The House Plan Forces 114 Million Americans Out of Their Current Health Coverage

A Lewin Group analysis of the House health reform bill finds that 2 out of 3 Americans will lose their current health coverage:

  • 114 million Americans would be forced out of their current private health coverage, including more than 106 million Americans who currently have employer-provided health care.
  • There will be substantial cost shifting to private health plans. The “public” plan will significantly underpay health care providers, generally compensating them at rates 20-30% below what private health plans would pay for the same services. As a result, physicians and hospitals would be forced to charge those with private insurance more in order to offset the losses they experience under the Democrats’ government-run plan.
    • A December Milliman Group study found current Medicare and Medicaid underpayments drive up the cost of private coverage for the average family of four by $1,788.
    • The Lewin Group study estimates that a government-run plan that pays Medicare-based rates would increase the cost shift to $3,628.
  • Medicaid enrollment will increase by 16 million.Many of those newly enrolled would previously have had employer-provided health care.

Comments (19)

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  1. Joe S. says:

    We will get a two tier system in which only about 10% of the population will have private coverage — just like Germany, Britain and elsewhere.

  2. Joe S. says:

    The Obama administration frequently talks about cost shifting from the uninsured to the insured, without ever mentioning how much more cost shifting there is from Medicare and Medicaid.

  3. Brian says:

    Yet more scare tactics from the right!!!

    Doctor’s payments will be competative and a reduction in expense by 20-30% is just what is needed. Insurance companies should get their paws off the practice of medicine and determining what you the patient can and cannot get treated for (RATIONING!!!).
    There should be true competition in the market and the present owners of the system, (insurance and pharma), are terrified over true competition. There has been NO competition in health care for YEARS now and when there is a chance that they are forced into a competative market, they freak out. Not because they care but because they will no longer have a monopoly over anything healthcare. They will no longer get away with outrageous buisness practice and actual robbery of people’s wealth for no return. They will be forced to more realistic pricing guides, realistic premium charges, and they will no longer be able to scare people into giving them money for nothing!
    Paying for healhcare may be high but doing nothing costs MORE than one trillion over ten years! In fact doing nothing and you surpass that magic trillion figure in under 2 years! If hospitals and doctors no longer have to write off losses, then you not only save the outrageous amounts paid to the hospitals for the un-insured, but you also can take the money saved and use it to pay down some of the costs of reform.
    Just think about it. The cost of the un-insured is in the billions of dollars a year. Times that by 10 and you get close to a trillion saved just from that factor alone! Next, enforce reasonable price guides and cost efficiency measures and VIOLA!! it is paid for and has actual and real results unlike the right’s insistance that there are NO un-insured and that the system is just fine as is! You get away from empty and useless proposals such as 5300 in tax relef…. $5300 won’t even cover 2 ER visits! $5300 will NOT make a difference as shown through time. None of the right’s proposals are new. NOT ONE THING! They have been tried and have proven ineffectual. Leaving things up to the “free-market” has proven ineffectual!

    Until the right comes up with something that actually has a chance of fixing the broken healthcare system, until the right can actually argue from a point of integrity and truth, ONLY then does the right deserve to take the hihg road. Stop trying to scare people with lurid stories of the horrors of socialized medicine because they are patently false.
    In our present system, rationing already exists, wait times are getting into the months and years right NOW, quality continues to decrease while premiums continue to rise, and the elderly are already denied critical services due to age and infirmity. This isn’t scare tactics but the truth. NORW the question is how to fix it. It is worth 200 trillion to fix the system because the cost of doing nothing, as the right proposes, costs more in the long run and preserves not the healthcare industry, but it rather preserves and assures that the healthcare problem only gets bigger and more complicated until the point that no-one will be able to afford health-insurance and small buisness owners will be priced right out of providing any coverage what-so-ever.

    The right should spend more time fixing the situation rather than spending all that time on scaring people and intimidating people into doing nothing, which is after all what the insurance companies are praying and paying for!

  4. Bart Ingles says:

    I agree, we certainly wouldn’t want all of the insurance companies and drug manufacturers to have a monopoly.

  5. Linda Gorman says:

    Brian says that “the elderly are already denied critical services due to age and infirmity” as a reason why ObamaCare should be enacted right now.

