Editore"s Note
Tilting at Windmills

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February 5, 2008
By: Kevin Drum

OBAMA AND MANDATES....Ezra Klein says that Barack Obama is "simply lying" when he attacks healthcare mandates by comparing them to solving homelessness by mandating that everybody buy a house. That's pretty far over the top. I think Obama is wrong on the merits and wrong to attack mandates, but his analogy doesn't register more than 3 or 4 on the Richter scale of political mischaracterization. He deserves grief for his position, but he's not lying.

That said, here's what I don't get. Ezra asks, "Why won't he stop?" and that seems like a pretty good question to me. When Obama is in a debate and has to defend his position, that's one thing. But why continue to push this line so hard in settings where he could brush it off if he wanted to? Does he seriously think this is a core part of his appeal? Has he drunk his own Kool-Aid so much that he's genuinely convinced that mandates are evil? Or what? He knows he's going to get attacked by potential supporters every time he brings this up, so why not just soft pedal it? He's got plenty of other fruitful lines of attack against Hillary, after all.

Kevin Drum 5:19 PM Permalink | Trackbacks | Comments (57)

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Government mandates are scary to a LOT of people, regardless of the actual implementation. I'm sure Obama is harnessing the fear of mandates, and probably wisely.

Posted by: BRM on February 5, 2008 at 5:25 PM | PERMALINK

I believe that Obama has made the political judgment that the word "mandates" in the hands of the Republicans during an election campaign can be turned into something even more sinister than outright socialism.

If it wasn't for political calculations, they would all be calling for a single-payer system. It's just that Obama's final political calculation differs from Hillary's (and Krugman's).

Posted by: JS on February 5, 2008 at 5:26 PM | PERMALINK

Because to the democratic base, his proposal is weaker and less liberal. From a point of weakness, attack rather than letting your opponent exploit your weakness.

He is positioning his healthcare plan to the right of Clinton for the general election.

Posted by: yep on February 5, 2008 at 5:26 PM | PERMALINK

Kevin,

Call me unsophisticated, but Obama's analogy seems pretty spot on. Care to make the counter-argument? Where does his analogy break down?

Posted by: Expat Teacher on February 5, 2008 at 5:28 PM | PERMALINK

Perhaps because those knowlegeble on the subject disagree on the subject of mandates and perhaps those advising Obama have a different take on the subject than does Klein, Krugman, and those advising Clinton.

Certainly folks can disagree without resulting to accusing those with whom they disagree of lying.

Posted by: Chris Brown on February 5, 2008 at 5:29 PM | PERMALINK

I'd vote for Obama in the primary, but Ezra is entirely right. Expat, see Ezra's post for why Obama is so far off base.

Posted by: Gore/Edwards 08 on February 5, 2008 at 5:31 PM | PERMALINK

Have to agree with Expat Teacher. What is wrong with the analogy? In both cases you're forced to buy something. Seems to me the analogy is perfect.

Posted by: Al on February 5, 2008 at 5:33 PM | PERMALINK

I don't think that mandates are the end all and be all of everything and I understand why he would not be in gung ho about them because they sound really good on paper but in practice they may do more harm than good. I see many people talk about how young people would avoid getting insurance because they are healthy but they fail to take into account that there are many young people who are working minimum wage jobs and living from paycheck to paycheck. It is not fair to force them to pay for insurance they cannot afford. I think that because Obama worked as a community organizer and lived in the inner city he would have a better understanding how people actually live rather than imposing their ideals on people who are nothing more than abstractions. To me this is not being conservative but being realistic as to what can be accomplished without harming the very same people who need it the most.

Posted by: MGJ on February 5, 2008 at 5:39 PM | PERMALINK

I think being against mandates is a winning issue. He may be alienating the policy wonk vote but he's not alienating the White Male leave me alone vote, and that's a group he REALLY needs some support from to win the election.

Posted by: will on February 5, 2008 at 5:39 PM | PERMALINK

He won't stop because he thinks he needs to triangulate. But in his case, it isn't triangulation, it's a new synthesis.

