Panorama: Poor America

[Darth Wong]

D.A., I don't know how many times I have to point out that he never painted himself as a leftist in the first place, and that a real leftist would never get elected in your country.

Non sequitur much? When did my post say I thought he ran as a leftist?

Fine, you're just whining endlessly that he's not a leftist. Well deal with it; your country won't elect a leftist. A centre-right politician is as far left as your country can willing go.

[Thanas]

Yes, I am sure the conservatives forced Obama to hire exclusively Goldmann Sachs advisors and forced him to propose only their stuff. How about you explain that?

Obama has technocrat leanings but not technocrat skills (he's a lawyer, not an economist or scientist), so he relies upon people who are perceived to have the most qualifications. In other words, he was tricked by a bunch of very smart and well-connected people into thinking that only they could understand the system and solve the problem.

I don't think being a great technocrat requires great "technocrat" skills - some of the best technocrats in history were lawyers, like Bismarck.

I don't believe he's a conservative in disguise, but I do think he got hoodwinked early in his presidency by some clever conservatives who outsmarted him.

Agreed.

And then there's the national security issues, where I think he's just reflecting the prevailing attitude of the voters. He did propose shutting down Guantanamo early on, and there was a huge backlash over the idea once Americans realized they would have to actually bring those prisoners onto American soil and give them proper trials.

I think he goes far beyond that - the mouthbreathers were willing to accept Bush era policies. Obama far transcends that.

Ultimately, I still blame the voters for most of the problems.

We all know the American voters are dumb, so no surprise here.

[Dominus Atheos]

D.A., I don't know how many times I have to point out that he never painted himself as a leftist in the first place, and that a real leftist would never get elected in your country.

Non sequitur much? When did my post say I thought he ran as a leftist?

Fine, you're just whining endlessly that he's not a leftist. Well deal with it; your country won't elect a leftist. A centre-right politician is as far left as your country can willing go.

2 things:

1. Obama won by nearly 200 electoral votes, he had plenty of margin to run a different campaign.

2. Regardless of what he actually ran as, there was a large perception by people on both sides of the isle that he was a leftist. No one would have felt betrayed if he had aggressively prosecuted the banksters or enacted a larger actually effective stimulus.

[Simon_Jester]

I like Neil D Tyson, but I think it's totally unrealistic to expect that the average person could be enlightened in this manner. The average person is stupid: this is something that someone like Dr. Tyson, with his high intellect and high-IQ peer group, might have trouble recognizing.

It would be nice if stupid people at least realized that they don't understand these issues. But the constant drumbeat of anti-intellectual rhetoric in the US makes that impossible. People love the idea that "common sense" trumps specialized experts.

It doesn't help that each generation gets hit with waves of experts who try to sell us a bill of goods. The baby boomers were treated to 'expert' generals and diplomats telling them things like "Vietnam is winnable" and "The Soviets will kill us all;" most of the ones who came out of it seriously believing them turned into crazy teabaggers.

In my own generation, we've been served up a nice big helping of economic collapse that was enabled and supported at every turn by "experts:" expert financiers, expert economists, people from Harvard and Yale with stacks of diplomas and curriculum vitae as long as your arm. If these people aren't "experts" at running an economy correctly, who is? And yet they ran it right into the ground.

Figuring out which experts to trust, in a nation which has refined the Big Lie to such a high art, is a tricky exercise. A lot of Americans get it wrong and wind up taking pro-idiot policies.

I don't think being a great technocrat requires great "technocrat" skills - some of the best technocrats in history were lawyers, like Bismarck.

If a would-be technocrat doesn't have the skills to understand it himself, he has to have an excellent sense for which people are trying to trick him into serving the interests of a narrow minority.

Bismarck had that, and so he was able to avoid appointing people who would ruin Germany by trying too hard to serve any one interest group. Obama doesn't have it, or doesn't seem to. I think he went into office honestly expecting to be something like the man he'd said he would be: a bipartisan consensus president who could say "okay, we've just been through the Bush years and nothing we tried worked, can we move on now?"

It was not to be; the Republicans and the big-money interests simply doubled down and tried to push all the same policies they'd used before, only harder. And Obama, who went into office on a reconciliation platform, lacked either the ability or the inclination to fight for the things he'd promised to do through reconciliation.