    Given that the elderly in the US are already in a government run public plan, one that successfully drove private plans for all but the very rich out of existence, one wonders why he thinks that pointing out denial of critical services for a group in a public plan provides a good reason for supporting its extension to people enjoying the comparatively good health care access provided by private health insurance.

  6. Brian says:

    First- off not all elderly are on government assisted plans.
    Second- The denial of service is not a financial issue but is rather an issue of who we as a society treat our seniors. Try getting a heart transplant at age 70 when yoyu are diabetic…. won’t happen unless you pay for it yourself.
    Third- First hand knowledge of insurance’s treatment of seniors.
    My Mother-in Law passed on feb 18 2010. We now have to pay 186,000 dollars because she was dropped at the last minute by blue cross/blue sheild of Tennessee for having a pre-existing condition. She died from Brain Cancer and she did have a test in 2008 which found possible pre-cancerous cells in her lungs. Ms. Robinson chose at thet time to refuse Chemo. Scince she decided not to take chemo, BC/BS choose to determine her cancer as pre-existing. That lady paid them premiums right up to the first of Februaury…. Private insurance desroyed her life after her faithful payment of premiums fore over 30 years! Even in today’s twisted predatory insurance arena, pre-exisitng should be penalized for just one year. That lady paid for 30 years. But its all legal and npow the insurance company is the sole inheritor of her estate, her house, her car, and every little thing she worked for in 84 years.
    True she had the option of medicare medicaid but scince she “had” insurance she opted out of that insurance— as many seniors do. This isn’t a government plan or public plan, this is private insurance at its finest. Its just standard operating procedure for them but it is life to us.

    You and other conservatives assume that all senior are on medicare, you assume that government should never stand up for its citizens. The constitution establishes the right to life, which includes competant healthcare, without healthcare you have no life. YOU ARE DEAD! It is the responsibility of the government to step in and enforce or mandate full coverage for all citizens it is constitutional. It is also in the oath of the Pres, VP, Congress, Military, etc. to defend american citizens from all enemies foreiegn AND domestic. It is past time we were defended agaist the predators in insurance and Pharma.

    Don’t assume or presume you have a clue about my life, that’s typical conservative playbook.

  7. Mike says:

    Your emotional dribble about insurance companies, big pharma and conservatives is pretty lame Brian. Your talk about the constitution establishing healthcare as a right and how the government should enforce it on everyone else just tells me your no different than the conservatives you complain about.

  8. Brian says:

    Really? no different from conservatives? At least I, unlike conservatives, I actually care about american citizens.

    Healthcare is a basic human right, we do need defending agaist predatory pricing, we do need healthcare reform that actually has a chance of working. Conservatives have yet to give one workable idea. The dribble may be emotional but it is truth none-the-less. Coservatives are bent on keeping healthcare out of the list of rights, and they wish to further de-regulate the health-care system to allow further price-hikes and more rationing. What I have talked about is nothing close to conservatives. I support healthcare reform, I support a public option, but I do not support mandated involvement in a public option. You want to stay with overpriced insurance and over-priced medications? Great for you but don’t try to force everyone else to rely on a crooked system. If there is no public plan to force competition, then I do support price-caps enforced through the government. I support the enforcement of accepting and actually covering pre-existing conditions. If that makes me a conservative then I am a conservative. I support the stopping of charging triple premiums for the poorest people. I support more fairness and more doctor/patient driven care instead of insurance driven care all of which will happen with a public option. But then again you have nothing to worry about as healthcare reform will yet again be swept under the rug and we the American citizens will remain hostages to insurance and pharma.
    I can’t be other than what I am and I am un-apologetic for being “emotional”. you might try it sometime. you might just find that by investing your emotion you will have more incentive to fight for ,(or against whatever your politcal leanings), healthcare and equal treatment under the law for all Americans.
    If you have nothing to lose or gain then you don’t have a horse in the race and that is precisly the problem people want to appraoch subject with impartiality always forgetting that it is IMPOSSIBLE to escape your own experiences and personal biases. You thoughts and vision for the future will always be colored by your bias. We are not unthinking, unfeeling robots but emotional human beings. Without some emotional involvement, (such as compassion and sympathy for others destroyed by insurance and pharma), nothing will ever get solved. reality is more than problem/answer, black/white. There are colors and shades to the world and tryiong to ignore reality starts you out from a faulty position because you don’t approach the issue from a realistic basis. People cease to be people and become mere numbers and no-one cares about numbers.
    So continue to pay high prices, your perogative, you can sell you soul to the devil if you want, again your perogative, but I choose to act in my own best interest and the best interest of the 80% of Americans who are either un-insured or under-insured.
    Lay down and let insurance dictate your healthcare and how much you will pay for thea care, roll over and show that you have been whipped and beaten into subservience, I don’t really care. One can lead a horse to water but you can’t make them drink but just remember that if that horse doesn’t drink, they die. Same here and again I don’t care if its emotional or not, at least its realistic which is far more than conservatives can claim, with their lies, half-truths, and fear-tactics, (the only things that conservatives excell at.

