Steve Spruiell at NRO, a conservative but not a DeLay fan, makes a pretty good argument in favor of this being a bogus indictment.Perhaps it takes a bad DA to indict Tom DeLay?I also wonder, with my friend at massBackwards, whether this AP article will even make it into the local news in anything as near as big a way as the DeLay indictment will.
anonsays
Good to see Patrick drive ahead on the issues and not just sit around and get ready to run TV ads. I love that non-statement from Reilly. Basically an “Uhhhh…yeah…healthcare, we got some poeple on that. We’ll get back to you.” How lame and uninspiring. I expect more…oh wait a second…it’s Reilly.
abbysays
I think that the confusion arises, because the proposals on Patrick’s web site do call for a universal state financed catastrophic coverage. I think that the ACT coalition supports a form of reinsurance to keep premiums down for those with insurance, but it doesn’t do much for people who are bare and find that they have cancer.The weakness of Patrick, from my perspective, is that he talks a lot about hope in Clintonesque ways without providing much in the way of policy details. Of course, electorally, this is probably a strength. And everyone knows that what comes out of a legislature is never exactly what you wanted at the start.
I appreciate his strong desire for universal healty care, but his approach seems overcomplicated and still too dependent on employers to provide health care. Health care, like fire and police, should be guaranteed by the state regardless of employment status. The state could achieve this with a much simpler single-payer plan, like that offered in S.755 “An Act to Establish the Massachusetts Health Care Trust”. This smells like a Clinton idea: a complicated and ultimately insufficient proposal instead of a single, more robust solution.
julie-vsays
Great blog! —Off topic:FYI: I caught you guys on google news when I went hunting for info from the Globe story on Health Care for All. Pretty nifty that you guys get listed on Gooogle news…—On topic:Those of us who are policy wonks can get into the nitty gritty of any proposal and get lost. What I find most impressive about this is that at least Mr. Patrick is willing to put issues, real issues, on the table and say this stuff matters. No real health care plan will happen unless people put aggressive ideas and plans out there and say “we need to talk about this stuff.” Mr. Patrick is at least willing to push aggresively on the issue, not just give it lip service. Are we going to blame someone for talking about the issue? Shouldn’t we reward them for bringing it up, for actually trying to accomplish something? What about those who remain silent and just play pure electoral politics? To me it seems like he is asking for the debate, and that he will modify plans based on those who chime in. Isn’t this what we really want from our elected officials? Isn’t that the core responsiblity of their jobs?
abbysays
Greg–I think that it would be extraordinarily difficult to do single payer in a state given the existence of Medicare and Medicaid. It would require a whole bunch of waivers which might not be forthcoming from the current administration.I’d love to see it done at the Federal level.
bensays
Abby makes a good point, and one which I was about to make before she beat me to it. I am troubled, some times, by Patrick’s some what obvious reaction to proposals such as these. Is this a signal of how he would react to things as a Chief Executive of the state? I don’t think so, because I think the position necessitates more pragmatic decision making process. The politics of hope needs to be more about “this is good, now can it be done” and less about “this is great, let’s go.”
Greg, I agree with you about single-payer; that would be great, especially at the federal level. If you count votes, either in MA or in DC, you will see that it’s not happening soon. I wish things were different. But in the meantime people who don’t have insurance are getting sick.And so we do what we can. The the ACT legislation will most definitely matter to the 400,000+ people who will be covered. No, it’s not complete, and no one who supports real health care reform will tell you that it is. I think Patrick is being as clear as anyone in saying this is the short-term strategy (i.e. the next 12 months), with universal coverage as the long-term goal. (How long is “long-term” I don’t know. That might also be a useful discussion.)It has seemed to me that all of those “micro-initiatives” under Clinton actually added up to a fairly impressive record of accomplishment, in the aggregate. And I wouldn’t describe the ACT legislation as “micro”; it’s a pretty significant step forward.In any event, check out our interview with John McDonough of Health Care for All, in which he addresses some of your concerns. Thanks for commenting.
