partisan hacks out their in the blogosphere that ought to be called out.  But before we start calling people "intellectual midgets" I suggest we ask ourselves whether our comment passes one simple test test--that is, i.e. is this negative characterization of another blogger so important that it\'s worth risking the reputation of TMV?</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11597245">\
	 <div id="dsq-comment-header-11597245" class="dsq-comment-header">\
	 <cite id="dsq-cite-11597245" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11597245">JasonArvak</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11597245" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11597245" class="dsq-comment-message">Just to correct the record and protect the innocent, I will point out that the only person who threw around the direct personal attacks like "intellectual midget" in no way is an indication of TMV\'s reputation.  He is not a TMV contributor or administrator.  And TMV\'s actual administrators were very helpful in addressing this problem.  I have no complaints about TMV\'s reaction to this situation and I think it would be very unfair to taint them with the over-the-top statements of a mere commenter.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11597507">\
	 <div id="dsq-comment-header-11597507" class="dsq-comment-header">\
	 <cite id="dsq-cite-11597507" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11597507">Dr J</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11597507" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11597507" class="dsq-comment-message">Kathy: "Well, that\'s an interesting idea."<br><br>Well, maybe this is the disconnect going on.  My position has never been that we shouldn\'t help the poor.  It\'s that we should split health care reform into two problems and address them separately:<br><br>1. Building an efficient system of doctors, hospitals, drug companies, regulators, etc that can deliver the maximum health per dollar spent.<br>2. Providing financial help to people who can\'t afford #1.<br><br>The way to do #1 is a free-market system where competition forces all the players to work hard to deliver results, while minding the dollars being spent.  It should be built around consumer choice, demanding transparency from providers, and should not be controlled by big bureaucratic gatekeepers like today\'s system is.<br><br>The way to do #2 is by writing checks, or giving tax rebates, or issuing vouchers, or I\'m sure other approaches would work fine too.  The only requirement is whatever we do must not micromanage the providers by dictating prices or policies, but should let them stay focused on goal #1: maximum health per dollar spent.<br><br>We have to do both of these things.  We can\'t just do #2, because today that group consists of darn near everyone, more than we can subsidize.  We also can\'t just do #1, because we\'d leave darn near everyone high and dry without coverage.  But we shouldn\'t try to consider them the same problem, because we\'ll end up with a solution that meets neither need very well.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11601339">\
	 <div id="dsq-comment-header-11601339" class="dsq-comment-header">\
	 <cite id="dsq-cite-11601339" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11601339">Dr J</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11601339" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11601339" class="dsq-comment-message">"Patients are not really in a position to negotiate with doctors or hospitals, even if they didn\'t need care urgently."<br><br>Consumers are in no better a position to negotiate with grocery stores or oil companies or airlines.  But grocery stores compete aggressively on price and quality.  Oil is a competitive, efficient commodity.  You don\'t even have to talk to an airline to shop for the best flights and prices, just go to a search engine that lets you choose.  A far cry from anything available to us for health care.<br><br>Haggling is actually the sign of a market inefficiency.  If people don\'t have good information about what the real market clearing price is, they test each other to try to find one.  Doing it can be expensive, too--for example a strike may go on for weeks as both sides try to figure out where the real bottom line is, during which both labor and management are losing a lot of money.  Provide a stable, transparent market, though, and no one has to bother.<br><br>And there\'s no paradox in the notion that competition could force prices down when price caps don\'t.  Shifting costs onto someone who won\'t notice is much easier than finding more efficient ways to work.  No one will do the second until they\'ve exhausted the first.  But the elasticity is there if they work at it.  Lord knows prices have had no trouble stretching upwards.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11634435">\
	 <div id="dsq-comment-header-11634435" class="dsq-comment-header">\
	 <cite id="dsq-cite-11634435" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11634435">DLS</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11634435" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11634435" class="dsq-comment-message">"2. Providing financial help to people who can\'t afford #1."<br><br>Vouchers (for health care only, even without monetary value, but denoting what the person can receive) -- the alternative is to end all such assistance programs of all kinds (not only health care) and just give people cash (even a "guaranteed minimum income" or "basic income guarantee," to use the two favorite terms that describe this concept and objective).  The simplicity is appealing, as well as the termination of so many counter-productive and harmful programs and bloated bureaucracies.  (AFSCME and other organizations would never want the programs ended, but expanded instead, in addition to the income entitlement.)<br><br>* * *<br><br>"Haggling is actually the sign of a market inefficiency."<br><br>I\'m not sure.  The potential is always there, as no two people or parties are alike, and moreover, we\'re seeing an upswing in haggling (the ability of buyers to negotiate prices downward, to be more specific here), which is a sign of a continued downward movement, decline, recession, depression, you name it.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11634587">\
