September 20, 2008
MARKET-BASED HEALTHCARE.... There have been plenty of comments John McCain has made over the course of the campaign, which he now regrets. Admitting he doesn't understand the economy certainly ranks right up there; calling Social Security a "disgrace" has to be in the top five; and his dismissal of those who seek national office after a short time as a governor certainly looks embarrassing.
But this is a real doozy. Here's McCain, very recently, on the benefits of market-based health reform:
"Opening up the health insurance market to more vigorous nationwide competition, as we have done over the last decade in banking, would provide more choices of innovative products less burdened by the worst excesses of state-based regulation."
As Paul Krugman explained, "McCain, who now poses as the scourge of Wall Street, was praising financial deregulation like 10 seconds ago -- and promising that if we marketize health care, it will perform as well as the financial industry!"
Josh Marshall added, "If the Obama folks are smart -- and they are -- they'll ride this one all the way to the election. But among ourselves let's admit that you could only be surprised by this statement if you were willfully ignorant to what McCain and his key advisors believe. Remember, his top economics advisor is former Sen. Phil Gramm, the legislative architect of the banking and financial services deregulation that led to the current crisis. And his health care proposals are all off-the-rack Heritage Foundation-style initiatives based on the premise that people have too much, not too little insurance."
Also note the very clever approach from Anonymous Liberal: "[I]f we bring the same approach to health care that we brought to the banking industry, maybe in eight years or so, our health care system will completely collapse and the government will have to step in and take over. Voila! A national health care system. Brilliant."
We'll be hearing more about this. McCain will have trouble living this one down.
—Steve Benen 8:05 AM
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Hope this is played to the full.
Posted by: JS on September 20, 2008 at 8:18 AM | PERMALINK
You know...I think John McCain -- because of all these self-inflicted wounds -- is probably getting close to whatever he feels is his 'nuclear option' in this election.
I mean, what else is left? Palin's trajectory is clearly downward. (If she was a rocket they'd push the self-destruct button and start over.) McCain's own credibility is faltering, and on the economy -- which nobody trusted him on much anyway -- he's now a cartoon.
So what does he do to change the discussion? Attack Obama on race? Question Obama's patriotism? His religion? All of the above?
McCain is exactly the kind of guy who could walk up to a microphone and utter the most insane charge with complete sincerity, even as he knew he was lying. Just ask Mitt Romney.
I look for big, big things from John McCain in the debates. The kind of things we haven't seen for a while. Like, maybe in our lifetimes.
Posted by: The Phantom on September 20, 2008 at 8:26 AM | PERMALINK
It's interesting that in the same article ("Contingencies"), McCain calls for more transparency and accountability, while saying we need to clamp down on "frivolous" law suits. As my father used to say, "I see, said the blind man."
Posted by: Danp on September 20, 2008 at 8:28 AM | PERMALINK
*
Posted by: Eric Blair on September 20, 2008 at 8:33 AM | PERMALINK
and my friends, why stop at Health care, let's also include Social Security. Could you imagine the success we could have achieved to Social Security that we brought to the banking industry. I just regret that Senator Obama and his Democratic friends did not reach across the aisle three years ago and enact the kind of Social Security reform that I was for.......
Posted by: mkrrpc on September 20, 2008 at 8:37 AM | PERMALINK
"So what does he do to change the discussion? Attack Obama on race? Question Obama's patriotism? His religion? All of the above?"
He tried questioning Obama's patriotism before the DNC, which Obama denounced forcefully in his acceptance speech. As to the other two: given the present mood of, even, much of the serious conservative media toward McCain's campaign, unless there's some skeleton the size of a plesiosaur left to be dug out of Obama's closet, McCain's using race or religion as wedges against Obama will be seen as the unseemly attacks of a desperate, already-sullied candidate.
Posted by: John B. on September 20, 2008 at 8:38 AM | PERMALINK
We'll be hearing more about this. McCain will have trouble living this one down.