And Julie, you are absolutely right — this is all about framing the terms of the debate. Patrick is taking a bolder stand than any other Gov. candidate, including Romney (who’s probably not a candidate, after all). I’ve asked for specifics from Patrick, especially when we interviewed him. He’s given us an answer on health care. I appreciate that very much, and really want to hear some meat n’ potatoes from Reilly and Galvin now.
bensays
Charley … I think you make a good point about the need for answers from all candidates, but is it necessarily advisable to be coming out with stances now? I’m not sold either way, it’s just a thought. The attention being devoted to the Gubenatorial at this stage in the game is very low compared to what it will be come spring and summer. I go back and forth on both strategies. There is an argument for coming out first, taking a stand, and forcing other candidates to respond to you, there is also an argument to be made for taking a stand when the audience to see it/hear it is so minimal. I know this is more about strategy and less about the health care bill, but its worth considering the dynamics of a campaign.
Ben, maybe this is a continuation of his grassroots strategy, to attract folks concerned about health care to his campaign. And many health care activists are in full swing these two weekends. So he becomes part of their news as well.I don’t know — what do you think? Is that too blatantly self-serving? :)Actually, in his interviews, he had talked about nailing down some specifics on policy over the summer. So maybe this is just one of the results of that. In light of that, the timing doesn’t seem surprising.
Charley,Patrick has been talking in this vein since I first met him in the spring. I am not surprised by his stance. He said from early on that doing something significant to solve the healthcare crisis would be the top priority of his administration, and he would be willing to spend a lot of political capital to make it happen. I would also see his position as the beginning of his effort to tackle health care — and not the end.That he made his announcment right now, when the subject is on people’s minds, seems like smart politics to me.
bensays
Charley and Frederick,Both very good points. Personallly, some times I look too much at the crass politics of an issue (how, where, when, and who) and miss the why – – in this case because he believes in the issue and cares.That being said, I don’t think we can ignore the other questions. I think whoever is the nominee from the Democratic party will aggressively attack the health care crisis in the state. The problem is, there are limitations to what can be done (I know, again this is drifting from why to how) within the federal framework. I’d be interested to see if anyone here knows about other states that have tried to implement systems similair to ACT. I want to say Hawaii has single payer, if anyone knows anything about this I’d greatly appreciate the input.Anyways, politics aside, I think we all can agree the more the healthcare topic is discussed the better. Once it is a major issue for all, it will require an actual solution.
abbysays
Ben,Hawaii does not have single payer. They have an employer mandate that requires that anyone working more than 20 hours per week be covered by their employer.They can do that, because a specific exemption was written into ERISA for Hawaii only.The ACT proposal doesn’t do that. It simply says that for payrolls above 50K, a tax of between 5-7% will be assessed to fund expansion of MassHealth and the Insurance Partnership which helps low income people buy their employer’s private insurance. To the extent that a company already provides healthcare they get a credit against the tax, but there’s no employer mandate in this legislation.
bensays
This is a classic case of towns, cities, and neighborhoods feeling the effects of systemic problems, and then being told by their “leadership” that they must find the solutions to their problems within their own communities.Let’s face it, the federal government is in a financial crisis, and that has put additional stress on states, counties, municipalities and communities. It’s all about choices and values. In 2000, when the current administration inherited record surpluses, they made a choice that reflected their values. Instead of investing in our nation, it’s people, and it’s future, they chose to line the pockets of the richest 1% of the entire country.Choices have consequenes and those consequences cannot be ignored. Now, more than ever before, we need creative, innovative leadership at the state and local level to stem this tide. Ultimately, though, what is required, is leadership on the federal level. Leadership that does not say you can have your cake and eat it too, but leadership that says, progress requires tough choices, join with me, let’s make them, and move forward in the best tradition of our country.
Well, I disagree with your categorizations. Truth be told, this real estate price increase should be lining the coffers of the cities and towns, who are primarily funded by real estate taxes. Cities like Cambridge have increased taxes over the last few years and now go by a standard of home resale value, rather than intrinsic worth. And not all towns are in trouble. The City Of Somerville is doing just fine, largely in part to their sale of lingering municipal property. These sales not only give the city a one-time burst of cash, but it also allows developers to own the land, which means those developers will pay taxes on that land. I really think that most municipalities are in the dark ages when it comes to cleaning house, supporting development, and using their tax dollars wisely.
