Skip to main content

We Democrats have waited SINCE PRESIDENT HARRY TRUMAN (the late 1940s!) for a chance at universal health care.  It's within reach.  Let's not blow it on a candidate whose plan is weaker and who's already making ill-considered policy shifts (see below for a sad description of Obama's illogical backpedaling on mandates by considering the imposition of penalties on those who don't sign up).

Here's the "money quote" from Paul Krugman's column in tomorrow's New York Times (February 4, 2008):

If you combine the economic analysis with these political realities, here's what I think it says: If Mrs. Clinton gets the Democratic nomination, there is some chance - nobody knows how big - that we'll get universal health care in the next administration. If Mr. Obama gets the nomination, it just won't happen.

Krugman cites essential new information -- that every voter should know -- from an M.I.T. study by a renowned health care analyst comparing the two candidates' plans, important because, Krugman notes, the "principal policy division between Hillary Clinton and Barack Obama involves health care":

[T]he difference between the plans could well be the difference between achieving universal health coverage - a key progressive goal - and falling far short.

... new estimates say that a plan resembling Mrs. Clinton's would cover almost twice as many of those now uninsured as a plan resembling Mr. Obama's - at only slightly higher cost.

Twice as many people.  That's huge. Obama has attacked Hillary Clinton repeatedly for mandating coverage -- but there are critical reasons that everyone be covered.  

NOW Obama is suggesting (as you'll see below) that he may "penalize" people who don't participate.  WHAT?  Penalize them by forcing them to pay BACK PREMIUMS?  Why not just include them in the first place?  

Talk about making up non-sensical policy on the fly!

Update [2008-2-4 2:13:6 by SusanHu]: HERE is what Ezra Klein reports, at Prospect, that Obama said in the debate on Thursday night:

Meanwhile, Obama not only has a mandate for kids in his own health care plan -- what if the parents can't pay, one might ask? -- but he said, in last night's debate, "If people are gaming the system, there are ways we can address that. By, for example, making them pay some of the back premiums for not having gotten it in the first place." That, of course, is exactly what a mandate does. Gaming the system, in this context, means not purchasing health care. And Obama is now threatening to force them to pay back premiums. That's a harsher penalty than anything Clinton has proposed.


Here's one key reason why mandatory universal coverage works: It forces insurance companies to cover everyone.  Another reason is that even young, robustly healthy people can face enormous medical bills from accidents or from rapidly growing diseases hitting the young, including diabetes and high blood pressure (that can be discovered and treated before they become expensive). And if they sign up before they get sick, the plan's costs would be lower.

(Find out more here, including great analyses from Ezra Klein, Steve Clemons and The Urban Institute.)

Krugman continues:  

... [Clinton's plan is] more explicit about affordability, promising to limit insurance costs as a percentage of family income. ...


Mr. Obama claims that people will buy insurance if it becomes affordable. Unfortunately, the evidence says otherwise.


[Obama's plan doesn't deal with] healthy people who ... don’t sign up until they develop medical problems, thereby raising premiums for everyone else. ...

Krugman reports that Jonathan Gruber of M.I.T., "one of America’s leading health care economists," explains in a new paper how Obama's plan leaves far more people uninsured -- and costs more:

Mr. Gruber finds that a plan without mandates, [like] the Obama plan, would cover 23 million of those currently uninsured [at] $102 billion per year. An otherwise identical plan with mandates would cover 45 million of the uninsured — essentially everyone — [for] $124 billion.

Clinton's plan, Gruber's analysis shows (says Krugman), would cost only $2,700 while Obama's plan would cost $4,400 per "newly insured person."  He notes that although Obama's plan costs 80% more, it only covers half of the people who are currently uninsured.

Krugman says that Gruber's analysis compares favorably with other analyses, including a 2003 study from the Robert Wood Johnson Foundation.  That study found that "mandates made a big difference both to success in covering the uninsured and to cost-effectiveness."

Krugman refers to the Obama campaign's ugly tactics against Clinton's health plan, and why "Mr. Obama’s campaigning on the health care issue has sabotaged his own prospects":

[T]he Obama campaign has demonized the idea of mandates — most recently in a scare-tactics mailer sent to voters that bears a striking resemblance to the “Harry and Louise” ads run by the insurance lobby in 1993, ads that helped undermine our last chance at getting universal health care.

I showed you that pamphlet the other day.  It's important to display it again.  It is UGLY, Chicago-style campaigning -- and, as Dr. Krugman points out, would sabotage the realization of even Obama's own weaker plan:

Image Hosted by

Image Hosted by

In a February 1 NYT blog post, "Obama Does Harry and Louise Again..." -- which I quote in my February 1st story, "Common Sense + Expert Opinions on Obama’s Dangerously Flawed Health Care Plan" -- Krugman points out:

The Obama campaign sends out an ugly mailer. Sorry, but this is just destructive — like the Obama plan, the Clinton plan offers subsidies to lower-income families. And BO himself has conceded that he might have to penalize people who don't buy insurance until they need care.

Read all of tomorrow's NYT column, "Clinton, Obama, Insurance."

THIS is the candidate who can make universal health insurance a reality:

[editor's note, by SusanHu] I cut down the quotations from Mr. Krugman's column because some were concerned about fair use.  if anyone has further objections, please e-mail me at susanunpc at gmail dot com

Originally posted to SusanHu on Sun Feb 03, 2008 at 10:16 PM PST.

Your Email has been sent.
You must add at least one tag to this diary before publishing it.

Add keywords that describe this diary. Separate multiple keywords with commas.
Tagging tips - Search For Tags - Browse For Tags


More Tagging tips:

A tag is a way to search for this diary. If someone is searching for "Barack Obama," is this a diary they'd be trying to find?

Use a person's full name, without any title. Senator Obama may become President Obama, and Michelle Obama might run for office.

If your diary covers an election or elected official, use election tags, which are generally the state abbreviation followed by the office. CA-01 is the first district House seat. CA-Sen covers both senate races. NY-GOV covers the New York governor's race.

Tags do not compound: that is, "education reform" is a completely different tag from "education". A tag like "reform" alone is probably not meaningful.

Consider if one or more of these tags fits your diary: Civil Rights, Community, Congress, Culture, Economy, Education, Elections, Energy, Environment, Health Care, International, Labor, Law, Media, Meta, National Security, Science, Transportation, or White House. If your diary is specific to a state, consider adding the state (California, Texas, etc). Keep in mind, though, that there are many wonderful and important diaries that don't fit in any of these tags. Don't worry if yours doesn't.

You can add a private note to this diary when hotlisting it:
Are you sure you want to remove this diary from your hotlist?
Are you sure you want to remove your recommendation? You can only recommend a diary once, so you will not be able to re-recommend it afterwards.
Rescue this diary, and add a note:
Are you sure you want to remove this diary from Rescue?
Choose where to republish this diary. The diary will be added to the queue for that group. Publish it from the queue to make it appear.

You must be a member of a group to use this feature.

Add a quick update to your diary without changing the diary itself:
Are you sure you want to remove this diary?
(The diary will be removed from the site and returned to your drafts for further editing.)
(The diary will be removed.)
Are you sure you want to save these changes to the published diary?

Comment Preferences

    •  I am married to one physician (54+ / 0-)

      who would strongly disagree.  And as a nurse who also managed a medical office and did all the insurance and billing myself, I disagree as well.  

      "I'm for Hillary because I believe that the United States right now is in a world of crap." - spoken by a Nevada voter

      by SaneSoutherner on Sun Feb 03, 2008 at 10:20:07 PM PST

      [ Parent ]

    •  That's naive at best (13+ / 0-)

      Both John Edwards' and Obama's plans work with the existence of insurance companies.

      •  Clinton copied Edwards plan. (3+ / 0-)
        Recommended by:
        Miss Blue, splashy, Rick Winrod
      •  I would like to know the answer (2+ / 0-)
        Recommended by:
        kyril, hardtoport

        to a couple of questions from both sides.

        1. How is Hillary's plan different this time from her plan in the early 90's?
        1. Both plans include subsidies. Suppose we are looking at a family of 4 making $45,000 year. What would their monthly premiums be for each plan? What would the government's share be?

        Those are the kind of question I would like answered. Anybody know the answers?


        by jennybravo on Sun Feb 03, 2008 at 10:46:57 PM PST

        [ Parent ]

        •  The answers are here (2+ / 0-)
          Recommended by:
          jennybravo, seattlegonz

          Hi Jenny,  it's best not to take my words for it.   I'm strongly against sound bite.  I'm pro-self-education, and form my own opinion.

          If you are still not satisfied,  you can send them your question here.  I asked them about veteran benefit, and they came back to me with the answer quite quickly.

          •  The answers are NOT there (2+ / 0-)
            Recommended by:
            jennybravo, hardtoport

            I challenge you to find the answer to how much a family of 4 (or any other size) making $45,000 per year (or any other level of income) would pay from those links.

            "Those who would sacrifice liberty for security deserve neither liberty nor security." -Ben Franklin

            by leevank on Sun Feb 03, 2008 at 11:02:35 PM PST

            [ Parent ]

            •  How much do they pay under Obama's plan? (2+ / 0-)
              Recommended by:
              Pacific John, jennybravo
              •  Obama's (1+ / 0-)
                Recommended by:

                Affordable premiums, co-pays and deductibles. Participants will be charged
                fair premiums and minimal co-pays for deductibles for preventive services.
                Subsidies. Individuals and families who do not qualify for Medicaid or SCHIP
                but still need assistance will receive income-related federal subsidies to keep
                health insurance premiums affordable. They can use the subsidy to buy into the
                new public plan or purchase a private health care plan.

                So the answer is, nobody is telling. So we have all this arguing about whose is best and nobody can tell an average family or individual what it will cost them. In my opinion that makes this argument fairly meaningless. Until the public has the answers to those questions they are not going to support either plan.

                I have spoken before about how I think mandates may be a bad idea. Most people who don't have insurance now are just getting buy, if even that. Say the insurance was to cost them $250.00 a month. Where would that come from? Why do they have to wait until the end of the year for a tax credit? Why not a supplement or reduce the payments right away?

                And how many people will a mandate add to the underground economy? You've already got a whole lot of people working under the table because they can't pay SS and income taxes. How many more will work under the table if insurance is mandated?

                I think those are practical arguments against mandates. But most of all, none of us knows how much the costs and/or subsidies for individuals will be. As far as I am concerned it is like if you need a car and start arguing about if you want the red one or the blue when you have no idea what either doesn't make sense.


                by jennybravo on Sun Feb 03, 2008 at 11:34:51 PM PST

                [ Parent ]

                •  Obama has mandates too (1+ / 0-)
                  Recommended by:

                  All the questions about mandates apply to Obama's plan as well...since he has mandates too. The difference is he doesn't think adults should be required to have health insurance if they don't want it. The problem with that is -- when an uninsured person becomes catastrophically ill, hospitals and doctors are required by ethics law to treat them. They run up huge, unpayable debt, which is ultimately passed on to the rest of us.

                  It's the same reason why you are required to put on a seatbelt. Because the cost of your choice not to, if you get into an accident, is too much for me to bear, and it isn't right they I should have to pay for your negligence.

                  •  Yes, (0+ / 0-)

                    but wearing seatbelt is free. If somebody added (for example) another $250.00 a month to our expenses we would be so screwed.


                    by jennybravo on Mon Feb 04, 2008 at 12:40:53 AM PST

                    [ Parent ]

                  •  Obama's mandates are for children (1+ / 0-)
                    Recommended by:

                    There are two reasons they're more palatable:

                    First, since children can't legally make their own decisions, most people will acknowledge that it is more reasonably for the government to mandate coverage.  Adults, on the other hand, are presumptively able to make their own decisions for themselves, without Big Brother (or Big Sister) deciding what's best for them.

                    Second, children are CHEAP to insure, because the vast majority of them are quite healthy.  Under the federal employees plan, the cost of insuring an entire family is barely more than that of insuring two adults.  Because the insurance would be cheaper, the enforcement methods could be much less onerous (and could probably be paid for by simply not allowing a personal exemption for any child for whom the parent(s) didn't show proof of insurance with their income tax return.

                    In fact, I've long thought that we should simply cover everybody under 18 (or possibly 22 or 25) under Medicare.

                    "Those who would sacrifice liberty for security deserve neither liberty nor security." -Ben Franklin

                    by leevank on Mon Feb 04, 2008 at 12:48:58 AM PST

                    [ Parent ]

                    •  Well personal exemptions don't cover (0+ / 0-)

                      25 year olds. You'd have to have some method of enforcement.

                      And, I agree, freedom of adults to make their own choices is important. The problem is -- if an adult chooses not to buy health insurance and he/she has an accident -- we all end up paying for the cost of his/her care. That's not right either. When your rights interfere with mine we've got a problem.

                •  Finally a reasonable person to talk to ! (0+ / 0-)

                  I think the mandates issue is important on a "meta" level only in that if the plans are not adequate people will force political change.

                  If people work under the table, the auto enrollment and means testing would get them covered. I am most interested that people get covered.

                  I really like the idea of the path to move to single payer. Mandates also make sure everyone gets on it.

                •  John Edwards had a plan, complete (2+ / 0-)
                  Recommended by:
                  jennybravo, splashy

                  with numbers - if you were at 250% of the federal poverty level, you would qualify for the new Medicaid program.

                  These numbers are published by the Office of Management and Budget.

                  Why aren't Hillary and Barack making these same kinds of figures available for comparision?

                  Universal health care for citizens, think of it as an Endangered Species Act for Homo Sapiens.

                  by Angie in WA State on Mon Feb 04, 2008 at 12:31:15 AM PST

                  [ Parent ]

                •  no clear cut winner here (0+ / 0-)

                  So the answer is, nobody is telling. So we have all this arguing about whose is best and nobody can tell an average family or individual what it will cost them. In my opinion that makes this argument fairly meaningless. Until the public has the answers to those questions they are not going to support either plan.

                  Exactly. This is the one issue Clinton supporters think they can dig at Obama with, but neither plan is clearly fleshed out. There is no clear cut winner here, and the sad reality is, it seems more likely both will not lead to UHC for different reasons. Using either candidates plan as the primary reason someone should or should not vote for a candidate is absurd.

                  If we truly want UHC, and not a particular candidate in power, then we must pressure both candidates to do more and be more clear. We must certainly pressure the winner. UHC isn't going to just be given to us, like other difficult issues, it only comes from outside pressure.

            •  I found it (2+ / 0-)
              Recommended by:
              splashy, kyril

              • Limit Premium Payments to a Percentage of Income: The refundable tax credit will
              be designed to prevent premiums from exceeding a percentage of family income,
              while maintaining consumer price consciousness in choosing health plans.

              basically no answer. Plus you have pay it up front, then get a tax rebate.

              I will now go look for Obama's and get back to you.

              sorry this took a while. I'm doing laundry and ironing while I read and write here....


              by jennybravo on Sun Feb 03, 2008 at 11:18:39 PM PST

              [ Parent ]

            •  A Clinton website be vauge (2+ / 0-)
              Recommended by:
              cdreid, jennybravo

              No, really?

            •  How much are you and your employer paying now? (0+ / 0-)
        •  Short answer: (5+ / 0-)

          She corrects the key political failures from '93/'94. Last time, Bill did not prioritize UHC, so it did not come to Congress until his honeymoon was already over. Also, Bill and Hillary did not ask Congress to write the law, the task force presented a detailed plan, with no room for Congress to have ownership. Also, last time Hillary's task force alienated the AMA. This time, doctors appear to be on board. The time is right.

          Not such a sort answer, but for a really long answer, read the lengthy piece by Ezra Klein the the current American Prospect.

          As to you question about costs, I can only say that initial costs for the currently insured should be identical. Since our system is at least 50% more expensive than better foreign systems, our cost will drop quickly once the public is invested in making it work, as they are in successful programs like Medicare and Social Security.

          •  So are you saying (0+ / 0-)

            her policy itself is basically the same as in the 90's?


            by jennybravo on Sun Feb 03, 2008 at 11:19:37 PM PST

            [ Parent ]

            •  Yes and no (1+ / 0-)
              Recommended by:

              Like Obama's and the '94 plan, it reforms the private market so companies have to treat people equally and fairly, not kick people off for getting sick, for instance, like they have tried to do to some of my employees.

              Unlike Obama's and unlike '92, she has a robust public option, open to all. This is a huge improvement over Obama, and over her plan from '94.

              •  Isn't Obama's (0+ / 0-)

                public plan open to all?


                by jennybravo on Sun Feb 03, 2008 at 11:52:54 PM PST

                [ Parent ]

                •  No. (2+ / 0-)
                  Recommended by:
                  linnen, splashy

                  He has equivocated on it. His initial version was only open to people who are already otherwise uninsured, as a pilot program. If you have private insurance, it would not be open to you. He has since made gestures that he would be more flexible, but is not saying it would have open enrollment to anyone who wants it.

                  This is deeply troubling to me because the public program will have fierce push-back from insurers and their GOP allies. Expanding a government program that is an obvious threat to profit will be like running into a buzz saw. We won't have multiple shots at it.

                  •  Am I reading the following differently from you? (0+ / 0-)

                    it seems to say anybody can enroll in the public plan?

                    (2) NATIONAL HEALTH INSURANCE EXCHANGE. To provide Americans with additional
                    options, the Obama plan will make available a National Health Insurance Exchange to
                    help individuals who wish to purchase a private insurance plan. The Exchange will act as
                    a watchdog and help reform the private insurance market by creating rules and standards
                    for participating insurance plans to ensure fairness and to make individual coverage more
                    affordable and accessible. Through the Exchange, any American will have the
                    opportunity to enroll in the new public plan or purchase an approved private plan, and
                    income-based sliding scale subsidies will be provided for people and families who need
                    it. Insurers would have to issue every applicant a policy, and charge fair and stable
                    premiums that will not depend upon health status. The Exchange will require that all the
                    plans offered are at least as generous as the new public plan and meet the same standards
                    for quality and efficiency. Insurers would be required to justify an above-average
                    premium increase to the Exchange. The Exchange would evaluate plans and make the
                    differences among the

                    plans, including cost of services, transparent.


                    by jennybravo on Mon Feb 04, 2008 at 12:38:16 AM PST

                    [ Parent ]

                    •  I have not read that version. (1+ / 0-)
                      Recommended by:

                      It does seem from this that he is now guaranteeing open access. I'll definitely follow up on it. Do you have a link?

