Innocence, Habits and Donald Duck


We recently remembered 9/11/2001.  We do not, however, remember 9/1/1973 when General Pinochet overthrew Chile’s popularly elected government with our very active support.

Why do we remember only when we were the victims, not when we were the perpetrators?

Ariel Dorfman reflects on that in A Tale of Two Donalds and his conclusion, “We really don’t have to leave this world as it was when we were born”, got me thinking.

Some preamble:  Why did we help to overthrow Chile’s government?   Because the Chilean people had for three years been working to build socialism via the ballot box and our leaders were afraid they might succeed, inspiring the same thing to happen here.

The focus of Dorfman’s book was Donald Duck because: “If there was a single company that embodied the overarching influence of the U.S. — not just in Chile but in so many other lands then known as the Third World — it was the Walt Disney Corporation.”

What was symbolized by Disney’s Donald Duck world?  “a belief in an essential American innocence, in the utter exceptionality, the ethical singularity and manifest destiny of the United States … the inability of the country Walt was exporting in such a pristine state… to recognize its own history”.

What history did we not recognize?  What, as Dorfman puts it, was our sin?  “[our] violence (the enslavement of blacks, the extermination of natives, the massacres of striking workers, the persecution and deportation of aliens and rebels, all those imperial and military adventures, invasions, and annexations in foreign lands, and a never-ending complicity with dictatorships and autocracy globally)”.

Why is Dorfman writing now about what happened almost half a century ago?   Because, he says:  “We are clearly in a moment when a yearning to regress to the supposedly uncomplicated, spotless, and innocent America of those Disney cartoons, the sort of America that Walt once imagined as eternal, fills Trump and so many of his followers with an inchoate nostalgia.”

Now here’s what struck me.  The innocence Disney conveyed is real.  At the same time, the violence, selfishness and greed that Dorfman points to are also real.  How can both be true?

It’s because, in the Buddhist understanding of existence, our intrinsic nature is good; we behave badly only out of habit.

What happens is, our mistaken acts accumulate into conceptual and emotional habits, then our behavior is governed by the things we always think and feelings we always have, not the unique circumstances in each moment.

Buddhists call all that programming karma.  We call the habits we share our culture.

By observing people who have studied, reflected and done Buddhist practices for long enough, we can see they are not on auto-pilot.  They are naturally kind.  The Buddhist understanding of our nature is confirmed by observation.

Buddhism is not the only way to overcome bad habits, of course, and Buddhist leaders in Myanmar are currently exterminating their Muslim Rohingya population.  We first need the right motivation, then whatever way works to train ourselves out of selfishness, greed and violence.

One of our greatest warriors was especially clear about making the right choice.  Three months into his first term President Eisenhower gave this speech:

“Every gun that is made, every warship launched, every rocket fired signifies, in the final sense, a theft from those who hunger and are not fed, those who are cold and are not clothed.  

“This world in arms is not spending money alone. It is spending the sweat of its laborers, the genius of its scientists, the hopes of its children.

“The cost of one modern heavy bomber is this: a modern brick school in more than 30 cities. It is two electric power plants, each serving a town of 60,000 population. It is two fine, fully equipped hospitals. It is some fifty miles of concrete pavement. We pay for a single fighter with a half-million bushels of wheat. We pay for a single destroyer with new homes that could have housed more than 8,000 people.

“This is not a way of life at all, in any true sense. Under the cloud of threatening war, it is humanity hanging from a cross of iron.”

Why did we not heed Ike’s words, or his warning eight years later about our emerging military-industrial complex?

And why did our current leaders just vote for another vast increase in military spending while trying to pay for it and a further tax cut for the wealthy by cutting medical care for tens of millions of other Americans?

Because, despite our intrinsic goodness, we keep choosing not to acknowledge the habits we inherited — our sense that we were entitled to exterminate Native Americans and enslave people of color, the greed, fear and violence that govern so much of what we do.  We keep reinforcing those habits.

We could, as Buddhist and other teachers explain, shed our selfishness, violence and greed.  We would just have to recognize our programming then work diligently and long to get free of those habits.

Castigating others feeds our own self-righteousness, so let’s stop doing that.  Let’s each of us just work at freeing ourselves.

And let’s stop electing leaders who subvert other governments.  In 1973 we worked to overthrow Chile’s democratically elected government.  Twenty years earlier, we’d done it in Iran.   Thirty years later we did it in Iraq, then Libya.  We’re trying it now in Syria and helping Saudi Arabia do it to Yemen.