[MKSheppard]

Hell, at one point I felt like sending a letter saying that I understand why run down areas should be deprived of all these street lights

Hmm...Maybe this is why?

Linky 2

Tl;dr: Copper thieves like to hit streetlights, because they have large amounts of wiring in them and are essentially unguarded.

The cost of the thievery can easily hit the hundreds of thousands of dollars; so for a city government, it may make more sense to remove the street lights in problem areas than to keep repairing them.

[Darth Wong]

Non sequitur much? When did my post say I thought he ran as a leftist?

Fine, you're just whining endlessly that he's not a leftist. Well deal with it; your country won't elect a leftist. A centre-right politician is as far left as your country can willing go.

2 things:

1. Obama won by nearly 200 electoral votes, he had plenty of margin to run a different campaign.

He won by nearly 200 votes because he's centre-right. You can't assume that if he was leftist, it would just shave a bit off his margin of victory.

2. Regardless of what he actually ran as, there was a large perception by people on both sides of the isle that he was a leftist. No one would have felt betrayed if he had aggressively prosecuted the banksters or enacted a larger actually effective stimulus.

Of course there was a large perception on both sides of the aisle that he was a leftist. Americans think a centre-right politician is a leftist. But you are saying that you want a real leftist, and I'm telling you that Obama is as far left as the American public was willing to go. And he's still faced an unprecedented level of hatred from his own countrymen; I don't recall people brandishing assault rifles at political speeches before.

[Darth Wong]

I like Neil D Tyson, but I think it's totally unrealistic to expect that the average person could be enlightened in this manner. The average person is stupid: this is something that someone like Dr. Tyson, with his high intellect and high-IQ peer group, might have trouble recognizing.

It would be nice if stupid people at least realized that they don't understand these issues. But the constant drumbeat of anti-intellectual rhetoric in the US makes that impossible. People love the idea that "common sense" trumps specialized experts.

It doesn't help that each generation gets hit with waves of experts who try to sell us a bill of goods. The baby boomers were treated to 'expert' generals and diplomats telling them things like "Vietnam is winnable" and "The Soviets will kill us all;" most of the ones who came out of it seriously believing them turned into crazy teabaggers.

In my own generation, we've been served up a nice big helping of economic collapse that was enabled and supported at every turn by "experts:" expert financiers, expert economists, people from Harvard and Yale with stacks of diplomas and curriculum vitae as long as your arm. If these people aren't "experts" at running an economy correctly, who is? And yet they ran it right into the ground.

Figuring out which experts to trust, in a nation which has refined the Big Lie to such a high art, is a tricky exercise. A lot of Americans get it wrong and wind up taking pro-idiot policies.

That's actually part of the problem: people just smear different kinds of experts together. They assume that an expert on fighting wars is the same thing as an expert on deciding whether to start a war. They assume that an expert in making money on Wall Street is the same thing as an expert on the national economy. They don't respect the nature of qualifications, part of which is their respective specializations. They pick and choose which "experts" to listen to (a task made more convenient by the fact that they couldn't care less whether someone is actually speaking in his area of expertise) precisely because they don't actually respect expertise. They just treat it like boilerplate.

[madd0ct0r]

Moving back the huddled massess;

seriously, what the fuck is wrong with America?

A while back i saw 'the blindside' about this homeless black kid who gets picked up by a rich white texan christian mom who then pushes him through school, college and into pro football.

It's made quite clear throughout the film that if she hadn't, he'd have been caught up in the projects and either failed to do anything or been killed in gang violence.

On the surface the film was about the importance of private charity - the only reason this guy got out was because his foster parents were willing to throw buckets of cash at the problem.

Fine, but really, should people be just left to the whims of the very rich? or should this thing be sorted out at a society level? Same as healthcare. In Europe it's a basic right, in America it's a privilege.
And the market is delivering the most expensive healthcare in the world.

I never really appreciated the NHS up until i moved to Vietnam. When you've been coughing for a fortnight but you don't want to go see a doctor because it's $50 it's just not good.

I'm starting to wonder if America should be counted as a developed nation, or just an extremely rich developing one.

[Zaune]

I don't think it really fits either category. It's an undeveloping one, or a regressing one, or whatever the hell the exact polar opposite of a developing country is.

[Darth Wong]

Moving back the huddled massess;

seriously, what the fuck is wrong with America?

A while back i saw 'the blindside' about this homeless black kid who gets picked up by a rich white texan christian mom who then pushes him through school, college and into pro football.