Posted by: larry birnbaum on February 5, 2008 at 5:42 PM | PERMALINK

He's using republican spin because he (or his advisors) think that he will be able to get away with lying after the election, just as GW has.

And he and his wife and supporters have drunk the camelot kool aid and seem to think they can do no wrong. Michelle is starting to come out with some rather nasty things. She needs to stop this. If Obama wins, he is still going to need the support of us old foagies come election time - after all we need to remember that the older we are the more we vote. If the insults to the "hillaroids, etc." continues we might just get pissed off.


Okay that is my rant for the day.

INKBLOT FOR PRESIDENT '08

Posted by: optical weenie on February 5, 2008 at 5:42 PM | PERMALINK

The real dishonesty in Obama's analogy is that it entirely fails to acknowledge that Hillary's plan actually does, in fact, make health care insurance affordable for those most in need -- indeed it is at least as good as Obama's in this respect.

Why does he persist in the deceit?

I don't know why there should be any puzzlement over this. I think the explanation is the simplest and most obvious possible. He and his campaign have realized that Hillary's criticisms of his health care plan as failing in universality have struck a real nerve in potential voters. The demonizing of mandates is a politically very effective comeback with potential voters. Therefore, Obama has adopted it. My guess is that the approach has been focus group tested, and has come out with flying colors.

Why should Obama care about the wonks and activists who can see the damage he's doing to the future of universal health care? First order of business is to win the nomination, and this seems to work.

I think that the only reason that people don't immediately see that this is what's going on is that they believe at least partially that Obama is a different kind of candidate. Once you remove that false assumption from your thinking, it all becomes obvious.

Posted by: frankly0 on February 5, 2008 at 5:46 PM | PERMALINK

Because he'd probably rather be arguing about health care minutia than arguing over the mentally retarded issues the press will focus on if left to their own devices, e.g. is he black enough or too black?

Why on earth would you be accusing Obama of drinking his own "Kool-Aid"? Health care is, after all, Hillary's signature issue. Why not challenge her on her own turf? So why has Obama positioned himself against mandates? I suspect there are two very good reasons for this position: one, he believes it's the correct approach; and two, it is probably less likely to alienate or frighten people who don't care about health care or are happy with the health care they already have.

(And let's be honest: if anyone is going to fail the test of sincerity for their positions on the issues, it's going to be Hillary, not Obama)

Doubtless for some the idea of government run health care conjures up images of free clinics and county hospitals that are the dumping grounds of the poor. Chances are the people who are most afraid of being forced into government run health care are the ones with the most influence and money in our society. If you scare or alienate too many of them, your chances of success will diminish greatly.

Of all of the questionable political posturing by the two Democratic candidates, it seems a little insincere if not transparently partisan for Ezra to deem this one worthy of the accusation "lying".

And frankly, Obama's position sounds more reasonable to me than Hillary's.

Posted by: Augustus on February 5, 2008 at 5:50 PM | PERMALINK

When I hear a conversation about insurance mandates and how they should work by increasing demand thereby lower rates, I like to point out how it was when California mandated everyone get auto insurance by making it illegal to operate a vehicle without insurance.

It didn't lower rates, but it did increase the income of the insurance companies involved... and the 'state's highway fund.

Posted by: nobody special on February 5, 2008 at 5:52 PM | PERMALINK

to the democratic base, his proposal is weaker and less liberal

That's not entirely clear to me. The unaffordability of mandates has been an attack from the left on plans already, in several states. Notably, California. Arguably, Obama is picking up the left and the moderates while alienating the wonks. That seems pretty politically smart to me.

Besides, this debate is fundamentally unnecessary from both sides because there is a wonky policy fix--just do what they did in Massachusetts and install an authority whose job it is to exempt people who can't afford the mandate.

But no one's bringing that up, because clearly there's been a political calculation on both sides to make this a big distinction, and to have a policy fight on being "pro mandate vs. anti mandate."

