What's wrong about progressive lines of attack on the health care bill

by: Adam Bink

Tue Dec 22, 2009 at 11:15

There is something that has been getting at me lately, and that is how some progressives choose to attack the health care reform bill. One of those principal routes is by attacking the mandate as "forcing people to buy insurance they don't want". Here's the first reason on Jane Hamsher's 10 reasons to kill the Senate bill:

Top 10 Reasons to Kill Senate Health Care Bill

  1. Forces you to pay up to 8% of your income to private insurance corporations - whether you want to or not.

PCCC/DFA has a poll out asking "Would you favor or oppose requiring all Americans to buy health insurance -- the so-called mandate -- even if they find insurance too expensive or do not want it?" with the results of 51% oppose, 38% favor.

Now, I have enormous respect and appreciation for the work Jane, FDL, PCCC and DFA have done on health care reform, and respect arguments on the basis of affordability, which is one part of this poll question. But this business about "whether you want it or not" is one step too far.

I explain why on the flip.

Adam Bink :: What's wrong about progressive lines of attack on the health care bill
In the first place, the messaging comes right out of the right-wing playbook. Conservative libertarian types have argued for years against mandatory participation in programs like Social Security on the basis of "the government is going to take part of your paycheck- whether you want it to or not! Tell the liberals you can make your own choices!" Making the same arguments on health care is echoing right-wing frames.

In the second, I don't care if people don't want health insurance. Do I care when people- young people just getting their first paychecks, libertarians, etc.- complain about being forced to pay into Social Security and Medicare when they don't want to? No. Pay up, folks.

Why do I say that? Because social insurance programs do not work without mandates. There are ten thousand pages worth of academic and policy economic literature on this issue. If you argue against the economic logic of mandates, or do polling just to demonstrate how much Americans hate mandates, you, as a progressive, really have no leg to stand on when arguing for compulsory Social Security, Medicare, Medicaid, worker's compensation, and so forth. None of those programs would work without a mandate.

In the third, Americans "don't want" a lot of things. I mean, I get that good people are trying to do anything they can to defeat the bill. And I no doubt have, or will, done or ignored polling results that fit my goal. For example, if we had 70% against the public option, no doubt progressive activists would be saying Americans just don't understand health care markets, and still push it anyway. Such is politics.

But one thing I can't deal with is polling Americans on academic policy concepts they don't understand, like health care mandates, and pretending like they have any clue what they're talking about. Hell, if I ran the question "Would you favor or oppose the government, without your consent, automatically deducting money from your paycheck- the so-called "Medicaid" proposal- to give to the poor, even if those receiving money do nothing to help themselves?" at the time of legislative passage, what kind of results do you think I would get? Americans don't understand concepts like risk pooling, adverse selection, moral hazard, information asymmetry, the health insurance death spiral, which are essential to understanding health care markets and the importance of a mandate. Hell, I only understand them myself because my boyfriend is a health economist. So I am certainly not going to honestly point to a poll result and say Americans know what's best for themselves when they seriously don't understand the background of the policy.

And frankly, if this were a wonderful bill with a public option and cost controls and good affordability, I would throw down money to bet a lot of progressive activists would tell conservatives opposed to the mandate, "tough shit, it makes economic sense!".

Now, that doesn't mean you can't attack a mandate. If you want to attack a mandate based on progressive principles, by all means. Talk about how Americans shouldn't have to buy insurance they can't afford. Do what Jim Dean did and talk about forcing people into the arms of the criminal insurance companies, and how that's different than a mandate for Social Security or Medicare. There are better ways to defeat the bill than using right-wing frames on choice or pretending the American public has any clue about health insurance markets.

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Insurance Mandate for Individuals: (4.00 / 3)
"Insurance Mandate for Individuals:
It seems that the Senate has privatized the tax system so our taxes go directly to the insurance companies.

By this fact, then can we privatize Medicare in the future and have payroll taxes go directly to insurance companies?" - Scott ffoliott

Right (4.00 / 3)
That is the problem with the bill, the reason I think the public option is so important, and Jim Dean's messaging on this is spot-on. I just think the frame re choice should not be used.

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[ Parent ]
Silly (4.00 / 3)
This is silly.

Social insurance programs via government -- fine. Government serves society, not profit.

"Social insurance" programs via private corporations -- not fine. Those corporations aren't interested in insuring society or the health of people, only profit. So...don't force people to do that.

Pretty cut and dry. Not need for over-analysis.

[ Parent ]
Great (4.00 / 1)
I'm glad PCCC included that important bit of messaging in its polling questions, or in its press statements accompanying the poll results.

Oh, wait.

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[ Parent ]
Social Responsibility (4.00 / 6)
"whether you want to or not" also ignores the fact that we live in a society, whether we like it or not, and that members of this society are at different points in their lives with different needs, as we will be when we're older (or if we're younger). Taking care of the elderly benefits the twenty-somethings whether they realize it or not. We would have a very different society if we did not pool our resources to help each other throughout our lives. Selfishness is wildly over-rated.

This social dynamic also applies to economics. Some times poor people are bums who refuse to work. But the vast majority of times poor people are human beings who never got a break and/or never got an education and/or lost a job and/or had a health emergency, the list of possibilities for poverty is endless. But the major reason for poverty is that our society (and most societies, but ours is particularly bad on this point) creates poverty as collateral damage while creating significant wealth and opportunity for a very small minority of people (the 1% who are wealthy) and some benefit for the majority who are not poor.

