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 February 1, 2008
OBAMA ON HEALTHCARE....Just when I'm warming up to Obama, his campaign pulls something like this. Yuck. There's nothing odious or unfair about this mailer. It's perfectly normal hardball politics. But it doesn't help the progressive cause on healthcare one whit. I sure wish Obama could figure out a better way to contrast himself with Hillary. As a side note, when the subject of healthcare mandates came up last night, I was surprised that Hillary didn't take (yet another) opportunity to suck up to John Edwards by using the argument Edwards himself put forward at the last debate to criticize Obama's voluntary plan. As John Edwards has said, the problem with Senator Obama's argument is you can make exactly the same argument about Social Security. I mean, you think about the analogy. What George Bush says is he wants people to be able to get out of the Social Security system, choose, elect to get out of the Social Security system. Well, that's exactly what Senator Obama's plan allows for healthcare. I dunno. Maybe the Social Security analogy isn't as good as I think it is. But it sure seemed like a quick, effective argument when Edwards made it. —Kevin Drum 1:12 PM Permalink | Trackbacks | Comments (176)Comments
I was undecided now leaning strongly for Hillary. Hillary Clinton from the Democratic Debate on 1/31/2008:
Now, in Barack's plan, he very clearly says he will mandate that parents get health insurance for their children. So it's not that he is against mandatory provisions, it's that he doesn't think it would be politically acceptable to require that for everyone. I just disagree with that. I think we as Democrats have to be willing to fight for universal health care. And what I've concluded, when I was looking at this -- because I got the same kind of advice, which was, it's controversial, you'll run into all of this buzz saw, and I said, been there, done that. But if you don't start by saying, you're going to achieve universal health care, you will be nibbled to death. Is this really any worse about Hillary's demagoguery about Obama wanting to raise trillions of dollars of taxes on the middle class by raising the cap on the most regressive of all federal taxes? Posted by: jbryan on February 1, 2008 at 1:21 PM | PERMALINKDo you honestly believe that a Democratic Congress -- which will include a very, very powerful senator named Hillary Clinton -- will pass a health care plan without clear universal coverage? I don't. In other words, if Obama is elected and Hillary Clinton remains in the senate then there's really no policy consequence to their differences now. But I understand the political principle involved here and it's an important one for Obama: don't force people to do things. It may not be a big deal to Democrats, but that sort of thing strikes a cord with independents and disaffected Republicans. Posted by: Callimaco on February 1, 2008 at 1:22 PM | PERMALINKI don't think the analogy with Social Security is a good one--too thick in the wonky weeds, and it gets you sidetracked by people who say, "I don't like the government telling me what to do." The idea of mandating that everyone buy health insurance is something that has to be carefully sold as a part of a comprehensive solution that means better and more secure care for everyone. Posted by: Steve W on February 1, 2008 at 1:23 PM | PERMALINKIn the real world, mandates won't fly. For one thing, they lead to things like Edwards' dopey nanny-state requirement that not only would people have to buy insurance, but they would HAVE TO VISIT THE DOCTOR once a year. Try getting that idea through Congress. Like Medicare, get the principle first -- a national health care scheme in place -- and worry about the details later. Posted by: Traven on February 1, 2008 at 1:23 PM | PERMALINKKevin, individual mandates are simply an awful idea. They blame the victim (Hillary spins and calls it "shared responsibility", but PEOPLE WHO CAN'T AFFORD HEALTH INSURANCE AREN'T RESPONSIBLE FOR THEIR PREDICAMENT!). They avoid taking on the insurance companies, who are responsible for a big layer of costs. They don't work (in Masschusetts, people pay the fines rather than signing up for coverage they can't afford). They don't achieve universal coverage-- we have an individual mandate for auto insurance in California, and plenty of uninsured drivers. So there is no "liberal" responsibility to not campaign against individual mandates. Posted by: Dilan Esper on February 1, 2008 at 1:23 PM | PERMALINKYou know, I'd like to hear once, just once, how it is that Obama is ever going to backtrack on his own attacks on mandates, when it finally becomes obvious to all -- as it is now to economists -- that they are the necessary ingredient to any universal health care plan, given the approach Obama himself has taken. Does anybody imagine that Obama's own Republican talking points won't be thrown right back in his face? How does he ever get around that obstacle? Can nobody in the Obama camp do the simple exercise in strategic thinking to realize that the political logic here renders universal health under an Obama Presidency as unachievable? Or is it that they just don't care? Posted by: frankly0 on February 1, 2008 at 1:24 PM | PERMALINKOnce again Obama attacks from the right, and once again he tries to spin the major defect of his plan. Rerunning Harry and Louise is an odious smear. Heretofore, most of Obama's attacks have been under the radar and they illustrate his win-at-any-price sense of entitlement. Is this really any worse about Hillary's demagoguery about Obama wanting to raise trillions of dollars of taxes on the middle class by raising the cap on the most regressive of all federal taxes? Yes, it is absolutely worse. What Hillary said has no impact on SS as we know it, or any other program. But Obama's own words will be thrown right back in his face the moment he tries to push for genuinely universal health care. There's no way of getting around that fact. I'd like someone to tell me how Obama could fight for mandates when he himself is on record essentially demonizing them Posted by: frankly0 on February 1, 2008 at 1:27 PM | PERMALINKI'm sorry, but anyone who's battled with their insurance carrier can understand why it is legit to attack a health care plan that forces people into a financial relationship with insurance companies (with no significant cost controls), and penalizes you if you don't go along. Posted by: Jrich on February 1, 2008 at 1:27 PM | PERMALINKLike Medicare, get the principle first -- a national health care scheme in place -- and worry about the details later. Except for the niggling fact that the "detail" of mandates is the precise thing necessary to make the whole scheme work as universal health care. So, by all means, go back the helpful technique of covering your eyes and ears and shouting as loud as you can. Posted by: frankly0 on February 1, 2008 at 1:31 PM | PERMALINKThis whole argument is silly. Whatever comes out of Congress will not be Obama's plan or Hillary's plan, but whatever the Dems, Blue Dog Dems and moderate Republicans can cobble together. Posted by: Slipsok on February 1, 2008 at 1:31 PM | PERMALINKYes, it is absolutely worse. What Hillary said has no impact on SS as we know it, or any other program. Seriously? You don't think it could have an impact if Democratic senators are shrieking "tax hike! tax hike!" at the drop of a hat? Taxes will need to be raised by the next president regardless of anything else, but especially if we intend to implement any sort of revised healthcare system. Reflexive anti-tax complaints are a hallmark of Republican obstructionism and they've been disastrous for our economic policies. I'd hate to see that mindset become only further entrenched within the Democratic ideal as well, else it really could be an awful setback for any sort of progressive causes, which was exactly Kevin's criticism. Posted by: jbryan on February 1, 2008 at 1:33 PM | PERMALINK"I'd like someone to tell me how Obama could fight for