The Nation: Obama vs. Clinton, Edwards and Paul Krugman

[Stop Cornyn]

Obama vs. Clinton, Edwards and Paul Krugman:

The Nation -- Give New York Times columnist Paul Krugman a little credit for pointing out the uncomfortable fact that Illinois Senator Barack Obama is campaigning against universal health care.

Krugman explained in Friday's editions of The New York Times:

The central question is whether there should be a health insurance "mandate" -- a requirement that everyone sign up for health insurance, even if they don't think they need it. The Edwards and Clinton plans have mandates; the Obama plan has one for children, but not for adults.

Why have a mandate? The whole point of a universal health insurance system is that everyone pays in, even if they're currently healthy, and in return everyone has insurance coverage if and when they need it.... As a practical matter, letting people opt out if they don't feel like buying insurance would make insurance substantially more expensive for everyone else.... In other words, when Mr. Obama declares that "the reason people don't have health insurance isn't because they don't want it, it's because they can't afford it," he's saying something that is mostly true now -- but wouldn't be true under his plan.... Krugman argues that it is time to stop cutting Obama that slack because the senator has begun defending his flawed plan by echoing right-wing talking points.

"Mr. Obama, who just two weeks ago was telling audiences that his plan was essentially identical to the Edwards and Clinton plans, is attacking his rivals and claiming that his plan is superior. It isn't -- and his attacks amount to cheap shots," argues Krugman.... Obama's point is, of course, a political one. He is trying, desperately, to position himself as the one serious challenger to Clinton. To do that, he must distinguish himself both from the national front-runner and from Edwards, who has attracted significant union and grassroots support with his economic populism.... But Obama has not tried to distinguish himself by being better than Clinton or Edwards.... Rather than acknowledge the flaws in his own plan, Obama has attacked Clinton and Edwards in language that does indeed "sound like Rudy Giuliani inveighing against 'socialized medicine.'" And Krugman is right to call the senator out on his wrongheaded approach.

[DemocratSinceBirth]

1. I Know A Guy Who Broke His Tibia

He was in the process of getting insurance and didn't get it treated until (after) his insurance plan kicked in...

That's what happens without a mandate...Everybody pays a little higher preimium because some folks got a free ride...

[acmavm]

2. It's okay. Just wait a few days. Barrie will change his position to fall in line

with the others soon. And then he'll claim that's what he always meant.

Barrie does have my total admiration in one area. He can change his platform and position from one day to the next smoother and faster than anyone I've ever seen in American politics.

[DemocratSinceBirth]

5. What's Sad Is That A Lot Of DUers Were Bashing Krug Ad Hominem

He is one of the most consistent Bush* critics in the main stream media...

[Snotcicles]

3. And Edwards plan allows one to buy into a private plan or into medicare.

This I feel is the best idea to incrementally move us to a single payer plan.

[Tejanocrat]

6. Kucinich's plan is best, but Edwards' plan is clearly second best.

[DemocratSinceBirth]

7. In Theory Single Payer Is Best

However there are millions and millions of people who are reasonably happy with their private insurance and are not going to give it up...

[Tejanocrat]

8. That's the advantage of Edwards' plan. It doesn't offer immediate single payer, but if offers a path

to single payer while allowing people who are reasonably happy with their private insurance to retain it.

Hillary's plan would be better if she amended it to add a not-for-profit health market pool which would force private insurance to compete against the Medicare-style public insurance (a fight private insurance will eventually lose as people realize that they are paying more and getting less with private insurance).

[DemocratSinceBirth]

10. I'm Paying $678.00 A Month For Health Insurance...

It would be tempting to go bare but I have a home and car that could be attached if i ever got really sick...

[Tejanocrat]

11. Best choice: You should get health care as a tax payer benefit. Second best: you must have coverage

and we'll make it as good, as affordable, and as portable as possible and if you can't afford it you will get it as an entitlement and if you can afford it you will get a tax credit to reimburse you for it.