                      •  yes I have a link (0+ / 0-)

                        sorry I forgot to provide it before. (it's a pdf)
                        It is more complex than Hillary's. But obviously, neither one of the plans that we can see begin to touch how complex they will be in real life....


                        Here is the link to where it is on his site:

                        On a different area of  health care debate which I never see covered is the following. It is from 2005, but the point that there is a huge undergound economy will make mandates difficult to enforce. Has anyone addressed this?

                        The report set for release today by the UCLA Anderson Forecast also highlights the growing importance of the informal economy -- consisting of nearly 2 million Californians who are working, but not at payroll jobs, in many cases getting paid off the books without having taxes withheld.

                        On the growth of the informal economy, UCLA Anderson economist Christopher Thornberg noted that roughly 1.9 million Californians, or 12.4 percent of the overall workforce, seem to be working at something other than a standard job. Some are contract workers and on the books, but others are under the table.

                        "This should be an ongoing concern for policymakers, as little is known about what these folks do, the type of benefits they may or may not have, and of course whether or not they pay taxes,'' Thornberg wrote.

                        Sandi Mason, an employment specialist with the Bureau of Labor Statistics in Washington, said federal job counters don't know much about this phenomenon other than that it exists and is an appreciable part of the workforce in many states.

                        Idaho, for instance, has a slightly larger percentage of informal workers than California, she said. Washington, Montana, New Hampshire, Oklahoma and Texas are also right above or below the 10 percent mark.



                        by jennybravo on Mon Feb 04, 2008 at 01:25:39 AM PST

                        [ Parent ]

          •  She could not correct the political failures (0+ / 0-)

            of 93/94 IMHO, because the failure of that plan was that it was created behind closed doors, without getting the proper buy-in from the public, so any so-called political "corrections" that she comes up with now absent a public process are equally flawed and useless.

            "Race Doesn't Matter"

            by pragprogress on Sun Feb 03, 2008 at 11:21:46 PM PST

            [ Parent ]

    •  she's playing the game.... (7+ / 0-)

      I think she's practicing what Obama has been saying about "giving health insurers a seat at the table", but not letting them dictate the agenda....
      She has the better health care plan (although Edwards and Kucinich had better ones).
      I wouldn't place too much stock in the donations she got. She got them from employees of these insurance companies, not the CEOs or anyone near their pay-scale.... these people are hardcore Republicans and hate her and Obama equally...

      Listen to Noam Chomsky...

      by MrBurns17 on Sun Feb 03, 2008 at 10:22:53 PM PST

      [ Parent ]

    •  don't worry (1+ / 0-)
      Recommended by:

      we're going to get rid of ins cos.  they don't knwo it yet but they're already obsolete.

      HR 676 or California's SB-840 - the only health reform proposals worth my vote.

      by kck on Sun Feb 03, 2008 at 10:49:44 PM PST

      [ Parent ]


      .... in the healthcare debates on Dkos thus far. Setting aside the weak connection between the bogeymen in you misinformed rant, here are some facts.

      A) There's a public option
      B) There are subsidies commensurate with family income
      C) Pooled risk does lower cost

      Also, I'm an Obama supporter. Just think he's wrong here.

      Charlie Young: "Sir, I need you to dig in now. It wasn't a nightmare. You really are the President."

      by crazymoloch on Sun Feb 03, 2008 at 10:53:18 PM PST

      [ Parent ]

      •  once again crazymoloch, your ability to see.... (2+ / 0-)
        Recommended by:
        Pacific John, Clem Yeobright

        ...clearly through bullshit is impressive.

      •  B is total crap (2+ / 0-)
        Recommended by:
        limulus, kyril

        The subsidies are capped at the current Medicaid eligibility limits, which are a total joke. Anybody making 5 cents over the minimum wage wouldn't get a subsidy. It's a canard meant to insulate from criticism over the disastrous implications of a wage garnishments.

        Obama's plan does all 3 things--which would lower costs and expand access--without the idiocy of a wage garnishment. Obama's plan doesn't force people into high deductible plans, as Hillary's plan would. Simply put, wage garnishments can't be much more than $100 a month. And the only thing $100 a month can provide is a high deductible plan.  

        And A is also somewhat misleading because even the Federal Employee Health Benefit Plan is administered by varying insurers with varying plans, etc. Her plan is a canard meant to fool people. She is the agent of big insurance. That's why we must not nominate her.

        Obama's plan sucks too, but it's better than Hillary's. Wage garnishments=corporate welfare for the big insurance industry.  

        •  dang, where'd you find this? (0+ / 0-)

          (Hillary's I assume)

          The subsidies are capped at the current Medicaid eligibility limits, which are a total joke. Anybody making 5 cents over the minimum wage wouldn't get a subsidy. It's a canard meant to insulate from criticism over the disastrous implications of a wage garnishments.

          That's kind of the question I asked above of both plans above. I couldn't find dollar figures for either.


          by jennybravo on Sun Feb 03, 2008 at 11:58:23 PM PST

          [ Parent ]

    •  Krugman is figting for mandates not really UHC (8+ / 0-)

      If people choose to defy mandates, as some surely will, there is no "universal" coverage. If Krugman really wants a true UHC system, why isn't he going all the way and making a case using his column for a single payer system and demanding that both Obama and Hillary go for single payer universal healthcare (SP-UHC) (which would positively guarantee 100% universal coverage)?

      Obama's plan will attempt to cover everyone that actually wants coverage. Hence his plan is a universal healthcare access plan.

      Obama can always make a switch to SP-UHC (which he likes, in principle) at a later point if an implementable and politically viable plan can be designed. With Obama as the nominee, we'd have a better shot at increasing our majorities in congress (because of his appeal to independents and young voters, and demonstrated capacity to bring new voters to polling booths) which, if it materializes, would help chart a bold progressive platform like FDR did, as DHInMI argues.

      I'd prefer not to repeat the other arguments I made in this thread on this topic.

      On a related note, Hillary should stop trying to duck and dodge the question of exactly how she intends to enforce mandates. Until she specifies that in crystal clear terms, the discussion trying to compare the two plans on the basis of mandates is not well founded.

      •  Clinton's dodging and ducking on mandate (0+ / 0-)

        enforcement mechanism she'd use:

        February 03, 2008
        On This Week, Clinton Again Refuses to Answer How She Will Enforce 'Mandate'


        FEBRUARY 3, 2008: Clinton Says People Who Don't Sign Up For Health Insurance "Won't Have to Pay Fines"; Then Says One Option For Enforcement is "Going After People's Wages." When asked about her enforcement mechanism, Clinton said, "Well, they don't have to pay fines, George. We want them to have insurance. We want it to be affordable." When pushed again on whether or not she would garnish wages, Clinton said, "George, we will have an enforcement mechanism, whether it's that or it's or it's some other mechanism through the tax system or automatic enrollments...And the reason why I think there are a number of mechanisms, going after people's wages, automatic enrollment, when you are at the place of employment, you will be automatically enrolled, whatever the mechanism is." (ABC, 2/3/08)

        BTW, Obama's plan would require employers to either provide coverage or pay into his public plan (w/ help provided to qualifying small business owners).

        Related Obama fact check items:

        15 Million and Mandates
        January 31, 2008

        February 01, 2008
        80 Health Care and Legal Experts: Universal Coverage and the Presidential Candidates’ Health Care Proposals

        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.


        M. Gregg Bloche, MD, JD
        Adjunct Professor
        Bloomberg School of Public Health
        Johns Hopkins University

        Nicholas A. Christakis, MD, PhD, MPH
        Department of Health Care Policy
        Harvard Medical School

      •  Did you read Krugman's op=ed? (3+ / 0-)
        Recommended by:
        linnen, catullus, ranee

        The problem with Obama isn't that his plan doesn't include mandates, its that he's running against the idea of mandates, so he can't add them at a later date when he educates himself on the subject realizes mandates are necessary.

        If Obama is elected we will, at best, get a plan that covers more but leaves millions of Americans uncovered.  

        The fact that you would frame the question as providing care to all those who want it shows how far off track Obama has taken the Democratic party on this question.  Every American should have health care, even those who think they don't need it.  I won't bother elaborating on this obvious point.

        The simple truth is that Obama's plan is ridiculous as health care reform.  And his rhetoric is damaging to the movement to create truly universal health care.  He likes this approach because it helps him among independent voters and Republicans, which allows you to claim that he will be better able to achieve health care reform by brining in these people.  I think the cost of trading good policy for Obama's politics is too much though.  Its not worth selling out 20 million Americans (as Krugman claims) .

        Inhofe is a wacko with a 46% approval rating: He's vulnerable.

        by tmendoza on Sun Feb 03, 2008 at 11:57:55 PM PST

        [ Parent ]

        •  I have read (0+ / 0-)

          the excerpts given by the diarist of Krugman's new piece and have had read Krugman's scores of other attack-Obama pieces on HC and other subjects.

          "Every American should have health care, even those who think they don't need it."

          There are many that don't agree with forcing a particular system on themselves or on others.

          Analytically, I don't accept these figures Krugman gives (quoting Prof. Gruber) in  either mandate or non-madate cases, because they depend on specific mandate implementation in the former case (Hillary is still dodging the question of what mandate enforcement method she'd use. And so, claiming that they'd apply to her system is completely baseless) and the outreach efforts in Obama's non-mandate case to get as many as possible to sign up.

          One can argue that a badly designed/sold mandates-based system would leave more people w/o coverage than an outreach based non-mandating approach.

          One can certainly argue that mandates would be a bitter pill  which only gives ammunition to the Republicans and could potentially help them defeat the entire HC reform effort via demagoguery and fear-mongering.

          Even a large number of Democrats in a recent poll I had seen opposed the idea of HC mandates.

          If we're going to fight a major war over HC, why fight it over mandates from a system that is still not what we want? Why not employ that fight for a fully universal system such as the single payer system once a functioning universal access system is quickly put in place to help everyone that actually want healthcare but currently can't afford it? Legislatively, Obama's plan would be far easier to pass.

          •  Universal Access? (0+ / 0-)

            That is one horrendous euphemism.  I'm glad Obama hasn't actually seized that one, and is still sticking dishonestly with the favored "universal health care."  

            "There are many that don't agree with forcing a particular system on themselves or on others."  Is that you Rush?  Most liberals believe that everyone should have health care in this country for their own sake and for everyone else's, which is why many of us favor single payer, which by the way is a much more coercive and much more intrusive in the private sphere than a plan like Hillary's.

            Obama's plan might be easier to pass, but aren't you then conceding that it would achieve less?  The reason it achieves less is that it doesn't challenge the status quo.  We wouldn't establish a norm that the government would guarantee health care for all.

            I personally would rather have a president who supports the principle of universal health care.

            Inhofe is a wacko with a 46% approval rating: He's vulnerable.

            by tmendoza on Mon Feb 04, 2008 at 12:36:57 AM PST

            [ Parent ]

            •  asdf (0+ / 0-)

              "Is that you Rush?"

              Don't abuse the respect I have been giving you in this discussion. I am capable of reciprocating in kind.

              "Most liberals believe that everyone should have health care in this country for their own sake and for everyone else's"

              Then you should excoriate Hillary's plan too, as there will be people defying mandates. There are also deductibles and co-payments etc, which people may not be able to afford in some cases, which again makes claims of absolute "universality" invalid.

              Only a system like single payer would ensure that your belief of universality is served justice to.

              "which is why many of us favor single payer, which by the way is a much more coercive and much more intrusive in the private sphere than a plan like Hillary's."

              Single payer doesn't limit care choices, as the govt doesn't run hospitals. It just administers insurance. See my response below.

              "Obama's plan might be easier to pass, but aren't you then conceding that it would achieve less?"

              No, I am not. It'll attempt to cover everyone that wants to get covered.

              "I personally would rather have a president who supports the principle of universal health care."

              Obama fully supports the principle. And, as I said, 100% coverage won't be achieved in Hillary's plan either.

              What you're doing is fighting for mandates and not really universal HC.

        •  So we are selling people out (0+ / 0-)

          by allowing them to act on their own opinions as to whether they need health insurance?  This argument, like mandates themselves, will never, ever work in the general election--even if you are right, mandates will be seen as condescending and paternalistic by most Americans.  They will at least torpedo the good parts of Clinton's place (i.e., the rest of it), and are a liability to the White House itself.  The Clinton people here can barely sell DailyKos on mandates, and yet you seriously expect to sell them to the country?

          Even if they do get enacted, they are nothing more but life-support for a predatory, parasitic industry that frankly needs to die.  I see no reason to take an incremental process towards a single-payer system, putting up hackneyed, cobbled together systems and replacing them almost as soon as they're done, like the last Ptolemaic astronomers before Copernicus...  when the foundation of the building is failing, it's a waste of time to fix the windows and painting the walls.  Tear it all down and build again on firm ground.

          "While there is a lower class, I am in it; while there is a criminal element, I am of it; while there is a soul in prison, I am not free!" -Eugene V. Debs

          by leftneck on Mon Feb 04, 2008 at 01:08:16 AM PST

          [ Parent ]

      •  Can you explain that single-payer claim, please? (0+ / 0-)

        I've seen a few Obama supporters make that claim:  Obama is against mandates, but he's for single payer.  I personally can't square the two.  He's against mandates because its too much government intrusion, but he's for single payer which requires much more government intrusion.

        Inhofe is a wacko with a 46% approval rating: He's vulnerable.

        by tmendoza on Mon Feb 04, 2008 at 12:16:50 AM PST

        [ Parent ]

        •  I think (0+ / 0-)

          Obama's approach here is to quickly put in place a system that would stop the bleeding, and he is approaching it from a strategic angle of getting there ASAP.

          But, he has always said that if he could start from scratch, he'd go for a single payer system.

          A single payer system doesn't necessarily make the care itself government run, but instead, one where the entire underwriting (i.e. insurance) is done via the government. Employers would pay into it, and the government would pitch in some amount to cover everyone. See Al Gore talk about it here.

          What is possible is that once we have a working universal access system (as Obama's plan is meant to be), then one can attempt to switch to a single payer system as a distinct next step to switch towards after laying the groundwork (design/political issues) for it.


          Also, even independent of single payer system considerations, once a working system (with a public plan which Obama's HC system does have, in addition to other ideas such as a national healthcare exchange) is in place, it would be easier to show it to people and push them towards getting covered. Obama has said this.

    •  I find this comment highly inappropriate. (1+ / 0-)
      Recommended by:

      Clinton is smart enough to work within the realm of the possible, which is much more expansive than in 1992.

      Please let's stay within the bounds of reasoned argumentation, and avoid the tone of a hit.  Maybe it's not what you intended; maybe it is.  If so, do us and the country a favor, and please back off a little.

      Just sayin'.

      The hungry judges soon the sentence sign, And wretches hang, that jurymen may dine.

      by magnetics on Sun Feb 03, 2008 at 11:19:46 PM PST

      [ Parent ]

      •  Tell that to Hillary (0+ / 0-)

        Who decided to cozy up to big insurance:

        A friend of big insurance is not my friend.

      •  HA HA HA (0+ / 0-)

        stay within the bounds of reasoned argumentation

        Where do you think you're at?

        Obama is the new relief valve for an entire disenfranchised minority. He's believed to be the one who'll make it all better. The media has told them he has a chance, and they don't want to hear one single word of criticism about him from you, no matter how valid. If you see toilet paper hanging from the back of his pants DON'T mention it! Just turn your head and walk on.

        It's just people being people.

