Blue Mass Group

Reality-based commentary on politics.

What Price Do We Pay For Obama’s Victory?

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In the choice between the two Democrats, I’ve seen several arguments like Charley’s, that they are close enough on healthcare and global warming that Obama’s foreign policy makes him better.  But Obama’s campaign has been putting out ideas that will make it harder for a Democratic majority in the House and Senate to actually pass universal healthcare coverage.  There are some things we do better together, Obama told us in 2004, and it’s true.  We all pay in for the military, the police and fire fighters to protect us.  But Obama never said, One of those things is healthcare.  

John Edwards and Hillary Clinton put out detailed plans for Universal Healthcare Coverage before Obama, and one way they proposed to get it was mandates, so healthy people pay in and insurers don’t drop sick people.  As Ezra Klein points out,

A mandate is not how you cover everyone, it’s how you force insurers to cover everyone, and discriminate against no one. And even if you don’t have a mandate in your plan, to argue against universal mechanisms because they force people to buy insurance is supremely damaging to the long-term goal, which Obama professes support for, of some system in which everyone is, and has to be, covered.

We’ve got to cover everyone in this country, and it means some of the better-off people in this country are going to have to help some of the worse-off people.  But Obama is putting out the idea that we “can’t afford” it (though somehow, we’ve afforded a one-trillion dollar war over non-existent WMDs), and voters will remember that idea when the next President is governing.  On-the-fence Senators will want to hear from their constituents–and if Obama has spread this idea that when it comes to healthcare, we Americans aren’t all in this together, that will buttress the anti-Progressive forces, who are already over-represented in the Senate.

Just last month, Obama heard a woman describe how she couldn’t afford both heating fuel and medicine.

Her tale seemed to captivate Obama, who listened with red eyes. “What would you do?” she pleaded with him.

“No, look, it’s outrageous,” Obama said, going on to say how insurers, drug companies, and other special interests in Washington had broken the healthcare system.

“Can you fix it?” Burt asked.

“I know I can fix it if I’ve got the American people understanding that it needs to be fixed,” Obama said, handing her a tissue.

He said the solution is getting the American people to understand our system needs to be fixed, but surely he has to understand how ideas that get repeated over and over in our country make or break new policy.  So, when he’s mailing out flyers that say we “can’t afford” getting everyone covered, he’s making the kind of rookie mistake that will trip him up if he wins.

Universal healthcare coverage and the security it will bring for the working poor and the lower middle class–the people who pump your gas, the people who butcher your beef, the people who dry clean your clothes–have been long, long overdue.  I have to vote for the candidate whose campaign is laying the groundwork to achieve lasting progressive legislation.  I want to vote for a President who can finally, at long last, make real the will of the majority of people to cover everyone for healthcare.  

Sometimes, the best man for the job is woman.

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  1. I would heavily advise that you don’t start a war over mailings.

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    p>HRC’s 527 friends and aligned PACs have created quite a stir in IA and NH.

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    p>Since the two now love each other, we should stick to promotion and not demotion. Yes.

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    p>We can go downtown, yo. We fear not, due to the mountain of evidence that supports my claim.

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    p>Though I am bored with the trash talk, kinda.

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    p>To you….

    • paid for the mailer.  So the 527s etc. aren’t relevant to this discussion.

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      p>The mailer strikes me as lame, and unworthy of the campaign that Obama says he wants to run.  I’m hoping he doesn’t make me regret my choice.

    • This kind of fearmongering from the Obama campaign is bad, and worthy of criticism, regardless of the Clinton campaign’s actions.

    • I appreciate that there’s a healthy debate on this issue, but to me using the Harry and Louise imagery is really insulting to a lot of Democrats.

      • It’s the imagery I object to.  But, as we discussed at length on these very boards two years ago, this is exactly the problem of the individual mandate.  It just takes a big problem (millions without health insurance) and makes not having it punishable by law.  Kind of like the way Giuliani “solved” the homelessness problem in New York by simply making being homeless illegal.

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        p>The issue is fair game.  The imagery is unfortunate.

        • Is you alternative single payer or more inline with Obama’s plan? If it’s single payer than I would argue it’s the same as a mandate – just payment via taxes. If it Obama’s plan than I believe we have a disagreement, but I would ask do you favor the same position on car insurance?

          • Jim – Like I said a couple of years ago, my problem with the mandate is that it forces you into to pay a third party for something you wouldn’t otherwise have bought.  It’s almost like a taking.  Whereas, with single payer, you’re right, your just paying through your taxes, instead of contributing to third party profit.

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            p>The difference between health insurance and car insurance is that, technically, you dont have to have car insurance because you dont have to drive. Theoreitcally, anyway.  But, what’s your alternative with health insurance?  Not living?

  2. I’m a little closer to going with Hillary. I liked her in what I saw of the debate the other day as well-although I didn’t see the whole thing. She seemed to have better specifics than Obama.

