We all know John Edwards’ basic pitch, by this point. You can’t cut deals with powerful special interests; you can’t give them a place at the table. You’ve got to shut them out. From my inbox:
I don’t believe you can sit around a table with the drug companies, the insurance companies or the oil corporations, negotiate with them – and then hope they’ll just voluntarily give their power away. You can’t nice them to death – it doesn’t work.
They’ll only give their power away when we take it away.
So. If you were designing a health care plan that would really take away power from health insurers, what would you propose? Wouldn’t you propose a plan that eliminates the need to deal with health insurers? That is, wouldn’t you propose single payer? I would.
But no. Edwards basically proposes a modified Massachusetts model, like everyone else. He sticks with employer-based health care, he sticks with private insurers as a central part of the system — and he forces individuals to purchase health insurance from the very companies he apparently detests. Yes, there are subsidies, and some new public insurers to fill the gaps. But as far as I can tell, his plan will not work unless he can get the private health insurers to play ball.
This strikes me as a huge disconnect. If you’re going to run a campaign based on not sitting around the table and not negotiating with, say, “the insurance companies,” how is this plan going to work?
Here’s what the Globe has on this today:
Corporations might be convinced to help stop global warming, be fair in paying for health costs, and keep jobs in the United States. But they might need to be beaten up a little bit first, says John Edwards, who thinks he’s just the man for the fight.
Call me a cynic, or a corporate shill, or something, but I just don’t see that working. Nor, frankly, do I see that Edwards really has the courage of his convictions, if he’s not willing to propose the health care model that a lot of people already support, and that would truly achieve what he says he wants — health insurance for everyone, without giving the health insurers a place at the table.
What am I missing? And don’t answer that by saying that single payer is “not realistic” or “not politically feasible.” None of what Edwards is talking about is especially “realistic” or “feasible” — he’s talking about a radical overhaul of Washington. If that’s what he wants, single payer shouldn’t be such a big deal.
my mandatory health insurance plan from Satan’s Health Care. United routinely denies claims and has been sued under the RICO statute. Well, duh, government just does not function anymore. It is now government mandated, your support of big pharma is now law in mAssachusetts.
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p>Please research Edwards again and specifically look for his lips attached to the asses of the biggest globally oriented organizations.
Edwards fanboy though I am, I will admit that there’s some hyperbole in the claim that JRE “won’t negotiate with the insurance companies”. Nothing can be accomplished without some kind of negotiation. I think the issue is not with JRE’s health care plan, which is considered sensible and forward-looking by, for example, Ezra Klein. It’s a great idea to make a reform along centrist lines, with a mandate and subsidies, in such a way as to leave the door open for a single-payer plan to eventually outcompete the private sector. And yes, this is more “feasible” than replacing however many percent of the economy with a single govermnent program. I don’t agree that this “shouldn’t be such a big deal” compared with the other things a progressive president might want to accomplish, like a tax reform, a $100B economic stimulus, cleaning up the housing mess, etc. — a more feasible health care program might leave more political capital for the rest of the agenda.
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p>The problem you rightly point out is to square the take-no-prisoners rhetoric with a health care plan that is not take-no-prisoners single-payer. JRE is trying to distinguish himself from HRC and BHO on the basis of his attitude and priorities, centering at the moment on the (correct) claim that he has less sympathy for and connections with corporate lobbyists than they. Differences between candidates always get exaggerated, and I think here the rhetoric has exaggerated the differences beyond what the actual policy proposals justify. That said, JRE’s attitude and priorities are different, and that’s why I support him.
I know because I used to do that kind of work within a law firm, and just one case on my own.
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p>I also know that the only way to cut a good deal is from a position of strength – and the lonely, always outgunned tort attorney has to be aware of that.
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p>I assure you, the funds that a large corporation puts in play against a plaintiff’s attorney like JRE was is generally 10, 20, 0r 100 to one in terms of the finances.
