Clinton, Obama Both Flawed On Health Care

In the middle of the mandate pie-fight (which just had a big ole can of gas dumped on it today by Paul Krugman), I think it's important for folks to understand that - mandates aside - there's still issues with both Hillary Clinton's and Barack Obama's health care plans that need to be addressed. I'm going to pick the big, blank area of each plan that leaves it open to attack, because my primary goal is to have a viable universal health care plan introduced by whoever wins the Democratic nomination (and then hopefully the presidency) as quickly as possible.

I suggest first off that folks read up on both of these plans.

Hillary Clinton's plan is here: http://www.hillaryclinton.com/feature/healthcareplan/americanhealthchoicesplan.pdf

Barack Obama's plan is here: http://www.barackobama.com/issues/pdf/HealthCareFullPlan.pdf

First off, a little housekeeping. I've read a number of threads on these health care plans and I've seen folks making the argument that the Clinton plan would force folks into private insurance. That is not the case - both the Clinton plan and the Obama plan have a public option. From page 6 of the Clinton plan (I'm retyping directly from the .pdf, my apologies for any typos):

In addition to the array of public choices offered, the Health Choics menu will also provide Americans with a choice of a public plan option, which could be modeled on the traditional Medicare program, but would cover the same benefits as guaranteed in private plan options in the Health Choices Menu without creating a new bureaucracy. The alternative will compete on a level playing field with traditional private plans.

Now, that being said, the big problem with Hillary's plan is that it is vague on regulation. With another politician this may be less of an issue, but as Hillary has a policy of taking lobbyist money (and has been pretty vocal on that subject), this leaves her plan - which includes mandates - more open to the charge that it's "putting money in the pockets of the insurance lobby". Regardless of the public option, folks will (and already have) drawn the connection between mandates and Hillary's friendly relations with Big Insurance. This is the language Hillary uses in her plan that speaks to how she would regulate insurers:

The plan creates rules that all insurers must follow, ensuring that no American is denied coverage, refused the renewal of an insurance policy, unfairly priced out of the market, or charged excessive insurance premiums. Health plans will compete on cost and quality rather than avoiding patients who need insurance the most.

snip

Require minimum stop loss ratios: Premiums collected by insurers must be dedicated to the provision of high quality care, not excessive profits and marketing.

In order for Hillary to answer critics she must put in more specifics on stop loss ratios. "Excessive" is in the eye of the beholder, and if she is mandating that all people opt into an insurance plan, folks have to know that this isn't one big scheme to fleece their already strained budgets to aid the profits of insurance companies. Being more specific on how she would cap insurance industry profits would go a long way to building consumer confidence in her plan.

Now, let's turn to Obama's plan. Although Obama could also be more specific on industry regulation (his plan mentions capping industry profits in certain markets that aren't competitive and removing caps in other markets that are more competitive, which frankly sounds pretty convoluted - see pages 9-10 of his .pdf), he has a much bigger problem that he hasn't dealt with yet: penalties.

From his interview on Meet The Press, December 30 (my emphasis added):

MR. RUSSERT: In terms of candor, you're running a political ad in Iowa and elsewhere about healthcare. And this is what the ad says. Here's the Obama ad. Let's watch.

(Videotape)

SEN. OBAMA: I've got a plan to cut costs and cover everyone.

(End videotape)

MR. RUSSERT: "Cover everyone." Every analysis of your healthcare plan says there are 15 million Americans who would not be automatically covered because you don't call for a mandate.

SEN. OBAMA: But, but, Tim...

MR. RUSSERT: Let me just give you a chance to respond. Ron Brownstein, who's objective on this, wrote this for the National Journal, and then we'll come back and talk about it. He says this: "Obama faces his own contortions. He commendably calls for building a broad healthcare consensus that includes the insurance industry. But in the states, the individual mandate has been critical in persuading insurers to accept reform, including the requirement" "they no longer reject applicants with pre-existing health problems. If such a requirement isn't tied to a mandate, insurers correctly note, the uninsured can wait until they are sick to buy coverage, which" would "inflate costs for everyone else. By seeking guaranteed access without an individual mandate, Obama is virtually ensuring war with the insurance companies that he's pledged to engage."

