Health Insurance Quotes

She's the most important person in the world and her family living in poverty. If our mother is so important to science, why can't we get health insurance?

America's health care system is neither healthy, caring, nor a system.

Anywhere you have extreme poverty and no national health insurance, no promise of health care regardless of social standing, that's where you see the sharp limitations of market-based health care.

Everyone should have health insurance? I say everyone should have health care. I'm not selling insurance.

Morelli beeped his truck unlocked. “If you’re looking for your rent-a-cop, I told Ranger you’d be with me this morning.” “Did he make you take a blood oath that you’d protect me?” “He asked me if I had adequate health insurance.

Loving someone is like having a mental illness that's not covered by health insurance.

Choose Life. Choose a job. Choose a career. Choose a family. Choose a fucking big television, choose washing machines, cars, compact disc players and electrical tin openers. Choose good health, low cholesterol, and dental insurance. Choose fixed interest mortgage repayments. Choose a starter home. Choose your friends. Choose leisurewear and matching luggage. Choose a three-piece suit on hire purchase in a range of fucking fabrics. Choose DIY and wondering who the fuck you are on Sunday morning. Choose sitting on that couch watching mind-numbing, spirit-crushing game shows, stuffing fucking junk food into your mouth. Choose rotting away at the end of it all, pissing your last in a miserable home, nothing more than an embarrassment to the selfish, fucked up brats you spawned to replace yourselves. Choose your future. Choose life… But why would I want to do a thing like that? I chose not to choose life. I chose somethin’ else. And the reasons? There are no reasons. Who needs reasons when you’ve got heroin?

In a society in which nearly everybody is dominated by somebody else's mind or by a disembodied mind, it becomes increasingly difficult to learn the truth about the activities of governments and corporations, about the quality or value of products, or about the health of one's own place and economy. In such a society, also, our private economies will depend less and less upon the private ownership of real, usable property, and more and more upon property that is institutional and abstract, beyond individual control, such as money, insurance policies, certificates of deposit, stocks, and shares. And as our private economies become more abstract, the mutual, free helps and pleasures of family and community life will be supplanted by a kind of displaced or placeless citizenship and by commerce with impersonal and self-interested suppliers... Thus, although we are not slaves in name, and cannot be carried to market and sold as somebody else's legal chattels, we are free only within narrow limits. For all our talk about liberation and personal autonomy, there are few choices that we are free to make. What would be the point, for example, if a majority of our people decided to be self-employed? The great enemy of freedom is the alignment of political power with wealth. This alignment destroys the commonwealth - that is, the natural wealth of localities and the local economies of household, neighborhood, and community - and so destroys democracy, of which the commonwealth is the foundation and practical means.

The issue of reimbursement by payers is an important factor that should be discussed. Is it possible that if radiologists use AI to read scans, they’ll receive less reimbursement? Or to approach this from the other angle, if payers are reimbursing for the use of AI, will they pay radiologists less as a result? My discussions with insurance executives have shown that they don’t think this is likely. If the use of these technologies will improve patient outcomes and lead to fewer errors, there are benefits to them that will motivate executives to pay for them in addition to radiologists’ reading fees.

I want a dyke for president. I want a person with AIDS for president and I want a fag for vice president and I want someone with no health insurance and I want someone who grew up in a place where the earth is so saturated with toxic waste that they didn’t have a choice about getting leukemia. I want a president that had an abortion at sixteen and I want a candidate who isn’t the lesser of two evils and I want a president who lost their last lover to AIDS, who still sees that in their eyes every time they lay down to rest, who held their lover in their arms and knew they were dying. I want a president with no air-conditioning, a president who has stood in line at the clinic, at the DMV, at the welfare office, and has been unemployed and laid off and sexually harassed and gaybashed and deported. I want someone who has spent the night in the tombs and had a cross burned on their lawn and survived rape. I want someone who has been in love and been hurt, who respects sex, who has made mistakes and learned from them. I want a Black woman for president. I want someone with bad teeth and an attitude, someone who has eaten that nasty hospital food, someone who crossdresses and has done drugs and been in therapy. I want someone who has committed civil disobedience. And I want to know why this isn’t possible. I want to know why we started learning somewhere down the line that a president is always a clown. Always a john and never a hooker. Always a boss and never a worker. Always a liar, always a thief, and never caught.

I want you, Elsie. All the time. I think of you. All. The. Fucking. Time. I’m distracted. I’m shit at work. And my first instinct, the very first time I saw you, was to run away. Because I knew that if we’d start doing this, we would never stop. And that’s exactly how it is. There is no universe in which I’m going to let you go. I want to be with you, on you, every second of every day. I think – I dream of crazy things. I want you to marry me tomorrow so you can go on my health insurance. I want to lock you in my room for a couple of weeks. I want to buy groceries based on what you like. I want to play it cool, like I’m attracted to you and not obsessed out of my mind, but that’s not where I’m at. Not at all. And I need you to keep us in check. I need you to pace us, because wherever it is that we’re going… I’m here. I’m already right here.

We paid for this instead of a generation of health insurance, or an alternative energy grid, or a brand-new system of roads and highways. With the $13-plus trillion we are estimated to ultimately spend on the bailouts, we could not only have bought and paid off every single sub-prime mortgage in the country (that would only have cost $1.4 trillion), we could have paid off every remaining mortgage of any kind in this country - and still have had enough money left over to buy a new house for every American who does not already have one.

My mother always says that the story you believe depends on the body you're in. What you believe will depend on the color of your hair, your word for god, how many times you've been born, your zip code, whether you have health insurance, what your first language is, and how many snakes you have known personally.

What I didn’t say was: I know you too well. You live your life idealistically. You think it’s possible to opt out of the system. No regular income, no health insurance. You quit jobs on a dime. You think this is freedom but I still see the bare, painstakingly cheap way you live, the scrimping and saving, and that is not freedom either. You move in circumscribed circles. You move peripherally, on the margins of everything, pirating movies and eating dollar slices. I used to admire this about you, how fervently you clung to your beliefs—I called it integrity—but five years of watching you live this way has changed me. In this world, money is freedom. Opting out is not a real choice.

I need to make money. I need to write today. I need to clean the bathroom. I need to eat something. I need to quit sugar. I need to cut my hair. I need to call Verizon. I need to savor the moment. I need to find the library card. I need to learn to meditate. I need to try harder. I need to get that stain out. I need to find better health insurance. I need to discover my signature scent. I need to strengthen and tone. I need to be present in the moment. I need to learn French. I need to be easier on myself. I need to buy organizational storage units. I need to call back. I need to develop a relationship with a God of my understanding.

If our mother so important to science, why can’t we get health insurance?

What exactly does that expression mean, 'friends with benefits'? Does he provide her with health insurance?

Because doctors can’t name the illness, everyone—the patient's family, friends, health insurance, and in many cases the patient—comes to think of the patient as not really sick and not really suffering. What the patient comes to require in these circumstances, in the absence of help, are facts—tests and studies that show that they might “in fact” have something.

I want you to marry me tomorrow so you can go on my health insurance.

I would advocate that chocolate be covered by health insurance, but that is admittedly a very French public policy perspective.

You are as well prepared as any young Westerner could hope to be, equipped with good diet, lavish health insurance, two degrees, foreign travel and languages, orthodonture, psychotherapy, property, and capital; and your skin is a beautiful color. Look at you – look at the burnish of you.