  9. Terry Gannon says:

    Brian, the emotional anger with concervatives is not a good purpose of this forum. First of all I find the original thought of pople loosing their health coverage a bit disturbing, and I trust that you do as well. Being a liberatarian, I can tell you that the one thing that has not been tried in healthcare is the free market. I would suggest you read more of Goodman, his book, and other articles at Cato before you level blanket criticism. Healthcare reform is not about SOP political infighting. It is about the future health of this country, its institutions, its economy, and so on. We have to treat the arguments for and against with deliberation and engagement. Look at the free market suggestions, for these are the only way this is going to come out well.

  10. Mike says:


    “de-regulate the health-care system to allow further price-hikes and more rationing”

    you clearly have no understanding of how free markets operate. If you think de-regulation is going to lead to more price hikes and “rationing” then you have a long way to go.

    you talked about fairness, the poor,triple premiums, encouraging comeptition etc… without providing evidence for how exactly a public plan will accomplish any of those things you mentioned.

    the rest of your writing is emotional nonesense much like your talk about reality and being “realistic”

  11. Brian says:

    You may keep you opinion as you want. It doesn’t hurt me at all.

    Does de-regulation not mean that buisnesses have more ability to raise prices without notice or cause? Does de-regulation not allow buisnesses to set quality standards for themselves rather than adhere to standards “regulated” by the government or other force?
    Then Common sense and historical fact shows that deregulation DOES lead to higher prices. If you truly think that insurance doesn’t charge triple premiums to high-risk groupd, (and poverty itself is a high risk group because health in general is directly impacted by financial wealth and standing), then you haven’t read basic factual information concerning insurance pricing.
    If you truly wish you can ignore how many people are dropped after years of paying into the system but that doesn’t change the fact that these things DO occur, are widly known to occur even governemnt admits that it occurs and getting government to admit anything is worse than pulling teeth, are admitted as occuring by insurance companies themselves.

    Yes prices go up when insurance is told they can do what they please. Premiums don’t go down they only go up. You insurance company isn’t going to send you a rebate because they drop their prices mid month but they will bill you mid month for increases to premiums.

    Even conservatives in government have admitted that premium rates have risen 300% faster than wages. If you can’t trust your on conservative politicians then you won’t beleive me.

    I apologize that I have imposed reality upon your world and shown how harsh and yes, UNFAIR, the system is, I am very sorry that you feel I have no right to express my opinions here, That my life experiences are either too emotional, or flat-out false and that I should stop whining over it.

    Free-market is a proven failure. We have operated with a free-market for YEARS now and yet the problem remains. If free-market solutions were the answer, the situation would have been resolved long ago. Scince that is NOT the case and healthcare continues to erode, free-market obviously doesn’t work. That is common sense— a lot more persuasive than any opinion.

    I have read these “free-market” solutions… (tax-credits, allowing across-state shopping, HSA’s) and none of them deal with reality. They are great ideas but when seen through the lens of real world events and consequences – they are all ineffectual.
    1) tax-credits do not cover one third of yearly healthcare costs, and meanwhile destroys credit ratings across the board thereby making escaping poverty, in general, just that much harder.
    2) HSA’s are limited in the amounts allowed to be saved ($7500/year),and again that limit is in-sufficient to covering yearly healthcare costs
    3) shopping across state-lines,I got excited and hopefull about this until I realized that all the insurance companies will do in that event, is raise all policies, regardless of state, to the same level of cost and with the same benefits across the board. That negates any advantage of cross-state shopping. Again Common Sense.
    What will not happen, (because it never has), is that the states with high prices will reduce cost to a standard level to retain sales in-state. It won’t matter.
    BC/BS of Tennesse is just one of fifty subsidiaries of one insurance company. The home buisness at BC/BS will standardize all costs or even eliminate state offices and just have BC/BS of America with a single high premium, and a singlular benefit package. That is the obvious buisness response to such “free-market” controls.

