Obama's Attack on Krugman

by: Matt Stoller

Fri Dec 07, 2007 at 17:24


The Obama campaign offers a weird attack on Paul Krugman, calling him inconsistent in his attacks on Obama's health care plan.  Krugman is perfectly consistent, as Ezra notes.  It's a strange fight to pick, since it forces Krugman into a position where either his credibility is damaged or he responds.  More to the point, Krugman isn't running for office.  Is Obama looking for more opponents or something?

Anyway, in reading to prep for this post, I ran across this article by Jonathan Cohn, and I think I identified what worries me so much about mandates.

One person who has done so is Sherry Glied, a Columbia University economist. She has co-written what appears to be the most definitive paper on the subject, in a recent issue of the journal Health Affairs. Surveying the evidence, not just from the examples I just described but also other types of government mandates (like childhood vaccinations), she and her co-authors concluded "mandates can be an effective tool in expanding health insurance coverage, but the devil is in the details."

Legislative complexity advantages Republicans and insurance companies, since they have a lot more capital to deploy on lobbyists, think tanks, and ideological political groups.  Simplicity advantages the public, which is why we won the Social Security fight in 2005.  We simply don't play the insider game very well, and they don't play the public support game very well.

A mandate is very complicated to explain, with lots of easy fear-mongering tools built into it the right can use (collection agencies, wage garnishment, etc).  And once the Village gets its mind set on mandates, any mandate will do.  That means that the likely outcome of this debate is going to be not just a universal mandate, but the worst possible universal mandate.  While I don't know what that would look like, with mandates, the "devil is in the details".  I think I now get why lots of wonks like the mandate plan, because they enjoy details, especially clever ones.  That could be something of a blind spot.

Matt Stoller :: Obama's Attack on Krugman

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It is mandated that people secure a (0.00 / 0)
driver's license and auto insurance in order to drive a car. However, lots of people ignore one or the other. Are they proposing jail for violators?  Just what we need.  More people with criminal records so they can't get jobs. 

that's silly (0.00 / 0)
For example what edwards plan proposes is that when you are in certain venues like a hospital emergency room without insurance....that you are automatically enrolled in some plan...perhaps the public one.

That's not criminal.  That actually helps build the the public system so that it can grow and the private one can shrink.

"Incrementalism isn't a different path to the same place, it could be a different path to a different place"
Stoller


[ Parent ]
Whatever happens with the mandate issue, (4.00 / 1)
reforming the industry is key. It would be horrible to have an individual mandate without proper reform. Think about it: somebody has been required by the government to pay a huge amount of money for an insurance plan--maybe even had their wages garnished by the IRS--and then they get sick and find out that insurance plan won't pay for the care they need.

As Krugman noted today, the mandate is what is going to be most discussed in the media. Conservatives are going to fight to make it the focus of a health care proposal. It definitely would not be worth giving up HMO reform in order to get a mandate. Keep in mind, the HMOs have a lot at stake here. They are going to be throwing millions of dollars at the Senators and Congressmen who will ultimately be deciding what the plan the President gets to sign will look like. Do trust that 50 Senators (possibly 60) and 218 House members will stand up to the insurance industry's lobbying efforts?

Another concern with mandates is that we get enough of a tax increase to get the subsidies to make them work. It is just unrealistic to ask a family of four making, say, $40,000 to pay for a $10,000/year health plan. They're going to need a significant subsidy. There hasn't been a lot of discussion about how much a family like that would have to start paying each year under the mandated plans, and that's definitely something that's going to come up in the general election/the battle in Congress.

I don't think any of the top 3 candidates has a great health plan. I prefer a single-payer plan. It's hard to see a single-payer plan having significantly less support than a mandated plan like Clinton's, and it would be a lot more simple to say "end the for-profit insurance industry" and "Medicare for all" on TV than "individual mandate," "wage garnishment," etc. etc. Plus, the results would be a lot more efficient.

(Also, it should be noted that none of the candidates' plans insures undocumented immigrant workers and their families, which means 15 million people are going to be uninsured no matter who becomes President.)


The premiums will not be huge-that's the point of universal (4.00 / 2)
Not as huge as they are now.  Universal coverage lowers costs. The premiums will be lower.  Those who can't afford them get subsidies directly to them,and the percenatage of your income that goes to health insurance is capped so if all you can afford is X amount per month that's what you or the subsidies pay.