    • Be sure you get your facts right.  It was a surrogate, and both the campaign and the guy’s employer have disavowed what he said, which was obviously stupid.

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      p>The Obama campaign will be much better off if Obama supporters, instead of trying to make excuses for lame moves like this idiotic mailer, call them on it and demand that the campaign live up to its ideals.

      • The update wasn’t in the original story that I read. This not only has more information on the supporter as well as an apology from him.
        What this all says is that these gotchas (charges of racism, Nazism, etc.) are really counterproductive at this point. We would all do better to focus on the specifics of their programs, their voting records, and the candidates expressed positions on the issues.

    • On a media conference call organized by the Hillary Clinton campaign today, Clinton surrogate Len Nichols compared an Obama health care ad to Nazis. The ad features a couple at a kitchen table, which some Clinton supporters said was reminiscent of “the famous insurance-industry-financed ‘Harry and Louise’ ads against the original Clinton plan,” as The Politico reports, and Mr. Nichols said it “personally outraged” him. He continued:

      It is as outrageous as having Nazis march through Skokie, [Illinois]… I just find it disgusting that this kind of imagery is being used to attack the only way to get to universal coverage.

      I think the Obama mailer works, becuae many of us are feeling the squeeze. That looks like a traditional suburban couple, not like old Harry and Louise, but I see the sensitivity of the Clinton camp, wearig its fears on its sleeve.

      Young workers I know told me this week that they love HSA accounts instead of traditional medical coverage, becuase they feel it gives them control over ‘their’ money.

      • 1 Using the Nazi comparison is sick.  Disrespects all those who suffered under Nazi terror.

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        p>#2 Yeah, young people like their HSA’s until they get cancer, or hit by a car, or break their pelvis skiing, or… As a nurse I’ve taken care of a lot of young people with these problems.

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        p>#3 Nichols came across as a bozo yesterday on the Kaiser webcast on insurance mandates; when asked whether a single payer social insurance model would be better than the individual mandate to purchase private insurance, his response was to go on and on and on to the effect of “the AMerican people do no want all doctors and nurses to be government employees, which is what would happen, with the government making all health care decisions…”

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        p>Is Nichols in touch with reality?  The single payer model discussed in the U.S. consists of public insurance (where gov’t administers the money side, as is done with Medicare) and PRIVATE DELIVERY of services. It is bizarre that Nichols is not familiar with the work of PNHP

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        p>Reforms that move us toward Improved Medicare For All are what makes sense and it appears that it’s what Obama knows will work, too.

        • Obama is, and he sent out literature that undermines the whole idea of universal health care.  Suppose Obama does become president.  What is one piece of his history that is likely to come back to haunt him now if he tries to pass a health care policy? It is this piece of campaign literature that misinforms the public. We should be troubled by this incident, not just because of the content of the lit, but because it shows a lack of strategic thinking by Obama.  Does he really understand what you have to do to get a major change to our health care policy passed by Congress?  You do not start by misinforming the public about what changes are needed, even if it is during a political campaign.    

          • I imagine that you noticed the amount of attention that Nichols got for his comments on this healthcare mailer issue. It’s b/c he’s such a “recognized expert”.  And he deserves to get called out if he can’t get simple facts right during a national “ask the experts” health policy event.

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            p>There was no misinforming the public with a dramatic mailer about the harmful flaws that are inherent in an individual mandate law to purchase private insurance. Mandate folks to participate in an Improved Medicare For All program, yes, I’ll  advocate for that.

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            p>It’s not my fault Clinton includes a crappy mandate in her plan; you can blame Jon Grubber over at MIT for that. I’m not interested in criticizing Clinton; I plan to support whomever is the Dem Nominee.

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            p>Re: where to assign responsibility/ownership/blame for the inherently flawed private insurance mandate policy, there’s plently of others who deserve a dose of that along with Grubber’s King-sized portion.

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            p>Blame the Urban Institute folks who were paid year after year by MA BCBS to do the MAss. “Roapmap to COverage” insurance co. funded and biased project. It pretty much led directly to our fake reform law and the MAss. private insurance mandate; being helped along enthusiastically by Romney and Bush Inc. too, of course.  btw BCBs explicity forbid the Urban Institue to include an expanded public insurance/ Medicare For All-model in their “Roapmap to reform” options This fact was stated publicly in front of 400 people (mostly health care industy insiders) by John Houlihan,Pres. of the Urban Institute, in response to a question I posed to him at a JFK Library forum.

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            p>btw I’ll fight any plan that seeks to mandate perpetuation of our totally f-cked up system that kills and maims people while it rapes our economy with spending on grotesque levels of admin. waste, 30-50% unnecessary care due to the current perverted market driven environment for healthcare services, and obscene individual and corporate profiteering.

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            p>Yes, if you were starting to wonder, I do have strong feelings and opinions on the subject.