It's made quite clear throughout the film that if she hadn't, he'd have been caught up in the projects and either failed to do anything or been killed in gang violence.

On the surface the film was about the importance of private charity - the only reason this guy got out was because his foster parents were willing to throw buckets of cash at the problem.

Fine, but really, should people be just left to the whims of the very rich? or should this thing be sorted out at a society level? Same as healthcare. In Europe it's a basic right, in America it's a privilege.

This "charity, not government programs" idea is a staple of American conservative politics, and Christian politics in particular. They appear to be keenly aware that government social programs function as competitors to the role that organized religion has traditionally played in western society, and this is a turf war.

[madd0ct0r]

Which is still fucking stupid, because exactly the same christian rationality and charity led to the development of things like the NHS in the UK.

meh, I'm preaching to the choir here, I just really, really don't understand what's going on in Joe Q's mind.

[Bakustra]

Social welfare is highly popular in the US- the entire existence of "Keep your government hands off my Medicare" signs shows just how much people value broad social welfare. The emphasis on private charity is because of several factors. One of them is that Americans are in love with the frontier ideology of self-reliance (never mind that it's bullshit), which, combined with the segregation of class in our society, means that the rich are able to convince themselves that private charity is better than "handouts" and "entitlements", which is helped by the fact that payroll taxes drive wages up and so if they manage to kill Social Security and Medicare, they can pay people less.

Then, too, rich and many middle-class Americans sincerely believe that ours is the Land of Opportunity, and this allows them to disparage welfare, because anybody can make a living if they try, so something must be wrong with people on welfare. The segregation of our society by class and by race ties into this as well. But there is still strong support for universal healthcare, and for the idea of welfare- it's simply ignorance (baked into us by schools) that keeps us from really understanding what our actions are.

Or I suppose we can just assume that Americans are somehow stupider than Canadians or French.

EDIT: Also, Americans tend to have negative experiences with bureaucracy which is inculcated by the ideology of the rich, socialization, and psychological factors which means that it's easier to sell us on universal healthcare by the government being a disaster.

[PainRack]

That's actually part of the problem: people just smear different kinds of experts together. They assume that an expert on fighting wars is the same thing as an expert on deciding whether to start a war. They assume that an expert in making money on Wall Street is the same thing as an expert on the national economy. They don't respect the nature of qualifications, part of which is their respective specializations. They pick and choose which "experts" to listen to (a task made more convenient by the fact that they couldn't care less whether someone is actually speaking in his area of expertise) precisely because they don't actually respect expertise. They just treat it like boilerplate.

How do you seperate out the differences in experts? The same Goldman Sachs advisors and Greenspan were hallowed out in the media as experts. Bernanke himself is hailed as being an academic expert in Great Depression economics, is he thus not the right person to trust regarding how to avoid another depression after the finanicial collapse?

And Bernanke surely didn't predict the huge impact the CDOs will have.

[Darth Wong]

Which is still fucking stupid, because exactly the same christian rationality and charity led to the development of things like the NHS in the UK.

True, and the same happened here in Canada. But it happened a long time ago, when Christians still felt comfortably in control of society. Today, Christians feel like they're under siege even though they're firmly in control, because the trend is downward: church attendance keeps dropping. They blame this on outside forces; it never occurs to them that the failure of the church to connect to the younger generation could be due to a complete failure to keep up with a changing society. So they feel like they're being attacked, and they think they must jealously guard every piece of turf that they think they own or used to own.

meh, I'm preaching to the choir here, I just really, really don't understand what's going on in Joe Q's mind.

Well, as I said, Christians (despite having virtually all the power and wealth) have adopted a siege mentality.

[Darth Wong]

That's actually part of the problem: people just smear different kinds of experts together. They assume that an expert on fighting wars is the same thing as an expert on deciding whether to start a war. They assume that an expert in making money on Wall Street is the same thing as an expert on the national economy. They don't respect the nature of qualifications, part of which is their respective specializations. They pick and choose which "experts" to listen to (a task made more convenient by the fact that they couldn't care less whether someone is actually speaking in his area of expertise) precisely because they don't actually respect expertise. They just treat it like boilerplate.

How do you seperate out the differences in experts? The same Goldman Sachs advisors and Greenspan were hallowed out in the media as experts. Bernanke himself is hailed as being an academic expert in Great Depression economics, is he thus not the right person to trust regarding how to avoid another depression after the finanicial collapse?