        Dkos = democracy. The only problem is that both give voice to idiot and genius alike. Read an anti-Hillary diary lately?

        by JamesBrown4ever on Mon Feb 04, 2008 at 12:51:59 AM PST

        [ Parent ]

    •  Fact-Check (8+ / 0-)

      Fact Check: ''Krugman Didn't Always Think So Poorly Of Obama's Plan''
      December 07, 2007

      "Krugman Didn't Always Think So Poorly Of Obama's Plan." First Read reported, "No Democratic-leaning pundit, it seems, has been more passionate or serious on the need for health-care reform than the New York Times' Paul Krugman. As a result, people took notice when his column today blasted Obama's health-care plan, as well as the candidate's recent statements on it...But, channeling the Washington Post's Ruth Marcus, Krugman didn't always think so poorly of Obama's plan. Almost six months ago, in a June 4 column, he mostly praised it -- although he did criticize its lack of a mandate. The substance of Krugman's two columns is essentially the same. The tone, however, is not." [First Read, 11/30/07]

      THE PLAN

      KRUGMAN THEN: Obama's Health Care Plan "Is Smart And Serious, Put Together By People Who Know What They're Doing." Paul Krugman wrote, "The Obama plan is smart and serious, put together by people who know what they're doing...So there's a lot to commend the Obama plan." [New York Times, 6/4/07]

      KRUGMAN NOW: "The Fundamental Weakness Of The Obama Plan Was Apparent From The Beginning." Paul Krugman wrote, "The fundamental weakness of the Obama plan was apparent from the beginning." [New York Times, 11/30/07]

      KRUGMAN THEN: Obama's Plan Passes A "Basic Test of Courage" And Gets "Points For Toughness." Paul Krugman wrote, "It also passes one basic test of courage. You can't be serious about health care without proposing an injection of federal funds to help lower-income families pay for insurance, and that means advocating some kind of tax increase. Well, Mr. Obama is now on record calling for a partial rollback of the Bush tax cuts. Also, in the Obama plan, insurance companies won't be allowed to deny people coverage or charge them higher premiums based on their medical history. Again, points for toughness. Best of all, the Obama plan contains the same feature that makes the Edwards plan superior to, say, the Schwarzenegger proposal in California: it lets people choose between private plans and buying into a Medicare-type plan offered by the government." [New York Times, 6/4/07]

      KRUGMAN NOW: "Obama's Caution...Led Him To Propose A Relatively Weak, Incomplete Health Care Plan." Paul Krugman wrote, "What seems to have happened is that Mr. Obama's caution, his reluctance to stake out a clearly partisan position, led him to propose a relatively weak, incomplete health care plan." [New York Times, 11/30/07]


      KRUGMAN THEN: Krugman Talked To An Architect Of Obama's Plan Who Said "Obama Is Reluctant To Impose A Mandate That Might Not Be Enforceable." Paul Krugman wrote, "I asked David Cutler, a Harvard economist who helped put together the Obama plan, about this omission. His answer was that Mr. Obama is reluctant to impose a mandate that might not be enforceable, and that he hopes -- based, to be fair, on some estimates by Mr. Cutler and others -- that a combination of subsidies and outreach can get all but a tiny fraction of the population insured without a mandate." [New York Times, 6/4/07]

      KRUGMAN NOW: "Most Troubling, Mr. Obama Accuses His Rivals Of Not Explaining How They Would Enforce Mandates" And Said He Was Implying That The Plans Would Require "Nasty, Punitive Enforcement." Paul Krugman wrote, "Third, and most troubling, Mr. Obama accuses his rivals of not explaining how they would enforce mandates, and suggests that the mandate would require some kind of nasty, punitive enforcement." [New York Times, 11/30/07]

      KRUGMAN NOW: "Obama Is Storing Up Trouble For Health Reformers" By Criticizing Mandates. Paul Krugman wrote, "Finally, Mr. Obama is storing up trouble for health reformers by suggesting that there is something nasty about plans that 'force every American to buy health care.'" [New York Times, 12/7/07]

      Mandates Don't Lower Costs
      January 21, 2008

      Massachusetts Officials Concede Mandates Don't Lead To Universal Coverage. "Jon M. Kingsdale, executive director of the Commonwealth Health Insurance Connector Authority, the agency that markets the subsidized insurance policies...acknowledged that their universal coverage plan is not likely to be universal anytime soon. 'There's good evidence,' Mr. Kingsdale said, 'whether it's buying auto insurance or wearing seat belts or motorcycle helmets, that mandates don't work 100 percent.'" [New York Times. 11/20/74]

      One In Five Uninsured In Massachusetts Will Be Exempt From The Mandate, Individual Mandate Would Only Apply To "Those Who Can Afford The Premiums." The Boston Globe reported, "Interestingly, the Commonwealth Health Insurance Connector Authority, the bureaucrats in charge of implementing the plan, decided that the universal individual mandate does not apply to everyone, but rather only those who can afford the premiums. Therefore, nearly one in five of the currently uninsured will be exempt from the law." [Boston Globe, 5/15/07]


      Washington Post: "It Could Be A Struggle For Clinton To Find Someone Who Wants Health Insurance But Doesn't Qualify Under The Obama Plan, Because It's Not Clear Such A Person Exists." The Washington Post reported, "For people who want to get health insurance and make an effort to do so, Clinton and Obama have almost exactly the same plan ...It could be a struggle for Clinton to find someone who wants health insurance but doesn't qualify under the Obama plan, because it's not clear such a person exists." [Washington Post, 11/28/07]


      Antos: Obama's "Health Care Plan Could Actually Have A Better Compliance Rate" Than Hillary's. The New York Times reported, "Mr. Obama's health plan could actually have a better compliance rate. The 15 million who would supposedly be left out equal about 5 percent of the population — a smaller portion than are going without auto insurance, said Joseph Antos, a health policy expert at the American Enterprise Institute, a nonpartisan group." [New York Times, 12/5/07]

      Reich: Obama's Health Care Plan Would Cover "More People" Than Hillary's. "I've compared the two plans in detail. Both of them are big advances over what we have now. But in my view Obama's would insure more people, not fewer, than HRC's. That's because Obama's puts more money up front and contains sufficient subsidies to insure everyone who's likely to need help – including all children and young adults up to 25 years old...In short: They're both advances, but O's is the better of the two. HRC has no grounds for alleging that O's would leave out 15 million people." [Robert Reich, 12/3/07]

      Clinton Campaign Health Care Adviser: Clinton's Health Care Plan Will Not Include Everybody. "MIT economics professor Jonathan Gruber, one of Clinton's health care advisers...acknowledges that the Clinton plan will not include everybody. 'Any system that does not have a single payer will not have 100 per cent coverage,' he told me, when I reached him after the Las Vegas debate. 'But you can come very close.'" [Washington Post Fact Checker, 11/19/07]

      Clinton's Plan Could Leave Out As Many As 4.5 Million People. The Washington Post wrote, "The system proposed by Clinton is more analagous to the government-subsidized private insurance system in the Netherlands, where roughly one and a half per cent of the population is estimated to fall through the cracks." One and a half percent of the US population is 4.5 million people. [Washington Post Fact Checker, 11/19/07; US Census, accessed 12/1/07]

      Harvard Program On Public Opinion And Health And Social Policy's Robert Blendon: Clinton's Health Care Plan Isn't Going To Cover Everybody. "Robert Blendon, director of the Harvard Program on Public Opinion and Health and Social Policy [said that] 'At the end of the's not going to be everybody.'" [, 11/16/07]

      Urban Institute's John Holohan: Clinton's Plan Won't Eliminate The Problem Of Uninsured Altogether. John Holohan, the author of a study conducted at the Urban Institute, a Washington-based think tank, does not believe that either the Clinton or the Obama plan will eliminate the problem of the uninsured altogether. "We would all be very happy if we got down to one and a half per cent," he said. [Washington Post Fact Checker, 11/19/07]

      15 Million and Mandates
      January 31, 2008


      Massachusetts Officials Concede Mandates Don't Lead To Universal Coverage. "Jon M. Kingsdale, executive director of the Commonwealth Health Insurance Connector Authority, the agency that markets the subsidized insurance policies...acknowledged that their universal coverage plan is not likely to be universal anytime soon. 'There's good evidence,' Mr. Kingsdale said, 'whether it's buying auto insurance or wearing seat belts or motorcycle helmets, that mandates don't work 100 percent.'" [New York Times. 11/25/07]

      One In Five Uninsured In Massachusetts Will Be Exempt From The Mandate, Individual Mandate Would Only Apply To "Those Who Can Afford The Premiums." The Boston Globe reported, "Interestingly, the Commonwealth Health Insurance Connector Authority, the bureaucrats in charge of implementing the plan, decided that the universal individual mandate does not apply to everyone, but rather only those who can afford the premiums. Therefore, nearly one in five of the currently uninsured will be exempt from the law." [Boston Globe, 5/15/07]


      "Clinton Uses A Dubious Statistic When She Claims Obama's Plan Would Leave Out 15 Million Of The Uninsured." reported, "Clinton uses a dubious statistic when she claims Obama's plan would leave out 15 million of the uninsured...Clinton based her claim on a column by The New Republic's Jonathan Cohn, who loosely estimated Obama's plan would leave 15 million uninsured...Cohn makes it clear here that he is offering an estimate based on the best information available, not a hard and fast calculation. And the best available information doesn't always agree." [, 11/16/07]

      Clinton's Claim "Based On Too Many Hypotheticals To Rate More Than A Half True." "It's a tough call, but because of the disagreements here, we find her claim to be based on too many hypotheticals to rate more than a Half True." [Politifact, 11/15/07]

      Clinton Cited "Hardly An Authoritative Source" For The 15 Million Claim. "So where did Clinton get her figure of 15 million uninsured under the Obama plan? Her website cites an article in the New Republic, hardly an authoritative source." [Washington Post, 11/15/07]

    •  Doctors already have to deal with bureaucrats (2+ / 0-)
      Recommended by:
      linnen, splashy

      Would you prefer dealing with a government bureaucrat whose job is to give people as much health care as he can, or a private company bureaucrat who was hired to cut costs, and will receive extra pay if they achieve their cost-cutting targets.

      To hell with independents... I'll stick with the party that brought us social security, civil rights, and environmental protection.

      by dianem on Sun Feb 03, 2008 at 11:47:22 PM PST

      [ Parent ]

    •  I need to correct my line (0+ / 0-)

      This is the right link:

      copying error.

    •  Funny. (0+ / 0-)

      In the past year I had emergency surgury for a broken elbow and medically necessary eye surgury.  I can tell you that the insurance companies are already interfering with doctors' ability to do their jobs.  It's a nightmare.  

      I'd like to see a single payer plan, but it's essential that all Americans get health care somehow.  I'm not thrilled with Hillary's plan, but I think she'll actually try to get something passed.  

      I think Obama wants to cut social programs and privatize as much as possible.  Why do I think that?  I read his book.

      If a free society cannot help the many who are poor, it cannot save the few who are rich. -- John F. Kennedy

      by Boston Boomer on Mon Feb 04, 2008 at 05:30:30 AM PST

      [ Parent ]

  •  Comments and Tips are welcome (31+ / 0-)

    I've waited all my life for a chance for ALL Americans to have health care.  Let's elect Hillary Clinton so it can happen.

    •  Some comments (9+ / 0-)

      Mr. Gruber finds that a plan without mandates, broadly resembling the Obama plan, would cover 23 million of those currently uninsured, at a taxpayer cost of $102 billion per year. An otherwise identical plan with mandates would cover 45 million of the uninsured — essentially everyone — at a taxpayer cost of $124 billion.

      Mr. Gruber's plan, which "broadly resembles" the Obama plan, apparently results in 47-23=24 million uninsured. Hillary's critique of Obama's plan claims a high of 15 million who chose not to purchase coverage. This does not inspire confidence in the relevance of his analysis.

      A "taxpayer cost" means how much the government has to pay in. Mandates are "cheaper" because you force people in low-risk pools to overpay for insurance they don't want to cover people in high-risk pools. When this low-risk pool is low/middle income single workers, you are essentially implementing a regressive tax.

      The alternative is to fund via general (progressive) taxation. This is "more expensive" but also more politically feasible and IMO more fair.

    •  Could you please tell us how HRC plans to enforce (7+ / 0-)


      What is her mandate enforcement mechanism laid out in detail? Please provide links to where she spells this out. W/o that, the discussion is moot (ill-defined actually) since whether mandates would first pass and then work effectively or not depends exclusively on what the enforcement mechanisms would be.

    •  Great Post, Susan (1+ / 0-)
      Recommended by:

      I think what most people forget about "universal health care" is that the overall costs are the most affordable when the insurance pool is the broadest.  We all get by with less when everyone is in the pool and with good subsidies, those who can't afford the cheaper insurance would get help from the rest of us to make sure we are ALL in the pool.  This was the main reason most of us think that a Single Payer system would work best because no excess payments would go for external profits - it would all be used to fund our care and the vastly cheaper system that would need to be setup to cover the bills.  If it is unrealistic to go for this goal now, then we at least have to make Universal Health Care the goal which means EVERYONE must be in the pool.  

      Otherwise, it's like people opting out of paying for roads because they don't use them, but then trying to figure out how to penalize them when they take a job that requires them to use them to get to work.   Healthcare truly is an area where the only smart thing a society can do is to solve the problem for everyone - anything less is an invitation to failure as we have seen for the past 30-40 years.

      "The less satisfaction we derive from being ourselves, the greater is our desire to be like others." - Eric Hoffer

      by Mary on Sun Feb 03, 2008 at 11:13:51 PM PST

      [ Parent ]

      •  Kaiser Family Foundation report (1+ / 0-)
        Recommended by:

        on the uninsured:

        Prepared for the Kaiser Commission on Medicaid and the Uninsured
        May 10, 2004

        Per capita medical spending for persons uninsured for the full year in 2004 is $1,629 compared to $2,975 by persons who are insured for the full year. This spending gap holds for both adults ($1,864 compared to $3,653) and children ($802 compared to $1,640).

        Total costs go down when people are out of the pool.

        INDIVIDUAL costs of the ALREADY insured people will normally drop when healthy people are coerced to pay for insurance they won't likely use however.

        If everyone is coerced to join a pool, you might see cost of your insurance drop 3% if there are no other changes.

        In reality, the premiums may only go up by 6% instead of 9% the following year due to health care cost inflation.

        If you want cheaper insurance, patent/FDA reform, hospital acquisition control, and Medicare-based billing are what you really need.

  •  GREAT POST! see also Erica Jong's Wash Post Op-Ed (4+ / 0-)

    Hillary: "Wait a minute... wait a minute... Let's have a reality break!"

    by Palladio on Sun Feb 03, 2008 at 10:19:44 PM PST

  •  I can't take you or Larry seriously anymore. (8+ / 0-)

    hit, hit, hit, yawn...

    I'll take our truths over their lies.

    by td on Sun Feb 03, 2008 at 10:20:11 PM PST

  •  Facts (21+ / 0-)

    Krugman has insisted on a real universal health care plan, which is only offered by Clinton and Edwards.  But in his daring to criticize Obama's plan and tactics, he has been villified by many here.  It's a shame.  He's been a truth-teller far longer than many who attack him for daring to look at facts, rather than emotion.

    Of course, this diary will attract all manner of harrassment below for going against the prevailing trends on this site.

    •  they'd rather win the nomination... (13+ / 0-)

      ...than cover the uninsured.

      Hillary 2008 - Flying Monkey Squadron 283

      by campskunk on Sun Feb 03, 2008 at 10:23:30 PM PST

      [ Parent ]

      •  Nope (4+ / 0-)

        We simply know that Clinton will come up empty again.

        Mandates will doom her plan.  The GOP is licking their chops to run against them.

        Oh no! A "Republican Talking Point!!!" Hide the children!

        by snout on Sun Feb 03, 2008 at 10:28:43 PM PST

        [ Parent ]

        •  Brain Melt (2+ / 0-)
          Recommended by:
          linnen, DemAC

          Wow, all that hope and all this negativity.  A lot of cognitive dissonance, I suspect.

          •  That's the stock answer, isn't it? (1+ / 0-)
            Recommended by:

            When it comes to healthcare, the negativity started when folks like yourself started trying to advance the lie that mandates and universiality were one and the same.  Clinton used it repeatedly as a wedge to try and take Obama down.

            Given this, why should he be mute about the obvious tactical weakneses in the design of her plan?

            Oh no! A "Republican Talking Point!!!" Hide the children!

            by snout on Sun Feb 03, 2008 at 11:03:24 PM PST

            [ Parent ]

        •  But somehow Barack Obama and this (2+ / 0-)
          Recommended by:
          Terre, JoeySky18

          "hope thing", this the the 'real deal'.

          Please, please  .. please

          Give me a break.

          Obama talks of "God and Guns" in Idaho, and you think the GOP is licking their chops to run against Hillary?

          They will take Barack's 'hope' message, the incredible things he's saying on the campaign trail, trying to be everything to everyone and tear him totally to shreds in a few HOURS.

          Omg, I dying here.
          From laughter.

          "If you want to go quickly, go alone.
          If you want to go far, go together.
          We have to go far, quickly."

          by shpilk on Sun Feb 03, 2008 at 10:48:24 PM PST

          [ Parent ]

        •  what about Obama's mandates and penalties? n/t (0+ / 0-)
          •  For children? (0+ / 0-)

            Much easier sell politically.

            Oh no! A "Republican Talking Point!!!" Hide the children!

            by snout on Sun Feb 03, 2008 at 11:05:19 PM PST

            [ Parent ]

            •  gee i don't know as the parents will be (0+ / 0-)

              FORCED to pay OMG!!!!!!!!!! and then when those that aren't covered (us that aren't mandated) need medical care, we have to pay back premiums. can you say PENALTIES????????  ;)

              no, mandates for children sound good now, but when it comes down to the wire, you are still FORCING and out will come H & L. i was just cruising around on other sites and you should see the comments people are making (abc/etc) OY! once the boogyman has been put out there it takes on a life all it's own. some people think they have to pay 2 premiums, others think their bank accounts will be raided, you get the picture, right? and that's just from today. the longer the false info is fed out there, the harder any health plan will be. and it's worse that another Dem is feeding it out there. must be true . . .

              •  Most are funded mandates (1+ / 0-)
                Recommended by:

                But hey,if you prefer we could forget healthcare entirely.

                Or we could have an honest debate.  You know - one where unfunded mandates and universiality are not conflated with each other...

                Oh no! A "Republican Talking Point!!!" Hide the children!

                by snout on Sun Feb 03, 2008 at 11:15:58 PM PST

                [ Parent ]

                •  sorry :) (0+ / 0-)

                  i'm not saying what i believe, just the type of reactions i'm seeing out there. some actually caught me by surprise and i remember Harry and Louise!

                  i just feel feeding into the old boogyman and breathing life into it again, especially from the Dem side, is going to make something as needed as mandated childrens health insurance harder to get accepted by the public. it's a card we should have let the thugs play and "united" against them to set the public straight :)

            •  Also, much easier to enforce (3+ / 0-)
              Recommended by:
              highacidity, snout, kyril

              Children are CHEAP to insure, because the vast majority of them are quite healthy.  Under the federal employees plan, it barely costs more to insure an entire family than to individual adults.  I strongly suspect that for most families that aren't eligible for Medicaid, the premiums could be covered merely by denying the personal exemption for any children for whom the parent didn't provide proof of insurance with their tax return.

