I'll be honest with you, I'm scared. Being safe is important to me.

And when it comes to my family, there is next to nothing I would not be willing to do to keep them safe. There are few sacrifices I would not be willing to make to keep them safe from harm.

The harm, for example, of being sexually assaulted.

What notion of safety demands submitting to sexual assault as a trade-off on the remote chance that the next attempted terrorist attack will use the exact same methods of the previous attempted terrorist attack?

What perversion of the very idea of safety demands a parent allow his or her child to be sexually assaulted?

And we are to submit to this, we are to force our children to submit to this, or face a fine. An $11,000 fine for refusing to submit to sexual assault. Ask any sexual assault survivor if there is a price she or he would not pay to not have to endure that pain. Or if emotional pain and humiliation aren't important enough to consider (as the authors of this policy apparently believe), if money is the only concern, ask what the cost of a lifetime of therapy would be for a child who was sexually assaulted ... while his parents looked on and did nothing. $11,000 seems a bargain in comparison.

Yes, I'm scared when I get on an airplane, scared that some deranged idiot will attempt to take my life and might even succeed, but the remote threat of death those few times a year that I board an airplane pales in comparison to the other threats I face every single day.

It turns out there is almost no limit to what I would do to keep my family safe, but there is a limit to what I would do to board an airplane. And I have reached that limit.

The United States pays more than any other country for health care. We pay more.

We pay enough for every person in this country to receive the so-called Cadillac of health care.

We pay enough for every person in this country to have no fear that an illness will send them into poverty because they have no insurance.

We pay enough for every person in the country to have no fear that a job lost will also mean health insurance lost.

We pay enough for every person in this country to have no fear that their insurance will be rescinded if they become ill.

We pay enough for every person in this country to have no fear that an illness or accident might leave them with a pre-existing condition.

We pay enough for every person in this country to seek the very best of care and to get it without delay or rationing.

We pay enough for every patient in every hospital to need to think only about getting well without the fear of the hospital's bill.

And yet, as a nation, we consider this kind of basic health security a luxury.

A luxury that every other developed nation already provides its citizens (and most of them freely extend to anyone within their borders).

We pay enough for every person in the country to have the Cadillac of health care, and yet most of us fortunate enough to have coverage at all, have something that better resembles a Pinto.

In the health care reform debate, the most effective, most efficient, best solutions to our national crisis were never on the table. There was no discussion of a National Health Service, no discussion of a Single-Payer system, and no real discussion of a strictly regulated non-profit but private insurance solution.

Even the solution I advocate, Medicare for All, is a compromise from a true Single-Payer system. And the Public Option is the most anemic of compromises even after all of the energy we have had to put into saving it.

At best, the bill working through Congress now amounts to a detailing job for the Pinto.

It is not enough.

The money is there. We are already spending the money. What we lack is the political will. That must change.

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Reference:

According to single-payer supporter Dr. David Himmelstein, if we're willing to keep spending at our current levels, we could cover everybody with no co-payment, no-deductible, first-dollar coverage with no rationing. However, if we wanted to cut our budget by 50 percent, "we'd have to have some waiting lines."

Watch the video or read the transcript here.

Cadillacading this article in the New York Times, and I was struck by the references to a “Cadillac tax” on "gold-plated insurance plans."

The plans referred to as "Cadillac plans" are typically plans that have low or no deductibles, low or no co-payments, and they require less in out-of-pocket costs for those fortunate enough to have them. In short, they provide good coverage.

Strange, isn't it, that we would think of good coverage as a luxury. Coverage that encourages preventative care and actually pays the costs of illness, that's a luxury now.

Isn't access to health care the reason we purchase health insurance in the first place? Isn't that what it is for?

According to the article,


So let me get this straight, their brilliant idea for lowering health care spending was shift more people onto lower-cost plans? Lower-cost, for-profit health insurance plans with higher deductibles, higher co-payments, and higher out-of-pocket costs?

But you know, the reason these plans cost less, is that they're worth less. And, at the extreme end of the scale, they are practically worthless.

