Everyone (including California's "Governator") seem to think that universal access to insurance will solve the health care crisis. Everyone also seems to conveniently forget that insurance is not the same thing as health care. What insurance does is that it gives us access to certain amounts of pre-approved types of health care, at a cost that is spread out over time and over a large pool of people, with the intention of supporting a large administrative staff and ensuring profits for the insurance company's shareholders.

Now, those insurance folks have us all coming and going--patients and providers alike! If we opt for "pay as you go," then the health care providers (the hospitals, more so than the physicians--physicians are often very happy to negotiate good terms for a cash payment up-front) will mercilessly price-gouge us, effectively making hospital services unaffordable. In order to help control their costs (and keep up their profits), insurance companies will negotiate reimbursements to their preferred providers that are as low as possible, and, in addition, they review each and every charge that is submitted to them, downgrading the reimbursement code that has been submitted to them whenever it's feasible to do so (e.g.,, "In our opinion, that patient may not have needed an 'extensive exam,' so we're only going to pay you for a 'brief exam'!"); when that happens the physician has to either protest the decision and re-submit the claim, or s/he has to "eat" the difference. Oh, and did I mention that they'll often stretch out the time they take to reimburse their providers as long as possible, so as to "work the cash flow"? And if a patient or his/her physician wishes to try what is considered to be an unorthodox treatment modality, it will rarely be covered by insurance, thus effectively limiting/eliminating "consumer choice."

My point? If medical care were affordable, then no one would need insurance for anything more than "major medical" expenses. We could pay out-of-pocket for routine medical care, and everyone would be happier...that is, the patients and the physicians would be happier. The insurance companies, however, would lose their cash cows--which they are profitably milking on both ends (forgive the pun/mixed metaphor).

Like Dickerson, I feel very uneasy with the assumption that people's supposed rights to have whatever they imagine they'd like, sexually, granted to them by a loving, considerate, flexible (or, as Savage likes to say, "good, game, and giving") partner, in that the right to sexual fulfilment seems to always trump the partner's right to feel dignified and un-conflicted.

It occurred to me that we don't necessarily expect non-intimate associates to "enable" us if we have "unusual" needs for personal fulfillment in non-sexual areas. But then, the more I thought about it, the more I realized that we DO often burden our friends with the expectation that our "eccentricities" will be both tolerated and enabled--this being in direct correlation to 1-the closeness of the relationship and 2-the level of "weirdness" of that which we need to feel fulfilled.

Whether the relationship is intimate or non-, though, it seems to me that the situation that creates the greatest level of discomfort is that in which the person who is doing the most compromising realizes that the compromising will forever be going in one direction, and that that's the price of maintaining the relationship.

Which is worse, feeling unfulfilled or feeling used? That's what it all seems to boil down to. Maybe the only way for people on either side of the equation to maintain their respective dignities is to "DTMFA" (Savage's cute/rude acronym meaning "drop that so-called friend and get on with your life").

Ms. Dickerson was referring to the fact that Savage used to refer to HIMSELF as a "faggot" in his columns. All letters addressed to him used the salutation "Dear Faggot," or "Hey Faggot," or something to that effect. I haven't seen that salutation in his more-recent columns, so, unless one is a long-time reader, one wouldn't be aware of the history of the use of that derogatory word and would assume that Dickerson was "pulling a Coulter." It wouldn't be reasonable to assume that Salon's readers would be aware of Dickerson's context when she used the word "faggot," so it would be bound to inspire resentment and outrage.