OK so I asked the one health-care blogger I know of, Alwin Hawkins of View From The Heart what he thought about my post, and he answered in the comments section below. It’s too good to risk folks missing it, so here it is:

OK, first question: do we have national health insurance? No, of course not. You answered that question yourself in your example; LA county hospitals are financed by a complex web of county, state, and federal grants to support the system – a system almost ready to collapse and due for major cutbacks.
(BTW, LA county health system is a great model for how such systems collapse. Currently there is a huge budget problem. The solution? Close the public health clinics, which provide primary care. Why? Because you have to provide emergency medical care; it’s a federal law. So you shut the inexpensive, cost-effective preventive services and keep the expensive emergency services going. It doesn’t have to make sense; it’s the law.)
As Ross pointed out, government health money only pays a fraction of the cost of services, and federal law prevents the hospitals/docs from getting the patient to pay the difference. That means that the private patients – both the insured and the un/underinsured – make up the difference. Whether it’s directly out of your own pocket or indirectly out of your employers pocket, individuals subsidize government mandated health care and federal/state reimbursements.
Government sponsored healthcare is one of those beasts that works only because the government sets the standards. Run out of money? Don’t pay and let the administrators decide which service gets cut, who doesn’t get paid, what capital expenditure gets deferred, what medications aren’t available. After all, sick people don’t bitch much- and if you cut off services, they don’t complain long, either.
To answer your final question, we do it better by requiring every government mandated program or law passed also have the money to provide those services. If we want universal health care, fine. But we have to also agree to pay for it, and to understand that it will be really, really expensive as the Boomers hit the Medicare barrier. We pay as we go, and we pay whatever it takes to provide the services so that employers aren’t left holding the bag.

Bob Morris, who writes the usually sensible ’Politics In The Zeroes’ blog, takes Ted Rall’s hook and gets reeled in (no permalinks, so just scroll down) with this:

Ted Rall on why it’s different this time
Wise words from Ted Rall, an investment banker turned cartoonist/political columnist.

The trouble is that the accounting scandal that brought down Enron, WorldCom and Xerox is something far more serious than a short-term cyclical correction. It threatens to undermine the foundation of market-based capitalism itself. Bush addressed investors twice in one week, but his assurances that help is on the way only drove jittery securities exchanges to record lows. “For lack of a better description, you have as much full-fledged panic as you are going to get,” commented Tony Cecin, director of institutional trading at U.S. Bancorp Piper Jaffray in Minneapolis. “The negative mentality is as pervasive as I have ever seen it, and I went through (the) `73 and `74 bear market.”
The panic is real and it is rational: Investors finally realize that they can’t trust earnings and other “audited” figures released by corporations. Absent that information they can’t evaluate stocks, which leads to only one logical conclusion: sell everything and stay out of the market.
“Independent accounting” was BS all along; even companies that didn’t bribe their auditing firms outright with lucrative consulting deals controlled them via the millions of dollars in fees paid out for their signing off on company financial statements. It’s hardly a unique moment in history to discover that some shepherds have been munching on lambchops from a flock they swore to protect.

Rall, sadly is no better on business history than military reportage. Off the top of my head, from the turn of the century to the 90’s:
Teapot Dome (and pretty much the whole Harding Administration)
Julian Oil, here in L.A.
Ivar Krueger, in Sweden
I.O.S. (Bernie Kornfeld)
Equity Funding
Cendant
People have always cheated; capitalism has survived, Rall’s apocalyptic fantasies notwithstanding.

Had lunch today with a political friend, and was chatting about healthcare; mentioned my distaste for ‘National Health’ type solutions, and was rewarded with a verbal smack to the head.
“What do you think we have now?” he asked, giving me the you-moron look.
He referred me to the LA County Budget (a pdf chart is here), and points out that in 2001-2, Los Angeles County spent 23% of its budget…or $3.85 Billion on healthcare. Public Protection, in contrast (Sheriff & Fire) were 20% of the budget, and Social Services (the County is the major provider of welfare) was 29%.
His point is well-taken. We already have publicly-financed healthcare. It’s just crappy, inefficient, and relatively ineffective because we persist in making believe that we don’t.
This is because the giant institutions…the giant hospitals, and the emergency rooms which increasingly serve as the primary-care physicians for a large portion of the population…soak up an increasing amount of the available dollars, and my guess is that they leave little for the kind of preventative, low-profile, relatively less expensive care which would potentially be less expensive and possibly provide better care.
Now this is a ‘newspaper’ set of interpretations; I’d be most interested in hearing from folks in the field.
But the one concrete point is that we have government financed health care for a large portion of the population, and folks like me who sit around and pontificate on how bad government-financed health care would be need to wake up and look at the real world.
So how do we do it better?