Let’s elect leaders who will inspire us to act as the good people we are.  But before that can happen we’ll have to work sincerely to overcome our amnesia and purge our programming.

Proposals for Healthcare and Tax Reform

A letter I recently sent to my Democratic Pennsylvania Senator and to Democratic Party leaders:

Dear Senator Casey:

I am growing more and more concerned about the future of our society and the Democratic Party.  We must change course.  I hope these proposals about healthcare and tax reform, top issues for you at this time, will be helpful.

Automation and artificial Intelligence are eliminating more and more jobs.  Making that worse, the profits are going only to the wealthiest of us, and many of our middle and lower income citizens are being impoverished by medical expenses.

We can eliminate that financial ruin with insurance for both the currently healthy and the sick.  Covering every American will also avert a looming Federal debt crisis because that system is much more efficient.

We can best do this is by extending Medicare.  It is an established and popular system that is far less complex and costly than other plans being proposed.

And we must finance it in a way that mitigates our fast growing disparity of wealth.  The very stability of our society is threatened if we allow that trend to continue.

Here’s how we can overcome both huge problems:

Replace Medicare’s 80/20 percent sharing of costs with a progressive Co-Pay amount based on income.  That is the only change for the already retired.

Authorize Medicare to negotiate drug prices with providers to cut costs.

Have working people: (1) continue to pay a progressive payroll tax to cover their Medicare participation when they retire, and (2) also pay a progressive payroll tax for their current medical care, with a progressive Co-Pay amount.

Note:  The tax for current medical care would be less than we pay now for private health insurance because (1) Medicare system costs are lower and (2) costs could be subsidized by other taxes described below.

Allow employers to  pay some or all of this tax to attract employees, but not require them to do so.  They would continue to pay their half of the tax for their employees’ retirement medical care.

Additional funding for this universal health care would come from tax system changes to reduce income and wealth disparity.

Specifically, tax all Personal Income including investment profits in the same way, and return marginal taxes on high incomes closer to where they were in President Eisenhower’s time, perhaps 50% for amounts between $5 million and $10 million, 60% between $10 million and $20 million, and 70% for amounts above that.  The bottom three brackets could be cut by 5% each.

Cut the top Business tax on profits to 25% to encourage re-investment in business instead of taking the money out for personal use where a much higher personal income tax would have to be paid.

Change the Estate tax so distributions are treated as ordinary income with an exclusion of up to $5 million from each person’s share of the estate.  This will reduce wealth disparity over time.

Tax Stock Transactions to reduce High Frequency Trading and increase government revenue.

Eliminate all Tax Expenditures (tax breaks/loopholes) after a five year period during which Congress could individually re-instate any believed to be beneficial with a 2/3 vote from each house.

Drastically cut government expenditures for so-called Regime Change and Nation Building.  We must stop trying to re-invent other nations in our image and destroying them in the process.

Under this Medicare-For-All plan, Medicaid would be eliminated because all citizens would have coverage regardless of their financial situation.  If they were out of work or working a low paid job, they would continue to receive coverage, but their payroll tax and co-pays, based on their income, would be low or possibly zero.

Non-citizens would have to buy their own coverage for the length of their stay, or the companies they work for would have to provide coverage, or there might be reciprocal coverage programs arranged between their country and the U.S.

Does all that sound too radical?  It’s not.  We must take a bold new approach.  Opposition to Trump and the Republicans is simply not enough.  We must win a mandate for sweeping positive change.

We must tell voters what big changes we will make so no American is bankrupted by medical costs.  We must show voters how we will reverse the flow of riches only to the very few.

I hope these ideas can begin to reinvigorate the Democratic Party to be not just a focus for unspecified hope or reflexive opposition, but the agent of great beneficial change.


A Stroke of Insight


Here’s a very powerful TED Talk by neuro-scientist Jill Taylor about her experience having a stroke and what it revealed to her about our two consciousnesses.  Her conclusion, “which [consciousness] do you choose, and when” is not very satisfactory so I’ve added my thoughts below.

My stroke of insight

We are raised to use our linear conceptual brain because we’d be unable to navigate life without it.  Just think for example, about Jill’s struggle to dial the phone.  But we also have moments of delight, and if we have an activity like painting, we also spend some time in our other consciousness, the one she describes as energy meeting energy, with no boundaries.