And Bernanke surely didn't predict the huge impact the CDOs will have.

A predictive failure doesn't necessarily prove that someone doesn't know what he's talking about, especially in a situation which was arguably fraudulent. But there is a crisis of unscientific methods in economics; I suppose one might argue that there aren't a lot of experts in economics as a science. It is treated more as an art, with people lining themselves up into competing "schools of thought" named after their founders.

[PainRack]

A predictive failure doesn't necessarily prove that someone doesn't know what he's talking about, especially in a situation which was arguably fraudulent. But there is a crisis of unscientific methods in economics; I suppose one might argue that there aren't a lot of experts in economics as a science. It is treated more as an art, with people lining themselves up into competing "schools of thought" named after their founders.

The weakness in political science and economics to provide trustworthy experts is a concern though.

And its echoed in other areas of governance as well. We have US generals who have either deliberately lied to the US public or are utterly ignorant, to proclaim that the Afghan insurgency is dying out when US casualty rates and attacks are rising. They have no real plan and ability to win the wars in Iraq and Afghanistan after entering it, and even after 10 years, the US is still floundering around on how to project force and protect its own soldiers. Surely those experts from West Point are experts, right?

Engineering as relates to civil infrastructure is the only hard science in governance and it isn't enough to run a country on.

[Haruko]

The Heritage Foundation, the group which had its spokesman telling the interviewer for Panorama that the poor in America are actually a bunch of whiny brats who have it pretty good, is all over the college textbooks. Most memorable to me was seeing a table by the Heritage Foundation in my world politics textbook that showed that Europeans have far less economic freedom than Americans.

[Broomstick]

I have just viewed the entire documentary and it is very fair and balanced. Typical European media, I would think and high quality reporting. The fact that somebody like Broomstick thinks it is an attack against Obama is pretty enlightening as to how coddling US media is.

I didn't think the whole thing was an attack on Obama, but thinking Obama could have done MUCH more than he actually has was a foolish idea from the start. I know a lot of people had that idea, but I can't do much about that.

I don't think the “typical European media” has as good an understanding of the US as they think they do. Oh, yes, names and faces and certain types of facts, but they don't have the same understanding of the culture.

I refer you to this editorial in the New York Times discussing why so many Americans vote against their own self-interest. A lot of Americans really believe, deep down, that wealth is earned and a sign of worth, and poverty is due to some sort of personal failure or even moral fault. It has been mentioned many times here that even many poor Americans believe that tax breaks for the rich somehow benefit all, and any form of taxes is bad bad bad. Oh, and the perennial favorite – in Europe, healthcare is a right, in the US it is a privilege.

Obama is supposed to work for ALL Americans, including the batshit crazy right wing nutjobs who vote rabid conservatives into Congress. Obama can propose all he wants, but he's not a dictator, and he's working for a country where a LOT of people really do believe that bailing out Wall Street is good and bailing out the auto industry or underwater homeowners is evil, all the while the sore losers are trying to discredit him as a citizen and disqualify him from office. Just how effective do you think someone can be under such circumstances?

Could he have pushed harder? Yep. I don't think it would have made a goddamned bit of difference in the outcome, though.

And then there's the national security issues, where I think he's just reflecting the prevailing attitude of the voters. He did propose shutting down Guantanamo early on, and there was a huge backlash over the idea once Americans realized they would have to actually bring those prisoners onto American soil and give them proper trials. Ultimately, I still blame the voters for most of the problems.

^ This.

He backtracked on Gitmo in a sense – but it was in response to the voters. Isn't that how democracy is supposed to work, the will of the people? I get that Europe doesn't agree with the US “will of the people” when it comes to Gitmo, but it's not a matter of Evil Politicians it's that most Americans are content with Gitmo as it is (And please don't dump on me for that, it's not my personal opinion – I'm not a typical American politically). Why should Obama expend political capital opposing the will of the majority on that issue?

If you don't understand that there really are some very deep cultural/political/social differences between the US and Europe then Obama's actions (or lack thereof) no longer make sense.

Pretty much this. The closest it really comes to blaming any of it on Obama is saying that he could have done more, but missed his opportunity because of his focus on trying to compromise and build consensus.