mandates when he himself is on record essentially demonizing them" Let Senator Hillary Clinton do the fighting for a policy that convincingly "mandates" coverage and let President Obama fight to make sure those mandates don't "punish" those who are mandated. Obama is not zero-sum game kind of guy. With the right policy I think he'd relent. But he'd have to be able to relent "on principle" -- ie with assurance that people would not be "forced" to buy coverage they can't afford. Here's the thing: I think having that fight and maintaining that principle would make it easier to pass universal coverage. The debate would not be whether to "mandate" coverage, but how to "mandate" coverage. Posted by: Callimaco on February 1, 2008 at 1:33 PM | PERMALINKThis whole argument is silly. Whatever comes out of Congress will not be Obama's plan or Hillary's plan, but whatever the Dems, Blue Dog Dems and moderate Republicans can cobble together. So let me see. What you're saying is that if, say, Obama is President, he's not going to have anything really to do with the actual details of the plan, or advocating for it to the American people, and so can essentially be ignored? Great reason to vote for him, of course. Posted by: frankly0 on February 1, 2008 at 1:34 PM | PERMALINKYuck is right. Neither of them have great health care plans. But the SLAP in the face -- A Harry & Louise Ad.... The the symbol of our 1992 HealthCare loss. I'm already making my 3rd choice (Gore, Edwards ...) How much do I have to compromise? Posted by: katiebird on February 1, 2008 at 1:36 PM | PERMALINKTop 10 recipients of healthcare donations in the 2006 election cycle (SOURCE: Open secrets): jbryan, Hillary's generic claim that it wouldn't be good to introduce an enormous tax hike is hardly going to be usable against her if she needs to implement specific tax hikes. If anything, it would serve to show that she's not against all tax hikes, but only against dumb tax hikes, to coin a phrase. But Obama's problem is very specific, and highly damaging. There's no way to get to universal coverage under Obama's plan without mandates -- ask any competent economist. But Obama himself has demonized mandates. Checkmate. We lose. Posted by: frankly0 on February 1, 2008 at 1:38 PM | PERMALINKKevin, Your analogy to Social Security would be correct if the health plans be discussed were single payer (i.e., government-run healthcare as in Canada, the EU, etc). Neither Obama or Hillary, unfortunately, believe that we can do away with the insurance industry at a moment's notice. Alas, they're probably right. So we're still stuck with negotiating with insurance companies for the best price. I'd really like to know what the envisioned cost would be per month. Also, what the subsidy level will be for the unemployed, the poor, the young just getting started out on a job. Obama is saying that it's not a good idea to have a mandate and requisite fines for nonparticipation. I would agree unless the cost/subsidy equation is clearly one that would enable all Americans to purchase health insurance without suffering a great financial burden. Posted by: nepeta on February 1, 2008 at 1:38 PM | PERMALINKIf Obama later decides mandates are needed he'll have his words thrown back in his face. Scary. Bush was going to cap CO2 emissions...and then decided not to. Bush said a bunch stuff about bridging the partisan divide, uniting the country, compassion, and it helped him get elected. If no mandates is necessary to appeal to general election voters, that's fine by me. I think core democrats over-estimate the popularity moving to government run healthcare in the US. Once people start losing insurance as they lose their jobs they'll be more amenable, but not now. Later, Obama can simply say that the problem has worsened and a more aggressive plan is needed. Rhetoric aside, I have a lot of trouble seeing Clinton as a progressive. Posted by: Rock on February 1, 2008 at 1:41 PM | PERMALINKOnce people start losing insurance as they lose their jobs they'll be more amenable, but not now. Later, Obama can simply say that the problem has worsened and a more aggressive plan is needed. And I'm sure that insurance companies and Republicans won't be running ads quoting Obama's own words back at him when that occasion comes. Why would they do that, after all, even though their economic and political lives might depend on it? He has such charisma! Posted by: frankly0 on February 1, 2008 at 1:44 PM | PERMALINKRobert Reich (Sec. of Labor under B. Clinton) had some good thoughts on the two plans: http://robertreich.blogspot.com/2007/12/why-is-hrc-stooping-so-low.html Posted by: crazymonk on February 1, 2008 at 1:46 PM | PERMALINKAs John Edwards has said, the problem with Senator Obama's argument is you can make exactly the same argument about Social Security. I mean, you think about the analogy. What George Bush says is he wants people to be able to get out of the Social Security system, choose, elect to get out of the Social Security system. Well, that's exactly what Senator Obama's plan allows for healthcare. This argument has a lot of appeal on the surface, Kevin, but there are differences between health care and social security. The fear of people opting out of social security is that they can go a lifetime thinking: "I don't need it" and then discover they do. And the tab for a lifetime of blindness re social security can be huge. Even if a wage-earner "gets religion" in his 40's or 50's, say, it's difficult to impossible to make up for all those years of not paying into it. And who pays for that if the wage-earner hasn't planned at all for his retirement? Tax-payers. Health care insurance is a different story. A lifetime of going without health insurance and being hit with something requiring treatment will not be significantly more expensive than being hit in your 20's or 30's. Furthermore, once you've discovered the need for insurance, you can buy into a plan. It won't cover you for whatever treatment you need at that moment, and there is the pre-existing condition problem, but you would at least then be covered, and whatever risk you once posed to society is now gone. Put another way, the risk of going without health care is not cumulative -- either to the individual or to society. That is not the case with social security, where the longer you go without social security, the bigger the risk is that you'll eventually be a burden to society. Finally, the "pre-existing condition" problem is bigger than simply the mandatory vs. voluntary issue and, in any case, can be dealt with separately. John Edwards came up with a good argument, one that might well be very effective in the court room, particularly if the jury didn't have time to think about it. But his argument is hardly bulletproof, and in fact can be shredded fairly easily with a reasonable amount of thought. And that may be why Hillary didn't say anything about his argument: she knew better. Figuring this stuff isn't rocket science, Kevin, and if you were honest, you would quit pretending you occasionally lean toward Obama and just admit you're for Hillary. Posted by: LynnDee on February 1, 2008 at 1:50 PM | PERMALINKThis particular line of attack from Obama hurts the larger cause of achieving universal health care. The point that neither candidate's plan is going to be enacted without major changes is not relevant. The point is, he's actively fighting against a major component of any remotely workable universal health care plan--the principle that every individual will have to participate or it isn't going to work. There is too much focus on what is and is not going to be palatable to the general public or to conservatives on this issue. What we need to do is rhetorically move the line forward. People need to be made to understand the concept of universal care and be won over to it. When you make arguments like Obama is making, you undermine the entire fight. Yes, mandates are a stupid way to provide universal care. But Edwards' plan (I don't know anything about forcing people to visit the doctor once a year) showed