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	<title>Doug-at-large &#187; Health Care</title>
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	<link>http://lerner.net/blog</link>
	<description>Doug Lerner reports from Tokyo and St. Louis, and points beyond...</description>
	<lastBuildDate>Fri, 17 Sep 2010 23:19:51 +0000</lastBuildDate>
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		<title>Polls turn in favor of new health care bill</title>
		<link>http://lerner.net/blog/2010/03/24/polls-turn-in-favor-of-new-health-care-bill/</link>
		<comments>http://lerner.net/blog/2010/03/24/polls-turn-in-favor-of-new-health-care-bill/#comments</comments>
		<pubDate>Tue, 23 Mar 2010 23:31:16 +0000</pubDate>
		<dc:creator>doug</dc:creator>
				<category><![CDATA[Health Care]]></category>
		<category><![CDATA[Politics]]></category>

		<guid isPermaLink="false">http://lerner.net/blog/?p=486</guid>
		<description><![CDATA[Republicans who thought health care reform was going to be Obama&#8217;s Waterloo and are hoping to make repeal their big campaign issue in the fall are going to have to think twice. The Democrats designed it to front load with lots of positive features that people just aren&#8217;t going to want to give back once [...]]]></description>
			<content:encoded><![CDATA[<p>Republicans who thought health care reform was going to be Obama&#8217;s Waterloo and are hoping to make repeal their big campaign issue in the fall are going to have to think twice. The Democrats designed it to front load with lots of positive features that people just aren&#8217;t going to want to give back once they give it some logical thought.</p>
<p>And opinion polls already show more people in favor of the new law than opposed:</p>
<p><a href="http://www.usatoday.com/news/washington/2010-03-23-health-poll-favorable_N.htm?csp=usat.me">http://www.usatoday.com/news/washington/2010-03-23-health-poll-favorable_N.htm?csp=usat.me</a></p>
<p>doug</p>
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		<title>New dieters social network Diet Harbor</title>
		<link>http://lerner.net/blog/2010/01/15/new-dieters-social-network-diet-harbor/</link>
		<comments>http://lerner.net/blog/2010/01/15/new-dieters-social-network-diet-harbor/#comments</comments>
		<pubDate>Fri, 15 Jan 2010 06:17:31 +0000</pubDate>
		<dc:creator>doug</dc:creator>
				<category><![CDATA[Diet]]></category>
		<category><![CDATA[Health Care]]></category>

		<guid isPermaLink="false">http://lerner.net/blog/?p=420</guid>
		<description><![CDATA[Please also visit my new social network for dieters, Diet Harbor (a safe harbor for dieting mutual support). http://dietharbor.com doug]]></description>
			<content:encoded><![CDATA[<p>Please also visit my new social network for dieters, Diet Harbor (a safe harbor for dieting mutual support).</p>
<p><a href="http://dietharbor.com">http://dietharbor.com</a></p>
<p>doug</p>
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		<title>Atkins, South Beach, Ornish &#8211; diet choice and heart health</title>
		<link>http://lerner.net/blog/2009/04/05/atkins-south-beach-ornish-diet-choice-and-heart-health/</link>
		<comments>http://lerner.net/blog/2009/04/05/atkins-south-beach-ornish-diet-choice-and-heart-health/#comments</comments>
		<pubDate>Sun, 05 Apr 2009 03:10:39 +0000</pubDate>
		<dc:creator>doug</dc:creator>
				<category><![CDATA[Diet]]></category>
		<category><![CDATA[Health Care]]></category>

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		<description><![CDATA[People who follow a low-carbohydrate, high-fat diet for weight maintenance, even for as little as a month, may worsen risk factors for heart disease compared to two other popular diets, a newly published study shows.]]></description>
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<div id="PrinterFriendly"><strong>Source:</strong> <a href="http://www.medicinenet.com/">http://www.medicinenet.com</a></p>
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<h2>How the Atkins Diet Fares in Cholesterol</h2>
<p><strong>Atkins-Like Diet Worse for Cholesterol Compared to South Beach, Ornish Diets, Study Says</strong></p>
<p><em>By <a href="http://www.medicinenet.com/script/main/art.asp?articlekey=57087">Salynn Boyles</a><br />
WebMD Health News</em></p>
<p><em>Reviewed By <a href="http://www.medicinenet.com/script/main/art.asp?articlekey=57059">Louise Chang, MD</a></em></p>
<div class="News_list_rdr">
<div class="News_list_top">
<h3><span style="font-weight: normal;">April 1, 2009 &#8212; People who follow a low-carbohydrate, high-fat diet for weight maintenance, even for as little as a month, may worsen risk factors for <a href="http://www.medicinenet.com/script/main/art.asp?articlekey=87976">heart disease</a> compared to two other popular diets, a newly published study shows.</span></h3>
