Sidney Blumenthal, in a piece called "What didn't go right?" in Salon, reviews the history of FEMA. He points out that FEMA had been widely criticized for its response to Hurricane Hugo in 1989 and Hurricane Andrew in 1992, but that Clinton appointed James Lee Witt as director and turned the agency around, "setting high professional standards and efficiently dealing with disasters." All that changed, of course, when Bush took over.

Bush appointed his former campaign manager, Joseph Allbaugh, as FEMA director. Allbaugh then "immediately began to dismantle the professional staff, privatize many functions and degrade its operations." Blumenthal quotes Allbaugh as testifying before the Senate: "Many are concerned that Federal disaster assistance many have evolved into both an oversized entitlement program and a disincentive to effective State and local risk management. Expectations of when the Federal Government should be involved and the degree of involvement may have ballooned beyond what is an appropriate level. We must restore the predominant role of State and local response to most disasters." The key word here is "entitlement": the idea that anyone might think that the government owes them, even that the government might lift a finger to help them, is the dividing line between the right and the sane in America today.

The sane position is that government belongs to the people, who charge it with the responsibility to support the common, collective interests of the people. There can be debates about what should or should not be supported, but when it comes to disaster relief, there are few who doubt that the government has to step in, and in all but the most marginal disasters that means the federal government. The plain fact is that state and local governments don't have anywhere near the resource level to handle anything like Katrina. Thanks to Allbaugh, his hand-picked successor Michael Brown, and the oversight of the Bush administration, the federal government didn't have the resources to respond either. Guess that'll teach Louisiana to do a better job of preparing next time? At least when a disaster strikes a state like California or New York there are competent people who care working for the state and local governments. In Louisiana and Mississippi, this sort of moral hazard argument is so ingrained that Governor Blanco's pre-storm preparations didn't extend much beyond urging residents to pray.

Due to the sudden, episodic nature of disasters, the rotting (or the looting) of FEMA didn't become unavoidably obvious until it was tested by a major disaster. Not that it couldn't have been measured. It certainly could, but no one in the Bush administration, and few in Congress, cared. And those who did care didn't have the clout or the visibility to make their case -- and in many cases didn't have the time, because they were too busy fighting other dumb and vicious acts of the administration. But it should have been clear what the plan was from Allbaugh's quote: make FEMA useless so people won't get used to the idea that the federal government might help them in times of crisis.

As Blumenthal points out, Allbaugh left FEMA in 2003 to cash in on his lobbying connections and, especially, to get in on the Iraq War graft. Leaving his crony Brown in place ensured that his work would be continued, and that he'd be well connected to help his clients siphon off any money that Congress foolishly allocates to FEMA. If Allbaugh was the only one doing this, he'd merely be a masterful crook. But he's not -- this is the way everything works in the Bush administration. The view there is that government spending is the new patronage system, especially where they can privatize: spend money, often wastefully (since they want agencies like FEMA to fail), get kickbacks (political contributions, jobs) in return. This system has built a powerful political machine, but at costs we're only beginning to be able to imagine -- because we've never seen such self-inflicted ruination before. Some still think this is incompetence, but there's too much malicious forethought for that to be the only problem.

Malcolm Gladwell wrote a very good piece on the health care system in the U.S. It is called "The Moral-Hazard Myth," and appeared in the Aug. 29 issue of The New Yorker. Moral hazard is an economics concept, mostly used in regard to insurance. The argument is that if one is insured against costs or adverse consequences of some act, one has no interest in preventing the act from happening. For instance, if you're insured against your house burning down, why bother to work to keep a fire from starting? Moral hazard argues that insurance causes fires. With regard to health, moral hazard argues that if one has insurance, one will use health care resources without any regard to cost. Hence, with more/better insurance, costs will rise as resources are overused. Hence, a way to limit health care costs is to transfer costs back to the "insured" through deductibles, co-payments, etc. Of course, the only way to eliminate moral hazard from health care is to eliminate insurance.

Economic dogma says that if everyone paid for their own health care, they'd spend their money optimally, buying only what services they need, and skipping any services they don't need. That this is a myth isn't a big surprise. One need only fill in a few blanks -- little things that the theory assumes but doesn't spell out. For starters, patients would have to understand medicine better than their doctors do. Otherwise, how can you know when you need a procedure and when you don't? Second, how do you know when one doctor is competent enough and another isn't? Another important factor is that different people value money differently, mostly because some have more than others. What one pays for health care comes out of some other budget (assuming the money exists at all). It's much harder to rationally spend food or rent money than it is to spend money that otherwise might go to a second Porsche. So even as a theory moral hazard doesn't provide much insight into health care economics.