We'll be hearing more about this if the so-called "liberal media" calls attention to it. But while McCain's lies have become so blatant that the MSM is now compelled to point them out, pointing out that McCain's -- and Bush's -- movement conservative ideology is idiotically unworkable is not somewhere the media seems willing to go.
Posted by: Gregory on September 20, 2008 at 8:43 AM | PERMALINK
Eric!
Stop bothering these good people with your Limbaugh quotes! And clean your room!
Posted by: Eric Blair's mother on September 20, 2008 at 8:48 AM | PERMALINK
If McCain is put out to pasture he doesn't need to worry about getting run through the rendering plant -- there just ain't no glue left in the old stud.
Posted by: lou on September 20, 2008 at 8:51 AM | PERMALINK
Eric
I would like to see citations. I heard this trash is a board meeting a couple of days ago.
If I understand what you are saying the housing crisis was "caused" by Bill Clinton and the Democrats or some such nonsense. Bankers were forced to make sub-prime loans by evil liberal social engineers. Yeh, right.
This crisis is squarely on all of use going all the way back to Reagan. We decided that government was evil. We, lead by Republicans, but really all of us, decided that our financial system would be would be better without pesky rules and regulators getting in the way. Imagine that college football game you are going to watch today without Refs and without rules. Yep, that is what the likes of Phil Gramm and John McCain believed in until about last Monday. That is what we got.
Our country is sinking fast into second world status. It might take us decades to recover. For those of you who cleave to the Heritage Foundation tripe, from those of us trying to find a bank to fund a simple short term, totally routine but unbelievably necessary business line of credit so we can pay our bills and our employees on time thanks a bunch. Go f**k yourselves. If the board member who tried to blame the liberals for our current mess hadn't been someone I need to work with I would have told him to go f**k himself too.
Posted by: Ron Byers on September 20, 2008 at 8:53 AM | PERMALINK
McCain seems to have very little trouble living anything down. POW! works well enough despite its overuse. And for all the talk of a compliant media finally waking up to the farce that is John McCain he still is granted second helpings of deference and fawning in the buffet line. There have been several whoppers, embarrassments and lapses in judgement on his part. Have ANY of them become a signal moment, a defining shortcoming in the minds of the electorate? There's been no Ford/Poland or Dukakis/tank event, no crippling faux pas. I say he continues to get a pass. Will the combined weight of all these idiocies crush him eventually? Hmmm. POW!! Be off with your impertinence!!
Posted by: steve duncan on September 20, 2008 at 8:57 AM | PERMALINK
McCain needs to retire and enjoy his "out to pasture" days just like America needs to "retire" all the stupid, corrupt Republican ideology that got us here.
Posted by: Glen on September 20, 2008 at 8:58 AM | PERMALINK
For goodness sake the institutions that lead to this meltdown were REGULATED by Government officials and under federal regulated guidelines.
I don't know what institutions you think you are talking about Eric - you didn't specify - but all legal entities private and public are regulated by the government in one sense or another. We live in a nation of laws after all. However, if you are talking about Fannie Mae and Freddie Mac, these were, in fact, formerly public entities that were privatized as part of the process of removing most of the regulatory restrictions that are normally present in public institutions. It is certainly arguable whether it was their de-regulation that was specifically to blame for the problems that occurred in those two institutions. But it is also clear that when one argues conversely that the problems were specifically caused by too much regulation than one is either being disingenuous or they do not know what they are talking about. I suspect a combination of both based upon your comment.
[Ignore the Orwell/Eric Blair troll - he has never offered a single comment of substance so all of his comments are reflexively deleted. --Mod]
Posted by: brent on September 20, 2008 at 9:03 AM | PERMALINK
So it seems I've arrived a tad too late and Eric's comments have been deleted.
Who decides which comments should be deleted and on what basis?
