Would Jesus Heal Someone in a High Risk Pool? The Theology of Health Care Reform

Like many people I know, I was quite dismayed by the House’s recent passage of the abominable American Health Care Act, which seems to most fundamentally be about giving the rich a giant tax cut with the horrific side effect of making access to health care far more difficult for poor Americans in particular. (Don’t miss Michael Austin’s thoughts on this at BCC.) This one hits close to home—I was one of those who was uninsurable prior to Obamacare, due to having had the audacity to get treated for depression. I still remember the rejection letter I got from a health insurance company telling me that if I could manage to be symptom-free for seven years, they would maybe reconsider. The delicate question of how I was supposed to achieve the enviable status of being symptom-free for seven years with no insurance to pay for treatment was of course not addressed. I remember asking around about what to do, and people telling me that I should have just lied on the application and not mentioned the mental health care I’d gotten, especially given that it was paid for out-of-pocket; no one will ever know, they said. But possibly more out of neurotic paranoia that I would get found out than commitment to honesty, that didn’t feel like a real option to me, so I made my way forward with no insurance. I was lucky in that I was young and physically healthy, and yet every time I thought something be wrong with me, I would be sick with anxiety that it would turn out to be something serious and I would have no way to pay for treatment.

(I know, I know; the Republicans are going to take care of people in my situation by setting up high risk pools. Yes, California had those at the time; I remember getting a letter about it after I was turned down for regular insurance. I don’t remember the details, except that the premiums were crazy high, and even if you could afford them it was difficult to get in, as enrollment was capped and you got put on a waiting list. I didn’t even bother applying. Forgive me if I’m not holding my breath for that to be the magical answer for people like me. )

A few years after I was turned down for insurance, I was struck by good fortune in the form of my grad school partnering with Kaiser to offer affordable insurance to its students. I’ve heard from people who both loved and hated Kaiser, but my experiences were largely positive—they gave me a lot of high quality mental health care in particular. But above all, just knowing that if I got really sick or something else happened to me, I could afford to get treatment, felt like an almost unimaginable luxury. I could breathe again. And after I graduated and couldn’t find a job, the implementation of Obamacare meant that having received all that mental health care (and being diagnosed with several disorders in the process) didn’t exclude from me from continuing to get health insurance.

In reading many, many debates about health care over the years, I’ve perhaps predictably found myself particularly struck by the underlying theological ideas that seem to shape people’s thinking. There are a couple of related themes which I’ve seen come up again and again:

1) Freedom as All-Important

Repealing Obamacare has been regularly framed by the GOP as a move toward greater freedom. To give just one example, a Representative from Texas explained that he was proud of his vote for the AHCA as a move toward “restoring health care freedom in America.” I’ve been trying to tease out just what conservatives mean when they use the term. As far as I can tell, the particular kind of freedom they are usually talking about is freedom in the sense of not being told what to do in the context of certain issues. Highest on the list, it seems, is the freedom to do what you want with your money; taxation is regularly described as an assault on personal liberty. In the context of health care specifically, I also see a lot of resentment of the Obamacare mandate, which required people to buy health insurance or pay a fine. This is regularly derided by conservatives as government interference with personal freedom. In this vein, I saw a Facebook comment from a person celebrating the recently passed bill because it would allow him to “keep living as a free man who can make my own decisions without a government making them for me whether I lose my job or not.”

I don’t deny that there is a real sense in which you have greater freedom if the government doesn’t take any of your money, and you aren’t required to buy health insurance. But this strikes me as a very narrow understanding of freedom, one which leaves a lot out. For one thing, what about the freedom to pursue life opportunities (such as, say, a better job)—a freedom which is sustained and strengthened by having access to good health care? Something like chronic illness can take a real toll on that kind of freedom—especially if treatment isn’t a possibility. If we’re going to take away health insurance from millions in the name of protecting personal freedom, I think we should at least acknowledge that many are in fact losing freedom in the process.