Mandates are the way we give back to our communities. That said, mandates must be fair across all income groups. The apparent lack of fairness (e.g. no public option and/or Medicare for All) is the reason I instinctively oppose the mandate set up in the Senate health care bill.

Thanks, Adam (4.00 / 1)
I'm always amazed when I encounter people who don't get this. I wonder who brought them up and/or what is going on in their lives that blinds them to how we all rise and fall together. In my case, you can blame the Jesuits who taught me high school, my parents, and some great grade school teachers. I had this stuff pounded into me early and often. 8-)

[ Parent ]
Why should I pay taxes for schools? (4.00 / 4)
I'm 67, don't have kids.  Why should I pay taxes to support a public University system?  Why should my pension and investment dollars go to pay for Pell grants to poorer students?

Because I am a member of a community and a society and I believe in the future.  Because I believe our society needs more equality, not less.

Adam's post is very important, as is TSlavin's comment.

It is NEVER just about us and what we want.  One of the most corrosive things that has happened to this society since 1980 is the rise of GOP philosophical ideas that are basically just tricked out selfishness and self-absorbtion.  These ideas have become entrenched on the Libertarian Left in destructive way.

It is very important to understand the different roles that people play in the political system and the necessity of having voices that are much more radical than what we eventually get.  And it is important to have compromisers too, so that we do get something.  But we are all in this together, and using arguments that belie our sense of shared responsibility are really not helpful.

John McCain--He's not who you think he is.

[ Parent ]
Seems like you are totally missing the point... (4.00 / 2)
...it is one thing to have a government program that is administered fairly like Social Security which mandates participation by everyone, and quite different to have a mandated program which requires people to pay private insurance companies an enormous percentage of their total take home pay whether they want it or not.  Not sure why you are ignoring the obvious, but I will be damned if I support any legislation that forces me and everyone else to provide huge profits and bonuses to insurance companies and their executives.  I will not vote for anybody who supports it.


Never before in all our history have these forces been so united against one candidate as they stand today. They are unanimous in their hate for me-and I welcome their hatred. - FDR

No, I didn't ignore that (4.00 / 3)
Do what Jim Dean did and talk about forcing people into the arms of the criminal insurance companies, and how that's different than a mandate for Social Security or Medicare.

You can talk about mandates and the difference between the government and private insurance companies without the choice frame.

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[ Parent ]
All I am saying is there should be a choice... (4.00 / 1)
...you should not be forced by law to pay a large portion of your income to a private corporation, especially one known for huge profits and enormous salaries and bonuses for its executives, for something basic like health care.  Those with pre-existing conditions will be forced to buy policies that have up to a 300% surcharge, this will be financially catastrophic for many middle class people.  I really believe this bill is a monstrosity that should be defeated.


Never before in all our history have these forces been so united against one candidate as they stand today. They are unanimous in their hate for me-and I welcome their hatred. - FDR

[ Parent ]
Absolutely (4.00 / 1)
The bill should have been crafted at Olympian altitudes and brought down before the GOP saying "We dare you to block such a gift to the people!"

The way it turned out was that there was no real concept of what America needed, only a well advertised "fall back position" for the Administration which the lobbyists took full advantage of.

Now, the bill is rife with flaws, omissions, and mis-pairings like the one you point out in passing.

We could go on all day, but it is too painful.

Fortunately, the bill is not yet in signatory form, and even when it does become law, it may never go into effect.

For the love of all that is good, may 2010 be a better year!

[ Parent ]
Limited Medicare for All as One Fix (4.00 / 1)
I'd argue we should push Medicare for All for people like the self-employed, unemployed, and small businesses with 5 or less employees, as a way to address the problems of paying money to private insurance companies.

These groups typically get individual policies or have no insurance. When they do get insurance, the administrative costs are way out of line (25-28 cents on the dollar compared to 12-15 cents on the dollar for large group and, of course, 3-5 cents on the dollar for Medicare) and in many cases insurers don't want to cover these people. Folding them into Medicare would be an easy way to get started on moving away from forcing everyone to pay private insurers.

Acknowledging that some people in this country should be excluded also can start a discussion about whether or not everyone should have the option to not be forced to pay private insurance companies. Once you create the structure to expand Medicare, you can expand it more easily than the current binary choice.

[ Parent ]
Pretty week (4.00 / 4)
so this snippet somehow "covers you" for whitewashing the federal government mandating you purchase a monopolistic product from the folks that have bought out the lying liar obama, repugs, and dem leadership?

Sorry - your post doesn't even start to touch the issue and if this snippit is the best you can do, you have actually admitted it.

[ Parent ]
Should be reply to ADAM, not FLGibsonJr (4.00 / 2)
Another thing - if you think obama/rahm, repugs, and dem leadership has been bought and paid for by healthcare monopolies and big pharma now, just wait until a federal law demands you pad their profits by purchasing crappy insurance coverage!

This bill will keep on giving - guaranteeing the same companies that created the healthcare crisis in the first place have a bottomless well of cash to bribe the white house and reps.

In fact - they will be able to buy off any of the so-called benefits (should they ever take effect in 5 years, which is a foolish assumption).

