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global reach

"Forever the King," from the newspaper "Hoy (Today)," Dominican Republic (via Huffington Post)

Global Pop: Finding Michael Jackson in Albania

Here's a small Michael Jackson story to place upon on the pile, one that illustrates the global reach and power of pop music.

Albania existed in totalitarian isolation from the rest of Europe for four decades. It broke with the Soviet Union during Kruschev's de-Stalinization reforms because its dictator, Enver Hoxha, liked Stalinism. Its only ally from that point forward was Maoist China, but even that relationship was severed after the fall of the Gang of Four and the death of Mao. It was illegal to even own a car there.

Like North Korea today, Albani was a closed country that allowed almost no foreigners in and let even fewer citizens out. Even listening to foreign media broadcasts was a crime. I arrived there in 1991 as one of the first wave of outside consultants sent there to help with reforms. People had already made improvised "cars" by welding windows onto the fronts of tractors. Saudi Arabian Wahhabi evangelists had already installed a loudspeaker and a muezzin at the local mosque, which had been unused for forty years. Although the government sent me to help with health care financing, it quickly became clear that they needed food and medical supplies far more urgently than they needed economic restructuring.

My host and translator was a warm and gracious physician who had learned his English by covertly listening to the BBC. He had been turned in once by a neighbor who heard the sound of English-language radio, and had spent a terrified day at secret police headquarters before being set free with a warning. The day I left for home I asked him what I could send him as a gift.

"Connie Francis records," he said. (Connie Francis, for those of you who don't remember, was a star from the pre-Beatles era whose big hits were "Lipstick On Your Collar" and "Where the Boys Are." )

Pop music's traces were faintly discernable elsewhere in the garrison country, too. When we walked into Tirana's only 'restaurant' - a barely-converted garage filled with card tables, folding chairs, and aid workers from everywhere in the world - Garth Brooks' voice was coming out of a boom box. And at a high-level diplomatic meeting some Albanians spoke of their country's best-known folk singer, saying that public use of English was so heavily forbidden that he had been given two years in prison for singing "Let It Be" at a folk festival.

"The last guy I heard singing it back home," I told them, "should have gotten five." They laughed - fortunately.

And when we went to see some remote medical clinics in the Sar Mountains, our car was stopped in remote villages by crowds curious to see a Westerner face-to-face. On one rock-filled road we were waved down by a gang of slightly-scary teenagers with dirty faces and rocks in their hands. When they saw me, the tallest boy - evidently the leader - reached into his pocket, pulled out a single glove, and put it on.   He tossed back the lock of hair that fell across his forehead, in a gesture common to tough kids everywhere.  There was a moment of silence.  Then ...

"Michael Jackson!" they screamed. "Michael Jackson!" The doctor translated for me as they kept talking. "They want to know if you know Michael," he said. I didn't. They let us pass.

I won't claim that Michael Jackson overthrew Albanian Communism. He never met Enver Hoxha in epic battle, although that picture on the cover of the History album made it look as if he had. I was in Prague when Vaclav Havel tried to make Frank Zappa a minister in his government, but I wouldn't say pop music overthrew Communism there, either. I'll say this, though: it didn't hurt.

Was Michael Jackson the first global pop star? Crowds in India mourned the death of country crooner Jim Reeves in 1964. And it took me a while to realize that the singer on an old African record called "Chimiraja," accompanied only by a loosely tuned guitar and someone banging on a Coke bottle, was actually singing about "Jimmie Rodgers," the "Singing Brakeman" of country music.

Jimmie Rodgers died in 1933.

Popular music has always been global. But Michael Jackson became a worldwide star in the first era to have satellite communications. People didn't just hear his music. They saw him. They experienced him - or at least an aspect of him. Michael Jackson broke barriers of race, language, and nationality. His private behavior had a strong impact on some people. But his music reached billions, and it did some good in the world.