Hopkins say they gave them cells away,” Lawrence yelled, “but they made millions! It’s not fair! She’s the most important person in the world and her family living in poverty. If our mother so important to science, why can’t we get health insurance?

One of my big revelations was that nobody cares whether you write your novel or not. They want you to be happy. Your parents want you to have health insurance. Your friends want you to be a good friend. But everyone’s thinking about their own problems and nobody wakes up in the morning thinking, ‘Boy, I sure hope Sam finishes that chapter and gets one step closer to his dream of being a working writer.’ Nobody does that. If you want to write, it has to come from you. If you don’t want to write, that’s great. Go do something else. That was a very liberating moment for me.

If there is one thing I'd learned about hospitals, it's that they aren't interested in healing you. They are interested in stabilizing you, and then everyone is supposed to move on. They go to stabilize some more people, and you go off to do whatever you do. Healing, if it happens at all, is done on your own, long after the hospital has submitted your final insurance paperwork.

I had no idea that marriage was only supposed to be between two people who wanted to get between the sheets and make more people. What ever happened to marrying for love— or to get on your partner’s health insurance policy, or for presents? No one was going to buy two people in their thirties a four-slice toaster if we just continued to live in sin.

Our job-based health insurance system does the very thing we most want to avoid—it discourages businesses from hiring.

Or maybe I work at Starbucks,” he said. She snorted. “Really?” “Really,” he said, still smiling. “Someday you’ll need health insurance, and you won’t think working at Starbucks is funny.

When the Crossfire paradigm loses its force, all that's left is a bunch of people with different views all sitting together in a room, wondering why they're all paying three bucks a gallon for gas, why they have no health insurance, why their tax rates are higher than Warren Buffet's. If we're all equally a bunch of suckers, how could any of us be worth hating?

Q: Why do you use swear words on your blog, but never the F word? A: Because I'm saving the F word for the day when I write a blog post about the for-profit health insurance industry and the way its CEOs become wealthy by not only preying on, but exacerbating, other people's personal tragedies. *ahem* Happy Monday, everyone :o)

She’s the most important person in the world and her family living in poverty. If our mother so important to science, why can’t we get health insurance?

Change was a privilege reserved for people whose families didn’t rely on them for food, shelter, and health insurance. I thought she’d know that by now.

Pick a leader who will not only bail out banks and airlines, but also families from losing their homes -- or jobs due to their companies moving to other countries. Pick a leader who will fund schools, not limit spending on education and allow libraries to close. Pick a leader who chooses diplomacy over war. An honest broker in foreign relations. A leader with integrity, one who says what they mean, keeps their word and does not lie to their people. Pick a leader who is strong and confident, yet humble. Intelligent, but not sly. A leader who encourages diversity, not racism. One who understands the needs of the farmer, the teacher, the doctor, and the environmentalist -- not only the banker, the oil tycoon, the weapons developer, or the insurance and pharmaceutical lobbyist.

What was to be a relatively innocuous federal government, operating from a defined enumeration of specific grants of power, has become an ever-present and unaccountable force. It is the nation’s largest creditor, debtor, lender, employer, consumer, contractor, grantor, property owner, tenant, insurer, health-care provider, and pension guarantor. Moreover, with aggrandized police powers, what it does not control directly it bans or mandates by regulation.

If I die this instant will you be more content with the morning news? Will your coffee taste better? I am not your fate. I am not your government…I am not your mother, not your father or your nightmare or your health. I am not a fence, not a wall. I am not the law or actuarial tables of your insurance broker. I am a woman with my guts loose in my hands, howling and it’s not because I committed hari-kiri. I suggest either you cook me or sew me back up. I suggest you walk into my pain as into the breaking waves of an ocean of blood, and either we will climb out together and walk away.

This was the Mecca of the American Dream, the world that everyone wanted. A world of sleek young women (allied with Slenderella to be so) in shorts and halters, driving 400-horsepower station wagons to air-conditioned, music-serenaded supermarkets of baby-sitter corporations and culture condensed into Great Books discussion groups. A life of barbecues by the swimming pool and drive in movies open all year. It did't appeal to me. Fuck health insurance plans and life insurance. They wanted to live without leaving the womb. It made me more alive to play a game without rules against society, and I was prepared to play it to the end. A tremor almost sexual passed through me as I anticipated the comming robbery.

If we are looking for insurance against want and oppression, we will find it only in our neighbors' prosperity and goodwill and, beyond that, in the good health of our worldly places, our homelands. If we were sincerely looking for a place of safety, for real security and success, then we would begin to turn to our communities - and not the communities simply of our human neighbors but also of the water, earth, and air, the plants and animals, all the creatures with whom our local life is shared. (pg. 59, "Racism and the Economy")

A novelist must wrestle with all mysteries and strangeness of life itself, and anyone who dies not wish to accept that grand, bone-chilling commission should write book reviews, editorials, or health-insurance policies instead.

Tentacles is my term — the Tentacles are the evil tasks that invade my life. Like, for example, my American History class last week, which necessitated me writing a paper on the weapons of the Revolutionary war, which necessitated me traveling to the Metropolitan Museum to check out some of the old guns, which necessitated me getting the subway, which necessitated me being away from my cell phone and email for 45 minutes, which meant that I didn’t get to respond to a mass mail sent out by my teacher asking who needed extra credit, which meant other kids snapped up the extra credit, which meant I wasn’t going to get a 98 in the class, which meant I wasn’t anywhere close to a 98.6 average (body temperature, that’s what you needed to get), which meant I wasn’t going to get into a Good College, which meant I wasn’t going to have a Good Job, which meant I wasn’t going to have health insurance, which meant I’d have to pay tremendous amounts of money for the shrinks and drugs my brain needed, which meant I wasn’t going to have enough money to pay for a Good Lifestyle, which meant I’d feel ashamed, which meant I’d get depressed, and that was the big one because I knew what that did to me: it made it so I wouldn’t get out of bed, which led to the ultimate thing — homelessness. If you can’t get out of bed for long enough, people come and take your bed away.

Amy ran on sugar, caffeine, and pain pills, and would sacrifice an entire night of sleep to level up a character in one of her games. The people with health insurance get antidepressants and Adderall, the rich get cocaine, the clean-living Christians settle for mug after mug of coffee and all-you-can-eat buffets. The reality is that society had gotten too fast, noisy, and stressful for the human brain to process and everybody was ingesting something to either keep up or dull the shame of falling behind. For those few who truly live clean, well, it’s the self-righteousness that gets them high.

The thing they're trying to stop is 30-million people getting health insurance. That's the substance.

Doesn't anything socialistic make you want to throw up? Like great public schools, or health insurance for all?

Choose life. Choose a job. Choose a career. Choose a family. Choose a fucking big television, Choose washing machines, cars, compact disc players, and electrical tin openers. Choose good health, low cholesterol and dental insurance. Choose fixed- interest mortgage repayments. Choose a starter home. Choose your friends. Choose leisure wear and matching luggage. Choose a three piece suite on hire purchase in a range of fucking fabrics. Choose DIY and wondering who you are on a Sunday morning. Choose sitting on that couch watching mind-numbing sprit- crushing game shows, stuffing fucking junk food into your mouth. Choose rotting away at the end of it all, pishing you last in a miserable home, nothing more than an embarrassment to the selfish, fucked-up brats you have spawned to replace yourself. Choose your future. Choose life... But why would I want to do a thing like that?