[ Parent ]
Arnie..actually your reply was to Adam. (0.00 / 0)
I definitely agree with your comments.


Never before in all our history have these forces been so united against one candidate as they stand today. They are unanimous in their hate for me-and I welcome their hatred. - FDR

[ Parent ]
Yup - my bad (0.00 / 0)
Thanks for pointing it out because text threads can generate enough misunderstandings between folks that agree on most of the issues.

[ Parent ]
I think you're missing the point... (0.00 / 0)
Adam's main point is that the current frame against a mandate sounds like it came from the Republican playbook.  Either come up with a better frame against the bill, or support it.  

And I don't think your distinction between government versus private administered insurance is compelling.  SCHIP, a Democratic program, gives taxpayer money to private insurers.  I am not saying this is a good thing, but to use this argument against the HCR reform bill seems uninformed.

I think the most important thing, as you mention, is fairness.  In achieving societal goals, mandates are good if and only if they are progressive: generous subsidies for those who would be burdened the most and insurance plans that efficiency address our health care needs.  Without these, the argument for mandates, from a Democratic perspective, has no legs to stand on.  

[ Parent ]
Don't miss the point - you did, (4.00 / 1)
repugs are CERTAINLY NOT saying that this bill just forces Americans to give cash to the same corporate interests that bought out obama/rahm, repugs, and dem leadership in the first place!

The premise of this post totally misrepresents progressive concerns.

[ Parent ]
My point... (0.00 / 0)
is about addressing the medical needs of people.  Your point is about political ones-upmanship.  

Now who's really misrepresenting progressive concerns?

[ Parent ]
Don't by you condenscending "analysis" (4.00 / 1)
Medical needs of people don't get addressed in this bill until 2014 - IF IT IS ALLOWED TO STAND.

Progressives can do better than this.  To say that folks that understand promises 5 years into the future are not our only option and that those that want to see meaningful reform somehow overlooks "medical needs of people" is one of the most blatant lies I have ever seen posted here.

I would expect this type of response on faux.

[ Parent ]
I just simply disagree... (4.00 / 1)
...I really do not care if it is a Republican or a Democratic plan...mandating that I give a significant portion of my or any other citizens income for something basic like health care, in order to provide corporations with huge profits and enormous salaries and bonuses for its executives is against every progressive core value that I have.  This seems like the perfect Republican/conservative plan, now by forcing everyone to enrich the wealthy and the powerful at the expense poor and the weak.

This odorous bill should be defeated.


Never before in all our history have these forces been so united against one candidate as they stand today. They are unanimous in their hate for me-and I welcome their hatred. - FDR

[ Parent ]
There is no "frame" on Hamsher's statement (4.00 / 4)
There's no right-wing frame on Hamsher's objection. She states clearly, directly, that the bill will force low- and middle-income people to buy insurance they don't want (that would be junk insurance from private insurance companies since that's the only option available in the Senate bill we advocate killing)?

Let's get back to saying things directly, as Hamsher does, honestly, and let the reader decide for himself whether he agrees or not.

This bill will force millions of Americans least able to afford it to buy junk insurance from a corrupt industry. It's not a tax; it's nothing like FICA or Medicare deductions from paychecks. Over 50% of Americans understand the idea and oppose it. There's no right-wing "frame" around Hamsher's objection. She just tells it like it is. It's refreshing that Hamsher has presented the question unadorned.

[ Parent ]
Wow, that's never happened before. (0.00 / 0)

From day one - back in the primaries - the ONLY proposals considered by any of the Democratic leadership were ones that kept the private insurance cartel largely intact and entrenched its role.  A non-subsidized public option, which would function almost exactly as a private insurer and which would probably cover 5% of the population if and when it was created, was the best thing ever realistically on the table.

Suddenly, there is outrage all over the liberal web, because instead of a 95% subsidy to the insurance companies, it is a 100% subsidy.

The public option wasn't really even pitched as a matter of principle, but as a mechanism of cost control.

Maybe you, personally, have always been against any mandate that subsidized corporate profits.  But most of the liberal web has played along all the way until the last week, accepting a bill that was insurance subsidy for months, then getting religion when they didn't get their (by the end) basially worthless public option.

The belated indignation at the horrors of the mandate is comical.  

[ Parent ]
You ignore the point (4.00 / 2)
we are going to forced to subsidize MONOPOLIES that were able to circumvent the process, creating a sham bill that will do virtually nothing until 2014.

And that is just what they were able to "buy" this year - do you really think this isn't going to be revisited by 2014?

Do you really think, when the public is forced to subsidize the profits of these same monopolies they won't use some of that windfall to further undermine reform?

Everyone that complains about failure to march lockstep with a mandate refuses to address these issues.  This is NOWHERE NEAR the same concerns that repugs address and it is a lie to proclaim that it is.

[ Parent ]
I don't think so. (0.00 / 0)
I didn't say the bill was good.  I didn't say that insurance companies aren't monopolies in many cases, or virtual monopolies in other cases.  I didn't say real reform would be easier in future years.  I didn't even say that this modest reform won't be further watered down or challenged down the road.

Because that wasn't the point I was making.

The point I was making was simply that everyone who pulled the lever for Obama has been delivered exactly what he promised.  No fights.  No reconciliation or arm-twisting.  No progressive stances.