Posted by: Old School on September 20, 2008 at 9:12 AM | PERMALINK
Anon Lib is cute but not that clever. Unless there is a strong alternative ideology to contend with and/or the threat of uncontrollable violence that directly affects them, the plutocrats and their wannabes will never bail out the lower half on healthcare. Even if the system 'collapsed', the upper half would get their care. The system is to big and varied to just vaporize. The number of uninsured may jump to 100M?, but hey that's just the market at work. Like most everything(rights, education, economic prosperity) about the American dream, health care is dissolving like that slow boiled frog.
Posted by: Michael7843853 on September 20, 2008 at 9:22 AM | PERMALINK
Beyond McCain's comments being very stupid, they also are an attack upon the GOP issue of "states' rights"/federalism. Until now, insurance regulation has been the province of the states. McCain wants to blow that up, allowing an insurer licensed in one state to issue policies in another.
This is a truly horrible idea for the country, and would cause a race to the bottom. If California has a reasonsible insurance commissioner who demands that insurance companies be adequately capitalized, right now insurance companies must comply if they wish to compete for California policyholders. But, if McCain's plan were to be adopted, one lax insurance commissioner (say in Idaho or Alaska) would set the floor for the entire nation. In addition, there would be a strong financial incentive for each state to make their regulations as loose as possible, in order to encourage insurance companies (and the billions of dollars in assets that they control) to locate in that state.
McCain's prescription for healthcare is a recipe for yet another disaster.
Posted by: Ephus on September 20, 2008 at 9:26 AM | PERMALINK
It's hard to decide which is more astonishing, this, or "the fundamentals of our economy are strong". I say tie the two together and body punch McCain with it all the way to Nov.
The fundamentals of our economy are strong...
And if we can do for health care what we've done for banking...
Posted by: JoeW on September 20, 2008 at 9:27 AM | PERMALINK
"McCain will have trouble living this down"?
Really? And we'll see that, what, reflected in his lower polling numbers?
From your lips to God's ears. And who knows it does feel like the worm is well and truly turned in some ways.
But more than half the people in Ohio have a very different view of things. Let's see if they won't let McCain "liv[e] this down."
Posted by: Jim Pharo on September 20, 2008 at 9:37 AM | PERMALINK
I am not a fan of McCain or his health care reform plan, but that statement on its face is not quite as awful as it sounds.
Right now health insurers must follow 50 different states' regs as well as some federal regulation. I'm not against regulation, far from it. Insurance is all about all the players getting their fair share of risk, and those regs play a strong role in protecting BOTH company and consumer. However in an industry wholly dependent on its systems, 50 different volumes of regulations is a nightmare to comply with. Creating and updating systems that can execute the regulations every time a state makes a change in their laws is frequently an expensive proposition, one the consumer ultimately shares in.
In the course of my job I often get asked which mandates cost money for someone's white paper, lecture, whatever, but I can almost never find mandates that we wouldn't cover anyway. Who cares if a state mandates mammography? I couldn't imagine not covering them in a product - it wouldn't be marketable and it would ultimately cost the insurer more money. Most mandates are things we would cover regardless, so I don't see that as an issue. Mandates in an of themselves are good consumer protections and good protection against the bottom feeders. Ideally they should not be a big deal to companies doing their job correctly. What is an issue is 20 different variations in contract language and claim adjudication (all amounting to the exact same level of coverage) dictated by 20 state state mandates that a SYSTEM now has to administer correctly by state AND get the extraterritoriality (ET) laws down correctly. What was common sense is now an expensive nightmare.
Part of the reason Medicare works so cost efficiently on administration is not because the government runs it (because not surprisingly it has private sector contractors handling a good chunk of this) but because there is ONE set of rules and regs and ONE basic core product. I doubt the non-Medicare working population is ready to give up choice and diversity for Medicare product structure, but having one overarching set of rules/regs set by the feds would sure make for more efficient administration in the private sector and allow for more product innovation. It would also set up systems and processes for an easier transition into national health care, although I'm pretty sure that isn't an aspect the McCain camp would like to acknowledge.