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<p>Researchers set out to compare the impact of the Atkins, South Beach, and Ornish diets on measurable risk factors for heart disease in people who were not overweight and were not trying to lose weight.</p>
<p>The idea was to examine the effects of the diets when they are used for weight maintenance and not <a href="http://www.medicinenet.com/script/main/art.asp?articlekey=18262">weight loss</a>.</p>
<p>Earlier this year, a widely reported study found that for weight loss, restricting calories is the key and that it matters little whether you count carbs, fat, or protein.</p>
<p>But the newly published research suggests that there are big differences in the diets in terms of effects on cardiovascular risk factors when followed by people who aren&#8217;t losing weight.</p>
<p>&#8220;If you are losing weight on a diet, that is probably beneficial for your health no matter which of these diets you follow,&#8221; lead researcher Michael Miller, MD, tells WebMD. &#8220;The question is, &#8216;Once someone has established a weight they are comfortable with, does it matter which diet they follow?&#8217; And it appears that it does.&#8221;</p>
<h3>Atkins, South Beach, and Ornish</h3>
<p>The study included 18 healthy adults who were not overweight, who followed each of the three diets for one month, followed by a one-month &#8220;wash-out&#8221; period in which they ate normally. Caloric intake was increased during any phase of the study if a participant began to lose weight.</p>
<p>The low-carbohydrate, high-fat diet designed to approximate the first, and most extreme, phase of the Atkins diet included 50% of calories from fat and 22% to 38% of calories from saturated fat sources like meat, cheese, and other whole-fat dairy products, Miller tells WebMD.</p>
<p>During their month on the Mediterranean-based South Beach diet, study participants ate 30% of calories in the form of fat, but olive and other vegetable oils, nuts, lean meats, and fish were the main fat sources.</p>
<p>While on the low-fat, high-carbohydrate Ornish diet, 10% of calories came from fat.</p>
<p>The researchers conducted blood tests throughout the study to assess risk factors for heart disease, including LDL (bad) <a href="http://www.medicinenet.com/script/main/art.asp?articlekey=320">cholesterol</a>, <a href="http://www.medicinenet.com/script/main/art.asp?articlekey=8893">triglycerides</a>, and C-reactive protein, which is a measure of inflammation in the body.</p>
<p>They also used <a href="http://www.medicinenet.com/script/main/art.asp?articlekey=510">ultrasound</a> to study changes in blood vessels&#8217; flexibility &#8212; specifically, their ability to widen to accommodate blood flow. Atherosclerosis, the hardening of the arteries, hinders that process and is associated with <a href="http://www.medicinenet.com/script/main/art.asp?articlekey=379">heart attack</a> and <a href="http://www.medicinenet.com/script/main/art.asp?articlekey=489">stroke</a> risk.</p>
<p>The study revealed that:</p>
<ul>
<li>While on the low-carb, high-fat diet, LDL cholesterol levels increased slightly, compared to decreases of about 12% and 17% respectively, during the South Beach and Ornish phases of the study.</li>
<li>After a month on the Atkins-like diet, study participants showed less blood vessel flexibility than they did after a month on the Ornish diet. </li>
<li>CRP levels remained in the normal range with all three diets, but levels went down slightly while participants were on the South Beach and Ornish diets and they went up slightly on the high-fat, low-carb diet, Miller tells WebMD.</li>
</ul>
<p>The study appears in the April issue of the <em>Journal of the American Dietetic Association.</em></p>
<h3>Atkins Responds</h3>
<p>Miller says the study makes it clear that high-saturated fat diets are pro-inflammatory and that they promote heart disease in other ways as well.</p>
<p>But a spokeswoman for Atkins Nutritionals says the eating plan the study participants followed in no way resembles what is recommended for weight maintenance.</p>
<p>In an email exchange with WebMD, Atkins Vice President of Nutrition and Education Colette Heimowitz, MSc, says that on the maintenance phase of the Atkins diet, fat should make up no more than 40% of total calories, and no more than 10% of calories should come from saturated fat.</p>
<p>The study participants typically ate about three times as much saturated fat as they should have if they were following Atkins for weight maintenance, she says.</p>