              "Those who would sacrifice liberty for security deserve neither liberty nor security." -Ben Franklin

              by leevank on Sun Feb 03, 2008 at 11:16:31 PM PST

              [ Parent ]

              •  i thought kids were always going to the doctor?! (1+ / 0-)
                Recommended by:

                i'm down with the fed emp plan if either offers it to us as "employees"

                it would be about 1/3 what i can get through the freelancers union or what was offered at my last employer. if i bought private insurance, it would be close to $500 a month for just me.

                on the child though, don't you need to add them to a plan, or can you get just a plan for the child?

                but basiclly my response above was more about overreaction by the public, not me :) i saw lots of crazy misunderstandings all over the place. OY! people think if you're poor your going to have to pay or face stiff fines etc. and it goes downhill from there. even though kids are cheap, it's still a "forced" added expense. lord only knows how they'll react after all the crap floating around out there and the scare tactics

                •  What's driving up health care costs isn't ... (0+ / 0-)

                  trips to the doctor for sore throats or ear infections or stepping on a nail.  It's treatment for cancer, and heart disease, and similar things that, although they can occur in children, are VASTLY more common in adults.

                  This is the fallacy of the Republican approach of "health savings accounts" which would give people the incentive to "comparison shop."  You can comparison shop for the cheapest routine doctor's office visit, but you really CAN'T comparison shop on the things that are driving health care costs, because none of us non-physicians (and not even physicians who aren't in the right specialty) have the knowledge required to do so.

                  "Those who would sacrifice liberty for security deserve neither liberty nor security." -Ben Franklin

                  by leevank on Mon Feb 04, 2008 at 12:54:39 AM PST

                  [ Parent ]

        •  So you buy into the right-wing frame also? (1+ / 0-)
          Recommended by:

          Government requiring everyone to have health care: bad.  Screwing millions of Americans so we can run on hope and change:  good.  Got it.

          Inhofe is a wacko with a 46% approval rating: He's vulnerable.

          by tmendoza on Mon Feb 04, 2008 at 12:21:05 AM PST

          [ Parent ]

      •  good one, camp....nt (1+ / 0-)
        Recommended by:
        Pacific John

        I proudly support Hillary Clinton for President...

        by Rumarhazzit on Sun Feb 03, 2008 at 10:31:23 PM PST

        [ Parent ]

      •  Look the feelings are running high right now (3+ / 0-)
        Recommended by:
        RNinNC, highacidity, kyril

        I'm an Obama supporter who is interested in this issue.  I'm looking for facts.  There are many rational Obama supporters out here!!!

      •  There isn't a single uninsured person who ... (2+ / 0-)
        Recommended by:
        highacidity, kyril

        would be unable to get insurance under Obama's plan.  NOT ONE.  They just wouldn't be FORCED to buy it if they didn't think they could afford it.

        And yes, I know, Hillary's plan would be what SHE considers affordable based on income.  And she would brook no nonsense from anybody who didn't think that was affordable for THEM, and would garnish their wages (or presumably seize thei bank accounts or other assets if they were self-employed) to pay for it.

        What Krugman doesn't understand (and what Hillary apparently didn't learn from the last time around) is that this kind of thing will doom the chances of getting ANY plan enacted at all, at least if it's not abandoned.  There were reports that Bill recognized that her mandatory purchases of insurance through "health alliances" was likely to doom her proposal the last time around, but she stubbornly insisted on retaining that aspect of the plan -- and we all know what happened.

        "Those who would sacrifice liberty for security deserve neither liberty nor security." -Ben Franklin

        by leevank on Sun Feb 03, 2008 at 11:12:30 PM PST

        [ Parent ]

        •  Actually that is wrong (0+ / 0-)

          What Krugman has written in his book, Conscience of a Liberal, long before all these words about the comparative benefits of Clinton's or Obama's approaches is there are two paths to Universal Healthcare Coverage:

          1. Single-payer - which most of us progressives have been advocating for years (and what Michael Moore strongly advocated in SiCKO) but the status quo will never allow.
          1. A workable compromise that could work in the US with it's entrenched healthcare industry where those who have don't have to worry about losing what they have (private insurance through your work still goes on) yet those who have too little insurance or none will be covered by the new plan.

          Here's what Krugman writes in his book:

          Now for the good news: Over the past few years policy analysts and politicians have been evolving an approach to health care reform that seems to be a workable compromise between economic efficiency and political realism.  In involve four basic elements:

          • Community rating
          • Subsidies for low-income families
          • Mandated coverage
          • Public-private competition

          Single-payer is the cheapest, most effective way to cover everyone. If you can't get there in one shot, then the next best thing is to use the other tools that Krugman lists to create universal coverage by making sure no one get left out when sick (community ratings), can afford to get coverage (subsidies), is included in the universal pool (mandates) and private-public competition because it is clear that government run healthcare is far cheaper and covers far more people than private plans - which spend a huge amount of their money and energy in figuring out how to keep from having to cover the sick.

          Here's what I wrote last summer about why it was essential to make the pool comprehensive:

          Insurance works because lots of people are paying their small share into a common pool. The bigger the pool, the less everyone has to pay to cover those who need to draw from the pool. This is why fire insurance works - because only a few people have a fire claim each year, the amount everyone pays to get fire insurance is minimal.

          The smaller the pool or the more people that have to draw from that pool, the more everyone has to pay to keep it whole. Our best solution to the health care crisis is to have every American part of the pool, because then we will have the lowest possible cost to provide universal health care which even conservatives are finally admitting is the only way to keep the health care costs from bankrupting American companies, our states and American families.

          Your solution covers people like our emergency rooms cover people today: paying through the nose for very little benefit.  Who is supposed to pay for the unfortunate accidents or illnesses that come on those who are uninsured (because they don't want coverage or because they can't afford coverage) under the Obama plan?  What is your solution to this problem?  And I guarantee you, if we don't solve fixing the healthcare industry this time, we will be held hostage to the greedy industry that cares nothing about your health and everything about racking in the bucks.  

          "The less satisfaction we derive from being ourselves, the greater is our desire to be like others." - Eric Hoffer

          by Mary on Sun Feb 03, 2008 at 11:56:09 PM PST

          [ Parent ]

        •  The point isn't to get ANY plan enacted (0+ / 0-)

          The point is to get a good plan enacted.  George W. Bush could get SOME health care plan passed, but it wouldn't do anything to achieve universal health care.

          Inhofe is a wacko with a 46% approval rating: He's vulnerable.

          by tmendoza on Mon Feb 04, 2008 at 12:23:21 AM PST

          [ Parent ]

      •  With us or against us? (0+ / 0-)

        Could the other side not just as easily say, "They'd rather win the nomination than end the Iraq War?" It's just as untrue and just as outrageous a statement.

        Seriously, where the fuck does talk like that get us?

        (-5.88, -6.46) Democracy is what happens between elections.

        by autoegocrat on Sun Feb 03, 2008 at 11:54:41 PM PST

        [ Parent ]

    •  Very well said, Athena (8+ / 0-)

      It's a sad "tell" about Obama's supporters that they behave like that.

      Yes, Edwards' plan was also excellent and, as Krugman noted, similar to Hillary Clinton's.  I know some prefer his plan, and I hope that she consults with him when she's in office.

      •  I'm a rational Obama supporter! (3+ / 0-)
        Recommended by:
        highacidity, holder, kyril

        Look you guys.  I care about this issue.  Can someone please answer this.  Why did Edwards plan not impose the mandates for 12 years.  Wasn't it to give costs a chance to come down?  Isn't it possible that trying to impose a mandate up front could be a problem because costs won't come down immediately?  Also because many of us very, very resistant to the idea about being forced to buy catastrophic because though we make good money, we have debt and little extra.

    •  THANK YOU!!! (0+ / 0-)

      People need to get off the soap box here and let FACTS dictate their assessment of these competing health care plans.

      Listen to Noam Chomsky...

      by MrBurns17 on Sun Feb 03, 2008 at 10:27:22 PM PST

      [ Parent ]

    •  They aren't universal health plans by far (4+ / 0-)
      Recommended by:
      Big Tex, pgm 01, alba, drizek

      Clinton and Edwards plans will do nothing to streamline and cut costs, as it does nothing to tackle the health insurance companies which should basically go the way of the dinosaur.

      You'll need a citizen's movement to convince the nominee that fundamental change will need to happen, otherwise the costs will keep going up and up.

      I'm mad as Gravel, and I'm not going to take it anymore!

      by ceti on Sun Feb 03, 2008 at 10:33:56 PM PST

      [ Parent ]

      •  Nonsense. When eveyone is included, (4+ / 0-)
        Recommended by:
        Mary, Athena, Terre, JoeySky18

        when the public is invested in the success of UHC, it will work. Just like Medicare. The reason why it works is because all seniors have a stake in it.

        The opposite is true with Obama's plan. It lets people opt out who don't want to be part of the system. And he does not have open access to his half-measure pilot program public option. As Edwards did, Hillary guarantees access to a Medicare-clone public option.

        Obama's plan is the free market all the way, baby.

        That's why he pulled Harry and Louise out, because he is saying he's not a socialist who will threaten the free market.

        •  i couldn't believe he pulled that one. (3+ / 0-)
          Recommended by:
          Mary, Pacific John, JoeySky18

          i knew he didn't walk on water, but i didn't realize he would be willing to jeapordize (sp?) healthcare for everyone just to win . . .  stupid (selfish) move.

        •  Obama's plan is UHC (1+ / 0-)
          Recommended by:
          Professor Fate

          While this claim/mis-understanding may have justifiable a few months ago, Obama has clarified that his proposed "Coverage for All" will be available to all Americans independent of their employment status.  For reference of the difficultly, previous drafts of Obama's "Coverage for All" did read:

          Obama plan will: (1) establish a new public insurance program, available to Americans who neither qualify for Medicaid or SCHIP nor have access to insurance through their employers, as well as to small businesses that want to offer insurance to their employees;

          It's very poorly worded, and in fact, non-nonsensical.  Anyway, I talked to several staffers for clarification over this past week and was told that the listing was intended for illustration, and not limitation.  The website has been updated:

          Obama will make available a new national health plan to all Americans, including the self-employed and small businesses, to buy affordable health coverage that is similar to the plan available to members of Congress.

          As I understand the PDF on the site still needs to be updated, but it will be fixed shortly.  Policy change or confusion, what's important to me, is that if Obama's plan truly did exclude people on the basis of their ability to get corporate insurance, it doesn't anymore.  I hope this helps.

          •  But he doesn't FORCE people to be covered ... (0+ / 0-)

            against their will, and since he doesn't do so, he's EVIL.

            "Those who would sacrifice liberty for security deserve neither liberty nor security." -Ben Franklin

            by leevank on Sun Feb 03, 2008 at 11:18:22 PM PST

            [ Parent ]

            •  Yes, because Social Security and Medicare (3+ / 0-)
              Recommended by:
              Mary, linnen, LeftOverAmerica

              are evil.

              I can't believe we are having this conversation just because some new messiah-candidate has decided to run to the right.

              •  They're government-run programs (0+ / 0-)

                I'd personally be in favor of a single-payer health insurance system (or some variant such as that in France), but there is ZERO chance that we're going to get there right now -- which is why no candidate with even a remote chance of being nominated proposed such a system.

                "Those who would sacrifice liberty for security deserve neither liberty nor security." -Ben Franklin

                by leevank on Mon Feb 04, 2008 at 12:56:34 AM PST

                [ Parent ]

              •  When Social Security came along (0+ / 0-)

                very few people were aged 65 or more.

                It was dirt cheap and the taxes trivial.

                When Medicare came along hospital costs were $12 billion a year for the elderly I believe.

                That's $60 billion in modern money, or $18 a month per person a month in an era of an historically maximal economic justice level.

                The modern lower level workers have seen a 30% wage drop in real terms and roughly 30% to %200 percent increase in housing costs since the 1960s. They are hurting bad. So bad Republicans are jumping ship.

                Employers are now perfectly willing to cut worker hours to maximize profits.

                Life for the poor is harder than it has been since the late 1930s.

                Grabbing part of their meager wages to hand them to medical workers making 4 to 60 times more per hour or drug companies making multi-billion profits is not going to endear you to the healthy poor.

                You need to restore Medicaid coverage to historically high penetration levels and increase primary care Medicaid payments to at least Medicare amounts.

                You need to take the money out of the defense budget, not from the paychecks of poor people or young people paying high rent and massive student loans.

          •  It's not there in black and white, is it? (2+ / 0-)
            Recommended by:
            Mary, LeftOverAmerica

            Face it, UHC is not his issue.

            It is mine. And Hillary's.

        •  but the funding comes from higher income people (0+ / 0-)

          buying insurance.  Is that correct?

          •  Most of the funding will be identical to (1+ / 0-)
            Recommended by:

            what we privately have. High income earners mostly already have insurance. A large portion of funding will come from sunsetting Bush's tax cuts.

            •  I'm high but variable income and I have high (0+ / 0-)

              debt and I'm self-employed.  I had to drop my insurance when I went to school (I'm a little older).  What will happen to me?

              •  I won't bullshit you (2+ / 0-)
                Recommended by:
                linnen, mrchumchum

                It's probably worth your time to read her plan. You can d/l the publication on the right of this page.

                Since I've been in business for a while, I know exactly how hard it is to have swings in income. It is reasonable to guess that the percentage cap for your maximum rate would be based on your income on your previous tax return, but I don't know, and this is the sort of detail that Congress would call their own.

                Also, Hillary subsidize low income earners (this might come in handy in a lean year), and small business owners.

                Hillary's plan requires standardized rates that do not discriminate against your health status. Insurance would not go up or be canceled if you got sick, quit a job, or got a new job.

                We will all have the choice of any current plan*, all of the reformed private plans, any of the federal employee plans, or (a plan identical to) Medicare. I can't see how private insurers will be able to provide the same coverage for less cost than the Medicare option because Medicare has a 20%+ advantage.

                The thing that is most attractive to me about this is I hope to retire early, and will be tickled if I can lock in a plan with rates that are not likely to skyrocket at the whim of Blue Shield, like they have recently.

                * - another key lesson from '94 is that people want to be guaranteed that they can keep what they already have.

  •  Let's recc'd this one up please!!!! (6+ / 0-)

    Hillary: "Wait a minute... wait a minute... Let's have a reality break!"

    by Palladio on Sun Feb 03, 2008 at 10:22:41 PM PST

  •  Does Krugman fail to mention again... (8+ / 0-)

    that worked for Bill's administration.  I don't see how Hillary Care Part 2: Now with Mandates is going to pass

    •  No, he didn't. (5+ / 0-)
      Recommended by:
      Radical Faith, jen, tmendoza, priceman, DemAC

      That is yet another lie being spread around by the Obama supporters.  Nor does he have a kid working for Hillary, which is yet ANOTHER of the lies the Obama folks keep telling.  (Krugman and his wife are childless.)

      "I'm for Hillary because I believe that the United States right now is in a world of crap." - spoken by a Nevada voter

      by SaneSoutherner on Sun Feb 03, 2008 at 10:30:26 PM PST

      [ Parent ]

      •  Do you really not think it's going to be (0+ / 0-)

        politically difficult to get mandates passed with costs so high and with high income people at the edge of bankruptcy?

        •  they are not going to force us to buy high cost (1+ / 0-)
          Recommended by:

          insurance. it's about bringing the cost down, subsidising, etc. offering plans we can afford. heck, if they offer the Fed Plan, i'm down with that as it would give me a nice monthly savings. if you are already happy with your insurance, on Hillary's you do nothing because you're already covered. If you see a plan you like, you can opt in and perhaps save.

          there is no way they can do this at the current price of insurance that i can see. both spoke of making it affordable, percentage of income, subsidising (sp?), covering low/no income, and having options on plans. they both also have plans to lower the cost of care on the doctor/hospital end also.

          •  i don't have insurance. (0+ / 0-)

            I'm self employed and though my income can be high, my monthly income is variable and my debts are VERY high.  I know the argument that I'm costing other insurers money because of "emergency room" care.  But I'm guessing that I won't be subsidized?  Or will I?

            •  self employed also (2+ / 0-)
              Recommended by:
              LeftOverAmerica, mrchumchum

              have you checked to see if the freelancers union is in your state? they started in NY but have been branching to other states. plans similar to employer plans. same rate as my last job. a little less than half of private insurance.

              someone in another diary a couple days ago was on the Fed Plan. on his plan, family was about 150mo, single was 66.

              the variable monthly income sucks :) but i can generally come up with 66 even during drier times. but if this goes through and they open medicare, that would be another option.

              i'm not sure how subsidized will work. here in NY, i make "too much" for most low cost plans. but to get the nation's uninsured insured, they'll need a lot of options. and they're aware of the debt load many are carrying. it looks like there will be a few posibilities through private and public plans.

              •  thanks for giving me info and no flames (1+ / 0-)
                Recommended by:

                So I will probably have to buy private or public catastrophic under her plan?  Am I reading that right?

                •  i haven't even looked at the catastrophic (1+ / 0-)
                  Recommended by:

                  in fact i don't remember hearing anything about it until this diary from the one poster in the comments.

                  my understanding is we either need to buy affordable private or public insurance. it's about prevention and getting routine healthcare etc. the idea is to get away from using the ER as walk in clinics or just not going to the doctor until things are bad. it's cheaper for all involved  :) if they just had us all buy catastorphic with a 2-5,000 deductible, i don't see it changing anything unless well, something catastophic happened to us. the poster was saying the catastrophic was 100 a month (which you can get now from insurers), but that would be stupid (imo) if you could get full coverage under a Fed Plan for 66, right? i'm going to look closer a bit later today, but i'm pretty sure they want us to be paying for low cost health insurance so we can maintain our health. for instance, i need to keep up on my BP, Choles, Blood Sugar etc because of things that run in my family. much better and cheaper to catch it early :) that is the basic goal i believe. Hillary is doing a Town Hall tonight on the Disney Channel @9pm. i'm going to watch it as i'm guessing this will be discussed as she's aware of the mailer etc.

                  anyway, i gotta hit the hay :) hope i helped a bit!

      •  how can you call it a "lie". I'm very (0+ / 0-)

        worried about the political viability of mandating.

    •  I'm going to assume (2+ / 0-)
      Recommended by:
      Pacific John, tmendoza

      you don't realize that "Hillary Care" is a Rush Limbaugh meme.