He asked for national compulsory health insurance to be funded by payroll deductions. Under the system, all citizens would receive medical and hospital service irrespective of their ability to pay. And

To insure good health: Eat lightly, breathe deeply, live moderately, cultivate cheerfulness, and maintain an interest in life.

Our God is sovereign. That means there's no such thing as luck. Anything that happens to you, good or bad, must pass through His fingers first. There are no accidents with God. I like the story of the cowboy who applied for health insurance. The agent routinely asked him, 'Have you ever had any accidents?' The cowboy replied, 'Well no, I've not had any accidents. I was bitten by a rattlesnake once, and a horse did kick me in the ribs. That laid me up for a while, but I haven't had any accidents.' The agent said, 'Wait a minute. I'm confused. A rattlesnake bit you, and a horse kicked you, Weren't those accidents?' 'No, they did that on purpose.

Apart from stemming consumption, the most intractable puzzle that Paul Ehrlich has encountered is why health decisions about Mother Nature—the mother that gives us life and breath—are made by politicians, not by scientists who know how critical her condition is. “It’s the immoral equivalent of insurance company accountants making decisions about our personal health.” Even

Fewer and fewer large and medium-sized companies offer their workers full health-care coverage—74 percent did in 1980, under 10 percent do today. As a result, health insurance premiums, co-payments, and deductibles are soaring.

Seeing modern health care from the other side, I can say that it is clearly not set up for the patient. It is frequently a poor arrangement for doctors as well, but that does not mitigate how little the system accounts for the patient's best interest. Just when you are at your weakest and least able to make all the phone calls, traverse the maze of insurance, and plead for health-care referrals is that one time when you have to — your life may depend on it.

the top causes of stress in the U.S. have been identified by scientists at Stanford Graduate School of Business in a major study. They are “a lack of health insurance, the constant threat of lay-offs, lack of discretion and autonomy in decision-making, long working hours, low levels of organizational justice, and unrealistic demands.

On Rachel's show for November 7, 2012: We're not going to have a supreme court that will overturn Roe versus Wade. There will be no more Antonio Scalias and Samuel Aleatos added to this court. We're not going to repeal health reform. Nobody is going to kill medicare and make old people in this generation or any other generation fight it out on the open market to try to get health insurance. We are not going to do that. We are not going to give a 20% tax cut to millionaires and billionaires and expect programs like food stamps and kid's insurance to cover the cost of that tax cut. We'll not make you clear it with your boss if you want to get birth control under the insurance plan that you're on. We are not going to redefine rape. We are not going to amend the United States constitution to stop gay people from getting married. We are not going to double Guantanamo. We are not eliminating the Department of Energy or the Department of Education or Housing at the federal level. We are not going to spend $2 trillion on the military that the military does not want. We are not scaling back on student loans because the country's new plan is that you should borrow money from your parents. We are not vetoing the Dream Act. We are not self-deporting. We are not letting Detroit go bankrupt. We are not starting a trade war with China on Inauguration Day in January. We are not going to have, as a president, a man who once led a mob of friends to run down a scared, gay kid, to hold him down and forcibly cut his hair off with a pair of scissors while that kid cried and screamed for help and there was no apology, not ever. We are not going to have a Secretary of State John Bolton. We are not bringing Dick Cheney back. We are not going to have a foreign policy shop stocked with architects of the Iraq War. We are not going to do it. We had the chance to do that if we wanted to do that, as a country. and we said no, last night, loudly.

Woe to you fans, if you would be as zealous about caring for the sick as you are about a ‘Christmas tree’ being called a ‘holiday tree,’ health insurance wouldn’t be a problem.

Mainly, though, the Democratic Party has become the party of reaction. In reaction to a war that is ill conceived, we appear suspicious of all military action. In reaction to those who proclaim the market can cure all ills, we resist efforts to use market principles to tackle pressing problems. In reaction to religious overreach, we equate tolerance with secularism, and forfeit the moral language that would help infuse our policies with a larger meaning. We lose elections and hope for the courts to foil Republican plans. We lost the courts and wait for a White House scandal. And increasingly we feel the need to match the Republican right in stridency and hardball tactics. The accepted wisdom that drives many advocacy groups and Democratic activists these days goes like this: The Republican Party has been able to consistently win elections not by expanding its base but by vilifying Democrats, driving wedges into the electorate, energizing its right wing, and disciplining those who stray from the party line. If the Democrats ever want to get back into power, then they will have to take up the same approach. ...Ultimately, though, I believe any attempt by Democrats to pursue a more sharply partisan and ideological strategy misapprehends the moment we're in. I am convinced that whenever we exaggerate or demonize, oversimplify or overstate our case, we lose. Whenever we dumb down the political debate, we lose. For it's precisely the pursuit of ideological purity, the rigid orthodoxy and the sheer predictability of our current political debate, that keeps us from finding new ways to meet the challenges we face as a country. It's what keeps us locked in "either/or" thinking: the notion that we can have only big government or no government; the assumption that we must either tolerate forty-six million without health insurance or embrace "socialized medicine". It is such doctrinaire thinking and stark partisanship that have turned Americans off of politics.

Sonny had a quintuple bypass in 2003, when he was fifty-six years old—the last thing he remembered before falling unconscious under the anesthesia was a doctor standing over him saying his mother’s cells were one of the most important things that had ever happened to medicine. Sonny woke up more than $125,000 in debt because he didn’t have health insurance to cover the surgery.

I'm flummoxed by this unraveling of time, I'm losing my grip on myself. I know that nothing awful will happen on the other side of the door. If anything, I'm about to have a perfectly forgettable day: a class to teach, a meeting with colleagues, maybe a movie. But I'm afraid of forgetting something crucial—my cell phone or my identity card, my health insurance or my keys. And I'm afraid of running into trouble.

health, social life, job, house, partners, finances; leisure use, leisure amount; working time, education, income, children; food, water, shelter, clothing, sex, health care; mobility; physical safety, social safety, job security, savings account, insurance, disability protection, family leave, vacation; place tenure, a commons; access to wilderness, mountains, ocean; peace, political stability, political input, political satisfaction; air, water, esteem; status, recognition; home, community, neighbors, civil society, sports, the arts; longevity treatments, gender choice; the opportunity to become more what you are that's all you need

And a young man with every reason to work—a wife-to-be to support and a baby on the way—carelessly tossing aside a good job with excellent health insurance. More troublingly, when it was all over, he thought something had been done to him. There is a lack of agency here—a feeling that you have little control over your life and a willingness to blame everyone but yourself. This is distinct from the larger economic landscape of modern America. It’s

TRUTH: Worry has little to do with waking up. It has little to do with anything of value. Yes, entire industries have been created in homage to worry: auto insurance, health insurance, life insurance, 401(k)s, retirement accounts. But do you not see what all of this is? It is making yourself sick in order to lay up something for a sick day. It is you, Fear, trying to control what cannot be controlled. And what is it you want to control so desperately?