We can all piss and moan about corporate domination but do we want a president who treats policy like a tort action? I love Edwards’ passion and focus for the oppressed but not for leading the country. It doesn’t make sense that the person responsible for pulling people together is inclined to separate people based on what they have and how they got it. When Edwards attacks these corporations the thousands of employees feel the pinch, not in their pocketbook but in their head and hearts. They feel like the bad guy. What are they to do, quit because their employer lawyers-up when legal challenges are mounted? Go find another job because the corporation and its lobbyists killed regulatory legislation?
The world of tort litigation, especially where Edwards worked, is an odd beast, uniquely American, and should not form the policy basis for a presidential campaign, let alone a presidency.
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p>Perhaps Edwards is just a one-trick phony?
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Edwards has said that he wants the American people to choose what kind of system of health care they want. That is why he has a single=payer component in his proposal – an expanded and improved Medicare plan. Medicare is a government-run plan for seniors and the disabled that was passed in LBJ’s administration and has been enormously successful. If the majority choose this plan it will tip the scale in favor of single-payer.
So let me assume you are not endorsing Edwards. Good! I can’t stand him (sorry charlie). I’m not much of an Obama fan either. I suspect you are going to end up in the same place I may, kinda of sorta by default end up. Clinton. But I’ll tell you I don’t like it.
David, this criticism seems so unlike you. All the health plans on the table are, each of them, an incremental reform.
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p>The question should be, what kind of reform?
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p>* A progressive reform, which (a) helps people and (b) makes further reform more likely, or
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p>* A reformist reform, which rearranges some deck chairs, creates a new set of winners and losers, and brings real reform no closer (or worse).
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p>I suggest that Edwards’ plan is both progressive and the best of the three. It doesn’t just kick the can down the road, it kicks it to a more advantageous playing field. And it does some good in the meantime.
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p>You might say that this argument violates your stricture
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p>and you’d be right. But clearly you anticipated it.
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p>But it is a big deal, David. The next president will have to choose his or her battles and pick his or her timing, or lose control of the agenda in a big way.
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p>You think one “radical overhaul” is as easy as another–well, that’s your privilege. But that’s a political judgment. Yours is good, but maybe his is good too.
you’re missing part of my point. I don’t have a problem in principle with incremental reforms. But reforms of that kind, by their very nature, demand working within the system, within the established power structure. But the whole point of Edwards’ campaign is that he wants no part of that — he wants to destroy the existing power structure and replace it with something else (what, exactly, is not entirely clear to me).
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p>So I’m not saying that Edwards’ plan isn’t a good one. It’s fine, and it’s just as good as (because it’s almost indistinguishable from) Clinton’s and Obama’s (save for the personal mandate issue). What I’m saying is that it doesn’t match his campaign rhetoric in what seems to me a fundamental way. In other words, if he’s true to what he’s campaigning on now, I don’t see how he can achieve this health care plan if he’s elected.
I consider that Edward’s health care plan is a “proceeding in the alternative” – a single payer with buy in, and a “quasi- Massachusetts plan” with the evolution towards one or the other to be by “buyin” as well as how well they work in the real world. That does not bother me, at least.
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p>Plus, as we have seen here in Massachusetts, the Executive does not “drive” the legislative agenda – but by choosing agency heads, judges, and having sense as to when and where to fight, who the executive is makes a huge difference. Look at where Bush choose to fight!
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p>And I point out that taking on two or more large fronts at a time has not worked for anyone in the real world of warfare and I don’t think it works in the stylized warfare which legislative work actually is.
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p>As an aside, whether it is Deval Patrick or our next president, I consider that Deval ran into problems by tackling too many “fronts” at a time [think of Napoleon with Europe and Russia and Egypt] – or in our own century, even Hitler’s war machine with Eastern and Western fronts. Have a #1 goal and stick to it, before riding off in another direction.
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p>Rightly or not, I trust John Edwards in that regard. One thing at a time.
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p>Legilsatures are not tame, and it truly is work to move legislation that requires insight, focus, teamwork, and staying on target.
It sounds as though you are criticizing Edwards for saying, in effect, I’ll never negotiate with those swine. Leaving perhaps two unlikely options: Caesar Chavez, or holding his breath until he turns blue.
