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AS LONG AS WE'RE ATTEMPTING TO RESHAPE THE COUNTRY: A Discussion About Food Stamps, Food Banks, Health Care, Responsibility, and Rights vs. Wouldn't It Be Nices?


We've had lots of discussion lately about health care, which has set my mind to wandering and wondering. As long as we're advocating for health care as a basic human right, shouldn't we be talking about our responsibilities to the system, and defining "rights" as they apply to those depending on the system?

Although health care is not specifically addressed in our founding documents, there are those who think a case can be made that it is. Still others think it is only for those who can afford it.

It seems clear that we here at TPM have elevated health care from a "wouldn't it be nice?" (WIBN) to a "right."  So for the sake of this discussion, let's assume we do have that right.

Additionally, although not a "right" per se, we have food stamps available for those unable to provide food for their families, and many areas offer food banks to further help those in need. (I'll tie this in down the road a piece.)

Now let's throw responsibility into the mix (and this is where the discussion gets a little dicey.)

We've set up the idea that all people have a right to healthcare. That means we will all be paying for everyone else's health care. So what does that include, and where do personal responibilities come in? Or do they?

I think we can all agree that emergency medical care fits in...injuries sustained in automobile accidents, accidents around the home and community etc.  But does it include injuries sustained as a result of participating in "extreme sports?"  Do we now get to pay for all the care involved when you have turned yourself into a quadraplegic? Would people participating in things like this be required to carry insurance policies to cover injuries inherent in these types of activities? Why? Or why not?

I think we can all agree that maternity needs would be covered, but does that mean that everyone can pop out as many kids as they want, and we all have to pay for it? Why? Or why not? And if not, how, in a free society can you stop the unfettered reproduction?

And what about smoking? Would people be required to stop smoking? If not, should the general population be required to pay for health care involved in smoking-related diseases, when CLEARLY this is optional behavior? Why? Or why not?

And what about obesity related diseases? Once our health care is the responsibilty of us all, do we have a social responsibility to maintain a healthy weight? Can we continue to eat and maintain a sedentary lifestyle while others are forced to bear the financial responsibility for our behaviors?

Here's where the food stamps and food banks come in...

If we as a society are going to take responsibility for feeding those who cannot afford to feed themselves, do we not have an obligation to feed them responsibly?  Should we be allowing food stamps to be used for buying Cheetos and Oreos and Coke? A friend recently posed the question "How come so many poor people are fat?" Well, I can tell you why. They are malnourished. It's not necessarily that they are eating too much (although that is true in some cases.) They have been forced to live off the dollar menu at fast food restaurants because it is cheaper than buying real food. Or they eat crap food because it provides comfort or they never learned how to eat a healthy balance diet.

What if when you signed up for food stamps, you had to take a few hour course in nutrition? Or how about if instead of getting dollar amounts of food stamps, someone, somewhere figured out how much food it took to sustain a family of (?) and you got certificates for so many bags of frozen vegetables and so many packages of (hold my nose and say it) meat and so many pounds of fresh fruit...no more government subsidies of twinkies (I mean, are twinkies a "right" or a WIBN?)

What if we started donating healthy food to food banks instead of crap food? I almost passed out when I saw a grossly overweight woman walking out of a food bank (to which I was delivering a bunch of cases of canned foods like soup and vegetables and bags of roasted almonds) with 3 huge bags of Oreos and a bunch of crap snack foods. Empty calories are not a good idea...they may keep people alive, but surely they deserve better than that!

So what do you think, people? What are our rights and responsibilities? Or should this all be unconditional, allowing any and all of us to abuse the golden goose until we've killed her?  







232 Comments

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Wow. You've given us a lot of food for thought, Stilli (pun intended). I can't quite comment yet, but give me time to think about it and I'll be back.

Methinks this post is going to generate quite the discussion....

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Well Stilli, I suppose any activity that is legal, (being overweight and smoking are so far as I know) they should be covered. Why? Because if they aren't then you've started down a slippery slope. Why should I cover your families Alzheimer's or Cancer when my family very sensibly and reliably die of massive heart attacks?

I think that you are over thinking this. Surely part of socialized medicine can be nutritional amd anti-smoking therapies, but I haven't heard of a country yet that limits medicine along the lines you bring up here.


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Totally incorrect.

Your car insurance is decided, in part, on what your job is (certain job classifications are less risky to insure), your age, and what kind of car you drive.

You want to drive that SUV that causes additional damage when it hits something? Well you pay extra insurance for that privilege.

You want to screw up your health by smoking and overeating? Well, you pay extra because you are now a higher risk.

Don't conflate things like genetic history to things that are choices. They are two separate issues.

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I didn't realize car insurance rates were based on our occupations as well as our cars. I wonder what kind of scale they use. Do you know? I'm just curious.

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There is often (among other things) a "teacher/scientist/engineer discount" because these individuals tend to follow rules, are more conservative in their personal lifestyles, etc. (It's the same reason why the IRS statistically audits them less than other professionals.) Similarly, there are "good student" discounts based on grades.

It's very similar to the "discount" you get when you are past the age of 25 on your car insurance. Once upon a time, I believe, teenage girls had lower insurance rates than teenage boys, but with the lifestyle changes, I think the gender difference disappeared.

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Don't conflate things like genetic history to things that are choices. They are two separate issues.

Why?

The crux of the matter is you want to quibble over pennies. So why should you get a break for genetic obesity, over someone with a food issue?

Why exempt that?

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If we are quibbling over pennies, then you can pay for my share.

After all, it's only pennies.

You are exactly the stereotype of the leftie who feels like they know how to spend everyone else's money.

By the way "genetic obesity" is one of the poorest excuses going. You can still take the fork out of your mouth.

It's not like you become obese without eating. Does it require more self control. Sure. Life isn't fair. Your "argument" is akin to a person of lesser IQ claiming "stupidity" as the reason they broke a law. If you have a larger issue than some with food, it's your particular cross to bear. Or perhaps you feel that insurance should cover hair treatments because some people are born with genetic patten baldness?

By the way, it's a known fact that Americans are growing in girth - it ain't genetic obesity causing it. Or thyroid conditions.

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I think many of us have noticed. I keep hearing it's due to growth hormones they put in livestock (maybe even produce?). All I know is it's definitely true, and it worries me. Any ideas as to where there are statistics and reasons listed?

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The size of meals has increased over time.