In whatever court he may yet face, even if it's only the court of public opinion, surely that counts for something.

Iran: It's Not About You, People

Some Westerners have been driving themselves into a narcissistic frenzy over events in Iran, blind to the contradictions in their own behavior.  John McCain's outrage over the tragic death of "Neda,"  a young woman who might have died under  American bombs in his alternate reality, is merely one case in point.  Suddenly the "clash of civilizations" crowd is finding new enthusiasm for an Islamist political party.

The President's remarks today went as far as they could wisely go, but the opportunists and fantasists will both say it wasn't enough.

Why are the people who've been insisting there's a monolithic evil called "Islamofascism" suddenly backing one Iranian faction over another? As Prime Minister in the early days of the Islamic Republic , Mir-Hossein Mousavi helped orchestrate anti-American acts in Lebanon. Yet the crowd that's been demonizing the entire Muslim world is suddenly wearing green, which was adopted by Mousavi's party because it is the color of Islam. What's behind this seeming change of heart?

The behavior of pols like Lindsay Graham comes off as political expediency of the most cynical kind. They exploit American support for the brave demonstrators of Teheran by insisting the President isn't doing enough, knowing full well that to express more support than he has done would be counterproductive. It's the unattractive face of politics as usual.

For others, like McCain, it seems more genuine but no less misguided. He perceives no inconsistency as he careens from "bomb Iran" 'jokes' to eulogies for those he might have bombed. He, like many Americans, is caught up in the emotions of the moment. And who can fail to be moved by the courage of the Iranian resistance? But let's not pretend that this moment is about us.

For some of us, people only become human and real when they give us an opportunity to play out our own ambitions or fantasies. That covers public figures like McCain. But it also includes bloggers who think they're commando superheroes because they're coloring their websites green and cut-and-pasting Tweets from Teheran.

To the virtual barricades, comrades!

That's exactly the kind of fantasy projection that allowed people to enthusiastically support an invasion of Iraq, against all reason. At last! A war of our own! A cause we can support, a flag we can wave, a battle that will make us the "greatest generation"!

But we're dealing with human beings, not figurines to be moved here and there on the maps of our own egos. Overzealous talk from narcissistic foreigners can get people killed. And Americans aren't the only offenders. Bernard-Henri Lévy's unsubstantiated assertion that this uprising is the "end of the Islamic republic" is equally irresponsible, playing directly into Ahmadinejad's hands by equating dissent with subversion. He may or may not be right about the outcome. Neither he nor anyone else can know right now. But either way, the Iranian people aren't helped by these sorts of grandiose pronouncements from the West.

There are several possible outcomes. Ahmadinejad and Khamenei could prevail. Or Moussavi and Rafsanjani could win out, thereby saving the Islamic Republic. Or this could be the beginning of a newly democratized Iran, with Mossavi as its Gorbachev figure.

Want to help the people of Iran reach that third outcome? Then why not start by seeing them as they are? They're people who adopted a very centrist candidate as the symbol, rather than the reality, of change. (Did I just hear some progressives mutter "that sounds familiar"? Now, now ...) In supporting a more moderate candidate they've been given a chance, but just a chance, to transform their country. Let's hope that history is with them.

Whatever the outcome, however, this is their battle. We can support the Iranian people and the principles of democracy without becoming partisans in an internal political struggle. That's a less melodramatic stance, and perhaps a less emotionally satisfying one. But it's wiser.

As much as we might like to wear green and dream that we and not they are on the front lines of history, that doesn't help anybody. Their movement is brave and important and real. But it's their movement, not ours. This is not our feel-good moment. Our play-acting is, in the end, a selfish act.

We all need to look in the mirror and remind ourselves: This isn't about you.

"Human Events": The Right's Superstars and the Great Gun Giveaway

Human Events is one of the oldest and most establishing conservative journals in the country. Newt Gingrich is a regular contributor. So are Pat Buchanan, Chuck Norris, and a number of the Right's other luminaries. In today's violence-laden atmosphere, why are they letting their work be used to promote gun giveaways and implied calls to vigilante acts?