[DemocratSinceBirth]

12. I Am A Pretty Free Market Oriented But (Not) When It Comes To The Basic Necessities Of Life

I believe a just society would provide a floor for all of us but not a ceiling...

[Tejanocrat]

14. So we agree that Kucinich's plan is the only gold standard. How do we get it passed?

I figure we have to move Edwards 1 mile, Hillary 5 miles, and Obama 20 miles to get them on board with Kucinich's health care plan.

[DemocratSinceBirth]

15. Medicare For All Is The Gold Standard

If folks want to supplement it than that's fine...However I don't know how we ever get there...

[cuke]

16. Here's how we get there

1) Offer Medicare (or some other Fed level insurance) to anyone who wants it (and can pay)
2) Expand Medicaid and Medicare to cover more people
3) Require insurance companies to insure anyone who can pay their premium
4) Limit the premiums and the increases in premiums
5) Regulate out of pocket expenses like deductibles, copays, etc

Both Edwards and Clinton's plan, which are very similar, do the 1st four of these five. I'm not sure about the last, I'll have to look into it, if no one here knows

[Snotcicles]

22. You won't have to regulate it because more and more people will

be choosing the Medicare plan, thus bringing down costs.
The more people participate, the cheaper it gets, the cheaper it gets the more people want in. Thats the beauty of it.
For those who wish to buy private plans they still can.

[Tejanocrat]

9. delete

dupe

[frazzled]

13. Obama's plan allows buying into public or private as well

The question is solely whether it is mandatory or not.

To tell the truth, Medicare itself is not mandatory (as I understand it): you have to sign up for it. You are not fined, as in Massachusetts, if you fail to sign up. (You do pay a higher premium, I think, if you don't sign up for it when you first become eligible).

I think there is something being missed here: Obama is being sensitive to that segment of society that will have most trouble with a mandatory plan --the working poor. They earn too much to qualify for totally state-supported insurance but don't earn enough to pay the premiums at even reduced rates without sacrificing other things: like food, rising transportation costs, etc.

And no mandatory plan will ever get 100% compliance. Never. I think that unless and until the system is totally government-run single-payer insurance, these plans are all pretty equivalent in terms of numbers who will get insured. We are arguing about the number of angels dancing on a pin.

Plus, I've never seen an election policy proposal (much less a primary proposal) that ever looked even moderately the same after election day.

[cuke]

17. I don't buy those arguments about mandates

Obama has no problem placing a mandate on poor parents to insure their children, and is willing to financially sanction them somehow (repossession, wage garnishment, fines, etc). I just don't see any reason to oppose mandates in a well-designed program, and Obama seems to agree as his plan includes mandates.

And it seems something less than confident to say "My plan will make insurance affordable but I'm not going to make you buy insurance because, who knows, maybe insurance will still be unaffordable even with my plan in place."

And yes, there will always be people trying to get over, but they will be breaking the law and they SHOULD face sanctions. Murder is illegal and people still do it, but if they get caught, they're going to jail.

The bottom line is if we want to have a UNIVERAL system, then there must be mandate(s) of some kind. Even single payer has a mandate to buy insurance from a monopoly

[frazzled]

18. Maybe he just doesn't want to use the word "mandate"?

Because I am looking at the explanation of Obama's health plan given after its rollout by his adviser David Cutler, a Harvard health economist who worked for the Clinton administration and was an adviser to John Kerry. Here's how he explained Obama's plan:

On Tuesday, Barack Obama laid out a proposal for universal health care plan that will guarantee every American affordable, comprehensive health insurance. I advised Senator Obama on the proposal, so I will not claim to be an independent voice.

As a health care analyst for nearly 20 years and a veteran of the Clinton Health Plan, however, I believe strongly that the Obama proposal is a bold, comprehensive, realistic approach to national health reform in the United States. It holds the potential for the single most important transformation of health care in a century: one that guarantees Americans health insurance coverage and does so in a way that wrings waste and inefficiency out of the system.