SEN. OBAMA: Well, Tim, here's the philosophical debate that's going on. First of all, every objective observer says Edwards, Clinton, myself, we basically have the same plan. We do have a philosophical difference. They both believe the problem is the government is not forcing adults to get healthcare. My belief is that the real problem is people can't afford healthcare, and that if we could make it affordable, they will purchase it. Now, they assert that there're going to be all these people left out who are avoiding buying healthcare. My attitude is, we are going to make sure that we reduce costs for families who don't have health care, but also people who do have healthcare and are desperately needing some price relief. And we are going to reduce costs by about $2500 per family.

If it turns out that there are still people left over who are not purchasing healthcare, one way of avoiding them waiting till they get sick is to charge a penalty if they try to sign up later so that they have an incentive to sign up immediately.

MR. RUSSERT: Which is a quasi-mandate.

SEN. OBAMA: But--well, no, it's not a quasi-mandate because what happens then is we are not going around trying to fine people who can't afford healthcare, and that's what's happening in Massachusetts right now. They've already had to exempt 20 percent of the uninsured, and you're reading stories about people who didn't have healthcare, still can't afford the premiums on the subsidized healthcare, but now are also paying a fine. That I don't think is providing a relief to the American people. We need to make health care affordable. That's what my plan does. And The Washington Post itself said, for the Clinton campaign to try to find an individual who wanted healthcare and could not get it under the Obama administration would be very difficult because that person probably does not exist. If you want healthcare under my plan, you will be able to get it, it will be affordable, and it will be of the high quality.

link: http://www.msnbc.msn.com/id/22409176/page/5/

I've reviewed Obama's health care plan (and double checked it again this morning) and I have yet to find any details about these "penalties". Any plan for universal coverage has to deal - at some point - with adverse selection (the probability of more high risk people signing up for a plan than low risk people, thereby forcing the plan to pay out more money than it takes in). Hillary is proposing to deal with this on the front end through mandates. Obama is doing this on the back end through penalties (and before folks start on about "making insurance more affordable"...both plans do that. Both plans also have an enforcement mechanism for adverse selection, and Obama seems to have the trigger for the enforcement when the person who hasn't paid into the plan goes to access benefits).

However, as Obama has not been very specific about what these penalties are, how many past premium periods they may cover, whether or not interest is charged, whether or not there is a wage or income garnishment involved, whether or not these folks would be charged higher rates for not opting in sooner, etc. etc. this leaves his plan weakened. It is also unclear whether putting penalties in place on the back end would give people "an incentive to sign up early". The opposite could also be argued: that folks may put off seeking treatment because they don't want to pay these penalties. This would in turn increase, not decrease, the cost of care.

I want universal health care. I want Democrats going in with a strong plan so that - in the eventual compromise stage in Congress - many elements of the plan remain in place. When the plans start to get whittled down I want them made out of oak, not balsa wood or soft pine.

I'd like to see both candidates address the weaknesses in their plans for this reason. Let's not attack each other over universal health care; let's work together to get it done.

Paul Krugman's Latest Pin Prick Of The Obama Bubble

Paul Krugman's piece today is already being derided by some vocal Obama supporters, as it makes the real world argument that any Democratic President will be attacked by the GOP. Although that may sound like a given to those of us here in the grown-up wing of the Democratic Party, to the post-partisan hopedacious crowd this is new to them.

What a hoot.

Krugman, being the realist that he is, feels that the best way to weather these attacks is through a well-formulated platform of detailed policies (and not half-baked compromises right out of the box):

"...I have colleagues who tell me that Mr. Obama's rejection of health insurance mandates -- which are an essential element of any workable plan for universal coverage -- doesn't really matter, because by the time health care reform gets through Congress it will be very different from the president's initial proposal anyway. But this misses the lesson of the Clinton failure: if the next president doesn't arrive with a plan that is broadly workable in outline, by the time the thing gets fixed the window of opportunity may well have passed..."

link: http://www.nytimes.com/2008/01/28/opinio n/28krugman.html?_r=1&ref=opinion&am p;oref=slogin

And although Krugman observes that this primary season has gotten "terribly off track" due to the politics of personalities and celebrity, he does have kind words for the one candidate who has tried to make his campaign about the things that actually affect all of our bottom lines:

"...What the Democrats should do is get back to talking about issues -- a focus on issues has been the great contribution of John Edwards to this campaign -- and about who is best prepared to push their agenda forward..."