how mandates can be a bridge to a true single-payer system. But this can only happen if everyone participates. If people opt out then what you have is just a new name for Medicaid and a massive subsidy for the insurance industry. Also, I find it very funny that the same Obama supporters who scream red-faced about the triangulating Hillary are pleased with how cleverly Obama meets the Republicans halfway on this issue. Score one for Hillary. Posted by: Rob Mac on February 1, 2008 at 1:52 PM | PERMALINKYep, race-baiting by proxy, "the surge is working," and "tax hikes are teh suck" are perfectly acceptable Clintonite advocacies of Republican talking points. But how dare Obama criticize healthcare mandates... I am so sick of primaries. Posted by: PTS on February 1, 2008 at 1:54 PM | PERMALINKJRich is absolutely right, about mandates being popular with the insurance companies. It doesn't mean they're bad policy, (I work for an insurance company, and I think they're a good idea) but I am puzzled exactly why having the IRS do my companies marketing for it is a essentially progressive notion. It seems rather like banning people from sleeping on the streets. Combined with other programs, it could be part of a solution to ending homelessness. But it might also be an attempt to look like you're trying to solve the problem, without doing anything about it. Posted by: Boring Commenter on February 1, 2008 at 1:57 PM | PERMALINKObama and his supporters probably agree with the Edwards analogy since the Obama rhetoric on Social Security thus far is almost exactly the same as Bush's; i.e. that the system is IN CRISIS. To this Edwards supporter, Obama is the real triangulator in this race. Posted by: howie on February 1, 2008 at 1:57 PM | PERMALINKnepeta, Best estimate on cost is $500/person/month--$2000/month for a family of 4. That's based on current cost of the healthcare system (16% of GDP), and assumes community rating (so everyone pays the same amount regardless of age or health.) Posted by: SamChevre on February 1, 2008 at 2:00 PM | PERMALINKFurthermore, once you've discovered the need for insurance, you can buy into a plan. Do you not get that this is the very reason Obama's plan is failed from the start? If healthy people simply opt out of the plan, then a greatly disproportionate number of people who go on the plan are there because they are unhealthy. That forces ups premiums, making the plan only less affordable than before. That's exactly why mandates are enforced, not through some perverse desire to make everybody buy something they don't really want. It's simply forcing both the healthy and the unhealthy to share the burdens of universal coverage. We don't generally allow people without children to opt out of paying for public schools, do we? The burden is rightly shared. So it is with universal health care. Posted by: frankly0 on February 1, 2008 at 2:01 PM | PERMALINKI seem to recall the Clinton campaign claiming that Obama was a hypocrite because he said that he wanted single-payer but his plan wasn't single-payer. No shit. We're not moving straight to a single-payer system in one move. Folks, if you're going to make a public show about having second thoughts about Obama over something that is this inside baseball, it helps to pay attention to the issue ... preferably from the beginning. Neither plan is going into law. Also, I find it very funny that the same Obama supporters who scream red-faced about the triangulating Hillary are pleased with how cleverly Obama meets the Republicans halfway on this issue. Really? I'm not saying that. I'm not sure which I would prefer, actually, but if I had to pick one without any further information, I think I would probably prefer mandates. That's why I'm really pleased with Obama's intention to do this with transparency so we the people can have some input into the process. So no, all I'm doing here is arguing against those like Kevin who are apparently ready to say: "John Edwards' argument was clever in a way that appeals to me and that has sold me, so that's it." Posted by: LynnDee on February 1, 2008 at 2:02 PM | PERMALINKWe all lost big when John Edwards left the race. Posted by: jame on February 1, 2008 at 2:05 PM | PERMALINKFolks, if you're going to make a public show about having second thoughts about Obama over something that is this inside baseball Under Obama's plan, it's predicted that 15 million Americans will be without health insurance. Tell them that that's "inside baseball". Posted by: frankly0 on February 1, 2008 at 2:05 PM | PERMALINKFurthermore, once you've discovered the need for insurance, you can buy into a plan. Do you not get that this is the very reason Obama's plan is failed from the start? You may be right. But, I suspect that's not immediately discernible from this one provision. I think it would depend on the rest of the program how big a problem this provision might be. As a mother with kids, I can't imagine opting out of health insurance. Like millions of Americans, having health insurance for my family is a huge factor in my decisions about work. In any case, this is a different issue from the flip argument attempting to analogize social security and health insurance that Kevin seems to have bought into. Posted by: LynnDee on February 1, 2008 at 2:08 PM | PERMALINKFranklyO, I don't think 'healthy' people are the ones who would opt out of the plan. As we've tried to convince our 23-year old daughter, you can always get into a bad car accident. The people who will opt out are those who feel they can't afford it (and admittedly those are probably the ones that need it most). Posted by: nepeta on February 1, 2008 at 2:09 PM | PERMALINKHere's a good link for what I mentioned above. In a video put out on YouTube, the Clinton campaign contrasts portions of the debate - in which Obama says "I never said we should go and try to get single payer" - and a speech Obama gave to the AFL-CIO in 2003 - in which he says, "I happen to be a proponent of single-payer health care coverage." Sounds fishy, eh? Kinda like Bill Clinton clipping the Obama quote about an AUMF vote. Here's an unclipped part of Obama's position on the issue: In a profile of the Senator in the New Yorker this past spring he offered that, "a single-payer system-a government-managed system like Canada's, which disconnects health insurance from employment-'would probably make sense. But we've got all these legacy systems in place, and managing the transition, as well as adjusting the culture to a different system, would be difficult to pull off. So we may need a system that's not so disruptive that people feel like suddenly what they've known for most of their lives is thrown by the wayside.'" After Clinton pulled that crap, I started leaning Obama. To the larger issue: yes, Obama keeps using Republican memes. I think that the blogsphere's obsession with that is due to our virtual nature. We think message is all that there is. But using Republican memes Brilliant! But gaging the man on this is naive. Look who've they've got working for them and what kind of organization they're building. Clinton is obsolete and shacked up with the wrong people. Well, I see the Obama supporters are getting their way, and turning this into a discussion of the relative merits of the plans, and away from the despicable nature of this ad. I mean really, Harry and Louise? Posted by: ChrisO on February 1, 2008 at 2:12 PM | PERMALINKTell them that that's "inside baseball". Not what I was talking about. Either you knew that, and this is snark, or you didn't, and this is a waste of photons. I mean really, Harry and Louise? I suspect it's being reminded of being defeated that's driving much of the hand-wringing in the left blogsphere today, at least among the over-30 set. Well, I see the Obama supporters are getting their way, and turning this into a discussion of the relative merits of the plans, and away from the despicable nature of this ad. I mean really, Harry and Louise? Re-read Kevin's post. He raised a glib argument by John Edwards that goes to the relative merits of the