Sure – except that is what the president is supposed to do, build consensus and compromise when necessary to get things done. Hell, that's what Congress is supposed to do. He's being criticized for doing what politicians do. Granted, the system wasn't set up with the idea he'd have to compromise and build consensus with batshit crazy obstructionists with a slice of them trying to declare the president a non-citizen.

Again, the PotUS is not a dictator, he has to work with Congress whether the various parties like each other or not.

I mean, just look at the sections where you have a Heritage Foundation stooge claiming with a straight face that no American child ever goes hungry right after we hear a kid talk about how her family was forced to eat rats one night because they couldn't afford food.

The kid had a rat for dinner – see, she didn't go hungry! [/sarcasm]

Not to put too fine a point on it, but a President who's granted himself the power to order US citizens extra-judicially executed by Predator drone strike on whatever dubious "national security" grounds he cares to claim has no excuse for complaining that he's being obstructed from acting on his manifesto pledges by the conservatives in his own party.

You’re ignoring the fact that a lot of the voters have no problem with the extra-judicial killing of what are perceived to be “traitor” citizens. Really, hardly a peep against that here in the US, with most folks either ignoring it happened or approving.

Especially when they threatend to totally destroy the US economy and political system one of the few times he showed any inclination to stand up to them!

Which might be why he's tried to avoid more such show-downs...?

D.A., I don't know how many times I have to point out that he never painted himself as a leftist in the first place, and that a real leftist would never get elected in your country.

^ This. Obama is “leftist” only compared to the batshit crazy right. By US standards he is centrist. By European standards he is way, way far on the right end of the spectrum.

.... and I'm telling you that Obama is as far left as the American public was willing to go. And he's still faced an unprecedented level of hatred from his own countrymen; I don't recall people brandishing assault rifles at political speeches before.

I don't recall people doing that during the 1960's when we had a spate of actual political assasinations – I don't think people outside the US (with rare exception) really grasp the level of post-election opposition and outright hatred Obama has faced.

seriously, what the fuck is wrong with America?

It has a social-cultural millieu based on very different principles than that of most other current “first world” nations. Like (as mentioned) healthcare is a privilege, not a right. While I agree that much of this can be described as “fucked up”, you have to remember than I am not a typical American. In fact, I'd guess the Americans who are long-term or frequent posters on SD.net are not typical and for the most part American leftists and liberals (that's by American definition, not in relation to others on the forum – in many instances an American leftist would be a European rightist).

A while back i saw 'the blindside' about this homeless black kid who gets picked up by a rich white texan christian mom who then pushes him through school, college and into pro football.

It's made quite clear throughout the film that if she hadn't, he'd have been caught up in the projects and either failed to do anything or been killed in gang violence.

On the surface the film was about the importance of private charity - the only reason this guy got out was because his foster parents were willing to throw buckets of cash at the problem.

Fine, but really, should people be just left to the whims of the very rich? or should this thing be sorted out at a society level?

For a large number of Americans – and not just the slack-jawed uneducated but often college educated ones as well – yes, they think these things should be left entirely to private charity and not society at large. It's a much larger slice of the US than I think most foreigners think it is. Even a lot of the poor underclass feel the same way. I have met a surprising number of people who would easily qualify for something like foodstamps but refuse to even apply for them, feeling it is morally wrong to accept such aid from the government and it's better to go hungry if one can't get to a church-sponsored soup kitchen or private charity distributing food.

I'm starting to wonder if America should be counted as a developed nation, or just an extremely rich developing one.

I'm beginning to think we're regressing.

This "charity, not government programs" idea is a staple of American conservative politics, and Christian politics in particular. They appear to be keenly aware that government social programs function as competitors to the role that organized religion has traditionally played in western society, and this is a turf war.

Damn, Mike, you really know your southern neighbors!

Which is still fucking stupid, because exactly the same christian rationality and charity led to the development of things like the NHS in the UK.

meh, I'm preaching to the choir here, I just really, really don't understand what's going on in Joe Q's mind.

And that's one of my points – those who aren't here (or very close by, like Mike) really do not understand what drives Americans to do certain things the rest of world thinks is fucked up. (And yes, a few of us lefty liberals, too, though I think by SD.net standards I'm pretty damn conservative)

[Broomstick]

Re: The guy who had a hernia for 10 years.