That has nothing to do with what the meals even contained.

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1929118

We can talk about these other issues, but it's not surprising that most people on the left keep looking for external reasons for woes rather than internal ones.

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Okay, point taken, I suppose. But I have no doubt that chemical additives may be playing a great role in a lot of our ills.

That being said, it is true that people should be taking more personal responsibility when it comes to their lifestyles, eating choices, and any other form of intake (smoking, drinking, drugs, etc.).

And, once again, I'm going to ask that we try to keep the discussion civil, moving forward. We've had our clashes, but I think it's time to move beyond those and keep a thoughtful and informative discussion going on.

On everyone's part.

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"That being said, it is true that people should be taking more personal responsibility when it comes to their lifestyles, eating choices, and any other form of intake (smoking, drinking, drugs, etc.)."

That is absolutely true, and more important than ever if we are going to be asked to be responsible for everyone else's health care costs. I just don't feel right asking you to pay for my health care costs for something I brought on myself...

A little gem I picked up from my doctor...Whatever you do to your body when you are in your 20's and 30's, you're going to pay for in your 50's. Of course he didn't tell me that until I was 50. I so wish he hadn't been right!

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Part of the reason for the additives is to provide more and more food in the same finite space as before and control costs. In other words, it's yet another consequence of overpopulation. But people still resist that as one of the bigger issues here.

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The rumor is that they used to put cocaine in coke and they definitely put lead in cosmetics. But by your analysis this didn't matter -- drinking coke (even if it contained cocaine you didn't know about) was clearly a voluntary behavior as was using cosmetics.

Hungry people eat. If there is something in how food is manufactured today which increases hunger in ways that we are ill equipped to deal with, true responsibility is funding the research to find out if this is true, and if it is, removing the additive for everybody except those who want to have it. Also, if so, cheaper for us in the long run.

Smoking is obviously voluntary in your view since all you have to do is put the cigarette down -- that fact that nicotine is addictive has nothing to do with it.

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It would have been a more interesting study had they compared the sedentary group that was the subject to a physically active group. In addition, the inclusion of such a broad range of BMI will distort the results.

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Right, so the poor (of course) who are prone to obesity from corn syrup and bulked up non-foods should pay for their poverty and misfortune.

That's fair?

This logically leads to, 'your genetic weaknesses aren't my problem'

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LOL! Yes, I know, the poor, the poor, the poor who can only eat fast foods.

Here's some help:

1) Eliminate ALL soft drinks. Drink only water. Hmmm... that even saves money and gets rid of a huge amount of corn syrup.

2) But if you must eat at the fast food places, here is a guide to eat healthier.

Your memes are tired and worn out.

By the way, as Stilli implies, perhaps the poor shouldn't have such large families? When teenagers are scared of the consequences of having children accidentally, we will have made real progress in this country.

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PS: You are on such thin ground here that every one of my responses is met with your changing the topic.

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No. That would be your gig. You say it's choice. I disputed that.

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Really? People grow cigarettes in their mouths?

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I feel you, Stilli, but what you're talking about is a basic rewiring of human nature in some areas.

Taking silly chances, well, some of us do that - mostly male, largely young, thinking we're invulnerable - been there, done that, survived it and still have the t-shirt.

As for donating healthier things, well, there's a lot of work there, instilling a taste for things other than sugar, salt, and fat in people, and getting those on the giving side to use it as less a "dumping ground" and more a positive effect. Coming at it from only one side will not solve anything.

Giving people food outright used to be part of how it was done. Maybe someone older and more acquainted with it could 'splain me why that changed. And I do believe the WIC and MAC programs used to do that even recently - has that changed?

Smoking - that's one that's gradually being resolved. Now, smokers are pariahs in most of society. Not the kindest, gentlest approach, still, it seems to be reducing the demand.

We're fallible creatures, we humans. We're very good at finding new problems to fit and modify every good solution, and quite versed in not acting in our own interests.

What you're posing here are very large and complex questions, and I know better minds than mine have worked on them for a long time. We're still waiting for the answers, and I suspect we will be for some time to come.

Here's hoping this can turn into a solid, well-reasoned discussion. Of course, it is a blog...

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"Here's hoping this can turn into a solid, well-reasoned discussion. Of course, it is a blog."

I know...I hit send and held my breath. I haven't been immediately tarred and feathered, so I'm holding out hope...

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SI,
Nice to see you...so to speak.

Grouch is correct. When I was young and my heart was.... No... not that song now... what I meant to say was, When I was young, I KNOW I was
10 foot tall and bulletproof.... I have the pictures.

Healthcare is SOMEDAY going to be considered a Right the sooner the better. But many of us are rather stupid, me for example I was a power smoker, if smoking was an olympic event I'd have been an Olympian, and probably a gold medal winner at that.

What we have to do is allow for those of us that screw up to get help from those that aren't currently screwing up. And because we are all screw ups at some point in our lives we should all have the benefit of helping others. (That paragraph works much better if you hum the Barney theme song while reading it).

Anyways, there is just too much shit that can just land on ANY of us on any given day, and to begin to start to kind of lay blame will cause "U.S." all to lose.

Tuck that conservative away or you'll lose control of it and go completly off the deep end!

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Okay, I've given it thought and here's what I've come up with. It shouldn't matter that we pay for some folks who take more risks than others. There are others who take their health more seriously than, say, I - a smoker who's thinking of quitting (but so far, just thinking and not really doing, unfortunately).

If universal health coverage is gonna work, it's gotta be universal. Case closed.

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So should part of the whole thing be an increased amount of education on health-related issues, or just pony up the money and forget it? So much of what we do ourselves results in health problems...Is there NOTHING we can do to help mitigate the NEED for so much health care? Do we have no responsibility at least TRY to?

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Of course we do, and it's my hope that we'll have more education on nutrition, diet, exercise, quitting smoking, safe sex, etc. It's my hope that better self-care will be a part of the whole package. Besides having an annual physical it would be nice if we could all visit a nutritionist as well, for example.

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How about requiring medical schools to provide more than a few hours of nutritional education to doctors, so that THEY can educate their patients as part of their yearly physicals?

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Most people know it's not nutritious to eat fast foods. Much of this isn't rocket science. Special diets based on specific ailments (cholesterol, sodium, etc.) are one thing. But by simply laying off the fast food would be a huge improvement right away.

And to eat less. That's the other problem with people's diets today.

Again, not rocket science.