plans. Not that I object to your talking about the mailer, but the merits of the plans are very much part of this discussion. Posted by: LynnDee on February 1, 2008 at 2:16 PM | PERMALINK"JRich is absolutely right, about mandates being popular with the insurance companies. It doesn't mean they're bad policy" Agreed. And, yes, because Single Payer doesn't seem politically viable, any working solution will have to include insurance cos. MY point, and I think Obama's point on this issue is the affordability issue. That's the striking thing about health care insurance: The cost of plans have skyrocketed. The honest way to ensure that mandated insurance won't break the back of a family of 4 who makes $90K (a little above 400 percent of poverty), is to combine with some sort of rate regulation. NO candidate has endorsed that idea, for obvious political reasons. As an aside, simply as a political issue, the point is Obama's on this and this argument is a winner among the working poor: "Hillary wants Government to force you into a relationship with insurance cos ... with penalties if you don't" Let's not forget this is a political campaign, and not a salon where we are sipping tea and discussing the latest New America Foundation report on health care. Posted by: Jrich on February 1, 2008 at 2:16 PM | PERMALINKSam, Thanks for the cost estimate. $500/mo, $2000 for family of four? I don't know about anyone else, but that sounds incredibly high to me. Btw, to continue with my 22 year-old daughter's situation, we finally decided that the best option, since she isn't given benefits from the company for which she works, to go with hospitalization coverage only. That amounts to $149/3 months coverage and includes out-patient procedures and tests. No way would she spend $500/mo on doctor's visits and drugs nor could she afford $500/mo. Posted by: nepeta on February 1, 2008 at 2:17 PM | PERMALINKGrand Moff Texan, If it's not mandates that you consider to be "inside baseball" -- the exact feature the lack of which will leave out 15 million people under Obama's plan -- then what are you talking about? Posted by: frankly0 on February 1, 2008 at 2:19 PM | PERMALINKPut another way, the risk of going without health care is not cumulative - LynnDee, I disagree with this statement of yours. People generally tend to accumulate health problems as they move along in life. If those problems can be addressed early on, the mortality risk decreases, the cost of treatment is less. Take cholesterol or LDL/HDL levels. If you see them start to rise you can address the problem by changing your diet. If you don't and continue to eat as before you can have a massive heart attack, or stroke, etc. While I know it is impossible to force people to go and see a doctor. It sure would be nice if we could get people to believe that going for an annual check up is good for them. Posted by: optical weenie on February 1, 2008 at 2:19 PM | PERMALINKStop playing the race card Kevin. If you don't approve of Obama's health care, you are racist to the core... Posted by: Hank Essay on February 1, 2008 at 2:19 PM | PERMALINKIf it's not mandates that you consider to be "inside baseball" -- the exact feature the lack of which will leave out 15 million people under Obama's plan -- then what are you talking about? Um, the subject of the post? Thought it was obvious. It (and most of the comments) have to do with why this is bad strategy. The rest of us understand that Obama's plan isn't going to go straight into law, so it's either childish or dishonest to keep waving 15 million hypothetical people around. And I really don't care which it is. The "mandate" argument was never sound and will soon be relegated to the dustbin, mark my words. Posted by: Jimm on February 1, 2008 at 2:28 PM | PERMALINKIf Obama discredits HillaryCare, and reminders of "Harry and Louise" will do that, then it will be difficult for Hillary to project Obama as inexperienced on the issue (which she does every chance she gets). Posted by: Ugly Moe on February 1, 2008 at 2:31 PM | PERMALINKIf this is all about political courage, then Clinton needs to spell out just how these mandates will be enforced. She had the opportunity last night and didn't. I'd also be interested to hear some evidence of the folks who get sick and go the emergency room and get care for free. Are they talking about folks that skip out on the bill? If that's the case, aren't you going to have that problem in a mandatory system? Or do you refuse coverage when the uninsured (but apply to pay) show up for coverage until they pay the penalty plus the back premiums? Posted by: Keith on February 1, 2008 at 2:33 PM | PERMALINKThe rest of us understand that Obama's plan isn't going to go straight into law, so it's either childish or dishonest to keep waving 15 million hypothetical people around. So what are you really claiming? That Obama will play no important role in advocating for health care by using the bully pulpit? What you don't seem to get is that given any of the proposals on the table, it is an essential economic element that mandates be included to achieve universal health care. No matter how they mix and match things in Congress, that essential economic fact does not go away. It's precisely because of that essential role that mandates were included in Edwards' and then Hillary's plan. It was not some perverse desire to punish the American people that led them down this path. And the lack of mandates certainly plays a major role in the reason Obama's plan misses covering 15 million people. Either Obama himself has got to become a fifth wheel when this whole debate comes up or he is going to have to go to the American people and advocate for that critical feature when finally it must be implemented. The notion that we can just pretend that this whole issue is just going to go away if we don't think about it and plan for it is groundless. It essentially comes down to denying basic facts of economics. Posted by: frankly0 on February 1, 2008 at 2:33 PM | PERMALINKAs long as we're trafficking in specious analogies, I think the mandate plan is actually more like Bush's Social Security pipe dream. To wit, you're required to give your money to a private company -- of your choice! -- to get a service that government is perfectly capable of providing. Except that mandates are worse, since there's nothing staking the amount of money you have to pay to the amount you have to earn. Subsidies? Plenty of people will still fall through the cracks. Mandates are an illusion of universal health care. Maybe they're only meant to be a stepping stone, but I'd rather not dabble in implementing bad policy that's supposed to be a bridge to good policy. Posted by: neil on February 1, 2008 at 2:34 PM | PERMALINKif you don't start by saying, you're going to achieve universal health care, you will be nibbled to death. Correction: If you do start by saying you're going to achieve universal health care, you've earned some powerful enemies from the very beginning. Those enemies succeeded in keeping the status quo around until now. Do we want to wait another 15 years? I sure don't. Posted by: neil on February 1, 2008 at 2:35 PM | PERMALINKLynnDee, I disagree with this statement of yours. People generally tend to accumulate health problems as they move along in life. If those problems can be addressed early on, the mortality risk decreases, the cost of treatment is less. That's actually a good point. I did think of it but decided not to raise it and further cloud things, unless I got a response. And I will add to your comment the observation that, excluding unforeseen accidents for the moment, the risk of catastrophic illness does increase with age. But, my point -- even if qualified by yours -- is still valid. It is possible to go without health insurance for some period time, even a long period of time, and then buy health insurance and not be penalized in terms of the health care then available to you and even in terms of your own health. You're rolling the dice, of course, because, as has been pointed out, you could be in an