Obama '08?

Foxfyre wrote:

should the government institute a single payer system, what power does the govenrment then have over what health care will be available to whom?

None of the leading two Democratic candidates is proposing a single-payer system. And quite obviously, neither does any of the Republican candidates. If you like the healthcare plan you're in, you can just stay in it! And that is true no matter who gets elected on November 20. How are the merits of a single payer system relevant to this election?

Foxfyre wrote:

Both do not provide coverage for treatment of prostate cancer for persons age 65 or older on the theory that something else will kill those folks before the cancer gets them.

This bold statement does not survive a Google search on "medicare prostate cancer". The reality is that Medicare does pay for operations, though it does not pay for radiation therapy. Several of the sources are very critical of this policy, and they may well be right. Maybe medicare should pay for prostate cancer therapy. But there's a big difference between that claim and yours that America's universal healthcare systems "do not provide treatment of prostate cancer."

Foxfyre wrote:

If we had not had our own private insurance, that would mean that my husband would now in all likelihood be dead or suffering a horrible impending death. As it is, he is alive, well, cancer free, and looking forward to many more healthy years to come.

That's fine! You like your private plan. Who's keeping you from staying in it? Certainly not Clinton's and Obama's plans for universal healthcare.

Foxfyre wrote:

Will the system be as it is in some countries that doctors are not allowed to accept private insurance or provide care that is not government approved?

No it won't. Don't take my word for it -- go read the plans.

Foxfyre wrote:

I think these are valid questions to consider before saying that single payer, mandated by the government, is the only reasonable option on the table.

You're absolutely right. I'll consider them as soon as a leading Democrat proposes such a plan. I don't see myself considering it anytime soon because -- did I mention this? -- all the Democratic plans let you stay in your private policy if you like it!

I think the government might look into something like that to ensure that everybody who WANTS access can have it.

Foxfyre wrote:

I think the government might look into something like that to ensure that everybody who WANTS access can have it.

So you'll be voting for Obama then? Cool! :-D

501(c)(4), evidently.

The NRA is another 501(c)(4), as an example.

Equating health insurance to automobile and homeowners insurance.....classic Foxy, and honestly this rises to the same level of validity as your Intelligent Design arguments (which is to say, "not very good")

Equating health insurance to automobile and homeowners insurance.....classic Foxy, and honestly this rises to the same level of validity as your Intelligent Design arguments (which is to say, "not very good")

other then those actions which may harm others,

Cycloptichorn wrote:

other then those actions which may harm others,

And here is where your argument breaks down.....

People not having health insurance financially harms EVERYONE.

Our country, thankfully, does not turn away the sick from our emergency rooms, this policy and the costs associated with it contribute significantly to our healthcare costs.

Healthcare insurance is different because WE DON'T TURN PEOPLE AWAY. This is different from automobile/homeowners insurance, if someone doesn't have auto-insurance the government doesn't still buy them a new car. If someone doesn't have health insurance, the government DOES step in a buy them a new heart.

In addition, healthcare is different because early checkups prevent catastrophic illnesses. I think in addition to mandating that people get insurance, you should also mandate a yearly checkup. Catastrophic coverage is one thing, but it surely wouldn't be "low cost".

The leading Democratic and Republican candidates for president have proposed major changes to our health care system. These proposals are worthy of serious consideration. Rising medical costs threaten our country's long-term fiscal stability. And our failure to provide health insurance to 47 million Americans is cause for shame.

As this year's competitive primary election season builds to a climax, arguments within each party are bound to become heated. As candidates seek a competitive edge, it is natural to magnify small differences. But if the political debate over health reform is to inform Americans about the choices we face, it should be grounded on facts.

The remarkably similar health plans proposed by Senators Clinton and Obama have the potential to reduce the number of uninsured Americans (citizens, permanent residents, and others lawfully present in the U.S.) to two percent or less of the population. Achieving this goal would require full implementation of these plans' subsidies and insurance market reforms, plus robust outreach efforts to get everyone to sign up for coverage.

The necessary outreach will not be easy, and it will be fruitless unless health insurance is made affordable and accessible to all. Some believe that an individual mandate to buy health insurance should be part of this effort; others hold that a mandate would be paternalistic or too onerous for families at the margins of affordability. Regardless of our feelings on this issue, what is clear from the evidence is that mandates alone, without strong incentives to comply and harsh punishments for violation, will have little impact on the number of uninsured Americans.1 Indeed, as the Massachusetts experience illustrates, non-compliance with mandates is a large problem, absent harsh sanctions. There is simply no factual basis for the assertion that an individual mandate, by itself, would result in coverage for 15 million more Americans than would robust efforts to make health care more affordable and accessible.

The inaccurate claim that an individual mandate alone would reduce the ranks of the uninsured by 15 million draws attention away from the challenges we must surmount to make good medical care available to all. These challenges include adequate public subsidies, insurance market reform, outreach to people at the margins of American life, and long-term control of medical costs. Individual mandates may have a role in health care reform, but there is risk of a specious "Mission Accomplished" moment. It is a time for rolling up our sleeves and addressing the hard work required to get everyone care. The central challenge is to make health insurance affordable and accessible, and to reach out to all Americans to help them obtain coverage. Voters should insist that candidates for president address these very real issues.

1 S.A. Glied, J. Hartz, and G. Giorgi, "Consider It Done? The Likely Efficacy Of Mandates For Health Insurance," Health Affairs 26 (2007): 1612-1621.

Signers:

Click the link to see who the 80 signers are.