Posted by: tds on September 20, 2008 at 9:41 AM | PERMALINK
In response to tds, if we traded 50 state regulation of insurance for Washington-based regulation, that might (but only might) be a good thing. But doing what John McCain suggests, and allowing out-of-state insurers to sell into a state without creating a national insurance commissioner will inexorably push us to disaster.
McCain's prescription for healthcare is a recipe for another disaster.
Posted by: Ephus on September 20, 2008 at 9:51 AM | PERMALINK
I am not a fan of McCain or his health care reform plan, but that statement on its face is not quite as awful as it sounds.
While I'm inclined to agree with you on this one particular statement by McCain, his overall "plan" for healthcare (if you can call it that) is indeed a whole lot worse than this one statement indicates, and buried in this statement is a glaring contradiction of massive proportions.
First, as to this statement and the underlying off-the-rack Heritage Foundation plan that inspired it: I do believe that some people have more insurance than they need, and that as a result, there is a not-insignificant number of people who overuse medical services. I'm referring to the people (and we all know a few of them) who run to the doctor for that antibiotic prescription whenever they have the sniffles. I personally have what I call "hit by a bus" insurance: the deductible is fairly high to keep the premium low, but once I get to that deductible limit, the coverage is 100%. It's more of an asset protection policy than it is something that will pay out every time I make a trip to the doctor. As a consequence, I only go to the doctor when I really need to, but in the case of a catastrophic illness, my out-of-pocket would be limited to the $5K deductible, which would keep me from losing the house, assuming of course that the insurance company didn't decide to get cute and try to deny coverage, which they not only try but get away with doing in way too many cases.
This is where the McCain "plan" really sucks, if we are to take him at his word about what it's intended to do: McCain has stated that his plan is designed to get people out of employer-provided plans and into the market shopping for "the most economical plan" as an individual. If McCain wasn't so out of touch and such a putz, he'd realize that a large number of people who currently are uninsured don't have insurance because no one will insure them as an individual thanks to often very minor events in their past medical history. People in this situation, as well as people with more serious or chronic health conditions, have only one hope for being insured, and that's getting in under a group policy where they can't be turned down. There's nothing I've seen in McCain's "plan" that would require insurance companies to insure all comers, and even if there was, many individuals would find that the premium rates they are offered would put the insurance out of reach. In other words, it's a "plan" that could only succeed in making the uninsured situation far worse without massive regulation and oversight to a)force insurers to cover risk at an affordable rate and b)looking over their shoulders to make sure they don't deny claims willy-nilly in order to protect their hefty profit margins.
In short, it's not a "plan" for reducing the number of insured in any sense of the word, and to make it worse, he's proposing to tax the health benefits that those fortunate enough to still get employer-supplemented insurance are still receiving. The McCain plan wouldn't really accomplish anything at all, other than to create more uninsured people and cost everyone else more for their health insurance.
Since the preceeding is far too complicated for any candidate or campaign to ever fully explain to voters, I think the best bet is for Obama to run ads alerting people that the McCain "plan" for "solving the health care crisis" is to tax people for the health benefits they get from their employer. While this is only one part of the McCain "plan", it illustrates how out-of-touch and awful the entire idea is in a way that voters can easily grasp, and it is, in fact, true. Maybe an ad centered around the idea of McCain being clueless to the plight of the uninsured that inserts this as the "how out of touch? here's an example" format, as in "John McCain believes that one of the biggest problems with healthcare is that you don't pay taxes on the insurance your employer provides." You know, real red meat stuff with a whiff enough of the truth to illustrate the awful unworkableness of what he wants to do.
Posted by: Jennifer on September 20, 2008 at 10:22 AM | PERMALINK
This, along with McCain's suppert of privatizing Social Security, should become the cornerstones of the Obama campaign right untill election day. McCain is desperately trying to turn things back to the twight zone distrations of the other week. He can't be allowed to set the agenda again. Obama should hammer him on these every day. THIS is something that resonates with the the everyday voter.