Jill suggests the world would be happier if we spent more time in our joyful consciousness.  Meditation practice helps us recognize that we have such a consciousness, something we forget during everyday, moment to moment living.  The amazing joyfulness she experienced in that consciousness is what many devotees of spiritual practice hope to achieve.  Many Western Buddhists think nirvana must be like that.

What I have slowly come to understand through my reading, reflection and practice was made clear by what she says about the structure of our brain.  Happiness and the good behavior resulting naturally from it come when we inhabit both consciousnesses simultaneously

It’s not that we could be happy some of the time by switching out of our conceptual consciousness into the other one and continue being stressed the rest of the time when we’re living in conceptual consciousness.  There’s nothing wrong with linear, conceptual consciousness.  In fact it’s essential as I said before.  The problem is conceptual habits, emotional habits, any kind of habits.

Happiness comes from simultaneous experience of both our consciousness that reveals the world we are in at each moment and of our logical, linear, conceptual consciousness which enables us to navigate that world.

The Tibetan Buddhist practice I do is one of thousands of ways to train oneself to live more of the time in that way.  It aims to disrupt fixed concepts, the ones that make us think situations are what we expect, not what they actually are.  Our ability to conceptualize is an enormous blessing.  Autopilot with the radar shut off is a curse.

A friend who has practiced as I do for many, many years put is this way: “Dharma is malware for conceptual thought”.  He is referring to Tibetan Buddhist practices that disrupt our everyday imagination of how things are.  They linger in our mind and resurface unexpectedly.

I mention this because living in both our consciousnesses is actually very difficult.  We’re greatly over-habituated to living in a world that appears as it does because we conceive it to be that way without noticing the reality.

An Angry Reply to Tom Perez


Here’s the reply I just sent to Tom Perez,  Chairman of the Democratic National Committee at

Tom –

You just made me very angry.  What you wrote is deceptive.

Senate Republicans did not just vote to repeal our health care.  They voted to debate repeal of the Affordable Care Act.

Yes, Congressional and Senate Republicans are trying everything they can to repeal the ACA and yes, they may yet succeed.

But hysteria makes it LESS likely that we can continue to block their cruel program.

Stop using every excuse just to seek donations.

Commit yourself and the Party to a health care system enough of us will vote for.

We will keep losing elections if you keep up this nonsense and I will continue NOT donating to our Party.


— Martin

And here is his email that got me riled up:

Senate Republicans just voted to repeal our health care — so we’re going to vote them out of office. Help us raise $100,000 to elect Democrats today, and get your donation matched.

Martin, the nightmare just became real: Senate Republicans voted to move forward with health care repeal. It’s only a matter of time before a repeal bill lands on Donald Trump’s desk and he eagerly signs it into law.

I’m devastated. Millions of Americans will lose their coverage, millions more will face skyrocketing premiums that put the care they need out of reach, babies born with chronic illnesses could hit lifetime caps on coverage before their first birthday — this is not who we are.

So here’s what we have to do now, Martin: pick ourselves up and get back to work so we can kick every single Republican who votes to take our health care away out of office.

We want to raise $100,000 before the end of the day to start laying the groundwork to win back the House and Senate, and a group of generous Democrats has offered to match it dollar-for-dollar. Chip in $3 or more right now to help us get there and get your donation matched.


Tom Perez
Democratic National Committee

The Democratic Party will almost certainly remain ineffective while Tom Perez and others who just want donations are in office.   We must do all we can to motivate them to change while simultaneously working to replace them when they ignore us.

To Senator Schumer


Here’s my reply to the email I got this morning from

Dear Senator Schumer –

I do hope this will be helpful.

In the middle of your email, you write:  “But resistance alone is not a recipe for progress. We also need a plan to improve the lives of the American people.”

That was exciting to see.  I couldn’t agree more.  So I clicked on the link to learn about your plan.

What did I find there?  No plan.  Nothing about what you will do.  Just another appeal for money.

I’ve said it before and I fervently hope I don’t keep having to say it.  I will only donate again when the Democratic Party commits to real changes and begins to market them well.

We aspire to be a society that prioritizes human flourishing over profit for a tiny minority.

Achieving that requires a theme with a long term program – the equivalent of tax cuts for Republicans.
It requires coordinated marketing to build unstoppable demand and mitigate cultural concerns that now divide us.

Any elected Democratic Party politician who is not committed to that program must be replaced.


And here’s the email from Senator Schumer:

Dear Martin,

It has been six whole months since President Trump took office. Six whole months of hearing the Trump administration claim they would “drain the swamp,” but instead continued the same old Republican agenda where government works for billionaires instead of the rest of us.