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You have not mentioned physical activity. Our infrastructure promotes various forms of riding transportation.

In Europe (fairly similar genetic stock) walking or bicycling is more common.

Food and physical activity both matter.

I think that it is much less likely that obesity arises from a fat gene or genes. There are of course examples in animals with metabolic defects that become abnormally fat, but none has yet been identified as a widely held characteristic of humans.

It is however possible that the gut flora have something to do with obesity, but proof of causation is not in yet.

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You are correct and I'm glad you brought up motion. Of course, we aren't even talking gym memberships, simply not being sedentary.

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It should very much matter. Your car insurance is based, in part, on what kind of vehicle you drive. Same thing here.

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That's true....and a very good point. At work, I pay a higher premium because I smoke, and I think that's fair. One good thing my company initiated was that they offer an incentive to quitting, by paying up to $300 (I think that's the amount, anyway) for non-smoking aids such as the patch, or gum, or a pill. I might be taking advantage of that very shortly, and am considering the patch. I try not to take pills if I can help it, and I hear some weird things about some of them, like that new Chantrix or whatever it's called. I've heard stories of everything from upset stomachs and headaches, to weird, sometimes violent nightmares.

But, yeah Clearthinker, I didn't think about car insurance and how it's tailored to the car involved. Excellent point.

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You bring up something important:

It's much cheaper in the long run to engage in preventative medicine than treat a disease. So, I'm all for a one time (capped cost) shot at getting someone off of cigarettes. Indeed, that service can be part of the additional cost that smokers put into the system.

So your insurance's program is a good deal for you, and a good deal for the rest of their insured.

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I have an anecdote for you. When I was at school, there was a female student who smoked. She was fond of criticizing the eating and drinking habits of others.

One day, in gross anatomy class several students decided they had heard enough of her preaching, and raised her horizontally above their heads, carried her over to one of the dissection tables and held her above someone who had been a heavy smoker while they pointed out to her the various sites of damage in the body.

She stopped.

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Lis,
Consider rolling your own cigarettes. When smoking packaged cigarettes my "habit" varied from just under 1 pack a day to more than 2 packs a day (when stressed).
I switched to rolling my own when I was destitute and reaped a benefit I had not expected. Those automatic ciggies (1st thing in morning,after meals, waiting for whatever, et al) were greatly reduced. I've since taken to self regulating (1 every two hours).
I'm down to 6-10 cigarettes a day. You can choose the amount of tobacco you wish to put in ciggie (I roll a bit of card for a filter). Thus my average smoking day is equal to 4-8 regular ciggies. You get the additional advantage of smoking less dangerous cigarettes (no additives).
Rolling machines are readily available and easy to use.

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I think that when we actually have single payer health care system we will have much greater preventative care and problems can be taken care of before they become intensive.

I also feel that we are more likely to come up more solutions to health problems when there is not so much profit being made off of people being sick. There may be fewer people on meds that they don't need.

I think there will be natural affects of bringing down costs that affect the system that will result in actions to curb risks etc. again more new solutions to issues that affect health and healthcare.

Nutritonal education might improve to reflect the reality of the nutrition in our food supply and differences in our bodies. And activities that contribute to more health risks such as smoking already have costs attached to help defray the costs.

I think food banks often get food pulled from the shelves in stores that are still edible etc and that's most likely how they would end up with twinkies. I don't think anyone actually donates twinkies to a food bank:) unless they purchased them and then decided not to eat them.

I think that there are upsides and downsides to the costs and choices issues but overall I just feel that everyone should have the ability to take care of their health and wellbeing and health care is becoming unaffordable even for people who are insured, choices are dwindling and we can't sustain the path we are on even though those who profit are happy to let it continue.

I think a single payer system is inevitable however long it takes...

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OK, here comes another one:

How about infertility? Isn't it a basic desire to have children? Isn't it normal? How about people who need help?

1. Those who just need a little "tweaking" to make them ovulate more regularly [cheap fix ]

2. Those who have more physiological problems, and require more "tweaking." [more expensive]

3. Those who have multiple issues -- male factor, female anovulation, etc [more $$$]

4. Those who cannot get pregnant without extreme measures like IVF [+$$$$$$$]

5. Those who are in the above category and are also, either because of age or other reasons, have not other option except for getting a young person to donate their eggs for IVF [+++$$$$$]

6. And then there are those who had their tubes tied and are now in a new relationship and want to have a family.

I could go on, but these are examples that we face in the future. Just FYI, most insurance declines most of these situations. Some will cover #1 and #2, and some will even cover up to #4, but it is rare, and in all cases, only after hours of phone calls for pre-authorizations.

More food for thought

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And I'm sure there are many more scenarios that we haven't even considered yet...

Thanks for the input. We have a lot to think about.
No wonder this isn't something that can be accomplished overnight.

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If you are infertile, it's Nature's (or god's) will you shouldn't reproduce.

If you can't have kids deal with it.

There are already too many people on the planet.

Now I know you are one of 14 and your job is in a clinic. But the bottom line is this: it is the height of vanity and childishness to go to lengths to have a kid when you can't naturally.

Adopt if you want a child that badly.

The first step to population control is not to assist those who can't contribute to the problem.

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Who elected you God?

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No one. You don't have to be a god to understand the concept. Just rational.

Nearly every one of our society's ills today comes from overpopulation.

Moreover, if you are so sympathetic, do you think that couples in their 50's and 60's should try an fertility clinic? Will that child be served by such elderly parents?

You can either control population by being the "rational" human beings we like to think we are, or we can simply be the bacteria we act like: fill up the petri dish and then a massive die off.

I prefer more control, don't you?

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I prefer evidence based medicine. If there is a readily available treatment that would permit a couple in their twenties to have a child I would support that. If a couple in their 40's wants to spend a fortune on a fertility treatment with almost no chance of success, I'd oppose that. I figure that the medical community ought to be able to come up with objective guidelines and as medical knowledge evolves and new treatments are discovered these guidelines may change.

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LOL! For someone who just asked me "who elected you god" your reply requires someone to be elected god to come up with the standards.

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Overpopulation? How is it the zero-population growth crowd and the food police always seem to have a "final solution" they'd willingly force upon everyone else? Your so-called concern for "the poor" (read: unwashed masses) seems a bit disingenuous, especially since nowhere in your comments do you mention the existence of "food deserts" or other critical issues that directly limit access to affordable, nutritious food.