Politically, I think Obama is getting way more out of this fight than Clinton is, and I think Clinton is in the bad position of being essentially forced to play a hand she's going to lose, in spite of a lot of early pundit support. I mean, Obama got her to say "garnish wages" on Sunday. The longer this goes on, the worse her position gets. And if she tries to back away from it at some point, god help her.

Posted by: anonymous on February 5, 2008 at 5:53 PM | PERMALINK


I think that Obama's priority is getting elected, and universal health care is not really his priority. He believes he cn distinguish himself from Hillary appealing to yuppies who do not want to pay for health insurance. He is going after the motorcylist who do not wnt to have government require them to wear helmets.

Posted by: Fred Ellis on February 5, 2008 at 5:58 PM | PERMALINK

The problem with mandates is that when the government orders you to write a check, its a tax. User fees, in contrast, are easy to legally avoid-- if you don't want to pay $25 to enter Yellowstone, then don't go to Yellowstone.

If the government is going to levy a tax, it should be done on a progressive basis like income taxes or, at the very least, on a proportional basis like the 1.45% Medicare tax (the part of FICA that isn't capped at $97,500). A federal mandate to pay insurance premiums is a poll tax. The last time a politician tried to impose one of those-- the Tories bounced Margaret Thatcher.

A poll tax, head tax, or capitation is a tax of a uniform, fixed amount per individual (as opposed to a percentage of income)... There are several famous cases of poll taxes in history, notably a tax formerly required for voting in parts of the United States that was often designed to disenfranchise poor people, including African Americans, Native Americans, and whites of non-British descent...
http://en.wikipedia.org/wiki/Poll_tax

Posted by: beowulf on February 5, 2008 at 5:59 PM | PERMALINK

Hillary hasn't talked about how she would enforce mandates apart from garnishing a person's wages..Mandates will need hard sanctions and enforcement of non-compliance...not entirely a pleasant experience.

And why don't we see how it works out first in Massachusettes before trying it in the other 49 states? I'm sure if it mandated healthcare is such excellent social policy we can wait till the hypothesis has been test practiced in the field.

Posted by: Steve Crickmore on February 5, 2008 at 6:05 PM | PERMALINK

Could anyone here explain how either Hill or Obama are going to achieve 'universal health care' when both are going to exclude illegal immigrants? (In other words, the illegal immigrants will still be clogging our hospital emergency rooms and those of us who pay taxes will still be footing their bill.)

What's universal about excluding 10 million people?

Posted by: sbj on February 5, 2008 at 6:06 PM | PERMALINK

Of course, in all the feeble defenses one sees here of Obama's approach, the one thing we don't see is any path whereby one can go from something resembling Obama's plan to genuine universal health care without mandates.

Given that that is without question the basic economic problem that drives the whole issue, you'd think that Obama's supporters would offer up an answer.

Instead, we get evasion. You know, someday in the future we can revisit it, or plans get revised when they go through Congress, or the Republicans will attack it, so Obama should attack it first, or some other such distracting or absurd argument.

What they can't answer is why Obama should have effectively removed mandates, one potential solution to the problem -- and perhaps even the only potential workable solution -- from the toolbox he and we might use to achieve UHC.

They can't answer that question, because it forces them to admit what they don't want to admit: that Obama has chosen to demonize mandates for no grander reason than that it works politically, right now, to defend against Hillary's (and before that, Edwards') attacks.

Posted by: frankly0 on February 5, 2008 at 6:09 PM | PERMALINK

Obama does not have "many" other fruitful attack lines against Hillary. They generally agree, and the most significant issue Obama tries to use to win the argument of him versus Hillary, Iraq, is not a big win for him. Despite what many Obama supporters say, Hillary's 2002 vote authorizing Bush to go to war if Saddam did not cooperate with inspections was not a terrible vote if you assumed you were dealing with a President whose word and judgment could be trusted; in 2002 the majority of the country, not just Hillary, believed Bush was an honorable man and also believed Iraq had WMD. Both of these assumptions turned out to be wrong, but people who think Obama knew Bush was a pathological liar and that there were no WMD in Iraq in October of 2002 are simply kidding themselves.