Will Americans wake up in enough time to realize that the politics of personality does nothing to help themselves or their families?

I don't know. But I have Hope.

Why Edwards Needs To Stay In

Okay, let me just objection-handle for a couple of moments. From all appearances Edwards is over 15% in South Carolina, meaning he will earn delegates from this thing when everything's said and done.

Now, before the punditry and the Clinton campaign start spinning all of the various reasons why John should drop out, let me address these concerns now.

*Objection One: The Sore Loser*

To reiterate talking points from a "senior Clinton advisor" this week:

The former first lady's allies say the longer Edwards stays in the race, the more problems his candidacy will cause the party down the road.

One senior adviser to the Clinton campaign said Edwards was "angry" because the primary race isn't turning out the way he had hoped. Now, Edwards just wants to make life miserable for everyone else.

Some think Edwards is playing the role of a spoiler, prolonging the day of reckoning between Clinton and U.S. Sen. Barack Obama of Illinois, the Democratic front-runners. They fear the longer the Clinton-Obama battle goes on, the harder it will be to heal the inevitable wounds in the Democratic Party. It's time for Edwards to drop out of the race, they say.

link: http://www.mercurynews.com/opinion/ci_8052139

*Why this is a false meme*

1. As seen by what is widely being acknowledged as a retaliatory vote by African Americans *against* the Clinton campaign tactics in South Carolina, it's pretty damn clear who in this race has already "caused more problems for the party down the road"...and that ain't John Edwards. By playing a cynical race game to try to downplay a defeat in South Carolina, the Clintons have thrown the fragile and often abused relationship between the Democratic Party and African Americans under the bus to achieve their own political aspirations. And they have the temerity to suggest that it's John Edwards who is causing the party problems?

Hillary, puh-leeze. Talk to the hand, girlfriend, cuz we ain't listenin'.

2. "Prolonging the day of reckoning between Clinton and Obama". Cute. As if we're spectators at some type of live computer game where Hillary and Barack are both Death Ninjas.

Uh-huh.

John Edwards being in this race is the tether to Hillary's attacks. She can't go too far out on that limb for fear of alienating folks and sending them his way. An all out flame-war between the Clinton campaign and the Obama campaign does nothing but give the GOP fodder for the general election. *This* is not in the best interests of the party. Edwards has consistently made his campaign about this issues, and his staying in this race is the best hope we have for the primaries to continue to *be about the issues*. Hate the flame wars? Keep Edwards in this thing.

3. John Edwards is "angry" and a "sore loser". Sigh...well at least we know how the Clintons are going to attack *his* character. No, John Edwards is not "angry". Edwards supporters are not "angry". We just want this election to be *about the issues*. And yes, we're in this to pull the debate to the left.

'Nuf said.

*Objection Two: If Edwards Pulled Out Obama Would Win This Thing*

This is the culmination of arguments I've read in threads, and diaries, and all over the place.

*Why this is a false meme*

1. There is no evidence that *all* or *most* of Edwards's supporters would vote for Obama.

2. If Edwards pulls votes from Hillary this only helps Obama in a brokered convention. Edwards has already made several declarations that he and Obama are closer on the issues to each other than they are to Hillary. He has already very publicly called her the "status quo candidate". Therefore, one could reasonably assume that if Edwards were to support anyone in a brokered convention that person would be Barack Obama. Edwards's support may be the deciding factor in such a scenario, and breaking toward Obama would give him the win.

So, Hillary folks: "Edwards is a loser and is hurting the party" won't fly. Obama folks: "Edwards pulling out would give Obama the win" isn't actually the case.

Y'all chill. Edwards is - and should - stay in this thing to the convention.

Peace.

Why Obama's Comment Stings My Soul

...Or, Fear And Loathing in the 1980's.

I don't mean this to be a hit diary, or a pile on. But in reading the discussions around the blogs today on Obama's growingly-infamous comment about Reagan's legacy, I feel like some folks just don't get it, they truly do not empathize with those of us on the left who hear the word "Reagan" and see red. I think a lot of this is due to not sharing a common history.

