The insuranc companies have to compete with medicare, which has no marketing costs, and low overhead.

Forcing people to by insurance is probably unconstitutional at the federal level - most federal legislation is driven by the federal government's constitutional mandates on foreign policy, defence, or inter-state commerce. It's hard to see how this mandate fits in any of these categories.

This is why insurance is regulated at the state level...

Legal opinion, please constitutional scholar?

So I'm so with you ideologically, Ian, on the US having universal healthcare, like Canada's.

And let me sidetrack with two direct examples of great healthcare in Canada. First, my niece, when she was 9, nearly died in a terrible ski accident at Whistler, was whisked by Chinook helicopter to BC Children's, and had one carotid artery wholly replaced by an amazing surgical team. US docs later would always call it "miracle" work, and good docs don't use the word "miracle" much if ever. Second, I recently admitted myself to the Cranbrook, BC, ER with radically elevated blood pressure. They treated it quickly, smartly, and thoroughly. Of course, in both cases, costs for US patients were high and not covered by the Canadian system. My niece's work was eventually settled out-of-court with the ski area (she crashed into a rack between two Blackcomb lifts, and is partially paralyzed for life), and I was billed over $500. I sidetrack to demonstrate Canadian healthcare can be as great, and as expensive, as that in the US.

But US lawmakers won't approve full federal healthcare. Not in the next Democratic administration anyway. We can talk what's practical and achievable, or what's ideal but impossible. Universal health insurance is practical, while universal healthcare is not, IMHO.

Part of it is the sheer cost. Edwards' plan would never get enough funding, even with reinstating wealthy taxes above $200,000/year. But plans like Massachusetts', where everyone has to have coverage, will fly, and indeed might be mandated across states, or just become de rigeur among enough states that it soon becomes standard practice, especially if Schwarzenegger leads similar reform in California. And for really small states they might pool their plans in a regional one, say where the Dakotas, Montana, and Wyoming share a risk pool.

Again, I would prefer a Canadian system, but it ain't gonna happen. A US plan where all citizens have to have coverage will mandate more responsibility both for indidviduals, governments, and insurance companies, as it has in Massachusetts.

Believe me, my wife and I discuss this a lot, because we both consult in US healthcare and see the considerable waste and cost throughout the system. For the sheer need of better public health, where universal diagnoses and treatments occur, we need universal coverage, which could be enacted by 2012 by a Democratic White House with a Democratic Congress. I think we all know Hillary would love to get back to her unfinished business, and a leftward swing of the pendulum in her direction would be just the vehicle for this sorely needed reform.

This latest move by Bush and Rove can be stalled until 2009. It's a clever joke, but Dem lawmakers can expose it as such.

When I have time (three jobs keep a gal busy) I need to work up a long post on this with solid links.

It's beginning to be painfully clear that since the 70s, Democrats will side with fellow oligarchs against American working people every time.

They were in charge when the Congress threw open their doors to Wall Street. That was their answer to the popular uprising in Chicago in '68. That plus savaging Carter and rolling over for Reagan.

Moving right along to the 90s, we got to watch Al Gore alienate 19 million Perot voters. Sneering at the unwashed for fearing NAFTA and being so provincial as to mind losing their livelihoods.

All of which is to say that Hillary and Edwards are from the same litter. When it comes to a choice between their fellow oligarchs and the millions of regular folk who hold our noses and vote for them, they will choose allegience to their fellow-rulers every time.

I don't know when, if ever, things will change in this country. I have a feeling it may be a generation that hasn't been born yet.