accident any time. Or, as you point out, you could end up allowing a progressive illness to, well, progress. Social security simply doesn't work that way, catastrophe or no catastrophe, progressive illness or not. You can't opt out through your 20's and 30's and suddenly decide to get with the program and not pay a big penalty. That makes the potential burden to society greater, possibly much greater. None of this is to argue for opting out of health insurance or even for the opportunity to opt out. I'm simply saying the analogy with social security is ultimately specious. Posted by: LynnDee on February 1, 2008 at 2:37 PM | PERMALINK"the progressive cause on healthcare" insurance is a single payer, not-for-profit publicly funded system of health insurance. The Obama, Clinton, and Edward's plans all accept their senses of the political reality that a progressive plan is not feasible, and none are willing to fight the good fight. If "There's nothing odious or unfair about this mailer" then why get lathered up about it. The mailer is entirely factual but omits mention of the subsides and limits on premium, as a percentage of income, included in the Clinton proposal. Despite such, my bet is that there would still be those uninsured under Clinton's plan, as mandates are unenforcible. The fact is that the Clinton and Obama plans differ only on the margin. I iam puzzled by those, such as Krugman, Klein, and Drum who work up such a lather over the matter. Posted by: Chris Brown on February 1, 2008 at 2:40 PM | PERMALINKSocial security doesn't cover everybody so how is it an argument for making healthcare cover everybody? Posted by: James B. Shearer on February 1, 2008 at 2:40 PM | PERMALINKAnybody see the statement released by the clinicians and health policy experts today: The important part: One more thing: the Hillary/JohnEdwards approach relies on market economics - the theory being that if everyone has to buy insurance, the cost per plan will come down. I get that in theory, but where is it in their plans that says the insurance companies can't raise the cost of the plans for no other reason than they want to? It's interesting to note that while there are penalities for consumers who don't buy in, there are no penalities for insurance companies who increase costs more than, say, the cost of living. In other words, these plans put A LOT of faith in insurers, mostly public companies, to not behave as bad actors. Watching the subprime crisis shake out, does that strike anyone else as naive? Posted by: Jrich on February 1, 2008 at 2:44 PM | PERMALINKfrankly0: You're assuming there's going to be one policy, one agency, like a Homeland Security of healthare, rolling things up into a monolith, being debated as the bill is crafted. I've already quoted Obama to show he knows better. Money quote: But we've got all these legacy systems in place, and managing the transition, as well as adjusting the culture to a different system, would be difficult to pull off. So we may need a system that's not so disruptive that people feel like suddenly what they've known for most of their lives is thrown by the wayside.'" So saying "the Obama plan does X" as if that's going to be the state of affairs in this country ignores what the man is actually saying. Look, there's a genuine policy difference here, and if universal health care is your main issue you should probably support Hillary Clinton. As an Obama supporter I respect that. You might even be pleased that we are having a debate about different kinds of health care plans i.e. a discussion with a wee bit of substance and a general premise that there will be some forward movement on this front after the election. I don't see why this is so hard or why people get so upset. Posted by: Colin on February 1, 2008 at 2:49 PM | PERMALINKLynnDee, ....I don't think 'healthy' people are the ones who would opt out of the plan.....nepeta at 2:09 PMActually, yes that is precisely the case. When people self-select, those who don't feel the need won't spend the money. However, that increases the rates because the theory of insurance is that all pay for some. The young and healthy have less need than the older, but if they were able to opt out, their low use doesn't contribute to the rate structure. That is called adverse selection. ...Insurance companies use the term "adverse selection" to describe the tendency for only those who will benefit from insurance to buy it. Specifically when talking about health insurance, unhealthy people are more likely to purchase health insurance because they anticipate large medical bills. On the other side, people who consider themselves to be reasonably healthy may decide that medical insurance is an unnecessary expense; if they see the doctor once a year and it costs $250, that's much better than making monthly insurance payments of $400 (example figures).... To make the rates less burdensome for all (because the young can also need the system), a policy called risk equalization is used. This is why in socialized insurance plans like those being proposed must have mandates in order to work. If they don't, they won't.
Regardless of our feelings on this issue, what is clear from the evidence is that mandates alone, without strong incentives to comply and harsh punishments for violation, will have little impact on the number of uninsured Americans.1 Indeed, as the Massachusetts experience illustrates, non-compliance with mandates is a large problem, absent harsh sanctions. There is simply no factual basis for the assertion that an individual mandate, by itself, would result in coverage for 15 million more Americans than would robust efforts to make health care more affordable and accessible. Yes, the idea is that a mandate needs something to make it enforceable, otherwise it fails. And that's exactly what Obama opposes in his ads: any method to enforce it. And of course "robust efforts to make health care more affordable and accessible" are the way to make those methods, whatever they may be, as painless as possible. Why this argument might be one favoring Obama is beyond me. Posted by: frankly0 on February 1, 2008 at 3:04 PM | PERMALINKAnd the lack of mandates certainly plays a major role in the reason Obama's plan misses covering 15 million people. Wrong. This has always been a bad argument, one that has never even seemed credible enough to seriously (in terms of time) dispute. There is room for disagreement, there are no "basic facts of economics" that argue one way or the other (since there are always dueling "basic facts of economics"), people really do want health insurance who can afford it, and there are ways to make that more doable and realistic without mandating that everyone must have health insurance. It just makes me chuckle sometimes that the real argument here is whether to go single-payer, not whether to require mandates like automobile insurance, where liability to others and property is the central concern (i.e. not concerns of people seeking their own medical care). Posted by: Jimm on February 1, 2008 at 3:05 PM | PERMALINKHillary Clinton is part of the reason why we have the SCHIP program. I get so tired of people focusing on a failure she shares with Truman, Nixon, and several other presidents and neglecting her successes. Michael Moore implied that she sold out to the lobbyists, but she went right on working toward what was achievable under the circumstances. That is why I will vote for her -- if she can't get what she wants and what is best, she'll go after whatever she can get and it will be better than what we have now. Posted by: Mary on February 1, 2008 at 3:06 PM | PERMALINKLook, there's a genuine policy difference here, and if universal health care is your main issue you should probably support Hillary Clinton. As an Obama supporter I respect that. Actually I think the goal with both plans is universal health care. Also, both plans leave something unanswered. With Hillary's plan, the question is: What do you do with the people who can't afford it? Yes, she plans to bring the cost as low as possible, but