So, briefly, these are some recollections that jump into my brain when I hear "Reagan"...

It was 1980. There was no internet. There was no cable (or at least none in my neck of the woods in small town Nebraska). We got our news from the local paper, the Lincoln paper and four broadcast network stations. I was a bored thirteen-year-old, walking the school hallways with her head stuck in a book and glasses perched on my nose, trying to grow through these years as quickly as possible so I could Get Out. Escape To The Great World Beyond.

In 1980 a lot of stores in our small town still closed on Sunday...and they were still huddled around the town square, encasing the county courthouse. If you wanted something you had to either get it Saturday or drive into Lincoln. We had a local movie theatre that was still open (although the local businesses stopped giving out "movie money" coupons a few years back).

The big news of the day was the Iranian hostage crisis. On the radio in the car, on the TV news at night, in the schools during our discussions of current events, everyone would get updated on "Day Number ____ ", a macabre notation of how many days the hostages had been held. This would be followed up with blurry film footage and photographs of men and women, blindfolded, surrounded by young men with guns. We were treated to reports of what happens when one is being taken hostage. What that feels like. Whether they let you go to the bathroom.

Analysts would discuss the Carter administration's action - or lack thereof. Carter refused to negotiate with terrorists. Eventually we heard news of a downed plane and a failed rescue attempt. People were frustrated and scared. It felt like the one battle in the Cold War that we were losing (regardless of the reality of things - trust me, this *is* what it felt like)...and we all collectively understood the threat that loomed if we let that happen.

It is this environment that elected tough-talking Ronald Reagan. The Man of Action. The choice of "Other" on your ballot. It was hardly the masses yearning for "...a return to that sense of dynamism and entrepreneurship that had been missing." After Reagan was elected and the hostages were freed the country breathed a sigh of relief, patting itself on the back for making the right choice. It was only later on that we would learn it was secret negotiations with these terrorists before we even cast our votes - and not all that tough talk - that freed these hostages.

But with the hostages freed we were still under a threat even more dire, that of total nuclear holocaust. Mutually Assured Destruction had been our policy since Kennedy, and - because we couldn't figure out any other way of going about things - it remained our policy since that time. We watched The Day After on the TV, and talked about that woman's hair falling out after being poisoned by radiation. In Nebraska we had a special network news treat: seeing a model of downtown Omaha being blown to bits in a nuclear blast. Unlike the rest of the country, Omaha would be ground zero in a nuclear war as it was the home of the Strategic Air Command.

We drove down gravel roads that suddenly became paved - roads with no names, only the ones that the locals gave them: "missle base roads". Because, well, they were built to lead to a missle base.

And in the middle of all of this the economy boomed, I went to high school and then college and I have to say, even for the eighties I had *really big hair*. And skin tight jeans. (Ah, to have my pre-mommy body back again).

But I digress.

I went to an Ivy League school "back east", where the campus was buzzing about who got the latest job on Wall Street, where the best place to go shopping was and where everyone wore the standard uniform of leather bomber jackets. And in the middle of all of this we learned, and studied, and discussed the Russian threat, the Eastern Block Countries, the history of La Belle Epoch, and, yes, Mutually Assured Deterence. Professors openly questioned the government's assessments of the Soviet threat, the number of missles they had and the numbers we needed to defend ourselves (as opposed to launching a first strike).

I was fortunate enough to go to Russia.

I hung out with engineering students there who openly questioned *their* government's allocation of resources to build these nuclear warheads. Their lack of testing them, and their dictates to just swap components when there were shortage issues. I saw people carrying briefcases and bookbags, to stock up on certain items that hit the store shelves and then disappeared just as quickly. I saw the cheaply made shoes, smoked the cheaply made local cigarettes and walked the streets where small three cylander vehicles - "put put cars" my friend called them - cruised the streets looking for the impossible to find parking spot.

And after all of this I thought to myself: *this* is the Evil Empire? It seemed like a surreal joke, knowing the trillions we had spent in "defending" ourselves against these folks.

It was then I understood I had been lied to. By Reagan. And that the trillions of dollars of debt we incurred at the expense of mentally retarded people being forced into the streets and government programs being stripped to the bone wasn't about protecting us. It was about something else, a more sinister remake of society that was being enabled by a combination of fear and consumption, forcing us to become a more "me" oriented society and less of a "thou" oriented society.