As the incidents of right-wing gun violence mount up - murdered Unitarians in Knoxville, cops shot dead in Pittsburgh, a doctor gunned down in Kansas - the magazine continues to distribute email ads for "free guns" offered by a "millionaire patriot" who "wants YOU armed and trained ... for what's coming."

"3,000 Handguns Almost Gone!" the latest ad reads. We're told that "Dr. Ignatius Piazza" - the reputed millionaire - "Pays His Own Money So YOU Get a Free Handgun Plus 5 Days of Training and a 30 State Concealed Weapons Permit for Pennies-on-the-Dollar!"

Email ads from Human Events are usually of the less lurid variety, like "The Ultimate Man Knows the Three Basic Baseball Pitches. Do You?" (I pitched a pretty mean slider back in the day myself.) There are quite a few quack medicine cures: "If your joints still hurt, read this now." "The 7 Great Diabetes Lies." "The Ultimate Man Knows Ben Franklin's 13 Rules of Improvement."

Then there's my personal favorite: "The Ultimate Man Knows How to Fight Off an Alligator: Do You?"

But the spiritual stepsisters of Dr. Piazza's ads are the editorial emails from Human Events or its political bedfellows and advertisers, messages that distort Democratic positions, suggest the presence of a religious war in our country, and question the legitimacy of the U.S. government itself:

- "Obama Do Not Need No Stinking Birth Certificate"
- "Is Obama Right? 'We're No Longer a Christian Nation'"
- "Judiciary Promotes Obama's Anti-Jesus, Pro-Allah Judge"
- "Chuck Norris: 'Got Your Permit to Study the Bible?'"
- "Why Aren't Scientists Allowed to Believe in God?"
- "Sen. Harry Reid: 'Punish Pastors, Protect Pedophiles'"

That latest piece, by Navy Pastor George Klingenschmitt, says "quoting the Bible in church will be punished" and "pastors will not be protected by the First Amendment." It calls the Matthew Shepard Hate Crimes Act the "Protect Pedophiles Act" and says that it would require U.S. Marshals to "protect 547 acts of sexual deviance," including pedophilia, necrophilia, zoophilia, coprophilia, and "fronteurism" (defined as "a man rubbing against a unknown woman's buttocks"). Besides being flatly dishonest (and from a pastor, no less!), it's a highly inflammatory work designed to convince readers that the full force of the U.S. Government will soon be put to use enforcing unwanted sexual invasions of children, strangers, and animals.

Is that much of a stretch to suggest that, having stated the extreme emergencies we now face, Human Events is also inviting Dr. Ignatius Piazza to help us fight back ... by any means necessary? We "want YOU armed and trained ... for what's coming ..."

It's possible that the entire Piazza ad campaign is a come-on, of course. Links direct you to "The Frontsight Institute," where I suspect that a slick cash-extrication scheme is soon presented to gullible gun seekers. But either way, this is a dangerous and highly violent pitch.

Human Events does include its usual advertising disclaimer with the gun ads. This standard language reads in part: "From time to time, we receive opportunities we believe you as a valued customer may want to know about. Please note that the following message does not necessarily reflect the editorial positions of Human Events." But what would have happened if, say, The Nation had started running "gun giveaway" ads immediately after George W. Bush became President?

I subscribed to the Human Events mailing list to understand what the mainstream Right is thinking, not to write an exposé . I've engaged in friendly email exchanges with its contributors in the past. I respect Newt Gingrich's work on healthcare, even though I disagree with most of his conclusions. (I also met Chuck Norris many years ago, when I was working at Francis Coppola's post-production studio. He was the only celebrity who ever came by the kitchen and thanked the workers for their help. Nice guy ...)