Something I don't understand about his medical bill: $20000 seems ridiculously high. Is it the same price in the UK? Is it just that the costs of those kinds of operations are spread out across the entire country so it ends up being affordable; or are the hospitals charging more than the actual cost of the operation to make a profit?

No, they're charging more than the actual cost just to break even.

Yes, I will explain.

Insurance companies contract with hospitals and various other systems to pay only a percentage of the “usual and customary rate” in exchange for encouraging their customers/patients to go to those medical providers. In some cases, these negotiated rates wound up below cost. In response, the “usual and customary rate” went up. And up. It's been a years-long tug-of-war between insurance companies negotiating percentage of rates down and medical providers raising prices. Likewise, Medicaid and Medicare pay only a percentage of usual and customary rates. The result is that when someone without insurance at all goes in for medical care they get slammed by the fully inflated price. The fact that quite a few of those uninsured people really can't pay means there is, on top of everything else, an incentive to raise rates still further to try to squeeze some money out of people to cover what just plain doesn't get paid.

Yes, $20,000 for hernia surgery, or any abdominal surgery, is quite in line with US medical costs.

Probably some of both, plus the fact that if he'd had access to proper medical care at a reasonable rate then he might have had corrective surgery at an early stage when the damage was more easily repaired.

Possible. Of course, we have no way of knowing if the hernia has been stable for awhile or is progressing.

Notable is that despite the urging of both his wife and a doctor he continued to refuse to go to an ER, repeating “I can't pay for it”. There really is an American meme that if you can't pay for a doctor you don't have a right to go to one, even if your life is potentially in danger. This is what I mean by a sharp cultural divide between the US and a lot of other countries.

[Zaune]

You’re ignoring the fact that a lot of the voters have no problem with the extra-judicial killing of what are perceived to be “traitor” citizens. Really, hardly a peep against that here in the US, with most folks either ignoring it happened or approving.

I was under the impression it was like most other political issues; a small but roughly equal number of people on opposite sides of the debate making a lot of noise while a majority don't care one way or the other.

And you missed my central assertion. How can Obama be that scared of the Republicans when he's given himself the power to order them killed pretty much at whim? I don't see why he has the moral right to do it to some radical imam on the other side of the world, but not to some nutcase spouting off about "2nd Amendment solutions".

Notable is that despite the urging of both his wife and a doctor he continued to refuse to go to an ER, repeating “I can't pay for it”. There really is an American meme that if you can't pay for a doctor you don't have a right to go to one, even if your life is potentially in danger. This is what I mean by a sharp cultural divide between the US and a lot of other countries.

You're sure that's him feeling he's not entitled to medical treatment, as opposed to merely fearing the consequences of incurring a huge medical bill he can't afford to pay? I mean, if I were in his position, I'd take the view that my wife would miss me a lot less than she'd miss a roof over our heads and food on the table.

[Darth Wong]

And you missed my central assertion. How can Obama be that scared of the Republicans when he's given himself the power to order them killed pretty much at whim?

You seriously think that Obama is going to run around killing political rivals? You actually think that is an even remotely plausible application of any recently passed law?

We're talking about what is politically feasible for Obama to do, and you're raving about Obama being Emperor Palpatine and sending Darth Vader out to kill anyone who pisses him off. Seriously, give your head a shake.

[Broomstick]

You’re ignoring the fact that a lot of the voters have no problem with the extra-judicial killing of what are perceived to be “traitor” citizens. Really, hardly a peep against that here in the US, with most folks either ignoring it happened or approving.

I was under the impression it was like most other political issues; a small but roughly equal number of people on opposite sides of the debate making a lot of noise while a majority don't care one way or the other.

And you missed my central assertion. How can Obama be that scared of the Republicans when he's given himself the power to order them killed pretty much at whim? I don't see why he has the moral right to do it to some radical imam on the other side of the world, but not to some nutcase spouting off about "2nd Amendment solutions".

"Political opponent" does NOT equal "traitor", at least not here and now. Seriously, Mike got this one covered.

Notable is that despite the urging of both his wife and a doctor he continued to refuse to go to an ER, repeating “I can't pay for it”. There really is an American meme that if you can't pay for a doctor you don't have a right to go to one, even if your life is potentially in danger. This is what I mean by a sharp cultural divide between the US and a lot of other countries.

You're sure that's him feeling he's not entitled to medical treatment, as opposed to merely fearing the consequences of incurring a huge medical bill he can't afford to pay? I mean, if I were in his position, I'd take the view that my wife would miss me a lot less than she'd miss a roof over our heads and food on the table.