Yet, thanks to the activism and acts of resistance of this movement, the Trump administration and Republicans in Congress do not have one major victory on the books. Not a single one. But resistance alone is not a recipe for progress. We also need a plan to improve the lives of the American people.

The truth is Americans deserve higher wages and better jobs, lower costs of living, and a better future to look forward to. President Trump and his corporate cronies promised voters all this and more — but instead he gave Americans a raw deal. Everyday Americans deserve a better deal.

Today, I’m joined by leaders from the House and the Senate in announcing the Democrats’ bold economic plan that works for the middle class. Government should have your back, working for you and the millions of hard-working Americans who make this country what it is. If you believe that Americans deserve a better deal like I do, check out our new site to learn about our plan and add your support.

We have given President Trump and Republicans a chance to lead. We have given them every opportunity to come to the table and work with us to get things done for the American people. They have not done their jobs, and they must be held accountable. It’s time for Americans to demand a better deal.

Thanks for joining me,

Chuck Schumer

Senator Schumer sounds as if he has at last realized a plan is necessary, he even says he has one, but then all he offers is an appeal for money.   Please join me in demanding change.

To the Chairman of the DNC


Here’s my reply to Tom Perez, Chairman of the Democratic Party, at democraticparty@democrats to help me remember what I wrote, and in the hope that you’ll join me:

I hope this helps, Tom.

What do you mean when you write: “all of us who believe that health care is a right for all Americans”?  The ACA does not provide that.

You write: “Republicans are determined to take away health care from millions” and ask me to give you money to: “throw them out of office.”  The Republican proposals are appalling, but…

What health care system is the DNC committed to instead?

Democrats keep losing elections because many voters want to throw US out of office and others don’t care enough to vote to keep us IN office.  Why?  They don’t know what we stand for.

Every other advanced economy provides universal health care and spends far less than we do.  Decent people can disagree about whether or not health care is a human right but there is no denying that every way other nations provide universal health care costs less than ours.

Is that what you want me to donate for?


— Martin

Here’s what I replied to:

Martin —

Tonight, because of millions of grassroots Democrats like you who banded together and fought against it, Republicans’ attempt to take health care away from millions of Americans failed again.

While this is a victory for basic human decency, for the families who rely on the Affordable Care Act, and for all of us who believe that health care is a right for all Americans, the fight is far from over.

Republicans are determined to take away health care from millions. We saw it when Donald Trump, Mitch McConnell, and Senate Republicans worked in secret, behind closed doors, to write a bill that would have given massive tax cuts to millionaires and billionaires, paid for by cutting working families off from the care they need.

They ignored the overwhelming opposition of their constituents — and now we’re going to make sure their constituents throw them out of office.

Help build the foundation to take on these Republicans in every state, elect Democrats who will protect every American’s access to health care, and take back our majorities in Congress. Chip in $3 or more tonight.

Thank you, sincerely, for everything you’ve done to stop health care repeal. Onward as we continue to fight for the values we believe in.


Tom Perez
Democratic National Committee

To the CEO of the DNC


To remember what I replied to Jess O’Connell at, and hoping you’ll join me, here’s my reply:

What would you do with the money if I gave it, Jess?

I have stopped donating until the DNC commits itself to and campaigns compellingly FOR legislation that benefits not mega-donors but we the people.


— Martin

To the following appeal:

Martin —

You marched, you called, you protested, you spoke up, you signed petitions, you made sure Republicans knew that if they voted for the GOP’s health care bill, we’d vote them out of office. And it worked. Mitch McConnell couldn’t get the votes for his truly dangerous bill.

So pat yourself on the back — and then get ready to get right back in the fight, because Republicans are making their next move.

McConnell just set a date for the next health care vote on Tuesday. And the repeal bill they’ll be voting on is no different from the last version! It would still cause 22 million Americans to lose the health coverage they rely on.

Clearly, Republicans are grasping at straws. But they want to score political points with their far-right base by saying they voted to repeal Obamacare, even if it comes at the expense of millions of American lives.

I need you to pitch in $10 or whatever you can now to help Democrats fight back against the GOP’s health care repeal. They won’t give up, so neither can we.

We’re the last line of defense. Thanks for stepping up.


Jess O’Connell
Chief Executive Officer
Democratic National Committee

Reversing our Government’s Direction

I just sent this to Democratic Party leaders.  Please join me in telling our leading politicians if you also recognize that our government is heading fast in the wrong direction.