For part of my dissertation, I explored the way in which the term “freedom” has been used in the history of Christian theology. And an observation made by a couple of theologians that really stayed with me was that “freedom” in the contemporary world has come to mean fundamentally consumer freedom. Not freedom from sin, or freedom to follow God, or even freedom to develop your human potential—but freedom to choose which breakfast cereal to buy. This model is blatantly apparent in Paul Ryan’s infamous tweet on the subject: “Freedom is the ability to buy what you want to fit what you need.” My first thought on seeing that was something like, “oh Paul, you need to do more time in Catholic school and learn some of the rich theology of your own tradition, because Thomas Aquinas is rolling in his grave.” And of course, not only is this view of freedom deeply impoverished in its scope, it’s really only relevant for those affluent enough to buy what they want (if only the pesky government would quit interfering with their consumerist dreams.)

Latter-day Saints, of course, bring in their own narratives to this, sometimes pointing to the fact that the War in Heaven was fought over agency to assert that being required to help others (in the form of taxes) is nothing short of Satan’s plan. I find it telling, however, that when it comes to being “forced” to be moral citizens in other areas—for example, to pick something that maybe everyone can agree is a bad thing: drunk driving, which the government strongly discourages you from doing by imposing fines and jail time if you’re caught doing it—that restriction of freedom is generally seen in a positive light. (Even more bizarrely, I remember the argument going around during Prop 8 that the people who were pushing for greater freedom for gay people in the form of legal same-sex marriage were the ones advocating Satan’s plan.) Unless you are equating true freedom with total anarchy, I simply don’t think this idea that agency can be defined as the government not making any demands holds water. (I also dislike how framing the conversation this way pays more attention to the needs of the well-off to develop moral character through choosing to give than to the needs of the poor to have basic life necessities.) I think both the left and the right can be fairly accused of being out to legislate morality in some way; they just pick different issues.

2. Resistance to Grace

Many theologians have observed that one of the tensions in the Bible is between a worldview of exchange, in which people get what they deserve, are rewarded for their merits and condemned for their failures—and one of gift, in which what is offered by God isn’t attached to whether people have earned it. The former seems to be the view of Deuteronomy: people are straightforwardly blessed for being righteous, and punished for being wicked. The book of Job, by contrast, throws a monkey wrench into this neat system by telling the tale of someone who had terrible things happen to him despite his righteousness. (Though as an aside, the particular theological explanation of what happened to Job, as related in the cosmological narratives found in the introduction and conclusion—notably believed by scholars to be later additions to the work—is if possible even more troubling).

I’ll come back to the Deuteronomistic worldview in my fourth point. But I did want to note here that the concept of grace in Christianity turns any such system on its head. God offers things that are entirely unearned. I’ve been thinking and writing about grace for a decade and a half now, largely in an LDS context, and it’s been interesting to see the resistance to it. Grace is by any reckoning deeply unfair; people simply don’t merit what they get. I don’t know if I can draw a neat equation between the LDS works-oriented, grace-wary culture and the concern that people will be given something they didn’t earn (a “handout”), given that perhaps the loudest voice in contemporary American conservatism is that of white evangelicals, who vehemently emphasize salvation by grace alone with no works at all, but often still want to make sure the government isn’t giving anything to undeserving people. But I find it fascinating that many Mormons and evangelicals, despite their theological differences, seem to share a deep belief in salvation by works when it comes to the secular realm.

Obviously parallels between the theological economy and the secular one need to be made with some care, given the point that grace is abundant and presumably won’t run out; God can give and give, and the supply will remain the same. That, alas, cannot be said to be true of health care—there are limits, and as a society we have to grapple with those limits. I think raising that concern is perfectly legitimate. But I still flinch when I hear people—especially people who are very loud about their Christianity—talk at length about how important it is that people earn every single thing they get, so that we don’t reward irresponsibility. By those lights, it would seem that God is hugely mistaken in being in any way generous to us—doesn’t s/he know that if s/he gives us a salvation handout, we’ll inevitably be unprofitable servants? I’m especially flabbergasted to hear the sentiment that it’s worth denying badly need aid to 90 people if it means that we’ll manage to thereby block ten people who are just taking advantage of the system.

3. Radical Individualism

You’re likely familiar with Jimmy Kimmel’s plea, arising from his own experience as a parent of a son born with a heart defect, that we shouldn’t be a country that lets babies die of treatable conditions based on people’s income. Joe Walsh, a former Representative from Illinois who is known for making inflammatory comments, responded: “Sorry Jimmy Kimmel: your sad story doesn’t obligate me or anybody else to pay for somebody else’s health care.” This obviously is connected to my first point, about the way freedom is understood as freedom from any obligation to others. It also reflects a commitment to a kind of radical individualism which lacks any sense of what I would call social goods. I see things like public education, roads, libraries, and yes, health care, as social goods. They benefit everyone. (For this reason, for example, I don’t resent paying taxes for education even though I have no children of my own, because I think educating everyone is hugely beneficial to society as a whole.)

