Paul Krugman | NYTimes

The obvious model for those hoping to reverse the fattening of America is the campaign against smoking. Before the surgeon general officially condemned smoking in 1964, rising cigarette consumption seemed an unstoppable trend; since then, consumption per capita has fallen more than 50 percent.

But it may be hard to match that success when it comes to obesity. I’m not talking about the inherent difficulty of the task – getting people to consume fewer calories and/or exercise more may be harder than getting people to stop smoking, but we won’t know until we try. I’m talking, instead, about how the political winds have shifted.

Public health activists were successful in taking on smoking in part because at the time corporations didn’t know how to play the public opinion game. By today’s standards, the political ineptitude of Big Tobacco was awe-inspiring. In a famous 1971 interview on “Face the Nation,” the chairman of the board of Philip Morris, confronted with evidence that smoking by mothers leads to low birth weight, replied, “Some women would prefer having smaller babies.”

Today’s food industry would never make that kind of mistake. In public, the industry’s companies proclaim themselves good guys, committed to healthier eating. Meanwhile, they outsource the campaigns against medical researchers and the dissemination of crude anti-anti-obesity propaganda to industry-financed advocacy groups like the Center for Consumer Freedom.

More broadly, the ideological landscape has changed drastically since the 1960′s. (That change in the landscape also has a lot to do with corporate financing of advocacy groups, but that’s a tale for another article.) In today’s America, proposals to do something about rising obesity rates must contend with a public predisposed to believe that the market is always right and that the government always screws things up.

You can see these predispositions at work in an article printed last month in Amber Waves, a magazine published by the Department of Agriculture. The article is titled “Obesity Policy and the Law of Unintended Consequences,” suggesting that government efforts to combat obesity are likely to be counterproductive. But the authors don’t actually provide any examples of how that might happen.

And the authors suggest, without quite asserting it, that because people freely choose obesity in a free market, it must be a good thing.

“Americans’ rapid weight gain may have nothing to do with market failure,” the article says. “It may be a rational response to changing technology and prices. … If consumers willingly trade off increased adiposity for working indoors and spending less time in the kitchen as well as for manageable weight-related health problems, then markets are not failing.”

How can medical experts who see obesity as a critical problem deal with an ideological landscape tilted in the direction of doing nothing?

One answer is to focus on the financial costs of obesity, and the fact that many of these costs fall on taxpayers and on the general insurance-buying public, rather than on the obese individuals themselves. (To their credit, the authors of the Amber Waves article do mention this issue, although they play it down.)

It is more important, however, to emphasize that there are situations in which “free to choose” is all wrong – and that this is one of them.

For one thing, the most rapid rise in obesity isn’t taking place among adults, who, we hope, can understand the consequences of their decisions. It’s taking place among children and adolescents.

And even if children weren’t a big part of the problem, only a blind ideologue or an economist could argue with a straight face that Americans were rationally deciding to become obese. In fact, even many economists know better: the most widely cited recent economic analysis of obesity, a 2003 paper by David Cutler, Edward Glaeser and Jesse Shapiro of Harvard University, declares that “at least some food consumption is almost certainly not rational.” It goes on to present evidence that even adults have clear problems with self-control.

Above all, we need to put aside our anti-government prejudices and realize that the history of government interventions on behalf of public health, from the construction of sewer systems to the campaign against smoking, is one of consistent, life-enhancing success. Obesity is America’s fastest-growing health problem; let’s do something about it.

healingarts | July 8, 2005 |

Paul Krugman | NYTimes

The Center for Consumer Freedom, an advocacy group financed by Coca-Cola, Wendy’s and Tyson Foods, among others, has a Fourth of July message for you: worrying about the rapid rise in American obesity is unpatriotic.

“Far too few Americans,” declares the center’s Web site, “remember that the Founding Fathers, authors of modern liberty, greatly enjoyed their food and drink. … Now it seems that food liberty – just one of the many important areas of personal choice fought for by the original American patriots – is constantly under attack.”

It sounds like a parody, but don’t laugh. These people are blocking efforts to help America’s children.

I’ve been looking into the issues surrounding obesity because it plays an important role in health care costs. According to a study recently published in the journal Health Affairs, the extra costs associated with caring for the obese rose from 2 percent of total private insurance spending in 1987 to 11.6 percent in 2002. The study didn’t cover Medicare and Medicaid, but it’s a good bet that obesity-related expenses are an important factor in the rising costs of taxpayer-financed programs, too. Fat is a fiscal issue.