You say:
"It's hard to see a single-payer plan having significantly less support than a mandated plan like Clinton's."

It doesn't with the public but with the very rich players in this arena....the health insurance companies themselves.  They will fight single payer with tens of millions of dollars in advertising, lobbying etc.  They will be even more vicious about single payer than Harry and Louise were against the 93 plan.  Mandated plans do keep them in the mix. Indeed they are in some sense bribed to participate because the healthy will have to have coverage.  The hope is the public plan will be so much better that that the it will grow like and the private ones will shrink. 

"Incrementalism isn't a different path to the same place, it could be a different path to a different place"
Stoller


[ Parent ]
reply (4.00 / 1)
Or force the private one to become better in order to compete with the public one. I agree a single payer system (which would be ideal) would be much harder to pass tham Obama's plan or even Clinton's, precisely because of the insurance lobby. I think the best first step would be an plan with no mandate (like Obama's) that way the people who really want health care will get it, either privately or publicly, and that way we won't have to figure out how to punish the millions of people who inevitably wouldn't adhere to the mandate.

If we are to be stuck with private care as opposed to single-payer the best way I can think of to cope with this is either create a large market with lots of companies competing with much lower costs or have a federal law that limits the percentage profit a private insurance company can make off the backs of people in need of health care. This second idea I believe is totally unprecidented, at least in this country. But this would be far superior morally, because a publicly owned profit-driven private corporation will always look for ways to increase quarterly profits. This is problematic especially in health care. Most likely instead of looking for ways to streamline or make the process more efficient to reduce administrative costs and lower prices to lour customers they will find ways to cut benefits or not pay out the most needed claims. In this way I think it would almost be better if these private insurance companies were actually privately owned instead of publicly traded on the market that way the owners would have to worry about moral responsibility and hopefully would be happy with a steady, fair profit margin. Shareholders will never settle for a steady stock price even if the corporation has a steady stream of profits.

End this war. Stop John McCain. Cindy McCain is filthy rich.


[ Parent ]
You should probably take a look at what Edwards is proposing then. (0.00 / 0)
http://www.johnedwar...

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[ Parent ]
forceful arguements (0.00 / 0)
Krugman has been arguing pretty forcefully for mandates lately I guess they decided that it was a good idea to point out that he hadn't always been so pro-mandate.  Personally I find mandates to be a bad idea unless we are going to go the whole way and guarantee that everyone is insured just for being a resident or citizen.

Without getting into the problems with enforcing mandates, their big brother quality, or concern about the "worst possible universal mandate", it seems like Obama's plan will actually mean that more American's are covered.

I wouldn't have framed it as an attack on Krugman persoanlly, but I did read this earlier today.

Mandates have not worked with auto insurance. While all drivers are required to have it, 15 percent of the nation's drivers have none, according to the Insurance Research Council.

Mr. Obama's health plan could actually have a better compliance rate. The 15 million who would supposedly be left out equal about 5 percent of the population...

The experience in Massachusetts, which has enacted universal coverage with a mandate that everyone obtain health insurance, shows how difficult it is to force everyone to comply. About 20 percent of people in that state do not have health insurance even with the mandate.

If this is accurate, then Clinton and Edwards are imitating a system which covers about 20% of the people in MA, and by their own estimates Obama's plan would cover all but 5%.  That seems a lot better to me.


My job is not to represent Washington to you, but to represent you to Washington- Obama
Philly for Obama


You are (0.00 / 0)
correct, if the 15% number without car insurance were true it would be a problem. However it's way out of date. For instance Georgia in recent years has begun a much more vigilant apporach to car insurance and inform drivers when they let their insurance expire. Even without a lot punishments being imposed, currently 98% of drivers in Georgia have car insurance.  With vigilance, mandates work.

[ Parent ]
The analogy between car insurance... (4.00 / 1)

.......and health 'insurance', as currently defined is fallacious.

You choose to drive a car. Might be tough to get around without one in many areas but it's a choice.

You do not choose to get sick. End of argument for any 'mandate' which is just another way for the blood-sucking 'insurance' companies to say.....

'I gotcha!'

Peace, Health and Prosperity for Everyone.


[ Parent ]
Different number (0.00 / 0)
I was looking at the part that said that in MA 20% of people do not have insurance.  This is my only source, but I guess we could look for more.