And that those on the liberal web who have suddenly decided, in the last couple weeks, that mandates are philosophically unacceptable and a reason to oppose the bill are largely hypocrites. The idiocy is almost to teaparty level.

Now, if you voted for Nader, or you were genuinely duped by Obama and are leaving the Democratic party behind, fine.  If your position is just that the public option was a deal breaker for you because you believe there is absolutely no other way to control costs, then fine as well.  

But, as the diary states, the mandate isn't the problem.  IF costs are contained, and the bill reduces the deficit, and all the other things that proponents say come true, then there will be people, millions of them, who will be better off with this bill than without it.  And the fact is, no one knows if the public will benefit from the bill.  I have my doubts.  

This phony indignation about corporate subsidies and mandates, coming from Obama supporters who made not a peep about the mandate for years, is flat out absurd.

[ Parent ]
Actually I was always against this type of plan... (4.00 / 2)
...and it is one of the reasons I voted for Nader.  I had finally come to the conclusion, albeit after decades of being being beaten over the head, that the Democrats could not be trusted to do anything progressive that would run counter to corporate interests.

They are a corporate owned party.  A few like Kucinich (who I would have voted for) etc are doing the best they can, but the party is rigged against them and they will never have power within the party.


Never before in all our history have these forces been so united against one candidate as they stand today. They are unanimous in their hate for me-and I welcome their hatred. - FDR

[ Parent ]
One Way to Change (4.00 / 1)
Actually this is precisely the reason I'd like to see progressives steal from Republicans (from the 1980s) and take over state Democratic parties in the next ten years. As a way to undermine the national party, make progressive ideas common, and to provide viable progressive candidates for Congress. Going head to head with the national Democrats seems like a fool's errand (although we should still try). Dean's 50 state strategy, to me, at least, proved that putting Dems in every state had a positive impact on voters and was well received by voters. We should build on that.

[ Parent ]
Instead they tried to jettison Dean into oblivion... (0.00 / 0)
...it looks like he is about at the end of his rope too.

Never before in all our history have these forces been so united against one candidate as they stand today. They are unanimous in their hate for me-and I welcome their hatred. - FDR

[ Parent ]
The problems is mandates without insurance company restraint (4.00 / 3)
There are a lot of countries with mandate-driven private insurance (Switzerland, the Netherlands, plus Massachusetts) and they work pretty well; but, as far as I know, without exception, they have some method for controlling the insurance companies. Most countries prohibit profits on basic insurance. Massachusetts has a public plan (small and weak, and, unsurprisingly, it has the highest rates).

The Senate plan places Americans completely and utterly at the mercy of the insurance market. That's without precedent (AFAIK). Given how brutally the insurance companies exploit people with they can, I think it's very risky as well.

Good points... (0.00 / 0)
...but I am still against mandate-driven private insurance.  One route to go would be to make insurance corporations public service corporations/utilities with strong public control of rates and salaries.

Never before in all our history have these forces been so united against one candidate as they stand today. They are unanimous in their hate for me-and I welcome their hatred. - FDR

[ Parent ]
Don't disagree with that at all (0.00 / 0)
Serious improvements would need to be made re cost control and checks on insurance companies.

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[ Parent ]
I have yet to see any advocate for capitulation (4.00 / 2)
address this issue:

This bill does VIRTUALLY NOTHING for 5 years - intentionally (and dishonestly) written to hide its actual impact.


Fact:  obama/rahm undermined the process from the start, enabling the likes of LIE-berman, snow, and a host of others.

Fact:  when push came to shove - obama/rahm demanded progressives cave and put not real pressure on obstructionists that just want to kill meaningful reform.

So how does anyone place any faith in these lying liars now?  If as many dems stay home in 2010 as current polls indicate, there will be less support for the crappy bill to take effect in 2014.

Even if obama/rahm win re-election in 2012 - they sold us out in 2009, why does anyone think that it will be any different when he is a lame duck?

Where (4.00 / 1)
In my piece did I "advocate for capitulation"?

Also, re your comments above, the Senate bill as currently written does suck pretty hard, so we agree. I'm not sure why you'd think I'm a huge supporter of the bill. I'm saying progressives need to be careful re how to attack it. Do you disagree?

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[ Parent ]
Just like "kinda pregnant" (4.00 / 2)
those that support passing this POS don't have to be "big fans" because the result is the same either way.

Anyone that advocates passage because of potentially "ghost" benefits five years down the road isn't acknowledging that the entire process was dishonest from obama/rahm on down.

Little chance we see the change we were promised.

[ Parent ]
Wow (0.00 / 0)
You chose to ignore both of my questions and instead rant at the world. Have a nice day.

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[ Parent ]
Not your monkey (4.00 / 1)
the only point I wish to share to you is that trying to hide behind supporting this bill and being a "big fan" if fairly meaningless.

You chose not to address my concern, but I won't be so inflated with self-importance to demand you address my points.

[ Parent ]
no one's yoiur monkey either, arnie (4.00 / 1)
You're ignoring what he's saying. I'm not sure that I'd call you "Inflated with self-importance", but you do seem to be full of hot air.

[ Parent ]
Why address red herrings? (0.00 / 0)
The issues he challenges me on are mute if they are based on false assumptions.