…that the character Jack Black played in ‘High Fidelity’ had a website??
Jaguaro.org lists 100 albums he is too cool to own…and sadly, you and I probably do.
Including the Kinks’ Arthur was the straw that put me over the edge.
[note: should have credited Matthew Yglesias.]

That last one seemed a little…I donno, serious, so I thought I’d balance things out with one of my favorite quotes from another of my teachers, Clint Smith, of Thunder Ranch:
“If you carry a gun, people will call you paranoid. That’s ridiculous. If I have a gun, what in the hell do I have to be paranoid about?”

First, a weak-ass apology; I’m diving into deep waters in raising these subjects, and I’m doing so knowing that I do not, at this moment, have the time to adequately address them. My outside life is pretty demanding right now; but I can’t give up completely. So I owe some of the folks I’m arguing with (in the best sense of arguing, I feel), and the folks just passing by and reading, an apology because I cannot spend enough time in front of the keyboard to hone the lengthy and deep arguments these issues require…if, in fact, I’m capable of making them. I’ll try and improve.
Plus I confused Derrida with De Man in a posting below.
Meanwhile, to paraphrase Truman Capote’s acid review of On The Road, instead of writing, I’ll type. (his review: “That’s not writing, that’s typing.”)
I’m very fortunate to have a great visual and spatial memory, which reminds me that the little purple book I’m looking for was next to the big Caro books on the upper right shelf, which means it ought to be in…yes! this!!…box.
The Aquinas Lecture, 1961. Metaphysics and Historicity, by Emil Fackenheim

This effect of contemporary events is reinforced by an intellectual development which, in the West, began in the nineteenth century. For a century and a half, Western man has developed an ever increasing historical self-consciousness. And this has not been without grave spiritual effects. In earlier ages, most men could simply accept religious beliefs or moral principles, as unquestioningly true. In this historically self-conscious age, few men can ever forget that what seems unquestioningly true to one age or civilization differs from what seems unquestioningly true to others. And fron historical self-consciousness there is but one step—albeit a long and fateful one—to a wholesale historical skepticism: to the despairing view that history discloses a variety of conflicting Weltanschauungen, with no criterion for choice between them anywhere in sight [A.L.: except essentially artificial and arbitrary ones, per Derrida]. But when events move as they do today, this step is easily taken.
Just how commonly it is in fact taken may be illustrated by a review of three typically contemporary attitudes. The first is what may be called skeptical paralysis. Here historical self-consciousness has led to two results: to the insoght that wherever there has been great purpose, there has been great faith; and to the loss of the capacity for commitment to such a faith. Hence there is paralysis which recognizes itself as paralysis and preaches doom.
Then there is what may be called pragmatic make-believe. Here man, caught in skepticism, seeks escape from its paralyzing consequences. Unable to believe and yet seeking a purpose, he falls to pretending to believe, hoping that a pretended might do the work of an actual faith. But it cannot. For a pretended faith is no faith at all. Pragmatic make-believe collapses in self-contradiction.
When men truly suffer from this contradiction they may seek escape in the most ominous form of modern spiritual life: ideological fanaticism. Unlike pragmatic make-believe and like faith, ideology asserts itself absolutely. But unlike faith and like pragmatic make-believe, it is shot through with historical skepticism. For it knows itself to be not truth, but merely one specific product of history.
Hence, unlike faith, ideology must by its very nature become fanatical. When challenged by a conflicting faith, faith may withdraw on its certainty of being true. Because it knows itself to be but one product of history, ideology can achieve certainty only by making itself true; and this it can do only be re-creating all history in its own image. When challenged, therefore, ideology cannot withdraw on itself; it must seek to destroy the challenger. That is, in order to resolve its internal conflict between absolute assertion and historical skepticism, it must engage in a total war from which it hopes to emerge as the only ideology left on earth.