The data is as clear as the theory is dubious. People without health insurance don't get adequate health care. They put it off until it becomes unavoidable, and often too late. Gladwell's first example is dental care, and the stories are harrowing. I mentioned this story to a periodontist I was seeing, and he told me: "Tell me about it. I've seen people wait so long I can't help them. I tell them they have to go to the hospital, and if they don't they could be dead in two weeks."

I want to quote two paragraphs from Gladwell's piece. The first summarizes what happens to uninsured people in America. The second is the single best description of America's "system" I've read.

The U.S. health-care system, according to Uninsured in America, has created a group of people who increasingly look different from others and suffer in ways that others do not. The leading cause of personal bankruptcy in the United States is unpaid medical bills. Half of the uninsured owe money to hospitals, and a third are being pursued by collection agencies. Children without health insurance are less likely to receive medical attention for serious injuries, for recurrent ear infections, or for asthma. Lung-cancer patienrs without insurance are less likely to receive surgery, chemotherapy, or radiation treatment. Heart-attack victims without health insurance are less likely to receive angioplasty. People with pneumonia who don't have health insurance are less likely to receive X rays or consultations. The death rate in any given year for someone without health insurance is twenty-five per cent higher than for someone with insurance. Because the uninsured are sicker than the rest of us, they can't get better jobs, and because they can't get better jobs they can't afford health insurance, and because they can't afford health insurance they get even sicker. John, the manager of a bar in Idaho, tells Sered and Fernandopulle that as a result of various workplace injuries over the years he takes eight ibuprofen, waits two hours, then takes eight more--and tries to cadge as much prescription pain medication as he can from friends. "There are times when I should've gone to the doctor, but I couldn't afford to go because I don't have insurance," he says. "Like when my back messed up, I should've gone. If I had insurance, I would've went, because I know I could get treatment, but when you can't afford it you don't go. Because the harder the hole you get into in terms of bills, then you'll never get out. So you just say, 'I can deal with the pain.'"

One of the great mysteries of political life in the United States is why Americans are so devoted to their health-care system. Six times in the past century -- during the First World War, during the Depression, during the Truman and Johnson Administrations, in the Senate in the nineteen-seventies, and during the Clinton years -- efforts have been made to introduce some kind of universal health insurance, and each time the efforts have been rejected. Instead, the United States has opted for a makeshift system of increasing complexity and dysfunction. Americans spend $5,267 per capita on health care every year, almost two and half times the industrialized world's median of $2,193; the extra spending comes to hundreds of billions of dollars a year. What does that extra spending buy us? Americans have fewer doctors per capita than most Western countries. We go to the doctor less than people in other Western countries. We get admitted to the hospital less frequently than people in other Western countries. We are less satisfied with our health care than our counterparts in other countries. American life expectancy is lower than the Western average. Childhood-immunization rates in the United States are lower than average. Infant-mortality rates are in the nineteenth percentile of industrialized nations. Doctors here perform more high-end medical procedures, such as coronary angioplasties, than in other countries, but most of the wealthier Western countries have more CT scanners than the United States does, and Switzerland, Japan, Austria, and Finland have more MRI machines per capita. Nor is our system more efficient. The United States spends more than a thousand dollars per capita per year -- or close to four hundred billion dollars -- on health-care-related paperwork and administration, whereas Canada, for example, spends only about three hundred dollars per capita. And, of course, every other country in the industrialized world insures all its citizens; despite those extra hundreds of billions of dollars we spend each year, we leave forty-five million people without any insurance. A country that displays an almost ruthless commitment to efficiency and performance in every aspect of its economy -- a country that switched to Japanese cars the moment they were more reliable, and to Chinese T-shirts the moment they were five cents cheaper -- has loyally stuck with a health-care system that leaves its citizenry pulling out their teeth with pliers.