    •  Dude/ette - brush up on your history (2+ / 0-)
      Recommended by:
      linnen, tmendoza

      Krugman was a trade economist under Reagan.

    •  This is troll-ratable (0+ / 0-)

      Its pushing a blatant lie.

      Inhofe is a wacko with a 46% approval rating: He's vulnerable.

      by tmendoza on Mon Feb 04, 2008 at 12:25:14 AM PST

      [ Parent ]

  •  Now it's personal! (3+ / 0-)
    Recommended by:
    sacrelicious, Joe B, Professor Fate

    Actually I think it has been for Krugman now for the past month plus.  The man has completely lost it.

    •  Again -- not a substantive response (13+ / 0-)

      in any way to the content of the material -- just slander against the authors.

      •  Lazy (7+ / 0-)

        Another great ad for the candidate he supports.   Ad hominem and lazy.

      •  You're thinking of "libel" (0+ / 0-)

        slander is spoken defamation. Libel is written defamation.

        Krugman is a public figure so you'd need to show actual malice on my part as well.  

        I have no beef with the man, it's just in this campaign his opinion pieces have been filled with nothing but vicious and personal attacks and bile directed against Obama -- all because Obama's staffers sent a stupid critical response out regarding an earlier Krugman article that questioned his omniscience.  The man is smart, but he is not all knowing.  

        •  You explain one thing... (5+ / 0-)
          Recommended by:
          Athena, Pacific John, jxg, linnen, DrKate

          ... the difference between slander and libel. But this post is about health care. Unfortunately, on that subject you didn't contribute anything. You just keep complaining about Krugman. Why not counter his arguments?

          •  OK . . . (4+ / 0-)

            substantive complaints (besides Krugman's clear vendatta).

            After all, we already have programs that make health insurance free or very cheap to many low-income Americans, without requiring that they sign up. And many of those eligible fail, for whatever reason, to enroll.

            Who says that lower cost premiums are just for lower-income Americans?  I know folks today who are middle class who drop their insurance because of premium increases which they can no longer afford out of pocket.  When people drop their policies, the insurance pool shrinks, costs go up, and the cycle continues.  That's my understanding.

            Another take worth reading contra Krugman is that of Robert Reich

            I’m equally concerned about her attack on his health care plan. She says his would insure fewer people than hers. I’ve compared the two plans in detail. Both of them are big advances over what we have now. But in my view Obama’s would insure more people, not fewer, than HRC’s. That’s because Obama’s puts more money up front and contains sufficient subsidies to insure everyone who’s likely to need help – including all children and young adults up to 25 years old. Hers requires that everyone insure themselves. Yet we know from experience with mandated auto insurance – and we’re learning from what’s happening in Massachusetts where health insurance is now being mandated – that mandates still leave out a lot of people at the lower end who can’t afford to insure themselves even when they’re required to do so. HRC doesn’t indicate how she’d enforce her mandate, and I can’t find enough money in HRC’s plan to help all those who won’t be able to afford to buy it. I’m also impressed by the up-front investments in information technology in O’s plan, and the reinsurance mechanism for coping with the costs of catastrophic illness. HRC is far less specific on both counts. In short: They’re both advances, but O’s is the better of the two. HRC has no grounds for alleging that O’s would leave out 15 million people.

            The entire piece is worth reading in its entirety.

            But what does Reich know?

            •  Reich is wrong on this one. (1+ / 0-)
              Recommended by:

              Yet we know from experience with mandated auto insurance – and we’re learning from what’s happening in Massachusetts where health insurance is now being mandated – that mandates still leave out a lot of people at the lower end who can’t afford to insure themselves even when they’re required to do so.

              Car insurance is different first of all, and most places that insurance is "mandated" the only enforcement mechanism is generally tickets for people stopped. Compliance is much higher where people have to show proof of insurance when licensing a vehicle.

              Secondly, if he wanted to use the "car insurance" example, he needs to also use it with Obama's plan. If not mandated at all the rates of uninsured is vastly higher than where mandated.


              HRC has no grounds for alleging that O’s would leave out 15 million people.

              and Obama has no grounds to claim that anyone new will be covered under his plan.

              The formula for those covered under Obama's plan would be "H*U" where U=current uninsured and H=factor of Hope.

              Shell game.

              •  Car insurance and health insurance . . . (2+ / 0-)

                are bad analogies period -- I agree with this much.  In the case of car insurance if a person gets in an accident every month (as is the case with a chronically ill patient in the case of health insurance) -- that person loses their insurance and their license -- health care is obviously a different question.

                As far as Obama's plan goes, it's true with any product -- including health insurance -- there are things called "price points".  e.g. in a hypothetical case in a population of 100 people if insurance premiums are priced at $10,000 a month maybe only 5 out of 100 would even be able to afford insurance.  At $1,000 a month 30 out of 100 might be able to afford it.  In the case of $500 a month 60 out of 100 will be able to afford the insurance.  etc, etc.

                Now there will always be cases where some people will just not see any need to buy insurance period -- even if they have the means.

                Based on anecdotal evidence -- this is not the case that I'm seeing.  The issue right now is that people want insurance, but they can't afford it because premiums are too high.

                There are a few ways to go about this.

                As far as mandates are concerned the argument is that if you force everyone to participate costs go down because of increased burden sharing (although private insurance is an odd beast -- in Massachusetts even after the enactment of their "universal" plan premiums have actually gone UP 12% over the past year -- faster than the rate of inflation -- also the plan is not truly universal).  

                With mandated insurance you also add another layer of costs in connection with enforcement mechanisms, which add to the overall cost of the program.

                If you attack the price issue first and reduce costs through efficiencies as Reich outlined the net impact is that you will start hitting price points where people can actually afford the insurance.  At least in theory, as the insurance pool grows the price should go down further lowering the price point of insurance to a point where anyone who wants insurance can get it (in Obama's plan there are subsidies which kick in at a certain point for those who don't have sufficient incomes to afford the lower priced insurance).

                At the end your left with a population which might not want to pay for insurance that you'll have to deal with -- and this might have to be done with a mandate.  It makes more sense to me though to add this on the back-end of a program, rather than to start first with a mandate.  

              •  the only evidence I've seen in-favor of mandates (2+ / 0-)
                Recommended by:
                Professor Fate, NotGeorgeWill

                is that it increased Switzerland's health insurance coverage from 97% to 99% -- frankly, we're barely holding 80%.  Help us get to 95% and we'll talk.  Obama's isn't opposed to them, he just doesn't think that they are the right thing at this time.  Even Edwards doesn't think that mandates are the right thing in the next 4 years -- his plan had mandates taking effect in 2012.

                •  The other side of this . . . (0+ / 0-)

                  that I think Obama's approach makes a lot more political sense -- it is much more realistic.  Even based on the impact and reaction towards the mailer it's easy to see how a mandated plan for 20% of the population could be derailed.  Applying a mandate to cover the remaining 5 to 10% at a later point would be a much easier sell politically.  

        •  You lose me with "vicious" (7+ / 0-)

          I've read Krugman's blog and his columns.  It's clear he does not want Obama to win, but there is no viciousness in it.

          Krugman has said that, in his opinion, the most important issue in this election is universal healthcare.  He is in a good position to analyze the plans of the candidates.  He makes statements based on his analysis.  

          You can disagree with him if you want, but what he is doing is eminently fair.

      •  Susan (0+ / 0-)

        Why don't you respond to this comment?

        I substantively rebuts the whole basis on which Krugman is arguing.

        Why respond to trolls or unsubstantive comments?

        Make sure everyone's vote counts: Verified Voting

        by sacrelicious on Sun Feb 03, 2008 at 11:09:15 PM PST

        [ Parent ]

    •  It is obviously a vendetta (3+ / 0-)
      Recommended by:
      Athena, jorndorff, NotGeorgeWill

      at this point for Krugman, and the diarist.  

    •  Way to challenge Krugman's argument! (0+ / 0-)

      Oh wait...The fact is no honest liberal can believe in Obama's plan.  He put the plan out because he wanted to do well among independents.  Thats worked like a charm for Obama, at least so far.  But he certainly doesn't have a health care plan that makes a lick of sense, and liberals should be worried about that.  

      Inhofe is a wacko with a 46% approval rating: He's vulnerable.

      by tmendoza on Mon Feb 04, 2008 at 12:27:35 AM PST

      [ Parent ]

  •  If Obama becomes president, (2+ / 0-)
    Recommended by:
    Joe B, Big Tex

    there's no chance for Krugman.

    That's what he means.

    It rubs the loofah on its skin or else it gets the falafel again.

    by Fishgrease on Sun Feb 03, 2008 at 10:24:30 PM PST

  • know that UGLY pamphlet (6+ / 0-)

    Imagine the one the GOP is going to come up with to kill Clinton's plan.

    When Krugman says there is "some chance" of universal care with Hillary Clinton, he is talking in very small percentage points.

    Obama's plan will pass.  Clinton's will fail.  Just like she failed the last time she had this opportunity.

    Oh no! A "Republican Talking Point!!!" Hide the children!

    by snout on Sun Feb 03, 2008 at 10:25:27 PM PST

  •  Go to hell, SusanHu (5+ / 11-)

    Mandates are not the same thing as Universal.

    Nuclear non-proliferation. Government transparency. Hillary's supporters dismiss Obama's record because it contains too many big words.

    by Troutnut on Sun Feb 03, 2008 at 10:26:26 PM PST

  •  We need to have single-payer for all... (4+ / 0-)
    Recommended by:
    ceti, Turkana, Montague, NotGeorgeWill

    the shift is happening.

    Beware the corporate-consolidated media that pulls in the big bucks on drug ads. It was advantageous to sell Americans Bu$h over Gore and Kerry to keep the status quo. A McCain victory will keep the status quo.

  •  Oh its you again SusanHu (8+ / 0-)

    You are the main attack dog for hillary on here. Now you are out to slander Barack's health care plan. Your last three posts that I have seen, were inflammatory propaganda that seems awfully like the lowest common denominator smears that come from the Clintons. I believe nothing you write.

    Private Property is the Curse. Those that Buy and Sell Land, and are landlords, have got it either by Oppression, Murder, or Theft

    by pacific ocean park on Sun Feb 03, 2008 at 10:28:54 PM PST

  •  that mailer is atrocious (14+ / 0-)

    It saddens me that his campaign would stoop to that level.

    John McCain: 100 years in Iraq "would be fine with me."

    by desmoinesdem on Sun Feb 03, 2008 at 10:29:25 PM PST

  •  Need evidence that Obama wants to penalize (8+ / 0-)

    "NOW Obama is suggesting (as you'll see below) that he may "penalize" people who don't participate.  WHAT?  Penalize them?  Why not just include them in the first place?"

    After your above statement you follow with a Krugman quote, asserting that Obama wants to penalize individuals that don't willingly participate.

    I need further evidence.  Krugman saying so doesn't make it so.  Why don't you show me an Obama policy that articulates this point, or a speech he gave.

    Obama has been completely consistent in everything that I've seen, heard, and read about penalizing being a bad idea, and that's why he disagrees with Hillary's plan.  I just don't buy that now HE is going to penalize people.

    •  Fair question. (1+ / 0-)
      Recommended by:

      I have read it in other publications but am tired and can't think of where just now.  Will you help me look for it?

        •  You're talking about (0+ / 0-)

          probably the most respected leftist in the United States. One of the most brilliant minds on economics in a generaton. The heir as it were of Galbraith (if you dont know who he is you REALLY should learn).

          I tremble for my country when I reflect that God is just; that his justice cannot sleep forever TJ

          by cdreid on Sun Feb 03, 2008 at 11:54:50 PM PST

          [ Parent ]

          •  I never said I didn't know who he was (0+ / 0-)

            I just don't accept blindly what someone says to be the case.

            I asked for evidence of Obama himself speaking about penalties, rather than presenting as evidences rhetoric written by someone else.  

            It was a perfectly reasonable request, and the author of the diary thought so too and has been very polite about it.

            It is worth mentioning she updated her diary with evidence per my request.

          •  Bow and kiss the feet... (0+ / 0-)

            of the almighty Krugman! For he is the most lefty left guy in the universe! No mind can compare to the Krugmonster, his brain is the size of a thanksgiving turkey. From his pen comes all that is good and liberal, from his typewriter begins a thousand revolutions. Without his brilliant guidance our markets would plummet to the depths of depression, not a dollar would be printed, not a dime would be spent. If Krugman were not around to praise FDR our father who art in heaven, then the democratic party would be lost in world run by Jeb Bush. Relegated to insignificance, never to win an election again. Anoint us in your light Krugman.

            Private Property is the Curse. Those that Buy and Sell Land, and are landlords, have got it either by Oppression, Murder, or Theft

            by pacific ocean park on Mon Feb 04, 2008 at 12:26:18 AM PST

            [ Parent ]

            •  Hmm (0+ / 0-)

              So you hate people who are smarter than you and i as well as resent their doing good, leading us back to sanity. I get it.

              I tremble for my country when I reflect that God is just; that his justice cannot sleep forever TJ

              by cdreid on Mon Feb 04, 2008 at 11:17:13 AM PST

              [ Parent ]

      •  obama will assess back premiums... (3+ / 0-)
        Recommended by:
        Pacific John, DrKate, DemAC

        ...if people without insurance try to get health care. you can call it back premiums, but it's a fine. it'll also run up costs by discouraging people without insurance from seeking non-emergency care.  they'll end up in crisis as their condition deteriorates. good thinking there, barack.

        Hillary 2008 - Flying Monkey Squadron 283

        by campskunk on Sun Feb 03, 2008 at 10:37:53 PM PST

        [ Parent ]

        •  we need to add that to the dictionary (0+ / 0-)

          under "penalty"

          if people aren't buying affordable insurance because they want to use their money for other things, you can bet they won't have the "back premiums" handy when they get the flu . . .

    •  The difference between the two proposal . . . (3+ / 0-)
      Recommended by:
      highacidity, Big Tex, begone

      is that Clinton has mandates on the front-end for everyone.  

      Obama only has mandates for children -- although in the debate this week he suggested that he might be open to mandating insurance on the back end of his policy (his priority is to first lower the cost of health care through increased efficiencies and some other approaches -- the idea being that you don't have to force people to buy health care if it's affordable).

      •  Yeah (1+ / 0-)
        Recommended by:

        This is consistent with my understanding.  Obama has been [correctly] dealing with the high cost of insurance as a primary reason people do not get health insurance.  Failure to address costs, mandating people get insurance, and penalizing people who do not is bad policy.  I think Obama has rightly been criticizing Hillary for this.

        If back-end penalties are in actuality something he is suggesting - and I have yet to get proof of this - it is a reasonable thing to do.  Once health insurance is more affordable, we can rightly expect people to participate.  

        This would still be significantly different than Hillary's plan which mandates coverage under the current high-cost system.

        •  she spoke of bringing the costs down (1+ / 0-)
          Recommended by:

          and "increased efficiencies and some other approaches" also and has more money allocated to that.

          cost would be based on % of income etc and obviously those that are low/no income will be taken care of.  she is not going to be forcing people into the poor house because of mandated health coverage. geeze.

        •  Let me tell you why you are wrong (2+ / 0-)
          Recommended by:
          linnen, LeftOverAmerica

          people are focusing on only one end of the "back premiums" concept, the concept of punishment.  But they are not looking at the other end, which is the "free lunch" end of it.  Let me put it this way- you have two choices.  You can take out $100 per paycheck every week, year in and year out, in case you get sick. Alternatively, you can keep that money, go to the ER when you do get sick, and then pay "some of the back premiums."  Which do you do?  The latter, obviously.  You see, the gamble is simple.  At the very worst, you pay the same in either case, but given that he said "some of the back premiums," and since you spent most of the money anyway, you're really talking about a few hundred, compared to the thousands you spent with insurance.  Your "back premiums" don't even cover the cost of the very expensive ER, much less contribute to the pool that makes the plan INSURANCE, rather than pay-as-you-go.

          Does that help explain the problem with Obama's "plan"? It is not a plan.  It is a platform.  

          If you refuse to vote for OUR PARTY'S nominee in November, the blood of a thousand back-alley abortions will be on your hands.

          by dhonig on Mon Feb 04, 2008 at 04:33:57 AM PST

          [ Parent ]

    •  Hang tough ... (2+ / 0-)
      Recommended by:
      Pacific John, DemAC

      I'm dealing with a lot of e-mail, etc.  And the search terms I used were lousy -- didn't get any results, sigh.  But I'll keep trying.  It may be tomorrow before I get a good answer to you.

    •  In the last debate, Obama said (1+ / 0-)
      Recommended by:

      something about making people pay retroactive premiums.  Now that sounds like a form of penalty to me.  

    •  I added an UPDATE to the diary (0+ / 0-)

      that proves that Obama himself said it in the debate on Thursday night.

    •  THe penalize part (0+ / 0-)

      Obama said during the debate in California that the people that don't have the plan have to pay penalty for the past, before they can get the healthcare they need.

      You can check the clip in youtube.

    •  The idea of penalties is silly (0+ / 0-)

      and it shows the dangers of just having plans instead of bills.

      Probably the premium less typical drug&doctor costs for the age group will have to be placed in a federal account.

      Other options are restricting the formulary of latecomers, making them get surgery in unpopular hospitals done by unpopular doctors, tougher restrictions on tests, higher co-pays for tests and patented drugs, reducing Social Security payment levels, higher car sales taxes, etc.  

    •  You want evidence? (0+ / 0-)

      did you see the debate?  Per Obama, people can go uninsured, go to the ER (the most expensive care available), then be penalized for "gaming the system" by being forced to pay "back premiums."  Not only is this a penalty, it is utterly moronic and proves Obama has no plan.  You see, if you can go uninsured until you get sick, and THEN just pay a few months of "back premiums," why would you get insurance in the first place?  It is not a health care plan.  It is a platform and nothing more.