This is why, today, I was deeply saddened listening to Senator Obama's remarks on Reagan. It just took me right back there to that moment in time when, for me, the lie began.

Again, this isn't a hit diary. Just an explanation of where I'm coming from.

Peace.

UPDATE: I was originally just trying to keep this as an expression of what Reagan was really like and what that election was like, but maybe that was a little too subtle. Sorry about that.

To answer everyone, here is Obama's quote, with the part that I take umbrage at highlighted:

I don't want to present myself as some sort of singular figure. I think part of what's different are the times. I do think that for example the 1980 was different. I think Ronald Reagan changed the trajectory of America in a way that Richard Nixon did not and in a way that Bill Clinton did not. He put us on a fundamentally different path because the country was ready for it. I think they felt like with all the excesses of the 1960s and 1970s and government had grown and grown but there wasn't much sense of accountability in terms of how it was operating. I think people, he just tapped into what people were already feeling, which was we want clarity we want optimism, we want a return to that sense of dynamism and entrepreneurship that had been missing.

If you notice, people actually *weren't* feeling that they wanted clarity, optimism and a return to that sense of dynamism and entrepreneurship that had been missing.

People were *in fear*. The 1980 election was about *fear*. It was not about *hope*. The GOP has been attempting to spread the message of Reagan the Great Optimist/Hopemonger/etc. in an effort to cannonize him. This spin is far from reality.

I hope this explains my feelings on the subject a little more directly.

This is a crosspost of a blog entry originally posted on Daily Kos: http://www.dailykos.com/story/2008/1/16/202428/519/291/438030

John Edwards And A Revolution of Values

There are forty million poor people here, and one day we must ask the question, "Why are there forty million poor people in America?"

snip

We are called upon to help the discouraged beggars in life's marketplace. (Yes) But one day we must come to see that an edifice which produces beggars needs restructuring.--Martin Luther King, Jr. "Where Do We Go From Here?"; August, 1967

link: http://www.stanford.edu/group/King/publications/speeches/Where_do_we_go_from_here.html

"With an increase in Americans without health insurance by two million to 47 million, nearly 37 million Americans still living in poverty and continued high levels of inequality, the need for fundamental change in our government is obvious.--John Edwards, Statement on New Census Data On Poverty in America, August, 2007

link: http://www.johnedwards.com/issues/poverty/20070828-poverty-data/

Martin Luther King, Jr. was a holistic thinker, and someone who saw the problems plaguing mankind through the prism of the inter-related, triple evils of racism, poverty and war. In speaking out against the Vietnam War, King called for the United States to engage in one, final systemic change which he called a "revolution of values" ( http://www.hartford-hwp.com/archives/45a/058.html ):

A true revolution of values will soon cause us to question the fairness and justice of many of our past and present policies. On the one hand we are called to play the good Samaritan on life's roadside; but that will be only an initial act. One day we must come to see that the whole Jericho road must be transformed so that men and women will not be constantly beaten and robbed as they make their journey on life's highway. True compassion is more than flinging a coin to a beggar; it is not haphazard and superficial. It comes to see that an edifice which produces beggars needs restructuring. A true revolution of values will soon look uneasily on the glaring contrast of poverty and wealth.

All of our Democratic candidates have great ideas and policies to help us right the ship of the nation after eight disasterous years. But for my money - and more than that, for my time, support and dedication - John Edwards has the holistic vision that can help us achieve that revolution of values that King called our nation to embrace over forty years ago.

Civil rights leaders, from Martin Luther King III, to Jesse Jackson, to Harry Belafonte, have praised Edwards for concentrating on the poor. This isn't because this is just one more issue in governance by laundry list. What these civil rights leaders realize is that when you focus on poverty it forces you to view our society in a fundamentally different way. Indeed, it makes you question the *ediface that produces poverty*.

In making poverty a central issue of his campaign - against advice from pundits and advisors and all of those smart folks who feel that this is just a downer issue - Edwards has shown his commitment to this revolution of values by laying out detailed policies on how we can reach this goal:

Creating a Working Society
Edwards has outlined a Working Society initiative to lift 12 million Americans out of poverty in a decade and beat poverty over the next 30 years. In the Working Society, everyone who is able to work hard will be expected to work and, in turn, be rewarded for it. The initiative includes major new policies in the areas of work, housing, education, debt and savings, and family responsibility.