<p>Heimowitz says that Atkins dieters consistently show improvements in blood fats, or lipids, in the form of decreased triglycerides. But this improvement was not seen in the study participants while they were on the low-carbohydrate, high-fat diet.</p>
<p>&#8220;Whatever diet Dr. Miller used, it was not &#8216;Atkins&#8217;, and the lipid response he reported is what one might expect to result from a rich mixture of carbohydrates and fat and overfeeding to avoid weight loss,&#8221; she notes.</p>
<p>She says three decades of research has shown the Atkins diet to be safe, and that the study by Miller and colleagues was too small and too short to allow for meaningful conclusions.</p>
<p>&#8220;The final sample size was 18, yet they make generalizations to many people,&#8221; she says. &#8220;The entire duration of the treatment was four weeks, yet they make statements about &#8216;long-term maintenance.&#8217;&#8221;</p>
<h3>Ornish Weighs In</h3>
<p>Miller acknowledges that the maintenance phase of the Atkins diet is not very different from the typical Western diet.</p>
<p>But he says many people stay on the more extreme, early phase of the diet, which is much higher in saturated fats, long after weight loss is no longer a goal.</p>
<p>&#8220;The main message is that reducing the saturated fat in the diet is better for overall heart health,&#8221; he says.</p>
<p>Low-fat diet proponent Dean Ornish, MD, tells WebMD that the study by Miller and colleagues explores the impact of high saturated-fat diets in a unique way.</p>
<p>He cites a separate study, published last week in the journal <em>Archives of Internal Medicine</em>, finding that older people who eat large amounts of saturated fat in the form of red and processed meat are more likely to die of heart disease and <a href="http://www.medicinenet.com/script/main/art.asp?articlekey=13931">cancer</a>.</p>
<p>He says the two studies &#8220;directly contradict&#8221; the idea that all diets are equally healthy as long as they promote weight loss.</p>
<p>Ornish is founder and president of the Preventive Medicine Research Institute in Sausalito, Calif.</p>
<p>The American Heart Association (AHA) recommends that no more than 35% of total daily calories come from fat, and no more than 7% of calories come from saturated fat sources.</p>
<p>Nutritionist Alice Lichtenstein, DSc, who is an AHA spokeswoman, says protein should come primarily from low-fat sources like fish, legumes, and lean meat. Dairy foods should be low-fat or nonfat, and, of course, eating plenty of fruits and vegetables is important.</p>
<p>&#8220;If you follow this pattern you will end up with a diet that is in line with what AHA recommends,&#8221; she says.</p>
<p class="credits">SOURCES: Miller, M., J<em>ournal of the American Dietetic Association</em>, April 2009; vol 109: pp 713-717. Miller, Michael, MD, associate professor of medicine, epidemiology and preventive medicine, University of Maryland School of Medicine, Baltimore. Alice Lichtenstein, DSc, senior scientist and director, Cardiovascular Nutrition Laboratory, Tufts University; spokeswoman, American Heart Association. Colette Heimowitz, MSc, vice president of nutrition and education, Atkins Nutritionals Inc.Dean Ornish, MD, founder and president, Preventive Medicine Research Institute, Sausalito, Calif.Sinha, R. <em>Achieves of Internal Medicine</em>, March 23, 2009; vol 169: pp 543-545.</p>
<p class="credits"> </p>
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		<title>Clinton or Obama &#8212; On Health Care the Difference is Big</title>
		<link>http://lerner.net/blog/2008/02/06/clinton-or-obama-on-health-care-the-difference-is-big/</link>
		<comments>http://lerner.net/blog/2008/02/06/clinton-or-obama-on-health-care-the-difference-is-big/#comments</comments>
		<pubDate>Wed, 06 Feb 2008 11:32:20 +0000</pubDate>
		<dc:creator>doug</dc:creator>
				<category><![CDATA[Health Care]]></category>

		<guid isPermaLink="false">http://lerner.net/blog/2008/02/06/clinton-or-obama-on-health-care-the-difference-is-big/</guid>
		<description><![CDATA[From the Huffington Post at http://www.huffingtonpost.com/gerald-mcentee/clinton-or-obama-on-he_b_85144.html by Gerald McEntee Clinton or Obama &#8212; On Health Care the Difference is Big There has been extensive coverage in the mainstream media and blogosphere about the health care proposals of Senators Clinton and Obama. This issue is important to me because I am a passionate advocate of health [...]]]></description>
			<content:encoded><![CDATA[<p>From the Huffington Post at http://www.huffingtonpost.com/gerald-mcentee/clinton-or-obama-on-he_b_85144.html</p>
<p>by Gerald McEntee</p>
<p>Clinton or Obama &#8212; On Health Care the Difference is Big</p>