unless it's "0" there will be some number who can't afford it. And the higher the price, the more people there will be who can't afford it. This is not a slam at her plan, just something that would need to be worked out. Similarly, with Obama's plan, you would have the people who can't afford it as well as those who, as he says, might "game" the system. This might sound like, Oh he's got more problems to worry about, therefore Hillary's plan is better, but I don't know that you can conclude that. It's clear, though, that provisions would need to be made for both contingencies. Bottom line is: Whichever plan is eventually adopted -- and keeping in mind that that plan may not resemble either of the proposed plans closely enough to say: It's Hillary's! Or: It's Barack's! -- the devil will be in the details. Posted by: LynnDee on February 1, 2008 at 3:10 PM | PERMALINKJimm, Rather than just blandly asserting that, sure, there are just so many other ways to handle the problem of guaranteeing universal health care, why don't you point to a case example of a proposed program where every good economist grants that it will do the trick, but it does NOT involve mandates, and does not have some other obviously fatal flaw from a political point of view? And then maybe you can explain to us all how it is that none of our three Democratic candidates plunked down for this plan. How strange that they didn't immediately reach for the political Nirvana you imagine is so easy to come up with. Posted by: frankly0 on February 1, 2008 at 3:11 PM | PERMALINKOh, give me a break. This ad is so dull it makes my eyes shut. Talk about the Clintons saying anything to get an edge. Sheesh, this so has nothing to do with the original Harry/Louise ad in '94 that it boggles the frickin imagination how someone could even think it was an attack ad. Hey, Clinton boyz & guhls - you'd better come up with something better than this load of hockeypucks. This website is obviously in the bag for Clinton. Last time I visit here! Posted by: Jrichards Tennessee on February 1, 2008 at 3:16 PM | PERMALINKThis idea that the mailer has something to do with "Harry and Louise" is as phony as the "snub." Posted by: coyote on February 1, 2008 at 3:21 PM | PERMALINKwhy don't you point to a case example of a proposed program where every good economist grants that it will do the trick, but it does NOT involve mandates, and does not have some other obviously fatal flaw from a political point of view? Why don't you go first, and show me that every good economist insists on mandates and muddled solutions over simple single-payer? As for single-payer, I'm not suggesting anyone should advocate it, but it is the obvious alternative, not the pseudo-solutions crafted to please special interests, who seem to have too much hold on our government since all 3 candidates, as you mention, have gutless health care reform proposals. In the end, if we're going to go with gutless and overly complex health care reform proposals, I don't see having or not having mandates as an especially burning issue, whether argued on this merit or on its own merits (i.e. even accepting that these health care reform proposals were not gutless and disastrously complex, there is still no burning need to have mandates and force this to be like automobile insurance, which has totally different concerns/issues). Posted by: Jimm on February 1, 2008 at 3:22 PM | PERMALINKThis idea that the mailer has something to do with "Harry and Louise" is as phony as the "snub." Looks like we got the latest Obama talking point here. I wonder if they distribute them by text messaging nowadays instead of fax. Posted by: frankly0 on February 1, 2008 at 3:24 PM | PERMALINKAs for those who want to "game" this system, going to an emergency room for basic health care, especially in an environment where that is less common and probably more hectored (on site), is not likely going to be a winning proposition. Make health insurance affordable, and even I'll buy it, or I'll pay the price. Posted by: Jimm on February 1, 2008 at 3:25 PM | PERMALINKfrankly0: No, it's original to me. But coming from you, I take that as praise. Posted by: coyote on February 1, 2008 at 3:30 PM | PERMALINKWhy don't you go first, and show me that every good economist insists on mandates and muddled solutions over simple single-payer? Look, I won't say I understand why none of the three candidates would go for single-payer. To me, that should be both possible in this political moment and highly desirable. But this much is certain to me: there's no hope at this juncture for single payer in one bold step. Even if it's in an abstract way politically possible, it's simply impossible that there will be anyone who will be able to champion that effort at this stage. The only ones who might have been able to do so would be the candidates themselves, who can take their plans as part of their mandate when elected. No one else than a President has the clout to push for an even more aggressive measure than those already proposed. I simply take the infeasibility of single payer as a fait accompli at this time, given what our candidates have themselves proposed. I can't imagine Congress itself proposing something even riskier from a political point of view, because they are, let's just say, not big risk takers. Short of single payer, I have never heard of a plan that has a path to get to universal coverage that does not incorporate mandates. Certainly none of our candidates has proposed such a plan, and I've got to believe that all the alternatives they considered exhibited only more grievous faults than the ones with mandates. Posted by: frankly0 on February 1, 2008 at 3:33 PM | PERMALINKI don't see why this is so hard or why people get so upset. Um, because the last several years have sucked? Having been in ideological combat for a very long time, now that we're about to be in power our means of confrontation haven't ratcheted down. Everyone's phasers are still set on 'kill.' Ideological combat leads to ideological rigor. That's a very stupid place to be. Kevin - The difference between healthcare and social security is that we already have social security and we don't already have universal healthcare. To get from zero to something, it often helps if you give people the chance to opt-out. Posted by: Peter Bautista on February 1, 2008 at 3:51 PM | PERMALINKWe already have universal coverage. Anyone can go to an emergency room or "ready care unit" (or whatever you call those things) and get health care. If you break your leg, you will not be walking around with the bone sticking out for the rest of your life, you will get that bone set. The primary problems we're dealing with today are cost and lack of preventive health care. These are the issues that the half-azz health care reform proposals we hear about today are addressing, and mandates is not an especially crucial element, nor is mental mistakes like likening health care insurance to automobile insurance (social security is not the apt likeness, either for actual or ideal reasons). You deal with cost by making more affordable, and you deal with preventive health care by again making more affordable so people actually have doctors (and you also have to emphasize some many other things/changes I won't bother going into now). The automobile insurance model is entirely different, dealing with liability and property, and social security is even more different, for so many myriad reasons there is no point in even talking about it. Posted by: Jimm on February 1, 2008 at 3:58 PM | PERMALINKThe Obama campaign sends out an ugly mailer. Sorry, but this is just destructive — like the Obama plan, the Clinton plan offers subsidies to lower-income families. And BO himself has conceded that he might have to penalize people who don’t buy insurance until they need care. So this is just poisoning the well for health care reform. The politics of hope, indeed. Update: Ezra Klein adds a screenshot of the original Harry and Louise ad — they’ve obviously deliberately copied it. Just to remind everyone, Harry