        • You disappoint me, you attack Nichols, yet you do not mention Hillary.  Her plan, does work to control costs and the means to get better care.  I work on the IT side, funding for CPOE, EMR and RHIOs were pushed and funded by Hillary’s efforts.  Yet, because of Nichols, Obama makes sense?  Where again has Obama championed any efforts?

          • That’s why I choose not to criticize Clinton directly.

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            p>Health reform is a David vs. Goliath battle.

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            p>Supporting or enacting a policy that mandates individuals (in other words that forces the uninsured) to buy expensive crappy insurance is abetting the enemy, it is not helping to build a movement for sweeping reforms. This is a matter of strategy.

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            p>I think Obama gets the fact that it’s gonna take an incredibly strong grassroots and political groundswell to get any kind of meaningful health reform enacted. And yes, it likely won’t happen with one piece of legislation in one fell swoop, but it’s gotta get off on the right foot. A Dem supporting an individual mandate would be crippling.

  4. sitting in that bright and beautiful kitchen can’t afford health care.  maybe they should scale down to 2000 sq ft.

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    p>what a sad ploy by Obama.  i remain undecided but have been leaning Clinton.  this doesn’t make me question that tendency.

    • that this couple is an unfortunate choice for the message that Obama is trying deliver. These folks don’t fit the profile of those who really would be negatively effected by the Clinton plan.
      I think overall Obama’s plan doesn’t depart greatly from the general goals of all the original Democratic candidates. In any case, ultimately, the only sustainable solution is single-payer coverage, and both of these candidates are not currently pushing for that. Also any plan would need to be able to overcome a 60 vote threshhold in the Senate making this close inspection of the details rather pointless now.

      • Clinton’s plan has a government insurance option, which to me is a great stepping stone to single payer. If we want single payer, what better way to do it than create a government plan that’s better, cheaper and – most importantly – available to everyone, regardless of income, health or age.

  5. they sure do have a nice kitchen with recessed lighting not to be able to afford healthcare.

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    p>Note: Part of the image is missing – there is more text on the bottom that is cut off in this blog post.

    • the point is supposed to be they can’t afford health care AND an 8-burner Vulcan stove and the latest model Sub-Zero fridge, so HRC is a bad person.  

      • Maybe they overbought with a ARM that adjusted in January, and now they’d like to cut back somewhere in order to hold onto the house.  Maybe, say, they’ll stop the health insurance until he gets a raise. Good bet since they’re both young and healthy?  Who’s to judge?  Oops… the government.  Forgot.

        • …of them gets cancer after they cancel the policy, the house is lost and they can’t pay for treatment after they have run out of all resources who is going to pay for their medical bills?

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          p>That’s right, you, me and everyone else.

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          p>The goverment already mandates plenty of insurance: auto; malpractice; worker’s comp., etc.  Why is health insurance such a sacred cow?

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          p>It is not about judgement but about equal allocation of risk.

          • And if one… (5.00 / 1)
            …of them gets cancer after they cancel the policy, the house is lost and they can’t pay for treatment after they have run out of all resources who is going to pay for their medical bills?

            That’s right, you, me and everyone else.

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            p>So?  What if one gets cancer while HAVING a policy.

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            p>That’s right, you, me and everyone else.

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            p>It is not about judgement but about equal allocation of risk.

            • ….if someone gets in a car accident without car insurance or someone is hurt at work and there is no worker’s comp policy the risk is allocated equally?

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              p>Of course not, and you of course know that.

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              p>You’re comment is diningenuous.

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              p>People without insurance overtax the system in a disproportionate measure.

              • ….if someone gets in a car accident without car insurance or someone is hurt at work and there is no worker’s comp policy the risk is allocated equally?

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                p>The guy goes to the hospital and the hospital treats him and hospital rates are higher because many people can’t or don’t pay the bills.  The higher rate is spread over all users (current ill) and potential users  (current insured).

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                p>

                People without insurance overtax the system in a disproportionate measure.

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                p>Those are just words without any context or support. Meaningless really and certainly off point to my original point which is this:  the current system spreads risk; the individual mandate spreads risk but eliminates choice.  

                • …just about spreading risk it is also about efficiency.  And you are wrong about a system without universal coverage spreading the risk.  If there are those than never have coverage and cannot pay their bills they never share in the risk at all.  Hence, disproportionate overtaxing of the system…a concept supportable by simple logic.  It is not spread amongst all users, just users that can afford to pay something when ill and only to the extent that they can afford to pay.  It is not a proportionate and efficent allocation of risk in any measure.

  6. …from the jaws of vistory.

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    p>Oh wow…this mailer is really bad. At the time Obama was making great strides recruiting us former edwards supporters…this appears. After Clinton’s rambling defense of her Iraq vote I had visions of Obama being the stronger one to withstand McCain’s defense of the Iraq fiasco.

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    p>What is a progressive to do?