Jeff Goldstein over at Protein Wisdom is heard from.
I hate my life…I have too much to do to sit down and try and integrate all this right now…so I’ll try and do enough to keep stirring the pot.

People are idea-driven creatures; our actions are as influenced by the ideas we hold as our opinions. Uniquely among living creatures, we can share ideas and that storehouse of ideas provides the structure within we individuals operate as cohesive social groups, or cultures.
N.Z. Bear has talked about memes as they apply to the Middle East; I’ll take a stronger case, and argue that while history is largely about material conflicts over resources and power; it is always framed in ideas and concepts.
Would Hitler’s ascent been possible without the legitimacy offered by the (slapdash, haphazard) philosophical arguments he made?? Without the roots in Schiller and even Hegel?? He had to appeal to his audience, and he did it in the form of ideas, metaphors, and memes. He had to persuade, and convince.
It’s much easier to persuade and convince if no one can challenge your arguments; it is much easier to persuade and convince in a world where soundbites and film clips are the equivalents of investigation and evidence.
Terminus argues that Jenin “is a bad example, because it is a political, not a historical, issue.” Excuse me? Isn’t that exactly what I’m talking about? I think Jenin is a perfect example. Leaders make political arguments, and as above these must be tested somehow; I’ll suggest that political arguments testable by fact are better than those which have not or can not be tested. And, in Jenin, the PA’s position, sadly echoed by the NGO’s, was to stand up and shout to the world that Israel had done certain things…which, had they been done, would have meant one thing. They appear not to have been done, which means another.
But in a world where competing narratives are ultimately equally valid…in Stanley Fish’s world…Israeli soldiers might as well have dragged women and children from their homes and shot them. Because that is the Palestinian truth. And no ‘fact-checking’ or ‘investigation’ could materially change that. Does this matter? Of course. It matters to the men and women who, living in that narrative, decide to put on explosive belts and walk onto Israeli busses.
And, ultimately, it is promoted and fed by a corrupt elite who manipulate the narrative…and for whom the malleability of ‘fact’ becomes the fuel for their political power.
Why did the Germans willingly follow Hitler? Because they believed in him. Because no one tested his narrative.

There’s been an interesting discussion going on below, and I thought I’d bring it up to the blog and see if we can’t take it further.
The subject is postmodernism and totalitarianism, and the main participants have been Terminus, Demosthenes, and myself…
Terminus opens:

To the extent that history is nothing more than facts, than it could be truthfully written. But it would be of little historical interest. The “meat” of history is the interpretation, and you’ll never get truth that way, because there is no independent standard of ultimate judgement. That’s the trouble: if you want to say anything that any kind of real meaning or relevance, you must sacrifice the absolute certainty that only comes with simple recitations of fact.

I reply:

I think you’re missing Orwell’s and my point; he clearly acknowledges and I believe that the facts are just an armature on which we hang understanding. But without that armature, what are we trying to understand?
And the post-modern, ironic acknowledgement that our selves color our world suddenly becomes justification for denial of the most basic facts, and leaves us with a world in which claims strongly stated have a validity equal to any kind of evidence.

He replies:

No, this is exactly what I’m getting at. How does this logical progression work? You start with:
1). There are facts, and there are interpretations.
2). Facts are at least in theory objectively veriable, interpretations are absolutely not.
This, I think, is pretty firm, pertty solid, and pretty non-controversial. So where does “denial of the most basic facts” enter into it? Which facts, denied by whom, for what reason?
How does that follow?

Me again:

Well, Orwell suggests that in totalitarian states, ‘basic facts’ are up for grabs. We’ve seen this ourselves, most recently in Jenin, where the ‘facts’ of the ‘massacre’ made political news long after the verifiable information disproved them.
Think of all the airbrushed May Day pictures during Stalin’s time…

Him again:

Jenin is a bad example because it’s a political, not an historical issue. The fact are the facts, they are to some extent known, and the will be more or less agreed to in the fullness of time. Let’s check back in 2050 (that how long this shit can take).
Ok, I understand that in totalitarian states, basic facts are up for grabs. This is a necessary component of successfully running a totalitarian state: you must control the flow and the content of information. I don’t see how believing that interpretations of facts cannot be judged objectively contributes either to a) the denial of facts, or b) the imposition of totalitarianism.
It’s like your saying “Totalitarianism denies basic facts, it looks like postmodernism is moving disturbingly in that direction, therefore postmodernism promotes totalitarianism.” You can’t actually be saying that, being that’s ridiculous, so I’m still missing something.