    Anyway I can’t say its been fun because it hasn’t been. Being the only voice, supportive of healthcare reform in this blog and the target of everyone’s disdain isn’t a comfortable spot. I say the only voice because again I am convinced that for conservatives, it isn’t about reform but maintianing the status quo. “conserving” buisness as usual.

    I won’t bother you again. You can continue to champion Big buisness and the predatory nature of insurance without me interupting you.

  12. Brian says:

    I have been to the Cato website and tried to find out their position and proposals but they aren’t listed. I called the Institute and got a recording but no information. I am, unlike others, interested in all variations of healthcare reform but just because I can take reality and measure the reform proposals and see the short-falls in the plans doesn’t mean that I have nothing to contribute to the conversation, (so sorry to disappoint you mike).

    Explain in simple terminology how a $5300 dollar tax credit can cover a policy that costs $12000/year minimum.

    Same for HSA’s that also do not approach adequate levels of healthcare. Also the Fact that HSA’s are for out-of pocket costs anyway and are therefore MORE expensive. Again inadequate to the problem.

    Consumer-driven health care? Such a vague term. Insurance tells you to pay a certain amount or else:
    1) go somewhere else
    2) deal with it.

    Consumers do not force insurance to lower costs, insurance forces you to pay their prices at their dictation. There is no consumer driven healthcare. Insurance tells your doctor what tests to perform and what drugs to proscribe, how long your doctor visit is, and what illnesses they will or will not cover. Those decision are not in the hands of the consumer ever. There is no negotiation or bartering involved in pricing, They tell you what to pay and when to pay it and if you don’t like it tough. How is that consumer driven? The consumer has no power against corporate America because insurance monopolizes an industry vital to life and longevity. They dictate rather than negotiate and they have no incentive to do so. They have no incentive to lower prices because, like it or not, insurance is swiftly becoming a neccessary possession and not having insurance leaves people and families bankrupt. (mike might say there are no medical bankruptcies ever like conservatives argue).

    And the reason for my anger towards conservatives is simple. It is the conservatives who have stopped reform for the last 30 years at least. It is conservatives who are engaged in selling us out to insurance and their lobby. The healthcare reform issue is dead anyway because mainly conservatives are delaying until it goes away yet again for another 4-8 years and beyond. Moderates aren’t against reform, liberals are noty against reform, only conservatives are against reform. therefore conservatives are the correct target for the anger and frustration that I and *)% of the nation feels when dealing with the issue of healthcare. America knows things are broken and that insurance has us over a barrel, and mostly it is only the conservatives who are trying to say that the system is fine as is and “nothing needs to be done”, or “things will work themselves out”, or “free-market competition will control costs and price”. All of which hasn’t happened yet and we have operated from a free-market competative model for over 200 years now and NO change. Regulations? sure they exist. They have have a slight impact in controlling cost. As it stands there can only be so much percentage change in pricing per year, without it? Un-fettered price hikes. They have what we REQUIRE not what we want,not what we would like to have, but what we MUST have. They in essence blackmail consumers into buying insurance at their price and at their consent, and after buying insurance they will tell you how you use that insurance. If I gpo into a store and purchase an item or service, that service or item is mine to do with as I see fit. Now if you go to the store and by a shirt, then the store tells you that you can only wear that shirt on a spewcific day and undert specific circumstances and that violating these requirements will cause themn to re-posses the shirt, you would be an idiot to buy that shirt at that store and go somewhere else. Yet when EVERY store adopts the same policies as the rest, then you lose and buy the shirt because you MUST.

    I am so frustrated with people who tell me that I and my life experiences don’t matter.(Mike).
    I am more frustrated that yet again nothing will get done and we as a nation get worse and worse. Reform will cost more the longer this is dragged out. The time for action is now,(this year or hopefully early next), but I’m not holding my breath. Like space operations there are few windows that we have and putting off the issue only makes the issue more difficult, complicated, more expensive and more entrenched.