<p>There has been extensive coverage in the mainstream media and blogosphere about the health care proposals of Senators Clinton and Obama. This issue is important to me because I am a passionate advocate of health care for all and because the way the candidates deal with it points to a major reason I&#8217;m supporting Hillary Clinton for President: She&#8217;ll get results.</p>
<p>New York Times Op-Ed Columnist Paul Krugman closed his Monday column about the political and economic differences between the two Democratic candidate&#8217;s health care plans by explaining that, &#8220;If you combine the economic analysis with these political realities, here&#8217;s what I think it says: If Mrs. Clinton gets the Democratic nomination, there is some chance &#8212; nobody knows how big &#8212; that we&#8217;ll get universal health care in the next administration. If Mr. Obama gets the nomination, it just won&#8217;t happen.&#8221;</p>
<p>Krugman makes a strong statement and it&#8217;s based on two points: the first is that Clinton&#8217;s plan provides universal coverage (through an individual mandate), and Obama&#8217;s plan does not cover everyone and does not include an individual mandate (except he does have one for children, which suggests he understands its usefulness). On this the experts agree &#8212; Obama&#8217;s plan leaves 15 million people uninsured while Clinton&#8217;s plan leaves no patients behind. According to the Wall Street Journal, &#8220;Outside experts agree that number is in the ballpark.&#8221; Obama has acknowledged this fact, saying that &#8220;Fifteen million sounds like a lot &#8230; I&#8217;ll have 97 percent covered.&#8221; The Washington Post notes that the &#8220;Obama plan could leave a third of those currently uninsured lacking coverage.&#8221;</p>
<p>Krugman&#8217;s second point is that Obama uses campaign rhetoric &#8212; straight from the pages of the right-wing, anti-government playbook &#8212; that demonizes mandates to the point where he would have a difficult time as president accepting a proposal that has one. The ideological intensity of Obama&#8217;s critique is a serious problem because an individual mandate is an effective mechanism for covering everyone. It&#8217;s far from the only way &#8212; but it is one way and it has lots of political support. If you&#8217;re trying to bring people together around a solution, ruling out something as big as this may well rule out your chance of success. In this way, says Krugman, &#8220;Mr. Obama&#8217;s campaigning on the health care issue has sabotaged his own prospects&#8221; of winning reform as president.</p>
<p>The case in point is Obama&#8217;s recent direct mail piece (PDF), which is misleading about Clinton&#8217;s plan and his own. Ezra Klein of the American Prospect says that Obama is &#8220;fear-mongering&#8221; and &#8220;demagoguing universal health care.&#8221; For example, Obama fails to mention that Clinton&#8217;s plan guarantees coverage for all. And while he says that affordability is the key issue, he neglects to note that her affordability provisions are stronger and more specific than his. Obama also fails to note that his own plan has an individual mandate.</p>
<p>The nonpartisan factcheck.org has done a thorough analysis of Obama&#8217;s mail piece that you can read on their site. Krugman and others note that Obama&#8217;s mailer is also reminiscent of the infamous &#8220;Harry and Louise&#8221; ads that the insurance industry spent millions on to kill national health care reform in 1993.</p>
<p>Jonathan Cohn from the New Republic, commenting on Obama&#8217;s mail piece, explains that &#8220;a presidential candidate who believes in a reform has to avoid making statements that could undermine that reform down the road. And that&#8217;s precisely what Obama has done here. Even he has admitted, in some instances, that a mandate might be necessary in order to get everybody into a universal health care system. (And he already has one for kids.) But this mailer &#8212; with all of its unmistakable echoes of Harry and Louise &#8212; makes that task much harder.&#8221;</p>
<p>&#8220;In the end,&#8221; says Klein, Obama&#8217;s &#8220;plan is not universal, does not attempt to be, and is probably less generous in its affordability provisions than Clinton&#8217;s. And even so, I wouldn&#8217;t really care, as it&#8217;s still a pretty good plan, except that he&#8217;s decided to respond to the inadequacies of his own policy by fear-mongering against not only a better policy, but the type of policy he&#8217;s probably going to have to eventually adopt. It&#8217;s very, very short-sighted.&#8221;</p>