In the last week most of us have discovered that New Orleans was a disaster waiting to happen. Even those of us who knew that much now know it in ways that were inconceivable before the fact. While the topography was critical in New Orleans, the region's poverty and its unrepresentative, uncaring government has also been exposed. The area is quickly becoming a public health disaster as well as a physical and economic wreck. The immediate response will be to suspend the rules: to provide emergency health care support to victims of the storm regardless of ability to pay. But the real problem goes a lot deeper and is much broader. The real moral hazard would be if the only way to get quality health care to poor people is in the wake of a hurricane.

There are a lot of things about economics that I don't understand. For instance, economists are obsessively concerned with savings, and they promote any government policy that promises to promote savings. This was just pointed out by Alan Greenspan in advocating a national sales tax, but you also run into it from economists as far away from Greenspan as Paul Krugman. (For instance, in his New York Review piece on "The Social Security Scam" Krugman defends the wisdom of building up a Trust Fund as a hedge against the impending retirement of the Baby Boomers, and goes on to recommend more of the same as a prudent hedge against expected increases in Medicare costs.)

But the first confusing thing here is the word "savings" -- what does that really mean? If I put my pennies in a piggy bank I'm saving them for future use -- at least as long as I don't get robbed, and I don't forget where I put them -- but that isn't what they're talking about. Simply taking money out of circulation doesn't do anything for the economy; if anything, delaying or foregoing consumption reduces demand, which slows growth, puts a damper on prices and profits, and ultimately puts people out of work. That may be good for the ecosystem, but that's hardly something that excites economists.

What economists really mean by savings is more like what the word "investment" means: giving your money to a business, in exchange for a promised rate of return or a future claim on profits, so that the business can spend the money on things businesses spend money for. If nothing goes wrong, you can expect your savings/investment to appreciate in value, so that you can consume more (or better yet, save/invest more) in the future. Meanwhile, all that really happens is that you transfer your spending to a business who, economists believe, will spend it more wisely. This leads us to a couple of big questions:

1. Do businesses really spend their money more wisely than individual consumers do?

2. Even where businesses do spend their money more wisely, is this the most efficient way to do so?

The first, at least, should be an empirical question: something that we can go out and measure and answer more/less definitively. (Admittedly, the word "wisely" calls for some subjective judgment; "productively" is a word that economists might prefer, or better than that, "profitably" -- turn the problem into one of counting money, but the story of Midas is just one cautionary tale about such a reduction. Moreover, "profitably" raises more questions: profitable to whom?) I can't answer this, but I can point out that many instances of household expense are not mere consumption: some save other expenses, some may appreciate in value, some make life easier or more productive or more rewarding. Greenspan talked about savings leading to "capital formation," but household spending on durable items like appliances, computers, vehicles, tools, etc., is also capital formation. On the other hand, there are many cases where business spending does not lead to capital formation, or (more basically) to the employment of productive labor. When a company builds a factory and employees workers to produce useful things, that adds meaningfully to our gross product. But when a company merely buys another company it doesn't produce anything, and may actually reduce gross product by laying people off and closing plants, while reducing value by eliminating competition.

Clearly, there are useful things that companies can do that households don't do, such as building factories. The question that I'm raising is how much savings/investment actually goes into making such useful things possible and how much doesn't? I don't know the answer there, but I'd be real surprised if it worked out to be more than 20%. (My first guess was more like 10%, but I hedged because a lot of business expenses are hard to classify. But note that it is very rare when buying stock actually increases the working capital of a company -- in most cases you are just buying from other speculators.) A big part of the reason private investment is so inefficient is that each investor and business only seek to maximize their own gains, and many opportunities to do so are at the expense of other investors and businesses -- or, an even bigger problem, at the expense of labor. From a big picture point of view this doesn't seem to be very efficient -- especially compared to public sector investment. The public sector manages to spend virtually 100% of its funds. The only question there is how wise/productive/profitable its spending is.

In the U.S. at least, government spending has a reputation for being grossly unwise/unproductive/etc. Whether that reputation is deserved is something we can argue about. Certainly there are plenty of instances where the charge is true, but there are also exceptions -- the management of health insurance is one such case. Governments also spend heavily in areas where there is no viable private sector business strategy, such as building roads, maintaining waterways, providing disaster relief. But there is reason to think that regardless of how efficient or not public investment has been historically, it could be made much more effective if guided by better principles. In particular, one of the major problems with public spending at present is the extraordinary level of corruption throughout the U.S. political system.