I hope this will be helpful.

I have stopped responding to appeals for uncoordinated advertising and campaigns like Jon Ossoff’s whose only rationale was anti-Trump.

We must not just thwart today’s cruel proposals by President Trump and Republicans.  We must recognize and respond to why we keep being defeated at every level of government.

We say Trump’s victory came from poor, white working-class voters.  That’s false.  Three-quarters of Trump voters were from households earning more than the national median income.

What was most important for the relatively small number of Trump voters was not economic dissatisfaction but social issues  Exit poll data show it was his words about race, gender and immigration that were the main factor with his mostly middle-class supporters.

What is much more important is Trump won mostly because so many in the working class did not to vote at all.  The Clinton campaign wrote them off as racist, nativist, misogynistic “deplorables”.

We must change that mindset.  We must focus on what motivates those who did not vote.

We’ve been ignoring the situation of the majority of Americans where the top one tenth of the top 1% now has as much wealth as the bottom 90%, and half our population is poor or near poor.

That’s what we must commit ourselves to change.

It may be helpful to understand why we are ignoring the need to change and this article explains it well but the only thing that really matters is to make the change.

We must regain electoral majorities to make a society that is no longer organized to profit a tiny few but one where all can flourish.

We must commit ourselves not just to hope but to a program for what the majority seeks.

Do you agree or disagree?  Please let me know.

— Martin

Human Flourishing or Vast Profit for a Tiny Few


Our society has for decades been changing for the sole benefit of a tiny minority.  I want it to change for all of us to flourish and I am now committing myself to help make it so.

We have been pouring money into a political wasteland where the Republican Party is no longer a thoughtful counterbalance to progressive impulses and the Democratic Party is simply anti-Trump.

Both major parties must be transformed because a society dominated by either one will be unfair.

I will focus chiefly on the Democrats, making modest and conditional contributions to half a dozen or so influential individuals and emailing them often.  I began this way:

Dear Congress(wo)man/Senator/Governor xxx,

I hope this is helpful.

As a life-long Democrat I am appalled that Democratic Party leaders have not learned from our defeats at every level of government.  I believe they must be forced.

I’m writing to you because party leaders will not notice I have stopped responding to their barrage of appeals to pay for uncoordinated advertising.

What I will do, however, is support you to establish a well marketed Democratic Party program of change for a better world.

Opposing what Republican leaders are now proposing is of course necessary but it simply is not enough.  We must be FOR changes that most voters want, and we must market them well.

We aspire to be a society that prioritizes human flourishing over private profit for a tiny minority.  Achieving that requires a long-term program — the equivalent of tax cuts for Republicans —  of coordinated marketing to build unstoppable demand and to mitigate the cultural concerns that now divide us.

Our economic message resonates, but we are creating powerful reasons to vote against it.   As Fareed Zakaria points out here: “More people prefer the [Democratic Party] views to those of Republicans on taxes, poverty reduction, health care, government benefits, and even climate change and energy policy … [but] Democrats need to talk about America’s national identity in a way that stresses the common elements that bind, not the particular ones that divide … stay true to their ideals, of course, but yet convey to a broad section of Americans — rural, less-educated, older, whiter — that they understand and respect their lives, their values and their worth.'”

We can hope to gain seats in 2018 and 2020 but we will not achieve a mandate unless we make a long-term effort.  Republican leaders started getting where they are half a century ago as Bruce Bartlett points out:  “In the wake of Goldwater’s defeat, many conservatives concluded that their philosophy was insufficiently well-grounded in the social sciences and lacked an empirical foundation. For example, Goldwater talked about privatizing Social Security, but had no plan whatsoever for how to do it. Hearing his rhetoric on the subject, those receiving Social Security assumed, not unreasonably, that they would just be cut off.”

Although we must build an equivalent infrastructure of think tanks and media for lasting change, we can quite soon begin to succeed because our theme, economic justice, is already popular.

Our program will only succeed, however, if it is based on the values we all share, not on those that divide us.

I am counting on you to convince our Party’s leaders to make the necessary changes.  Please let me know if I can help.  I will be watching.

Preaching to those who agree will not make our future better and ranting at those who do not agree makes it worse.  We must focus on values we share.

And because only politicians can establish government changes, we must above all convince them to make the changes we want.  

That will require persistent and emphatic effort.  I hope you will join me.