    • Clinton isn’t exactly my cuppa tea, but I’m pretty sure we can at least expect incremental progress, even if it frustrates the hell out of us. I just hear too many things from Obama that’s shown me not only does the rhetoric not match the actions, but in fact often times the rhetoric would be a disaster in office (Republicans will never, ever be bipartisan. I’m sorry, they just won’t. We either win this war they’ve waged against us for decades – even if most of us don’t know it’s going on – or we lose it.)

  7. I gotta say…I don’t see what the real problem with the ad is. The basic idea behind the Harry and Louise ads was that the costs to government would rise as a result of the reforms, and thus taxes would go up (a standard Republican line).

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    p>On the other hand, the point of this ad and Obama’s comments during the debate is that the enforcement mechanism for the mandated purchase of insurance (not from the government, but from a private insurer) will have the result of punishing people who are already too poor to afford insurance in the first place. I also don’t follow Klein’s argument that arguing against universal enforcement mechanisms necessarily says anything about universal coverage. There’s many ways to go about getting universal coverage, and mandates are only one (probably fairly ineffective) way of going about that.

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    p>I don’t know if I agree with all of Obama’s critique of Clinton’s proposal, but it clearly seems quite a bit different to me than what the Harry and Louise ads were meant to suggest (i.e. government involvement=higher taxes=bad!).  

    • …plan contains a mandate as well.  And I fail to see the difference between taxes being higher or personal cost being higher.  It is an irrelevant distinction if the point is you are going to have to deal with paying for something you can’t afford either out of your own pocket or taken from your pocket by the government.

    • Obama’s criticism of the Clinton plan is legitimate. I think he articulated that well enough last night: universal coverage that is not affordable for all and not enforceable is hardly what we want. If Clinton’s plan is not at least an incremental step towards single-payer, it’s not worth rallying around. Now if one of them advocated for single-payer, then all this finger pointing would have some meaning.

      • It is an incremental step. It includes a government option that anyone could buy into. In effect, that makes it a little bit like Germany’s plan. Over the long term, it could become much more like that, where over 90% of Germany’s population chooses the public health care option as opposed to private plans. I wouldn’t be opposed to a system like that.

        • How does her plan bring us to a point where the government is the principle player in negotiating with health-care providers and drug companies, fully regulating both industries, and eliminating the huge profits and waste? This is where the savings are and what will make universal coverage sustainable.
          It’s not an option between selecting from an expensive private plan an equally expensive, albeit subsidized, govt plan.

          • It’s a much bigger step than Obama’s plan, that’s for sure. He isn’t even going to mandate HMOs to insure people, as Joel points out.

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            p>If we have a good public option that people take – and enjoy – then it will become increasingly popular. Hence, 90% of Germany’s population use public insurance instead of the private option. We just need to keep on the US Senate and House to make sure that the public insurance option in the plan is a good one.

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            p>Luckily, if we have a strong candidate for President, she could help us elect more progressive legislators to help make sure the eventual program is a strong one. But it’s going to take a lot of work on our parts. No one person, Hillary or Obama, can do it alone, but at least Hillary’s plan is a good start.

        • Mandating health insurance with a for-profit company has a tinge of unconstitutionality to it.  There has to be a better way.  Single-payer, privately-provided, health insurance funded by a general tax via the federal government may be the best way to go, as it is more likely to be cost-efficient because of universal coverage, reduction of duplication, and standardization of policy.  The general tax applied to companies could replace their health care costs, and a general tax applied to personal income could replace the individual costs for health in a progressive way.

          • The mandate isn’t for the people, it’s for the private insurance companies.

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            p>But either way – be it an individual mandate or single payer – Americans still have to pay for it. The question is what value are we getting out of our pay? Anything closer to a single payer, government run system – even if it’s just optional – is  a step in the right direction. The whole developed world can’t be wrong, especially when their patients pay less, get better care on the aggregate and everyone has access.

            • “But either way – be it an individual mandate or single payer – Americans still have to pay for it.”

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              p>I’ve seen a few people voice this idea on this thread and it’s a very shaky equation. The mandate, considered as a tax, is likely to be monstrously regressive. That’s the case if you look at our law.

              • On what the subsidies would be versus single payer taxes. I agree with you that doing it any other way than single payer would be more expensive to this country, but that doesn’t necessary mean it would be less regressive.  

      • …is critical of the fatt that he may criticize her plan.  It is the way he has chosen to do it.  This just further drives home Clinton’s criticism of his dipping into the republican play book when it is poltically expedient to do so.  That charge sticks much better now than it did before.

        • But I guess my point is that I don’t see how the ad has anything to do with the “Republican Playbook”. The ad has some superficial similarities (a couple sitting at a table), but I don’t think attacks taken from the Republican playbook include concerns about the effect of a new policy on poorer people — it’s about tax cut fundamentalism and scaring people about government growth.