The attacks against progressives that say LET'S SEE IF WE CAN GET REAL HEALTHCARE REFORM instead of empty promises FIVE YEARS FROM NOW don't deserve to all be addressed.

The framing of this issue that we can only take some promises 5 years from now from obama/rahm and dem leaders when they clearly mislead us the entire way is enough of a lie in and of itself to call BS on much of this post.

[ Parent ]
I agree with some of those above (4.00 / 3)
The key part of the question, to me, is "private insurance." I have no trouble with a mandate, per se.

Alternatively, if the government is going to force me to buy private insurance (like auto insurance, for example), it's going to have to involve more regulation of that industry than this bill does (like Switzerland, for example, or again like the auto insurance industry).

More regulation (4.00 / 1)
and some meaningful competition (which a public option is aimed at addressing).

It is so intellectually dishonest to say:

1.  Progressives can only accept a bill that does nothing for 5 years and may never actually do anything at all.

2.  Being against a mandate that further enables monopolies is somehow a right-wing talking point.

[ Parent ]
No, what she is saying is that this is a POISON PILL!!!!! (0.00 / 0)
And she, Kos, Dean, Olbermann (do names really sway you?) are right!

1) The "fuck what Americans 'want'" argument, though it is refreshing to hear such honesty, is political suicide.

2) The swing voters are not, as many have rightly said, ill-defined "centrists", they are the socially liberal and economically conservative who cannot find a home in the two traditional parties. They can be made to live with a safety net, but it would have to be counterbalanced with conclusions of the Empire, the surveillance state, the War on Drugs, etc.

3) They abandoned the GOP in 06 and 08. Democrats won by default, yet they arrogantly supposed themselves to have been endorsed by the people. If anything, "Change" was endorsed. Where is that change? Gates at Sec Def? The Chairman of the New York Fed at Treasury? Bernanke reappointed for doing such a smash-up job the last 6 years? God help us.

On the merits, the bill is horrid Rube Goldberg shit. Unfortunately the Establishment Dems fumbled 2009, so we are left to salvage what we can in the hopes of a better 2010, and that necessitates preventing the Obstructionists from drawing first blood.

Strategists for the left may yet realize that in order to achieve anything they must go beyond the sclerotic status quo, but when victory for the sake of victory, or purity for the sake of purity is the order of the day, nothing but a humbling awaits them in 2010, and God forbid in 2012.

That's a high price to pay for a humbling, don't you think?

Well (0.00 / 0)
First, as Mike wrote yesterday, there are lots of progressive voices on both sides of the fence on this.

Second, this entire comment is on the political win. I'm focused on the policy aspect. Regarding what Americans want, again, there are lots of things Americans are polled on that they want. Progressive activists selectively choose the ones they want to bring attention to (public option) and the ones they don't (elimination of lots of kinds of taxes). I certainly agree health care reform is a big one that will spell political problems, but it depends on whether you're more interested in political wins or improving public policy. At some point, you need to ignore the public. The public eternally clamors for bipartisanship and, to the Village, "sent a message" by electing Obama with his red state blue state let's all get along talk. Yet Democratic leadership has had no problem stuffing Democrats-only bills all year long. So what?

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[ Parent ]
Are you blaming progressives for failure of our media? (0.00 / 0)
The real progressive solution, single payer was cut out of the debate from the git-go.  This was entirely the result of media framing - anyone talking about this option was buried in silence.

The public option was a compromise away from single payer - again, the media said nothing.

I believe in holding progressives accountable, but the failure of our media to participate in a rational debate is another issue all together.

Its also another example of how obama/rahm, dem leadership, and repugs are working with the same special interests - each using the way the media frames issues for their own purpose.

[ Parent ]
Sorry, but 2) is a baseless fantasy (0.00 / 0)
Swing voters are mostly low-information people with no ideology at all.  This is probably the single most important, most demonstrated, finding of academic public opinion research.  Plus, among the minority that is informed, there are at least as many economic liberals/social conservatives as your libertarians.

This fantasy is shared by intellectuals of all ideologies, i.e., the swing voters are really on our side, who haven't taken polsci 101 (or learned the facts elsewhere).

[ Parent ]
Actually the economic liberals/social conservatives... (4.00 / 1)
...is a large group that has largely been dismissed by the Democratic Party leadership...this group does not mesh well with a corporate controlled socially liberal party...but they were key and perhaps a foundational group supporting the New Deal.


Never before in all our history have these forces been so united against one candidate as they stand today. They are unanimous in their hate for me-and I welcome their hatred. - FDR

[ Parent ]
I'd say the largest group being ignored (4.00 / 1)
are people that support broad efforts to ensure economic security and opportunity - the core idea behind the New Deal (updated to include groups that were excluded back then). They are a large majority, and yet neither party is offering that today. That's not the same as saying "economically liberal" exactly, and includes people of different social views. I'm convinced that if you give people what they want on the first front, the second front is going to matter a lot less (when its about opposing equality rather than advancing it.)

Politics is the art of the possible, but that means you have to think about changing what is possible, not that you have to accept it in perpetuity.

[ Parent ]
Not sure about this (0.00 / 0)
The swing voters are not, as many have rightly said, ill-defined "centrists", they are the socially liberal and economically conservative who cannot find a home in the two traditional parties. They can be made to live with a safety net, but it would have to be counterbalanced with conclusions of the Empire, the surveillance state, the War on Drugs, etc.