Posted by: Bob C on February 5, 2008 at 6:14 PM | PERMALINK

Easy:

I (the government) mandate that you buy a house. You can't afford a house and I don't help. Result- you can't buy a house.

or

I (the government) madate you buy health insurance (through payroll deduction, not garnishment). You can't afford health insurance. I help you buy it. Result- you can buy health insurance.

If you talk to a state Governor, they will explain the difference between funded and unfunded mandates. Mandatory health insurance with subsidies for the poor is a funded mandate.

Posted by: solar on February 5, 2008 at 6:16 PM | PERMALINK

I'm a citizen of Massachusetts who supported the law with mandates, but at this point I'm skeptical about it surviving.

The reality is that the people who are being forced to buy insurance are very angry. The law has not done enough to bring down costs, the cheapest packages are still too expensive, and families cannot afford to spend $10,000 a year on it.

There is a huge backlash brewing and the advocates are still in denial.

Mandates may be the right thing in an economic model, but that doesn't make them politically feasible. Maybe Obama continues to push his hard line because he's the only Democrat who understands this.

Posted by: Andrew on February 5, 2008 at 6:16 PM | PERMALINK

Bob C,

I don't know about you, but in 2002 I was out in the streets, talking to other citizens, and doing everything I could to prevent this war. Hillary didn't vote to give Bush the authority to invade Iraq because she trusted Bush. She did it because she thought it was the only vote that would preserve her path to the White House. Do you sincerely believe that in 2002 Hillary though Bush was "honorable" and trustworthy? Wow. And they call Obama supporters naive. There was no doubt at the time of that vote that Bush was going to invade. I knew it. She knew it.

Suppose for a second that you were right, and she did believe that Bush was honorable and trustworthy. Isn't that itself an egregious enough breach of judgment to avoid her as a president?

Posted by: Oaktown on February 5, 2008 at 6:22 PM | PERMALINK

Mandates are a new payroll tax. Not only is it true the Republicans will absolutely hang that fact around the head of Hillary should she try to push for them.

If it isn't a tax then it isn't enforceable. How exactly will the government know that you have health insurance if you are paying for it yourself? All the providers are going to give this information to the government? What if you joined Bob's health insurance consortium for $1? Would that qualify? If it doesn't how do health insurance companies become certified in this context?

It simply CAN'T work UNLESS we make it a payroll tax. Why are none of the people advocating for mandates admitting as such?

Posted by: flyerhawk on February 5, 2008 at 6:24 PM | PERMALINK

I think Obama has been more sympathetic to single payer coverage than Hillary. Many times he has said if he was 'starting from scratch,' if it wasn't for the legacies of private insurance, single payer is what he would be advocating...That is the the only plan that gurantees 100% universal coverage..He has also said that his plan which is perhaps more accurately described as 'univeral access' rather than 'universal coverage' might be but a first step in getting there some day.

Posted by: Steve Crickmore on February 5, 2008 at 6:25 PM | PERMALINK

Andrew, good point. Are there any community or political leaders in MA that are talking about this publically?

Posted by: Keith G on February 5, 2008 at 6:25 PM | PERMALINK

Of course, in all the feeble defenses one sees here of Obama's approach, the one thing we don't see is any path whereby one can go from something resembling Obama's plan to genuine universal health care without mandates.

Actually, the defense is easy and the path is much easier from Obama's plan to real Federal health insurance than Hillary's.

Obama will introduce a Federal paid option for those who can't afford private insurance now. Probably by expanding Medicare to the non-retired or something like it. At the same time, this huge pool will offer insurance to anyone that wants to buy in. If, as I suspect and he must too, this single payer plan is more than competitive with private insurance, it will lure many people in who have private insurance or no insurance. Once much of the country is in this single payer plan, it will be that much easier to simply extend the plan to everyone. Here the free market works for progressive ideas.