Quote:

http://www.vnews.com/02012008/4601389.htm

In Albaquerque today Obama went straight at... McCain.

He's realized that he can be as tough and attacking against McCain as he wants without getting any flack from the Dem base about being nasty or mean. It allows him to present a more confrontational and aggressive side of himself, something which many voters wanted to see. It also allows him to address concerns that he isn't going to be able to hang with the dirty-playing Republicans in the general.

Brilliant - if it works.

nimh wrote:

But I sure understand his frustration after all that self-excusing BS of Hillary's about the reasons to at the time believe that Saddam etc etc... she should have been at one of the anti-war rallies in '03, then she could have heard then already the stuff that she and all those other top US Democrats of the time only discovered years later...

Harold Meyerson on Tapped speaks my mind:

But the during the Iraqi discussion, the fact that the candidates had far more time than they had in the earlier, multi-candidate debates began to work to Hillary's disadvantage. The more she argued that she had interpreted the October 2002 vote to authorize the war as a vote to authorize inspections, the more deeply ridiculous she became. At the time, the common understanding of the vote was that it authorized war. That is why 126 House Democrats, led by Nancy Pelosi, opposed it. That is why there were major demonstrations in the streets across the country. That is why, here at The American Prospect, Bob Kuttner, Paul Starr and I co-authored an editorial then -- in October, as the vote approached -- warning against going to war and urging Democrats to oppose the resolution. If Hillary Clinton really thought that the vote was about sending inspectors into Iraq, even though, as she said during the debate, that she "did enormous investigation and due diligence," she was having a delusional moment. And I don't think she was.

http://www.huffingtonpost.com/harold-pollack/universal-coverage-and-t_b_84386.html

Click the link to see who the 80 signers are.



"Universal Coverage and the Presidential Candidates' Health Care Proposals"
Posted January 31, 2008 | 10:29 PM (EST)
Harold Pollack

Harry and Louise -- They're Back!

A quick follow-up on last night's debate over health care reform -- and then a new development.

1. A substantial group of 80 intellectuals have signed a letter arguing that the mandate debate is overblown and that "There is simply no factual basis for the assertion that an individual mandate, by itself, would result in coverage for 15 million more Americans than would robust efforts to make health care more affordable and accessible." And while not everybody on the list qualifies as a heatlh care scholars -- I'd love to see Harvard Law Professor Laurence Tribe on the Supreme Court, but when did he start studying insurance mandates? -- it includes a lot of people I know and respect, including Henry Aaron from Brookings, Stuart Altman at Brandeis, and Ted Marmor at Yale. I'm also a fan of the University of Chicago's Harold Pollack, who posted the letter at Huffington Post -- where you can read it.

Read what they have to say; take it seriously. Since I've certialy had my say on this, and then some, I'll give only a very brief response.

Last night, I concluded my item by saying "about the policy question asked during the debate -- whether this mandates make a difference -- the overwhelming consensus among experts is that they do." This was overstated. What I should have written was that it's the overwhelming consensus among economists who model these propoals -- i.e., people who have worked closely with the actual available data on this and projected the impact of various policy levers. (Whether or not you put faith in that judgment, it's worth mentioning that, when it's time to actually pass legislation, everybody will have to go by the estimates of the Congressional Budget Office. And CBO will use a similar model for making its estimates.)

I'll also point out that, as proof of their point, the letter-signers reference a paper by Sherry Glied, a Columbia University economist. It's the right place to look for answers -- she's very well-respected and has looked at this issue closely. I know, because I consulted that paper, too. And then, to go more deeply on this issue, I contacted Glied herself. I wrote about that in one of my original articles, which you can read here.

(For more on this specific dispute, see another Huffington Post entry -- this one by Gene Sperling of the Congressional Budget Office.)

The letter also makes a broader point: That the similarities between Clinton and Obama -- and the relative difference between them and the Republicans -- are far more impotant than the mandate dispute. I agree. As I've written many times, I think Obama's support for health care reform is genuine and that, overall, his plan is still very good. And there are aspects of this mandate issue, particularly the political elements of it, that are open to genuine debate. On the other hand, I continue to think that Clinton (and John Edwards before her) have been bolder, at least on paper, when it comes to health care.

Of course, that doens't mean I like the way Obama and his campaign have sold his plan lately. Which brings me to this...

2. Like Ezra Klein, my inbox this morning contained all sorts of mail from folks about this new Obama mailer on mandates.



And Ezra says pretty much everything I would say about it. It's one thing for Obama to defend his position, which (I believe) he genuinely prefers to Clinton's. And in the heat of the campaign, it's hard to avoid saying things that might ultimately come back to hurt your opponent if he or she becomes the nominee. So I'm happy to cut some slack there, particularly since he's been on the receiving end of all sorts of campaign trash lately.

But a presidential candidate who believes in a reform has to avoid making statements that could undermine that reform down the road. And that's precisely what Obama has done here. Even he has admitted, in some instances, that a mandate might be necessary in order to get everybody into a universal health care system. (And he already has one for kids.) But this mailer -- with all of its unmistakble echoes of Harry and Louise -- makes that task much harder.

--Jonathan Cohn

1) She decided early on that it was a matter of principle not to disavow it and is sticking to her guns
2) She decided early on that she was not going to admit she was wrong, and certainly can't do so now because it will look she is just bowing to pressure.
3) She has wanted and continues to want to hold some sort of position that she can fashion to look more centrist when the general elections roll around.

Any other possibilities?

I tend to think it's a mix of #'s 2 and 3.