The best idea for slowing the growth of health care spending was to shift more of the costs onto the patient?

Which, I guess makes a certain amount of sense. If you have to pay more of the cost of going to the doctor, you'll be less likely to go to the doctor. Money saved, right?

Except that it's wrong. If you put off preventative care, if you don't catch something early when it's treatable, if you don't effectively monitor and manage a chronic condition ... we know how this ends.

The problem with low-cost plans, as implemented in our for-profit health insurance industry, is the plans are designed to shift more of the burden for paying for health care onto those who can least afford to pay.

If you can't afford to buy good insurance, you can't afford to have bad insurance. The goal isn't to make sure everyone in the country has an insurance card, it's to give everyone access to health care. Bad insurance takes money in premiums without providing health care.

Good coverage isn't a luxury, it's a necessity.

But as long as we are stuck in a predatory system of profit-driven insurance companies, good coverage that is also affordable coverage will be an impossibility.

Maybe it's just me, but every time I hear the phrase Robust Public Option I think it's the name of some trendy coffee shop. You know, the kind that only sells organic, shade grown coffee and can tell you the first name of the co-op farmer who grew the microlot. The kind of place where the person who makes the coffee is called a Barista.

Barista: Good morning, what can I get for you?

Me: I'm not sure. What is good today?

Barista: Well the French Roast is the best in the world.

Me: Oh, well, I'll have that then.

Barista: Sorry, you can't have that. It's not on the table.

Me: I hear the Canadian Blend is pretty good.

Barista: Sorry, you can't have that either.

Me: Let me guess, not on the table?

Barista: That's right.

Me: Well, you know, I've heard some really good things about the British Breakfast Blend.

Barista: British Blend?! Are you crazy? We don't sell that, our customers would never go for that. It's not even coffee. It's tea.

Me: Well, um, what do you have then?

Barista: Our house specialty. It's called an Americano.

Me: What is it?

Barista: You start with a strong, robust shot of espresso coffee--

Me: Sounds promising.

Barista: -- and then you water it down.

Me: Oh.

I don't want a watered-down public option. I can't afford a watered-down public option and neither can anyone else.

When I say I want a robust public option, I mean I want a real option, a good option, for anyone.

Anyone who wants it can get it. Not just the uninsured. Not just people who qualify by meeting certain income criteria. Not just people who currently buy individual policies. Anyone. So if I have insurance that costs too much and covers too little, I can drop it and get the public option instead. If you don't want it, you don't have to get it -- that's your option.

And I want it to be as good as Medicare (and I know Medicare isn't perfect, but I've compared it to my policy that costs more than 4 times as much, and Medicare coverage is better). Or better yet, I want it to be Medicare. Don't just call it Medicare for Anybody, make it Medicare for Anybody. And then, use my money to make Medicare better.

And I want it to start now. Not in eight years or four years or whenever we can get around to it. Now. Today.

Because people are losing their homes today.
Because people are going bankrupt today.
Because people are suffering without treatment today.
Because people are dying today.

So Congress, I don't want an Americano Public Option. I'm asking you, begging you, make it robust. Make it strong. Make it real. Make it now.

Let me be clear, I respect you. I know you work hard. You have to churn through patients every 15 minutes to pay the rent and the billing staff and people to help you to keep track of the approved procedures and approved prescriptions for each insurance plan you have a contract with, and to pay huge premiums for malpractice insurance.

And maybe it's because you can see the system isn't working any better for you than it is for your patients that 70 percent of you support some form of public option (and 10 percent of you support single payer). I applaud you, at least 70 percent of you (and 10 percent of you with enthusiasm).

But here's the thing, what I keep hearing is that you need tort reform to bring down costs. That the key to reducing healthcare costs in this country is to limit the amount of money that can be awarded to someone who has proven in a court of law that they have been harmed by malpractice. And that's where I can't agree.

I mean sure, I hate lawyers, you hate lawyers, everybody hates lawyers -- ambulance chasers, vultures, whatever we want to call them. It's an acceptable prejudice. It's a historic prejudice -- even Shakespeare hated lawyers -- and it's a prejudice we don't feel guilty about, right?