Hunger is a major issue in this country and blaming the poor doesn't cut it. Instead of pontificating, try volunteering at a food bank or charity kitchen. While there, please note the increasing influx of formerly middle-class recipients who daily choose whether to feed their families or become homeless. Since you're familiar with PubMed, you can search for citations related to the rising incidence of severe malnutrition, even kwashikor, in the United States.

Guess what happens when your Temporary Aid to Needy Families (TANF) assistance runs out? Food stamps (EBT, actually) and TANF are no longer considered long-term supports. When they end, participants are usually ineligible for further assistance of this kind. For years, I've volunteered my time and money by teaching low-wealth individuals literacy and other self-sufficiency skills. Instead of cursing the darkness, what have you done to improve the conditions of this world?

More revealing comments:

"That's the point: people who choose to abuse themselves in various ways do not deserve the same health care at the same price as the rest of us."

"Do we worry about spending public money on an 80 year old to give him a few more months, maybe a year of life, or the 30 year old diabetic for insulin? There isn't the resources for both ultimately."

Oh, I get it: market-driven eugenics. Somehow I suspect that "the rest of us" of whom you speak will be younger, paler and more affluent than the subjects of your not-so-subtle derision. For a citizen in THIS country to whine about scarcities when Americans consume the lions' share of world resources is absolutely laughable...and a racist conceit when "population control" is promoted as a means to control the less educated, less affluent, or Third World individuals. The dire either/or choices exemplified in your "lifeboat ethics" example were laughable even back in 1975.

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If you hurl a few more invectives my way, you might qualify as one of those enraged hosts on FNC.

Food deserts are often caused by the unwillingness of companies to set up shop in neighborhoods that are overrun with criminal element. We can talk about the sociology of this if you like, but if the neighborhoods can't band together to create an air of safety, then no amount of legislation will. But that's a whole 'nother issue as you can plot where these food deserts occur and it's not just any random poor neighborhood, is it? And even in food deserts, there are things like canned foods, etc. that I've referred to present an alternative to fast foods.

And if you really bothered to read my posts, you can see that there are alternatives even at a fast food place.

Speaking of eating, stop trying to feed me words I didn't say, shall we? You have no idea as to the charitable work I do or do not do but perhaps you can kindly keep your sanctimonious attitude to yourself? The fact is that since you know nothing about my work - which I have pointedly kept off TPM - your comments are ignorant at best and an ad hominem attack at worst.

I'm still looking for a definition of "poor" -- you used great unwashed masses. But that doesn't define anything. I am disappointed your mis-use of English by using a term like "low-wealth", but I do admit to a personal peeve about making up phrases that mask true meaning ("height-challenged"). So that we can file as my problem.

And then you bring up race:

Somehow I suspect that "the rest of us" of whom you speak will be younger, paler and more affluent than the subjects of your not-so-subtle derision.

Why not flick that racial chip from your shoulder and come back and we can have a real conversation? Yes, you really pissed me off with that comment and the follow on that was even more blatant but I don't want to repeat. It's a hot button issue and you tried to sneak it in as a means to refuting my arguments. Nice try to tar and feather me. If you bothered to read any of my posts you will know that I believe Americans share more of the responsibility for population control because they use more resources.

Instead you essentially accuse me of racist behavior because in your myopic little world anyone that disagrees with you is a racist. Shame on you!

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Invective? I just called you on your B.S..

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If your appendix ruptures, I hope you manage to find a surgeon who has the same philosophy that you do. Or pneumonia, for that matter. By the way, if god meant for you to go faster than your feet would carry you, he would have built an internal combustion engine into your butt, and he would also have put wheels at the end of your legs instead of feet.

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One of the most classic moronic comments of all time.

"Well, if you worry about population control, kill yourself."

Thanks for the reasoned reply.

I understand why you reach for it: there's little else you can argue.

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I'd like to think that after last weekend, we can all just get past that bullshit and have a good conversation, all of us.

My reply is not just directed at you, Clearthinker, but at all of us.

Peace.

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Thanks for the reminder, lissy...

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I'm all for a reasoned conversation, however, that will surely challenge some of the "obvious" beliefs of some here.

I was disappointed with CVille Dem's response which really was how I portrayed it -- and thus I figured I make her point quite clear.

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You were so disappointed in my reponse that you made up a quote that had nothing to do with what I was saying, and attributed it to me. See below:

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Although you put the comment about killing yourself in quotes, you were not quoting me. I was pointing out that if your assumption is that infertility means you should not be a parent, then the logical extension of that is that if your appendix rupture, you should just suffer, rather than have medical treatment.

Before you label a statement "moronic," perhaps you should ascertain that you even understand the statement in the first place.

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Is that where you would go with this thinking CLEARthinker? That the only medical issue that should be left to the fates is infertility?

Because if not, I can list a ton of "unworthy illnesses" that you could deny treatment for. Do you want to play?

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Bottom line:

You are helping to kill the planet just as much as any large corporation who is polluting.

You can play whatever games you want, but I just want to be clear how you earn your livelihood. If you can live with it, that's cool.

By the way, are you in the 20% of clinics who keep within the guidelines?

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I'm sure you'll get a response when you start acting like the adult you think you are.


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Since no one was addressing you in this part of the conversation why did you feel a need to butt in with a total non sequitor? Your homework assignment was left for you higher in the thread.

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If all fertility treatments were stopped it would result in a virtually imperceptible change in population growth. Its meaningless yet you attack it with such extreme language.

If you're truly interested in the problem of over population than engage in dialog of the substantial causes rather than a bellicose attack on something trivial with such antagonistic language that make it clear you're again just looking for a fight.

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Quite incorrect. Closing of fertility clinics is an easy first step and would represent a monumental statement that humans will start controlling the population. Nothing grand is ever done with a sweeping action (it took 100 years after the Civil War to have true Civil Rights worked into society).

The closing of fertility clinics is only the first step.

Eliminating tax credits for the number of children you have is the second step.

Step by step...

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Quite incorrect.
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Eff off ct. Quite incorrect, totally incorrect, that seems to be one of your most popular arguments. We might have a difference of opinion but that doesn't make my opinion incorrect.

The most that might be accomplished if fertility clinics were closed is that many people would feel they had made a substantial effort to deal with the problem of over population and could take a break for a while. Just as recycling is a rather meaningless feel good measure that lets people think they are making some real effort to deal with our environmental problems.