	 <div id="dsq-comment-header-11634587" class="dsq-comment-header">\
	 <cite id="dsq-cite-11634587" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11634587">DLS</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11634587" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11634587" class="dsq-comment-message">"experts in relevant fields think nonprofit health care is a sensible and timely idea"<br><br>Many in academia ("experts") are more liberal than the public and form a liberal community; I would look at doctors, and others who are actual _providers_.<br><br>Many of the providers are ready to go to public health care, to simplify and ease paperwork as contrasted with what they face with the insurance companies.<br><br>They also want the lawsuit-abuse problem corrected, but I doubt a Dem administration will correct this.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11634844">\
	 <div id="dsq-comment-header-11634844" class="dsq-comment-header">\
	 <cite id="dsq-cite-11634844" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11634844">DLS</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11634844" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11634844" class="dsq-comment-message">"the assertion that a single payer (or public option) system might not save anything"<br><br>I\'ve never said that.  There are up-front savings and it\'s logical to assume that Medicare for All would be "streamlined" compared to what we have now.  But there won\'t be a permanent cap or brake on the costs, because the demographics (aging of the population) and increasing expense of improvements in medical treatments will force costs upward.  "Wellness" emphasis that goes beyond the well-known preventive care will not achieve miracles, and there are limits, anyway, to what people should be expected or worse, required [compelled] to do in the name of wellness or prevention, or what restrictions, taxes that aim at medical-related social engineering, or prohibitions people should be subjected to.  Wellness at the cost of too much freedom or quality of life ends up being the well-meaning equivalent of keeping the very elderly and sick (near death) alive at an effort that some routinely argue is not justified, and in fact is inappropriate.<br><br>Food for thought...</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11635020">\
	 <div id="dsq-comment-header-11635020" class="dsq-comment-header">\
	 <cite id="dsq-cite-11635020" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11635020">DLS</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11635020" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11635020" class="dsq-comment-message">"As to the points about \'rights,\' I have avoided using that term, though others did. Rather, it\'s a public policy decision about whether or not we will care for our citizens."<br><br>Absolutely.  There is no "right" [sic] to this (nor to so many other things that in practice are claims on others\' time, labor, and money).  It is merely a decision to create an entitlement, that word being fully sound not only legally but conceptually.<br><br>A significant fraction strongly want public health care, and plenty among the many who are wary of too much government and loss of freedom (and privacy, etc.) would still look to it as a default alternative if everything else seems worse or intolerable eventually.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11635088">\
	 <div id="dsq-comment-header-11635088" class="dsq-comment-header">\
	 <cite id="dsq-cite-11635088" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11635088">DLS</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11635088" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11635088" class="dsq-comment-message">"care for our citizens"<br><br>Note the correct meaning of that word "care" here means specifically, "provide medical care," not anything more general or broad and subject to being a rationale for all kinds of entitlements as well as a way of satisfying feelings or cravings some might have.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11635203">\
	 <div id="dsq-comment-header-11635203" class="dsq-comment-header">\
	 <cite id="dsq-cite-11635203" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11635203">DLS</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11635203" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11635203" class="dsq-comment-message">"Krugman is extremely left wing when it comes to fiscal/economic issues"<br><br>Well to the left (far left of the public, like a left-wing Dem or even playing with Green-dom).  Part of where he appears at any time (what words he chooses) depends on the lib Dem point of view on the issue of the moment about which he wants to contribute.<br><br>Krugman is like other "economists" notably in the Northeast who are well left of the public and routinely mix their economics with politics.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11635361">\
	 <div id="dsq-comment-header-11635361" class="dsq-comment-header">\
	 <cite id="dsq-cite-11635361" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11635361">DLS</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11635361" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11635361" class="dsq-comment-message">"I would agree that mammograms and all other preventative screening tests should be covered for everyone that does not have private insurance by a government health care plan."<br><br>But then you run into a serious problem.  What you say (and other examples I can think of) appeal wonderful in theory, but you\'ll find that in many cases, the tests, for example, have been considered by people already in the government(s) and rejected as not cost-effective.<br><br>This is something to keep in mind as the scope of public health care grows (as it is likely to do).</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11639176">\