But why would we hate victims? It just seems wrong to limit the right of someone who has been hurt to seek justice through the court system.

But I also can't agree, because I don't believe that the occasional award to someone who now has a malpractice-caused pre-exising condition, someone who has lost a limb or a loved one because of gross negligence ... I don't believe that really is why your malpractice insurance premiums are so high.

According to this article, medical malpractice insurance companies have higher profits than nearly all other companies and are even more profitable and less accountable than for-profit health insurance companies.

And according to this article, after Texas capped malpractice awards, malpractice insurance premiums did not go down.

I think your problem is the same as my problem. You're being gouged by for-profit malpractice insurance companies, just like I'm being gouged by for-profit health insurance companies.

So here's my idea. What if we help each other? What if any doctor who accepts patients from the Public Option would qualify for a non-profit malpractice insurance system?

Win-win. You help me escape the corporations that are gouging me, I'll help you escape the corporations that are gouging you, and we all get a system that works better.

And as for those doctors who don't merely make an understandable mistake, the ones who are grossly negligent and missed the class that taught, "first, do no harm," let's encourage them to pursue other careers, such as politics, perhaps (not naming any names).

So what do you say?

Question: What is the difference between a leech and a private, profit-driven health insurance company?

Answer: The leech has a legitimate role in the practice of medicine today.

Seriously.

No, really. Leeches can be used to provide medical care (read more about medical uses of leeches and maggots here and here).

Insurance, on the other hand, is not and has never been Health Care.

Insurance is a way of paying for Health Care.

Insurance is supposed to make Health Care affordable. But it doesn't, at least not in this country.

The problem we face is not how to provide all Americans with insurance. The problem we face is how to provide all Americans with affordable Health Care.

We have been told that we must stick with the private, profit-driven health insurance system we have because change would be too disruptive. We must invest more in a system that has proven it does not work. Even though insurance does not do the one and only thing it is meant to do -- make health care affordable -- we must all buy it.

It's tradition. It's history.

We'd be better off with leeches.

My friend didn't die because she didn't have Health Insurance. She died because she had cancer.

Her cancer went undiagnosed because she couldn't afford to go to the doctor for routine check-ups that might have caught it early.

Her cancer went untreated when treatment might have worked because it wasn't diagnosed. She wouldn't have been able to afford the treatment anyway.

Her cancer went undiscovered and untreated until it was too late. Too late for anything but a futile attempt to give her more time. And then a desperate attempt to make her more comfortable in the time she had. And then a caring, human attempt to give her ugly, painful death some dignity.

But she didn't suffer, and she suffered in a way that I hope never to see again, because she didn't have Health Insurance. She didn't die because she didn't have Health Insurance.

She suffered and died because she didn't have Health Care.

She didn't have access to care she could afford. And if we've learned one thing from our experiment in relying on Private Insurance, it's that Private Health Insurance is really bad at making Health Care affordable.

If my friend had had a low-cost Health Insurance plan, she still wouldn't have been able to get regular check-ups, because she couldn't afford the co-pays. She still wouldn't have been able to afford treatment, because she couldn't afford to pay the "patient's portion" for hospital stays and chemotherapy and radiation and medication.

The problem isn't that some people don't have insurance. The problem is that all of us don't have access to Health Care.

The problem is that all of us don't have access to affordable, reliable, universal Health Care.

Insurance doesn't solve that problem.

And it's a problem that costs us all.

My friend's community lost a voice in the church choir, lost a volunteer at events, lost a tasty dish at the potluck, lost a sympathetic ear and a heart open to anyone's troubles. My friend's family lost a daughter, a wife, a mother, a sister, a cousin. And I lost a friend.

It is a cost that is incalculable in human terms. It is a cost that is devastating in financial terms.

As a society are we willing to pay that cost, that cost in lives -- a cost we pay every day, over and over again, a cost with faces we know, and names we've heard, and hands we've touched -- are we willing to pay that cost any longer?

I'm not.

How are they not bad people?

How could Insurance Company Executives do this:



or this:



and not be bad people?

