Folks who exert themselves to stay informed and can actually use critical judgement are ignored by national political speech, because they are unlikely to be swayed by such silly measures. This latter group is the focus of the mass media, who systematically lie and conceal so as to confound rationality. Confused and divided by sources of false information, thinking people who would normally impose some rational restraint on political speech are effectively marginalized and made socially and politically impotent. So we end up with a "respectable" press spouting fantasies and spinning lies and politicians who appear to be insane.

The crux of the problem, in my estimation, is that news, like medicine, shouldn't be in the hands of the corporate profit motive. So long as news is provided for profit by corporate entities, coverage will always be slanted toward corporate interests. There's no profit in exposing the lies of political leaders. Quite the contrary, heavy losses (financial or otherwise) await any "news network" or newspaper that challenges the well-spun lies -- and all manner of profits await those media entities and mouthpieces who reiterate and reinforce the fantasies.

I don't know how to "un-allow" this, how to strip control of mass media from the depraved plutocracy or corporate control. It would require something akin to anti-trust legislation, but bold lawmaking depends on bold lawmakers, while corporate control of media ensures that virtually everyone in Congress is a wholly-owned subsidiary of Big Business.

inevitable. What I care about is monopoly control of news. How about tolerating a little real competition? I am not a libertarian. I just sound that way at times. Most people reject anti-militarism on the basis of a propaganda program that leaves them thinking that such logic is flawed, cynical, elitist, or whatever other negative label that can be pinned on the pursuit of truth. Once convinced, following the original framers of our republic, that a standing army is an intolerable threat to our liberty, progress can start towards regaining and ensuring our liberty. Give me demilitarization or give me death, which at my age and state of health is not as dramatic a statement as when Patrick Henry first expressed the underlying idea. We need to declare war on wars of all kinds if we are to earn our freedom. This is not a pacifist approach, just a common sense one. ***           ***           *** I don't usually forward e-mails but I have what I think is a blanket permission from Don. The report of the Medical Society of the State of New York and Don's commentary on it underlines what I was just saying about concentrations of power. In order for private medical insurance to function in a benign way there would have to be an enforced policy of limiting their size, geographic scope and therefore their power, in relation to professional autonomy and standards. The absurd result of insurance companies controlling the practice of medicine is a function of the economic power represented by oligopolistic control of "the medical marketplace" and the inevitable abuses that such an arrangement lead to. The acronym MD used to mean Medical Doctor now it means Marketing Deputy. Another interesting aspect of this ignorant control focused only on quarterly profits for the handful of insurance companies is that doctors are being forced to act outside their scope of training and expertise. A survey was done that showed that 75% of doctors report being forced (as a result of insurance company control, by my analysis) to do things that they did not feel competent to do based on training and experience. Trust is essential in medical care. Most people believe that their doctors are doing for them and their loved ones what she feels is right. In fact, under insurance company control, this is unlikely to be the case. Every time someone presents an insurance card, public or private, the doctor becomes a mere pass-through for insurance company policy. Their trust is betrayed. Imagine if auto mechanics were forced to work on any job that showed up (essentially the situation that exists in such shops as Pep Boys). Someone brings in their Mercedes and a tractor mechanic does the repair work while the shop proclaims its competency. Our current system is designed to impose mediocrity and dishonesty because that is the best way to short-term profits (fraud and theft being the traditional way to short-term profits). Professionals go along with this or get out of medicine. I know of several fine doctors that have left medicine completely rather than to submit to this oppressive system who's main goal is to swindle patients. Don McCanne is a firm supporter of single-payer legislation. I would be too, if I was not convinced that it would just perpetuate and perhaps worsen the destruction of medicine in the US. If such a system avoided making clinical decisions, maybe it would work. But can you imagine our current managerial elite with their MBAs and management theology staying hands off? In a healthier management climate, like exists in parts of Europe and Japan, a single payer system makes perfect sense, but here in the crumbling USA we will be better served by decentralizing controls and elaborating a diverse set of choices so that natural market forces, based on real competition, can come into play. In this decentralized environment integrity and skill

Email from Don McCanne Doctors pressured by the intrusion of private insurers The Medical Society of the State of New York: Survey reveals that doctors feel pressured by health insurers to alter the way they treat patients Excerpt:  The Medical Society of the State of New York just released survey results, which indicate that health insurer rules often force New York State physicians to alter the way they treat patients -- and not necessarily for the benefit of patients. Instead, the rules appear to have been developed to increase insurer profits at the expense of the best health practices and patients' health. The survey results indicate: Ninety percent (90%) of the physicians surveyed said that they have had to change the way they treat patients based on restrictions from an insurance company, and 92% said that insurance company incentives and disincentives regarding treatment protocols "may not be in the best interest of the patients." Physicians' most common complaint was that health insurers required them to change prescription medications; 93% of the physicians voiced this complaint. Over three-fourths (78%) said that an insurance carrier has restricted their ability to refer patients to the physicians they believed would best treat their patients' needs. A majority (87%) of physicians said that they sometimes feel that they are pressured to prescribe a course of treatment based on cost rather than on what may be best for the patient. Over half (62%) of the physicians surveyed, however, are either somewhat concerned or very concerned that they may be cut out of an insurance network if they do not follow the policies requested by insurance companies. ... Complete survey results Press release [PDF] Comment:  No person disputes the fact that it is wise to use a less expensive generic medication when a newer product on patent is more expensive, has not been shown to be a better therapeutic agent, and has not been in use long enough to identify potential adverse effects that only post-marketing surveys could demonstrate. A public insurance program would be designed with incentives to provide the best care possible, with secondary incentives to avoid more expensive options that have no advantage over less expensive options. For example, a $100,000 cancer drug that has not been demonstrated to be any more effective than established agents, and which has a 100 percent incidence of toxic side effects, may not be covered by a public program except perhaps as part of an approved research protocol. This survey once again confirms that private insurers are intrusive in the patient-physician relationship. We know that their interventions are based on business contracts that they have with pharmacy benefit managers and pharmaceutical manufacturers. Their business interests take precedence over the interests of the patients. In some instances, recommended changes may incidentally benefit patients, but they are made only after the insurers first have made a determination that the change will benefit their bottom line. Moreover, insurers usually dictate which specialists and which hospitals can be used without the patient incurring significant financial penalties. These authorized referrals are based on provider contracts that accrue to the benefit of the insurer without regard to the wishes of the patient and the advice of the physician. In a well designed public program, patients would have choices within the full range of provider options. Before we adopt reform based on the private insurance model, we should think about what that means. Amongst the great multitude of problems, we would be adopting a system that allows businessmen to intrude between the patient and the physician and take away with them whatever money they can. That doesn't seem wise when we could have our own public program that is designed to provide the best care for all of us with the resources that we have. Don McCanne