For several decades now it has been apparent that the incredibly sophisticated and ever-improving quality of technology in health care is not something that any nation can afford to provide always to each and every citizen. For example, we cannot afford to put every dieing person on the planet (whose family might want the very best health care possible for their loved ones) on dialysis when the kidneys fail, a ventilator when the lungs fail, and/or an intra-aortic balloon pump when the heart fails. The basis upon which to decide what is and is not an appropriate intervention in all cases is impossible to describe succinctly (as is necessary if you want to put things into law), and is a decision that in any case should be made between health care providers and families. And of course families are entitled to listen to the advice from anyone they choose, be it their friends or their churches. Government should have the least role in this difficult decision making process.

At the same time, we have a federal government whose big priority was making political hay over a vegetive comatose woman in Florida. The leader of the Republican Senate at the time was Senator Frist, who was of course a cardiac surgeon, but also scion of the family that owns Hospital Corporation of America [HCA] – the largest hospital corporation in the world.

We need dramatic change in our health care system, not changes around the edges. The health care system cannot be “reformed” – it must be dramatically changed. For example, simply having one standard insurance form, instead of hundreds of insurance company forms, would save many billions of dollars. This could easily done with a “one party-payer system” and makes sense if we really care abut everyone’s healthcare, and not just our own health here, say here in relatively affluent Portsmouth.

Nonetheless Senator Frist and his friend John McCain would tell you that Clinton would give us “Hilliarycare” – as if that means anything, other than raising the ugly bugaboo of “Socialized Medicine” as if we don’t already have that - or as if that might not be a bad thing -- After all, we already have a “socialized" interstate highway system, a “socialized" education system and even socialized firemen and police! Some towns even have "socialized" sewer systems!

I thank Hillary Clinton for the great efforts she took to try to over-hall health care when she was first lady. And we should put some of the blame on how that turned out on those republicans for whom (in the words of House Majority Leader Nancy Pelosi) “we can negotiate” means “my way or the highway.”

The bottom line for me is that Barack Obama may have a better chance of effecting the dramatic change needed in health care (and elsewhere). And though he is a man who certainly is a man with “style” he is not without “substance.” For example, (to stay on subject) he says he would overturn the rule that prevents Medicare or any federal agency from negotiating with drug companies for prices.