I'm not advocating a wholesale shift from private sector to public sector business finance, but it seems obvious that there are areas where such a shift would be beneficial. (I also think that we should look into reforming policies that tend to make private sector investment ineffective -- a big topic I can't go into here.) But the current political drift is moving the other direction, toward more and more privatization. This sounds like another pet theory of economists I don't understand, but in one critical respect it fits in perfectly: just as savings is a scheme to transfer money to business, so is privatization. It shouldn't be hard to figure out what all these businesses, sucking up private savings and public expenses, have in common: they are the province of the rich.

One begins to suspect that economists are just apologists for the rich. The political program of the rich is get all the money, and they pursue this program with methodical desperation because they compete not with the poor but with their fellow rich. Most economists, especially the ones you're likely to run into on TV or in the press, happily rationalize this program, often spouting utter nonsense as scientific truth. (An astounding example of this is the assertion that it didn't matter who took control of Russia's businesses, just as long as they were privately owned. Most soon fell into the hands of Russian mafiosi, who proceeded to destroy over a third of Russia's GDP.) At least that's my best theory to account for most of what I don't undersatnd about economics.

When I started this piece, I meant to comment on Paul Krugman's piece on Social Security. By the time I wrote it Alan Greenspan had taken over the news, arguing for slashing Social Security benefits and proposing a national sales tax while decrying the budget deficits that he help create in supporting Bush's tax cuts.

Three more points I want to make about Krugman's piece (which otherwise is level-headed and reasonable):

1. Regardless of its merits (or, I think, lack of) the Social Security trust fund dating back to the 1980s set a very unfortunate political precedent, which was to reinforce the public's idea that Social Security is some sort of trust fund as opposed to a pay-as-you-go welfare commitment. The idea that Social Security could go bankrupt, which is the stick driving the Bush program, depends on the notion that it is funded in advance. (The carrot is the equally fallacious idea that private accounts would generate more benefits.) Without this principle of advance funding: (a) there is nothing to invest (i.e., to feed the rich), and (b) the idea that sometime in the distant future America's voters will decide to stop supporting the welfare of the old and infirm is mere speculation. So I believe that this was a political mistake even if it made economic sense.

2. Krugman has two levels of defense for the trust fund. One is the idea that we should save for the future, which I think is sound policy for individuals -- that at least is the way my mother raised me -- but dubious for the nation as a whole. But the other idea is that we should prepare for forseeable future liabilities by getting our affairs in better order today: in particular, by paying off as much government debt as possible in order to make it easier to face up to future burdens. I don't have a problem with that.

3. Krugman argues that the increase in medical expenses is due to the continuous addition of new medical services, and that this will continue for the forseeable future, thereby increasing the share of GDP that goes to health care and adding to the burden of health insurance programs like Medicare. That's true as far as it goes, but within this macro picture there are systemic distortions of cost and quality of service (mostly denial), and those problems are critical. The only thing Krugman proposes is another trust fund. Much more needs to be done, not the least of which is transparent public funding of medical research replacing the current system of private monopolies.

Greenspan's proposal for a national sales tax is nothing more than an attempt to shift the tax burden away from profits (aka the rich) and onto everyone else. He justified this, of course, by claiming that it would encourage savings and capital formation. It isn't clear to me why he thinks we don't have enough capital, but the more fundamental issue there is whether the rich have enough money, which of course they don't -- they never do. The rationale behind this scheme is that if consumption becomes more expensive (as it does when taxed) people will have more incentive to save instead of consume. That assumes that their consumption is optional, that it can be refactored as savings, and that the difference is significant enough to lead people to change their behavior. But it should be obvious, even to a sheltered banker like Greenspan, that much of what most people spend their money on isn't really optional -- it goes for things like food, shelter, utilities, transportation, communication, basic necessities, most of which instantly become more expensive, if anything leaving less money for savings. Secondly, even among the middle classes, who could afford to save more if they lived more spartanly, there is little eagerness to do so. On the contrary, most of them are deep in debt, and a higher tax burden isn't likely to get them to rethink their lifestyles. That leaves the only beneficiary of this bit of wishful thinking to be, duh, the rich.

Actually, I think that there is a case that could be made for a national sales tax (probably in the form of a VAT, although I would do it differently than in Europe). But that would be as one part of a tax strategy that would be more progressive elsewhere, especially in taxing estates. But that's another story, and it's safe to say that that's not what Greenspan has in mind.