Obviously its you who is "totally incorrect."

All this doesn't address my main point which is that saying things like, "it is the height of vanity and childishness" is very insulting and some people will respond to such invective by considering or calling you a nasty bastard. People will quite reasonably deduce that your main purpose in posting is to find something, anything and someone to fight with.

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Many countries in the developed world have declining populations.

The less developed countries do not apparently need fertility clinics.

https://www.cia.gov/library/publications/the-world-factbook/fields/2002.html

http://demoblography.blogspot.com/2008/04/towards-long-term-population-decline.html

Demography. 2003 Nov;40(4):589-603

So I doubt that closing fertility clinics will help very much.

Affluence is generally correlated with decreased birth rate.

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Another nice paper on the subject of population cycles and the problems of long term predictions.

Ann N Y Acad Sci. 2009 Apr;1162:1-17

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You assume all people consume resources equally. This is not the case.

Wealthy people burden the planet far more than poor people. Americans have 4x the carbon footprint of the average world citizen. Even American homeless people have 2x the footprint!

But, you see, in your attitude is one of entitlement. Absolutely no sacrifice on our part. Since we can afford to make kids, we are allowed to.

Again, that's the biggest problem with population control in this country. And we can't even make a very simple step.

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I have not made any assumptions with my reply. I presented some citations for discussion.

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You very much do pick a side:

So I doubt that closing fertility clinics will help very much.

One American couple not giving birth is the same, carbon footprint wise, is the same a couple in a less affluent society not giving 4 births.

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I've picked a side now, in addition to assuming?

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Personal responsibility should count for something.

There was a gine analyst on one of the news shows.

He was speaking of a tiered system. It is something like this:

First Tier
Everyone is entitled to ER services

Everyone needs a physical. I would say every year. And not just blood pressure, but to check the blood for viruses etc...A good physical

Everyone is entitled to certain basic health care.

Now the second tier would be mandatory insurance for those taking special risks. I mean if you are one of those flying guys in the movies, you are insured. believe me. And if that means smokers pay extra, fine. If obese people pay more. That is fair.

And the third tier. Well you can imagine. I mean today, if you need a kidney, you are on a list.
So many factors come into it. And some hospital panel makes the decision. etc


There will never be one plan. Never.

Right now for me the issue is whether the government can get its 'foot in the door' on this new health care package.

The next move for me would be to take profit out of the picture. Now it will never be gone. I mean who is going to manufacture MRI machines?
But there should not be for profit health insurance companies. Non profits are another thing.

Great post. Takes a lot of guts to approach these issues. BUT THEY MUST BE APPROACHED.

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"BUT THEY MUST BE APPROACHED."

Seems like it, Arthur...We're talking a lot about what we want/need, but not a lot about the details.
The devil is in the details.

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2D,
I would be happy if we could just take the profit out of insurance and then step on its throat for about 3 days.
Profits of the health insurance industry will be the death of most of "U.S."

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I'm lol when Old Grouch said: "Here's hoping this can turn into a solid, well-reasoned discussion. Of course, it is a blog..."

Nevertheless, I'll take the plunge. With all due respect to our beloved smokers (I once was one myself) I have to pass along the comments that I often hear from my wife, who is an ICU nurse. She says that (paraphrasing) drug addiction, alcohol addiction, tobacco addiction are the straws that break the back of the camel that is our health care system we now have. Because people who fall prey to these bondages rack up mucho grandebills, especially in the latter stages of life. So there you have it, the cold hard truth. Sorry to have to break it to ya.

As for the nutrition part, I'm tracking with ya stilli, absolutely. But the complexity of the issues here will lead ultimately to just a big can of gummi worms. So we really, for the sake of minimizing bureaucracy, can't go down the road.

Nevertheless, it's a point very well taken. And it's all about education. So we can deal with it in the schools. But more efficiently...try this: print out a copy of stillidealistic's posting above and send it to your local food bank manager.
Let them make the decisions about what foods to accept, and what foods to request, and more importantly, what foods to release to what clients based on, well, you know, their weight and all.

That's the American way. Go local, and educate.

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"what foods to release to what clients based on, well, you know, their weight and all."

YIKERS! I can't even get behind that one, Carey! I would prefer to just say that food banks cannot accept junk food, rather than force them to police who gets what.

I'm not hearing anything about food stamps...any thoughts on limiting them to nutritional foods? We have a right to eat what we want, but does society have an obligation to provide nutritionally deficient food to people who cannot afford to feed themselves?

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My sister just emailed me to let me know she's having trouble creating an account here at TPM, Stilli, but she wanted to let you know that, in regards to food stamps, there are limits to the kinds of food one can purchase with them. Milk, eggs, meat, produce are all allowed. Twinkies, chips, etc. are most definitely not.

My first job was as a cashier at Publix Supermarket in FL and I remember having to separate out the "allowed" items with food stamps versus the items that had to be paid for with cash.

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I'm so glad to hear that Lis! That didn't used to be the case. Thanks for letting me know!

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Yet I somewhat have a problem with that, Stilli. Is there anything wrong with a food stamp Mom wanting to give her kids a treat now and then?

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In my initial list of things I mentioned I put maybe a goodie or two a month, then I figured that could probably be purchased w/o food stamps...but no, I don't think that is out of line. But I gotta tell you, I see the grocery carts of people shopping with food stamps, and I'm often appalled at what I see. But then, I'm often appalled at what I see in everyone's shopping cart, so what do I know? If only I could run EVERYONE'S lives!!! (That's a joke!!!)

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There's nothing wrong with it, if she can afford it.

If she can't, that's life.

All of us live within our budgets. I know what I can and cannot afford. I stay within my budget.

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I think we can all agree that maternity needs would be covered, but does that mean that everyone can pop out as many kids as they want, and we all have to pay for it? Why? Or why not? And if not, how, in a free society can you stop the unfettered reproduction?

Here is much of the confusion:

People don't have a "right" to live a life of comfort. They have a "right" to be able live to their greatest potential without the interference of a government (short of violating the social contract). That's it.

Our society has changed in the past 80 years. People now look for the quick payoff, the lottery win, rather than hard word to a goal... and not expecting to have a pot of gold either.

Things like smoking and overeating are personal choices and people should be allowed to do these activities if they want. They also should expect society will not cover the consequences of them. It's right to expect that smokers pay a higher insurance premium, just as SUV drivers pay a higher insurance premium.