Now, if you mandate everyone buys private insurance, how do you get people to single payer universal?

How do you garnish the wages of the self-employed or unemployed?

Posted by: Patrick on February 5, 2008 at 6:25 PM | PERMALINK

Frankly0, Obama has addressed it. In fact, I think Kevin Drum addressed it here too.

Under Obama's plan, everyone would default into being covered by the (near) universal program unless an individual specifically opted out of the plan.

In order to prevent healthy people from gaming the system, those who opt out of the plan would then pay higher health care costs than people who were in the plan (the same way hospitals currently charge your insurance companies a fraction of the cost they would charge you if you had no insurance), as well as a penalty if they opted back into the plan at a later point in time.

Of course the devil is in the details for both Obama and Hillary's plans. Hillary's plan is a bit simpler in terms of implementation and the implication is that a larger pool of insured translates into lower average costs. One immediate downside to Hillary's plan is that it's likely to face far more opposition from people who are afraid of being forced into a government run program. Also, without more direct private competition, there are concerns that costs might rise faster under a universal health care system than one that faces at least some free market competition.

You also should not discount the added difficulties Hillary and Bill Clinton will have passing this program or others simply because (deserved or not) they are such polarizing figures for the Right. Barack's approach has its flaws, but I believe it has a better chance of success than Hillary's. Hillary's universal mandate is just one obvious example where I think your average voter will be less receptive to Hillary's plan than Obama's.

Posted by: Augustus on February 5, 2008 at 6:30 PM | PERMALINK


"Mandates" scares a lot of people. To me, it sounds like the Massachusetts plan, or how California mandates Car Insurance but doesn't do anything to make it affordable or cover everything.

The only people who have really understand what is meant by 'mandates' are the policy wonks who understand the gaming possibilities.

My sense is that its not a bedrock principle for him as much as a temporary political calculation. Hilary, on the other hand, is going to have to explain to the non-wonky masses how her 'mandates' are not just a repackaging of 'Hilary-care'.

Posted by: kis on February 5, 2008 at 6:33 PM | PERMALINK

Bob C, you are one of those easy marks who can't spot a transparent street con until long after you've been baited, hooked and cleaned out. Then, in defense of your own self image, you assume everyone else has the same deficiency.

Posted by: Boronx on February 5, 2008 at 6:36 PM | PERMALINK

Maybe it's because he has no intention of introducing any meaningful healthcare reform. Why not take him at his word? He will only introduce reform that costs nothing to anybody who doesn't want to pay. A kindler, gentler version of Republican selfregulation.

Posted by: jussumbody on February 5, 2008 at 6:40 PM | PERMALINK

Kevin, Obama is not a Democrat. He's an Eisenhower Republican. If nominated, he's going to use the general election to shed the last vestiges of populism from his campaign, which will let him cruise easily to victory.
Expect him to make no movement towards UHC, and expect him to privatize Social Security.

Posted by: MarkL on February 5, 2008 at 6:56 PM | PERMALINK

No surprise if you've decoded Obama's overarching strategy and its relation to policy.

Posted by: RonK, Seattle on February 5, 2008 at 7:16 PM | PERMALINK

the strong words "lying" "deceit" don't belong in a debate this important
No one in US has succeeded in Universal Health Care and there are legitimate differences of opinion

The words "mandate" and "garnishing" wages which come with the Clinton plan and anethema to a lot of people and Obama may prove to have been very wise to avoid these

David Brooks had an important piece "The Cooper
Concerns" that is an important read

http://www.nytimes.com/2008/02/05/opinion/05brooks.html?em&ex=1202360400&en=1fb0ebeb0aa7e9a6&ei

Obama may very well have the better plan

Posted by: alison weil on February 5, 2008 at 7:18 PM | PERMALINK

Mark L

he was rated most liberal senator - and then compared to Reagan

He is not black enough to some and too black to others

Obama is a true progressive - look at his record but to get elected and bring the country together and succeed - to be tranformational and have multiple years of a progressive agenda - he cant and we cant demonize other ideas

The idea is to be in power - listen to others and then do what you want

Unlike Hillary who feels the constant need to prove she is the smartest person in the room by monopolizing every conversation and having to be the last word on everything -- Obama IS the smartest person in the world and confident in that.