	 <div id="dsq-comment-header-11639176" class="dsq-comment-header">\
	 <cite id="dsq-cite-11639176" class="dsq-comment-cite">\
	 <a id="dsq-author-user-11639176" href="http://greendreams.wordpress.com" target="_blank" rel="nofollow">GreenDreams</a>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11639176" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11639176" class="dsq-comment-message">Good comments, DLS. When the fight is over, regardless of what happens, we still have to deal with the major reason for cost increases. We have a high cost burden for end of life procedures that place a major part of an individual\'s lifelong medical care cost in the last few months of life, plus we have only a few % of individuals who incur especially high costs. Clearly we will need to set some limits, and that will be harder and more contentious even than who pays, which is the focus of the current fight.<br><br>As for prevention, through lifestyle or other incentives, we could do much there. I think most are not aware of how poorly we do in this area. In the US, we have only 4 preventive medicines available over the counter: fluoride toothpaste, sunscreen, seasickness prevention and aspirin. There is actually a 5th, formerly ulcer medicines, now approved for "indigestion prevention." When we talk about "preventive medicine" we usually mean early disease detection (mammograms, prostate check, cholesterol testing). The realm of preventive medicines is relatively unexplored, except in the dietary supplement world.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-11697956">\
	 <div id="dsq-comment-header-11697956" class="dsq-comment-header">\
	 <cite id="dsq-cite-11697956" class="dsq-comment-cite">\
	 <span id="dsq-author-user-11697956">JasonArvak</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-11697956" class="dsq-comment-body">\
	 <div id="dsq-comment-message-11697956" class="dsq-comment-message"><blockquote>Jason, your demonizing of "the left", which from your blog, appears to be your style, is ironic, especially as you seem fond of demonizing lefties for demonizing righties. We actually could have a rational discussion, but we\'re so polarized that it always seems to degenerate into something like this. Too bad.</blockquote><br><br>GreenDreams, I do criticize lefties strongly but I don\'t think I demonize them. (I think the difference lies in not making direct attacks against their character even if I do criticize their behavior.  As can be seen above as well as broadly throughout this site and throughout the left-leaning blogosphere, direct character attacks BY leftists AGAINST non-leftists are pretty much a routine and acceptable response to any disagreement.  But any criticism, no matter how mild, BY non-leftists AGAINST leftists is considered intolerable.  Also, the fact that you had no complaint about the most vicious personal assault on this entire thread undermines your legitimacy here.) <br><br> And I would love to have a rational debate among alternatives and moving towards a compromise on health care.  But as long as people like Kathy keep inserting into the debate their presumption that anyone who disagrees with them or even doubts their purist demands for a second is not only wrong but a <em>bad person</em>, I don\'t think that is likely.  Asking conservatives and moderates to compete on a rhetorical playing field that is intentionally and dramatically rigged against them is unreasonable.<br><br>Unfortunately, people like Kathy have no reason to alter their openly vicious rhetoric as long as their fellow liberals and leftists remain silent about it while at the same time criticizing the other side any time it puts so much as a rhetorical toe out of line.  As long as their preferred audience continues to support their rigging the game, they will eagerly continue to rig it and, apparently, believe themselves to be laudable for doing so.<br><br>But please don\'t ask me to smile and love it.</div>\
	 </div>\
	 </li>\
	 <li id="dsq-comment-12715325">\
	 <div id="dsq-comment-header-12715325" class="dsq-comment-header">\
	 <cite id="dsq-cite-12715325" class="dsq-comment-cite">\
	 <span id="dsq-author-user-12715325">charity01</span>\
	 </cite>\
	 </div>\
	 <div id="dsq-comment-body-12715325" class="dsq-comment-body">\
	 <div id="dsq-comment-message-12715325" class="dsq-comment-message">Personally I would have preferred the Insurance Companies, Hospitals, Drug companies would have been willing to make health care affordable rather spend 1 trllion dollars we don\'t have. But guess what folks it\'s this thing called greed! So now we have to look at another alternative. If the private sector rather risk going under becuase of pending profit margins than so be it!  I guess that means some CEO will not be able to purchase his yacht!</div>\
	 </div>\
	 </li>\
	 </ul>\
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}

// Global event handler for narcissus.
if (Dsq.jsonData.integration.theme == 4) {
	var g = Dsq.Utils.ie ? document : window;
	Dsq.Utils.addEventListener(g, 'keydown', function(event) {
		// Handle "enter" key on input for post box.
		if ((event.keyCode || event.which) == 13) {
			var target = Dsq.Utils.ie ? event.srcElement : event.target;
			// For Safari bug, detect text node.
			if (target.nodeType == 3) {
				target = target.parentNode;
			}

			if (target.nodeName == 'INPUT' &&
				target.parentNode.className == 'dsq-input-wrapper') {
				var postId = Dsq.Utils.extractId(target);
				Dsq.Templates.postComment(postId, this, false);
			}
		}
	});
}

})();