Someone named Jim Clark (associate director of the Center for Economic Education and is the associate dean of the Barton School of Business at Wichita State University) wrote a "My View" piece in the Wichita Eagle today [Feb. 4], called "Get Facts Straight on Social Security Reform." I fired off a letter:

The big problem with the Social Security reform facts that Jim Clark wants to get straight is that they aren't facts yet: all he's done is speculate about the future. For instance, he assumes that Americans in the future won't have the moral backbone to increase taxes if necessary in order to fund the Social Security needs of the old and infirm, even though ever since the founding of Social Security they have done whatever needed to be done. Moreover, he asserts that the federal government of the future will default on its borrowing of the excess taxes that workers have paid into Social Security since the last time the politicians "fixed" it. If this is true we have much more serious things to worry about than pensions in the latter half of the 21st century. The only way Social Security can go bankrupt is if the U.S. government goes bankrupt first. Given Bush's tax cuts and exorbitant spending on war and corporate welfare, the trade imbalance and the sinking dollar -- that's the real threat we need to take seriously.

Clark also argued that Bush's privatization scheme wouldn't lead to telemarketing scams trying to fleece the new private accounts. He asserted that all of the proposed schemes involve a small number of options of conservatively managed funds. This gets into one of the intrinsic contradictions of the anti-Social Security movement. On the one hand they promise higher returns than the current fund gets from federal government securities. On the other hand they need to minimize the appearance of risk, since most people realize that the stock market can go down as well as up. But increased management fees will take a cut out of the returns, so where does that leave us? More importantly, why should we care? If the point behind greater returns is to justify benefit cuts, the bottom line is at best a wash, at worst a disaster.

George W. Bush claims that Social Security "is on the road to bankruptcy." When CNN reported this, they noted that "Democrats say that's an exaggeration of problem." Clueless as ever, those Democrats. Stuck in that old-fashioned reality-based paradigm. Bush's statement wasn't an assertion. It was a threat. Here's how you should read it: Social Security has been overtaxing workers in order to build up a cushion against future claims. This excess has been invested in U.S. bonds. When the future claims catch up with Social Security, all we need to do is to cash in those bonds. U.S. bonds are normally a safe, dependable investment, and those savings are sufficient to keep Social Security viable, even without tax increases, for a long time. So where's the problem? Well, there's no problem, at least as long as the U.S. government remains solvent.

The problem here in the Democrats' logic is that they, like every other financial planner in the world, assume that the U.S. government will always be able to service its debts. But Bush's tax policies chop away at the government's ability to remain solvent. Back in 2000 the U.S. government was running a surplus, so the excess Social Security tax could have been used to reduce the government's other debt load, making it easier to refund Social Security when the flow shifts. But Bush didn't do that: he used the surplus to fund huge tax cuts for the rich. Every years since then, even when there was no surplus, Bush pushed for more tax cuts for the rich. His State of the Union address this year, coinciding with his warning about the impending bankruptcy of Social Security, contains yet more tax cuts for the rich. Exorbitant spending on war and corporate giveaways hurt too, as does the trade imbalance and the magically deflating once-almighty dollar, but Bush's tax-cut jones doesn't leave him any other future: the U.S. government is headed for bankruptcy, and when it goes, well, Social Security's going down with it.

Bush's Social Security proposal isn't actually meant to fix this problem. It's more like what you might call a pre-emptive strike on the future. Moving tax money into private accounts adds a huge element of risk to the scenario, and that will help explain to future retirees why they won't receive anything like the Social Security that pre-Bush retirees have received: good idea, but bad luck. Of course, it's also a bonanza for Bush's patrons in the finance business, and it locks up more savings where the rich can make more money. But mostly it disabuses ordinary people of the idea that when they get old and infirm their fellow citizens will look out for them.

The weird thing about Bush's Social Security con game is that now he's pretending that we owe this to our children, when he's been totally oblivious about what the growing debt burden might mean to them. Not to mention other long-term issues, like the environment. His whole program seems to be built on the notion that end-times are well nigh upon us, so we never have to save or preserve anything. He wants to pump all the earth's oil now, chop down all of nature's tree, mine every profitable mineral. He's so short-term he leaves no prospect of a viable long-term untouched. But now we have to slice through all this pompous rhetoric about the sanctity of our children's retirement.