      If you refuse to vote for OUR PARTY'S nominee in November, the blood of a thousand back-alley abortions will be on your hands.

      by dhonig on Mon Feb 04, 2008 at 04:28:55 AM PST

      [ Parent ]

  •  The healthcare debate is phony (11+ / 0-)

    Neither candidate dare speak the truth. Were either to make so much as  a mention of single payer, the HMO's would spend every dime they own to defeat that candidate. That is why, whatever their ultimate intent, neither Clinton nor Obama can say what they really want.

    WARNING: I do not support any specific candidate!

    by Anne Elk on Sun Feb 03, 2008 at 10:31:31 PM PST

  •  All the plans suck, except Single Payer (13+ / 0-)

    I've said this before, I don't know how Krugman misses how Hillary's plan subsidizes the health insurance industry and does nothing to reduce pharmaceutical costs which are fueling the the unsustainable cost of medicare.

    You should not have mandates! Health care should be paid through progressive income taxation, like everything else. You get into all this trouble with mandates and premiums when you don't treat health care as a human right and a basic service of the government. That's what single-payer is about and that's how it would wipe out the enormous administrative costs of the health insurance industry once and for all.

    I'm mad as Gravel, and I'm not going to take it anymore!

    by ceti on Sun Feb 03, 2008 at 10:31:45 PM PST

  •  Hey Teddy! What's the word?! (1+ / 0-)
    Recommended by:

    Is Senator Kennedy down with BHO's plan? What is his position on mandates?

  •  how dare krugman stoop to using facts (5+ / 0-)

    "There are many truths of which the full meaning cannot be realized until personal experience has brought it home." John Stuart Mill

    by kuvasz on Sun Feb 03, 2008 at 10:33:47 PM PST

  •  I think that HRC supporters don't understand (15+ / 0-)

    why "Universal Health Care" is desirable.

    They seem to think that Universal Health Care is desirable for its own sake.  For some of them, apparently the current system would be fine just so long as there was a law insisting that everyone buy health care.

    So, I ask you, which is important?

    a) That everyone has the option of affordable health care.

    b) That everyone must buy health care.

    Krugman makes the intellectually dishonest argument that b) is the progressive cause while it is a) that we should be fighting for.

    Krugman acknowledges that health care is (slightly) more affordable under Obama's plan.  That's worth repeating: ***health care is more affordable under Obama's plan***

    The difference in people not covered are that under HRC's plan some people who would choose not to buy coverage under Obama's plan are mandated to buy coverage.

    That's the difference.

    Arguing, that they are "not included" or "left out" is dishonest.

    Now, an intellectual honest argument can be made that people would have to great an opportunity to game the system under Obama's plan.  I'd listen to that argument.  That more subtle argument, however, is not the argument that either Clinton nor Krugman are trying to make.  Instead, they make the ridiculous "Universal for Universal sake!" argument.

    Just one more thing that turns me off HRC.  I think she'll be fine, and I've come to the realization that I probably have no choice but to vote for her if she's the nominee but this kind of stuff is really off putting.

    •  The reason that universal health care is (0+ / 0-)

      desirable is... because it would mean that everyone will receive treatment for health needs!

      Obviously single-payer is the best option.  It's also the goal.

      That more subtle argument, however, is not the argument that either Clinton nor Krugman are trying to make.  Instead, they make the ridiculous "Universal for Universal sake!" argument.

      Not true for Krugman, at least.  He talks about it in detail in his book, The Conscience of a Liberal.  There's a discussion of how people would game the system if they were permitted to opt out only until they needed it.  And once the law says that insurance companies cannot refuse to cover someone based on a pre-existing condition, then you would have millions of people staying out until the last possible second, thus disrupting the risk pool and making the system insolvent.

      •  ok (2+ / 0-)
        Recommended by:
        highacidity, NotGeorgeWill

        fair enough, I haven't read his book.

        But in his columns he seems to stick to the intellectually dishonest argument.

        There's a discussion of how people would game the system if they were permitted to opt out only until they needed it.  And once the law says that insurance companies cannot refuse to cover someone based on a pre-existing condition, then you would have millions of people staying out until the last possible second, thus disrupting the risk pool and making the system insolvent.

        I think this is a good argument against Obama's plan and the argument Hillary should be using.

        But the "we know best!" argument that people over the age of 25 should be forced to buy health care even if they don't want it at the price offered just because we like the idea of them having it, doesn't seem right to me.

        Now, I've volunteered in an emergency room and seen the inefficiency caused by people not having health care (the result is only emergency care and no preventative care) so I find arguments like the one you made convincing.  The one Clinton has made and that Krugman has made (in the columns I've read and the one discussed in this thread) are not.  By comparison, Obama's mailer, while not presented the whole story, is relatively honest.

        •  This is relatively easily addressed (2+ / 0-)

          Under the federal employees' plan, there is an "open season" once a year (but ONLY once a year) during which you can enroll in a specific plan, or change plans.  Otherwise, you can only enroll upon hiring, or upon a relatively narrow set of circumstances (as I recall, including if a spouse under whose non-government plan you were covered loses their coverage).

          In 22 years of federal employment during two different periods, I never knew a single federal employee who went without insurance -- including the young and completely healthy, and even though participation was neither mandatory nor free.  Very few people are foolish enough to risk bankruptcy by refusing to buy affordable health insurance and betting that they won't be in a serious accident or develop a serious illness over the course of the upooming year.

          But to the extent that there ARE some people who want to play that game amd get unlucky, I personally wouldn't feel too sorry for them if they had to declare bankruptcy because of their foolishness.

          "Those who would sacrifice liberty for security deserve neither liberty nor security." -Ben Franklin

          by leevank on Sun Feb 03, 2008 at 11:27:48 PM PST

          [ Parent ]

          •  yeah (1+ / 0-)
            Recommended by:

            I'm not a libertarian but part of the American philosophy is that we allow adults to be foolish with their own health if they so choose.

            Now, we don't always do this.  We let people smoke (as we should) but we don't let them smoke put etc.  

            Still, the idea that we should mandate that people buy something, is going to strike a lot of people the wrong way.  

            I understand if it's a public good, in that some people not buying cheats others (we can't each choose individually to pay or not pay for roads, for instance) but that is the case you need to make if you want mandates.

            Leevank, presents a solid case against that argument.  I'd also add that Krugman states that Obama's plan is projected to be somewhat cheaper so apparently the potential gaming of the system isn't making it insolvent.

            All that said, I'm not sure how much projections about these kinds of things are worth.  I'm guessing that the economists are making all sorts of assumptions that they are far from sure about.  What you need to do is actually make health care affordable and then see what happens and be ready to adjust in necessary.  That's basically what Obama has said he'd do which is why I think he's the one talking most honestly about this.

        •  I loaned the book out (0+ / 0-)

          so I can't go look up the details right now.  It's true that I read his blog and columns with the background of having first heard him give a talk about the topic and then having read the entire book.

          As you say, emergency rooms provide only emergency care, not preventive and also not followup care.  

          I feel that the bottom line is, most of us here on DKos really want a fix to the health-care system in the US.  It's high time our government did something about it.  It's going to be hard enough to get it passed the Rethugs as it is, but I believe the people of this country are ready to get behind their elected representatives who push it forward.

  •  Oy Vey (8+ / 0-)

    Neither of the candidates proposals are going to be enacted. Congress hasn't even weighed in.  This is silly.

    Krugman knows his stuff but his stuff isn't what a future Congress will do.

    "Mr. President, I'm not saying we wouldn't get our hair mussed." General Buck Turgidson

    by muledriver on Sun Feb 03, 2008 at 10:35:04 PM PST

    •  it would be fair to assume that it probably will (1+ / 0-)
      Recommended by:

      take several submissions & a lot of hard work to get anything close to universal health care enacted. the question becomes, who do you trust to actively pursue the issue. mrs clinton's history of putting a plan forward & then forgetting the issue for the next 15 years, should gives me pause.

      Anyone who advocates, supports, defends, rationalizes, or excuses torture has pus for brains and a case of scurvy for a conscience. - James Wolcott

      by rasbobbo on Sun Feb 03, 2008 at 11:03:54 PM PST

      [ Parent ]

  •  btw (5+ / 0-)

    I agree that single payer is the way to go and the only truly "Universal" health care (since there are clearly people who will dodge buying health care under Clinton's plan).

    Still, it appears that both candidates realize (or seem to think) that single payer isn't political feasible.

    I wish single payer was an option but without it, I'm convinced that Obama has the more principled, progressive and politically feasible plan.

  •  Once we're in... (0+ / 0-)

    NHS USA!!!

  •  2 Questions For Hillary (2+ / 0-)
    Recommended by:
    tazz, NotGeorgeWill

    The first ... how does she expect to pass through a 60+ Vote Senate the requirement to require private citizens purchase a private/public product.

    How is it constitutional to require that private citizens purchase a private/public product.

    a lot of the other 'attacks' on Hillary's plan i think are unfair.

    i completely support universal single payer health care, so much of what the support for "mandates" re: risk pool, cost containment, etc i agree with.

    i just don't see it passing these 2 hurdles though.

  •  Great read! (2+ / 0-)
    Recommended by:
    Athena, DrKate

    Thanks for sharing an engaging and issue-oriented piece, Susan.

  •  we're not talking about (9+ / 0-)

    havaing "health care", we're talking about having "health care insurance" which is not the same thing.  

    Words can sometimes, in moments of grace, attain the quality of deeds. --Elie Wiesel

    by a gilas girl on Sun Feb 03, 2008 at 10:41:10 PM PST

  •  I don't really like the mailers (4+ / 0-)

    but everything they say is true.

    Now, you could argue that they don't tell the whole story.  After all, there is a solid argument to be made for mandates (Clinton and Krugman aren't making it but there is one).  So, I would prefer Obama not send out mailers like this.

    Still, I think this is closer to honest than Hillary's public claims that Obama's plan "leaves people out."  

    "doesn't force people in" would be the honest way to state it -- and I'm someone who thinks that there are legitimate reasons to force people in.  Still, if that's what you want to do, you have to be willing to admit it.

    •  Same with the Willy Horton ads, I suppose. (0+ / 0-)

      And guess what? You still wouldn't sabotage out party with either.

    •  Actually there's a lie (1+ / 0-)
      Recommended by:
      Pacific John

      "Hillary's plan forces everyone to buy insurance."

      Nope.  Anyone who already has a plan they like, e.g., a plan provided by an employer, can keep what they have.

      So there's a lie right there.

      •  the mailer (2+ / 0-)

        doesn't suggest that people with insurance would have to buy other insurance.

        Your reading of it is a absurd stretch, in my opinion.

        •  Of course it does. It says right there: (1+ / 0-)
          Recommended by:
          Pacific John


          It's extremely clear.  Note that it was not worded like this:  Hillary's health care plan forces everyone to HAVE insurance, even if you can't afford it.

          That would have been true.

          Or it could have said: Hillary's health care plan forces everyone who doesn't already have insurance to buy insurance, even if you can't afford it.

          Hence, the flyer has a bald-faced lie right on the front.

          •  that's a very strange reading (0+ / 0-)

            I would have read that and thought

            "Oh. I already buy insurance (through my employer) so it doesn't effect me."

            I can't imagine anyone reading that and taking it to me that they'd have to drop their current insurance.

            It does force everyone to buy insurance.  Yes, some people are already buying it.  

            yes: "Hillary's health care plan forces everyone who doesn't already have insurance to buy insurance, even if you can't afford it."

            would have ruled out any chance of confusion on that point but I think the your interpretation is an absurd one.

            You're trying to make it a lie but reading something that isn't there.

            •  That's how it struck me from the first moment (0+ / 0-)

              And seriously, it doesn't force everyone to buy insurance.  If I'm covered through my employer, I don't have to buy it.  It's part of my benefit package.  You could possibly argue that I've "bought" it. [sigh]

              My real concern is that the way it is worded is intended as a scare tactic.  A carefully crafted scare tactic that probably is working, just as it worked back in the early 1990s.

              •  I don't know (0+ / 0-)

                Honestly, it wouldn't occur to me to read it that way and I don't think people will so I wouldn't worry.

                Being sensitive to wording, don't you think that HRC's wording "leaving 15M people out" is deliberately deceptive?  It intends to give the impression that there are people who would have access to health insurance under her plan who couldn't get it under Obama's plan.  I think that deeply deceptive.

                •  Not really (0+ / 0-)

                  Because independent health economists agree with her.  Also, because people reading it will think they aren't one of the 15 million.  If you say "everyone" they worry, because every citizen belongs to that subset.  But people usually think that the group that won't get the benefit (whatever it is) is a subset of other people.

            •  Some people, mainly public employees (0+ / 0-)

              get free health insurance they don't have to buy.

              It is a very small group.

              It is a major reason why single-payer isn't on the presidential primary table because some super delegates like their super coverage.

      •  This is laughably illogical (0+ / 0-)

        If I passed a law saying that you had to give me $1,000 unless you'd already given me $1,000, I think you'd say that I was FORCING you to give me $1,000, and it wouldn't be a lie for you to say that I was forcing you to do so.

        "Those who would sacrifice liberty for security deserve neither liberty nor security." -Ben Franklin

        by leevank on Sun Feb 03, 2008 at 11:32:57 PM PST

        [ Parent ]

  •  this diary is loltastic (0+ / 0-)

    thanks i needed that.  srsly.

  •  Reading these comments (10+ / 0-)

    I see the usual Krugman hate and Susan hate but none of them address the reality of what is being said about the effort to achieve UHC.

    Obamas ad attacking mandates are just dumb considering he himself has mandates in his plan. Also the meme of penalizing someone who doesn't sign up is over the top when he also said that late comers to his plan will be penalized.

    Obama is field testing oppo for the pugs, that will surely be used against any plan introduced. It seems that it is more important to Senator Obama that he win the nomination than have a real shot at getting Healthcare for the American people.

  •  Gerber's paper was taken out of context. (17+ / 0-)

    This is one of Kurguman's most dis-honest op-eds I've ever seen.  The "analysis" of Dr. Gerber pulls compliance numbers out of his rear end, he even says it in his paper:

    "We have no experience to date with such a mandate, so it is hard to predict the success of enforcement .... For simplicity here I assume that the [simulation with the mandate] provides close to universal coverage .... In particular I assume that 95% of those who would not voluntarily choose to insure are forced to insure through the mandate."

    It's actually a stupid assumption, the closest we have to numbers, that I've seen, is Switzerland's switch to mandates.  Compliance went from 97% to 99% -- hardly a "huge" swing.  Anyway, the purpose of the doctor's paper is to work on models to assess the impacts of mandates, not to actually run the numbers, he says so:

    "But a critical issue for policy makers is to 'get under the hood' of all models of this type and to consider the implications of key sensitivity checks  of the models’ construction."

    In other words, I have alot of assumptions here, and what policy makers need to do is start validating those assumptions before this model can be used for any realistic purpose.   In short, Krugman twisted this to mean what he wanted it to mean -- it has nothing to do with reality.


    I'd note that Edwards plan didn't have mandates take effect till 2012, and that Obama has stated that he'd be open to re-considering mandates once we have sufficient information in order to do a impact analysis.  Both Edwards and Obama want the public health insurance plan to be out there, and field tested before the mandates go into effect.

    Hillary's rhetoric has been less clear.  Either she wants the mandates to be immediate before the public plan is ready or field-tested (a huge big-business wet kiss), or she actually has the same 4 year time line in mind -- in which case, this is a moot issue, since Obama isn't opposed to reconsidering.

    Let's focus on getting coverage from 80% (current estimates) up to 95% before we start bickering about mandates.  If we get that far, it will have been huge progress.

    Peace out.

  •  Universal health INSURANCE (5+ / 0-)
    Recommended by:
    moiv, hhex65, Bill White, rcbowman, pgm 01

    is NOT universal HEALTH CARE.  People need to stop conflating those terms.  It's a flat-out LIE to suggest that they are the same thing.

  •  I don't want universal health care. (0+ / 0-)

    There, I said it.

    •  I hear ya (5+ / 0-)
      Recommended by:
      miriam, Pacific John, linnen, splashy, hhex65

      And some people don't want to pay taxes.  But we all drive on the roads and drink clean water and use the education system, so we all need to pay into the system to get something out of it.

      •  But that's just the problem with these plans. (0+ / 0-)

        Hillary's plan amounts to expanding medicaid and then increasing the taxes of people already being forced to pay  for their own health care to cover the expansion.  

        In other words, we're going to be paying for even more "charity" health care, without benefitting from that program ourselves.  That just doesn't work.  I resent paying extra for others when I'm still paying so much for myself.

        A universal health care program that works necessarily benefits everyone equally.  That way, people realize the benefits of it and want to keep it.  They're happy to pay in.  They don't resent that they're expected to pay for so many others without benefit themselves.  It's not "charity-based."  That's why Conservatives in the rest of the civilized world would never run on getting rid of universal health care.  Everyone in the country benefits from it.

        In other words, only Kucinich's plan would work as a mandated plan.

        Obama proposes mostly reduction in premium costs for everyone, through a group plan that benefits everyone who buys insurance, even people like me who can afford to buy it.  

        Until we can get Kucinich's plan, I prefer Obama's.

        by keeplaughing on Sun Feb 03, 2008 at 11:28:27 PM PST

        [ Parent ]

        •  No (3+ / 0-)
          Recommended by:
          miriam, perro amarillo, splashy

          Medicaid is actually a smooth-running system.  It's essentially single-payer for the elderly and for some disabled people who qualify.  It permits humongous savings in bureaucracy because there is only one system, not hundreds of different health carriers.  It offers prevention and routine care rather than waiting until something is an emergency, because emergency care costs more than anything else.

    •  Are you even liberal? (4+ / 0-)

      UHC is one of the biggest, most important future goals of the Democratic party.

