Who would've thunk that a slight disagreement over Barack's position on individual health insurance mandates would become the wedge issue of the 2008 Democratic Primary?
After all, the wider policy differences between the respective health care plans being advocated by each of the frontrunners are miniscule as compared to the difference between all of them and single payer, or all of them and what the Republicans are proposing. Obama himself advocates mandates for children and each of them concedes that these are just proposals; in the end Congress will write the legislation, not the President.
But after weeks of Krugman columns, AFSCME fliers, Hillary attacks, etc., it's clear that there's something more significant at stake. The more I learn about this battle, the more convinced I am that Barack Obama is the best candidate. Details after the jump...
Barack's own statement on the issue sums up my own opinion on the issue pretty succintly:
"Their essential argument is the only way to get everybody covered is if the government forces you to buy health insurance. If you don’t buy it, then you’ll be penalized in some way. What I have said repeatedly is 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."
-- Barack Obama, Nov. 24, 2007
More interesting to me, however, is the way the politics have been playing out. It started with Paul Krugman. The substantive issues about his critiques have been hashed through pretty well, but more perplexing to me were his priorities: given the incredible influence and reach of the opinion page of the New York Times, does this small shade of difference really warrant three separate columns? Could it be that Krugman has an ulterior motive in this (a Cabinet post perhaps)?
I began to get a fuller picture, however, when I read this from the California Nurses Association blog:
INSURERS HIJACK CALI HEALTH REFORM
Unbelievable. Yesterday most of California’s major insurance corporations (Blue Shield, Kaiser, Cigna, etc. etc.) testified in support of Arnold Schwarzenegger’s healthcare reform bill...and the donations they have given to Assemblymembers was money well-spent, as the bill passed and was sent to the Senate.
No wonder the private insurance corporations love this bill: by including an "individual mandate," it creates a forced market where individuals are forced to purchase expensive, wasteful products from the very people who wrecked our healthcare in the first place.
But it was the AFSCME flier scandal that really tipped the scale for me. Putting aside the ethics of the attempted "false flag" smear against the Edwards campaign (and thank you John for promptly disavowing any responsibility for the flyer), here we have a national union coming into Iowa and paying for hundreds of thousands of dollars worth of attacks against Barack for...not advocating mandates?
Now we learn that the flier goes directly against AFSCME's own stated position on mandated health insurance. In August of 2006, at their national convention, AFSCME adopted its Health Care Reform Blueprint for 2007 and 2008, which included the following language:
In the absence of federal solutions, states will continue to initiate their own reforms of the health care system, especially reforms targeted to the most vulnerable populations. Some of these reforms, such the reforms adopted in Massachusetts in 2006 which rely on "individual mandates," are incompatible with AFSCME’s principles and long term interests.
And just this past April, AFSCME president Gerald McEntee testified in Congress on health care reform and had this to say:
The Massachusetts reform model attempts to achieve near-universal coverage through the use of individual mandates that require those without access to coverage through their jobs to buy coverage in the individual market. Although there are subsidies to help low-income families, many working families will be forced to pay much higher prices for coverage. The most recent estimates for coverage under this initiative for a family with an income of $50,000 would include a $7,000 premium and a $2,000 deductible. Health care costs that approach 20 percent of total family income are unaffordable and unacceptable to working families and they will ultimately doom this plan to failure.
Fortunately, even if AFSCME's national leaders were willing to sell out their "principles and long-term interests" for political gain, AFSCME's own state-level Iowa and Illinois leaders were also willing to call them on it:
"This is definitely hypocritical, absolutely," said Carter Woodruff, an activist with Iowa AFSCME and a former official of the union state council. "It's a desperate attempt to attack [Obama] for unfounded reasons. It's a shame they stooped so low."
. . .
Woodruff along with Henry Bayer, Executive Director of Illinois-based AFSCME Council 31, spoke to reporters on a conference call organized by the Obama campaign. Council 31, representing 75,000 Illinois public employees, endorsed Obama this month. "Senator Obama has fought like hell for working people," said Bayer. "His health care plan is most in line with that of our national union."
The dissident union members, indeed, pointed out that AFSCME's national health care resolution passed earlier this year declared that individual mandates are "incompatible" with the principles and interests of the union membership.
Here's what I think: a deal's already been made in Washington between Hillary and the insurance companies and that deal is based on mandated health insurance. No mandates, no deal. Hillary will take credit for "universal" health insurance (if only by fiat), and the insurance companies will increase their profits exponentially with 47 million new captive customers.
The only problem: the public. This deal will go over with them like a lead balloon. Marc Ambinder included the following tidbit in his column the other day that might shed some light here:
Buried in the latest CNN/WMUR poll of New Hampshire is this intriguing stat:
On the question of which candidate would do a better job on health care, Clinton has always led. But in a month that saw Clinton deride Obama's plan for its lack of a mandate, the gap has narrowed by 16 points. All the other issues were relatively static.
Maybe this is why Hillary has not explained how her mandate would be enforced.
Meanwhile, here comes "Mr. Smith Goes to Washington" Barack Obama not only opposing mandates, but promising to put the whole debate on national television for everyone to see. His challenge, then, is not only to her nomination, but to the deal upon which much of her candidacy is based. Hence, the very long knives that have come out of their sleeves, even if it means dividing unions against themselves and weakening the Democratic Party.
But in the end, this attack on Barack, like so many others, only serves to highlight once again why he deserves to be the nominee. He's the only candidate with a legitimate shot who is really thinking about what's best for the American people, and not how to push through a deal struck by Washington insiders. Good for him for standing up to this insanity and hypocrisy.