But it’s also, alas, a partisan issue.

First, let’s talk about what isn’t in dispute: around 1980, Americans started getting rapidly fatter.

Some pundits still dismiss American pudge as a benign “affliction of affluence,” a sign that people can afford to eat tasty foods, drive cars and avoid hard physical labor. But all of that was already true by 1980, which is roughly when Americans really started losing the battle of the bulge.

The great majority of us (yes, me too) are now overweight, and the percentage of adults considered obese has doubled, to more than 30 percent. Most alarmingly, obesity, once rare among the young, has become common among adolescents, and even among children.

Is that a bad thing? Well, obesity clearly increases the risks of heart disease, diabetes, back problems and more. And the cost of treating these weight-related diseases is an important factor in rising health care spending.

So there is, understandably, a movement to do something about rising obesity, especially among the young. Bills that would require schools to serve healthier lunches, remove vending machines selling sweets and soda, and so on have been introduced in a number of state legislatures. By the way, Britain – with the second-highest obesity among advanced countries – has introduced stringent new guidelines on school meals.

But even these mild steps have run into fierce opposition from conservatives. Why?

In part, this is yet another red-blue cultural conflict. On average, people living outside metropolitan areas are heavier than urban or suburban residents, and people in the South and Midwest are heavier than those on the coasts. So it’s all too easy for worries about America’s weight to come off as cultural elitism.

More important, however, is the role of the food industry. The debate over obesity, it turns out, is a lot like the debate over global warming. In both cases, major companies protect their profits not only by lobbying against policies they don’t like, but also by financing advocacy groups devoted to debunking research whose conclusions they don’t like.

The pro-obesity forces – or, if you prefer, the anti-anti-obesity forces – make their case in part by claiming that America’s weight gain does no harm. There was much glee on the right when a new study, using data from the Centers for Disease Control and Prevention, appeared to reject the conventional view that obesity has a large negative effect on life expectancy.

But as officials from the C.D.C. have pointed out, mortality isn’t the only measure of health. There’s no question that obesity plays an important role in many diseases that diminish the quality of life and, crucially, require expensive treatment.

The growing availability of such treatment probably explains why the strong relationship between obesity and mortality visible in data from the 1970′s has weakened. But the cost of treating the obese is helping to break the back of our health care system.

So what can we do?

The first step is to recognize the industry-financed campaign against doing anything for the cynical exercise it is. Remember, nobody is proposing that adult Americans be prevented from eating whatever they want. The question is whether big companies will have a free hand in their efforts to get children into the habit of eating food that’s bad for them.

healingarts | July 4, 2005 |

Kelly Hearn | Conscious Choice

It’s everywhere and here’s why limiting your kids’ exposure makes good health sense.

For five decades, fluoride has been pitched as insurance against mottled teeth, a prerequisite for a healthy smile, a trophy for modern preventive medicine. But as the chemical has been added to drinking water and ingested by millions of Americans each day, scientists and activists are warning that both adults — and kids in particular — are getting far too much fluoride, translating to potentially severe health problems.

Mainstream medical associations, corporations and the U.S. government have invested money and reputation trumpeting the benefits of water fluoridation programs, saying community water fluoridation is an equitable, cost-effective way to prevent dental cavities, especially for poor children. Opponents say spiked water supplies combined with a sea of fluoride-containing products like toothpastes, gels and rinses are delivering large and harmful exposures — and kids are getting the brunt of it.

J. William Hirzy, a fluoride expert and chemist in residence at the American University in Washington, D.C., is one in a list of established scientists who oppose community fluoridation programs. Hirzy is disturbed that fluoride is added to municipal drinking water supplies at a level far greater than what nature delivers. “Human breast milk has about 1/100th the level of fluoride that so-called optimally fluoridated water has,” says Hirzy. “If Mother Nature had intended for human beings to get fluoride at that level, the human breast would have accommodated [it].”

This is where the effectiveness of fluoride in preventing cavities clashes with numerous health concerns about ingestion of the chemical. It’s generally accepted that limited amounts of fluoride prevent cavities but few realize the potential dangers that lurk with overexposure — or, as some call it, toxicity.