Ralph Hancock recently wrote an editorial  arguing that LDS progressives fundamentally diverge from LDS teachings—he is specifically concerned about what he calls “borderless globalism” and “free ‘sexual expression.'” (His concern about the latter is particularly interesting in view of my earlier comments about the worship of freedom—evidently freedom is virtuous when applied to your getting to do what you want with your money, but of dubious value when applied to your getting to do what you want with your body.) Even setting aside the question of whether he is accurately representing progressives, I am struck by his argument that these values are problematic because they “are part of the same ethic that seeks to emancipate the individual from the needs and norms of all real, concrete national and religious communities.” This comment genuinely surprised me, because I see conservatives as having largely abandoned commitment to the good of communities in favor of the all-important right of the individual to accumulate as much as she or he can. To be fair, I may be as guilty here of caricaturing conservatives as Hancock is of caricaturing liberals. But I do wish that the idea of a social good played more of a role in our national discourse.

4. Prosperity Gospel

In a recent Atlantic article, Vann R. Newkirk suggests that underlying the Republican approach to health care is a familiar theme: the prosperity gospel. If you’re not familiar with the term, it’s the Deuteronomistic worldview mentioned earlier in which the righteous are blessed, and the wicked are punished. (Social scientists call this the “just world hypothesis.”) Some Christians have gone pretty wild with this, arguing that God actually wants you to be rich, and will reward you with material blessings if you do the right things. See for example Paula White, one of the pastors invited to pray at the inauguration, who is described as an influential spiritual adviser to Trump. According to White’s website, you need to give God your “first fruits”, and in response, “He gives you the power to acquire wealth to establish His covenant.” (If you’re wondering just how to get this first fruits offering to God, clicking on the provided link will send you to a page where you can—surprise! —donate to White’s ministry.) This is of course nothing new; prosperity theology in its current form dates back to at least the 1950s, and has its roots in earlier movements.

While I am generally hesitant to draw hard and fast lines about who gets to use the label “Christian,” I find it frustrating that this nonsense is usually packaged in a Christian form. (I should mention that the prosperity gospel has been widely denounced by Christians of all stripes, including evangelicals.) I find the worldview troubling for many reasons, including the way it preys on the vulnerable, but I think perhaps the most insidiously toxic aspect of seeing wealth as a reward for righteousness is the obvious corollary that if you’re not rich, it’s your own fault—the poor have only themselves to blame. But as Newkirk points out in the aforementioned Atlantic article, “The prosperity gospel sold by televangelists fit—and fits—so well in many American homes because it mirrors the established national secular ethos. ” And, relevant to the health care debate, the prosperity gospel teaches that not only wealth but also physical health is a divine blessing bestowed on those who do the right things. The recent CNN interview with Alabama Representative Mo Brooks was especially revealing. Brooks spoke of “those people who lead good lives, they’re healthy, they’ve done the things to keep their bodies healthy” as ones who needed protection from the costs brought about by sick people. The equation here is pretty clear: those who are sick are those who made poor choices. Yet, as Newkirk notes, along with race (blacks having been historically excluded from health care), “perhaps the most direct societal predictor of health is still wealth.”

Mormons, in my experience, have little love for televangelists like Paula White. But the prosperity gospel is not alien to Mormonism, either; I can’t count the number of Sunday School lessons I’ve sat through on the subject of the warnings about riches laid out in Jacob 2 which have turned into full-throated defenses of wealth, which is not uncommonly described using the language of divine favor. (When my Catholic friends first told me about the idea of the “preferential option for the poor,” which draws on biblical injunctions to care for the poor and the oppressed to argue that God has special concern for those in poverty and on the margins of society, I only half-jokingly responded that Mormonism has a “preferential option for the rich.”) Code words like “self-reliance” and “personal responsibility” are tossed around to indicate that the poor have brought their unfortunate situation on themselves. Consider Utah Representative Jason Chaffetz’s much-derided comment that people need to save money for their own health care “rather than getting that new iPhone that they just love.” In addition to indicating so much obliviousness about the actual cost of health care that I strongly suspect that Chaffetz has never had to pay for it himself, this statement suggests that the core problem is irresponsibility. The poor would not be struggling to afford health care if they would just spend their money more responsibly. The prosperity gospel is lurking here somewhere.

