Obama '08?

Cycloptichorn wrote:

I would say: the Obama plan ain't bad for a first or second draft, which is essentially what any plan such of this nature is, when presented at this time.

Thats not how he presents it though, is it?

Actually, come to think of it, that would have been an interesting approach to take. Come out with a first draft and just roundly say, "Lookit," (OK, perhaps not "lookit" Smile

) - "this is my campaign's first draft - and now I want to gather all of your input, have a Democratic dialogue about this, to perfect it. And on Random Date 2007, I will present the conclusive Obama health care plan, which will have come about also thanks to you!"

Mighta been a good strategy actually. Well, its roughly what Segolene Royal did in France. Didnt win her the election, but she came as close as any Socialist in the last 18 years.

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nimh wrote:

OCCOM BILL wrote:
Don't waste one second on Bill Richardson. I watched him on Meet the Press, and he's a complete moron. I don't think he could tell you what time it is without contradicting himself.

snood wrote:
It's the first time I've tried to listen to him at any length. He impresses me as someone totally impressed with his own importance in the scheme of things, and also pretty clueless.

Wow, that must have been quite the fiasco, if people as different as you two both came away from it with such a devastating impression!

Says Slate: The New Mexico governor self-destructs on Meet the Press

Damn.

I was kind of hoping Richardson would still be a good back-up option, if Edwards would peter out and Obama didnt firm up.. doesnt look like it.

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I'm also not as up on this as I'd like, still gathering info and deciding, thanks for all the info above, nimh.

I'm not sure I agree with the "it's not universal health care" criticism. I think the idea behind "universal health care" is, "health care for people who currently can't afford healthcare but desperately need it." I think Obama's plan does address that.

"People who just don't wanna" is a different kind of thing. It's not obvious if they'll exist, for starters. (I do have a hard time figuring out who will turn this down, with the various options available to people who are low-income, etc.) And Obama seems to be saying that if there IS a significant subset of plain-don't-wannas, they will be cause for a change to some kind of mandate.

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Obama outlines universal healthcare plan

By Edward Luce in Washington

Published: May 29 2007 19:26 | Last updated: May 29 2007 19:26

Barack Obama joined his Democratic presidential rivals Hillary Clinton and John Edwards on Tuesday in offering a plan to provide all Americans with "affordable, universal healthcare".

Speaking in Iowa, which holds the first presidential caucus next January, Mr Obama laid out a five-point plan that he said would lower average family health-insurance costs by $2,500 (1,859, £1,263) and would bring the 45m uninsured Americans into full coverage.

Mr Obama, a first-term senator from Illinois who was criticised at a Democratic debate in March for being the only presidential contender without a healthcare plan, had strong words for the pharmaceutical and health-insurance companies. He said the two sectors had spent $1bn in the past decade lobbying Congress to ensure that America's expensive and inefficient system of healthcare remained intact. Premiums had risen by 90 per cent in the past six years - four times the rate at which wages have risen. Over half of all American personal bankruptcies are caused by medical crises, he added.

"In the richest nation on earth it is simply not right that the skyrocketing profits of the drug and insurance industries are paid for by the skyrocketing premiums that come from the pockets of the American people," he said.

"The cost crisis is trapping us in a vicious cycle. As premiums rise, more employers drop coverage and more Americans become uninsured."

Like Mrs Clinton and Mr Edwards, Mr Obama would help pay for his plan by allowing George W. Bush's principal tax cuts to expire in 2010, a proposal attacked by Republicans as a tax increase. Mr Obama would also save on healthcare costs by fully computerising medical records, increasing competition between insurance companies and offering the uninsured the same coverage as federal employees.

Mr Obama's plan was criticized for failing to sever the link between employers and healthcare and also for omitting to specify whether tax breaks would continue to be available to the very wealthy - one of the highest costs associated with US healthcare.

"The Obama plan relies heavily on the current employer-based system, which leaves workers at risk of losing their healthcare if they lose or change their jobs," said Ron Wyden, a Democratic senator for Oregon. "It also puts US companies and workers at a disadvantage in the long term when they have to compete in a global economy against overseas companies whose workers get their healthcare paid by their government."

All the Democratic candidates are likely to face strong criticism from Republicans for proposing to roll back Mr Bush's tax cuts and for increasing public subsidies for healthcare. According to opinion polls, the cost of healthcare will be one of the three issues of most concern in the 2008 election.

On Tuesday Mrs Clinton outlined her plans for addressing rising income inequality in a speech in New Hampshire. "I believe that one of the most crucial jobs of the next president is to define a new vision of economic fairness and prosperity for the 21st century," she said.

The Financial Times

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sozobe wrote:

"People who just don't wanna" is a different kind of thing. It's not obvious if they'll exist, for starters.