I have to agree with ACitizen as well, Driving is a privilege.  Both Clinton and Edwards want to make health care mandatory for all of us, that makes me nervous there is no way to opt out.  In particular Clinton's plan seems more like a boon to the insurance industry than to the poor uninsured like me.

My job is not to represent Washington to you, but to represent you to Washington- Obama
Philly for Obama


[ Parent ]
Jerk (0.00 / 0)
You haven't commented there, but do you want to justify troll rating me on the other thread? It seems a little childish to just do it back to you, so I won't, but unless snark is suddenly troll-rate worthy I think you need to GROW UP.

I support John McCain because children are too healthy anyway.

[ Parent ]
Uh (0.00 / 0)
You linked to a story mainly sourced to a hack at the American Enterprise Institute. Ezra Klein demolishes it here.

Join us at the Missouri community blog Show Me Progress!

[ Parent ]
differnet point (0.00 / 0)
I saw that it was AEI and cut that part from my quote actually.  The important comparison is to the Massachusetts system.  I understand that auto-insurance is a different issue, but it is usually the people in favor of mandating it that bring up that we already do it with cars.

My job is not to represent Washington to you, but to represent you to Washington- Obama
Philly for Obama


[ Parent ]
Did you bother to read the Ezra Klein post? (0.00 / 0)
He demolishes the auto insurance comparison.

Join us at the Missouri community blog Show Me Progress!

[ Parent ]
Solving the problem (4.00 / 5)
Krugman sees everything in stark politcal terms, and he's absolutely right: 1)The Republicans don't give a damn about universal health care. 2)Single-payer is a pipe-dream. 3) It may be wonky, but mandates are essential to actually SOLVING the problem. 4)We can NEVER echo Republican/Insurance Lobby talking points. 5)Obama is giving the bad guys a big fat pitch to hit out of the park--and he's done it more than once.

i disagree... (0.00 / 0)
I don't think he's giving them an easy pitch at all. In fact I think quite the opposite.

With Hillary or Edwards the Republicans will scream "the Democrats are forcing you to buy health care which will take more money out of your paycheck and if you are healthy and don't want it or think its overpriced you are breaking the law!" Obama's plan removes the Republican's ability to use this talking point. He can argue it gives people more choice and tell the ultra-rich that they will still be able to keep their great private plans and tell the poor they aren't forced to do anything but better public plans (and hopefully the private ones will follow) are now available to them. It will be much easier to pass Obama's version of this reform, and in the end it will probably cover about the same number of people. Mandates can come later, once we get affordable insurance. Otherwise we will have to explain how to penalize those who refuse to follow the mandates. Obama's plan gives those who want and desperately need health care the most the best opportunity to get it. If other people don't want to get either the public or private plan than they are probably pretty healthy or not in need anyway. It will be easy to force them into the pool later.

Large-scale reform like this needs to be done in baby steps....

End this war. Stop John McCain. Cindy McCain is filthy rich.


[ Parent ]
another thought...l (0.00 / 0)
Health insurance reform should be about helping those in the greatest need who desperately need coverage and not (immediately) about forcing those who might be healthy or resist into the coverage pool just so you can pay a little bit less.

The idea is that in the long term the fact that we are providing so much more preventative care (at a low cost) to people who were not previously receiving it will help prevent them from contracting more catastrophic and life-threatening illnesses in the future which the taxpayers would have eventually ended up having to pay once the deathly ill person finally ended up in an ER (critical care comes at a much higher cost than preventative).

The amount of money that we have the potential to save through providing regular low-cost preventative care to people which could help stop the all too common preventable-illnesses people contract is extraordinary and very hard to estimate or measure. Not to mention how much money we could save on health care if we could convince people to take better care of themselves by eating right, excercizing, and not smoking. At the very least these harmful behaviors which will soon have the consequences paid for by the taxpayers (moreso than they already are) should be more heavily taxed. Tobacco is already adequately overtaxed. Other unhealthy things like fast food should be more highly taxed in my opinion. I know this tax would mostly affect poor people who are the biggest consumers of fast food but it should be enacted at the same time as a different measure which lowers the tax or costs of groceries s to encourage poorer people to go to the grocery store which is both more healthy and smarter economically.

End this war. Stop John McCain. Cindy McCain is filthy rich.


[ Parent ]
one phrase (0.00 / 0)
free rider. look it up.