You hear about Obamicans - republican crossovers - but other than Ann Coulter - there will never be Clintonicans --

Progressives need a majority to get things done--

Posted by: Barbara Levin on February 5, 2008 at 7:23 PM | PERMALINK

Fuck mandates. Oh, and btw, fuck Ezra too.

Posted by: Econobuzz on February 5, 2008 at 7:32 PM | PERMALINK

My theory is that Obama did not include mandates bcz young people are among those most likely to "put off" buying health insurance, unless it's provided as part of their jobs. And Obama is courting younger voters.

Otherwise, I don't see one whit of advantage to this line of bull crap.

I heard his heathcare plan adviser on To The Point yesterday, and the guy was almost as vague as Obama. Wants to move "incrementally," slowly toward greated coverage of Americans. So, we're back to the 80's. Thanks a lot, adviser!

Posted by: jawbone on February 5, 2008 at 7:38 PM | PERMALINK

The word "mandates" is probably just another incomprehensible academic term to the average voter -- the real question is how the Republicans will translate it into easy-to-understand words.

That's where politics meets (and trumps) economics.

Posted by: JS on February 5, 2008 at 7:45 PM | PERMALINK

Franklyo & others: Actually Ezra is being less then fully honest. Medicare is currently mandated for those 65 & older & drawing SS retirement income. You may opt out of Medicare, but must pay a hefty premium to opt in eventually, which is then taken out of your SS check every month.

OK. My SS check (& total income) is currently $850/mo. When Medicare kicks in at age 65, I will be forced to have about $100/mo taken out of my already small check for just the basic Medicare(w/o parts B or D or whatever). IIRC, that amount is fixed, regardless of my income.

Obviously, I am very dubious about mandates considering the choice I face in a little over a year. I have no desire to see an even larger payroll deduction due to whatever Health care plan becomes law. Until I can see the final draft of any such plan, I will be very skeptical of any mandate proposal.

Posted by: bob in fla on February 5, 2008 at 8:07 PM | PERMALINK

I believe Obama has made a political campaign calculation to avoid the dangerous minefield of discussing the details - such as mandates - of how universal healthcare might actually be implemented. Clinton has already tripped into that minefield by making the terrible mistake of suggesting that folks might have their wages garnished to pay for her "mandates." Now she's guaranteed the Rethugs an effective attack ad campaign in the fall if she's the nominee. Obama is not going to follow her into that minefield when it's all an academic exercise anyway - it's Congress that will ultimately establish the nature and details of a revamped healthcare system. It's that herd of cats that we have to pressure to do the right thing once we have a much larger majority than we do now.

I would also suggest that we should be talking not about mandates but how it will just simply be "transfers" of money folk are already spending on uncertain and iffy healthcare to a new and expanded more assured system with even more real choice. After all, with the amounts we spend per capita on overhead and 9 figure health industry CEO salaries we ought to have plenty of funds to work with. It looks to me that the policy wonks have been listened to more that the message framers on this campaign issue.

Posted by: Ian S on February 5, 2008 at 8:20 PM | PERMALINK

I think that the comparison is quite apt. When you want to mandate the purchase of health insurance to get rid of the uninsured, that is very like requiring those without housing to buy or rent so you can eliminate homelessness.

Insane. With no money, no purchase is possible. Garnishing crap wages will only make people starve or get them evicted -- but insured!! oh wow!!

Worse than insane.

Posted by: Scorpio on February 5, 2008 at 8:27 PM | PERMALINK

HEY!

Duh.

He won't stop because it's a great line! It is brutally easy to understand, even if it oversimplifies to the point of dishonesty.