If you visit his issues page, Edwards outlines specifics behind this vision, including increasing the minimum wage, creating stepping stone jobs and making it easier for workers to unionize: http://www.johnedwards.com/issues/poverty/

Our country needs a change of direction, but more than that we are still in need of a revolution of values. By addressing the issue of poverty, Edwards is putting us on that road. Harry Belafonte expressed this last week when he endorsed Edwards for President:

"I also happen to believe that had he not so forcefully and precisely put the issue of poverty into this campaign, I don't think we'd be talking aobut it as much as we are," Belafonte said.

Our revolution of values shouldn't start next year, next decade or in the middle of someone's second term. It needs to start today. For me, that's why I'm supporting Edwards and volunteering for him in the following weeks. I'd like to invite folks to take a look at Edwards and if you agree, help him win the nomination and then the Presidency.

Let's be the change we want to see.

John Edwards: Toward A New, Democratic Politics

The in-tuned blogosphere already knows a lot about John Edwards: the endorsements he's received by state SEIU chapters including the important states of Iowa and New Hampshire; the endorsement by Friends of the Earth and the most recent endorsement by Iowans for Sensible Priorities. Folks are also aware of his calls for an end to the corrupt system in Washington, D.C., a system he defines as being "rigged" against all of us people who work for a living.

At first blush, this may seem like smart politics. Appealing to the base. Riding the wave of middle class anger. But there's something a lot more profound going on here, something that is an anti-Bush, Rove-free approach to democratic politics.

Come follow me and I'll tell you what I mean...

If you're going to try to fix a problem or address an injustice, there's a few ways to go about it. You could, for instance, focus on the immediate problem at hand and do a lessons-learned analysis (for instance, not putting a well-connected but incompetent fellow in charge of FEMA, and just hope that disaster doesn't strike). You could also do some investigations to try and examine the immediate causes of the injustice (for instance, holding hearings on how billions of dollars were just misplaced in Iraq, never to be heard from again). Or, you could try to look at the whole mess holistically, peel away the layers and get to the core issue. You could also look at where we are, where we need to be and set out a roadmap for how to get there.

That's what Edwards is doing, and that's what makes him a truly unique candidate...especially if you want *change*.

Peruse the Edwards website and you'll come across the issues page: http://johnedwards.com/issues/ . On that issues page you'll see the following three main areas, with links to specific policy proposals:

1. Standing up for Regular Families, including links to policy proposals for universal healthcare, poverty, policies to improve the quality of life in rural America, strengthen food safety and other policies and programs that reach out to and improve the quality of life for the individual.

2. Restoring America's Leadership Role In The World. Here you'll find Edwards's foreign policy and proposals that shape how our nation is viewed across the world, including the areas of Iraq, Iran, terrorism, civil liberties and global poverty (for my own analysis of Edwards's foreign policy, including his firm stance against preventive war, please see this diary: http://www.dailykos.com/story/2007/11/6/17523/4824 ).

3. Investing In Our Future And Our Communities, an area which addresses policies and proposals that impact health and well-being of the community at large, including the areas of global warming, education, open media, veterans and civil rights.

All three of these main areas affect each other, and all of the policies inside of these three areas also impact other policies. Everything is inter-related. All of the pieces and parts of the proposals need to work together in harmony in order to create the systemic change we need to reclaim our country.

Finally, none of this can happen, none of this systemic change can take place unless we remove the influence of lobbyist money in politics. Bill Bradley outlines in this in this June, 2007 talk on how the influence of lobbyists can corrupt these policies through an "unstated connection" between the contribution and the result of that contribution:



Sure, John Edwards is a great orator, and there's wonderful speakers across the field of Democratic presidential candidates. But to get systemic change you need more than just speeches: you need well thought-out policies and proposals so you can hit the ground running and start creating that change as soon as you're elected. You need a roadmap, and Edwards provides an impressive one that shows us the steps we can take to fix our problems, take care of our citizens and become a respected member of the community of nations once again.