She described her new treatment with a topical chemotherapy that came in the form of a potent cream that she applied, wearing gloves, to burn off the cancerous areas—then she produced a package of the stuff from the bathroom so I could see how mundane this lifesaving medication looked. I blinked in disbelief as she held up what resembled a tube of toothpaste, and explained that each one cost over two thousand dollars. Or that’s what it would cost, if not for the insurance she had purchased through the health insurance exchanges that had been set up as part of Obamacare. I thought—and spoke—of that moment often, later, as I talked about why health policy was not a theoretical question for our family.

The chief reason [Bill] O'Reilly is a conservative is that like all conservatives he offers no solutions for the major issues confronting those he pretends to champion--such as better wages, workable health insurance, education for every deserving child, controls on the corporate thugs that are destroying our earth, an unfettered national voice for the ordinary citizen, reform of the election laws of this country that permitted corporations to own the country and enslave the people.

Wake up America! The insurance companies took over health care! Wake up America! The pharmaceutical companies took over drug pricing! Wake up America! The speculators took over Wall Street! Wake up America! They want your Social Security! Wake up America! Multinational corporations took over our trade policies! Wake up America! We went into Iraq for oil! WAKE UP AMERICA!

Why should insurance companies continue to get away with limiting the skills that a health profession has always previously required of its members if they were to be considered fully trained?

I need to make money. I need to write today. I need to clean the bathroom. I need to eat something. I need to quit sugar. I need to cut my hair. I need to call Verizon. I need to savor the moment. I need to find the library card. I need to learn to meditate. I need to try harder. I need to get that stain out. I need to find better health insurance. I need to discover my signature scent. I need to strengthen and tone. I need to be present in the moment. I need to learn French. I need to be easier on myself. I need to buy organizational storage units. I need to call back. I need to develop a relationship with a God of my understanding. I need to buy eye cream. I need to live up to my potential. I need to lie back down.

For one thing, most available jobs for undocumented immigrants are jobs Americans will not do, which takes healthy young migrants and makes them age terribly. At a certain point, manual labor is no longer possible. Aging undocumented people have no safety net. Even though half of undocumented people pay into Social Security, none are eligible for the benefits. They are unable to purchase health insurance. They probably don’t own their own homes. They don’t have 401(k)s or retirement plans of any kind. Meager savings, if any. Elderly people in general are susceptible to unscrupulous individuals taking advantage of them, and the undocumented community draws even more vultures. According to the Migration Policy Institute, around 10 percent of undocumented people are over fifty-five years old. This country takes their youth, their dreams, their labor, and spits them out with nothing to show for it.

Yeah, it's real easy to look in the mirror and be proud when you're wearing pleated shorts. And you know what's really pathetic? I don't even have any dividends to get tax-decreased. When'll they cut taxes on not-having-health-insurancends?

The therapist I once talked with but never went back to, because the copay was too steep even with Dad's health insurance, would probably call this wallowing. Unhealthy. Destructive. But I'm not so sure. I treasure my newfound feelings, Hoard them. Every once in a while I study them, turn them around, squint at them like they're a ripe piece of fruit, plucked from a mysterious tree that shouldn't even be growing in my yard. When I pop them in my mouth to swallow them whole, they taste bitter and delicious.

You might also be wondering how the Obama administration thought they would get away with this disaster. I think their intention was simply to blame insurance companies when people started seeing their health insurance plans canceled. Liberals excel at vilifying the business sector, and the more they can demonize private-sector insurers, the more leverage they believe they will have for continuing to move toward the Holy Grail of the left that Ronald Reagan warned against in 1961—a single-payer, government-funded, socialized health-care system.

Bear in mind that since medications do not fix anything, they allow the underlying problem to continue uncorrected and actually accelerate. Meanwhile, new symptoms and new seemingly unrelated diseases are the inevitable consequence of this biochemical faux pas. Furthermore, drug side effects are the leading cause of death. NSAIDs as an example of only one group of medications, are fatally toxic to thousands of people each year by damaging joints, lungs, kidneys, eyes, hearts, and intestines. And they are covered by insurance. You and your doctor have been screwed into believing every symptom is a deficiency of some drug or surgery. You've been led to believe you have no control, when in truth you're the one who must take control. Unfortunately, the modus operandi in medicine is to find a drug to turn off the damaged part that is producing symptoms.

Society never advances. It recedes as fast on one side as it gains on the other. It undergoes continual changes; it is barbarous, it is civilized, it is christianized, it is rich, it is scientific; but this change is not amelioration. For every thing that is given, something is taken. Society acquires new arts, and loses old instincts. What a contrast between the well-clad, reading, writing, thinking American, with a watch, a pencil, and a bill of exchange in his pocket, and the naked New Zealander, whose property is a club, a spear, a mat, and an undivided twentieth of a shed to sleep under! But compare the health of the two men, and you shall see that the white man has lost his aboriginal strength. If the traveller tell us truly, strike the savage with a broad axe, and in a day or two the flesh shall unite and heal as if you struck the blow into soft pitch, and the same blow shall send the white to his grave. The civilized man has built a coach, but has lost the use of his feet. He is supported on crutches, but lacks so much support of muscle. He has a fine Geneva watch, but he fails of the skill to tell the hour by the sun. A Greenwich nautical almanac he has, and so being sure of the information when he wants it, the man in the street does not know a star in the sky. The solstice he does not observe; the equinox he knows as little; and the whole bright calendar of the year is without a dial in his mind. His note-books impair his memory; his libraries overload his wit; the insurance-office increases the number of accidents; and it may be a question whether machinery does not encumber; whether we have not lost by refinement some energy, by a Christianity entrenched in establishments and forms, some vigor of wild virtue. For every Stoic was a Stoic; but in Christendom where is the Christian?

Contemporary American politics also revolve around this contradiction. Democrats want a more equitable society, even if it means raising taxes to fund programmes to help the poor, elderly and infirm. But that infringes on the freedom of individuals to spend their money as they wish. Why should the government force me to buy health insurance if I prefer using the money to put my kids through college? Republicans, on the other hand, want to maximise individual freedom, even if it means that the income gap between rich and poor will grow wider and that many Americans will not be able to afford health care.

Another, related issue is that longevity itself, and healthspan in particular, doesn’t really fit into the business model of our current healthcare system. There are few insurance reimbursement codes for most of the largely preventive interventions that I believe are necessary to extend lifespan and healthspan. Health insurance companies won’t pay a doctor very much to tell a patient to change the way he eats, or to monitor his blood glucose levels in order to help prevent him from developing type 2 diabetes. Yet insurance will pay for this same patient’s (very expensive) insulin after he has been diagnosed. Similarly, there’s no billing code for putting a patient on a comprehensive exercise program designed to maintain her muscle mass and sense of balance while building her resistance to injury. But if she falls and breaks her hip, then her surgery and physical therapy will be covered. Nearly all the money flows to treatment rather than prevention—and when I say “prevention,” I mean prevention of human suffering.

I want you, Elsie. All the time. I think of you. All. The. Fucking. Time. I’m distracted. I’m shit at work. And my first instinct, the very first time I saw you, was to run away. Because I knew that if we’d start doing this, we would never stop. And that’s exactly how it is. There is no universe in which I’m going to let you go. I want to be with you, on you, every second of every day. I think—I dream of crazy things. I want you to marry me tomorrow so you can go on my health insurance. I want to lock you in my room for a couple of weeks. I want to buy groceries based on what you like. I want to play it cool, like I’m attracted to you and not obsessed out of my mind, but that’s not where I’m at. Not at all. And I need you to keep us in check. I need you to pace us, because wherever it is that we’re going . . . I’m here. I’m already right here.