I miss the days when we could engage with civilized conservatism. These ads from Human Events seem to reflect in microcosm the descent of the entire conservative movement into lurid extremism tinged with incipient violence. Forgive the cussin', but what the hell is happening over there on the Right? Why aren't Gingrich, Norris, and Buchanan saying this is not the movement we want, that they refuse to be associated with smears, lies, and implicit violence? Here's a question for those three individuals, and for the editors of Human Events:

"The Ultimate American knows how to lead a high-minded opposition. Do you?"

Could Doctors Go the Way of Record Companies?

Those of us who follow health care may be overlooking the big picture. Most of the profound (and sometimes disruptive) changes of the last half century -- computers, the Internet, social networks -- weren't initiated by the political process. They arose at the intersection of technology, economics, and mass social change. So here's something to think about:

Could the medical profession go the way of the record industry?

Consider the path that led to the current crisis in the music business:

1. An industry with a near-total monopoly experiences a minor disruption (in music's case, with the invention of cassette tape recording).

2. It 'relaxes' and assumes the crisis has past.

3. An even better technology comes along (the Internet) that includes lateral as well as vertical connections. (Individuals could only make tapes for themselves; sharing was possible but cumbersome, until the Net and mp3s made it instantaneous and worldwide.)

4. The industry fails to recognize the long-term significance and risks of this new tech.

5. Enterprising individuals use this new technology to distribute "information" of mutual interest - songs - through "P2P" (peer-to-peer) file sharing.

The result? A massive and ongoing implosion of the music biz. (David Byrne provided an excellent overview in Wired, with some corrections on his blog.)

Could the same thing happen to the medical profession? Many people's immediate reaction will be to say 'no.' They'll list the many barriers to what we might call a 'P2PMed' disruption of our medical economy (with 'P2P' here meaning either 'peer-to-peer' or 'patient to patient'.) Doctors are too respected. Regulations won't permit it. Doctors control access to medications. Medical information is walled off behind expensive, subscription-only medical journals. It's unthinkable.

That's pretty much how the record industry reacted in the 1990s. Let's look at those objections:

160 million people looked up medical information on the Internet circa 2007, according to Harris polling data. Yet they still go to doctors. That's true -- just as millions of people made tape copies of music for decades without seriously undermining musical economics.

Each of these searches was a solitary activity. The difference will come when a new technology allows lateral information-sharing in a way that people trust. It hasn't happened yet, but smart people are banking on the idea that it will soon. I agree with that assessment, although none of the many projects I've looked at so far struck me as a breakthrough. But a lot of folks are working on it.

Doctors monopolize access to medications through the power of the prescription pad. That monopoly's already eroding as online pharmacies provide low-cost 'doctor consults,' a legal work-around that allows -- to an sometimes disturbing extent -- easy access to meds. Where there is demand, there will be suppliers.

People won't spend money based on self-referral. The multi-billion dollar complementary medicine industry demonstrates this is untrue. Most "CAM" (complementary and alternative medicine) transactions are based on self-referral out of the traditional MD/patient relationship.

Medical information is walled off. True, but a backlash against the sequestering of research data is already underway. Case in point: A new publication called The Journal of Participatory Medicine hopes to provide peer-reviewed articles on self care for patients, as board member Kevin Kelly writes.

The Journal's Advisory Board reads like a Who's Who of Internet and medical business pioneers (and it's an open-source publication, meaning its content will be free to all). The Journal goal of helping patients take "responsibility for their own health and healing" (in Kevin Kelly's words) aligns with decades of movement toward a more patient-centric model championed by both the Left (as "patient's rights") and the Right (as with high-deductible "consumer-directed health plans").

Once again, the left/right paradigm is ill-suited for new developments... and don't blame initiatives like the Journal if medicine goes the way of record labels. They're symptoms of broader socio-informational change, not its cause.

Not all doctors would go out of business after such a transition, of course. They're still selling some CDs, too. So who would be most likely to thrive after the transformation?

