The machine may not be the cause. Do you have examples?

I sense in some of the opposition to universal health care the fear that freely available health care only serves to insure an underclass has access to health care and that by making that available, removes incentives for members of that underclass to work themselves into payers into the system, thus making their status in the underclass permanent. In England, they called it 'living on the dole'.

That is in fact is likely to occur. So? Would one want them to be healthy and capable or unhealthy and desperate as they are now?

Amen (to what ADG said, not to invoke the Egyptian god of life and reproduction).

I would humbly add that, imho, those out there in the world who preach the gospel of personal responsibility might better spend some time contemplating their own responsibilities. Our lives are far too interdependent for any of us to confidently say that our own ways of living have no effect on the health of others. Anyone who has ever driven on a freeway, for example, may be one of many responsible for respiratory impairment in kids living near freeways. (http://www.nytimes.com/2007/01/30/healt ... nd&emc=rss) When we create a problem as a community, I think we have a responsibility to address it as a community.

Some will do well to take a deep breath and understand that disentangling and reentangling the fiduciary, contractural, operational and policy/legal relationships in the health care system will take mighty and tedious effort. If those bills are voluminous, they have to be. This is not a fresh ground level start and it can't be as much as one might like that.

There is an unholy amount of regulatory instruments already in place for health care. For example, the HIPAA policies for privacy alone are a significant instrument and only one.

Untangle this:

http://www.hhs.gov/ocr/privacy/hipaa/understanding/coveredentities/businessassociates.html

A single payer system might go a long way to enable some simplification of these as various entities could be removed, paperwork reduced and barriers to modernizing the logistical support removed. This isn't likely but do note that this kind of reform of existing systems is augean at best.