What the doctor brought up about Medicare and Medicaid made me think, "How American," because it is just this sort of half-baked fractional approach that makes it our government so bureaucratic and unaccountable to people in the first place, a large percentage of our money spent on separate administrations of Medicare and Medicaid rather than both of them together, and the public option/co-op will further increase that fractionalization by creating yet another separate agency--all because the elected officials are too timid and too wholly owned by the insurance companies to simply extend Medicare to everyone.

Then, it makes the job of universal coverage even harder, because you have these three or four different agencies that must be merged together. I don't think, however, there will be much "turf wars" the way those testosterone-drenched three-letter agencies we call the FBI, CIA, NSA, and so forth, engage in when Bush attempted to merge them under the distastefully-named Homeland Security.

What it also brought to mind is Andrew Sullivan, the gay conservative, who laid out his own ideas of what is a "conservative" government, and why he thought that extending marriage to gay couples was a conservative approach to gay rights, compared to civil unions, which is a liberal approach. In his mind, the liberal approach is always to create something new to deal with problems, and the problem with civil union, regardless of how much you try to say that it confers every benefit equal to marriage, is that you must maintain a separate set of documentations, a new bureaucratic technicality, for them.

Namely, Sullivan conservatives are concerned primarily with preserving institutions and maintaining social orders, but also that conservative and liberal ideas are dependent on and require each other. He cited Burke: "A state without the means of some change is without the means of its preservation."

What's interesting is also that when countries created civil unions, more straight couples are likely to use civil unions instead of marriage because they might not be ready to commit to marriage and would rather "cohabitate" even if civil union is equally a marriage and doesn't smell as sweet. In effect, civil union became for these straight couples a step between merely living together and getting the benefits of marriage.

I find Sullivan's definition of conservative vs. liberal fascinating, but I recognize his ideas are predominantly of British origin, and America has a different, more ideological, definitions of each, and unfortunately, there is also a large pathogenic strain of libertarianism and anarchy, naivete mingled with a large dash of corruptive and corrosive lust for power.