“It is now the consensus view of the dental research community that fluoride’s primary benefit to teeth comes from topical application to the exterior of teeth, not from ingestion through the water supply,” says Michael Connett, project director of the Fluoride Action Network, a Burlington, Vermont-based watchdog group. “Since … the risks are primarily from ingestion … adding fluoride to the nation’s water — and thereby to the bulk of the nation’s processed food — is not a good way of minimizing ingestion of fluoride.”

Hardest on the Kids

There are growing worries about fluoride’s effect on children’s behavior and other neurological functions. A 1995 study conducted by a leading neurotoxicologist, Phyllis Mullenix, Ph.D., and published in the journal Neurotoxicology and Teratology showed that baby rats — depending on when they were exposed to fluoride dosages similar to what human children receive — exhibited hyper- and hypo-activity. Some scientists believe this could be a link to the widespread problem of hyperactivity in many kids.

Mullenix, who formerly conducted research at Harvard’s Children’s Hospital, reported impacts on the central nervous system that flagged fluoride as having the potential to cause motor dysfunction, IQ deficits and/or learning disabilities in humans. Moreover, her work found traces of fluoride in the animals’ brains, which also contradicted the widely held assumption that fluoride does not cross the blood-brain barrier. Her findings upset the toothpaste industry and fluoridation supporters, she says, and eventually cost her her job at Forsyth Dental Center, which historically supported systematic fluoridation.

Fluoride toxicity is also fingered as a cause of thyroid dysfunction, especially that of underactive thyroid, termed hypothyroidism, a widespread medical condition that can cause fatigue, weight gain, cramps and a slow heart rate. In the mid-1900s minute doses of fluoride were used to correct overactive thyroid function. This has not escaped the observation of Hirzy, the chemist, who says the amount of fluoride most of us are exposed to in drinking water, processed foods and dental products is far beyond doses used to suppress an overactive thyroid. He theorizes that currently accepted fluoridation levels in water systems could slow thyroid functioning, leading to hypothyroidism.

Clearly, health issues linked to fluoride toxicity and the science behind it are controversial. But less disputed is the fact that fluoride overexposure, from water and personal care products, causes dental fluorosis — the mottling of teeth. The Journal of Public Health Dentistry (2002) found that dental fluorosis has increased in the U.S. and Canada over the last three decades in communities with and without fluoridated water.

In two other studies published in 1999, the same Public Health Dentistry journal noted that some children exceed the total daily fluoride ingestion simply by using toothpaste alone. (Age and body weight dictate an appropriate amount of fluoride needed to prevent cavities — see info box). In the second study, it found that more than 50 percent of infants are currently formula fed by one month of age, and, because of fluoride in the formula, they “are likely to be continuously exposed to high intakes of it for 9 or 10 months …”

Other research points to specific food products increasing risk of fluorosis. The Journal of the American Dental Association (1996) presented data suggesting that young children who drink substantial quantities of juice “possibly should not receive dietary fluoride supplements, since they might be at increased risk of developing dental fluorosis.” Another of its articles (1997) found high-fluoride-content chicken in infant food.

Yet other research, a 2001 study by Oregon State University, showed that foods made with mechanically separated chicken contribute to fluoride intake, reporting that infant foods had the highest amounts of fluoride, followed by packaged chicken sticks, luncheon and canned meats. The study’s authors concluded “a single serving of chicken sticks alone provides roughly half of a child’s upper limit of safety for fluoride.” This is because fluoride gets stored in animals’ bones and teeth, and some industrial deboning methods can leave residual pieces of both in the food.

Additionally, ingesting fluoride happens in a variety of other ways. Many pesticides sprayed on vegetables contain fluoride; sodas are made with fluoridated water. Tea leaves accumulate fluoride from water and soil.

Connett, of the Fluoride Action Network, and other activists point to the fact that countries in Western Europe which do not fluoridate water have shown the same decline in tooth decay as the U.S. and currently have the same low levels of childhood tooth decay. The fact that Europeans can independently choose their fluoride exposure — by using products such as fluoridated toothpaste (or not) makes activists like Connett wonder aloud, “If Europe can do the job with individual fluoride products, then why can’t we do the same here?”