Yeah, reasonably sure. I haven't spoken to the guy personally, of course, but between my knowledge of the region he comes from (Tennesee, where I do have in-laws) and his focus on the money angle it strikes me as a definite possibility.

Remember, I've been uninsured in the US and I have sought medical care for both me and mine. It IS possible to negotiate and there are programs for the the low income folks out there. They sort of suck, but not as badly as not getting the help you need. Ten years is a long time to deal with a hernia and never see a doctor about it, even by US standards.

Let's also put that $20k into perspective. That's less than what many people will spend on a new car or truck. Hospitals will let you make payment arrangements. It's certainly possible to get financing for medical procedures. You don't have to pay the bill in one lump sum. $20,000 over 5 years works out to about $334 a month, and if you can negotiate that amount with the hospital rather than borrowing you won't even have to pay interest. If you can get them to stretch over 10 years (possible - my spouse did that to pay off surgery that saved his right leg from amputation) that's $167 a month. What his wife said about "they can't take our house away because of an unpaid medical bill" is true - they can't. Assuming such surgery goes well (and odds are it would) he would be able to go back to work and continue to earn money. Failure to pay the medical bill might leave their credit completely trashed but it won't take away the house or the food on the table (being completely unable to work might, though, but that's a risk he faces now if some complication to his hernia occurs).

On top of that - as a "self-pay" patient, or an uninsured person paying on my own, I have managed to negotiate a 40% reduction in fees on my own. One thing that marks me as someone brought up in the middle class is that I act as though I have just as much right to negotiate such deals as a wealthy person. Those raised poor all too often either don't think they can do this, or it never occurs to them.

Bottom line - there are ways to get a hernia surgery paid for in the US even if you're not insured. People who think they are entitled to seek medical care do attempt to find a way to pay for it. This gentleman apparently has not. Therefore, I suspect part of the problem here is that he feels that if he can't pay for it he doesn't deserve to have it.

[Zaune]

You seriously think that Obama is going to run around killing political rivals? You actually think that is an even remotely plausible application of any recently passed law?

We're talking about what is politically feasible for Obama to do, and you're raving about Obama being Emperor Palpatine and sending Darth Vader out to kill anyone who pisses him off. Seriously, give your head a shake.

Yeah, sorry, fair point. That was bitterness (and caffeine deprivation) talking there. But it does frustrate and depress me that so much could have been achieved but wasn't because Obama let himself and his party be intimidated. The Republicans threatened to make things worse if he tried to make things any better, and he folded.

I thought that was the right thing to do at the time, not least because I think there's a better-than-even chance that the Teabaggers really will go out and start another War of Southern Aggression if pushed too far. But I'd seriously underestimated just how bad the status quo was back then.

[RIPP_n_WIPE]

On top of that - as a "self-pay" patient, or an uninsured person paying on my own, I have managed to negotiate a 40% reduction in fees on my own. One thing that marks me as someone brought up in the middle class is that I act as though I have just as much right to negotiate such deals as a wealthy person. Those raised poor all too often either don't think they can do this, or it never occurs to them.

This is very very very true. I didn't even realize it myself until I started having to pay bills. Poor people and those who are even successful but raised poor do not have often times financial education since you're used to money coming in and someone taking it. There's a very low sense of financial self esteem where your money is YOURS and not something that you receive only to give to someone else.

[Chirios]

Let's also put that $20k into perspective. That's less than what many people will spend on a new car or truck. Hospitals will let you make payment arrangements. It's certainly possible to get financing for medical procedures. You don't have to pay the bill in one lump sum. $20,000 over 5 years works out to about $334 a month, and if you can negotiate that amount with the hospital rather than borrowing you won't even have to pay interest. If you can get them to stretch over 10 years (possible - my spouse did that to pay off surgery that saved his right leg from amputation) that's $167 a month. What his wife said about "they can't take our house away because of an unpaid medical bill" is true - they can't. Assuming such surgery goes well (and odds are it would) he would be able to go back to work and continue to earn money. Failure to pay the medical bill might leave their credit completely trashed but it won't take away the house or the food on the table (being completely unable to work might, though, but that's a risk he faces now if some complication to his hernia occurs).

Would the 200 bucks a month be considered a lot of money to someone working his job?