and Louise were the center of the vile smear campaign the insurance lobby waged against health care reform in 1993 — and this time a Democratic candidate is doing the smearing for them. Ezra also points us to an Urban Institute study that shows that yes, mandates are essential. The key passage: Voluntary measures would tend to enroll disproportionate numbers of individuals with higher cost health problems, creating high premiums and instability in the insurance pools in which they are enrolled. I know that Obama supporters want to hear no evil, but this is really, really bad.One must bear in mind, of course, that since Krugman started evaluating Obama he has apparently become deranged with Obama hatred and his otherwise superb reasoning faculties have entirely deserted him. Posted by: frankly0 on February 1, 2008 at 3:58 PM | PERMALINK Unless of course we considered single-payer, then health insurance would be more aptly likened to social security. Posted by: Jimm on February 1, 2008 at 4:00 PM | PERMALINKKrugman is not "all economists", and all economists make "choices", and it's people with health problems that need insurance most obviously, why should relatively young, healthy individuals have to pay for that care? Posted by: Jimm on February 1, 2008 at 4:03 PM | PERMALINKThe more you explore this issue, when actually taking into consideration single-payer, the less sense Krugman makes, especially economically. I don't know why the guy has a hair up his azz, but as an economist who has bought into a certain political "reality", he does noone justice by splitting those hairs up his azz and declaring them the only popular weave of the next era. Posted by: Jimm on February 1, 2008 at 4:07 PM | PERMALINKwhy should relatively young, healthy individuals have to pay for that care? Jimm Because relatively young, healthy individuals eventually age and become sickly feeble senior citizens. Unless of course their hearts blew up at a young age because they had high cholesterol levels but never bothered to get an annual check up because they thought they were invincible. Jimm - universal health care is a progressive policy. That means all for one and one for all. franklynO, how much are the Hillary people paying you to spend all day writing on the comments section of this blog? Posted by: Traven on February 1, 2008 at 5:02 PM | PERMALINKI'm so disappointed that single-payer seems to have flown out the window. Stupid for-profit insurance companies, the bane of healthcare. Does anybody have a solution? Posted by: nepeta on February 1, 2008 at 5:06 PM | PERMALINKI thought Kevin had posted comments from policy wonks that suggested starting single-payer, and at the same time allowing people to stay with their employment benefit plans or buying private insurance. So there would be three options. If the single-payer plan was very good, then people would be tempted to opt out of employment benefits to which they contribute an increasing amount, and opt for the single payer plan. Obviously single-payer requires a tax hike (a progressive one), but isn't it worth it in the long run? Posted by: nepeta on February 1, 2008 at 5:14 PM | PERMALINKNepeta, As people have said upthread, it doesn't seem to me that forcing people to pay insurance companies for health benefits, when those same companies, I assume, will still be reaping a profit, is anywhere close to a liberal healthcare plan. Posted by: nepeta on February 1, 2008 at 5:18 PM | PERMALINKoptical weenie, I'll write-in Inkblot for Prez! Btw, do you know what my name means??? A riddle... Posted by: nepeta on February 1, 2008 at 5:21 PM | PERMALINKNepeta is latin for Catmint. I have several plants in my yard. Cleopatra the Empress of the Universe likes to sit on one in particular. Posted by: optical weenie on February 1, 2008 at 5:29 PM | PERMALINKthis so has nothing to do with the original Harry/Louise ad in '94....Jrichards Tennessee at 3:16 PMIt just happens to mimic the entire style and message. Yeah, right. This idea that the mailer has something to do with "Harry and Louise" is as phony as the "snub." coyote at 3:21 PMKeep the faith, O 'bamabot, keep the faith! We already have universal coverage. Anyone can go to an emergency room ....Jimm at 3:58 PMAnd some have died waiting. Seriously, those services as well as free medical clinic are overwhelmed and the wait for treatment is long. ...since Krugman started evaluating Obama he has apparently become deranged with Obama hatred.....frankly0 at 3:58 PMIsn't that the fate of everyone who is underwhelmed by the Euphonious balonious? ....The more you explore this issue, when actually taking into consideration single-payer....Jimm at 4:07 PMIt's called reality. They entrenched power of the corporate medial interest groups is too strong. It was too strong in 1947, it's stronger today. Perhaps if we had government election financing so that capitalists could not buy and own the government, things might be different. That would be probably harder to establish than socialized insurance. Remember, the only way we have Medicare Part D is because it subsidizes pharaceutical companies. The government is still subsidizing Advantage Care Medicare even though it's more expensive than straight Medicare. Posted by: Mike on February 1, 2008 at 5:29 PM | PERMALINK franklynO, how much are the Hillary people paying you to spend all day writing on the comments section of this blog? As much as your own comments are worth. Posted by: frankly0 on February 1, 2008 at 5:38 PM | PERMALINKoptical weenie, Congratulations! And here I thought I would at least make you google. I love catmint. I have a few different species in my garden and my cats love to lie in it and nibble on it too. Posted by: nepeta on February 1, 2008 at 5:39 PM | PERMALINKYou. Have. GOT. To. Be. Freaking. KIDDING! An ad that apes the Harry and Louise ad is being attacked and compared to the dirtiest of dirty politics -- and this web site is trying to both not say it's dirty politics but then attack it as if it IS? Talk about talking out of both sides of your mouth! By the way, whatever policy issues could have been illustrated, or whatever "dirty pool" could have been charged against Obama, has been completely obliterated by the Clinton campaign's official reaction (from Americablog - note the third paragraph): "The Clinton campaign convened a conference call with health policy experts to denounce Obama's new mailer (.pdf), which attacks Clintons plan for "forcing" Americans to sign up for insurance, and which features a couple at a kitchen table that recalls, for some, the famous insurance-industry financed "Harry and Louise" ads against the original Clinton plan. ""I am personally outraged at the picture used in this mailing," said Len Nichols of the New America foundation, a leading supporter of mandatory insurance, who called it a "Harry and Louise evocation." ""It is as outrageous as having Nazis march through Skokie, Illinois," Nichols said. "I just find it disgusting that this kind of imagery is being used to attack the only way to get to universal coverage." "Clinton advisor Neera Tanden called the mailer "politically dangerous."" Link to original quote: http://www.americablog.com/2008/02/clinton-campaign-call-obama-ad-evokes.html