It's not as though Insurance Company Executives just made honest mistakes that ended up having tragic consequences. They knew what they were doing when they did it.

And these things don't happen in the passive voice. Patients don't just lose coverage, Insurance Companies cancel coverage.

Insurance Company Executives made calculations. Insurance Company Executives made decisions. Insurance Company Executives invented pretexts. Insurance Company Executives canceled coverage. Insurance Company Executives delayed treatment.

And patients died.

It's not as though they only did it once. It's not as though they have stopped doing it. They do it every day.

And why do they do it? Because it's profitable. They make money, a lot of money, when they do these things.



So why aren't they bad people? They do bad things. On purpose. Not just once, but over and over again.

Apparently Wall Street made them do it. Wall Street demanded profits.

And they had to cheat their customers to provide those profits. They couldn't control their administrative costs to provide profits. They couldn't be more efficient in their business. They couldn't limit their own compensation.

It's all Wall Street's fault. You know, maybe it's just me, but I don't think "the devil made me do it" is an acceptable defense for anything unless you're trying to establish grounds for an insanity plea.

Anyone can make a mistake. And mistakes can have catastrophic consequences. Anyone can make an error in judgement that can result in tragedy. But as people we define ourselves by our actions.

And what we do, what we do on purpose, what we do over and over again, our actions establish what kind of people we are more than any words we say. More than any excuses or rationalizations we give.

With all due respect, I have to disagree. They ARE bad people.

A reasoned, logical follow-up (I was going to say, "rant," but thought it would be false advertising) to I don't have Health Insurance and I don't need Health Insurance. Incidentally, I wrote most of that post while I was on hold with my insurance company.

I listened to the President's speech last night and I've been reflecting on it all day. I have a few thoughts and a lot of questions.

Part 1: I might get Health Insurance

To recap, right now the insurance I pay for every month could vanish as soon as a member of my family becomes ill. So in the sense that it's not going to be there if I really need it, it's not really insurance.

The President's plan would address the most egregious of these practices, practices which are industry-wide and routine. No pre-existing conditions. No dropping coverage when a customer gets sick. No higher premiums for women just because of gender. Limits on variation in premiums because of age. Out-of-pocket spending caps for customers. No annual or lifetime benefit caps imposed by insurers.

These are desperately needed reforms. People are dying. People are living in misery. People are living with physical pain and mental anguish. Right now. And they can't wait for change, real change, right now.

But.

But will regulation work? The major insurance companies have been found guilty and have been fined for defying existing regulations. What confidence can we have that they will not simply defy these laws as well? Why won't they simply continue to calculate the fine vs. the cost of the treatment vs. the chance they'll actually be forced to pay the fine after appeals, and then just go on with business as usual?

And since they've been right there at the table helping to craft the legislation, what are the odds that they've missed any opportunities to fill the legislation with loopholes big enough to drive a pre-existing condition through?

But let's just say the legislation is loophole-free. That still doesn't mean it will work. Eight years of the Bush Administration taught us that. As they so ably demonstrated in the areas of consumer and environmental protection, all a hostile Executive Branch or Legislative Branch needs to do to defeat good regulation is underfund the agency responsible for overseeing it ... and appoint opponents of regulation to head the agency ... and then systematically understaff the agency so there aren't enough people to handle the caseload. If the defying the law means money on the balance sheet and the chances of being caught are low, what profit-hungry corporation would resist temptation?

Part 2: Insurance still isn't what I need.

To recap, I buy insurance coverage for my car, my home and even my life so it will provide a benefit IF I need it. But when it comes to my health, sooner or later, I WILL need health care and sooner or later, it will be expensive.

From what I've heard last night, this scenario doesn't change.

A whole lot of people who currently don't have insurance will get insurance, and that sounds great. But insurance is not the same thing as care. Right now most of us have insurance, but too many of us still don't have access to affordable care -- subsidizing the premiums won't help if you still can't afford the co-pays.

Part 3: I don't need more choices.

I don't need more choices. I need good choices.

