More seriously, I'm not the final say on these talking points. Anyone who has participated in a sales meeting will tell you that these meetings are dynamic. Many times the person with the least seniority has a great new way to explain a concept. So, give me what ya got!

I picked five of the objections that I hear most often when it comes to opposition to health care reform, Universal Health Care and Single-Payer Insurance. I put links into the peer reviewed sources for the information in my responses, but usually in everyday conversation, people don't challenge your sources. Unless you work at a school like I do, where, yes, I can also say where I found the factoid du jour; in that case that information is there for you too.

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The government screws up everything!

Offer: It's easy to say that, but;

The National Weather Service (NOAA) does an incredibly good job tracking hurricanes and telling us with good accuracy the wind speed, track cone and likely level of destruction.

The National Park Service does a good job in preserving our wild spaces. (I'm sure a lot of environmentalists would disagree with this, but you are likely to be arguing with Republicans who won't.)

Our Libraries do an incredible job with the shrinking budgets allocated to them. Their librarians are unsung heros in my town.

The National Archive tracks, maintains, files and can produce on demand a myriad of documents on demand.

I don't have any complaints with the water, sewer or garbage collection services my city provides and they stepped up their recycling programs without prodding in my community.

My fire department has a great response time, is well trained and performs well.

911 service for the number of calls they take, they are incredibly able to route and respond to these calls correctly. Yes, there are occasional tragedies, but thankfully they are rare.

The US interstate road system is 65,000 miles of interstate roads regularly maintained. Yes, there are problems; but thankfully few. We could live in Iraq. I'm sure they'd be fine with our roads if they could have them.

Animal control offers adoption services, low cost spaying and neutering as well as traditional collection services.

Torture and a few other issues aside, the U.S. military is actually pretty good considering what BushCo has asked them to do over the last 5 years. (Again, you are more likely to use this one on Republicans where it will work. Do NOT use this argument on a Libertarian, Progressive or Anarchist.)

Leave this one for last:

Tricare - a government insurance that has a high level of participant satisfaction. Medicare beneficiaries report greater satisfaction than people in employer sponsored plans and their satisfaction doesn't vary with regional spending differences.

So, no, I'm not afraid the government will totally screw up health insurance. They're more likely to improve it.

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That's Socialized Medicine!

I've always found this one more than a little annoying and if you do too, you'll need to practice saying it so you don't say it through clinched teeth or sound like a parrot because you memorized it.

We have socialized fire departments, police departments, water, sewer, libraries and education. We wouldn't know where to begin if we didn't have these government services offered to us.

About 60%* of the $2.3+ trillion dollars spent on health care in the U.S. every year already comes from tax dollars. 22.1% of all U.S. collected tax dollars is spent on health care initiatives like Medicare, Medicaid and SCHIP. An undisclosed amount is spent on Tricare from the military's budget and all the other government agencies also keep their own health care budgets. There is no one pot in the U.S. budget for health care programs - there's about 500 pots to tally up. Tax dollars fund Medicare, Medicaid, Tricare, SCHIP, Worker's Comp, Veterans programs and FECA Black Lung as well as pay for the benefits for government workers. It seems to me that the only people who don't get the medical benefits of these programs are the working people who pay for them.

Social Security is a social program that thankfully wasn't privatized like George Bush wanted to do 2 years ago. If he had succeeded, our bailout would be more like $16 trillion dollars which is a case in point that not all socialized programs are bad.

Obama's Health Care Exchange is more comparable to the U.S. Postal Service. The post office is socialized to provide a steady important service, but there are many profitable private companies providing package services and courier services. Which also tend to keep the post office somewhat competitive and the private companies from price gouging.

UPDATE

U.S employers who provide health care for their employees compete globally with international companies that don't have these expenses due to their countries having a Universal Health Care System that isn't employer dependent. Moving health care onto a "socialized" model will improve our global competitivness.

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Universal Care is Second Rate Care. You have limited choice in doctors and long waiting lists for specialized care. And I don't want to deal with rationed care.

This is really all one objection. I don't want any obstacles in my way when I'm getting health care. Yep, it's all about me, me, me!

Our current health care system is second rate. It's a general assessment from many peer reviewed sources. The U.S. health care system is expensive, inefficient and doesn't serve the U.S. population very well. We have the second worst newborn death rate. In fact, the U.S. is pretty far down the list on any health care indicator you wish to choose. The countires with higher life expectancies and lower infant mortality rates and better rates on just about everything else are countries with a first rate, progressive health care systems.

Our current government plans, Medicare and Tricare, have a great deal of customer satisfaction. Many people who have these insurances are very pleased with what they receive in the way of care and their choice of doctors and facilities. Medicare patients and Tricare patients don't complain about waiting lists lasting longer than a month for normal care. Medicare and Tricare enrollees are an indication of the quality healthcare system the U.S. can develop.

We already have waiting lists in this country for care. If you have the money and can pay in advance for care, you go first. If you don't have the cash and use your insurance and you have stingy insurance, you will go when there isn't anybody more profitable ahead of you. The waiting lists are heavily weighted along ethinicity and those in poverty. Medicaid and HMO patients often deal with long waiting lists while Medicare and Tricare don't. There is no way the U.S. will stand for "Medicaid for all" we want a progressive and functional Universal Health Care System.

The U.S. currently rations care based on your ability to pay for your care or your ability to get a third party to pay for your care. Your prognosis has nothing to do with our current health care rationing system. If you are terminally ill, but have the ability to pay, you will get care. If you are acutely ill and have a prognosis of a full recovery, but no ability to pay for your care; you won't get it until you are hours away from death under how EMTALA is interpreted today. Currently, if your provider can't get you into the hospital for a procedure they will tell you the physician or surgeon is booked, but if that same surgeon is offered a patient who is willing to pay cash in advance; I guarantee you an opening will be found.