    Insurance is laughing at everyone, rubbing their hands and waiting for the next round of price hikes. Dreaming over maintaining and expanding their monopoly. Insurance is LOVING the conservatives today because they know that they will increase their profit margins another 2 or 3 hundred percent, and still we will roll over and pay it.

  13. Felicia says:

    I worked in health care administration at the uppermost levels for 20 years. I know the story from the inside and have never been politically active in my life until now. But this march toward socialized medicine has to be stopped. Obamacare will lead to the death of quality, accessible healthcare for working Americans.

    The government already controls a very large chunk of the healthcare infrastructure in the US. Much of the damage to our system is the direct result of the government programs that exist today. Medicare, Medicaid, and the VA system already account for close to half of the cost of healthcare. And all of those programs are failures.

    Medicaid is the healthcare program for the poor and was established in the mid 1960’s. It is a dismal failure. Very few quality physicians accept Medicaid patients mostly because of very low fee schedules. Medicaid pays about 10% of a doctor’s charges. The program does not allow the doctor to charge the Medicaid patient the difference. So, the doctors who do accept Medicaid in their practice have to overcharge the patients with private insurance or no insurance. Access is poor for this group, and many seek primary care in emergency rooms because they have no doctor. Hospitals are not permitted to turn away emergencies, and Medicaid pays them much less than their costs, so they too have to cost shift.

    More physicians are dropping out of Medicare every day, or severely limiting the number of Medicare patients they see because of declining fees and increasing administrative cost of participation. Cost shifting occurs for doctors who see this group as well. Virtually ALL Americans over 65 are on Medicare. THERE ARE NO OTHER OPTIONS FOR MIDDLE CLASS AMERICANS OVER 65. And the federal government charges the elderly for coverage. With no free market competition available, the elderly are in effect “taxed” for their healthcare. In addition, Medicare beneficiaries need to pay for Medi-gap policies through private insurers to pay the large deductibles and co-pays that Medicare doesn’t pay. My dad, who is a healthy 88 year old, pays over $6,000 per year in health insurance premiums, including the amount deducted from his Social Security for Medicare premiums, (Part B and Part D), and for AARP Medi-Gap insurance. So, the wonderful government run program that provides so called “free health care for the elderly” costs retirees a VERY large portion of their retirement income every year. And it’s becoming increasingly more difficult to find quality doctors to care for them because of this “wonderful” government-run health insurance program.

    The quality of care in the VA system is akin to that you would find a third world country. The VA system accounts for a relatively small portion of the healthcare system, but the quality is abysmal. Veterans with no other options are forced to use this system. It is TOTALLY government owned and operated, and the facilities and equipment are antiquated and the personnel sub par. No one would elect to go to a VA hospital if they had other insurance.

    The only part of the system that actually works is the private health insurance market, and the services that are provided through that portion of the system. The health insurance industry is fraught with overlapping, complicated federal and state regulations that stymie competition and increase costs. We do need reform. We need to REDUCE government involvement in the healthcare system, not increase it.

    The increasing cost of health care is the result of increased technology, life saving drugs, government bureaucracy and malpractice awards. But even with our fractured system, Americans have better health outcomes than any other nation. We can control the cost of healthcare by doing three things:

    1. Do away with government run programs and give vouchers to seniors and the poor to purchase private insurance;

    2. Decrease regulations, facilitate multi-state insurance policies to encourage competition; and

    3. Implement serious tort reform.

    In short, let the private free markets do their jobs. The fact that the Washington crowd refuses to consider giving up their government paid “best-in-the-world health insurance” in exchange for what they are proposing for the rest of us, should give everyone a clue. The elitist, Marxist, crowd now running Washington should cause every red blooded American to stand up and take notice. Become informed, and KNOW WHO YOU ARE VOTING FOR!!

    Hopefully, its not too late to change the course of this country.

  14. Felicia says:

    Your response was excellent for someone trying to understand this whole health care issue. What you explained described my 82 year old dad with his VA insurance. I can understand Brians frustration above because I am also frustrated with my current HSA insurance program and how much I have to pay but still think its much better than any goverment run program which the current administration is proposing. We need fixes as you listed to help control rising costs. We must NOT ALLOW THIS “FORCED” GOV’T POLICY TO PASS!!