High-touch practitioners: Empathetic, comforting, and warm doctors.

"Mechanics": The most gifted and accomplished surgeons sometimes use this word to describe themselves. We will need talented neurosurgeons, cardiac surgeons, and other "fixers" for the foreseeable future (at least until the self-programmable nanobots take over).

Innovators: Doctors who are always exploring, changing, and trying new things, staying one step ahead of the curve.

Integrators: Doctors who can bring together seemingly unrelated ideas and solutions, whether in diagnosis or in treatment. Integration is the foundation of creativity, and creative doctors will always be valued.

Who'll fail? Doctors who function by rote, who make routine diagnoses, and who connect patients to other resources based on past relationships and not need. Anyone whose expertise and connections are easily replicated on the Internet (think "travel agents") will struggle to survive.

Watching the AMA defends its turf on issues like doctor reimbursement is like watching the RIAA file copyright lawsuits against teenagers, even as its business model collapses around it. You can't fight your own market and win, and you can't fight yesterday's battles. Doctor groups should look more like think tanks and less like a lobbying groups. (Come to think of it, so should the RIAA.)

Predicting this kind of change is not the same thing as endorsing it. But, like it or not, we should be talking about it now.

Because -- like it or not -- it's coming.

Antisemitism vs. Reasonable Opposition to Israeli Policy

Posts like this one from Lincoln Mitchell tend to be ineffective at best, in my opinion, when they suggest there's a problem with progressive anti-Semitism and don't provide specifics. 

His post suggests that there is a "constant drumbeat" of bigoted remarks "in the comment section of ... 'progressive' websites."  The implication is that lefty blogs are overrun with commenters who are saying there's " a Jewish cabal driving American foreign policy" (to use his words.)

He adds:  "The notion that one can be critical of Israeli policy without being anti-Semitic is, of course, true. Many, if not most, American Jews are critical of various aspects of Israeli policy while being far from anti-Semitic."

Fair enough.  The problem is that he doesn't provide any examples of fair or bigoted speech.  Which comments are reasonable criticisms of Israeli policy, and which does he feel cross the line?  He doesn't say.  The end result is another post whose overall point is unclear.  Does he think progressive anti-Semitism is a real concern, or is he just offended by a few ugly comments?

It's hard for the reader to know.  I've certainly read an occasional anti-Semitic-sounding comment that set my teeth on edge.  I've found them to be pretty rare - more like a stray rim shot here and there than a "constant drumbeat."  But I don't read everything and of course I could be wrong.

There are those who hope to suppress open debate with charges of anti-Semitism.  If Lincoln Mitchell does not want to be counted among them  - and I don't think that's his intent - then he needs to 1) link to posts that he feels contain such comments, and 2) identify those that he feels are anti-Semitic.  That permits the reader to judge for her- or himself, and avoids the risk of tainting an entire online community (progressive, in this case) with unfair suggestions of bigotry.  It might even help some commenters learn that their speech can be hurtful.

Specifics, please.  Let's not tar everyone with the behavior of a few.

Health Reform: Ideas At Work vs. Self-Negating Arguments

The opposition to a public health plan option seems to be imploding, victimized by logic which looks something like this:

1. A public health plan will be a nightmare. You won't get the doctor you want. Waiting times will be horrendous. Government pencil-pushers will stand between you and your physician while political hacks decide what treatment you'll get. Everybody will hate it.

2. Public health care will have an "unfair advantage" on price. It will then drive private insurers out of business because it will be so popular that everybody will join it.

What's wrong with this picture?

These self-negating arguments¹ aren't displaying much faith - either in free markets, or in the imagination of people working within the current system. Speaking of which ...