Most people are surprised to learn that the chemicals used to fluoridate water — hexafluorosilicic acid and its sodium salt — are actually waste materials taken from pollution scrubbers used in the phosphate fertilizer industry. Fluoridation critics allege that corporate coziness with government has turned North America’s public water systems into toxic dumping grounds for industrial pollutants. Investigative journalist Christopher Bryson, author of The Fluoride Deception, documents how fluoridation of water is linked to multiple layers of conspiracies and fraud within the military-industrial complex. Hence, the political will to mirror Europe may grow as anti-fluoridation opponents spread information. In fact, more than 60 U.S. communities have rejected water fluoridation since 1999.

Kelly Hearn is a freelance writer based in Washington, D.C. and Buenos Aires, Argentina.

healingarts | May 25, 2005 |

Morgan Spurlock, from Don’t Eat This Book: Fast Food and the Supersizing of America

Every waking moment of our lives, we swim in an ocean of advertising, all of it telling us the same thing: consume, consume. And then consume some more. The epidemic of overconsumption begins with the things we put in our mouths. The United States is the fattest nation on earth. Sixty-five per cent of American adults are overweight; 30 per cent are obese. In the decade between 1991 and 2001, obesity figures almost doubled.

But the truly shocking thing is that we’ve taught our kids how to be fat, too. Obesity rates in American children remained stable throughout the 1960s, but they began to climb in the 1970s. In the past 20 years, the rate of obesity has doubled in children and trebled in teenagers. Kids are starting to clock in as obese as early as the age of two. If we find that surprising, we shouldn’t.

During the McMonth I endured for Super Size Me, in which I ate every meal at McDonald’s, every day – taking up the option to have a Supersize portion whenever I was offered it – I couldn’t get over how many kids there were in the restaurants almost any time that I walked in. Children with their parents. Gaggles of them stopping off for breakfast or for a pre-dinner snack in their cute little school uniforms. Kids in all the play areas. Kids as little as three and four having Happy Meal McBirthday parties. Or, in a McDonald’s in Houston, at 9am, a mother with her two very overweight kids who, having just finished their fat-filled breakfasts, were now eating hot fudge sundaes.

Ray Kroc, the man behind the McDonald’s empire, understood from Day McOne that youngsters were his target market. He had no sooner bought the company from the McDonald brothers than Ronald McDonald was brought in to attract the kiddies to the burgers and shakes.

The first Ronald was the TV weatherman Willard Scott in his younger, but apparently not leaner, days. Scott had been doing Bozo the Clown on local television. When the show was canceled, an enterprising McDonald’s franchisee asked him to come up with a clown figure that would lure the kids into the restaurant. Kroc saw it, liked it and extended the idea to the whole country.

But first he canned Scott. Kroc understood the negative publicity implications of an icon who looks as though he’s been eating too much of the company’s food. To this day you’ll never see Ronald McDonald eating the food; not in any commercial. He dances and sings, grins and giggles, and smiles at the kids while they stuff their faces, but he never touches the grub. Why? Presumably because, as the late Eazy-E said in the song “The Dopeman”: “Don’t get high off your own supply.”

Kroc also understood the value of promoting McDonald’s as a caring, family-friendly sort of place, a place with a heart, not heart disease. Early on, he began linking McDonald’s with various children’s charities. One executive told John F Love, author of McDonald’s: Behind the Arches: “It was an inexpensive, imaginative way of getting your name before the public and building a reputation to offset the image of selling 15-cent hamburgers. It was probably 99 per cent commercial.”

Thus the Ronald McDonald House Charities were born. They have now provided housing (and McMeals) for the families of more than two million seriously ill children. Never mind the fact that today an increasing number of children are going into hospital because of eating-related illnesses.

Talking of which, one of the most shocking things I saw during my McMonth was a McDonald’s in Texas Children’s Hospital – a hospital that is now stapling obese children’s stomachs. To me, that seemed utterly irresponsible, a flagrant violation of the doctor’s pledge of “Primum non nocere” (First, do no harm). In fact, hospitals across the US have fast-food franchises in them. The top-ranked pediatric hospital in the country, Children’s Hospital of Philadelphia, has a McDonald’s outlet. Why shouldn’t there be one in Houston?

Recently, a combination of good information and bad publicity has encouraged some hospitals to reconsider their food-service contracts. But Ronald won’t always leave without a fight. The Cleveland Clinic, for example, wants to rid America’s leading heart hospital of its McDonald’s. But according to the Cleveland Plain Dealer of 22 November last year, the clinic’s chief executive, Dr Toby Cosgrove, received a letter from a McDonald’s corporate vice-president called Marty Ranft, which “defended the franchise, and vowed … that ‘McDonald’s has no intention of terminating’ the remaining 10 years on its lease”.