Posted by: mirror on February 5, 2008 at 9:08 PM | PERMALINK

Out here in wingnut land, that sort of thing plays real big. Any and all mention of changing one iota of the current system brings a thunderous chorus of "socialized medicine!" from people who aren't even registered to vote, who barely even know the names of the candidates (one of them thought Huckabee was a Democrat). By taking this line and pandering to those people, Obama demonstrates again what turned me out of his camp. He's supposed to have all these great oratorical skills, supposed to be on a mission to be an "agent of change," but he just refuses to take the political risks it's going to take. He has made an implied comaprison between himself and Reagan, but there really should be no comparison. Like him or not, Reagan went out and attacked the status quo. Obama flinches away when it comes to doing that, and that won't change a thing. Those of us who want change are left with the hope that he's lying about it all, that once he gets in office he'll actually do something to get people healthcare, regardless of his current rhetoric. That's not a good thing to have to hope for. In effect, we have to hope that the guy is just a good liar.

Posted by: Martin Gale on February 5, 2008 at 10:02 PM | PERMALINK

Obama will say what he thinks will get him a vote. He and his advisers know, national health care will have to be mandated, just like car insurance. Young people would most likely be covered with the parents as long as they are dependents, like students, and have no income of their own.
So far, Obama has not even served a full term in the Senate. We don't really know much about him. Maybe a few years down the road he will be ready to become president, just not now.
Just to give good speeches just is not enough.

Hillary has the potential to become a great president. There is a huge job to be done after Bush. I don't believe Obama could handle it, not yet anyway.

Posted by: Renee on February 5, 2008 at 10:17 PM | PERMALINK

The emphasis should be on affordable. Hillary talks of people being able to pay and don't.And Obama is fogy about back pay premiums, Medicare part D has penalty payments for seniors who don't sign up immediately too. Past performance is a better guide to help decide, no stump speech or TV ad will inform you.

Posted by: Renee on February 5, 2008 at 10:31 PM | PERMALINK

I have insurance through my employer. The insurance companies only administer the plans; they don't pay the claims; the company is self-insured and pays the claims itself. Despite this separation of plan administration and payout responsibility, I still have had the most incredibly frustrating experience in getting legitimate claims even recognized by the plan administrator despite repeated submittals, year-long delays in getting claims paid, endless follow up on my part, which inevitably takes away from my focus on my job. I have to act as an unpaid liason between the insurance company claim processors (or claim deniers, more accurately), healthcare providers, and my company HR department. Speaking of which, if it weren't for the healthcare red tape hassles, my company could probably cut the overhead HR department in half.

And now all the policy wonks want to mandate (!) that everyone buy a policy from these same insurance companies that have been responsible for so much waste, red tape, and cost-shifting to other parties, basically creating a fee paid to private companies for simply being alive. And this is advocated by the supposedly more liberal party in the U.S. It's nuts!

Posted by: Bob on February 5, 2008 at 11:36 PM | PERMALINK

That's sort of sad. You don't know what your candidate believes and you vainly struggle to understand Obama's words when they contradict the Obama in your dreams.

Expect the cognitive dissonance to increase when Hillary drops out. When he starts courting independents in earnest you'll have to be satisfied with the stump speech.

Posted by: B on February 6, 2008 at 12:13 AM | PERMALINK

They've been talking mandates here in New Mexico, and from what I gather, the only thing more abhorrant than not having medical insurance is having mandated medical insurance. Believe it or not, there are some people who don't like the concept.

Posted by: Varecia on February 6, 2008 at 12:41 AM | PERMALINK

I think he keeps talking about it because he's a self-obsessed narcissist. He can't stop obsessing over any criticism. His stump speech still includes complaints about the debate question on each candidate's greatest weakness (he said he wasn't a paper person and Hillary took advantage of that). Of all the trivialities, who cares, yet he can't stop talking about it.

Posted by: Amelia on February 6, 2008 at 12:54 AM | PERMALINK

Sorry, Kevin, but I agree with Ezra. Obama clearly knows better, and the issue's getting under his skin.

As for Hillary, tis true, mandates alone are, if you will, antiliberal.