Presumably there would be quite a few "just don't wanna"s among those healthier than average, and rich enough to pay their medical bills when something bad happens. They will find it wealth-maximizing not to insure themselves, gambling that they'll pay less in medical cost than they would on insurance premiums. While that doesn't prove they'll opt out, it would be strange if none of them acted on this incentive.

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Most Americans favor a Univeral Health Care.

Poll: The Politics Of Health Care

Quote:

SHOULD GOVERNMENT GUARANTEE HEALTH INSURANCE FOR ALL?

Yes
64%
No
27%

WHICH IS MORE SERIOUS?

Providing health insurance for all
65%
Keeping health care costs down
31%

The tax cuts will have to repealed (which were largely unfair anyway)if it is going to be paid for. Unless of course we want to be like the republicans and have expensive expenses (Iraq war, embassy...) without paying for it. While Obama's health care plan may not be perfect, at least he is thinking in the right direction. As for what republicans will or will not vote for, who cares? It's looking like they are outnumbered on this one and a lot more issues.

As far as Obama on all issues, I found a pretty good website.

On the Issues

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Thomas wrote:

sozobe wrote:
"People who just don't wanna" is a different kind of thing. It's not obvious if they'll exist, for starters.

Presumably there would be quite a few "just don't wanna"s among those healthier than average, and rich enough to pay their medical bills when something bad happens. They will find it wealth-maximizing not to insure themselves, gambling that they'll pay less in medical cost than they would on insurance premiums. While that doesn't prove they'll opt out, it would be strange if none of them acted on this incentive.

I see.

Is that how it works for car insurance, too? I don't know, can probably go look for it. I was thinking that people who had the least money wouldn't want to pay because it wasn't completely essential, not that people who had enough money (they think) to pay for any problems would eschew it.

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sozobe wrote:

Is that how it works for car insurance, too?

I don't know, but I doubt it. The difference between car insurance and health insurance is that in car insurance, you want a policy where the premium covers the individual car's risk. In universal health insurance, you want to redistribute some money from the good risks (i.e., healthy and solvent) to the bad risks (i.e., sick and poor). Compared to car insurance, this repels "don't need it" clients and attracts "can't afford it" clients of universal healthcare.

That reminds me of a point I didn't understand from Obama's proposal. At what rate does he want to cover the policy holder? If Obama makes it illegal for insurers to turn down applicants, what keeps them from "accepting" them at premiums they can't afford? Did I miss something in the plan?

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That's back into over-my-head territory. I dunno, but I'll keep an eye out.

Doesn't ALL insurance work on the redistribution principle? Everyone pays a certain amount in (more for some and less for others according to risk), then some of them get much more out and some people don't get as much out as they put in? I don't really get how car insurance would be different, there.

OK I just added the "(more for some...)" parenthetical, is that the difference? With car insurance, high-risk drivers pay considerably more, while under Obama's plan, even if you are very high risk you can still get insurance at a reasonable rate?

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sozobe wrote:

Doesn't ALL insurance work on the redistribution principle?

Let me make a distinction between "before the fact" and "after the fact". When you buy car insurance, house insurances, and the like, they redistribute money between possible futures of yours. One possible future is that your car breaks down, another possible future is that it doesn't. If it does, the insurance policy will, after the fact, have been attractive for you and unattractive for the insurance company. Conversely if your car doesn't break down. But before the fact, at the time you buy the insurance, the expected redistribution between the two futures is near zero. If it wasn't, there would be no mutually profitable contract. It would either be stupid for the insurance company to bet your car won't break down, or stupid for you to bet that it will. Because this is true for every policy holder, there is no before the fact redistribution between them.

Universal healthcare is different. Take Bipolar Bear's epileptic son, for example. (He talked about his illness, so I think it's okay to discuss him here.) The policy holder and the company both know what his medical expenses will be. If you handle his case like a car insurance, the premium that would make him a mutually beneficial risk is very high. To get him insured in a universal healthcare system, you have to take some money from healthy people to subsidize his insurance policy. That's what I would call "before the fact" redistribution.

In practice, one could subsidize his premium or oblige the insurance company to cover him at the same rate as everybody else. Either way, you end up making insurance unattractive for healthy people. It's not "they think they don't need it, but they do". Insurance may really turn into a bad bet for them. Even rational egoists -- not just dumb, greedy egoists -- may find it attractive to stay out of a universal healthcare system.

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That doesn't strike me as being correct. It may well be that I'm missing something. But while there are different rates according to risk, there is still redistribution in car, house, life, etc. insurance. These are companies, who insure many people at once. If person A pays the insurance company faithfully but never, ever has need for that money, the insurance company will use some of person A's money to pay for a new car for person B, who rammed into a tree.