It's a sad fact that most people will not be able to exercise self control in key things. Safety nets are wonderful, but the type of programs espoused on the left is often akin to taking a safety net and making it a de rigueur service. Kind of like using abortion as a means of birth control.

This is where the left is wrong.

Our country is decadent, in the classic sense of the word... just like the Romans right before their empire collapsed.

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Should society have to pay for the heart attack of the type A workoholic?

People are human, sorry, but it's a fact. People have different weaknesses. Some people are not prone to chemical dependency or obesity. Some are not prone to heart disease or cancer. Some never get arthritis. Some work around chemicals. Some work in the sun.

I lost a very dear friend to a mosquito. Should society have refused to pay for her care because she neglected DEET?

I lost an uncle to an icy road. Should we pay more for insurance in states where there is ice?

My sister got a decade long terminal illness in her twenties when she had been fit as a fiddle. My mother is 88 and she smoked for 30 years.

I knew a guy who died working out in the gym. He was 28.

Sure encourage healthy lifestyles but I am sceptical of the moral superiorty of some who figure they have the ability to judge the character of others on sight. That overweight fellow you see may be on medication because he's mentally ill. He hates the medication but his strength of character motivates him to stay on it inspite of the contempt he may get from those who make snap judgements.


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Smoking and overeating are personal choices. They are not one time events like getting bit by a mosquito. You are simply trying to make an argument by conflating random things.

If you can't control yourself, you have no right to expect society to support your "habits". Insurers should charge higher premiums for these habits. LisB notes above her insurance gives her $300 to try to kick the habit. That's an excellent way to go. Go ahead and try to conflate that statement as a "superior morality" if you wish.

In your view, everyone is a victim. If you keep sticking that fork in your eye, don't expect me to pay for your surgery.

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Smoking is an addiction that is easier for some to kick than others. Obesity can be almost impossible to kick even with surgery. Sure, there is choice involved but there is also a genetic component to both plus complex emotional and enviromental triggers.

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Guess what? That's life.

"Some have an easier time"?

Doubtful. Food tastes good. The person that regiments themselves didn't have an easier time -- quite the contrary, they knew what they were giving up.

Everyone has different issues to bear, but the point of this blog is that there really are some areas where personal responsibility does matter. The problem is that most people simply can't control themselves. With debt, with eating, and on and on and on.

The societal attitudes in the country weren't always like this. True, once upon a time, the pendulum was too far in the other direction, but that time has long past and we are in an overcorrected mode right now.

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If I was a life insurer, I'd look twice at the amount of enemies you are able to make and probably turn you down.

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It's my hope that, for everyone's sake, we can keep this discussion thoughtful and not resort to trashing another post, eh, luv?

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I think seashell was making the point that personal responsibility also requires some self control in social settings.

There was hardly anything uncivil about that point.

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Nah, you just like jumping on me. I note that you had no issue with what Jan wrote. As usual, few here can rise above the avatar and consider the issues.

LisB is one of the few of the "group o'friends" who can. Were I you, Bwak, I'd take some heed from her words.

Not everything negative on TPM is a result of people who you personally don't like.

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We disagree. I see it quite differently.

At any rate, nice dodge. You still haven't explained why genetic weaknesses should be exempt from higher premiums.

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Once again, Bwak:

Unlike you, I won't equate behavior with genetics.

As I said above:

Do cigarettes grow out of people's mouths?

Do starved genetically obese people get larger with no food?

Insurance rates for autos have always been based on car choices. Just as any health care rates should be based on lifestyle choices.

Of course, in your world view people are too stupid to not listen to advertising, will give into whatever their kids want, etc. If that's the case, then these people are too stupid to participate in policy decisions and their opinions aren't to be taken seriously. You can't have it both ways. Either people are capable of thinking things through or not.

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CT, STOP SAYING THAT I TOLD YOU TO KILL YOURSELF! I DID NOT SAY THAT, EVEN THOUGH YOU PUT IT IN QUOTES AS THOUGH I HAD!

You said that if you are infertile the law of nature says that you should not be a parent although there are legitimate medical treatments for that. I responded with examples, such as apendicitis and pneumonia for which there are medical treatments, and challenged you to not go against nature if you had those problems.

Anticipating that you wouldn't "get it," I even gave an amusing example of what nature wants you to be able to do, and said that if god wanted you to go faster than your feet, you would have wheels at the end of your legs.

You never get anything, because you are so single-minded that you interpret everything as either an insult (victim much?) or proof of your moral superiority to others.

NEVER MAKE UP A QUOTE AND ATTRIBUTE IT TO ME AGAIN -- IT MAKES YOU LOOK LIKE A VERY FOOLISH YOUNG FELLOW.

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Your guilt over creating part of the problem we have today in the world creates quite a cognitive dissonance, eh?

Your comment is moronic:

Curing a disease in an organism that was once healthy is not the same as creating new life.

Continue to make irrelevant comparisons all you like, Jan.

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Jeez CT

Your contribution becomes absolutely nothing... everything of value that you share becomes worthless when you let yourself fall into the snyde, righteous, immature guy...

The guy how tells people how they feel and what they think and what they 'always' do 'every' time. Making everything very personal.

If you really see others the way you do then maybe you should consider not 'sinking' to their level as 'you' perceive it.

If the real intention is to contribute... and I really think you do have much to offer in terms of bringing different elements and perspectives into the conversation...why lose all of that by saying cutthroat, immature, petty things? The more you refrain the more others will look foolish for aiming them at you...

As far as who attacks who first and blah, blah, blah... does it really matter. You are so intelligent, you clearly have better ways of defending yourself at your disposal. In fact I am seeing much more evidence of that.

I would love for people to be able to 'listen' to what you have to say.. not because I agree with it all but you bring out elements that I know I do not often think of or have not at all... there is value there... but it becomes completely lost when you let yourself get distracted and you start telling people how they feel, how worthless they are, what they think, etc.

Your choice...

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Whether one chooses to listen or not is their business. LisB, for example, seems to have no problem tuning in.

I know it's comfortable to be in the majority and blame my tone and my posts, but until you show you aren't just dogpiling, your comments are rather self-serving. No one, for example, mentioned that seashell made a really toxic comment, and out of the blue.

A truly mature person would note I follow the tit-for-tat philosophy. I will respond in kind. When a person manages to keep a comment invective free, no snarks against a person (feel free to attack ideas all you like), you will find my response is the same.