What I didn't say was: I know you too well. You live your life idealistically. You think it's possible to opt out of the system. No regular income, no health insurance. You quit jobs on a dime. You think this is freedom but I still see the bare, painstakingly cheap way you live, the scrimping and saving, and that is not freedom either. You move in circumscribed circles. You move peripherally, on the margins of everything, pirating movies and eating dollar slices. I used to admire this about you, how fervently you clung to your beliefs-- I called it integrity-- but five years of watching you live this way has changed me. In this world, money is freedom. Opting out is not a real choice.

You’re lucky to be alive,” I told her. “I still can’t believe you didn’t have any health insurance.” “Oh but I do have insurance,” she said. “You do?” “Yes. Jesus.” “Jesus?” “Jesus.” “Jesus is your health insurance?” “If God is with me, who can be against me?” “Okay, Mom.” “Trevor, I prayed. I told you I prayed. I don’t pray for nothing.” “You know,” I said, “for once I cannot argue with you. The gun, the bullets—I can’t explain any of it. So I’ll give you that much.” Then I couldn’t resist teasing her with one last little jab. “But where was your Jesus to pay your hospital bill, hmm? I know for a fact that He didn’t pay that.” She smiled and said, “You’re right. He didn’t. But He blessed me with the son who did.

Another blatant case of regress as part of the capitalist progress is the enormous rise of precarious work. Precarious work deprives workers of a whole series of rights that, till recently, were taken as self-evident in any country which perceived itself as a welfare state: precarious workers have to take care themselves of their health insurance and retirement options; there is no paid leave; the future becomes much more uncertain. Precarious work also generates an antagonism within the working class, between permanently employed and precarious workers (trade unions tend to privilege permanent workers; it is very difficult for precarious workers even to organize themselves into a union or to establish other forms of collective self-organization). One would have expected that this increasing exploitation would also strengthen workers’ resistance, but it renders resistance even more difficult, and the main reason for this is ideological: precarious work is presented (and up to a point even effectively experienced) as a new form of freedom – I am no longer just a cog in a complex enterprise but an entrepreneur-of-the-self, I am a boss of myself who freely manages my employment, free to choose new options, to explore different aspects of my creative potential, to choose my priorities

I don’t think the people today who start hearing voices, stop eating and sleeping, and run amuck are likely to get good treatment. Having more knowledge, better diagnostic capabilities, better medications with fewer side effects, can’t make up for the fact that most patients are being treated by doctors, therapists, and hospitals, who are operating under constraints and incentives that reward non-treatment, non-hospitalization, non-therapy, non-follow-up, non-care. Lost to follow-up is the best outcome a health insurer can hope for.

There's a certain amount of ambiguity in my background, what with intermarriages and conversions, but under various readings of three codes which I don’t much respect (Mosaic Law, the Nuremberg Laws, and the Israeli Law of Return) I do qualify as a member of the tribe, and any denial of that in my family has ceased with me. But I would not remove myself to Israel if it meant the continuing expropriation of another people, and if anti-Jewish fascism comes again to the Christian world—or more probably comes at us via the Muslim world—I already consider it an obligation to resist it wherever I live. I would detest myself if I fled from it in any direction. Leo Strauss was right. The Jews will not be 'saved' or 'redeemed.' (Cheer up: neither will anyone else.) They/we will always be in exile whether they are in the greater Jerusalem area or not, and this in some ways is as it should be. They are, or we are, as a friend of Victor Klemperer's once put it to him in a very dark time, condemned and privileged to be 'a seismic people.' A critical register of the general health of civilization is the status of 'the Jewish question.' No insurance policy has ever been devised that can or will cover this risk.

A Harris/Harvard School of Public Health poll of 1989 showed that most Americans (61 percent) favored a Canadian-type health system, in which the government was the single payer to doctors and hospitals, bypassing the insurance companies, and offering universal medical coverage to everyone. Neither the Democratic nor the Republican party adopted that as its program, although both insisted they wanted to “reform” the health system.

The United States spends more than twice as much per capita on health care as other rich capitalist countries —around $9,400 compared to around $3,600—and for that money its citizens can expect lives that are three years shorter. The United States spends more per capita on health care than any other country in the world, but 39 countries have longer life expectancies. [...] Under the current US system, rich, insured patients visit doctors more than they need, running up costs, while poor patients cannot afford even simple, inexpensive treatments and die younger than they should. Doctors spend time that could be used to save lives or treat illness by providing unnecessary, meaningless care. What a tragic waste of physician care.

Many political scientists used to assume that people vote selfishly, choosing the candidate or policy that will benefit them the most. But decades of research on public opinion have led to the conclusion that self-interest is a weak predictor of policy preferences. Parents of children in public school are not more supportive of government aid to schools than other citizens; young men subject to the draft are not more opposed to military escalation than men too old to be drafted; and people who lack health insurance are not more likely to support government-issued health insurance than people covered by insurance.35 Rather, people care about their groups, whether those be racial, regional, religious, or political. The political scientist Don Kinder summarizes the findings like this: “In matters of public opinion, citizens seem to be asking themselves not ‘What’s in it for me?’ but rather ‘What’s in it for my group?’ ”36 Political opinions function as “badges of social membership.”37

The value of land may be determined by how it can be used. For example, it may contain valuable resources such as water, minerals, tillable soil, timber or wildlife. There also may be commercial value in the natural attraction of land such as caves, lakes or trails. Land value can be reduced by erosion, flood, earthquake, fire or regulation.

The insistence that healthcare finance must be obtuse, that we must be condemned to illness because of an untranslatable series of runes and glyphs accessible only to a specialized wonk class—that it just has to be hard and thus anything that isn’t hard isn’t a solution—is a kind of epistemic violence against us non-wonk humans.*4 It is a lack of ambition, disguised as pragmatism. So let’s start simple. Here’s single-payer in one sentence: we pool the money we already pay to insurance companies and use it to insure everyone, in full, with no cost-sharing.

In my time in Washington, no battle has consumed more energy than stopping Obamacare. On the evening of September 24, 2013, it began with a prayer. In my tiny “hideaway” office wedged into a dome in the Capitol Building, Senator Mike Lee and I bowed our heads, read from the Book of Psalms, and asked for the Lord’s guidance. I then walked to the floor of the U.S. Senate and announced, “I intend to speak in support of defunding Obamacare until I am no longer able to stand.”* I opened by noting that “all across this country, Americans are suffering because of Obamacare.” And yet politicians in Washington were not listening to the concerns of their constituents. They weren’t hearing the people with jobs lost or the people forced into part-time work. They had no answers for the people losing their health insurance, or the people who are struggling. With good reason, men and women across America believe that politicians get elected, go to Washington, and stop listening to them. This is the most common thing you hear from the man on the street, from Republicans, Democrats, Independents, and Libertarians: You’re not listening to me.

Aye. 'Tis a free country." Monq had come to check on Elora just as she asked that question. "Well, that kind of has to be qualified," he interjected. "You can't come or go without a passport. You can't drive without a driver's license, registration, auto insurance and proof that your vehicle is up to code. You can't work or even get health care without a social security number. You have to pay taxes on everything including air and water. The closest distance between point A and B may involve paying a road toll. There are over three hundred thousand federal laws. You have to educate your children according to legal standards set by someone that's not you. There are laws about who can marry whom. But other than a few more such trivialities, it's a free country.