nepeta: it doesn't seem to me that forcing people to pay insurance companies for health benefits, when those same companies, I assume, will still be reaping a profit, is anywhere close to a liberal healthcare plan Germany and Japan have UHC systems where private insurers play a large roll, and Germany is widely considered to have one of the best systems. However, the devil is in the details. IIRC the German insurers are not-for-profit and are closely regulated. That's certainly not the case here, and, under our "finest government money can buy" system, it never will be. Face it: the root of the problem is the bribery we call campaign finance. Without publicly financed campaigns (ala the People's Republic of Arizona) real improvement hasn't got a chance. Yet this issue gets almost no attention. As for Obama, his Harry and Louise ad has pushed me over the edge. I've never been a fan of Hillary, and before this said that it was just a meaningless contest between Republican-Lites. No more - Obama looses the "Lite" qualifier. I hope that Hillary rips him a new one over this (not that I think she will). What's appealing about Obama other than the fact that he gives pretty speeches? I think he's an image candidate, just as Reagan was an image president. By that I mean someone who projects an appealing image, but whose actions contradict it. Whatever happens this will be another "hold your nose" election, where you fight the stench of voting for someone whose only qualification is that they're not quite as bad as the opposition. With Hillary I'll hold my nose, but with Obama I'll need a gas mask. Truman is dead - any chance we can draft Feingold? Posted by: alex on February 1, 2008 at 5:44 PM | PERMALINKEdgewaterJoe, Edwards was our last, best, hope on Health Care. Whether it's Hillary or Obama, we will ALL be the Health Insurance Industry's BITCHES for another 9 years, at least. My plan? Don't get sick. If you've never been in a situation WHERE YOU HAVE ABSOLUTELY NO POSITIVE CASH-FLOW COMING INTO YOUR HOUSEHOLD, then I guess you can't relate to people who are terrified of mandated insurance. "Subsidies" pheh. How would those work? How much paperwork? What are the requirements? What's the appeal process should I be unfairly denied? How long after I pay the premiums until I receive the "subsidy"? How much less than the out-of-pocket will the subsidy be? If I'm somebody who has been laid-off and my spouse is sick and my unemployment benefits have run out - where the hell do I get the money to cover the difference? As somebody who has been there, and knows people in that circumstance right now, I can relate to Obama's incrementalist approach, and appreciate it. Proponents of mandates have done little or nothing to assuage these concerns, and Obama's campaign is right to remind the voters of this. He's not trying to sabotage universal coverage, and you can't look at the man's background and seriously believe that's where he's coming from. He's protecting the interests of the people he cares about. Damn good for him. You don't agree with his approach, fine. But stop with the "GOP-Lite" bullshit, their are real progressives out there with real concerns about mandates, and Obama is one of them. Posted by: Brautigan on February 1, 2008 at 6:08 PM | PERMALINKOnce people start losing insurance as they lose their jobs they'll be more amenable, but not now. Later, Obama can simply say that the problem has worsened and a more aggressive plan is needed. What is needed is that Americans must understand the truth: They're losing their jobs because their employers can no longer afford the healthcare costs. Salary's becoming a relatively trivial component, of the cost of compensating a professional. The healthcare component is increasing at an astounding rate, and the service is declining, leading to less healthy (both physically, and financially) employees; so what's the point of group healthcare plans again? Oh, that's right - to SUCK ever other sector of our economy dry, until it crumbles and blows away like dust. Posted by: osama_been_forgotten on February 1, 2008 at 6:09 PM | PERMALINKMike: Perhaps if we had government election financing so that capitalists could not buy and own the government, things might be different. Thanks for mentioning that. Sometimes I feel like a voice in the wilderness. I wish I could say that I have great insight, but I'm more like the kid who said that the emperor was naked. optical weenie: EdgewaterJoe, You need to tell the whole story Save you breath (electrons?, photons?). Here's the Obamabot approach in a nutshell: 1. He speechifies so prettily that you should ignore what he actually says or does. 2. What he says is meaningless - a tool to appeal to the heathens. Much as early Christian missionaries tolerated their converts continued use of certain pagan symbols and rituals so that they were more likely to accept Christ, we believe that words and actions are just a veneer. We know, as an article of faith, that he's a stealth liberal, progressive or other good thing. 3. You're either with us or your against us. 4. Hope, change, change, hope. Lather, rinse, repeat. osama_been_forgotten: Don't get sick. Under the current or future regime, where you have a choice between crony economics or more blatant crony economics, that's about the only practical advice. Please provide details. Forget Harry Truman, even Adam Smith is rolling over in his grave (look at the economic system he was criticizing and you'll see what I mean). Posted by: alex on February 1, 2008 at 6:11 PM | PERMALINKThe pivotal issue in last night's CA debate wasn't health care. It was Iraq. Barack Obama was against the war from the start. Hillary Clinton can't say that, nor has she ever apologized for her vote to authorize war. That's the issue that will turn red states blue in November. Bringing a swift resolution to the war in Iraq -- that's the issue that will unite a coalition of Democrats, Independents, and disgruntled Republicans in November. (Though it's interesting to note that the Hillary Clinton campaign has tried to create buzz on the health care issue in the days leading to every primary thus far.) To turn a phrase, "It's the war, stupid." Posted by: Edith on February 1, 2008 at 6:23 PM | PERMALINKThe very poorest of us already have coverage thru Medicare, so their premiums are not an issue. The richest of us can afford to pay whatever it costs. It's the vast middle of us who pay more and more for less and less care, or lose it entirely and can't get new insurance. We need to get to universal single payer (Medicare for all) and Obama is fighting AGAINST a step along the way, ensuring we'll never get there with him as President nor will we even get closer to single-payer. It's bad policy, ensures no progress and more strain on our already overburdened and underfunded public hospital system, and repeats GOP talking points (again, from him). It really is appalling--he couldn't hurt us all more on this issue if he tried. Posted by: amberglow on February 1, 2008 at 6:44 PM | PERMALINKObama may be right on day 1 about Iraq, but Clinton is right on day 1 about healthcare. That clinches it for me. Harry and Louise Redux just cost Obama a campaign contribution. For shame! Posted by: Sharon on February 1, 2008 at 7:05 PM | PERMALINKScrutinize Obama's "Harry and Louise" ad just a little bit here. We've got a married couple in their 40's. The house looks pretty decent-quite a bit *LARGER* than the original "Harry and Louise" ad. I'd guess that both of them are employed and they certainly don't look like factory workers-more like middle-managers or technical professionals. They just don't seem to fit the picture I have in my mind of people that don't ALREADY have insurance from an employer and are fussing about how to find money for their premiums. Uh, when you hit 40-45, usually some significant medical attention has been required, and if you've got insurance available from your employer wouldn't you be electing to pay your 20% of the premium every month? That's what's wrong with this picture here. I think Obama is sending a subliminal message here about those extra TAXES this middle-income educated working couple would have to pay under Hillary's plan to make her plan more "affordable". Posted by: Doc at the Radar Station on February 1, 2008 at 7:20 PM | PERMALINKAnd I can see your argument about the thing called health insurance if one considers it like we consider home insurance. That's a good analogy. To extend it a bit further, social security is more like buying a house in the sense that, by paying into it, you build up equity. If you don't pay into it, you are nowhere close to having a house at the end of 30 years. Medical health insurance, OTOH, is more like buying insurance on that house. Assuming nothing goes wrong, you're never more than one payment away from being insured. Big risk, though. No doubt a | |