  •  Maybe I am thick (2+ / 0-)
    Recommended by:
    sunbro, NotGeorgeWill

    Fining people for not purchasing what they can't afford
    helps how? I would love to see everyone on healthcare insurance. However having people's wages garnishing wages because they can't afford to pay seems to make things worse. Let's say that both plans have the same fundamental flaw which is over reliance on the private insurance carriers. Is the US ready for govt. managed healthcare? I too saw Sanjay Gupta's Broken Government special and mandates seemed punitive for people of a certain salary range. regardless it seems Krugman has spent more time on this (Obama) than even talking about the recession.

    No race has a monopoly on intelligence or beauty . . . there is room for all at the rendezvous of victory--Aime Cesaire

    by Sansouci on Sun Feb 03, 2008 at 10:51:48 PM PST

    •  The mechanism will be up to Congress (2+ / 0-)
      Recommended by:
      miriam, splashy

      and as Hillary said today, one option is simply mandatory enrollment.

      As to affordability, low income earners are subsidized, and maximum premiums are capped at a percentage of income.

      Let's say that both plans have the same fundamental flaw which is over reliance on the private insurance carriers.

      Not true. Clinton offers open access to Medicare. Obama limits access to a pilot program for people who are otherwise not covered, a la free market experimentation. This is a major problem because the public Medicare option should be the most successful option, and out-compete wasteful private policies. The public option should draw a flood of participants, but Obama won't let us all choose it. And he has to know that, once established, expanding a public program will be harder than hell. We have this thing called Congress, and we'll only have one shot at this for a decade or more.

      •  Where does Clinton offer open access to Medicare? (0+ / 0-)

        It's certainly not in the description of her plan on her website.

        As for the mechanism of enforcement of the mandates "being up to Congress," EVERYTHING is up to Congress.  But by using this dodge to avoid saying exactly how she'd propose to enforce her mandates, she no more has a plan that will IN FACT cover everybody than Obama does, because she has no plan at all.  Mandates are ONLY effective to the extent that they can be enforced, and if she refuses to say how they would be enforced, there is no indication that anybody would obey them.

        "Those who would sacrifice liberty for security deserve neither liberty nor security." -Ben Franklin

        by leevank on Sun Feb 03, 2008 at 11:39:19 PM PST

        [ Parent ]

  •  This isn't rocket science (3+ / 0-)
    Recommended by:
    Athena, Pacific John, Montague

    Hillary has spent years trying to make health care available for all Americans.  She's not going to let go of this issue, and its passage will define her presidency.  This is a make or break deal for her.  On the other hand, Obama has already said he doesn't want to fight the fights of the past. Do you honestly think that universal health care will happen during an Obama presidency?  Not a chance.

    Clinton/Obama 08 The Team to Beat!

    by Izarradar on Sun Feb 03, 2008 at 10:56:19 PM PST

    •  keep in mind (2+ / 0-)
      Recommended by:
      highacidity, NotGeorgeWill

      that Hillary's first attempt at this was a debacle.

      It was George Mitchell's plan that was derailed by negative advertising.  Hillary's plan failed because it was a complete mess.  

      Does that qualify her as the best person to get it done?

      •  Yes, it does. (0+ / 0-)

        She cared enough to try.  And she's not backing down because she failed.  That kind of tenacity is what America is all about---You get knocked down, but you get up and still go after it.  THAT'S what the American dream is all about.

        Clinton/Obama 08 The Team to Beat!

        by Izarradar on Mon Feb 04, 2008 at 08:44:09 AM PST

        [ Parent ]

  •  Clinton with narrow majority (8+ / 0-)

    ... or Obama with a working majority.

    Which is more likely to get something done on healthcare?

    I say Obama.

  •  You know what's great about Krugman's numbers (5+ / 0-)

    He says that 45 million Americans (all of whom are uninsured) will be covered under the use of individual mandates.

    That figure - 45 million - includes 12 million undocumented workers. Krugman's numbers are f-ed up, as both Obama and Clinton have admitted that their plans would not cover undocumented workers.  

    Maine did a health care study on the use of individual mandates with a 50% equal employer contribution. At FPL levels 100%, 200%, 300%, 400% and on, it went as:
    6800, 6400, 6200, 6000, 6000, etc. on cost by income level. The charts showed that for individual mandates, those under the 400% FPL had to pay more, and that they would be disproportionately hurt even with a sliding income system.

    Moreover, Krugman is being disingenuous. In Mass, loads of people under a certain income (probably 400% FPL) were waived from the individual mandate. The mandate only applied, then, to people who could afford it. In other words, it did very little.

    Last, but not least, here's the guy Krugman quoted on Mass's health care plan:

    A state panel yesterday outlined for the first time the minimum requirements for coverage under the state's new health insurance law, a package estimated to cost $380 a month on average for an individual, more than $100 above recent estimates.

    Panel members struggled yesterday to balance affordability with protection from catastrophic medical bills and remained divided on many issues.

    "If we're going to mandate this, people need to see that they're getting some value," said panel member Jonathan Gruber, an economics professor at the Massachusetts Institute of Technology. But, he added, the premium is "bad news."

    "To whom much is given, much is expected" - Michelle Obama '08!

    by bhagamu on Sun Feb 03, 2008 at 11:00:57 PM PST

  •  oh well Krugman can't always be right (2+ / 0-)
    Recommended by:
    highacidity, NotGeorgeWill

    I've respected a lot of his pieces on bush and the economy, but he is flat wrong on Obama imho.

    I like a little rebellion now and then. It is like a storm in the atmosphere ~ Thomas Jefferson

    by valadon on Sun Feb 03, 2008 at 11:06:19 PM PST

  •  I prefer Obama's plan (7+ / 0-)

    to watching Hillary fail to reform healthcare.


  •  oh please, all 3 planes are the same basically (4+ / 0-)

    If you want socialized insurance, a first step to REAL universal healthcare which nobody is offering right now, then vote OBAMA.

    He will actually get elected.

    You wont get anything when Hillary loses to McCain.  Her strongest point right now is that she has "experience", does she have more experience then McCain?  Can she sell that in the general?

    Can she run against him on the war when she voted for the war?  She doesnt even regret her vote!  She still thinks her vote was the right thing to do!

  •  This is a ridiculous post (3+ / 0-)

    It's the same reason politics in general is ridiculous. Nothing says that once Obama becomes president he couldn't change the plan based on feedback. Same with Hillary's.

    Have any of you ever worked for profit? People toss out ideas and they get refined until the best product or service is delivered. To say the first proposition is the gold standard and Obama couldn't change direction is so fucking stupid. It really is blatantly fucking retarded.

    To say "We will Not get Health Insurance" based on the campaign messages to date is beyond ludicrous. Krugman and you are both fools on this one, and I like Krugman. But, you are still proven fools.

  •  From America's newspaper 'of record...' (2+ / 0-)

    that endorsed Billary.   Bah, scam - you don't scare me one bit. It's the politics of negatives again. Same deal, new day.

    Obama's not ready on day one, vote for hillary or you won't get healthcare... What a load of tripe. take it down creep.

    First they ignore you, then they laugh at you, then they fight you, then you win. -Mohandas Gandhi

    by ezdidit on Sun Feb 03, 2008 at 11:12:14 PM PST

  •  No one is going to force me to buy (5+ / 0-)

    health insurance that still has "corporate profit" in the price. I'm not alone.  Every poll I've read says that most Democrats, let alone Americans, agree with me.  Force me to buy into a single payer tax funded program, definitely.  But I won't stand for being forced to line the pockets of Hillary's corporate donors.

    Frankly, no one is taking Krugman seriously on this issue anymore.   He's become a charicature of himself.

    by keeplaughing on Sun Feb 03, 2008 at 11:13:59 PM PST

  •  They're both bad plans as long as (4+ / 0-)

    "insurance" is the delivery system.

    Health for profit has GOT to GO!

    Universal Health CARE not universal health insurance.


    "You can't be neutral on a moving train." - Howard Zinn

    by bigchin on Sun Feb 03, 2008 at 11:14:57 PM PST

  •  Garnishing Wages = No President Hillary = No UHC (6+ / 0-)

    "Hillary Clinton Will Garnish Your Wages."

    "Hillary Clinton Will Garnish Your Wages."

    "Hillary Clinton Will Garnish Your Wages."

    That is all we are going to hear for months and months and months until President John McCain is elected.

    With the implementation of Obama's plan, we will indeed see that there is a problem with people forgoing insurance. But we will then be able to solve it. Perhaps we will change the law to a mandate, or perhaps (my biggest hope) we will decide that healthcare should be paid in taxes, and received through Medicare. Medicare for all. That is my dream. It is not possible now. But it can be.

    After all we've been through as a country, to have hope again feels so good.

    by Michael D on Sun Feb 03, 2008 at 11:18:35 PM PST

  •  Hillary Said Her Plan Will Garnish Wages From (2+ / 0-)
    Recommended by:
    NotGeorgeWill, tampa traveler


    Hillary on ABC's This Week: "I think there are a number of mechanisms" that are possible, including "going after people's wages, automatic enrollment."

    Obama / Edwards '08 REAL Change From The Status Quo

    by DFutureIsNow on Sun Feb 03, 2008 at 11:20:40 PM PST

  •  Obama's plan is better (2+ / 0-)

    The argument for mandates seems primarily to be that if you don't have a mandate, some healthy people might not sign up, which skews the risk pool; or that they might not sign up until they get sick and need to jump in so they can receive care.  

    While it is true that these individuals might take these approaches, the main reason anyone would skip signing up is the cost.  No one can predict if they will get in an accident or suddenly be diagnosed with cancer or some other problem, so I think there is a built-in desire for most people to want medical coverage.  However, if it's too expensive, that's where they decide to take their chances and that is why Obama's plan is more concerned with making coverage affordable.

    Also, politically speaking, passing a plan with a mandate will be a lot tougher than passing a plan without one.  If it turns out that not enough healthy people are enrolled, then, okay, fine, maybe that will be the time to start amassing the political capital to modify the existing plan to add a mandate, but getting any plan passed in the first place will be unlikely if it includes an individual mandate.

  •  Garnishing wages is not a solution (4+ / 0-)

    Who will be most impacted by this proposed garnishing?  Low income Americans.  Those that live precariously from paycheck to paycheck.  Where $100 can keep heat and electricity on.  These are the people least able to afford it.  

    Our health care system is broken.  But garnishing the wages of low income workers to pay for "universal health care" does not seem like a logical solution to the problem.  

    Finally, the tone of this diary is exactly why I know that Obama is the only candidate who can unify our country.  Wouldn't expect less from a SusanHu diary.

    Fox is to "news" as WWE is to "wrestling."

    by skisb on Sun Feb 03, 2008 at 11:21:45 PM PST

    •  Exactly. You nailed it. (1+ / 0-)
      Recommended by:

      Universal Health Care should be single payer. If ou can't pay for it from taxes, you absolutely shouldn't make it mandatory.

      What happens to the poor bastard who has a financial disaster and can't make his payments? It's bad enough dealing with just the IRS, we don't need yet another government agency demanding that we pay tribute.

      You know what? I do want Obama to be my hip black friend.

      by tampa traveler on Sun Feb 03, 2008 at 11:56:07 PM PST

      [ Parent ]

  •  Moving to Single Payer vs. Subsidizing Corps (1+ / 0-)
    Recommended by:
    Great Uncle Bulgaria

    Everything's up in the air and it's largely a matter of who you trust to follow through. (Easy 4 me)

    The most important thing is to open the Federal Employees' Plan to everyone asap. It's a wonderful modified single-payer like Canada which regulates charges and premiums. Of course it would have to be voluntary to move to that plan to not scare people, but I'm sure that within a few years 90% of people and businesses would change to it voluntarily. As in other countries (like Canada) there will then be increasing public demand to increase government subsidies for moderate-income people and increase benefits and coverage.

    The alternative is from people like the Clintons who get health industry lobbyist money. That is to require everyone by law to buy insurance from private companies and give tax deductions for the premiums. This is more a way to subsidize private companies and save them from the losses they incur having to treat uninsured people.Usually when this happens the "subsidy" just turns into higher pricing  , so it's great for the companies. (This is a problem I have with BHO's $4000 credit for college, it will just lead to tuition going up $4000.)

    But the bottom line is are we going to start on the road to a modified single payer (BHO) benefiting citizens, or go down the familiar road of subsidizing corporations with tax deductions (HRC).  

    Personally it's unbelieveable to me that we regulate  
    everything from telephone fees to electric rates but we don't regulate health care costs.

  •  Yeah, GREAT IDEA! (1+ / 0-)
    Recommended by:
    Great Uncle Bulgaria

    Let's elect a President who is proposing a plan that has absolutely no chance of passing and will galvanize the right wing against any of her proposals.

    She couldn't get it right the first time, why should we trust her now?

  •  We should all just be thankful that (0+ / 0-)

    Obama did the honors of killing this stupid mandated health insurance idea before we had to run on it in the general election. That anyone would even propose and/or argue for such a coercive and authoritarian approach to solving this health care crisis shows just how out of touch with the American people some Democrats really are.

    This proposal is political suicide, plain and simple. It seems dumb from a policy standpoint also (why not just make it affordable and good first, then worry about the free riders), but the policy is beside the point. It's dumb politically, and Hillary is in no position to tout her judgment with respect to how to sell health care reform to Congress and the American people, having miserably failed and doomed the issue for generation already.

    But the question I would like to see ask is this: if mandates are what makes Hillary's proposal universal and Barack's not, couldn't we get universal health care by simply passing a law requiring every American to buy health insurance for themselves and their families, without even worrying about subsidies, and cost reductions and all of the rest? Wouldn't that still be "universal health care"?

    •  What are you talking about? (2+ / 0-)
      Recommended by:
      linnen, splashy

      BOTH of them are for mandates. It's just that Obama's are "back door" mandates--i.e. you get penalized if you apply for insurance once you actually need it. He's probably trying to avoid endorsing mandates--although he clearly realizes that they're necessary--for political reasons, to get them in under the radar. But aside from how they're being presented, their plans are almost identical, a private-public compromise that borrows (steals?) heavily from Edwards' original plan. And of course mandates are necessary. How else do we keep costs down? And both candidates support subsidies for lower-income people. Nor are mandates and universal insurance politically "suicidal". The public overwhelmingly wants it. The real problem is neutralizing the other side, which will go all-out to kill it.

      Read up on the actual plans before spouting CW RW talking points. This ain't 1994.

      I just changed my sig line again because some other bozo asked me to.

      by kovie on Mon Feb 04, 2008 at 12:11:37 AM PST

      [ Parent ]

      •  Forcing people to buy something that they (0+ / 0-)

        either don't want or can't afford is not the same thing as penalizing people for gaming the system once they do want/need health insurance.

        Otherwise, I would agree that the plans are similar. I think it's silly to be arguing their finer points when whatever comes out of Congress will likely bear little resemblance to what is proposed.

        "Race Doesn't Matter"

        by pragprogress on Mon Feb 04, 2008 at 12:46:47 AM PST

        [ Parent ]

        •  What people want and what they need-- (2+ / 0-)
          Recommended by:
          linnen, splashy

          and what society needs--are sometimes two different things. Some people want to drive without auto insurance or sell heroin to children. Should we let them do that just because it's what they want? The reality is that with health care costs so high and everyone needing it sooner or later, it's simply irresponsible to not have insurance, even if you probably won't need it yourself for a while. You will, eventually, and your initial investment will almost certainly pay off down the line. And in the meantime, other people get to have the health care that they DO need, at more affordable prices.

          The only people whom this would be "unfair" to would be low-income people, and both candidates have already emphasized that they'd be subsidized so the insurance that they'd be "forced" to buy would be affordable, and possibly even free. No one's talking about taking food out of the mouths of the children of poor people. That's a straw man.

          I just changed my sig line again because some other bozo asked me to.

          by kovie on Mon Feb 04, 2008 at 01:00:00 AM PST

          [ Parent ]

          •  Several fallacies here . . . (0+ / 0-)
            1. "Insurance" is supposed to cover YOUR risk, not the risks of others. If the system relies on those who are unlikely to use much in the way of health care to subsidize the care of those who will be using more, all that that tells me is that those relatively healthy people will not be paying premiums based on their actual level of risk. Theoretically, the system as a whole should not care who does or does not become a part of it because each person is being charged a premium that reflects their individual risk factor.
            1. That these irresponsible "free riders" are so critical to the financial health of the system is further proof that the subsidies will be insufficient for many. We are obviously looking to get a significant amount of money out of the people who do not currently have health insurance, and a very small percentage of that group is affluent.
            1. Health insurance is not the same thing as health care. Ultimately, what difference does it make if the federal government pays for the care of people who cannot afford it at the time they go to the clinic or hospital for the care they need or by subsidizing their premium? Right now the federal government pays close to 50% of all health care costs in America, and to the extent that will change under any new plan, I'd rather the new money be applied to additional health care rather than health insurance.
            1. Having health insurance does not guarantee that you will receive the health care that you need when you need it; just as Natalie Sarkysian's parents.
            1. It is not the same thing as auto insurance or selling heroin to children. If you don't want to buy auto insurance, you don't have to. You just can't drive. You don't have to sell heroin to children or anyone else either. But you will have to buy health insurance, just by the bare fact that you are alive. That is oppressive.
            1. It's not just about whether or not someone will or will not buy health insurance; it's a question of bargaining power. How can I expect to get a good deal on any product where I don't have the ability to reject it? How much more fundamental a principle of capitalism is there than that lack of freedom of choice leads to higher prices?

            "Race Doesn't Matter"

            by pragprogress on Mon Feb 04, 2008 at 07:48:03 AM PST

            [ Parent ]

            •  Too many points to respond to here (0+ / 0-)

              But basically, if you're looking for a perfect system in which everyone gets to pick the insurance coverage they want at the price that they want to pay--or no insurance at all--that is affordable to society and provides everyone with great health case, you're SOL. Compromises will have to be made, and one of those is that risk needs to be pooled--i.e. everyone other than the poor will have to pay in something, whether they like it or not, and everyone will receive some minimum level of health care.

              There will be "choice"--i.e. if you foolishly choose to not buy coverage, you will have that choice, but you're going to pay for it one way or another, either via penalties, or by paying more than you would have for health care when you end up needing it.