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          p>I do think Obama’s criticism of the universal mandate IS legitimate, even if I’m not sure if I entirely agree with it. That said, I really don’t see what the ad has to do with typically Republican attacks or inhibiting support for universal health care.

          • …an attempt to frighten people who probably need not really be terribly concerned into believing that health care reform will corrupt them financially.  I see little difference between the two.

      • universal coverage that is not affordable for all and not enforceable is hardly what we want.

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        p>It might be affordable to all if some regulation of the Administrative and Executive costs were implemented.  For years we have heard the insurers cry for “cost containment” which translated into less coverage, more hoops to jump through, increased co-pays and percentage of employee pay-in.  Let’s start by reforming this loose cannon in the MA Health Care law.

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        p>BTW, a family member recently lost her minimum wage job as a service worker in a major hotel chain.  She has $5,000.00 of medical bills to pay from last year when they dropped her from the health plan.  She was never notified in writiing, she is cognitively challenged and was told once by a manager that since her hours had dropped below 32/week, she wouldn’t have coverage. She is cooperative, pleasant and didn’t understand what happened.  Meanwhile, she had cysts and needed to be operated on.

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        p>The reason her hours dropped….catering was slow so they would send her home.  She would pay a cab since there is not public transportation to get to her job, only to be sent home.  Hotel worker reality.  She is better off unemployed with full MassHealth coverage than she was with Blue Cross.

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        p>We are already paying for universal coverage for many who are not employed or paying into the system.  Level the playing .  Open it to all and don’t friggin’ spin it (Obama campaign) as a burden on the middle class.  If I want that BS I could vote for Willard.

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        p>Manage the GD Adminstrative/Executive costs.

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        p>It’s a shame Hillary didn’t get health reform through in the early 90’s we’re still suffering.

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        p>I think Hillary just got my vote.

        • A human being in need of medical care should get it–and not have to worry about going bankrupt, going without heat, or going homeless.  I remember a recent Mass news story about some Blue Cross executive who bailed out with a golden parachute.  Gary calculated it cost $6 per BCBS member.  Well, maybe that executive could have retired with less so someone like your family member could get an operation.  Our democratically elected leaders write the tax laws that govern non-profits like BCBS, and if those nonprofits are not properly serving people’s health interests (and in your family  member’s case, they obviously weren’t) then we need to change those laws and regulations, to take excess money away from executives who don’t need it and spend it on sick people who do need it.

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          p>We, as a society, can afford to treat all our citizens with decency and with decent healthcare.  This is something that is long past due.  It was long past due when the GOP stopped it in 1994, as well.

  8. Bet this wasn’t his idea ….

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    p>Hey and 50-41 in Illinois? (ARG) yikes, some HRC slippage too, maybe every state will be a jump ball, count me in!

  9. Mandates will be very difficult for people in the “not poor enough for Medicaid but still living paycheck to paycheck” category. That’s a lot of America.  As I’ve said before, if you want Universal Coverage, funded through taxes.  Don’t force me to buy insurance I can’t afford from a company that will work as hard as it can to deny me care when I actually get sick.  The Insurance Industry is the problem, not the solution.

      • made the point that the Harry and Louise ads:

        spread fear, uncertainty and doubt among the middle class that bringing the working poor and lower middle class into the insurance pool would cost too much.  It’s a standard conservative line:  you, as an individual, can’t afford to help your fellow Americans.

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        p>But what does Obama’s ad have to do with this? I don’t get that suggestion whatsoever from that flyer.

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        p>And also, a little perspective — this is a minor flyer on one of many issues in this campaign. The idea that one flyer could be the basis for people (not you, but some others in the thread) changing their vote in a critical Presidential primary seems a bit extreme.

        • …comments by one of the candidate’s spouse’s is reason enough to change??

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          p>If it leaves a bad taste in voter’s mouths it leaves a bad taste in voter’s mouths.  At least this is something that Obama approved as opposed to holding the words of someone else against Hillary.

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          p>And the import of the mailing is the same as the old commercials – Hillary is trying to cover everyone and you are gonna have to pay for it even if you can’t aford it…oogity boogity!

          <

          p>I fail to see any substantive difference.

        • Hillary’s plan will cost people too much money, right?  

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          p>We could dispute the assertion by pointing that Hillary would cap individual costs as a percentage of income (Obama would use a sliding scale), and so basically say that Obama’s omitting key information here.  We could point out that the newspaper quoted is a college newspaper, not a major paper of record with really experienced journalists and columnists, too.

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          p>But the real problem here is that Obama is planting the impression in people’s heads that Hillary’s plan is too expensive.  But since Hillary’s plan is closer to universal coverage than Obama’s, Obama’s tactic is going to stall progress on healthcare, making it more difficult to get to the point of universal healthcare coverage.  If there is a President Obama, and his plan for voluntary insurance gets enacted that would be an improvement.  But then, when there are still a few million more people who need coverage, Progressives will need to push for something mandatory and the anti-progressive forces are going to say, “Oh, no, we can’t afford it–Barack Obama said so himself when Hillary Clinton promoted that.”