The exchange sounds like a good idea. But I didn't hear anything last night and I don't see anything in the materials on the White House website that guarantees this multitude of new choices among companies and plans would include good choices. I don't see guarantees for quality of coverage (though it's possible they're in there and I'm just missing it.)

But I'm still having trouble the idea of choosing a level of coverage. I can't predict the future. I can accurately gauge the minimum requirements I need in a plan, but there's no way that I can know the maximum.

I'm ethically troubled by the idea of low-cost, bare-bones, minimal plans, particularly after reading this article in Business Week. In a section talking about industry representatives pressuring Senators to reduce coverage levels, the article reads:

But if someone gets one of these bare bones plans because he or she is too poor to afford the premium without subsidies, how can they afford to pay a higher portion of their medical bills if they get sick?

If you're too poor to buy good coverage, how can you afford to have lousy coverage?

And speaking of options, what about the Public Option? That's assuming, of course, that a Public Option even makes it into the bill and, considering the President's tepid support, that doesn't seem to be a safe assumption. The Public Option would only be available for people who don't currently have insurance. So I can't get it, even though my insurance is over-priced. My insurance company knows I can't get it, so it doesn't provide meaningful competition for them, so they have no reason not to continue raising my premiums 20% a year, or more. Would it really provide competition even in the individual market if only 5% of eligible Americans would use it AND it has to pay for itself through their premiums? How can that be a large enough pool of people to spread out the risk and make the plan work?

Part 4: What I need

What I still need is affordable, reliable universal healthcare. What I heard last night, what I read today, does not begin to deliver on that.

I'm still reserving judgement until I can read it all a few more times, but I can't muster any enthusiasm for the plan I heard last night.

I still support the President. He's still a great speaker. I just wish, in this case, he had something more encouraging to say.

A rant in 4 parts.

Part 1: I don't have Health Insurance.

Don't get me wrong, I pay for coverage. I pay nearly $1000 a month in premiums for a healthy family of four. As of the end of this month, I face a 21% increase in those premiums. But what I get for that outrageous monthly fee is not really, "insurance."

"Insurance" is something that is there when you need it. You pay your premiums every month, and then IF something happens, you're insured. So no, what I have isn't insurance.

Because I buy my coverage through the poorly regulated individual market, what I have is "insurance" only as long as no member of my family is ill. But if anyone becomes ill and the illness becomes expensive, my insurance company will work very hard to find a pretext to deny or cancel my coverage.

So I don't really have insurance. It's more like a weather report -- I have a 20% chance of insurance if I really need it. So, to recap, next year, paying more than $1000 a month will buy me an 80% (or greater) chance of getting nothing in return.

Part 2: I don't need Health Insurance

But here's the thing, I don't need health insurance. I don't need insurance at all.

Insurance is the wrong model. Insurance is something I get in case I need it. I insure my car, though I've never been in an accident and hope not to be. I insure my home knowing that it will probably never burn down. I insure my life through term insurance which is essentially a bet between me and the company -- they're betting I won't die before the term expires, and while I hope they're right, just in case, I want to be sure that my family would have that protection if I did. In all of these cases, I pay my premiums and I may never use my coverage. The insurance company makes a profit by spreading the risk around a large number of customers, knowing that only a relatively small percentage of them will ever need to be paid the benefit.

But when it comes to health, the question isn't IF I will need it, it's WHEN. Sooner or later every one of us will need health care. And sooner or later, it will be expensive care.

Currently, the industry is making a bet: they cover only the young and employed betting that by the time health care gets expensive they will not have to pay. Either the customer gets old enough to become eligible for Medicare, or looses the ability to work and looses work-based coverage. In any case, no longer the industry's problem. It's a good bet for them and the house usually wins.

But for consumers, it is a system that sucks money out of the economy. It's a system that fails to provide care. It is a system that is morally unconscionable. Or, to put it plainly, it's not simply a stupid investment, it is wrong.

So I don't need Health Insurance. I don't want Health Insurance. I need HealthCARE.

Part 3: I don't need more choices

I have choices right now, but they're all bad. I can pay too much for unreliable coverage from Company A, or I can pay too much for unreliable coverage from Company B, or I can take my chances and go without.