As discussed last week, there are a few here that really want to control tone and style. It's more evident when you aren't part of the group, I suppose.

In the meantime, I welcome your taking whatever value you find in my comments and incorporate the useful ones into comments of your own where you can disperse the concepts in a tone more to your liking.

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I addressed you as an individual based on observation. Just because I have some fun with some of the folks here doesn't mean I am part of some 'group' think. I spoke up from observation and sincerity... not piling on anything or anyone.

I think you're kidding yourself if you think you only respond in kind and are never attempting to initiate an attack with your words.

But hey, if it's working for you... swing away...

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Then where was your lecture for seashell's comment?

Which I may add, was quite content-free.

That's my point. Something to think about.

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No, it's not my point...

The point from my view is that I have observed more than this behavior on more than one blog and I had the very experience of you making broad sweeping generalizations about me on a blog of my own at one point. I see that a dynamic has been set in motion between you and others here that it seems you have the greatest power in changing...

This 'he did it first crap' seem like a ridiculous excuse. Well maybe not. I thought you could do better than this but maybe that is unfair on my part. It seems you think I don't notice that others are sometimes attacking you out of context now... I see it... that's actually the reason I said something in the first place.

As I said if this is working for you... swing away, it will lead somewhere eventually.

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Again: then why single one side out for a lecture? Why not make a comment in the spirit of LisB?

The fact is that I was posting on these boards before you showed, and back then, there was not nearly the kind of groupthink we presently have. What we have at TPM today is somewhat the tyranny of the majority where different standards apply to different subgroups. Otherwise, why lecture just one side?

And apparently, there are those here (including you) that do read my posts. And think about them.

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Blaming group blah, blah, blah. And maybe even inferring that this perceived 'group problem' showed up after I arrived is just silliness.

I am not saying that there is no validity to how people interact as they become familiar with each other etc. I already laid out in my previous comment about why I was addressing you and not everybody.

Still and again... you got attention for sure, you got listened to some, so if this working for you go right ahead. I would just suggest that you consider how to best deal with people of different backgrounds, skills, and different levels of development so that you don't miss out on what they have to offer you.

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Quite. Thank you, bwak. :-)

It also looked at the statement "Guess what? That's life." and made a judgment on different forms of life.

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Sometimes I sit and think about all the more valuable things the carbon in your body could be used for.

Pencil lead for starters.

If you feel a need to post, how about something of content in addition to the childish attack, seashell?

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This is despicable.

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I think so, Bwak. But I'm taking myself out of the conversation, if it can be called one, when one person feels the need to respond to every comment rather than just stating his own once or twice and being done with it, as most commenters do.

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You can't take yourself out of something you never participated in.

Many of your comments, and certainly the ones directed at me, are simply content-free. That, in and of itself wouldn't so bad if at least they were clever... but they aren't even that. I will give you points for hostility and anger though.

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You really are a very little boy. I think you should sit in the corner until you learn the proper way to speak to people.

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And you are the biggest hypocrite around.

Or maybe you think it's okay to say that perhaps YOUR enemies will knock YOU off.

Again, you are not principled in any manner, you simply defend your clique. You are simply like all the right-wingers just with different friends.

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Which comment, Bwak?

Oh, you must mean the one where seashell infers that my enemies will kill me. Especially as we've had a doctor shooting last week for essentially that reason.

You like to think of yourself as principled, but that is hardly the case. You never follow your principles, only your sense of emotional rage.

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"Emotional rage?" You could write a book on that one, CT.

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Oh, I don't know. You are the one calling me a "little boy". I've never called you an "old biddy". You tell me. I know you feel justified in that type of patronizing insult to me as a person, but you will note I don't post whole comments (like you, for example) that don't address the topic at hand.

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Personal responsibility does matter, but it is personal. The government can't dictate it and the government is not competent to measure how much personal responsibility you take. I agree we should have incentives to motivate people to make difficult lifestyle changes. I support regulations that discourage reckless behavior like driving while using a cell phone or without seat belts. But I would not deny healthcare to someone because they failed to live a faultless life.

If you have the need to regulate behavior, I'd focus on behavior that endangers others. Now, you might make a good case there on second-hand smoke.

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Again, you are taking things to extremes!

"Faultless life"?

We are talking about quitting smoking and stop overeating. Again, you conflate all kinds of issues to get to "faultless life".

LisB, a smoker, saw the connection between the choice of car and insurance rate. Why can't you?

You are correct, the government shouldn't tell one to stop smoking in your own personal space. Just in the same way, one shouldn't tell society how we should support the consequences of your habit.

If you have one, you have the other, simple as that.

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It is an unfortunate thing that people require "incentives" to do what is good for them. I wonder if that will ever change?

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Well, at least some counter-actions, to the propaganda and incentives they've had to do things that are bad for them. Corn subsidies enable food manufacturers to produce cheap bulky foods, which they then make addictive with sugar, fat, and salt, and then mark them up shamelesly as the fleece the not so well off.

Look at what gets advertised.

McKiddie meals?

Lots of conditioning and incentives right there.

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STOP ALREADY, BWAK!

You always think of the pyramid as the vast "poor" and a few wealthy people. The fact is the middle class is really what is at issue.

How do you respond to my point of eliminating soda from your diet?

Yes, yes, everyone is a victim. "Conditioning". Evil corporations. etc. etc.

Your world view is that everything is a vast conspiracy against you. I've yet to see you post something outside that realm.

Let's be frank: you want real socialism (not the FNC kind) where everyone is exactly at the same level.

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Codswallop.

I don't drink soda except for an occasional coke for an upset stomach. Your assumptions are invalid. As usual.

It ain't rocket science to look at the numbers here, CT, fact is, the middle class has been screwed out of wages, been screwed by energy, oil, and medicine, and the numbers don't lie. A few have made obscene profits to the detriment of the many.

Your spin belies reality. I think Americans should call for restitution. I don't want to abolish the rich, I want some accountability.

Knock off the personal comments about people that disagree with you. It is boorish.

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LOL!

First: grow up. You can stop making every comment about you personally. The soda comment was in response to the poor being subjected to corn syrup.

It wasn't about you.

Second, you talk in terms of vague realities. The middle class is perfectly capable of eating more healthy. They have to stay in budget to do so and that will mean not giving their kids as many presents on birthdays and the like. It's called weighing choices.