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          p>This is the problem with Barack’s tactic–echoing the look and feel of the Harry and Louise ads will bollocks up the progressive effort by “resonating” with conservative opposition to spending any money to help out fellow Americans in need of coverage.

      • Of course, it’s possible it was a coincidence. But that seems unlikely.

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        p>I think what is notable is how exceptional this unimpressive ad is. In general, I think Obama has run an impressively high-minded campaign, to the degree such a thing can be done.

    • Obama is, of course, right that affordability is an issue, and needs to be in place before a mandate. But what a mandate does is, additionally, force you to think about affordability. The Clinton campaign does that, with a plan that limits total expenditures to a percentage of income. Not a dollar amount, a percentage. If you make very little, your total expenditure, by law, can’t be very much. Obama’s plan has a more traditional subsidy mechanism that simply goes on a sliding scale by income, and given how much money goes towards his reinsurance plan, he’s actually got less in there for subsidies than Clinton. So while he’s warning that she’ll make you pay even if you can’t afford it, she’s actually got the right affordability mechanisms in there — she keeps it to a small percentage of income. By pretending her plan lacks those and is just a mandate, he’s misrepresenting its fundamental premise, in much the way the Clinton campaign misrepresented his arguments on Social Security taxes.

      In the end, his plan is not universal, does not attempt to be, and is probably less generous in its affordability provisions than Clinton’s. And even so, I wouldn’t really care, as it’s still a pretty good plan, except that he’s decided to respond to the inadequacies of his own policy by fear-mongering against not only better policy, but the type of policy he’s probably going to have to eventually adopt. It’s very, very short-sighted.

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      p>From the Ezra Klein post linked to above.

  10. Obama: “some people will say and do anything to get elected.” what he needs to add is: “including me.”

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    p>Very disappointed in him and this distortion.  

    • The language in the mailer sticks exactly to the facts … No embelishment required.
      That is what Hillary proposes, a mandate.
      As for the imagery … should the couple have been discussing finances while jogging in the park?
      That is the setting where most people conduct such conversations.
      I dont see how its wrong for the Obama campaign to point out factual differences in policy positions with their opponent .. More than that I would add that its about time the campaigns start defining more in the way of specific policies, not less.

  11. How is this guy a Democrat again?

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    p>My first thoughts was that Obama was never going to do anything about health care.  His plan is basically a voluntary both in reducing cost and subscribers.  It doesn’t jib with the economics of health care or any other industry as well.  He is saying that he trust heath care insurers, drug companies, etc. to voluntarily reduce costs, then we can all afford health insurance.  Wow, now that’s wonderful.

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    p>In case you haven’t figured it out yet.  Ain’t going to happen.

    <

    p>When someone is actually trying to push towards universal coverage, instead if embracing it, he turns to Republican smears.  Nice job Barack.

    • Just because the candidate doesn’t embrace the most extremist option does not mean that he has no interest in reform. Indeed, one can equally well argue that the people who advocate single payer as the only desirable reform aren’t good Democrats because they know such an extremist solution is unlikely to be adopted and, thus, in effect argue for no reform at all. I think the latter argument is unfair too, incidentally, but it is a similar to this caricature.

      • Hillary is not pushing what you call the most extremist solution, single payer.  Both Barack and Hillary have said that they both think that single payer is the best solution in their speeches but we already have an entrenched system that we need to work with.  I agree with that.

        <

        p>But the fact of the matter is that Barack’s plan allows an industry to choose between serving everyone at an affordable price, or serving those who can afford it.  They can cherry-pick what is more profitable. The only way to stop this is put everyone in the system and at the same time reduce costs. Getting to voluntary universal coverage by trying to encourage lower costs and hoping everyone will join in will not work.  We alk know that, so does Obama.  So why is he taking this stance and this aggressive action against health care?

      • the system.  That’s why mandates are key.

        <

        p>As the Urban Institute, a DC thinktank found:

        In this brief we conclude that, absent a single payer system, it is not possible to achieve universal coverage without an individual mandate. The evidence is strong that voluntary measures alone would leave large numbers of people uninsured. Voluntary measures would tend to enroll disproportionate numbers of individuals with higher cost health problems, creating high premiums and instability in the insurance pools in which they are enrolled, unless further significant government subsidization is provided. The government would also have difficulty redirecting current spending on the uninsured to offset some of the cost associated with a new program without universal coverage.

        <

        p>Hillary’s plan goes closer to getting everyone in the system.  Once people have coverage, it becomes politically difficult for the Republicans to take it away from them.  We can afford to bring these people in, and her plan caps the costs as a percentage of income, as well as provides aid for people to pay for their insurance.  We’re likely going to have a bigger Dem majority in Congress, so let’s not start polluting the national discourse with the concept that universal healthcare is something people “can’t afford,” thus making it more difficult to achieve a progressive goal.