Amac (a civilian – i.e. non-blogger, as far as I can tell):

The preceding dialog between Terminus and A.L. is great to see. Terminus is intelligent, articulate, obviously educated, and so quite capable of grasping Orwell’s point about facts and totalitarianism. Yet s/he won’t acknowledge the connection, in general or specific (Jenin, airburshed May Day photos) terms. This way of looking at the world seems currently to be most enthusiastically embraced by the academic left. To some of us outside the Academy, what makes “post-modern” ways of thinking fascinating and scary is precisely the intelligence and articulateness of its practitioners.

Demosthenes weighs in:

There is, of course, a difference between out-and-out hiding of facts and history and the inevitable differences in interpretation. There is a false comparison being made here (and by many others) between discussions of the two.
Personally, I found Fish’s thesis in-and-of-itself mostly benign, and have been wondering why the Blogosphere has been foaming at the mouth over it, accusing it of all manner of evils which the essay simply doesn’t support. He wasn’t defending totalitarianism, relativism, or anything of that sort… he was simply noting that while we may know in our hearts something is true, we cannot convince others of these things, and have no way of reliably doing so. This isn’t totalitarianism, it’s simple common sense. (It also arguably isn’t postmodernism… he’s left behind the textual elements). Remember that the term “post-modernism” is entirely a reaction to “modernism”… which is the idea that things are universal and can be understood through reason, which is entirely benign and morally righteous itself. While the evils of post-modernism are shadowy (if not wholly made up by those who can’t bear to think that someone might reasonably disagree with them), the evils of modernism are well known and well documented.
In any case, there are also political philosophers and fiction writers besides Orwell… while an intelligent and capable writer, I’ve certainly read better dystopian fiction than 1984, and it’s worthy to remember that in many respects that novel was a more polished version of the old Russian proto-SF story “We”.

Demosthenes again:

By the way, AMac: they won’t acknowledge the connection because they don’t believe one exists. That is a difference of opinion, not willful denial. The difference between those two things is precisely what postmodernism is about.

Terminus:

Thanks for the kind comments, AMac. I am, for the record, a he. [The name Terminus is an affectation, not an attempt at anonymity, btw… anyone so inclined would not find it difficult to determine my true identity from my blog.] Anyway, I see the connection you mention in the sense that they are similar. But it’s not valid to argue that postmodernism is bad because it is, in this sense, similar to totalitarianism, which is bad. That is simply not a valid argument structure. However, if there is some link which I do not grasp that demonstrates how these academic notions somehow promote or lead to totalitarianism, then I’d like to hear them (and I say that without sarcasm).
Well said, Demosthenes.

And, finally, me:

Terminus says:
It’s like your saying “Totalitarianism denies basic facts, it looks like postmodernism is moving disturbingly in that direction, therefore postmodernism promotes totalitarianism.” You can’t actually be saying that, being that’s ridiculous, so I’m still missing something.
No, that’s exactly what I’m saying. I’m not convinced that the connection is causal or direct…that because Derrida was a Fascist apologist he arrived at his philosophy or vice versa.
But I do believe in the power of ideas and philosophy, and that Fish’s ironic post-factual philosophy absolutely lays the groundwork for totalitarian despots.
A.L.

OK, next I’ll cook up a reply to Demosthenes and Terminus. Probably won’t be up for a few hours (I have to go to a meeting), but should be here by evening.

From the same essay:

We in England underrate the danger of this kind of thing [AL: totalitarian conquest of the world], because our traditions and our past security have given us a sentimental belief that it all comes right in the end and the one thing you most fear never really happens. Nourished for hundreds of years on a literature in which the Right invariably triumphs in the last chapter, we believe half-instinctively that evil always defeats itself in the long run. Pacifism, for instance, is is founded largely on this belief. Don’t resist evil, and it will somehow destroy itself. But why should it? What evidence is there that it does? And what instance is there of a modern industrialised state collapsing unless conquered from the outside by military force?

The USSR and Eastern Europe collapsed without being invaded. Does that invalidate this? Somehow I don’t think so, but I’d love to hear what folks think.