There's a very interesting new proposal from "Health CEOs For Health Reform," a project of the Health Policy Program at the New America Foundation. The "Health CEOs" come from a diverse set of healthcare companies, and their proposal focuses heavily on - in their press release's words - " quality, efficiency, care coordination, and patient-centeredness." The proposal itself emphasizes a radical shift away from today's fee-for-service model, favoring total case care, accountability for outcomes, and new payment models for chronic care. Many of these ideas have been around for a long time, but the proposal seems to go further in some of its global recommendations.²

Yesterday Sen. Kent Conrad announced a new alternative to the public plan option: non-profit health cooperatives. I would argue with Sen. Conrad's timing. We don't need a milder alternative to the public option, since momentum for it seems to be building . And independent cooperatives would not have the research, development, or innovation capabilities that a public plan could muster. This is not the moment to undercut the public plan idea with another fragmented program. That said, Sen. Conrad's "chartered cooperative" alternative could enrich the set of choices reform can offer, even if it's not a substitute for the public plan.

We already have operational health plan cooperatives and other nonprofit groups throughout the country. Some of them incorporate elements that relate to the "Health CEO" proposal, and surveys usually show that their members are very satisfied with the care they provide. The presence of a public plan option doesn't preclude all sorts of imaginative initiatives from the private and nonprofit sectors. It should encourage them, in fact, germinating new financial and medical models that help them thrive.

It's particularly disappointing to see someone like Sen. Charles Grassley echo the opposition's self-contradicting arguments. Grassley's a Republican who's often been willing to reach across the aisle on health care. His hearings on corruption in medical research have been both courageous and profoundly important. It's time for Sen. Grassley and others to either frame a more defensible and coherent opposition to the public plan option, or step down and let it be enacted.

Why not create a health system that taps into all of our country's resources - government's tools, the private sector's energy, and the capabilities of our growing nonprofit/"social entrepreneurship" sector? After all, choice and competition are basic American principles.

Let's redesign our health system so that it encourages ideas that work. And how will we know what works? In our country's tried-and-true way: by letting the people decide.
_______________________

¹ I may be oversimplifying, but not by much. Opponents may say, for example, that their real concerns involve a long-term scenario where a public plan forces its opponents out of business and then turns dictatorial. But we don't make policy based on hypotheticals, especially extreme ones. Congress can always pass new laws if circumstances change. And private capital will always move in if there's a new marketing opportunity.

.²I should note that I need to study this just-released plan in greater detail, especially its recommendations for an overhaul of Medicare's reimbursement structure. And to be clear, the "CEO" plan is silent on the issue of a public plan option. I don't want to leave the impression that it took a position either way on that subject.

A Health Care Bailout For the Middle Class

It's on. The President's assuming direct ownership of the health debate. Draft bills are beginning to circulate on the Hill. Dozens of policy details are being debated. Universal coverage is one way to describe the objective, but here's one that might be better: We need a healthcare bailout for the middle class.

High-income Americans will make out fine, and public programs will be strengthened for lower-income groups. But medical illness caused nearly two-thirds of all bankruptcies, and most of these bankrupt debtors had medical insurance. That raises two questions:

1. What's the value of "universal coverage" if "coverage" isn't providing the financial security people need?

2. If we can rescue troubled banks, what are we doing to rescue families whose "toxic assets" consist of unpaid medical bills for urgently needed care?

It's a mistake to assume that health reform will inevitably ease the financial burden for financially imperiled households. Medical problems caused 62.1% of all bankruptcies in 2007. Three quarters of these bankrupt debtors had health insurance. And 92% of them had medical bills of at least $5000, or 10% of pretax family income.

"10% of pretax family income" is also the figure many health policy analysts say families should be prepared to spend for health care under a mandate. But for many people that was a burdensome figure even before the financial crisis. We can't assume that a policy forcing them to spend that much will be either effective or politically popular. Nevertheless, AP reports House Dems are floating the idea of "slapping an unspecified financial penalty on anyone who refuses to purchase affordable health insurance." That's what is known as an "individual mandate."