The doctors at Texas Children’s Hospital told me they had young patients who were dying of cancer, and it was hard to get them to eat anything. At least these poor kids would eat some fries, take a bite of a burger: food they were familiar with. It was junk that they had been eating all their lives.

But it’s not enough to get young people to come to your restaurants; you have to get them to keep on coming back. McDonald’s operates something like 8,000 Playlands around America. They’re especially attractive to children in neighborhoods in which playgrounds are scarce. Burger King has about 3,200 of its own. Then there’s the Happy Meal, launched in the US in 1979. It cost a buck in those days. Inside a cardboard box with a circus theme, children found a McDoodler stencil, a puzzle book, a McWrist wallet, an ID bracelet and McDonaldland character erasers.

The meal-plus-toys packaging proved to be an instant hit, with the first Star Trek Happy Meals that very year. Soon, toy versions of all your favorite McDonald’s mascots were included: Ronald, Grimace, Hamburglar, Mayor McCheese, Big Mac, Birdie and Captain Crook. Later, toys would be themed for tie-ins with brands and films such as Barbie, Hot Wheels, The Little Mermaid, Finding Nemo and so on. By 2003, Happy Meals accounted for about 20 per cent of all meals sold (about $3.5bn in annual revenue).

And let’s not forget the Mighty Kids Meal, introduced in America in 2001. McDonald’s realized that by the time kids were eight or nine years old they felt they had outgrown the Happy Meal. Those were for little boys and girls. So the Mighty Kids Meal comes in a slightly more “grown-up” package. It offers bigger meals: a double cheeseburger, double hamburger or a six-piece chicken McNuggets, but still comes with a toy. We may be older, but we still like toys.

In 2004, McDonald’s celebrated the 25th anniversary of the Happy Meal with a year-long barrage of promotions and advertisements. The company also launched a version for adults, the Go Active! Adult Happy Meal. This included a salad, a bottle of water, a book that told you how to exercise, and an adult “toy”: a Stepometer, so you could measure how few steps it was from the counter to your car.

Good old Ronald. Under his smiling, caring guidance, an entire generation of overweight American adults who grew up following him into their local McDonald’s are now raising their own overweight children to follow in their heavy footsteps.

Recently, the magazine Advertising Age cited Ronald McDonald as No 2 on its list of top 10 advertising icons of the 20th century. Who was No 1? It was the Marlboro Man.

* * *

Adults bear an enormous responsibility for the obesity epidemic among children. Yet there’s also no question that even conscientious parents and guardians, who really do try to do well by kids and teach them healthy life choices, are not playing on anything like a level field. They’re going up against billions and billions of dollars spent every year in corporate marketing, all aimed at teaching kids to make exactly the opposite sorts of choices.

McDonald’s and the other fast-food chains make no secret of the fact that kids are their primary targets. “We have living proof of the long-lasting quality of early brand loyalties in the cradle-to-grave marketing at McDonald’s, and how well it works,” James McNeal, a well-known children’s marketing guru and the author of Kids As Customers, has said. “We start taking children in for their first and second birthdays, and on and on, and eventually they have a great deal of preference for that brand. Children can carry that with them through a lifetime.”

Today, corporations spend more than $15bn every year on marketing, advertising and promotions meant to program American children to consume, consume and consume some more. Why? Because they realize that children not only have more expendable income of their own, but they influence how their parents spend their hard-earned bucks, too – to the tune of more than $600bn a year. What do children choose to buy with all that cash? What do you think?

Nor is it just their current expenditure that corporations want a slice of: they’re looking at the long term. Brand logos for all sorts of crap now turn up on nursery blankets, crib toys and mobiles. In my office, I have a collection of baby bottles shaped like little bottles of 7 Up, DR Pepper and Pepsi. I found them on eBay. When we contacted the California manufacturer, Munchkin Bottling, they told us they had produced these things for a few years in the mid-1990s. They’d developed the concept themselves, then licensed the various drinks companies’ names and logos. Think about the associations formed in infants’ minds by these things. Think about the mentality that sees nothing wrong in marketing them.