Another example is the modern political order. Ever since the French Revolution, people throughout the world have gradually come to see both equality and individual freedom as fundamental values. Yet the two values contradict each other. Equality can be ensured only by curtailing the freedoms of those who are better off. Guaranteeing that every individual will be free to do as he wishes inevitably short-changes equality. The entire political history of the world since 1789 can be seen as a series of attempts to reconcile this contradiction. Anyone who has read a novel by Charles Dickens knows that the liberal regimes of nineteenth-century Europe gave priority to individual freedom even if it meant throwing insolvent poor families in prison and giving orphans little choice but to join schools for pickpockets. Anyone who has read a novel by Alexander Solzhenitsyn knows how Communism’s egalitarian ideal produced brutal tyrannies that tried to control every aspect of daily life. Contemporary American politics also revolve around this contradiction. Democrats want a more equitable society, even if it means raising taxes to fund programmes to help the poor, elderly and infirm. But that infringes on the freedom of individuals to spend their money as they wish. Why should the government force me to buy health insurance if I prefer using the money to put my kids through college? Republicans, on the other hand, want to maximise individual freedom, even if it means that the income gap between rich and poor will grow wider and that many Americans will not be able to afford health care. Just as medieval culture did not manage to square chivalry with Christianity, so the modern world fails to square liberty with equality. But this is no defect. Such contradictions are an inseparable part of every human culture. In fact, they are culture’s engines, responsible for the creativity and dynamism of our species. Just

Climate change denialists are therefore engaged in intergenerational economic warfare on their own societies. They won’t witness the worst aspects of climate change—luckily for them they’ll die before they occur. But their children and grandchildren will be affected by them. The refusal of older people, and particularly old white males, to accept the need for climate action shifts costs that they themselves are causing onto their descendants, all of whom will pay higher prices, higher taxes and higher insurance premiums and enjoy poorer health, lower economic growth and fewer jobs because of climate change. Denialists are a form of economic parasite preying on their own offspring, running up a bill they’ll die before having to pay. And every year of delay increases the costs that future generations will have to bear.

White supremacists are the ones supporting policies that benefit racist power against the interests of the majority of White people. White supremacists claim to be pro-White but refuse to acknowledge that climate change is having a disastrous impact on the earth White people inhabit. They oppose affirmative-action programs, despite White women being their primary beneficiaries. White supremacists rage against Obamacare even as 43 percent of the people who gained lifesaving health insurance from 2010 to 2015 were White. They heil Adolf Hitler’s Nazis, even though it was the Nazis who launched a world war that destroyed the lives of more than forty million White people and ruined Europe. They wave Confederate flags and defend Confederate monuments, even though the Confederacy started a civil war that ended with more than five hundred thousand White American lives lost—more than every other American war combined. White supremacists love what America used to be, even though America used to be—and still is—teeming with millions of struggling White people. White supremacists blame non-White people for the struggles of White people when any objective analysis of their plight primarily implicates the rich White Trumps they support.

Romantic literature often presents the individual as somebody caught in a struggle against the state and the market. Nothing could be further from the truth. The state and the market are the mother and father of the individual, and the individual can survive only thanks to them. The market provides us with work, insurance and a pension. If we want to study a profession, the government’s schools are there to teach us. If we want to open a business, the bank loans us money. If we want to build a house, a construction company builds it and the bank gives us a mortgage, in some cases subsidised or insured by the state. If violence flares up, the police protect us. If we are sick for a few days, our health insurance takes care of us. If we are debilitated for months, social security steps in. If we need around-the-clock assistance, we can go to the market and hire a nurse – usually some stranger from the other side of the world who takes care of us with the kind of devotion that we no longer expect from our own children. If we have the means, we can spend our golden years at a senior citizens’ home. The tax authorities treat us as individuals, and do not expect us to pay the neighbours’ taxes. The courts, too, see us as individuals, and never punish us for the crimes of our cousins. Not only adult men, but also women and children, are recognised as individuals. Throughout most of history, women were often seen as the property of family or community. Modern states, on the other hand, see women as individuals, enjoying economic and legal rights independently of their family and community. They may hold their own bank accounts, decide whom to marry, and even choose to divorce or live on their own. But the liberation of the individual comes at a cost. Many of us now bewail the loss of strong families and communities and feel alienated and threatened by the power the impersonal state and market wield over our lives. States and markets composed of alienated individuals can intervene in the lives of their members much more easily than states and markets composed of strong families and communities. When neighbours in a high-rise apartment building cannot even agree on how much to pay their janitor, how can we expect them to resist the state? The deal between states, markets and individuals is an uneasy one. The state and the market disagree about their mutual rights and obligations, and individuals complain that both demand too much and provide too little. In many cases individuals are exploited by markets, and states employ their armies, police forces and bureaucracies to persecute individuals instead of defending them. Yet it is amazing that this deal works at all – however imperfectly. For it breaches countless generations of human social arrangements. Millions of years of evolution have designed us to live and think as community members. Within a mere two centuries we have become alienated individuals. Nothing testifies better to the awesome power of culture.

New Rule: Republicans must stop pitting the American people against the government. Last week, we heard a speech from Republican leader Bobby Jindal--and he began it with the story that every immigrant tells about going to an American grocery store for the first time and being overwhelmed with the "endless variety on the shelves." And this was just a 7-Eleven--wait till he sees a Safeway. The thing is, that "endless variety"exists only because Americans pay taxes to a government, which maintains roads, irrigates fields, oversees the electrical grid, and everything else that enables the modern American supermarket to carry forty-seven varieties of frozen breakfast pastry.Of course, it's easy to tear government down--Ronald Reagan used to say the nine most terrifying words in the Englishlanguage were "I'm from the government and I'm here to help." But that was before "I'm Sarah Palin, now show me the launch codes."The stimulus package was attacked as typical "tax and spend"--like repairing bridges is left-wing stuff. "There the liberals go again, always wanting to get across the river." Folks, the people are the government--the first responders who put out fires--that's your government. The ranger who shoos pedophiles out of the park restroom, the postman who delivers your porn.How stupid is it when people say, "That's all we need: the federal government telling Detroit how to make cars or Wells Fargo how to run a bank. You want them to look like the post office?"You mean the place that takes a note that's in my hand in L.A. on Monday and gives it to my sister in New Jersey on Wednesday, for 44 cents? Let me be the first to say, I would be thrilled if America's health-care system was anywhere near as functional as the post office.Truth is, recent years have made me much more wary of government stepping aside and letting unregulated private enterprise run things it plainly is too greedy to trust with. Like Wall Street. Like rebuilding Iraq.Like the way Republicans always frame the health-care debate by saying, "Health-care decisions should be made by doctors and patients, not government bureaucrats," leaving out the fact that health-care decisions aren't made by doctors, patients, or bureaucrats; they're made by insurance companies. Which are a lot like hospital gowns--chances are your gas isn't covered.