If you look at the Commonwealth Fund's studies and WHO's studies and Kaiser Family Foundation studies that compare the U.S. health care quality with other nations, you'll see the U.S. has lower ratings on multiple quality of care measures.

There are multiple studies done by peer reviewed organizations that show people in the U.S. are ready for a Universal Health Care system and that they are not afraid of a Single-Payer system. Those same studies show the average person in the U.S. is very disatisfied with the status quo.

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Yeah, but how can we afford it? We can't make health care "free"!

There's several approaches to this one. It's important to get the finance better understood.

We are already financing the full $2.3 trillion dollars and getting a lousy ROI as our system doesn't include nearly 16% of our population. We can rearrange the dollars we are already paying, get everyone under the umbrella, improve access to health care which, in turn, will improve our national patient outcome statistics. Changing up how we structure health care delivery will drastically improve our ROI in health care dollars invested into our society.

We're already nearly financing Universal Health Care in the U.S. People think the entire $2.3 trillion annual cost will be added to the U.S. budget in one year, but the U.S. taxpayer already pays 60%* of that $2.3 trillion. You'll never find that figure in a single line item. You have to go through the U.S. budget picking up the lines for health care in every department (the U.S. armed forces, EPA, CIA, FDA, FBI, ATF, Congress and so on). You have to add all those items up and add it to the single line item for Medicare, Medicaid and SCHIP and that's just for the feds. You then need to figure out how much the states and local governments pay toward health care with your property and sales tax dollars and add that in. You'll be amazed at the final figure. The other 40%? That's already paid out by you and me in cost sharing in our premium contributions, deductibles, excluded services and co-pays.

No one really believes health care will be "free" for everyone in every circumstance. We know it will be funded with taxes, premiums, deductibles and co-pays. What we want is to replace our current regressive health care system with a progressive system where health care will be more accessible to those who need it most.

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The uninsured isn't that big a problem.

Any health care system that excludes nearly 16% (47mil/300mil)of it's population from it is regressive and uncivilized. The unisured aren't stereotypical. They are young, disabled waiting for Medicare, workers who can't afford the premiums and many are latino. Even if uninsured only went without insurance for a few months in the year, people tend to be nervous about using a new insurance policy. Plus, if there are gaps in the policy dates, there are the preexisting condition issues. The uninsured are a problem. It's a moral problem and the U.S. is not dealing with it in an ethical, moral way.

The numbers of uninsured have increased from 40 million in 2000 to about 47 million in 2005 and it's held at that level for 3 years. Much of this increase is from employers cutting back on coverage and benefits in response to rising costs and adverse economic circumstances. There is further evidence that this trend is increasing pushing more and more working people off their employer provided insurance to "going bare". Eventually this problem will get bigger and bigger until only highly paid employees will be able to buy the insurance offered to their workers.

The uninsured have a greater chance of going without care and then run up a big bill once they get on some insurance like Medicare that doesn't have issues with preexisting conditions. They also are a source of uncompensated care for many providers. Some uninsured are young and healthy and don't need care, but those who are designated as disabled, but ineligible for Medicare do need care. These are the people who only get care when they are in a crisis and then the provider often doesn't get paid.

And some of these uninsured are children between the cracks of SCHIP and well compensated parents. The number of uninsured children grew by one million between 2004-2006. Many of those that have employer insurance currently only cover themselves. You usually have to pay extra to cover the rest of the family. Not that children get as sick as adults but they have no ability to trade up parents like you can at least try to change your job.

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*The 60% figure is hard to track down. It takes work on your part and it helps to have spreadsheet software available when you do the calculations. Some people say it's 50% and AHRQ has said it's 45%. I'm OK with all of these figures because they change with the date, year and cohort included in the calculations; but to the uninitiated it looks like everybody's a liar. The first statement my statistical professor said to us is true. When you look at a stat, identify exactly what the statistician is talking about before you accept it. The point I make about funding Universal Health Care remains the same, a huge chunk of health care is already paid for with tax dollars. Whichever figure you use is fine as long as you understand the basis of the stat.

Page 26-29 id'd page number (or 45-48 using Adobe's page numbers) of this CDC publication shows per capita and total health care expecditures and near that page is the table with out-of-pocket expenditures. In general, these pages refer to the year 2003. This AHRQ table is for 2005. Here's another look at 2005. Then, the CMS chimes in with these figures for 2006. Then if you have time you can wade through this batch of tables. What should strike you is that these tables all come from the government, but different agencies and the numbers are similar, but not spot on. That doesn't mean these figures are meaningless, it means they are within an acceptable statistical varience.

Another issue with the government figures is that they seem to be inconsistent with including health insurance premium payments into health care costs. I can't prove that, because since BushCo has moved in, any table that would have proved that case seems to have been purged from the census, CDC, CMS and AHRQ sites. I think the data is still there, but hard to recognize. This is one area where I believe Obama as President will have some impact. I think he'll direct the agencies to stop deleting uncomfortable facts and report them without the subterfuge.

Then occasionally you run across something like this and have a WTF moment. It takes a while to determine these figures came from the UN and WHO on a 2007 document. I try not to use a source like this in my diaries and work my way back to the original source (look at the page labels 247, adobe page number = 19; the U.S. is number 12 on this table).

Finally, some of you might be starting to understand why sometimes there's a week between my diaries. Slogging through this stuff takes time. It also points out why the talking heads often get it wrong. Verifying the statisical source and pouring through this stuff isn't a "quick and dirty" endeavor.