Posted by: Saint Zak on September 20, 2008 at 10:27 AM | PERMALINK
tds has it right. The number one problem we have with health care in this country is insurers. There needs to be a single system with a single set of codes and procedures. And it needs to be non-profit. No more CEO bonuses based on cutting care to people who've paid their premiums.
Posted by: Art Eclectic on September 20, 2008 at 10:39 AM | PERMALINK
Art Eclectic - I agree with you, but go one step further: health care is not a suitable industry for profit. Any time you set up a system whereby someone will profit by denying someone else the care they need to stay alive, you've created an incentive for not providing care and allowing people to die, which is of course at odds with the whole notion of health care to improve and prolong our lives.
It's not a workable system; the profit motive is so completely at odds with the notion of providing individuals with appropriate care that we should just do away with it altogether and nationalize health care.
Posted by: Jennifer on September 20, 2008 at 10:52 AM | PERMALINK
if you were willfully ignorant to what McCain and his key advisors believe..............
************
this of course describes ANYONE who would vote for/ 'believe' in McEvil and his Bitch Palin ... willfully ignorant ... that is indeed what is so fucking scary about these people .. no matter how much they are exposed to the actual reality or truth of McEvil .. and the Repiglicans in general .. they more they dig their heels in and MAKE THEMSELVES BELIEVE IN THE LIES AND DECEPTIONS, THE DELUSIONS AND ILLUSIONS, of the charade called McEvil ..........
Posted by: stormskies on September 20, 2008 at 10:59 AM | PERMALINK
Yes, I have noticed that Krugman, Delong, and others have become down right communist in demanding the federal take over of something like another 10% of the economy in the last few days.
We are headed toward 30% of the economy in federal hands which collects 19.7% of the revenue.
It will take another 4 year, minimum, to straighten this out, and expect interest payment on the debt to approach $500 billion a year near the finish line.
That deficit will not hold, and after this is digested, we will enter an "overshoot" where taxpayers shut down a good chunk of the federal and state spending.
You cannot assume that one side won, you have to assume that the point is coming in which the "other side" takes over, a point progressives never seem to understand.
Posted by: Matt on September 20, 2008 at 11:11 AM | PERMALINK
Mark Kleiman -- who I quote so often because I get RBC updates in my e-mail, and because he is one of the five bloggers (with Steve, Hillzoy, Ezra, and Ed Brayton) I read regularly -- had the following comment about McCain's heath 'plan.'
"I spent last weekend with a group including a brilliant conservative health policy wonk, who argued that the virtue of the McCain plan was that it would so wreck the existing system as to create the crisis required for a move toward single-payer. I can understand why confronting the current mess could generate a Leninist worse-is-better mindset, but, I repeat, this is not a serious candidate for President."
The whole piece is at
http://www.samefacts.com/archives/health_care_/2008/09/unbeforkinglievable.php
and compares both candidates' health plans.
Posted by: Prup (aka Jim Benton) on September 20, 2008 at 11:21 AM | PERMALINK
What is an issue is 20 different variations in contract language and claim adjudication (all amounting to the exact same level of coverage) dictated by 20 state state mandates that a SYSTEM now has to administer correctly by state AND get the extraterritoriality (ET) laws down correctly. What was common sense is now an expensive nightmare.
It's funny -- this is exactly the same complaint my husband has from the other side. They deal with something like 10 or 20 different insurance companies, all of which have different rules and rates of reimbursement. They have to have a team of people dedicated to deciphering what is covered and what isn't by that specific insurer.
Single payer. It's the way to go.
Posted by: Mnemosyne on September 20, 2008 at 11:23 AM | PERMALINK
It's not a workable system; the profit motive is so completely at odds with the notion of providing individuals with appropriate care that we should just do away with it altogether and nationalize health care.