[ Parent ]
huh? (0.00 / 0)
I looked it up but not sure what you mean in this context.

Do you mean a single-payer system suffers from a free rider problem because some people will not work and thus pay nothing towards the system?

I don't see any issue with "free riders" in either the Clinton or Obama proposal. Clinton's proposal has a mandate which requires people to purchase health care. Obama's proposal has no such mandate. Neither proposal would provide health care to "free riders," both of them are asking citizens to BUY health care. Unless you are counting the medicare/medicaid or the childrens health programs which do have free riders but these programs already exist and I'm not aware of any changes to them by either of these proposals.

End this war. Stop John McCain. Cindy McCain is filthy rich.


[ Parent ]
the free rider problem is acute in Obama's case (0.00 / 0)
because he proposes not allowing insurance companies to deny coverage based on previous conditions. Well, why would I purchase coverage until I have a problem? Why pay premiums until I actually have a problem? Maggie Mahar has a lot more: http://www.healthbea...

Join us at the Missouri community blog Show Me Progress!

[ Parent ]
replay (0.00 / 0)
With Clinton's plan isn't is possible to do the exact same thing?

End this war. Stop John McCain. Cindy McCain is filthy rich.

[ Parent ]
I suppose, because she hasn't proposed an enforcement mechanism (0.00 / 0)
Edwards calls for proof of insurance to be presented when paying taxes, enrolling in school, starting a new job, etc. If you don't have insurance then, you'll automatically be enrolled. So under Edwards, it would be difficult to be a free rider, Obama actually incentivizes it, and Clinton theoretically makes it harder, but we don't know the details yet.

Join us at the Missouri community blog Show Me Progress!

[ Parent ]
Obama v Krugman (0.00 / 0)
Harvard versus Princeton--an intellectual slugfest!

Actually (4.00 / 2)
a Princeton economics professor vs a Harvard lawyer in an argument about economics.  Nut much of a slugfest there.

[ Parent ]
I'd weigh in on this argument but.... (0.00 / 0)

...since the vile John Woo is a professor at my alma mater....

I'll just shut up.

Peace, Health and Prosperity for Everyone.


[ Parent ]
American Exceptionalism just oozes out of.... (4.00 / 3)
....most of the viewpoints expressed here.

How do they do this in:

Canada...

England....

France...

Germany...

Sweden..oops, bunch o' socialists there!

Norway...

Spain...

They do it  the only way it can be done:

Single payer, not for profit, paid by the state. Let the insurance companies play vampire with someone besides the citizenry. Far from being a 'pipe dream' the countries I've named have solved the problem of healthcare, let me repeat myself, in the only way it can be.

As for Obama, don't make me laugh. The guy who learned his 'bi-partisanship' meme at the knee of the previous #1 recipient of Big Pharma campaign bribes cash Ol' Joey the Liarman is interested in only one thing:

Getting elected.

HIs healthcare 'plan' is just another scam from his industry backers as Krugman and actual expert on economics points out.

Bah....utter bullshit from Senator 'Hopeless'.

And no, no bonus points for which criminal Senator currently gets the most swag from Big Medicine.

Peace, Health and Prosperity for Everyone.


Wrong (0.00 / 0)
The UK, France, Germany, and Spain do not have single payer.

Join us at the Missouri community blog Show Me Progress!

[ Parent ]
Hmmmmmm..... (0.00 / 0)
The UK...from Wikipedia: 'services free at point of use..' some privatization being attempted, not working out.

France....private insurance covers estimated 3% of costs

Germany.....In the 1880s, most Germans became covered under the mandatory health care system championed by Bismarck.

Spain....All of Europe has publicly sponsored and regulated health care. Countries include Austria, Belgium, Denmark, Finland, France, Germany, Greece, Hungary, Ireland, Italy, Slovenia, the Netherlands, Norway, Poland, Portugal, Romania, Russia, Spain, Sweden and the United Kingdom

So.......

Maybe not a all single-payer but in every single fuking case the government, that annoying thing 'conservatives' hate so much, is looking out for the interests of the people.

Not the insurance companies.

Which is what Obama, Clinton and the existing power structure is determined to do.

Why?

Because they are paid to do so.

Obama, Joey the Liarman protege is just following in his mentor's foot steps, Ol' Joe used to be the #1 bloodsucker of Big Pharma cash, and no doubt feels some jealousy about Hillary's preeminent role as the new #1, in the Senate, recipient of Big Pharma cash.