Insurance was originally designed to eliminate financial ruin for individuals by distributing costs among many people. Does it make sense to insist that people buy coverage that won't necessarily protect them from disaster?

Feelings run high about this issue among us health policy wonks. Most Democratic/liberal analysts insist that reform can't succeed unless all individuals are first mandated to obtain coverage. The idea's based on sound economics: If some people can opt out, the healthiest are most likely to do so. Then the system will be burdened with sicker enrollees, driving up costs and making it harder to achieve universal coverage.

That's why smart and knowledgeable people like Jonathan Cohn can imply, as he does here, that individual mandates are indistiguishable from "good public policy."

I understand the economics, but here's the concern: The underlying concept of "shared responsibility" is sound, but in other countries - and in Medicare - that responsibility is mainly shared through the progressive mechanism of taxation. Unless carefully designed, individual mandates run the risk of being overly punitive and politically explosive among middle-income Americans.

Consider Sen. Kennedy's new draft proposal. It offers more generous subsidies than other proposals, with a sliding scale of assistance that goes up to $110,000 in income for a family of four. But a lot can happen beneath and near that $110,000 mark, especially in these perilous times. Yearly premiums for family coverage reached $12,680 in 2008 and continue to climb. That's one reason why families struggling to make ends meet sometimes 'bet' that they won't have catastrophic medical costs. That may be a bad bet, but using the levers of government to force them to pay $8,000 to $13,000 in premiums alone might not be the best solution.

And the assumption that mandates are more politically liberal is just that: an assumption. Mandates could, in fact, be economically regressive. They could also give the GOP a hot-button issue for 2010 and 2012. Proposals like Jacob Hacker's, which limit out-of-pocket premium costs to $2,500, go a long way toward addressing those concerns. But they're also costlier from the government side, so they don't seem to be on the table right now (even if those costs could ultimately be offset by improved compliance).

What's the solution? At least one proposal that has been anathema to Democrats might help. The Democrats campaigned against McCain's plan to tax health benefits. But a health tax, like any other, can be either progressive or regressive. (There's a good discussion of the topic here.)

It's true that a tax on all workers receiving health benefits could be disastrous. And nobody's receiving overly luxurious benefits, despite what some partisans claim. As Merrill Goozner observes, there are no "Cadillac health plans" for employees, though that phrase is has become a buzzword. (And Cadillacs are made by GM, where a little help was also needed.)

Here's one possibility: a health benefits tax that kicks in at high income levels. That could conceivably pay for some Hacker-like caps on premiums. It would also have the added benefit of sensitizing corporate decision-makers to the true cost of medical care in this country. It might even motivate more of them to take a proactive stand on health issues.

There are a number of other possible ways to "bail out" the American middle class in health care, too:

1. Phase mandates in slowly, as overall health costs are reduced through other measures. (This one's unpopular with a number of analysts, but I think unfairly so. It's do-able.)
2. Emphasize the public plan option. (If you're going to lay a heavy cost burden on the middle class, it's a good idea to give them every choice you can.)
3. Develop innovative ways of helping consumers pay their health debts through easy-to-use financing tools at favorable interest rates.
4. Ensure than health benefits include appropriate caps on out-of-pocket costs.

Universal coverage without universal financial security would be a Pyrrhic victory. The President and Congress can ensure successful health reform by making sure that American families can receive the care they need at a price they can afford.

Free Speech and Responsibility: The Conversation With Ron Kuby

Note that I didn't use the words 'debate,' 'fight,' or 'argument.'  I enjoyed the conversation and think it's an important topic that deserves more scrutiny and discussion.  Here it is (it runs about 11 minutes in total):

Free Speech and Responsibility: The Mitch Albom Show

Here's a clip of my appearance with Mitch Albom discussing Bill O'Reilly and the murder of Dr. George Tiller:

Albom Eskow-0

The broadcast was yesterday (Wednesday).