Swing voters (i.e., people that do not identify with either party and that might vote either way depending on the election) are an exceedingly small group. Almost all voters (and a lot of non-voters) do not fit into that tiny category.

As for the rest, the safety net - when it is universal and not targeted solely to the poor - is popular with the vast majority of Americans, including majorities of independents and even (depending on the issue) Republicans.

I'm all for making the other things you mentioned a more central part of progressive appeals, and trying to advance those causes however we can.  But the problem with a universal safety net is about opposition from elites, not the populace.  

Politics is the art of the possible, but that means you have to think about changing what is possible, not that you have to accept it in perpetuity.

[ Parent ]
Many of you are missing Adam's point (4.00 / 1)
which is to put it succinctly

Don't use right-wing memes to validate your left-wing talking points.

There are criticisms to be made of mandates.  "Even if you don't want to" is a right-wing meme and should not be one of them.

Learn the difference!

Looking at it another way, fear of the campaign slogans we expect Republicans to use should not lead us to use them ourselves.

A similar note was the mistake Darcy Burner made on Hardball last night.  Attempting to argue that the bill might still be improved and the Public Option was still alive, she cited as evidence Joe Lieberman's assertion that Obama never lobbied him for the Public Option - as if he might be a yes vote if only we'd asked.  Talk about grasping at straws!  Matthews nailed her on this and while I'm no fan of Matthews, I had to give him the point.

sTiVo's rule: Just because YOU "wouldn't put it past 'em" doesn't prove that THEY did it.

This is not a right-wing meme (4.00 / 2)
This is a response to something that has NEVER happened before in American history, where a law is passed that forces millions of Americans to buy a product from private companies.

I don't want to be forced to buy junk health insurance from a private corporation.

If I've missed it, please tell me what the right-wing meme is that compares?

[ Parent ]
It is a lie to say it is a right wing meme (4.00 / 2)
Its all about using the power of law to demand the public support monopolies, further entrenching them so that additional reform of a still-broke system is impossible.

Absolutely NO relationship with progressive concerns that any type of mandate should not funnel more money to the corporate interests that undermined reform, creating a cash cow to undermine virtually EVERYTHING this POS bill proclaims it will do.

[ Parent ]
You're wrong (4.00 / 2)
"Forcing people to pay for insurance they don't want" is a rightwing meme. It will be used against any mandatory medical insurance, public or private, good or bad, that isn't paid for entirely from taxes. The same people will also fight against any tax increase.

On the net, across the entire population, and over a long time span public health insurance will benefit almost everyobody but the very rich and the perfectly healthy, but some groups will always be paying involuntarily, whether it's taxes or monthly payments. Some will object on general conservative principles, and some because they don't think they need health insurance.

It's also not true that this bill does nothing until "FIVE YEARS FROM NOW". Some of the provisions kick in immediately.

The basic point is that people shouldn't be using arguments against this plan that could also be used against a good plean, and "forces people to pay for insurance they don't want" is one of them.

[ Parent ]
you are arguing semantics..when there are bigger problems (4.00 / 1)
The abortion language alone will set Women's rights back 50 years. There will be no federal funding for abortion services....Period. There are only a limited number of physicians that will cover medicaid, and now even fewer will agree to treat patients with Medicaid. Young people are not applying to medical school because they will not pay off the cost with the salary that they can expect to make. There is already a doctor shortage and this bill will only compound that. All of those people who get subsidized aid to buy insurance will get insurance that physicans will refuse to accept. There is no way you can put this bill in any light except a bail out for Insurance and Pharmaceutical corporations and funding of congress people and the president for future elections.
Good luck everyone. You have just been sold out ...again

Recommended, don't necessarily agree (0.00 / 0)
But recommended because it at least raises what seem to me valid questions that are never raised by anyone in the debate regarding whether doctors will accept various forms of insurance such as Medicaid (it's true that most don't), along with the related issue of frequently inferior care for people with "less than good" insurance.

I have no knowledge regarding numbers or indicating that the problem will get worse however.  Evidence?

[ Parent ]
I agree with Adam (0.00 / 0)
Some of the points being made against this bill would work just as well against a good bill.

I'm going to find the present bill hard to defend to the less-political, less-liberal people I know. Some of the centrist features actually made it harder to defend. (The same is true of the bailouts and stimulus). There's voter-related centrist, and then there's donor-related centrism. This bill is the latter.

Gotta disagree with you here, Adam (4.00 / 4)
The flaw here is your equation of private insurance with social insurance. This bill is NOT a New Deal or Great Society style program. It's like privatizing the post office and making us pay a company to send our mail. Or like privatizing water, or fire departments.

There is a fundamental difference between making someone pay a private company and hope that they get service in return, and making someone pay a tax and giving them entitlement to a service in return.

Further, this notion of "buying insurance they don't want" is being misunderstood by a lot of folks. When I was battling - successfully - against Arnold Schwarzenegger's efforts to impose an individual mandate here in California in 2007, I was uninsured. I couldn't afford the COBRA and couldn't afford coverage on the open market.

But more fundamentally, I didn't want private insurance. I wanted health care. I would have loved the opportunity to buy into Medicare. I didn't want eligibility for buying a private policy, I wanted to be able to afford health care that would be guaranteed to me.