I have read proposed plans that would allow me to choose a level of coverage based on my needs, paying more for more coverage and less for bare-bones plans that provide less.

But here's the question, how do I know what I need? I'm healthy, so at the moment I don't need a plan that would cover certain reoccurring costs that for example someone with a chronic condition might need. I don't take any prescriptions, so I don't need a drug benefit.

But I have seen, sadly, how in a moment all of that can change. Young, healthy people get cancer, even with no known risk factors. I have no assurance that when I least expect it, I might be hit by a car, or struck by lightening, or eat cookie dough tainted with E. Coli and suddenly need a level of care that I didn't plan on when I signed a contract.

I know what I need now, but I can't know what I might need tomorrow, so I don't need choices.

Part 4: What I need ...

I need a system that spreads the risk around, including the young and the healthy as well as the aged and the ill. I need a system that doesn't just cover me and my family, because we don't live in a universe unto ourselves, we live in a community. My community suffers when my neighbors are forced into bankruptcy by medical bills. My community suffers when my neighbors are too sick to work. My community suffers when my neighbors die because they lack access to care they can afford. I need a system that covers everyone.

I need a system that doesn't suck money out of my pockets and put it in the hands of lobbyists who work against my interest. (Believe me, I have other places to spend that money -- my local economy, for example.) I need a system that doesn't put healthcare choices in the hands of MBAs, but leaves them in the hands of my MD.

I need a system that covers a minor illness or a major illness, an acute illness or a chronic illness, and doesn't rely on my ability to predict the unknown. I need a system that covers my kids as well as it covers their grand-parents. A system that covers my day-care provider every bit as well as it covers the CEO of my company, but charges them based what they can afford to pay.

What I need is affordable, reliable, universal healthcare.

It's called MEDICARE FOR ALL.

I've been following the health reform debate (or what passes for debate) with a growing sense of despair. So today, reading that the Public Option has been taken off the table and that real health reform is dying a death of a thousand cuts, I did something.

Instead of feeling helpless and depressed (the way I feel every year when I get the notice from my private insurance company that my premiums are once again increasing in the double digits but I have no choice other than to simply go uninsured), I did something.

It may not be much and it may not make a difference. But it felt good.

I wrote an email to the White House (I considered calling, but whenever I get on the phone my small children decide it is time to start making a lot of noise).

This is (more or less, because I don't remember the exact words) what I wrote:


Like I said, I don't know if it will make a difference, but I feel better. And I'm inviting you to do the same.

Please, send an email or call and just say, in your own real words, "I'm a real person and ... I support a real Public Option," or "I want real Health Care Reform," or whatever comes to your mind. Write a paragraph, or just a sentence. Just do it.

This is my first thread post in GD-P and will probably be my last, so I’ll try to make it count. It will be long and will not include any facts or links, so you should probably stop reading now and leave me to my incoherent ramblings.

Still here? Well, you were warned.

First off, let me say as a disclaimer to any statements to follow that I am a yellow dog dem. In the general election, MY candidate is any creature with a D next to its name.

The primary, however, is a whole 'nother story, And my primary is today so I have just a few hours left to gnaw on this decision.

In years past, by the time my primary rolled around there really wasn't a choice, so I suppose this time I should be thankful that things are so close and so exciting and this day isn’t just an empty symbolic step toward coronation.

And so I am torn. How to vote? Should I vote my conscience? Should I vote strategically?

If I were to vote my conscience, well, then I would write-in Gore. But I’m not quite Quixotic enough to vote for him today. My next choice, closest to my conscience, would be to vote for Edwards. Still a somewhat Quixotic choice, but perhaps enough mad fools like myself will do so in my state to give him another delegate or two with which to bargain at the convention. He is on my ballot, so I just might cast my vote for him in the hope he’ll do some good with it. But hope is not a strategy.

And perhaps what this contest needs is strategy. Of the two media-selected, corporate-financed contenders, which would be the more strategic vote? Which one would win the GE against McCain, the full bag of dirty tricks, and the complicit media? If I could tell the future, this would be an easier decision, but I can only wonder and guess.