        <

        p>BTW, I understand what you mean by calling single-payer “extremist,” because it is at the other end of the continuum of ways to pay for healthcare.  However, it would be nice to find another word for it because “extremist” has connotations of harm to it, and single-payer would actually help many people who are harmed (or untreated) by our current system.

      • surely you don’t think Hillary’s health plan is extreme…

        <

        p>By the way, Bob, what Democrats do you know who suggest Single Payer or else? Even Jamie Eldridge, who pretty much built his campaign around single payer, voted for the Mass Health plan. I don’t think there are many Democrats opposed to incremental steps, but they ought to all be steps forward. Obama’s plan seems like a few too many steps backward followed by any forward momentum.

        <

        p>The fact is we need everyone insured and we need true competition. If Hillary were to allow a government insurance option people could get, but not force all private insurers to accept everyone (ie a mandate), then it would be an utter disaster. The only way a government option can work is with a mandate. Now, I’d rather just have single payer, but incremental steps in the right direction, all forward momentum, still sounds good to me.

  12. …OK, I’ll concede that Hillary’s health plan is better than Obama’s (but I’m not a wonk and haven’t really compared them.

    <

    p>But I found your comment

    <

    p>”But Obama is putting out the idea that we “can’t afford” it (though somehow, we’ve afforded a one-trillion dollar war over non-existent WMDs), and voters will remember that idea when the next President is governing. “

    <

    p>So ironic…you mean the trillion dollar war that Obama thought was a bad idea in the first place and Hillary voted to give Bush the green light on?  

    <

    p>Obama was right on the bigger issue.

    • I can accept that someone who thinks the war is a bigger issue than Universal Healthcare Coverage will side with Obama.  That’s logical.  

      <

      p>But I don’t think Hillary Clinton’s previous stance on the AUMF will slow down how fast she gets troops out of Iraq.  

      <

      p>I do think that by running to the right on universal healthcare, Obama is giving the Republicans ammunition to resist it, and giving fence-sitting Senators excuses to talk the legislation to death.  In short, he’s chosen to run against a plan that would be the next step if his own plan were to be adopted.  If we get a Progressive majority, his making the case against one of the 3 major progressive goals.  

      <

      p>The reasons I see universal healthcare as a bigger issue than the war is numerical: about 40 million people lack health coverage, and their health & our nation’s economic success suffer for it.  By comparison, on the order of 1,000,000 soldiers & Marines have served in Iraq.  No doubt the war was/is incredibly costly, and when we finally get a President who ends our entanglement there, that will be a great relief to the nation and the world.  I wish that Obama and Clinton had lobbied harder in the Senate to cut off funding for this war.  I don’t know why Mr. 27% gets so much deference from the Legislative Branch.

      <

      p>But if, next year, America starts covering everyone, then we will start seeing fewer bankruptcies due to medical bills, we start seeing some more people taking the risk to start their own small business because they can keep their families insured, we start saving the opportunity costs of our current system.  Once we get everyone in the system, it becomes much more difficult for the conservatives to take it away.  Just like Social Security.

      • …how long will it take her to triangulate all the interests involving health care and come up with a mush plan?  Based on the history of the Clinton’s, do you really believe for one second she will fight for her plan?  

        <

        p>Certainly Obama will not be perfect…he’s to consensus orientated to fight for the whole piece of the pie (and I have other reasons for supporting him).  The bottom line is they are both comprising-focused people.

        <

        p>As a side comment–I’d wager that the ACTUAL long-term health care costs (or more accurately–the societal costs) of the 1 million troops serving in a combat zone will be close to (or even exceed) 40 million ordinary Americans.  That is especially true when taking into consideration the generational/societal costs of Post Traumatic Stress Disorder that will impact the children and grandchildren of soldiers.

        <

        p>And to address the comments about Obama supporting the funding of the war (that other posters pointed out)…I’ve always been perplex about what to do in Iraq.  I opposed the war from day one (like you and Obama) because I thought it was opening a Pandora’s Box…and that is exactly what happened…all the demons of Iraq and the Middle East escaped the Box.  Sorry if I sound like John McCain here, but I never liked the idea of walking away from the open box and always felt we had to close it.  
           

    • if Obama wasn’t right along there voting to help fund it. Voting to fund the war in Iraq = losing all cred on the Anti War candidate front.

  13. Besides the fact that the AD is just to ‘politics as usual” for the pristine obama campaign….he is wrong on the issue…..The three legged stool approach that Massachusetts used is the way it works……remember 300K people have health insurance that did not have it 18 months ago!!! Go Hillary…..she knows a good thing when she sees it!

    • The numbers add up to 272k newly insured per state documents since the Mass.Ch58 Law took effect. And most of them are covered by using public dollars to buy private HMO insurance.