Where's the VOUCHERS? That's the only way you can do a play that's not top-down single-payer and have any sort of real progressivism to it.

Another good reason to vote for neither one of them; from either one, we're going to get some unfunded, unprogressive clusterfuck.

Posted by: SocraticGadfly on February 6, 2008 at 1:19 AM | PERMALINK

Obama is making an analogy. Now, an analogy can be more or less apt, but it's not even possible for an anaology to be a lie!

Posted by: Gene Callahan on February 6, 2008 at 9:38 AM | PERMALINK

Obama is making an analogy. Now, an analogy can be more or less apt, but it's not even possible for an anaology to be a lie!

Gene, Obama's supporters are like Mao's Red Guard youth who turned against their own family, even sometimes sending them off to re-education camps, in service of some fanatical, misbegotten cause.

But don't worry, that's only an analogy! Depends on how you interpret it!

Posted by: frankly0 on February 6, 2008 at 11:03 AM | PERMALINK

The Obama campaign is masterful at what we call "sell copy" in the marketing business. I think he's got a lot of offer as a candidate, but I still can't point to any specific steps that's he's going to take to accomplish some of these big goals he lays out. It's great to say he'd like that single-payer model if he were starting from scratch. But, hey, so what? He's not starting from scratch. I want to know how he thinks his proposal is going to get us from the insurance stranglehold toward single-payer universal access. Until he offers more on that score, this Democrat's not signing on for Team Obama.

Posted by: louise on February 6, 2008 at 11:12 AM | PERMALINK
But why continue to push this line so hard in settings where he could brush it off if he wanted to?

Because its an important point, and he's right.

Has he drunk his own Kool-Aid so much that he's genuinely convinced that mandates are evil?

Individual purchase mandates are "evil", in that they make it much more likely that there will be popular revulsion against health-care subsidy programs as a whole if they are implemented and the subsidies are ever miscalibrated than if such programs are implemented without individual purchase mandates.

It adds punishment on top of policy failure to the people the miscalibration causes the policy to fail.

He knows he's going to get attacked by potential supporters every time he brings this up, so why not just soft pedal it?

He know's he's going to get attacked by "potential supporters" (i.e., other Democrats that are not actual supporters) anytime he says anything critical of Hillary or her policies. So perhaps, extending this logic, he should soft-pedal everything: an approach Democrats seem to be fond of failing with in general elections extended to the primary.


Posted by: cmdicely on February 6, 2008 at 1:14 PM | PERMALINK

I believe Obama sees himself as morally above the kind of lobbying that Hillary's mandates invite, and that he won't have his WH come down to that level.

Posted by: albert geiser on February 6, 2008 at 1:39 PM | PERMALINK

"Franklyo & others: Actually Ezra is being less then fully honest. Medicare is currently mandated for those 65 & older & drawing SS retirement income. You may opt out of Medicare, but must pay a hefty premium to opt in eventually, which is then taken out of your SS check every month.

OK. My SS check (& total income) is currently $850/mo. When Medicare kicks in at age 65, I will be forced to have about $100/mo taken out of my already small check for just the basic Medicare(w/o parts B or D or whatever). IIRC, that amount is fixed, regardless of my income."

Bob, you're an idjit about this. Luckily for you, there is currently no tax on ignorance.

Medicare comes in two parts, Part A (chiefly hospital) and Part B (chiefly doctors). We'll leave out Part C (optional Medicare HMOs) and Part D (optional drug coverage) for now.

Part A is free if you are eligible for Medicare and get a monthly Social Security check. Since it's free, there is no provision to "opt out" of Part A. People who don't qualify for Social Security checks have to pay for Part A.

Part B, on the other hand, is not free and requires a monthly premium to be paid. You can opt out of Part B when you first become eligible, but if you join up later your premium is increased by a penalty for late enrollment.

So, Bob, Medicare (that you pay for) is not mandatory. You are not forced to buy Part B, and you do not pay for Part A.

Posted by: solar on February 6, 2008 at 2:06 PM | PERMALINK




 

 

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