<p>The substantive difference between Clinton and Obama on health care is that Clinton will cover everyone and Obama will not. There&#8217;s no reason to hope that every man, woman and child in our country will be covered under Obama&#8217;s plan because that&#8217;s not what he intends to do. When it comes to health care, the difference is clear: Obama&#8217;s plan sets us back. Clinton&#8217;s plan moves us forward.</p>
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		<title>Conservative Republicans get it all wrong on health care facts again</title>
		<link>http://lerner.net/blog/2007/10/11/conservative-republicans-get-it-all-wrong-on-health-care-facts-again/</link>
		<comments>http://lerner.net/blog/2007/10/11/conservative-republicans-get-it-all-wrong-on-health-care-facts-again/#comments</comments>
		<pubDate>Wed, 10 Oct 2007 22:38:13 +0000</pubDate>
		<dc:creator>doug</dc:creator>
				<category><![CDATA[Health Care]]></category>

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		<description><![CDATA[From the NY Times October 10, 2007 POLITICAL MEMO Capitol Feud: A 12-Year-Old Is the Fodder By DAVID M. HERSZENHORN WASHINGTON, Oct. 9 â€” There have been moments when the fight between Congressional Democrats and President Bush over the State Childrenâ€™s Health Insurance Program seemed to devolve into a shouting match about who loves children [...]]]></description>
			<content:encoded><![CDATA[<p>From the NY Times</p>
<p>October 10, 2007<br />
POLITICAL MEMO<br />
Capitol Feud: A 12-Year-Old Is the Fodder</p>
<p>By DAVID M. HERSZENHORN<br />
WASHINGTON, Oct. 9 â€” There have been moments when the fight between Congressional Democrats and President Bush over the State Childrenâ€™s Health Insurance Program seemed to devolve into a shouting match about who loves children more.</p>
<p>So when Democrats enlisted 12-year-old Graeme Frost, who along with a younger sister relied on the program for treatment of severe brain injuries suffered in a car crash, to give the response to Mr. Bushâ€™s weekly radio address on Sept. 29, Republican opponents quickly accused them of exploiting the boy to score political points.</p>
<p>Then, they wasted little time in going after him to score their own.</p>
<p>In recent days, Graeme and his family have been attacked by conservative bloggers and other critics of the Democratsâ€™ plan to expand the insurance program, known as S-chip. They scrutinized the familyâ€™s income and assets â€” even alleged the counters in their kitchen to be granite â€” and declared that the Frosts did not seem needy enough for government benefits.</p>
<p>But what on the surface appears to be yet another partisan feud, all the nastier because a child is at the center of it, actually cuts to the most substantive debate around S-chip. Democrats say it is crucially needed to help the working poor â€” Medicaid already helps the impoverished â€” but many Republicans say it now helps too many people with the means to help themselves.</p>
<p>The feud also illustrates what can happen when politicians showcase real people to make a point, a popular but often perilous technique. And in this case, the discourse has been anything but polite.</p>
<p>The critics accused Graemeâ€™s father, Halsey, a self-employed woodworker, of choosing not to provide insurance for his family of six, even though he owned his own business. They pointed out that Graeme attends an expensive private school. And they asserted that the familyâ€™s home had undergone extensive remodeling, and that its market value could exceed $400,000.</p>
<p>One critic, in an e-mail message to Graemeâ€™s mother, Bonnie, warned: â€œLie down with dogs, and expect to get fleas.â€ As it turns out, the Frosts say, Graeme attends the private school on scholarship. The business that the critics said Mr. Frost owned was dissolved in 1999. The familyâ€™s home, in the modest Butchers Hill neighborhood of Baltimore, was bought for $55,000 in 1990 and is now worth about $260,000, according to public records. And, for the record, the Frosts say, their kitchen counters are concrete.</p>
<p>Certainly the Frosts are not destitute. They also own a commercial property, valued at about $160,000, that provides rental income. Mr. Frost works intermittently in woodworking and as a welder, while Mrs. Frost has a part-time job at a firm that provides services to publishers of medical journals. Her job does not provide health coverage.</p>
<p>Under the Maryland child health program, a family of six must earn less than $55,220 a year for children to qualify. The program does not require applicants to list their assets, which do not affect eligibility.</p>