  15. Don says:

    Brian, please name one thing that the government is now in control of that has improved. Amtrack (has never turned a profit), US Post Office (cost tax payers billions), Medicare (talk to anyone in the program), Social Security (It’s going broke).

    Can the health care system in the US be improved? YES!

    Will the governments make it better? NO!

    Last poll 8/7 – 68% of Americans or pleased with there health insurance. Thats reality.

  16. Rianne Willey says:

    A quote from above:
    “People cease to be people and become mere numbers and no one cares about numbers” (this was in defense of government run health care)…does he not think that we will not be “numbers” in a government system?

    Also, my personal experience with my brother going through the VA system was an absolute nightmare!! Horrible, horrible treatment…we finally had to search out real CARE for him in the private sector..thank GOD it was there as an option..doctors took his Medicare and treated him like a person, not a number. He would not have survived the VA but maybe that was their intent in ignoring him — since under government budgeting he was “not cost-effective”. He, too, had a preexisting condition and they wrote him off. He lives today because of private care.

    Yes, I do pay high insureance payments and yes, I do, treat it as a service — I can go to the doctor when I decide to go, I can choose what doctor I want to go to — I don’t have to take what I can get, long waiting times, not the same doctor, etc. which I have seen my friends who have elected less costly insurance suffer through – even in cancer situations – through HMO’s (developed about ten years ago by the government) where people do not get the care they need upfront because of costly treatments and they die because they couldn’t qualify for costly treatment and they probably could have been saved…so

    Government health care, submit your number and wait in line — nor for me, not for the health of this country…I don’t want to see any of us listed as a number and, subsequently, as not “cost-effective”.

  17. Linda says:

    My Mom is 92 years young. Since turning 90 she has had a heart valve replaced, bypass surgery, pacemaker installed, shoulder rebuilt, hip replaced and successfully battled breast cancer. She lives alone, drives, takes care of all her own needs and is fiercely independent. Medicare and her supplemental insurance have been beneficial to her but she does have high premiums. Her income is low enough that she qualifies for the state drug payment plan. Her fear is that under Obamacare she would be denied all these treatments because of her age and I don’t blame her.

    I myself just went through surgery for diverticulitus. I have an employer provided high deductible plan and contribute to an HSA. I’m also covered by my husband’s employer provided insurance. Total cost of my surgery, doctors, drugs, came to roughly $60,000.00 and that was only 4 days in the hospital. My max out of pocket is $8,500.00 for in-network coverage which this procedure was. If it had been out of network, that figure jumps to $33,500.00 I have yet to read or hear what anyone considers “affordable”. My primary care doctor had dropped out of my United Healthcare plan because they paid him so little. The only other medical insurance plan that paid less was the state plan.

    Massachusetts has mandatory health insurance coverage and they have seen no reduction in the use of the emergency rooms. They still have many people who are uninsured and cost of the plan has tripled since its inception.

    The Obama administration and Congress are ignoring the facts. Honestly…how can anyone say that adding 45 million people to the healthcare system will not impact the quality of care. It defies logic.

  18. Gary says:

    It is understandable but unfortunate that many Americans cannot envision the duplicity, hypocrisy and evil intent of many in this administration. For one who does their homework, the “hand writing is on the wall”. Simply listen to or read what they have said. One who can justify the killing of unborn infants is capable of anything. The next step to euthanasia of those who are “unproductive” [however that may be defined by the policy makers] is an easy one to justify reducing costs and managing other “emergencies”.

  19. Eileen says:

    I can not believe all lies and fear that have been generated around a public option. People need to educate themselves. I have studied the health care system in all countries including the USA. We do not have the best system, the medicare system has been working adequately and other countries (European and Canada) would not trade their systems for ours. This is a moral issuee. After World War II other countries made a decision that people were entitled to pension (so your house and other things did not get taken from you and everyone had at least basic health insurance); that everyone would have an education. We have become so individualistic that greed and corruption has been taken over by corporations and the government and people buy into all the twisting of facts and the fear without knowing the real facts. For shame Washington and corporate greed, you have known since the 1970’s the systems needed to be fixed but NO, you would not address it, I don’t care whether you are repulician or democrat you have an obligtation to the American people.

    FIX this, every American citizen should be entitled to health care, education, and social security.. Period. This is a must. Somehow we have lost sight of the good for all, and only what is good for me.