In a section of The Vaccine Book titled “Is it your social responsibility to vaccinate your kids?” Dr. Bob asks, “Can we fault parents for putting their own child’s health ahead of that of the kids around him?” This is meant to be a rhetorical question, but Dr. Bob’s implied answer is not mine. In another section of the book, Dr. Bob writes of his advice to parents who fear the MMR vaccine, “I also warn them not to share their fears with their neighbors, because if too many people avoid the MMR, we’ll likely see the disease increase significantly.” I do not need to consult an ethicist to determine that there is something wrong there, but my sister clarifies my discomfort. “The problem is in making a special exemption just for yourself,” she says. This reminds her of a way of thinking proposed by the philosopher John Rawls: Imagine that you do not know what position you are going to hold in society—rich, poor, educated, insured, no access to health care, infant, adult, HIV positive, healthy immune system, etc.—but that you are aware of the full range of possibilities. What you would want in that situation is a policy that is going to be equally just no matter what position you end up in. “Consider relationships of dependence,” my sister suggests. “You don’t own your body—that’s not what we are, our bodies aren’t independent. The health of our bodies always depends on choices other people are making.” She falters for a moment here, and is at a loss for words, which is rare for her. “I don’t even know how to talk about this,” she says. “The point is there’s an illusion of independence.

The best available apples-to-apples comparison of inflation-adjusted earnings shows what the typical fully employed man earned back in the 1970s and what that same fully employed man earns today. The picture isn’t pretty. As the GDP has doubled and almost doubled again, as corporations have piled up record profits, as the country has gotten wealthier, and as the number of billionaires has exploded, the average man working full-time today earns about what the average man earned back in 1970. Nearly half a century has gone by, and the guy right in the middle of the pack is making about what his granddad did. The second punch that’s landed on families is expenses. If costs had stayed the same over the past few decades, families would be okay—or, at least, they would be in about the same position as they were thirty-five years ago. Not advancing but not falling behind, either. But that didn’t happen. Total costs are up, way up. True, families have cut back on some kinds of expenses. Today, the average family spends less on food (including eating out), less on clothing, less on appliances, and less on furniture than a comparable family did back in 1971. In other words, families have been pretty careful about their day-to-day spending, but it hasn’t saved them. The problem is that the other expenses—the big, fixed expenses—have shot through the roof and blown apart the family budget. Adjusted for inflation, families today spend more on transportation, more on housing, and more on health insurance. And for all those families with small children and no one at home during the day, the cost of childcare has doubled, doubled again, and doubled once more. Families have pinched pennies on groceries and clothing, but these big, recurring expenses have blown them right over a financial cliff.

From the very beginning of its history, the manifold social evils of capitalism have given rise to oppositional movements. The one I am concerned with in this book is cooperativism, specifically worker cooperativism. There are many other kinds of cooperatives, including those in the credit, agriculture, housing, insurance, health, and retail sectors of the economy. But worker cooperativism is potentially the most “oppositional” form, the most anti-capitalist, since it organizes production in anti-capitalist ways. Indeed, the relations of production that constitute worker cooperativism also define socialism in its most general sense: workers’ democratic control over production and, in some varieties, ownership of the means of production (whether such ownership is organized individually, by owning shares of equity, or collectively). As one common formulation states, in the worker co-op, labor has power over capital, or “labor hires capital.” In the conventional business, by contrast, capital has power over labor, i.e., “capital hires labor.” None of the other kinds of cooperativism directly rejects these capitalist power-relations, although some may signify an implicit undermining of capitalism insofar as the co-op exists not primarily for the sake of maximizing profit but for satisfying some social need.

Stigma takes many forms, comes from all directions, is sometimes blatantly overt, but can also be remarkably subtle. It is the cruel comment, the unkind smirk, the extrusion from the group, the lost job opportunity, the rejected marriage proposal, the ineligibility for life insurance, the inability to adopt a child or pilot a plane. But it is also the reduced expectation, the helping hand when none is needed or wanted, the solicitous sympathy that one cannot really be expected to measure up. And the secondary psychological and practical harms of having a mental disorder come only partly from how others see you. A great deal of the trouble comes from the change in how you see yourself: the sense of being damaged goods, feeling not normal or worthy, not a full fledged member of the group. It is bad enough that stigma is so often associated with having a mental disorder, but the stigma that comes from being mislabeled with a fake diagnosis is a dead loss with absolutely no redeeming features.

The Unknown Citizen by W. H. Auden (To JS/07 M 378 This Marble Monument Is Erected by the State) He was found by the Bureau of Statistics to be One against whom there was no official complaint, And all the reports on his conduct agree That, in the modern sense of an old-fashioned word, he was a saint, For in everything he did he served the Greater Community. Except for the War till the day he retired He worked in a factory and never got fired, But satisfied his employers, Fudge Motors Inc. Yet he wasn't a scab or odd in his views, For his Union reports that he paid his dues, (Our report on his Union shows it was sound) And our Social Psychology workers found That he was popular with his mates and liked a drink. The Press are convinced that he bought a paper every day And that his reactions to advertisements were normal in every way. Policies taken out in his name prove that he was fully insured, And his Health-card shows he was once in hospital but left it cured. Both Producers Research and High-Grade Living declare He was fully sensible to the advantages of the Instalment Plan And had everything necessary to the Modern Man, A phonograph, a radio, a car and a frigidaire. Our researchers into Public Opinion are content That he held the proper opinions for the time of year; When there was peace, he was for peace: when there was war, he went. He was married and added five children to the population, Which our Eugenist says was the right number for a parent of his generation. And our teachers report that he never interfered with their education. Was he free? Was he happy? The question is absurd: Had anything been wrong, we should certainly have heard.

A statistician for the Prudential Insurance Company predicted the imminent extinction of Black people in his epic book that relied on the 1890 census figures. Unlike the Plessy ruling, Frederick Hoffman’s Race Traits and Tendencies of the American Negro received plenty of attention in 1896. Packed with statistical tables and published by the American Economic Association, the book was a pioneering work in American medical research, and it catapulted Hoffman into scientific celebrity in the Western world as the heralded father of American public health. At “the time of emancipation,” he wrote, southern Blacks were “healthy in body and cheerful in mind.” “What are the conditions thirty years after?” Well, “in the plain language of the facts,” free Blacks were headed toward “gradual extinction,” pulled down by their natural immoralities, law-breaking, and diseases. Hoffman supplied his employer with an excuse for its discriminatory policies concerning African Americans—that is, for denying them life insurance. White life insurance companies refused to insure a supposedly dying race. Yet another racist idea was produced to defend a racist policy.3

Ironically, many of the institutions that run the economy, such as medicine, education, law and even psychology are largely dependent upon failing health. If you add up the amounts of money exchanged in the control, anticipation and reaction to failing health (insurance, pharmaceutical research and products, reactive or compensatory medicine, related legal issues, consultation and therapy for those who are unwilling to improve their physical health and claim or believe the problem is elsewhere, etc.), you end up with an enormous chunk. To keep that moving, we need people to be sick. Then we have the extreme social emphasis placed on the pursuit and maintenance of a lifestyle based on making money at any cost, often at the sacrifice of health, sanity and well-being.