Too many people are missing how new the notion of forcing people to buy a product on the private market really is. That's not how the New Deal worked and not how the Great Society worked. As far as I know it's unprecedented in our history.

So when people say "we don't want this" it's not a right-wing argument and it's not an irresponsible argument. It's a recognition that health insurance companies are the living embodiment of evil on this planet and that not everyone welcomes the prospect of handing their wallets over to them.

Hi Robert (0.00 / 0)
I understand that distinction, which I why I wrote progressives should talk about the difference between a government-run program like Social Security, and this. Here's an example:

This is not reform that guarantees fairness, like Medicare or a public option. This bill hands over 30 million people to the clutches of the failed health insurance companies who have, time and time again, proven they are more interested in profits than providing health care. It is health insurance, not health care, and we know that doesn't work for America.

You can achieve your goal of messaging that health insurance companies are evil, and that the bill should be killed, without endorsing a right-wing frame that people should be able to opt-out of any programs they don't like.

Also, I'm totally with you on the distinction between health care and private health insurance. And I didn't say anywhere I think this bill is great or that people should jump at the chance to buy private insurance.

Also, I'm curious if you would, absent a single-payer system, support a mandate to purchase health insurance, and under what conditions (in an ideal world).

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[ Parent ]
Still disagree here (4.00 / 1)
When you say "opt out of a program" it still seems like equating the individual mandate to a program like Social Security or Medicare, and I reject that equation.

The only way I might consider supporting a mandate to purchase insurance is if we radically change both the insurance industry and taxation, through at least the following:

1. Abolish all for-profit insurance companies

2. Impose high taxes on high wages, and mandate pay caps for health insurance employees

3. Medical/loss ratio of at least 90% (Franken Amendment)

4. Full community rating, no surcharges for preexisting conditions

5. Include a public option, either a Medicare buy-in or something that is robust

6. Full subsidies to 500% of FPL, then decreasing as you get to 1000% FPL

Even then I would still see it as an essentially neoliberal solution, and since progressives exist in part to oppose neoliberalism, I would have a hard time supporting mandated purchase of private insurance. Our goal should be to expand the public sector and reverse the trend of asking the market or private companies to administer what should be public services available.

Health care should be a right of being alive, not a reward for being able to purchase a product.

[ Parent ]
Call it what you want (0.00 / 0)
But a mandate would be a necessity in health insurance markets- irrespective of private or public- the same way it is in Social Security or Medicare.

We are a long way away from accomplishing your list. Mandates work in other countries with private insurance markets through much tighter controls, as FairEconomist points out above, without accomplishing some of your requirements. Of course single-payer is the ideal solution.

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[ Parent ]
Also (4.00 / 1)
Perry's comment above is an interesting point in this context. In the name of providing at least some coverage, S-CHIP sends lots of people who have no coverage, along with taxpayer money, to the private insurance companies. It enables the entire system.

Did you support the reauthorization of S-CHIP?

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[ Parent ]
Yes (4.00 / 1)
Because it's a subsidy to help people buy something. In the absence of single-payer it's a sensible move, because there's no requirement people spend money out of pocket to buy insurance. S-CHIP is imperfect and a stopgap, but still worthwhile.

[ Parent ]
Okay (0.00 / 0)
And instead of being an adult rejecting private insurance in California, if you were a child, would you take it?

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[ Parent ]
Says it All (4.00 / 2)
Robert, what you've just written here is so important I thought it needed emphasis:

Too many people are missing how new the notion of forcing people to buy a product on the private market really is. That's not how the New Deal worked and not how the Great Society worked. As far as I know it's unprecedented in our history.

So when people say "we don't want this" it's not a right-wing argument and it's not an irresponsible argument. It's a recognition that health insurance companies are the living embodiment of evil on this planet and that not everyone welcomes the prospect of handing their wallets over to them.

It doesn't matter much to me anymore whether this outcome was a case of Versailles Dems missing the key point as you so perfectly present it or the preferred path all along.  This is political disaster--perhaps even permanent political disaster--for the Party going forward.  But most importantly, it is simply terrible social policy that many Americans will come to rightly hate--no matter the framing.

(and I didn't even mention the seething anger those of us who still care deeply for abortion rights in this country are feeling...)

[ Parent ]
seriously Adam, did you miss her point?!?! (4.00 / 3)
Jane's point is that we should not be mandated to pay PRIVATE companies! Your arguments are completely irrelevant and unresponsive.  

Her point is even larger (4.00 / 1)
WE ARE BEING FORCES TO GIVE MONEY TO MONOPOLIES that have been abusing market powers and have totally undermined the dialog for meaningful change.

I believe the arguments go far beyond "irrelevant and unresponsive" and are simply dishonest.

[ Parent ]
The mandate is a political disaster (4.00 / 4)
Jane is spot on - this is a political disaster for the Dems of the first order.  I don't care what the polls say - once folks start getting fined for not having insurance we, I mean the Democrats, will be blamed as we should be.  Once folks find that the minimal insurance to escape the fine is junk we will be blamed.  Once folks spend hours comparing insurances and trying to make a decision on which one to take out because we are forcing them to do so we will be blamed.  Once insurance companies start raising rates on all the newly insured folks we will be blamed.  Once they start fighting with the parasites of the Insurance Industry to pay for stuff they thought would be covered we will be blamed.  And, every time they make their monthly premium payment we will be blamed.  And boy they will be motivated to vote.  This should increase turnout by at least 10% or more.  The party will be wiped out.