jrp says
Steve Spruiell at NRO, a conservative but not a DeLay fan, makes a pretty good argument in favor of this being a bogus indictment.Perhaps it takes a bad DA to indict Tom DeLay?I also wonder, with my friend at massBackwards, whether this AP article will even make it into the local news in anything as near as big a way as the DeLay indictment will.
anon says
Good to see Patrick drive ahead on the issues and not just sit around and get ready to run TV ads. I love that non-statement from Reilly. Basically an “Uhhhh…yeah…healthcare, we got some poeple on that. We’ll get back to you.” How lame and uninspiring. I expect more…oh wait a second…it’s Reilly.
abby says
I think that the confusion arises, because the proposals on Patrick’s web site do call for a universal state financed catastrophic coverage. I think that the ACT coalition supports a form of reinsurance to keep premiums down for those with insurance, but it doesn’t do much for people who are bare and find that they have cancer.The weakness of Patrick, from my perspective, is that he talks a lot about hope in Clintonesque ways without providing much in the way of policy details. Of course, electorally, this is probably a strength. And everyone knows that what comes out of a legislature is never exactly what you wanted at the start.
greg says
I appreciate his strong desire for universal healty care, but his approach seems overcomplicated and still too dependent on employers to provide health care. Health care, like fire and police, should be guaranteed by the state regardless of employment status. The state could achieve this with a much simpler single-payer plan, like that offered in S.755 “An Act to Establish the Massachusetts Health Care Trust”. This smells like a Clinton idea: a complicated and ultimately insufficient proposal instead of a single, more robust solution.
julie-v says
Great blog! —Off topic:FYI: I caught you guys on google news when I went hunting for info from the Globe story on Health Care for All. Pretty nifty that you guys get listed on Gooogle news…—On topic:Those of us who are policy wonks can get into the nitty gritty of any proposal and get lost. What I find most impressive about this is that at least Mr. Patrick is willing to put issues, real issues, on the table and say this stuff matters. No real health care plan will happen unless people put aggressive ideas and plans out there and say “we need to talk about this stuff.” Mr. Patrick is at least willing to push aggresively on the issue, not just give it lip service. Are we going to blame someone for talking about the issue? Shouldn’t we reward them for bringing it up, for actually trying to accomplish something? What about those who remain silent and just play pure electoral politics? To me it seems like he is asking for the debate, and that he will modify plans based on those who chime in. Isn’t this what we really want from our elected officials? Isn’t that the core responsiblity of their jobs?
abby says
Greg–I think that it would be extraordinarily difficult to do single payer in a state given the existence of Medicare and Medicaid. It would require a whole bunch of waivers which might not be forthcoming from the current administration.I’d love to see it done at the Federal level.
ben says
Abby makes a good point, and one which I was about to make before she beat me to it. I am troubled, some times, by Patrick’s some what obvious reaction to proposals such as these. Is this a signal of how he would react to things as a Chief Executive of the state? I don’t think so, because I think the position necessitates more pragmatic decision making process. The politics of hope needs to be more about “this is good, now can it be done” and less about “this is great, let’s go.”
charley-on-the-mta says
Greg, I agree with you about single-payer; that would be great, especially at the federal level. If you count votes, either in MA or in DC, you will see that it’s not happening soon. I wish things were different. But in the meantime people who don’t have insurance are getting sick.And so we do what we can. The the ACT legislation will most definitely matter to the 400,000+ people who will be covered. No, it’s not complete, and no one who supports real health care reform will tell you that it is. I think Patrick is being as clear as anyone in saying this is the short-term strategy (i.e. the next 12 months), with universal coverage as the long-term goal. (How long is “long-term” I don’t know. That might also be a useful discussion.)It has seemed to me that all of those “micro-initiatives” under Clinton actually added up to a fairly impressive record of accomplishment, in the aggregate. And I wouldn’t describe the ACT legislation as “micro”; it’s a pretty significant step forward.In any event, check out our interview with John McDonough of Health Care for All, in which he addresses some of your concerns. Thanks for commenting.
charley-on-the-mta says
And Julie, you are absolutely right — this is all about framing the terms of the debate. Patrick is taking a bolder stand than any other Gov. candidate, including Romney (who’s probably not a candidate, after all). I’ve asked for specifics from Patrick, especially when we interviewed him. He’s given us an answer on health care. I appreciate that very much, and really want to hear some meat n’ potatoes from Reilly and Galvin now.