The truth is that we're drowning in busywork, nonproductive work, everything from "creative" banking and insurance bureaucracies to the pointless shuffling of data and the manufacturing of products designed to be obsolescent almost immediately- and I would argue that a great deal of what we're doing should just stop. Interestingly, people of all sorts are beginning to reconnect to skills and sensibilities that were bulldozed in the frenzy of 'development' that remade our world during the past two generations. Those orchards and fields that once covered the peninsula, the East Bay, and Silicon Valley are haunting us now, as we seek to relocalize our food sources and our economy more generally. People are relearning how to reuse things, how to fix broken items, and even how to make new things from the scraps of industrial waste. The world shaped by capitalist modernization is not good for human life and is certainly rough on the health of the planet. The hollowing out of communities whose lives were once anchored in the old Produce Market area or who shared life along the vibrant Fillmore blues corridor is precisely what people are trying to overcome.

With this warning, Mussolini demanded and was given authority to do just about whatever he wanted; but his initial priority, surprisingly, was good government. He knew that citizens were fed up with a bureaucracy that seemed to grow bigger and less efficient each year, so he insisted on daily roll calls in ministry offices and berated employees for arriving late to work or taking long lunches. He initiated a campaign to drenare la palude (“drain the swamp”) by firing more than 35,000 civil servants. He repurposed Fascist gangs to safeguard rail cargo from thieves. He allocated money to build bridges, roads, telephone exchanges, and giant aqueducts that brought water to arid regions. He gave Italy an eight-hour workday, codified insurance benefits for the elderly and disabled, funded prenatal health care clinics, established seventeen hundred summer camps for children, and dealt the Mafia a blow by suspending the jury system and short-circuiting due process. With no jury members to threaten and judges answerable directly to the state, the courts were as incorruptible as they were docile. Contrary to legend, the dictator didn’t quite succeed in making the trains run on time, but he earned bravos for trying.

In her book The Government-Citizen Disconnect, the political scientist Suzanne Mettler reports that 96 percent of American adults have relied on a major government program at some point in their lives. Rich, middle-class, and poor families depend on different kinds of programs, but the average rich and middle-class family draws on the same number of government benefits as the average poor family. Student loans look like they were issued from a bank, but the only reason banks hand out money to eighteen-year-olds with no jobs, no credit, and no collateral is because the federal government guarantees the loans and pays half their interest. Financial advisers at Edward Jones or Prudential can help you sign up for 529 college savings plans, but those plans' generous tax benefits will cost the federal government an estimated $28.5 billion between 2017 and 2026. For most Americans under the age of sixty-five, health insurance appears to come from their jobs, but supporting this arrangement is one of the single largest tax breaks issued by the federal government, one that exempts the cost of employer-sponsored health insurance from taxable incomes. In 2022, this benefit is estimated to have cost the government $316 billion for those under sixty-five. By 2032, its price tag is projected to exceed $6oo billion. Almost half of all Americans receive government-subsidized health benefits through their employers, and over a third are enrolled in government-subsidized retirement benefits. These participation rates, driven primarily by rich and middle-class Americans, far exceed those of even the largest programs directed at low income families, such as food stamps (14 percent of Americans) and the Earned Income Tax Credit (19 percent). Altogether, the United States spent $1.8 trillion on tax breaks in 2021. That amount exceeded total spending on law enforcement, education, housing, healthcare, diplomacy, and everything else that makes up our discretionary budget. Roughly half the benefits of the thirteen largest individual tax breaks accrue to the richest families, those with incomes that put them in the top 20 percent. The top I percent of income earners take home more than all middle-class families and double that of families in the bottom 20 percent. I can't tell you how many times someone has informed me that we should reduce military spending and redirect the savings to the poor. When this suggestion is made in a public venue, it always garners applause. I've met far fewer people who have suggested we boost aid to the poor by reducing tax breaks that mostly benefit the upper class, even though we spend over twice as much on them as on the military and national defense.

Did you ever think much about jobs? I mean, some of the jobs people land in? You see a guy giving haircuts to dogs, or maybe going along the curb with a shovel, scooping up horse manure. And you think, now why is the silly bastard doing that? He looks fairly bright, about as bright as anyone else. Why the hell does he do that for living? You kind grin and look down your nose at him. You think he’s nuts, know what I mean, or he doesn’t have any ambition. And then you take a good look at yourself, and you stop wondering about the other guy… You’ve got all your hands and feet. Your health is okay, and you make a nice appearance, and ambition-man! You’ve got it. You’re young, I guess: you’d call thirty young, and you’re strong. You don’t have much education, but you’ve got more than plenty of other people who go to the top. And yet with all that, with all you’ve had to do with this is as far you’ve got And something tellys you, you’re not going much farther if any. And there is nothing to be done about it now, of course, but you can’t stop hoping. You can’t stop wondering… …Maybe you had too much ambition. Maybe that was the trouble. You couldn’t see yourself spending forty years moving from office boy to president. So you signed on with a circulation crew; you worked the magazines from one coast to another. And then you ran across a little brush deal-it sounded nice, anyway. And you worked that until you found something better, something that looked better. And you moved from that something to another something. Coffee-and-tea premiums, dinnerware, penny-a-day insurance, photo coupons, cemetery lots, hosiery, extract, and God knows what all. You begged for the charities, You bought the old gold. You went back to the magazines and the brushes and the coffee and tea. You made good money, a couple of hundred a week sometimes. But when you averaged it up, the good weeks with the bad, it wasn’t so good. Fifty or sixty a week, maybe seventy. More than you could make, probably, behind agas pump or a soda fountain. But you had to knock yourself out to do it, and you were standing stil. You were still there at the starting place. And you weren’t a kid any more. So you come to this town, and you see this ad. Man for outside sales and collections. Good deal for hard worker. And you think maybe this is it. This sounds like a right town. So you take the job, and you settle down in the town. And, of course, neither one of ‘em is right, they’re just like all the others. The job stinks. The town stinks. You stink. And there’s not a goddamned thing you can do about it. All you can do is go on like this other guys go on. The guy giving haircuts to dogs, and the guy sweeping up horse manute Hating it. Hating yourself. And hoping.

Inarguably, a successful restaurant demands that you live on the premises for the first few years, working seventeen-hour days, with total involvement in every aspect of a complicated, cruel and very fickle trade. You must be fluent in not only Spanish but the Kabbala-like intricacies of health codes, tax law, fire department regulations, environmental protection laws, building code, occupational safety and health regs, fair hiring practices, zoning, insurance, the vagaries and back-alley back-scratching of liquor licenses, the netherworld of trash removal, linen, grease disposal. And with every dime you've got tied up in your new place, suddenly the drains in your prep kitchen are backing up with raw sewage, pushing hundreds of gallons of impacted crap into your dining room; your coke-addled chef just called that Asian waitress who's working her way through law school a chink, which ensures your presence in court for the next six months; your bartender is giving away the bar to under-age girls from Wantagh, any one of whom could then crash Daddy's Buick into a busload of divinity students, putting your liquor license in peril, to say the least; the Ansel System could go off, shutting down your kitchen in the middle of a ten-thousand-dollar night; there's the ongoing struggle with rodents and cockroaches, any one of which could crawl across the Tina Brown four-top in the middle of the dessert course; you just bought 10,000 dollars-worth of shrimp when the market was low, but the walk-in freezer just went on the fritz and naturally it's a holiday weekend, so good luck getting a service call in time; the dishwasher just walked out after arguing with the busboy, and they need glasses now on table seven; immigration is at the door for a surprise inspection of your kitchen's Green Cards; the produce guy wants a certified check or he's taking back the delivery; you didn't order enough napkins for the weekend — and is that the New York Times reviewer waiting for your hostess to stop flirting and notice her?