Kindly remove head from rectum and realize the only area where the U.S. 'leads' the world in medical care for it's citizens is in being chumps for the insurance industry.

Our nation is being destroyed by the rampant greed of the corporatist scum who've ridden the Republican Party to power for the last four decades.

It's not helpful to split hairs about the fact that we, the people, are getting screwed by the insurance industry re: healthcare.

One last helpful factoid: http://www.cnn.com/2...

If that don't get the message across that big, radial change has to happen then there is little hope for the nation.

Peace, Health and Prosperity for Everyone.


[ Parent ]
single payer's window of opportunity is RIGHT NOW!!! (4.00 / 1)
I agree with AC that cutting out the insurance companies is the only workable solution. The attempt to mash up the Hippocratic Oath with the modern business model of infinitely increasing profits and fat executive compensation has been a predictable and complete failure.
I don't think it's much of an exaggeration to assume that almost every American family enrolled in managed care has a horror story about insurance company malfeasance and deceit, or lives under a burden of doubt and fear about catastrophic illness or unemployment. Is there a service industry sector that is more hated or distrusted than health insurance? Channel this tsunami of disgust through a simple frame that emphasizes full coverage under an expanded Medicare/Medicaid,the cost-savings possible through preventive care and the return of basic medical decision-making to the hands of doctors and their patients and I think you would drown Harry and Louise like Pharaoh's army.
But you can't build any popular momentum if, like in 92, you deal the special interests in from the start with all the complications their middle man status brings to the table. In fact, this time it would be worse, because, after 15 years, we all know just what an abortion managed care has turned out to be. What decent person would think that publicly subsidizing an industry that does its utmost to deny coverage to poor and sick people would be "progressive" in any way?
Managed care is another lousy conservative idea well past its sell-by date and everybody knows it. We can put it in the trash bag with deregulation, privatization and preventive war and kick it to the curb if we seize this moment of right-wing crack-up. Unfortunately, this would require a degree of audacity, fortitude and populist spirit somewhat lacking in our candidates right now..but that doesn't mean we shouldn't keep pushing them, eh? 

[ Parent ]
Senator Hope's oppo on Krugman's (4.00 / 1)
articles could have kept going instead of cutting it when they did, but then this would have come out.

In the "then" section above there is another point completely left out of Obama's (ahem) "Fact Check" item:

  Now for the bad news. Although Mr. Obama says he has a plan for universal health care, he actually doesn't - a point Mr. Edwards made in last night's debate. The Obama plan doesn't mandate insurance for adults. So some people would take their chances - and then end up receiving treatment at other people's expense when they ended up in emergency rooms. In that regard it's actually weaker than the Schwarzenegger plan.

  I asked David Cutler, a Harvard economist who helped put together the Obama plan, about this omission. His answer was that Mr. Obama is reluctant to impose a mandate that might not be enforceable, and that he hopes - based, to be fair, on some estimates by Mr. Cutler and others - that a combination of subsidies and outreach can get all but a tiny fraction of the population insured without a mandate. Call it the timidity of hope. ... ..

There is no "then" and "now" with Krugman. Referring to Obama's health care plan as the "timidity of hope" is hardly positive. Krugman has been consistent throughout. However, you sure won't get that from Obama's "Fact Check" page.


Jonathan Cohn (0.00 / 0)
ends his recent article about the issue, Mandate Overboard, with a very odd paragraph:


If the significance of including a mandate as part of health care reform really came down to nothing more than the numbers, it would not be so important. Obama's plan may not reach as many people as Clinton's or Edwards' would, but it would reach an awful lot of people--and, as such, do an awful lot of good. And, thankfully, Obama continues to say he wants to achieve universal coverage--that is, to make sure everybody has insurance. At least he has the right goal in mind. But achieving universal coverage is as much a political challenge as a policy one. And by talking down a mandate, he makes the political challenge that much harder. Among other things, the moderate Republicans and business groups willing to consider universal coverage will likely demand that a mandate be part of the package, because they see it as a way to reinforce personal responsibility. The insurance industry, meanwhile, will demand it because they think it essential to prevent an adverse selection death spiral. If the idea is to pass universal health care with bipartisan support, then a mandate may be essential.

Right off he cuts the legs out from under the Clinton/Edwards argument that it is all about the numbers.  As Cohn says, the difference in numbers is not so important.