ben says
Charley … I think you make a good point about the need for answers from all candidates, but is it necessarily advisable to be coming out with stances now? I’m not sold either way, it’s just a thought. The attention being devoted to the Gubenatorial at this stage in the game is very low compared to what it will be come spring and summer. I go back and forth on both strategies. There is an argument for coming out first, taking a stand, and forcing other candidates to respond to you, there is also an argument to be made for taking a stand when the audience to see it/hear it is so minimal. I know this is more about strategy and less about the health care bill, but its worth considering the dynamics of a campaign.
charley-on-the-mta says
Ben, maybe this is a continuation of his grassroots strategy, to attract folks concerned about health care to his campaign. And many health care activists are in full swing these two weekends. So he becomes part of their news as well.I don’t know — what do you think? Is that too blatantly self-serving? :)Actually, in his interviews, he had talked about nailing down some specifics on policy over the summer. So maybe this is just one of the results of that. In light of that, the timing doesn’t seem surprising.
frederick-clarkson says
Charley,Patrick has been talking in this vein since I first met him in the spring. I am not surprised by his stance. He said from early on that doing something significant to solve the healthcare crisis would be the top priority of his administration, and he would be willing to spend a lot of political capital to make it happen. I would also see his position as the beginning of his effort to tackle health care — and not the end.That he made his announcment right now, when the subject is on people’s minds, seems like smart politics to me.
ben says
Charley and Frederick,Both very good points. Personallly, some times I look too much at the crass politics of an issue (how, where, when, and who) and miss the why – – in this case because he believes in the issue and cares.That being said, I don’t think we can ignore the other questions. I think whoever is the nominee from the Democratic party will aggressively attack the health care crisis in the state. The problem is, there are limitations to what can be done (I know, again this is drifting from why to how) within the federal framework. I’d be interested to see if anyone here knows about other states that have tried to implement systems similair to ACT. I want to say Hawaii has single payer, if anyone knows anything about this I’d greatly appreciate the input.Anyways, politics aside, I think we all can agree the more the healthcare topic is discussed the better. Once it is a major issue for all, it will require an actual solution.
abby says
Ben,Hawaii does not have single payer. They have an employer mandate that requires that anyone working more than 20 hours per week be covered by their employer.They can do that, because a specific exemption was written into ERISA for Hawaii only.The ACT proposal doesn’t do that. It simply says that for payrolls above 50K, a tax of between 5-7% will be assessed to fund expansion of MassHealth and the Insurance Partnership which helps low income people buy their employer’s private insurance. To the extent that a company already provides healthcare they get a credit against the tax, but there’s no employer mandate in this legislation.
ben says
This is a classic case of towns, cities, and neighborhoods feeling the effects of systemic problems, and then being told by their “leadership” that they must find the solutions to their problems within their own communities.Let’s face it, the federal government is in a financial crisis, and that has put additional stress on states, counties, municipalities and communities. It’s all about choices and values. In 2000, when the current administration inherited record surpluses, they made a choice that reflected their values. Instead of investing in our nation, it’s people, and it’s future, they chose to line the pockets of the richest 1% of the entire country.Choices have consequenes and those consequences cannot be ignored. Now, more than ever before, we need creative, innovative leadership at the state and local level to stem this tide. Ultimately, though, what is required, is leadership on the federal level. Leadership that does not say you can have your cake and eat it too, but leadership that says, progress requires tough choices, join with me, let’s make them, and move forward in the best tradition of our country.
ed says
Well, I disagree with your categorizations. Truth be told, this real estate price increase should be lining the coffers of the cities and towns, who are primarily funded by real estate taxes. Cities like Cambridge have increased taxes over the last few years and now go by a standard of home resale value, rather than intrinsic worth. And not all towns are in trouble. The City Of Somerville is doing just fine, largely in part to their sale of lingering municipal property. These sales not only give the city a one-time burst of cash, but it also allows developers to own the land, which means those developers will pay taxes on that land. I really think that most municipalities are in the dark ages when it comes to cleaning house, supporting development, and using their tax dollars wisely.