Healthcare — the Fundamental Choices

One of our fundamental choices about health care has moral and practical dimensions.  The other is purely practical.

Let’s first address the practical issue.  Our  appruoach to health care puts our businesses at a serious and growing competitive disadvantage.  US corporations currently spend $12,591 on average for coverage of a family of four, up 54% since 2005.

Our national health care spending, which was 5% of GDP fifty years ago, is now 17 % of GDP.  It has more than tripled.  Meanwhile, Germany’s spending is two thirds of ours and is growing much less rapidly.

We spend half again as much or more on health care as other advanced economies.  And the gap is growing.  Germany now spends 11% of GDP on health care, only increased from 9% half a century ago.  Japan spends 10%,  Britain 9%.

It’s no coincidence that our health care system is fundamentally different from our competitors’.

Our business leaders say their competitiveness is hobbled by corporate taxes, but while our health care spending has more than tripled in the last half century, corporate taxes that were then 4% of GDP are now half that at about 2%.

It’s true we have industrialized nations’ highest corporate tax rate but many of our great multinational corporations pay little or none.  It’s also true that our high tax rate hurts smaller domestic corporations but that’s much less important than our health care system’s costs.

To remain competitive, we must restructure our health care system.  

The choice with both moral and practical dimensions is whether everyone will have health care, or only those who can pay?  

If only those get health care who can pay, the others will suffer and die.  If we favor this approach we should consider, are we okay with that fact?

If everyone will get health care, there must be some rationing.   If we favor this approach, do we recognize that fact?

It’s misleading to think of health care as a human right.  Nations choose what rights their citizens will have and embody them in laws.  Those laws can and do change.

Our current legal system specifies that, with an exception I’ll get to in a minute, those of us who cannot pay for health care do not get it.  Why is that, and could it change?

It is an article of faith with us that we are rugged individuals who take responsibility for ourselves.  We resist anything we think could make us less responsible.

Another of our articles of faith is that competing organizations motivated by profit always get the best results.

But that could be about to change.  The Medicare for All act has 108 sponsors as of May 13, 2017:

We would get better results from a unified approach to health care.  We do not, after all, provide for our defense with autonomous, competing armies.  We know that kind of service can only be supplied effectively by our central government.  And we know our government has encouraged, not stifled innovation in that field.

Here are links to what I’ve written before about some important aspects of our approach to health care but if you’re out of time, just skip past them to the conclusion — a single payer system works best.

In I pointed out that we do currently provide not health care but at least medical treatment to all via the Emergency Medical Treatment and Active Labor Act (EMTALA) passed under President Reagan.  That approach means: “We have in the USA universal access to medical treatment via the most costly system possible.”

Data I posted at: show that:  “US health care delivers poorer results at higher cost because it is based on the flawed assumption that market based systems always deliver the best results. While in most cases they do, for health care they do not. The incentives are perverse”.

Exploring our Federal deficit at: I noted that: “more important even than getting rising Federal healthcare spending under control is to get rising health care cost under control.  As noted in previous posts, we spend double what other advanced economies do on healthcare without getting better results.”

Examining national spending and results at: I pointed out some contributors to our abnormally high costs:  “our obesity rate, the highest of all OECD countries and more than twice as high as the 15% OECD average …  The percentage of our adult population considered obese rose from 13% in 1965 to […] 34% in 2007.  Obesity-related medical spending in the USA doubled […] between 1998 and 2008.”  

Focusing at: on Medicare and Medicaid I pointed out that: “The primary cause of increased Medicaid spending is that it now services 16% of all Americans, up from 2% at its inception [while] Medicare now serves 15% of the population, up from 10% in 1966 and the percentage will continue to increase as our population ages … The key fact about Medicare is that an aging population, unhealthy lifestyles and technology advances are driving its costs up 8% annually, much higher than Medicaid.”

The conclusion?  Our need to remain competitive means we must restructure our health care.  Our competitors did that long ago.  They all established a unified system for all their people, they all have much lower costs than ours, and they all get the same or better results.

Our current approach to health care is not exceptional in a good way.

When the government acts as the one health care buyer it has the market power to negotiate the lowest price that is profitable for suppliers.

A competitive health care market benefits consumers only for procedures like breast enhancement where they have enough time to make an informed choice.

To remain competitive we must change our health care system.  We must either stop providing care to many millions more of those who can’t afford it or establish a single buyer to negotiate the lowest profitable price for providing care to the largest pool of consumers, which is both the currently healthy and the sick.