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p>But that’s not his position. In your own quote, he says
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p>The phrase “I don’t believe you can” does not apply to the phrase “negotiate with them.” It applies to “hope they’ll just voluntarily give their power away.” The main thrust of the quote is, “I don’t believe…they’ll just voluntarily give their power away.”
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p>I don’t see where you get the “won’t negotiate” stuff. What I get is, Will negotiate–from strength.
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p>Have I been fooled?
Maybe. From a new Edwards email (emphasis mine):
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p>You tell me.
I’m not supporting Edwards (I like him, but my tendency is more and more towards Obama), but if I recall correctly, he has my favorite of the health care plans. Well, Kucinich has my favorite one out of context, but I don’t think it’s possible to do, whereas Edwards’ is. And IIRC, Edwards’ plan is the one that allows a public health care plan (something like Medicare but I think based on the insurance members of Congress gets) to compete with the private plans. It basically provides an opportunity for single payer to slowly be instituted by market forces, as people dump bad private plans with excess bureacracy and denied claims, for a public plan that works better.
In Massachusetts, those who don’t qualify as low income must choose one of the plans offered by the insurance industry. Under Edwards plan, you can sign on to single payer no matter what your income. That will allow more people to “try it on” and, if it works well enough, grow to include a majority of the population. With a larger base, the single payer system will be able to negotiate better prices for drugs and services, lower health care administration costs and become the foundation for true universal healthcare.
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p>Obama’s plan is the worst of the three Democratic front runners. It is a patchwork program that relies heavily on employer-based insurance. According to the NYT, he has accepted more money from the health care industry than any (including Republican) candidates with the exception of Hillary Clinton. Clinton cribbed most of Edwards’ plan, but I don’t trust her to follow through.
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p>If a candidate were committed to removing the insurance companies from the equation, he would need to go further than single payer and consider a national health service. It’s not surprising to see the candidates hesitate to take this on. Medical professionals are happy to join in excoriating the insurance companies, which they see as exerting too much control over the delivery of care and pinching them on payment. But that doesn’t mean that most want to hand over their status as independent professionals and businesspeople in order to become salaried members of a national health service.
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p>This is why you’ll see the candidates advocate for expansion of health insurance, but not take it farther than that.
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I tried to make a similar argument to David’s in a previous post, that the single payer system should be the natural and logical health care reform model for a politician, such as Edwards, who advocates a radical overhaul of corporatist American system and bringing equity and fairness to the health care system, in particular.
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p>The single-payer system, accompanied by meaningful cost controls such as reasonable limits on medical liability, and mediation and arbitration in lieu of costly civil litigation, would eviscerate the power and the influence of the private insurance companies Edwards assails consistency.
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p>The place where I may part company with David is the question of Edwards’s motive in offering such a tepid health care reform model to overhaul the corporate-dominated, health care system and bring authentic equity and fairness to health care consumers.
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p>I doubt the sincerity of John Edwards’s assertion that he would like to “destroy the system” because as he has personally benefited generously by successfully playing one of the key roles in the “medical-industrial complex” that dominates our health care system. Specifically, Edwards has starred as the crusading, zealous plaintiff’s attorney against the “incompetent, reckless, and heartless doctors, hospitals, and insurance companies” and earned a substantial living from his well-rehearsed and persuasive trial performances.
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p>John Edwards does NOT advocate a single-payer system because as a representative of the system he claims to abhor, he cannot bring himself to advocate a “radical” single payer system that would essentially put his ilk out of business and require many of his colleagues to find a new and less lucrative line of business. The personal is political.
I believe you mischaracterized Edwards’ health care plan. The role of the Medicare-style public insurance isn’t just to “fill the gaps”, it is competing on equal footing with the private insurers. Medicare is cheaper and as good or better than most private insurance, so in all likelihood, people would opt for the public option. If the private insurers don’t want to “play ball”, fine, then they’ll just cede all the business to the public insurance and we’ll have single-payer.