His reasoning politically is not very saavy in terms of how to negotiate.  If he is correct that a mandate is something Obama or any President is going to have to give to accomplish the political goal of Reform, then it is certainly wiser to hold back that chip to exchange for other parts of his plan he needs, like lowered costs, no exclusions, etc. etc.  To structure the plan to give that up unasked right from the starting point of the negotiations is not very smart.  Perhaps that's why Obama slyly admits to being open to mandates if it becomes necessary but wants to wait to see if that's the case.

And Cohn doesn't cover in much depth the other issue of how mandates will play in the GE when the conservative wing of the Republican party makes it into an issue of Big Government dictating how to live our lives.  So let's recap: Mandates create a hot button argument in the GE, weakens your negotiating position by giving the other side what they want right from the start, and achieves an unimportant advantage of more coverage.  I think I'll stick with the Obama Plan.


Cohn (0.00 / 0)
I think you completely misunderstood Cohn's article.  He is very much for mandates in a UHC plan.

[ Parent ]
Cohn (0.00 / 0)
I never said otherwise, but his conclusion is not very persuasive in terms of the necessity or the political wisdom of making it part of the plan at this point.  The numbers issue has been blown out of proportion by the Edwards/Clinton campaigns trying to score points, but people are slowly coming around to see how very well crafted the Obama Plan is in terms of starting down the path toward universal coverage while realizing the final Plan will be the result of intensive negotiations with all segments of the Health Care industry, and trying to avoid letting Health Care become a political football in the GE. 

[ Parent ]
I don't (0.00 / 0)
think so.  Rather it seems what we are seeing is an unwillingness on the part of the Obama camp to admit that his plan is not the best, so they're defending it in silly ways.
Reminds me of the current administration way too much for comfort.

[ Parent ]
Why don't you say where you disagree? (0.00 / 0)
Cohn says the difference in numbers is not so important in the long run.

Please explain how giving Insurance industries what they want before they insist upon it in negotiations is a smart thing to do.

Please explain how making something which is not so important into a big issue  which will be used against us in the GE is a smart thing to do.


[ Parent ]
Sure (4.00 / 1)
I disagree because my own common sense tells me that in the US  we won't get anywhere near UHC without mandates. There is a percentage of people which will free ride on the system until they need it, if they can, thus screwing up the pricing for everyone else. 

I see absolutely no reason not to disavow such antisocial behavior.  With proper subsidies, everyone needs to pay their own way. Personally, I think that is very important and, if you don't, then we'll just have to disagree.


[ Parent ]
Free riders (0.00 / 0)
should be fairly easy to reduce by instituting, after an initial enrollment period, a waiting period between application and benefits kicking in, so someone who can afford health insurance can't just show up to an emergency room and sign on.  The prospect of gambling your life savings and assets to save a little money should take care of most of the free riders - who we should point out will also exist in the mandated plans.  Exactly how quickly do you think the IRS will act to garnish wages from the people who just do not pay?

[ Parent ]
easy (0.00 / 0)
Yes, that would be easy if your purpose was to bankrupt sick people.

[ Parent ]
Arrogance and more (0.00 / 0)
Obama has been very much having it both ways on health care and is sailing towards the nomination, just 14 or 16 days away from the Christmas break and he picks a fight with a princeton economist on his weakest point.  What in blazes is wrong with the guy.  No turmoil and he, like it or not, sails through as Mr. Nice Guy on a pass.  This year's John Kerry.  He's picking up ground every day and Hillary has really problems while Edwards won't be taken seriously by the Media.  And ...

I guess Obama knows he's smarter than everybody on everything (even in their specialties) and he needs to show off about it.  That is the mindset that gave us some seriousl;y screwed up policies like Vietnam because it was just unthinkabke to querstion the "wisdom" of Versailles.  On the Republican side it gave us Iraq.  Bad signal.

Meanwhile, Obama is running head on against a candidate in Hillary who has no overarching message or theme.  He's running on the vague but supremely satisfying "change."  Edwards is stuck with "socia; justice" (I like it but it is not nearly as strong as change.  See Dave Nagle's December 6 column in the Des Moines Register laying it all out (he's a former congressman and state Dem Party chair in Iowa).

What a maroon.  he had the thing gift wrapped for under the Christmas tree and nobody could stop this?  Do you really wan topt open up the underbelly of the meaningless "hope" "change" for another 20 years of status quo.