Here's how it works: If you don't have health insurance through your employer, you will be enrolled into a new, comprehensive public health insurance plan that emphasizes prevention, chronic care management and quality care. The benefits will be similar to those available today to every federal employee.

This plan will enjoy the great efficiencies we see in public plans like Medicare but, if you still cannot afford it, you will receive a subsidy to pay for it. Of course, you can choose private insurance if you prefer but the private plans will have to compete on a level playing field with the public plan—without the extra payments that tip the scales in favor of private Medicare Advantage plans today.

Employers who do not offer meaningful coverage or a meaningful contribution to the cost of quality health coverage for their employees will be required to pay a percentage of payroll to the plan and their employees will be enrolled. Any employer can decide it no longer wishes to administer insurance and can offer insurance through the exchange. Self-employed Americans will find it easy to enroll as well at no disadvantage. Children will be covered and no one can be denied health insurance because of a preexisting condition or illness.

All Americans will be covered automatically under this plan. And the resources are set aside in the plan to do whatever is necessary to guarantee affordable coverage for every American.

http://commonsense.ourfuture.org/advisor_describes_obama_health_plan

Now, when Cutler uses phrases like "you will be enrolled" or "employers will be required to pay a percentage of payroll" ... it's sounding pretty mandated to me. In other words, employers are going to have to offer the "public" plan if they are not currently offering other health insurance. Only self-employed people seem to have an option: "...they will find it easy to enroll."

[cuke]

21. Interesting

I hadn't seen that language before.

[RaleighNCDUer]

4. Universal health insurance is NOT universal health care.

The young people who choose not to have health insurance are making that choice based on their MINIMUM WAGE JOBS.

You cannot mandate that someone pay what what they cannot afford in the first place.

Single-payer health coverage provided by the government, paid by taxes. It is the ONLY way to get universal healthcare.

Hillary, Edwards, Obama ALL have it wrong.

[Stop Cornyn]

19. You're right, but Edwards has it significantly LESS wrong. As you point out "You cannot mandate that

that someone pay what what they cannot afford." Well, the Edwards plan requires all employers to either provide insurance to their employees through a company policy or help fund coverage for their workers by subsidizing regional nonprofit government-based health markets. The employers get a tax credit for this (as do those who are self employed and buy their coverage straight from the nonprofit government-based health markets. The nonprofit government-based health markets would force traditional private plans to compete against a government-run plan similar to Medicare or Canada’s single-payer system, in which insurance is publicly funded to control costs but doctors and hospitals remain private. For those who are unemployed (so the have no employer based coverage) and can't afford even the reduced cost coverage under the health care markets, Edwards covers these people by expanding Medicaid and SCHIP to serve all adults under the poverty line and all children and parents under 250 percent of the poverty line.

It's not as good as Dennis' plan, but it's much better than Hillary's and miles-and-miles better than Obama's.

[Tejanocrat]

20. That makes sense.

[RaleighNCDUer]

24. I hadn't caught that part of the employer mandate was to help subsidize

the government insurance, which because of its size would have to be less expensive than paying for private insurance - that could conceivably reduce the employers' healthcare costs, rather than increase them as I had supposed. Even though it keeps private insurers in the loop, you are right, it is head and shoulders abover Hillary's or Obama's.

I will personally be very happy when the health insurance industry is reduced to selling supplemental and luxury premiums.

[Stop Cornyn]

25. Amen!

[ClarkUSA]

23. WTH is John Nichols? He simply regurgitated Krugman's hit piece on Obama after a pat on the back..

Thanks for the sixth - or is it seventh - repeat of Hillary cheerleader Krugman's Clintonian talking points. What's next, a review of
Krugman's Obama bashfest by HillaryIs44 or The Left Coaster?