One last point. A health care system that truly covered everyone wouldn’t actually be fair. Paul Ryan complained that “the idea of Obamacare is . . . that the people who are healthy pay for the people who are sick.” But that’s the reality of how insurance works—it spreads the costs around, and healthy people pay more so that sick people can pay less. That’s a bad financial deal for the healthy people; I don’t deny it. But framing it in just those terms leaves out some things—even if you are generally healthy, surely there is something to be said for knowing that if your health does fail you at some point, or perhaps even more significantly, if someone you love needs help, it will be accessible. (Of course, this does mean abandoning the untenable idea that health is so closely tied to morality that if you are sufficiently righteous, you’ll never need health care, so there is no need to worry.) And even if this set-up means that some people run the risk of over the course of their lifetime paying more into the system than they get out of it, that doesn’t sound like a terrible outcome to me (if that’s the worst that happens to you, in fact, I would say that you led a pretty fortunate life.) Additionally, as I said earlier, I think the idea of a “social good” should play some role in the discussion, if even for purely selfish reasons on the part of individuals—everyone benefits from living in a society in which people can get health care when they need it. (To give just one example, if other people can get treated for communicable diseases before they spread them to you, that’s good for you, too.)

I’m not an economist, a health care professional, a politician, or really an expert on anything practical, and I realize there is a lot to be worked out in the health care debate, and that compromises will likely be required. But I would like to at least challenge the problematic theological ideas I see getting a lot of airtime, including freedom (and freedom defined in a certain way) being worshiped as the highest good, “morality” being equated to making sure no one gets anything s/he didn’t earn or deserve, a belief in a kind of radical individualism which is disconnected to larger social goods, and prosperity theology.

10 comments

  1. I think that you misunderstand many conservative arguments for scrapping the abomination that is Obamacare. Your point #1 is probably the most cited reason, but put into conservative policy terms: Obamacare restricts economic freedom in a large sector of the economy. A freer market in health care will most likely do what free markets around the world and across time have done: increase prosperity for most people. The current replacement and the pre-Obamacare regime are not stellar examples of really good free markets, but both are significant improvements. I expect more than a single health insurance company to offer individual policies if the AHCA is put into law. A real insurance alternative could allow me to get into a proper risk pool and not lumped into the local meth-head and heroin addict risk pool.
    I would go down the list and point to many Christian scriptures that can back up the principles being argued for changing Obamacare, but you have cited the Old Testament sources of several. I think that most LDS teachings regard Deuteronomy as a covenant with the nation of Israel collectively as much as individually. The extent to which it applies collectively makes it a good resource for discussion of national policies.
    There is one other thing that you seem to have overlooked, or discounted completely. Obamacare has not improved the overall health and well being of the nation. Now there are many factors involved, but the life expectancy of a large group of citizens has declined post-Obamacare, for the first time in anyone’s memory. To put the title question another way: Would Jesus curse a supplicant with poorer health?




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  2. A freer market in health care will most likely do what free markets around the world and across time have done: increase prosperity for most people.

    I completely disagree. I’m already dubious about the worship of free markets, which in their purest form seem to be more than happy to exploit the vulnerable in their relentless pursuit of profit, but I especially disagree that they work for things like health care (which doesn’t seem to follow the normal rules of economic forces).

    I think that most LDS teachings regard Deuteronomy as a covenant with the nation of Israel collectively as much as individually. The extent to which it applies collectively makes it a good resource for discussion of national policies.

    I honestly have no idea what you mean by this. Though if by “collectively” you think that as a society we’re answerable to God for our sins (such as our treatment of the poor), I wouldn’t disagree.

    To put the title question another way: Would Jesus curse a supplicant with poorer health?

    Do you honestly think that something like the AHCA will help with declining life expectancies? I don’t see how making insurance less accessible to the poor will make people live longer. And by the way, I don’t by any means think that Obamacare was without flaws. (In my view, it didn’t go nearly far enough, and left a lot of the deep structural flaws in our system untouched.)