      <

      p>Yet, intentionally misleading spin has told us (repeatedly) that “300k have signed up since the law went into effect…”

      <

      p>Did you know that only 4.14% of the newly insured have “signed up” for insurance where they must pay the full cost?

      <

      p>The vast majority of the newly insured have fully or heavily subsidized coverage. That would be fine with me if it was done in a cost-effective manner. BUt it’s not. Now on to the individual mandate discussion.

      <

      p>Using an individual mandate is a fatally flawed approach. Forcing people to buy individual policy insurance in a private, profit-driven insurance market, within the larger dysfunctional health care system IS A TERRIBLE IDEA AND WILL NOT WORK.

      <

      p>I am a nurse and health reform activist here in Massachusetts and have in my possession reams of state documents that reveal how badly the plan is going here in Massachusetts, “badly”, that is, if reform of the system including near-universal access to needed care is the goal.

      <

      p>Most of the uninsured in Mass. CANNOT AFFORD the insurance and are being threatened and intimidated by the state to buy these expensive crappy products. The “more affordable” policies have high deductibles and big co-pays, and some have 20-30% “co-insurance” meaning after you pay the $2,000-$4,000 deductible you still have to pay 20%-30% of any bills!!

      <

      p>The state will be taking money from hundreds of thousands of people thru the state dept. of revenue simply because they cannot afford to comply with the mandate and they are not eligible for a waiver. Patients have been told by their legislators’ staff to default on a mortgage payment to get a special appeal waiver for the mandate requirement, or to get another job at Starbucks b/c they provide health insurance plus you’ll get a free bag of coffee every month – These things really were said to people!!

      <

      p>Thank heavens Obama gets it.

      <

      p>Getting to Improved Medicare For All is the optimal approach for state and nat’l health system reform and, I, as an Obama supporter, will be urging him to lead us toward that after he becomes President.

      <

      p>Improved Medicare For All wouldn’t be “Gov’t forcing us to…”. There could be an option for the people (all 2 or 3 of them) who still want to keep their private insurance coverage. Coverage that diverts anywhere from 10-25% of every premium dollar AWAY FROM CARE, to pay for the claims adjusters, and benefits managers, and acctuarials, and middle managers, all the people whose jobs are designed to deny care.

      <

      p>Here in Mass. there has been tremendous public support for a state level bill similar to Medicare For All, it’s Senate bill 755, with details at
      http://www.mass.gov/legis/bill…

      <

      p>Over the past 12 years, anytime the bill gets traction in the legislative process the “health care industry” crushes the political support for it.  That’s partly why we got the crappy fake reform law Chapter 58 with the individual mandate, b/c grassroots reform efforts were gaining serious momentum. These grassroots efforts include the citizen initiative to amend the state constitution to establish a legal right to affordable and equitably financed comprehensive health insurance. details on this at
      http://www.healthcareformass.org

      <

      p>There’s so much more to the health reform story here in Massachusetts and maybe the Obama-Clinton health care plan battle will help expose the truth. It’s about time.  Maybe then we’ll actually begin to accomplish health care reform.

  15. I have yet to hear a good argument against universal health care for all American citizens. The money argument does not hold water. Will it be expensive? Yes, but we have the money. What we lack is the political will to make it happen, we would have to cut drastically in other areas to provide it.

    <

    p>In 2008, the most powerful country the world has ever seen can easily offer its citizens coverage. We just have to want to do it. The money is there, but, unfortunately, much of it gets squandered on self-serving earmarks, bureaucracy, foreign aid, and wars like Iraq ($1 trillion?).

    • We don’t need to continue spending on average, twice as much per person, on healthcare than every other industrialized country in the world. btw All of whom have better health status outcomes and none have millions of their people uninsured. Shame on us.

      <

      p>Improved and Expanded Medicare For All would not cost more than the current 17% GDP we spend on healthcare and it might cost less.

  16. One of the things I like about the Obama plan is that its a honest passable plan that does not hurt people like me.

    <

    p>Its incredibly good for students, I can keep my parents plan until I’m 25 and I am not required by law to buy insurance I can’t afford and I am not forced to sell out early and take a corporate or government job to pay for health insurance under his plan.

    <

    p>Also mandates would really hurt small businesses not to mention retain the very employer based insurance system that is unfair to everyone involved. It forces people to work for their healthcare and sometimes make the unfortunate decision between a good job and a bad job with healthcare as both of my parents have had to several times. Not to mention its bad for employers since they are forced to cover everyone and hence the big three autos and other American companies are not nearly as competitive.

    <

    p>I think we can all agree that some kind of universal coverage model is desireable but Obamas plan is a great step forward, Clintons and Edwards and Romneys all retain and even strengthen the existing employer based HMO system that in my view needs to be scrapped since it cannot be reformed. Obama’s plan does not scrap it but it definitely weakens it and gives more choice to individuals. Mandates by definition eliminate choice and thus are both politically unpopular and poor policy. The ad in my view is honest and justified.  

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