<p>In a telephone interview, the Frosts said they had recently been rejected by three private insurance companies because of pre-existing medical conditions. â€œWe stood up in the first place because S-chip really helped our family and we wanted to help other families,â€ Mrs. Frost said.</p>
<p>â€œWe work hard, weâ€™re honest, we pay our taxes,â€ Mr. Frost said, adding, â€œThere are hard-working families that really need affordable health insurance.â€</p>
<p>Democrats, including the House speaker, Nancy Pelosi, have risen to the Frostsâ€™ defense, saying they earn about $45,000 a year and are precisely the type of working-poor Americans that the program was intended to help.</p>
<p>Ms. Pelosi on Tuesday said, â€œI think itâ€™s really a sad statement about how bankrupt some of these people are in their arguments against S-chip that they would attack a 12-year-old boy.â€</p>
<p>The House and Senate approved legislation to expand the child health program by $35 billion over five years. President Bush, who proposed a lower increase, vetoed the bill last week. Mr. Bush said the Democratsâ€™ plan was fiscally unsound and would raise taxes; the Democrats say he is willing to spend billions on the Iraq war but not on health care for American children.</p>
<p>Mr. Bushâ€™s plan could force states to tighten eligibility limits, but it seemed likely that the Frost children would still be covered.</p>
<p>Republicans on Capitol Hill, who were gearing up to use Graeme as evidence that Democrats have overexpanded the health program to include families wealthy enough to afford private insurance, have backed off.</p>
<p>An aide to Senator Mitch McConnell of Kentucky, the Republican leader, expressed relief that his office had not issued a press release criticizing the Frosts.</p>
<p>But Michelle Malkin, one of the bloggers who have strongly criticized the Frosts, insisted Republicans should hold their ground and not pull punches.</p>
<p>â€œThe bottom line here is that this family has considerable assets,â€ Ms. Malkin wrote in an e-mail message. â€œMarylandâ€™s S-chip program does not means-test. The refusal to do assets tests on federal health insurance programs is why federal entitlements are exploding and government keeps expanding. If Republicans donâ€™t have the guts to hold the line, they deserve to lose their seats.â€</p>
<p>As for accusations that bloggers were unfairly attacking a 12-year-old, Ms. Malkin wrote on her blog, â€œIf you donâ€™t want questions, donâ€™t foist these children onto the public stage.â€</p>
<p>Mr. and Mrs. Frost said they were bothered by the assertion that they lacked health coverage by their own choice.</p>
<p>â€œThat is not true at all,â€ Mrs. Frost said. â€œBasically all these naysayers need to lay the facts out on the page, and say, â€˜How could a family be able to do this?â€™ S-chip is a stopgap.â€</p>
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		<title>Republicans offer no health care solutions</title>
		<link>http://lerner.net/blog/2007/08/07/republicans-offer-no-health-care-solutions/</link>
		<comments>http://lerner.net/blog/2007/08/07/republicans-offer-no-health-care-solutions/#comments</comments>
		<pubDate>Mon, 06 Aug 2007 23:12:09 +0000</pubDate>
		<dc:creator>doug</dc:creator>
				<category><![CDATA[Election 2008]]></category>
		<category><![CDATA[Health Care]]></category>
		<category><![CDATA[Society]]></category>

		<guid isPermaLink="false">http://lerner.net/blog/2007/08/07/republicans-offer-no-health-care-solutions/</guid>
		<description><![CDATA[The Republican candidates all talk about &#8220;tax credits&#8221; for getting personal health insurance. I never understood how this would make private health insurance, which would cost like $6,000 &#8211; $9,000 a year for comprehensive coverage for a family of four affordable to an average family who can&#8217;t make ends meet already. Also, I haven&#8217;t heard [...]]]></description>
			<content:encoded><![CDATA[<p>The Republican candidates all talk about &#8220;tax credits&#8221; for getting personal health insurance.</p>
<p>I never understood how this would make private health insurance, which would cost like $6,000 &#8211; $9,000 a year for comprehensive coverage for a family of four affordable to an average family who can&#8217;t make ends meet already.</p>
<p>Also, I haven&#8217;t heard any Republican candidate address the elephant in the room &#8211; pre-existing conditions. Unless that is part of the overall solution it isn&#8217;t a solution at all as far as I can see.</p>
<p>I&#8217;m not a dyed-in-the-wool Democrat by any means. But I don&#8217;t see how anybody with the slightest interest in solving the health care issue in the U.S. can even consider voting for a Republican.</p>
<p>doug</p>
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