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  3. El oso, which data do you rely on for your opinion?What specific mechanisms of the ACA’s rollout would have affected mortality rates? Isnt’t true that he USA has been a laggard in health and healthcare for a long time and that the short period of time that that ACA has been in operation, is unlikely to have made inroads into that decline. As for scriptures, I find that people generally abide by those precepts which mirror their politics not vice versa.




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  4. There are two rather significant problems with starting an argument about either Obamacare or the AHCA with a phrase like ” A freer market in health care will most likely do what free markets around the world and across time have done. . . .” The first problem is that Obamacare has nothing to do with health care. It is entirely concerned with health insurance, which is an entirely different industry. The second is that neither health care nor health insurance are free markets. They are both heavily subsidized markets that are structured to benefit some classes of people at the expense of others. Employers of about 75% of the population subsidize health insurance, and health insurance subsidizes health care. Calling either market “free” creates a smokescreen that prevents us from seeing it correctly.

    The core of our health care problem in the United States–which Obamacare tried very minimally to address and the AHCA completely ignores–is that insurance is a spectacularly bad way to distribute health care. Insurance works by apportioning risk. Fire insurance works wonderfully because the risk that my house will burn down is really quite small. It makes sense to distribute this risk across a large population. But needing health care is not a risk. It is, for most people, a fact of life. Health care is more like food and clothing (a consumer good that most people use every year) than like a house fire or accidental death (risks that can be distributed because they happen to a very small portion of the population every year). It makes about as much sense to apportion health care through health insurance than it does to apportion food through “hunger insurance.”

    So, what most employers are doing when they provide “health insurance” is providing health-care subsidies to their employees. But because these subsidies are masked as “insurance,” they have a tremendously distorting effect on the market. For example, I have a blood-pressure medication that costs $100 a month. My co-pay is $4.00. To me, the market price is $4.00. But to an uninsured person–a person much less able to afford expensive prescription drugs–the cost is $100. My employer’s subsidy has driven the market price to the price of a co-pay, so the person without insurance faces health care costs that have been distorted far beyond their actual price in a free market.

    Obamacare tries to solve this problem by making insurance available to more people, which doesn’t actually give them health care,; it just allows them to pay the same price for health care goods and services that other people with insurance pay–which, it happens, is where the distorted market has set those prices. The great flaw in Obamacare is that it keeps the illusion of health insurance alive and, therefore, preserves the distorted market for health care that makes it completely unaffordable for the uninsured. The AHCA, among other things, eliminates 800 billion dollars of Medicaid subsidies that allowed low-income people and those without employee subsidized health care to at least enter the health care market without being penalized by the market distortions created by employer subsidies. It coverts these subsidies into tax cuts and tax credits that can only benefit the top half of the economy that pays taxes. So it is a fairly direct negative wealth transfer.

    The only way to solve the problem is the way that every other industrialized democracy has solved the problem which us a single-payer health care system that equalizes the subsidies so that everybody can pay the same minimums and co-pays that everybody else pays. Otherwise the market will remain distorted and stacked heavily in favor of wealthy people. And Jesus will be sad. There are times when a Christian desire to help the poor conflicts with a philosophical belief in free markets. But health care is not one of them. It is currently a distorted, non-free market that benefits the rich at the expense of the poor. If the AHCA passes the Senate, it will become exactly the sort of thing that every prophet of the Old Testament and the Book of Mormon warned us not to ever allow: a legal way for the most powerful people in society to murder and get gain.




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  5. Vajra2, I’m wondering too about the ACA and mortality rates; the jump from correlation to causation there seems like a real leap, given that from what I’ve read, they’re not very clear on the reasons for the decline in life expectancy.

    As for scriptures, I find that people generally abide by those precepts which mirror their politics not vice versa.

    Too true! I’m also guilty of this, I have to admit. I’ve been thinking a lot lately about how the most bitter divides in our country right now seem to be political rather than religious, and how most people seem to interpret their religious commitments through the lens of their political commitments, and wondering how that dynamic is playing out in my own life.

    Michael, thank you so much for decimating the free market argument far more thoroughly and informatively than I ever would have been able to do!

    Jason K, thanks!