Personally, the Republicans could not have devised a better plan to destroy the Democratic Party if they had all the money and time in the world.  Obama and Company have sold the Democratic Party to the Insurance Companies and we have bought into the disaster hook, line and sinker.  We own Health Insurance now and may god have mercy on our soul because every nasty thing those villains do we will be blamed for and, as we all know, you can expect them to do a lot!!!!!!!!!!!!!!

In the first place, the messaging comes right out of the right-wing playbook. (4.00 / 1)
No, Adam, the bill comes right out of the right-wing playbook.  No wonder it's so unpopular.  Disaster in 2010.  Worse yet, disaster for those who can't afford it.

Full Court Press!  http://www.openleft.com/showDi...

You are nuts (4.00 / 1)
The right wing wants no bill at all. The corrupt centrist want this bill. It's not right wing. It's corporate centrism and will enrage the right wing.

The right wing didn't want a good bill, and they don't want a bad bill.

Get a grip, people. This is a bad bill, some say better than nothing and some say worse than nothing. It looks politically damaging to me. For all I know Adam agrees about this.

He was just saying is that we should not oppose it with stock right wing messages, and we should not misrepresent it. People are talking crazy.

Progressives can't buy into the libertarian agenda. Libertarians want no health bill at all, no public money paid on health care at all, no mandates of any kind, no medicare for anyone, no single payer, no nothing, and "Don't force people to pay for insurance they don't want" is their talking point.

[ Parent ]
you got it wrong! (4.00 / 1)
I't's don't force people to pay for insurance they can't AFFORD!

Full Court Press!  http://www.openleft.com/showDi...

[ Parent ]
No, you're wrong (0.00 / 0)
What he's talking about is this:

"1. Forces you to pay up to 8% of your income to private insurance corporations - whether you want to or not."

[ Parent ]
No, you're more wrong (4.00 / 1)
What I'M talking about is don't force people to pay for insurance they can't AFFORD!

Full Court Press!  http://www.openleft.com/showDi...

[ Parent ]
I disagree with the term "corporate centrism"... (0.00 / 0)
corporatism represents the economic right-wing if anybody does.


Never before in all our history have these forces been so united against one candidate as they stand today. They are unanimous in their hate for me-and I welcome their hatred. - FDR

[ Parent ]
There is so much wrong with this bill.... (0.00 / 0)
NNU cited ten significant problems in the legislation, noting many of the same flaws also exist in the House version and are likely to remain in the bill that emerges from the House-Senate reconciliation process:

 1. The individual mandate forcing all those without coverage to buy private insurance, with insufficient cost controls on skyrocketing premiums and other insurance costs.

 2. No challenge to insurance company monopolies, especially in the top 94 metropolitan areas where one or two companies dominate, severely limiting choice and competition.

 3. An affordability mirage. Congressional Budget Office estimates say a family of four with a household income of $54,000 would be expected to pay 17 percent of their income, $9,000, on healthcare exposing too many families to grave financial risk.

 4. The excise tax on comprehensive insurance plans which will encourage employers to reduce benefits, shift more costs to employees, promote proliferation of high-deductible plans, and lead to more self-rationing of care and medical bankruptcies, especially as more plans are subject to the tax every year due to the lack of adequate price controls. A Towers-Perrin survey in September found 30 percent of employers said they would reduce employment if their health costs go up, 86 percent said they'd pass the higher costs to their employees.

 5. Major loopholes in the insurance reforms that promise bans on exclusion for pre-existing conditions, and no cancellations for sickness. The loopholes include:

        * Provisions permitting insurers and companies to more than double charges to employees who fail "wellness" programs because they have diabetes, high blood pressure, high cholesterol readings, or other medical conditions.
        * Insurers are permitted to sell policies "across state lines", exempting patient protections passed in other states. Insurers will thus set up in the least regulated states in a race to the bottom threatening public protections won by consumers in various states.
        * Insurers can charge four times more based on age plus more for certain conditions, and continue to use marketing techniques to cherry-pick healthier, less costly enrollees.
        * Insurers may continue to rescind policies for "fraud or intentional misrepresentation" - the main pretext insurance companies now use to cancel coverage.

 6. Minimal oversight on insurance denials of care; a report by the California Nurses Association/NNOC in September found that six of California's largest insurers have rejected more than one-fifth of all claims since 2002.

 7. Inadequate limits on drug prices, especially after Senate rejection of an amendment, to protect a White House deal with pharmaceutical giants, allowing pharmacies and wholesalers to import lower-cost drugs.

 8. New burdens for our public safety net. With a shortage of primary care physicians and a continuing fiscal crisis at the state and local level, public hospitals and clinics will be a dumping ground for those the private system doesn't want.

 9. Reduced reproductive rights for women.

10. No single standard of care. Our multi-tiered system remains with access to care still determined by ability to pay. Nothing changes in basic structure of the system; healthcare remains a privilege, not a right.

"Desperation to pass a bill, regardless of its flaws, has made the White House and Congress subject to the worst political extortion and new, crippling concessions every day," Burger said.  link


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