Amen. I spent twenty-plus years in the belly of the beast and it radicalized me. If I could be dictator for a day, I would have exactly one item on my agenda. I would federalize the healthcare system in this country and be done with it. And since the jobs are high-stress and physically demanding, I would give healthcare workers the same retirement deal that members of the military have.
Posted by: Blue Girl on September 20, 2008 at 11:32 AM | PERMALINK
I'm starting to wonder if the entire GOP isn't a Communist front group at this point, bound on nationalizing the whole economy one piece at a time.
Posted by: Mike Jones on September 20, 2008 at 12:05 PM | PERMALINK
Anonymous Liberal's point can be extended. The US has just entered public housing in a truly gigantic way. I'm not unhappy to see a government provide public housing for its least wealthy citizens and to engage in jobs-promoting programs of building inexpensive but well-built housing, but the US is likely to be going about this in the worst of all possible ways. We are likely to be buying up the worst and most overpriced housing, in the process bailing out some very wealthy citizens, banks, and investment companies who made bad mortgage investments, and the government (not believing in public housing but being very comfortable with cronyism and subsidies for the rich) will no doubt try to resell the properties quickly, at rock-bottom prices, thereby favoring wealthy investors the most.
Posted by: N.Wells on September 20, 2008 at 12:43 PM | PERMALINK
McCain will have trouble living this one down.
I can see it now: WALL STREET MEDICAL CARE---COMING TO A DRIVE-THRU BEER-AND-WINE CARRYOUT NEAR YOU!!!
Imagine that you---or a family member, a neighbor, or a friend---go in for surgery. Halfway through the procedure, your coverage value depreciates to the point that it's worthless, while the cost of the procedure goes up.
The surgical team suddenly finds itself unemployed, and they leave for home with their instruments tossed into cardboard boxes---while the patient is still on the surgical table, looking like a half-filleted rainbow trout and laying wide open for all the world to see....
Posted by: Steve on September 20, 2008 at 1:08 PM | PERMALINK
Yes, I have noticed that Krugman, Delong, and others have become down right communist in demanding the federal take over of something like another 10% of the economy in the last few days.
Posted by: Matt on September 20, 2008 at 11:11 AM | PERMALINK
Errr Matty, Krugman came out against the plan. Look to your side of the aisle for who is pressurizing house and senate democrats to get it done right away. Tool.
http://krugman.blogs.nytimes.com/2008/09/20/no-deal/
Posted by: Northern Observer on September 20, 2008 at 10:24 PM | PERMALINK
Anonymous Liberal is on the right track.
How about Obama running an ad claiming that McCain is FOR a National Health care plan... in about 8 years. Explain that a McCain administration would do exactly the same deregulation his economic advisers have done for the banking industry. In less than a decade, the government has been taking over and bailing out financial companies. ... Then ... Obama appears on the screen and explains that he would cut out the decade long wait by avoiding the bail outs and give us a a comprehensive health care plan without all the greedy corporate excesses witnessed in the financial sector's collapse.
Posted by: bruno on September 20, 2008 at 10:32 PM | PERMALINK
I'm starting to wonder if the entire GOP isn't a Communist front group at this point, bound on nationalizing the whole economy one piece at a time.
Pretty much, except for the things that might actually benefit real people, like education and health care.
Posted by: on September 20, 2008 at 10:45 PM | PERMALINK
Did you see the Bunk study stating 2/3 of doctors in America want National Health Care. The doctors who did this study also conducted one in 2002 and found that the majority of doctors did not want national health care, the problem with this is that the 2 question surveys drastically differ in there 2nd question. I found this article, 60% of Physicians Surveyed Oppose Switching to a National Health Care Plan, It's worth a read.
Posted by: Matt on September 21, 2008 at 3:46 AM | PERMALINK
"Innovative products"? Hmm, imagine a health-care derivatives market...cancer default swaps, anyone?
Posted by: Nancy Irving on September 21, 2008 at 4:58 AM | PERMALINK