Your biggest issue is that you want to live with a certain set of options but don't like the choices you have to make to do so.

Death sucks. Divorce sucks. Not everyone has the same as everyone else. But the fact is that more people here have more than elsewhere in the world. So apparently we aren't being quite as raped as you would have it.

You have always talked about the woes in your life as being someone else's fault. It's the corporations! It's the Bush Administration! It's the ex-husband!

This is central to Stilli's thesis: much of our lives are a result of our actions, our choices, our responses.

It's a shame that some of the extreme left don't get that because that issue will soon become a meme for the resurgence of the GOP.

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CT

I would like to point out to you that when referring to anything to do with another person... using terms like 'always', 'every' and such suggests a familiarity/intimancy that you most likely do not have:) and this will lend itself to your comment being taken or reacted to 'personally'.

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I'm with you there, Miss Perky Feathers. We are in a position where we can eat little refined foods, cook from scratch a majority of the time, and buy mostly organic foods. Most people are not. How in the world you are supposed to balance nutritional needs with the need for quick food, and the cost of everything is beyond me. No wonder so many of the poor resort to McDonald's value menu. "Cheap" should not have to mean "unhealthy."

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...and conversely, "healthy" should not mean "expensive."

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Jut so, Still.

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Stilli,

First, drinking only water is not only cheaper, it's healthier. No sympathy for anyone who can't start there.

Second, fast food is cheap because it is force grown. It is force grown because that is the only way to maintain costs while producing an ever increasing quantity of food.

Third, I posted a link above showing healthier choices even for fast food.

Fourth, it's possible to eat better and not break the bank, but that requires more effort. And more effort is the problem here. (Again, it's a personal lifestyle choice!)

Fifth, the "arguments" presented here have not been based on specifics but vague notions (some correct in general, but put together in incorrect ways). Poor people in other countries aren't necessarily fat! That should be proof enough that it ain't "genetics" special to America.

Sixth, good post. I think it was brave to put this up because it's not in the linga franca of the typical TPMer (who prefer a victimization characterization of things).

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I'll reply below to stay away from the teeny width...

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It is amusing to see your statement that if someone doesn't switch to water you have no sympathy for them. I happen to prefer water, but the "sympathy" really got me.

You don't display the ability to sympathize with anyone for anything, so saying that you don't sympathize with someone who switches to water means the same to me as Alberto Gonzales saying that he doesn't remember if he drinks water or not. It means NOTHING!

So many of your responses are like this:

An irrelevant question and has nothing to do with the issue at hand.
that it amazes me that people keep responding to you in a way that indicates that they think you actually listen. You are like a very young O'Reilly; full of bluster and insults and putting words into mouths, and discounting what others say.

Good luck to you; I hope you gain some maturity to go with that superiority that is bringing you down.

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The incentive is already there: the consequences are scary.

Part of the problem we see today is readily apparent on this thread: there is a huge gut reaction from the extreme left that everyone is a victim of their circumstances and society's rule is to level the playing field.

Most people won't ascribe to that.

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Good points, again.

I hear from a lot of Republicans and conservatives comments like, "Who is the government to tell me how I should live, how I should eat?"..."How dare our President tell us that we all need to lose weight?"....."If I wanted to be a communist I'd move to goddamn Russia" (as if it's still Russia, lol).

I agree it was very brave of Stilli to put these thoughts out there, and this has been a very good discussion. I, for one, have learned a lot from all the comments.

What it boils down to is that we all have to start taking more responsibility for our own choices and lifestyles and ways of living. Nothing wrong with that, and with all the problems we have right now, I think it's not just a desirable or a WBN (would be nice), but a necessity.

And, yeah, I'm pretty damn sure I'll be a non-smoker shortly. So - word up, folks, I may become a real right ranty bitch for a while, heh heh.

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Yes, and our leading leaders in industry can start leading on this. Make food healthier. Employ more people to verify quality and safety, (a particular sore point) and stop marketing junk food to kids.

If we can't expect that our leaders will do that, how can we expect the overworked and underpaid to catch on?

Healthy eating is an economic issue.

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Again, good points... If we stop buying it, they will stop making it. Every time I go into Trader Joe's I thank the checker for carrying more organic products and suggest that if they could just get rid of the trans fats and high fructose corn syrup I'd be a super happy camper. The last time, I said it to a manager, and he said, "believe me, we're working on it." It pays to make noise. And Trader Joe's proves you can get good food w/o paying an arm and a leg. I'm continually amazed at how much less their products cost than the traditional grocery store's.

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It's because they (a) carry less variety and (b) don't necessarily carry the same stuff week to week.

However, you will note that the veggies (say tomatoes or peppers) are coming from Mexico these days and not the US. The difference in cost is, to a great deal, the fact that Mexico doesn't have the same regulations on growing the food.

Again, the cheapness does come at some cost.

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I'm glad you brought up the additive issue. The fact is that fast food is cheap precisely because it's "manufactured" chemically. Part of the problem is that people don't realize you can't have the food output that is required to feed the population and yet grow it in old fashioned ways. So the issues of "what you are eating", cost, health, and "population to feed" are intimately linked. By the way, growing things in hot houses has yet to be perfected (and perhaps never will). That's the reason why those vegetables from someone's garden taste better.

Your lungs with thank you, LisB, for the non-tokes. And your skin will be healthier and you will radiate! (But in a good way!) Good luck in quitting. It's something that is psychologically addictive, so it's best to be kind to yourself and just deal with it "one day at a time." It usually isn't easy, but like all habits, once it's broken, you are free!

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I think we need a post just about the additives in food, and food preparation overall. Cuz, I admit, since living alone for the first time, I'm relying on a lot of frozen dinners (not much of a cook, I'm afraid), and I've noticed their quality has really deteriorated since I was a kid.

And thanks for the well wishes on the quitting. For me it's mostly a hand-to-mouth kind of oral addiction, but luckily I don't care for sweets so I don't think I'll need to rely on those for a substitute. I think I'm more likely to be buying a lot carrots and celery and just dealing with it that way.

That, along with the patch, should hopefully work. I'm downright tired of having nicotine stains on my walls and two fingers, and I'm tired of stinking like cigs when I enter a room. And it's an expense and I could put my money elsewhere more wisely.

So if I keep looking at it as a win-win, it's all good.

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I'm very proud of you, lissy, and we'll be here for you when you need to be bitchy! We love you and want you to be around for a long, long time!