Not to be outdone, McDonald’s marketing genius M Lawrence Light – the guy who rolled out the “I’m lovin’ it” campaign – wants to surround the youth of the world with McDonald’s brand images. “Light wants to turn everything he can into an ad for McDonald’s,” wrote Business Week magazine in July 2004. “He’s pushing the Oak Brook chain to open clothing shops so kids will walk around in T-shirts with the Golden Arches logo, just as they already do with Old Navy or Disney. He envisions a deal with the National Basketball Association to play the five-note tagline of the ‘I’m lovin’ it’ ad in the stadium every time a player shoots a three-pointer. He’s even toying with making the jingle available over the internet so it could be downloaded as a mobile phone ring tone.”

Light chose China as the market in which to open the first McKids store. “There will be 25 McKids stores there,” he told Business Week. “It’s got a line of toys, a line of clothes, a line of videos, all directed at young kids.” Why China? Because after years of communist rule, these children can’t get enough American products. A company like McDonald’s can easily swoop in and corrupt young consumers from the start.

This is adapted from ‘Don’t Eat This Book’, by Morgan Spurlock..

healingarts | May 23, 2005 |

Paul Krugman | NYTimes

The United States spends far more on health care than other advanced countries. Yet we don’t appear to receive more medical services. And we have lower life-expectancy and higher infant-mortality rates than countries that spend less than half as much per person. How do we do it?

An important part of the answer is that much of our health care spending is devoted to passing the buck: trying to get someone else to pay the bills.

According to the World Health Organization, in the United States administrative expenses eat up about 15 percent of the money paid in premiums to private health insurance companies, but only 4 percent of the budgets of public insurance programs, which consist mainly of Medicare and Medicaid. The numbers for both public and private insurance are similar in other countries – but because we rely much more heavily than anyone else on private insurance, our total administrative costs are much higher.

According to the health organization, the higher costs of private insurers are “mainly due to the extensive bureaucracy required to assess risk, rate premiums, design benefit packages and review, pay or refuse claims.” Public insurance plans have far less bureaucracy because they don’t try to screen out high-risk clients or charge them higher fees.

And the costs directly incurred by insurers are only half the story. Doctors “must hire office personnel just to deal with the insurance companies,” Dr. Atul Gawande, a practicing physician, wrote in The New Yorker. “A well-run office can get the insurer’s rejection rate down from 30 percent to, say, 15 percent. That’s how a doctor makes money. … It’s a war with insurance, every step of the way.”

Isn’t competition supposed to make the private sector more efficient than the public sector? Well, as the World Health Organization put it in a discussion of Western Europe, private insurers generally don’t compete by delivering care at lower cost. Instead, they “compete on the basis of risk selection” – that is, by turning away people who are likely to have high medical bills and by refusing or delaying any payment they can.

Yet the cost of providing medical care to those denied private insurance doesn’t go away. If individuals are poor, or if medical expenses impoverish them, they are covered by Medicaid. Otherwise, they pay out of pocket or rely on the charity of public hospitals.

So we’ve created a vast and hugely expensive insurance bureaucracy that accomplishes nothing. The resources spent by private insurers don’t reduce overall costs; they simply shift those costs to other people and institutions. It’s perverse but true that this system, which insures only 85 percent of the population, costs much more than we would pay for a system that covered everyone.

And the costs go beyond wasted money.

First, in the U.S. system, medical costs act as a tax on employment. For example, General Motors is losing money on every car it makes because of the burden of health care costs. As a result, it may be forced to lay off thousands of workers, or may even go out of business. Yet the insurance premiums saved by firing workers are no saving at all to society as a whole: somebody still ends up paying the bills.

Second, Americans without insurance eventually receive medical care – but the operative word is “eventually.” According to Kaiser Family Foundation data, the uninsured are about three times as likely as the insured to postpone seeking care, fail to get needed care, leave prescriptions unfilled or skip recommended treatment. And many end up disabled – or die – because of these delays.

Think about how crazy all of this is. At a rough guess, between two million and three million Americans are employed by insurers and health care providers not to deliver health care, but to pass the buck for that care to someone else. And the result of all their exertions is to make the nation poorer and sicker.

Why do we put up with such an expensive, counterproductive health care system? Vested interests play an important role. But we also suffer from ideological blinders: decades of indoctrination in the virtues of market competition and the evils of big government have left many Americans unable to comprehend the idea that sometimes competition is the problem, not the solution.

healingarts | April 22, 2005 |