I've never taken proposals to privatize Social Security all that seriously, because they are inevitably too crackpot to be taken seriously. Sure, the poor and the working classes get screwed all the time, but the pain that bankrupting the U.S. government would cause doesn't stop there. Nobody gets more value from the government than the rich, and nobody stands to lose more in its meltdown. You'd think that they, at least, would start to put the brakes on their Boy Wonder.

But the other thing that bothers me about Social Security is that we're losing track of the moral basis of the program. It used to be a pay-as-you-go program, and the logic there is simple: we, as a nation, understand that we have an obligation to support the welfare of those of us too old or infirm to work and support themselves. Given that understanding, when expenses rise, we simply have to pony up whatever it takes to cover the bill. An older demographic may be a challenge to Social Security, but it cannot be a crisis. The only way Social Security can be in crisis is if we shirk our moral responsibilities. This, of course, is the very essence of Bush's political program. He seeks to convince us that we are never responsible for anyone other than ourselves, and that by exclusively pursuing our own interests everything will work out for the best. The patent fallacy of his worldview is most clearly illustrated by pointing out what a fine example he has set.

Yesterday my hometown newspaper had an article about how Bush's health care plans are proceeding at a faster pace than his efforts to wreck Social Security. We can't quite talk about his plans for health care is an intent to wreck, because the system itself is in such ill repair that wrecking it would almost be superfluous. For a quick overview, take a look at the recent book by Donald L. Bartlett and James B. Steele, Critical Condition: How Health Care in America Became Big Business -- and Bad Medicine (2004, Doubleday). I just finished reading this book -- mostly stuff that I already knew, but spelled out in detailed case histories that even I found shocking.

The Bush plans are centered around Health Savings Accounts -- yet another tax-avoidance scheme for the rich -- tied to mandatory high-deductible catastrophic health insurance. As far as I can tell, there are two ideas here:

1. If you're rich enough, you can finance your own health insurance; if you're healthy, you'll save some money that way, and if you're not, you're still covered for worst case scenarios.
2. If you run a business, you can push your employees into this sort of plan, cutting your insurance costs by shifting them to employees. If they're healthy, they may not notice; if not, they won't be your problem.

The net effect is to force individuals to manage their spending decisions on health care, much as they decide whether it's worth the extra money to buy a brand name detergent vs. the store brand. Economic theory tells us that responsible shopping would wring a lot of wasteful overtreatment out of the system. The problem is that health care doesn't work like detergent. With detergent you go to the store, look at a shelf with 5-20 alternative choices, look at the prices, read what little info is provided by on the boxes, and guess which one to buy. If it works, fine; maybe you can experiment with a lower-priced one, or maybe the potential savings on the lower-priced one doesn't matter enough to bother. If it doesn't work -- if, say, it destroys your clothes -- you throw it out and never buy anything like it again. Worst case is you have to buy some new clothes. With health care, you know next to nothing about what's wrong with you or what one doctor vs. any other doctor might do about it; you don't even know what they'd charge. You can't even get that information -- if doctors had to sell you on every detail of their practice and competence they'd never have any time to treat you. In many cases the doctors would rather not treat you, so you usually wind up begging and hoping, and are stuck with whoever will see you. Moreover, the worst case scenario is you die.

Given this, all that making you spend your own money to get in the health care door means that those who cannot afford it will avoid the door as long as they can -- in many cases allowing their diseases to become critical, in some cases fatal. That this would happen isn't mere economic theory: we have more than 40 million people in the U.S. right now who have no insurance, and a great many more who have inadequate insurance -- including many with the sort of high deductibles that come with the HSA scheme. Many of those people are undertreated for their ailments; many die, and many suffer needlessly. Pushing high-deductible health insurance means that more people will fail to get necessary health care.

However, the silver lining in Bush's proposals comes in the form of government-backed catastrophic health insurance. The need for this was shown in an article in today's newspaper, titled "Bankrupt cite health bills as a top woe." As you may know, bankruptcies have increased virtually every year in the last two decades. The article attributes 50.35% of all bankruptcies to illness or medical debts. The article also points out that 68% of those filing bankruptcy for reason of illness or medical debts actually have insurance. The problem is that many private insurance company plans max out at some limits -- i.e., they don't really insure you against illness or injury -- and many more disallow claims for myriad reasons. Bush's plan won't help anyone lead healthier lives, but it should at least cut down on some of the bankruptcies. That would be a good thing, but note who benefits: the creditors, i.e., the health care industry and the bankers. That, at least, is a constituency Bush cares about.