Should I cast my vote for Hillary? She speaks with a voice of experience, this former Goldwater Girl, she has organized and triangulated and compromised and made deals … that dirty business of politics that gets things done. And she CAN get things done. But would she try to do the things I want, the things our country desperately needs? Or would her agenda be shaped by the needs of her corporate donors? Can she make compromises without being compromised?

Of course, that’s a question for any elected official, not just Hillary.

Then there’s the Hillary hatred to contend with. Living in the south when Bill was running for the first time, I was amazed by the unreasoned venom cast at her. They really hate her. They hate her for not changing her name when she married; they hate her for changing it when she did. They hate her for hairstyles and pant suits and cookies she bakes or doesn’t bake and for everything she says or doesn’t say. They hate her for being an uppity female. They hate her for just being.

But on a scale of 1 to 10, they already hate her at a 10, so they can’t hate her any more than they do already. And they wouldn’t vote for Obama either. With Obama in the GE, they might stay home. With Hillary in the GE, they might hold their noses and vote McCain to vote against her. Might. Maybe. Who knows?

As a woman, I’m familiar with the damned if you do and damned if you don’t double standard that allows her to do nothing right. I can sympathize. It sucks. But that alone isn’t enough to earn my vote.

I respect Hillary, and yet Hillary has disappointed me. She has made poor, calculated decisions that she must now try to defend (IWR) and she has pandered to the right in ways that have earned her no goodwill from them, but have cost her with me. I mean, seriously, flag burning? Flag burning? To paraphrase "President" Bartlet, Is there an epidemic of flag burning of which I am unaware?

And there’s the Maggie Thatcher syndrome to consider -- would President Hillary Clinton feel compelled to use military force at every opportunity just to prove she isn’t weak?

So I could cast a vote for Hillary, the known quantity, or then there is the change candidate, Obama.

I have much less to ponder about Obama. I know relatively so little about him. He has charisma, to be sure, but that really counts as a negative with me (I’m a Gore fan, after all).

Obama is inspirational. He energizes the youth and can bring waves of them to the polls to support him (whether their votes will be fairly counted is a different question, though). He oozes with celebrity endorsements, but to the extent I like him, it’s more in spite of endorsements than because of them.

Obama has a shorter record, much shorter. But even a short record can be problematic. I don’t like the "present" votes, or the missed votes, or the general pattern of playing it safe so his record will be pristine for future polling. Would first term President Obama also play it so safe to try to ensure a second term? Once in office, what would he do?

He speaks about unifying the country, but I wonder, if "unity" means cosmetically smoothing over the very real and very deep divisions, is that really for the best right now?

So, it’s down to the devil we know and the devil we don’t know. Which one can win? And what would she or he do in office afterward?

I wonder which candidate will be most likely to investigate and doggedly prosecute the abuses of the current administration. Healing unity can only come after the cancer is removed.

Which corporate-funded candidate will pander to us most often and which one will pander to us on more important issues? Which candidate will disappoint us less (though I’ve been around long enough to know the only guarantee is that we will be disappointed)?

Neither candidate is an outsider. Obama represents the Kennedy democrats; Hillary, the Clinton democrats. Two cliques vying for power within the party, both with plenty of sins to live down for those of us whose memories are long.

Of course, an having outsider isn’t always a good thing, as we learned with Jimmy Carter, probably the most principled man to ever hold the job, but who failed to play the game with congress. Think for a minute what our world would now be like if only we had heeded his call to conserve energy, invest in alternative fuels, and deal fairly with foreign nations.

And yet, whatever misgivings I have about the candidates, either President Clinton or President Obama would be far, far preferable for the future than the unmitigated disaster that would be President McCain.

So of course, those are the stakes. The future. And that is why I cannot sit home and let others decide. Why I still ponder and fret and gnaw on this decision.

I go to vote in an hour.

Will I vote my ideals and my conscience and damn the consequences?

Will I find a path through the strategy that solves the unanswered questions?

Or will I just flip a coin?

I don't know. I still don’t know.