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  6. Michael Austin,
    I agree with almost everything you say until you get to your last paragraph. When I speak about Obamacare being a less free market, and the AHCA being an improvement, the primary issues are two:
    1) There is currently a single health insurance provider in over half of the states for Obamacare. Most other locales have 2 or 3 large companies that offer plans. This is effectively a regulated monopoly for a huge chunk of the economy and even worse,
    2) Health insurance of a certain type (not just catastrophic which would be more like most other types of insurance) is a government mandated requirement, enforced by the tax code and the full weight of the federal government.
    The AHCA takes steps to eliminate both of these huge issues. If nothing is done, the average Obamacare premium will be rising 20+% annually.
    Your final paragraph states that single payer is the way to go. I agree that it is superior to Obamacare, primarily because of my issue #1 above. The government does not try to profit from its services, and will hopefully charge less than any monopoly for the same service.

    Now there are many other market distortions that AHCA does little to nothing to address. These may lead to further deterioration of certain parts of US health care, but application of free market principles will improve some things, especially cost. I do not believe that single payer would do much to improve cost or service versus our current situation. The only thing that it would do would be to shift more costs to high-end taxpayers.
    I also note that there seems to be agreement by Michael and Lynnette that more health insurance does not necessarily equal more healthy citizens. Life expectancy data show a significant change recently. I cannot say which provision of the current health care policy, if any, caused the life expectancy decline. This is merely a signal that something is wrong and has gotten worse in the past few years.

    Lynnette,
    You ask me, “Do you honestly think that something like the AHCA will help with declining life expectancies?” As I imply above, I am not certain what is the cause of the life expectancy decline. If I were to make a guess as to the top 5 likely reasons for the decline, the AHCA and related policy changes are a significant improvement for one of the five (overall cost and quality of health care), and a minor improver of two of the others (overall economic performance and drug abuse).
    I think Michael answered your first response to me about why it seems that free markets do not improve health care. The basics are that there are many crazy market distortions, and normal market signals have not been working well. The AHCA does not eliminate many of the distortions, but it does tackle two of the worst that I list above.

    Thanks for the respectful responses to my counterpoints.




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  7. el oso,

    I think we are focusing on different parts of the two acts. I agree with you that the Obamacare exchanges are a mess right now, for all the reasons you mention. But, as I see it, this is a consequence of the last-minute removal of a public option for purchasing insurance. When the bill was originally created, it included provisions for a single-payer-like public entity that would provide an insurance option in all 50 states and would prevent any of the existing exchange partners from becoming monopolies. The public option was specifically designed to ensure that there would always be competition. Then Ted Kennedy died and Joe Lieberman and Ben Nelson declared that they would not support a public option, so we were left with an exchange system that was always in danger of becoming monopolistic.

    The part of Obamacare that I thought worked was the expansion of Medicaid–another single-payer system that allowed people without job-subsidized insurance to have some kind of health insurance. And the thing about the AHCA that I find so disturbing is the gutting of Medicaid. It removes 800 billion dollars from the Medicaid fund and converts it to tax credits and other incentives that low income people (who generally do not pay taxes at all) cannot use. This is what I refer to as a negative, upward transfer. What this does is leave a market-distorting insurance system in place and then make it impossible for large segments of the population to afford insurance.

    So, I go back to what I said earlier–health care is not really something that can be rationally distributed through health insurance, and the great failing of Obamacare was leaving the insurance system in place. But this is the conservative side of Obamacare, as was the abandonment of the public option. By trying to placate conservative Democrats, Obamacare got rid of all of the things that looked like a single-payer system (which were the things that would actually work) and tried to work with existing insurance companies. This kept the market distorted, but at least it allowed low-income Americans to play the game by expanding Medicaid. The AHCA is trying to rationalize an inherently irrational market. If Republicans want to try to do that, fine. Go for it. But leave the Medicaid expansion in place while you do it. Otherwise, poor people are going to face an inherently distorted market without any way to pay the prices it sets.




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  8. Ye apostles of the free market have not pointed out a single case — a single country — where free market principles have worked on behalf of that country’s citizens when it comes to providing decent healthcare, uniformly decent. The truth is, the free market doesn’t work when it comes to healthcare. More doctors doesn’t translate to cheaper doctors; more hospitals does not result in cheaper hospital visits. The free market puts lots of doctors in the suburbs, very few in our rural areas and only doctors with foreign names in our inner cities. Having our health insurance pegged to our employment means some of us get fabulous healthcare while others get rotten tomatoes. Americans could learn a lot from other countries, many of them free market capitalist countries, who have gone the single payer route with far, far better results than we in this country enjoy.




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