I understand what you're saying about pre-existing conditions and health care. There isn't really such a thing with car isurance, just a higher RISK. (A teenage male driving a red Porsche has a higher risk of crashing but may not.)

But there is still a lot that is unknowable, for most healthy people and even for people with chronic conditions. Will it get worse? Will it cause other problems? Will a drug be discovered that controls it but is very expensive? Will another very expensive and effective drug become generic and greatly reduce the expense involved? Etc.

None of this is actually knowable. It's still relative risks.

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sozobe wrote:

I understand what you're saying about pre-existing conditions and health care. There isn't really such a thing with car isurance, just a higher RISK. (A teenage male driving a red Porsche has a higher risk of crashing but may not.)

So does a gal who has crashed her last three cars while driving drunk. Reckless driving would be to her car insurance what pre-existing conditions are to health insurance.

But maybe you have stumbled because I made the wrong distinction in my post at first. The right distinction is "before the fact" v. "after the fact". I edited the post accordingly -- perhaps while you were reading.

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Thomas wrote:

So does a gal who has crashed her last three cars while driving drunk. Reckless driving would be to her car insurance what pre-existing conditions are to health insurance.

That was precisely my point.

You are saying that there is a significant difference between the types of insurance, I'm not seeing it.

Thomas wrote:

sozobe wrote:
Doesn't ALL insurance work on the redistribution principle?

Let me make a distinction between "before the fact" and "after the fact". When you buy car insurance, house insurances, and the like, they redistribute money between possible futures of yours.

I did start my response before you edited, then saw your edit and adjusted. The above still doesn't seem right. They redistribute amongst various policy holders. There doesn't seem to be a true difference.

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sozobe wrote:

Thomas wrote:
So does a gal who has crashed her last three cars while driving drunk. Reckless driving would be to her car insurance what pre-existing conditions are to health insurance.

That was precisely my point.

You are saying that there is a significant difference between the types of insurance, I'm not seeing it.

The difference is that as a society, we want the reckless driver to pay premiums out of her ears. We wouldn't want the careful drivers to bail her out. By contrast, we don't want Bear's cub to pay premiums out of his ears that, so we insure him at the same rate as a healthy client. Or subsidize him at the expense of healthy people. Or something similar that we'd never do for the reckless driver. That makes health insurance much more attractive to him, but less attractive to healthy policy holders.

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Isn't that pretty much what I said back here?

sozobe wrote:

OK I just added the "(more for some...)" parenthetical, is that the difference? With car insurance, high-risk drivers pay considerably more, while under Obama's plan, even if you are very high risk you can still get insurance at a reasonable rate?

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sozobe wrote:

Isn't that pretty much what I said back here?

Yes. Except for the part where the system drives out good risks.

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OK. That's what I was getting at, though. I wasn't arguing any specific idea, I was trying to figure out what was up, and was trying to figure out if that was the difference (why one would drive out good risks and the other wouldn't).

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Thomas wrote:

That makes health insurance much more attractive to him, but less attractive to healthy policy holders.

Unless you look at it like life insurance where the earlier you go into the program, the lower your ongoing premiums will be. Buy in at $20/month now, it's $20/month forever. Wait 10 years, it's $100/month forever. Wait another 10 years, it's going to be $1000/month forever. (obviously not actual #'s, but representative of the multiplier effect you see on common policies)

If you bring everyone into the healthcare insurance plan early, the plan will get the value of the 'unnecessary' premium money at the front end to distribute along the way/earn interest for further distribution.

I don't think the perfect plan's been developed/conceptualized yet, but there are enough good plans out in the world to review and base a successful American plan on.

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ehBeth wrote:

Thomas wrote:
That makes health insurance much more attractive to him, but less attractive to healthy policy holders.

Unless you look at it like life insurance where the earlier you go into the program, the lower your ongoing premiums will be. Buy in at $20/month now, it's $20/month forever. Wait 10 years, it's $100/month forever. Wait another 10 years, it's going to be $1000/month forever. (obviously not actual #'s, but representative of the multiplier effect you see on common policies)

I'm not sure that's a good analogy. If you get health-insured earlier in life, you're going to make more payments, but you're also going to get sick more often while you're covered. By contrast, if you get life-insured earlier in life, you're still only going to die just once, even though you make more payments. That's why life insurance premiums can be lower if you get insured earlier.

Or are you saying the premiums rise much more dramatically than inversely proportional to your life expectancy?

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People don't necessarily get sick more often if they're covered for longer periods (that's why private carriers kinda like to sell the policies, it's dang good money for them) - or at least not in any directly proportional way. No actuary would go for that.

On the life insurance side, the premium escalates steeply as you age.

(deleting the whole rest of my post because I found this chart (life) and the health premium one as well.

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