A simple form for those that do not wish any health care reform:

[kentuck]

I, name here , do affirm that I do not wish to have any “government-run” program for my health-

care. I will retain the right to negotiate with my insurance company on my own grounds. If a

public option is passed, I affirm that I will not apply or use the option.

Furthermore, I retain the right to withdraw from any government-run program at any time I

desire. This would include Social Security, Medicare, veterans benefits, unemployment insurance,

and any other government-funded program.

In return, I do affirm that I will not obstruct the efforts of others to get what they want in health

coverage.

Signature

[ejpoeta]

1. that's great, but haven't you learned by now..... it's not what they want for themselves

it's what they want to force the rest of us into. just like with our rights to make choices for ourselves regarding our reproductive rights... just like people in some states trying to force creationism and abstinence only education on everyone else.... they want to force us all to remain in the system we have right now. i don't understand why.... how many of these folks are on medicare? how many are on other programs?? how many have ever had to call the police or needed the police or fire??? how many have driven on a highway?? in a car that has been required to be safe by a government agency?? ate food that was required to be safe by a government agency?? it just baffles me.

[Cresent City Kid]

2. I like the idea

If the opposition was coming from individuals who want to opt out, this would work. I would present this at town halls to protesters. They would mull it over long enough for proper discussion to take place.

Of course we all know the dissent is all top down, and just having teabaggers opt out would still cut into profits.

[SeattleGirl]

3. I like that, though I would add this:

I also pledge that, if I have no insurance at all, I will not make use of any emergency room services, because I know that by doing so and being uninsured, the cost for my visit will fall upon my fellow Americans. As I am firmly against any type of charity, I promise not to avail myself of any.