A maroon? (0.00 / 0)
A runaway slave?  What are you trying to have your own personal macaca moment? Nice.

[ Parent ]
I hope (4.00 / 1)
that was maroon as in the Bugs Bunny sense.  "What a maroon."

[ Parent ]
That's right... (0.00 / 0)

.....but I caution you that Ol' Bugs was using that word as a fill-in for moron. So...we may be hearing from the developmentally disabled next. Maybe even this guy:

http://memewatch.com...



Peace, Health and Prosperity for Everyone.


[ Parent ]
Don't forget (0.00 / 0)
That this fact check things is done at the campaign level, I highly doubt that Obama himself was aware that the page was put together.  Someone probably felt that they had heard too many people quote Krugman when talking about health care and decided to be clever and post what they saw as a contradiction.

My job is not to represent Washington to you, but to represent you to Washington- Obama
Philly for Obama


[ Parent ]
That;s (0.00 / 0)
a mighty fine distinction.  haha

[ Parent ]
I don't really get what you're saying (0.00 / 0)
A mandate is very complicated to explain, with lots of easy fear-mongering tools built into it the right can use (collection agencies, wage garnishment, etc).  And once the Village gets its mind set on mandates, any mandate will do.  That means that the likely outcome of this debate is going to be not just a universal mandate, but the worst possible universal mandate.

This is unclear. The right will use the mandate as a basis for fear-mongering, stirring up opposition to UHC based on a mandate. But then a mandate will get passed, except it will be a bad mandate with little or no subsidies forcing people to buy poor coverage at exorbitant rates. In other words, the right ensures that the exact thing that they publicly oppose comes to pass. How does that work?

Join us at the Missouri community blog Show Me Progress!


Phased solutions? (4.00 / 1)
The big ol' elephant in the room is private insurance, which is where we have the problem: Profits come from denial of health care. 31% overhead costs (15-20% insurance companies, 10% provider-side overhead). The problem with mandates is that they subsidize and maintain the insurance industry, don't deal with that 30% problem, and are designed to eliminate the threat of more serious reform.

Of COURSE we want more people covered for moral reasons, and mandates are one way to increase coverage. It's cheap politics because you don't have to raise very much in additional tax dollars, and you can push the blame off on "those" uninsured people. 96% of VOTERS have insurance, so the uninsured are also the most marginal to the political process.

The Politicians (Dems as well) are running as fast as they can from Single Payer, because they're deathly afraid of the 8% tax increase to fund single payer (never mind the 12% of income decline in insurance premiums). Even the most idealistic single payer proponent can see the political difficulty of the problem.

There are various phased approaches to achieving single payer:
  - Mandates with the Competition Option (let people or businesses buy into medicaid, for eg.)
  - Age group segmentation (Start with all kids, then all college, then ...)
  - Split Primary care & chronic condition off from Major Medical and Specialists (Segment health/insurance industry by provider class or ICD-9 Codes)

Any of these approaches could move toward single payer, but as they say, the devil is in the details.

Mandates without the competition option are PURELY insurance industry subsidies, and ARE DESIGNED to be an effort to stop single payer.

Age group segmentation still leaves most of the insurance company subsidies in place. Doctors offices aren't split into age groups.

Single Payer Primary Care has the advantage of freeing a whole segment of health care (general practitioners and clinics) from insurance company overhead. It is an area of health care that costs less and would result in healthy outcomes. So, maybe a 1% tax increase can give us 100% single payer across all clinics and GPs, and take out a good chunk of the insurance industry.


Mandates, Subsidies, the whole complicated dance profits ONLY Insurance Companies (0.00 / 0)
It is stupid--and an ENORMOUS fucking scam--to take public money (from taxes) to supply health insurance subsidies for poor folks to pay to Insurance companies to waste in overhead and GIGANTIC fucking salaries for their elite execs...

There is only one rational approach to the problem of health care coverage in the US: Generous, comprehensive, compassionate "Medi-Care" for EVERYONE!

Chuy, people. Get fucking real.


not 'theoretically'... (0.00 / 0)
as Clinton's plan provides for no actual "theory" on why this would be harder. As it stands at this point, its more like a recommendation, the government is asking "please don't wait till you are ill to get insurance."

But here lies the moral delema,

End this war. Stop John McCain. Cindy McCain is filthy rich.


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