              You entire argument is based on the belief that a likely very small set of people--i.e. those who can afford insurance but foolishly don't want to buy it--will be "penalized" by universal health insurance. So be it. I'm quite ok with these people "suffering" for their foolishness. There are also people who don't believe that they should have to pay social security taxes either. Tough on them. The system is designed to serve the needs of the many, not the all.

              I fail to see who else would "suffer" from a well-crafted and implemented universal health insurance system. No one who already has good insurance would pay more for it or get worse coverage or care than they do now. So what's the problem? A few silly stragglers who think that selfish libertarianism, "rugged individualism" or plain old denial are respectable lifestyle choices that we must respect and tailor government around?

              I just changed my sig line again because some other bozo asked me to.

              by kovie on Mon Feb 04, 2008 at 09:25:06 PM PST

              [ Parent ]

  •  too much mis-information here (1+ / 0-)
    Recommended by:

    nice hit diary though -- good night ;)

  •  That pamphlet is astonishing (2+ / 0-)
    Recommended by:
    miriam, invisiblewoman

    I can't believe the Obama campaign put that thing out.   It has to be the work of the Heritage Foundation or the Club for Growth.

    Inhofe is a wacko with a 46% approval rating: He's vulnerable.

    by tmendoza on Sun Feb 03, 2008 at 11:35:45 PM PST

    •  why? (1+ / 0-)
      Recommended by:
      Great Uncle Bulgaria

      Mandates=liberal orthodoxy?  I don't think so.

      If wishes and buts were clusters of nuts we'd all have a bowl of granola!

      by vejoaronda on Sun Feb 03, 2008 at 11:45:07 PM PST

      [ Parent ]

      •  He attacks the very idea of universal coverage (3+ / 0-)
        Recommended by:
        linnen, splashy, invisiblewoman

        Obama seems to think it is wrong for Hillary to "force" everyone to buy insurance.  Thats the essence of any universal health care plan in the world.  Its in some measure coercive, although liberals typically support this because we think the benefits of requiring everyone to have insurance far outweigh the costs of constraining a person's liberty by some degree (either "forcing" them to buy insurance or "forcing" them to pay higher taxes to pay for single payer).

        Inhofe is a wacko with a 46% approval rating: He's vulnerable.

        by tmendoza on Mon Feb 04, 2008 at 12:03:40 AM PST

        [ Parent ]

        •  sorry (0+ / 0-)

          many other nations with UHC don't use mandaaaaaaateeeeessssss.

          If wishes and buts were clusters of nuts we'd all have a bowl of granola!

          by vejoaronda on Mon Feb 04, 2008 at 12:05:26 AM PST

          [ Parent ]

          •  Agreed (0+ / 0-)

            Any UHC plan will require some coercion for it to work,  most especially single-payer countries.  Obama is attacking the idea of the government coercing people into having health care.  Can you really argue with a straight face that he would be against mandates, but for getting rid of the entire insurance industry and having a government run system?  What happened to his fear about "forcing" people into a health care plan?

            The fact is Obama likes to appeal to conservatives, so he doesn't want to have mandates in his plan, else people will think of him as a liberal.  So he wins big margins among independent voters, and we sacrifice any hope for universal health care in the next presidency.

            Inhofe is a wacko with a 46% approval rating: He's vulnerable.

            by tmendoza on Mon Feb 04, 2008 at 12:09:59 AM PST

            [ Parent ]

  •  90 Healthcare Experts Say That Krugman is Wrong (12+ / 0-)

    Here's a letter signed by more than 90 of the most prominent names in healthcare policy and practice.  Krugman clearly isn't being "fair and balanced."  Just look at these names:

    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.


    Stuart Altman
    Dean and Sol C. Chaikin Professor of National Health Policy
    Heller School for Social Policy and Management
    Brandeis University

    M. Gregg Bloche, MD, JD
    Professor of Law
    Georgetown University
    Non-Resident Senior Fellow
    The Brookings Institution
    Adjunct Professor
    Bloomberg School of Public Health
    Johns Hopkins University

    Nicholas A. Christakis, MD, PhD, MPH
    Department of Health Care Policy
    Harvard Medical School
    Department of Sociology
    Faculty of Arts and Sciences
    Harvard University

    David Matchar, MD
    Professor of Medicine
    Director, Center for Clinical Health Policy Research
    Duke University Medical Center

    E. Richard Brown, PhD
    Professor of Health Policy
    UCLA School of Public Health

    Henry J. Aaron
    Senior Fellow, Economic Studies
    The Bruce and Virginia MacLaury Chair
    The Brookings Institution
    Paul Weiler
    Emeritus Professor of Law
    Harvard Law School

    Elliott S. Fisher, MD, MPH
    Professor of Medicine and Community and Family Medicine
    Director, Center for Health Policy Research
    Dartmouth Institute for Health Policy and Clinical Practice.

    Harold Pollack, MPP, PhD
    Faculty Chair, Center for Health Administration Studies
    Associate Professor
    School of Social Service Administration
    University of Chicago

    Lainie Friedman Ross, MD, PhD
    Carolyn and Matthew Bucksbaum Professor of Clinical Ethics
    Professor, Departments of Pediatrics, Medicine, and Surgery
    Associate Director, MacLean Center for Clinical Medical Ethics
    University of Chicago

    David Blumenthal, MD, MPP
    Director, Institute for Health Policy
    Physician, Massachusetts General Hospital
    Samuel O. Thier Professor of Medicine
    Harvard Medical School
    Professor of Health Care Policy
    Harvard Medical School

    Theodore Marmor, PhD
    Professor Emeritus of Public Policy and Management
    Professor Emeritus of Political Science
    Yale School of Management

    Barbara Starfield, MD, MPH
    University Distinguished Professor
    Johns Hopkins University

    Paula Lantz, PhD
    Professor and Chair
    Department of Health Management and Policy
    University of Michigan

    Mark Schlesinger, PhD
    Professor of Health Policy
    Yale University

    Nancy L. Keating, MD, MPH
    Associate Professor of Medicine and Health Care Policy
    Harvard Medical School

    Gerald F. Kominski, PhD
    Associate Dean for Academic Programs
    Professor, Department of Health Services
    UCLA School of Public Health

    Diane S. Lauderdale
    Associate Professor
    Department of Health Studies
    University of Chicago

    David Cutler
    Otto Eckstein Professor of Applied Economics
    Harvard University

    Einer Elhauge
    Petrie Professor of Law
    Director, Petrie-Flom Center in Health Law Policy
    Harvard Law School

    Kathleen A Cagney
    Associate Professor
    Department of Health Studies
    University of Chicago

    Ronald S. Sullivan Jr.
    Clinical Professor of Law
    Director, Harvard Criminal Justice Institute
    Harvard Law School

    Henry J. Steiner
    Jeremiah Smith, Jr. Professor Emeritus
    Harvard Law School

    Martha Minow
    Jeremiah Smith, Jr. Professor
    Harvard Law School

    Jerry Mashaw, PhD
    Sterling Professor of Law and Management
    Yale University

    Laurie Zoloth, PhD
    Director, Center for Bioethics, Science and Society
    Director, Brady Program in Ethics and Leadership
    Professor of Medical Humanities and Bioethics
    Feinberg School of Medicine
    Northwestern University

    Dayna Bowen Matthew
    Associate Dean of Academic Affairs
    Professor of Law
    University of Colorado School of Law

    Elizabeth Bartholet
    Morris Wasserstein Professor of Law
    Faculty Director, Child Advocacy Program
    Harvard Law School

    Ellen Meara, PhD
    Department of Health Care Policy
    Harvard Medical School

    Donald E. Fry, MD, FACS
    Professor Emeritus
    Department of Surgery
    University of New Mexico School of Medicine

    Mark E. Courtney
    Ballmer Endowed Chair for Child Well-Being
    School of Social Work
    University of Washington

    Jacqueline Fox
    Assistant Professor
    School of Law
    University of South Carolina

    Oliver Oldman
    Learned Hand Professor of Law, Emeritus
    Harvard Law School

    Jane Loewenson
    Nueva Vista Group LLC

    Laurence H. Tribe
    Carl M. Loeb University Professor
    Harvard Law School

    Thaddeus Mason Pope, JD, PhD
    Visiting Professor, Widener University School of Law
    Senior Scholar, Thomas Jefferson University Medical College
    Assistant Professor of Law
    University of Memphis School of Law

    Mervin Shalowitz, MD Visiting Scholar
    Kellogg School of Management
    Northwestern University

    Barbara A. Noah
    Associate Professor
    Western New England College School of Law

    William Pitsenberger
    Adjunct Professor, Health Law and Policy
    Washburn University School of Law

    Philip J. Rosenthal
    Department of Medicine
    University of California, San Francisco

    Sarah-Anne Schumann, MD
    Clinical Associate
    Department of Family Medicine
    University of Chicago Pritzker School of Medicine
    Chicago Family Health Center

    Daniel H. Lowenstein, MD
    Professor of Neurology
    Director, Physician-Scientist Education and Training Programs
    University of California, San Francisco

    Jonathan Skinner, PhD
    Dartmouth College & Medical School

    Robin Henry Dretler MD, FIDSA
    Infectious Disease Specialists of Atlanta

    Laurel Coleman, MD, CMD, FACP
    Augusta, Maine

    Ann M Labriola, MD
    Associate Professor of Medicine
    Division of Infectious Diseases
    Department of Medicine
    George Washington University Medical Center

    Jens Ludwig
    Professor of Social Service Administration, Law, and Public Policy
    University of Chicago

    Norman Daniels
    Professor of Ethics and Population Health
    Harvard School of Public Health

    Donald H. Taylor, Jr. Ph.D.
    Assistant Professor of Public Policy
    Duke University

    Colleen Grogan
    Faculty Director, Graduate Program on Health Administration and Policy
    Associate Professor
    School of Social Service Administration
    University of Chicago

    Leon Wyszewianski, PhD
    Associate Professor
    Director, Executive Master's Program
    Department of Health Management and Policy
    University of Michigan School of Public Health

    John Henning Schumann, MD
    Section of General Internal Medicine
    MacLean Center for Clinical Medical Ethics
    Human Rights Program
    University of Chicago

    Michael Pine
    Lecturer in Medicine
    University of Chicago

    Wade S. Smith, MD, PhD
    Professor of Neurology
    University of California, San Francisco

    Keith W.L. Rafal, MD, MPH
    Assistant Clinical Professor
    Brown University Medical School

    Bob Arnold
    Professor of Medicine
    Leo H Criep Chair in Patient Care
    Chief, Section of Palliative care and Medical Ethics
    University of Pittsburgh

    James Tulsky, MD
    Professor of Medicine and Nursing
    Duke University

    William M. Altman, JD, MA
    Senior Vice President of Strategy and Public Policy
    Kindred Healthcare, Inc.

    Rebekah E. Gee, MD, MPH
    Robert Wood Johnson Clinical Scholar
    University of Pennsylvania

    Clarissa K. Wittenberg
    Health Education Consultant

    Jason Block, MD
    Brigham and Women's Hospital

    Harlan M. Krumholz, MD SM
    Harold H. Hines, Jr. Professor of Medicine
    Yale University

    S. Claiborne Johnston, MD, PhD
    Professor of Neurology and Epidemiology
    Director, Stroke Service
    University of California, San Francisco

    Richard Kronick
    Department of Family and Preventive Medicine
    University of California, San Diego

    Maggie Czarnogorski, MD
    George Washington University
    Carl Vogel Center, Medical Director

    Howard P. Forman MD, MBA
    Professor of Diagnostic Radiology, Management, and Public Health
    Lecturer, Economics
    Director, Yale MD/MBA Program and Yale MBA for Executives: Leadership In Healthcare
    Yale University

    William Terry, MD
    Brigham and Women's Hospital

    Rahul Rajkumar, MD, JD
    Brigham and Women's Hospital

    Frederick A Masoudi, MD, MSPH
    Associate Professor of Medicine (Cardiology)
    Denver Health Medical Center

    David A. Richardson
    Health Care Consultant

    Helen Levy, PhD
    Research Assistant Professor
    University of Michigan

    Robert Burt, JD, MA
    Yale Law School

    David B. Wilkins
    Kirkland & Ellis Professor of Law
    Director Program on the Legal Profession
    Harvard Law School

    Gene Webb, PhD
    Manager of Planning
    Biological Sciences Division
    Pritzker School of Medicine
    University of Chicago

    Nikhil Wagle, MD
    Brigham and Women's Hospital

    Clifford E. Douglas, JD
    Executive Director, University of Michigan Tobacco Research Network
    Adjunct Lecturer, University of Michigan School of Public Health
    Senior Policy Fellow, Michigan Public Health Institute

    Thomas G. McGuire
    Professor of Health Economics
    Department of Health Care Policy
    Harvard Medical School

    Robert A. Berenson, MD
    Senior Fellow
    The Urban Institute

    Stanley S. Wallack
    Heller School for Social Policy and Management
    Brandeis University

    Charles J. Ogletree, Jr.
    Jesse Climenko Professor of Law,
    Harvard Law School

    Jon Klein, MD, PhD
    James Graham Brown Foundation Endowed Chair in Proteomics
    University of Louisville

    Sara Rosenbaum
    Chair, Department of Health Policy
    Harold and Jane Hirsh Professor of Health Law and Policy
    Professor of Health Care Sciences
    George Washington University

    John C. Coates IV
    John F. Cogan, Jr. Professor of Law and Economics
    Harvard Law School

    Peter J. Hammer
    Professor of Law
    Wayne State University Law School

    Meredith B. Rosenthal, PhD
    Associate Professor of Health Economics and Policy
    Department of Health Policy and Management
    Harvard School of Public Health

    Barron H. Lerner, MD, PhD
    Professor of Medicine and Public Health
    Columbia University

    Lucian L. Leape, MD Harvard School of Public Health

    Kasturi Haldar
    Charles E. and Emma H. Morrison Professor
    Department of Pathology
    Northwestern University

    •  DEFINITELY diary this (4+ / 0-)
      Recommended by:
      onanyes, fhcec, Aliosman, NotGeorgeWill

      susanhu needs to be countered!

      If wishes and buts were clusters of nuts we'd all have a bowl of granola!

      by vejoaronda on Sun Feb 03, 2008 at 11:46:03 PM PST

      [ Parent ]

    •  Thank you for this (4+ / 0-)
      Recommended by:
      fhcec, begone, Aliosman, NotGeorgeWill

      Please make it into a diary.  It's extremely important.

      "Those who would sacrifice liberty for security deserve neither liberty nor security." -Ben Franklin

      by leevank on Sun Feb 03, 2008 at 11:47:43 PM PST

      [ Parent ]

    •  This doesn't contradict Krugman. (0+ / 0-)

      The key passage in the cited document is:

      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.

      From what I've read, Krugman has argued that, unless health insurance is mandated (and those mandates are enforced), the plan is prone to failure.  I don't see how the cited document contradicts him.

    •  Paul Krugman is not the conservative, Obama is (0+ / 0-)

      this is another example of Obama supporters turning themselves inside out to defend their candidate.

      Obama made a poltical decision when he put out this compromise ahead of time....and now he uses his poor plan to attack hers, unfairly and untruthfully, and Krugman has been there, a lonely voice in the wilderness since 2001...and he is the progressive.

      it all hangs together----on every policy position from health care to energy proposals and votes by the way to his initally appalling stimulus plan, that he is the conservative in this race and she is the progressive.

      When George landed on that aircraft carrier in triumphalist glee, I said they would rue the day...and those folks who care about a more progressive America will now rue the day they ever got led down the garden path to vote for Obama.

  •  Thanks for the excellent diary. Recommended! (4+ / 0-)
    Recommended by:
    markw, ranee, TracieLynn, splashy

    I am struck by the vitriol and hatred of so many of the Obamafans.  I cannot imagine that real Democrats act like I have seen on this site.  I am convinced that they must be recent Republicans who used to swoon for Bush in his flight suit and have come now to swoon for Obama.  What a loss of civility.  It is such a shame.

    The soul is not the ego in drag. Ken Wilber

    by macmcd on Sun Feb 03, 2008 at 11:46:24 PM PST

  •  A question for all Obama critics (2+ / 0-)
    Recommended by:
    brendanm98, Pometacom

    If he wins the nomination--which is looking more and more possible--after having a good cry or scream or double shot of scotch or tequila or whatever one does to get over a huge loss, will you support and vote for him in the general? Because this Obama supporter will certainly support and vote for Hillary if she wins.

    This is all that I need to know. The rest is all just campaign rhetoric and venting.

    And you all know it. They're not that different in policy and anyone who says otherwise--or believes that they'll actually govern as they campaigned--is just making stuff up or naive.

    And Krugman needs to stop being such a concern troll. This is starting to get really old. Their health insurance plans are essentially identical, and would be even more so as president. The real question is who has the greater political ability to make it happen, because in the end, it will come down to politics, not policy--and especially not ephemeral campaign policy.

    I just changed my sig line again because some other bozo asked me to.

    by kovie on Sun Feb 03, 2008 at 11:59:09 PM PST

    •  Let's See A LARGE Sampling of Obama Supporters... (1+ / 0-)
      Recommended by:

      here at "Daily Obama" join you in declaring your support for Clinton.

      I don't see it happening.

      This site has lost all credibility. The attacks against old-line Kossacks who won't drink the Hopey-Changey Obama-Aid have been relentless, vicious, and unwarrented. Any piece of gossip, whether sourced or a right-wing fantasy, that disses Clinton gets front page treatment, and if a diary, immediately zooms to the top of the charts.

      I'm not a Kossack, so I don't really care. You guys are the ones that are going to have to make nice. But it's depressing to see what once looked like it could be a force for progressive politics completely and utterly collapse into schoolyard, Freeper-esque bullshit.

      •  you do realize (0+ / 0-)

        that at this moment, YOU are the one being insulting.

        I will vote for HRC over any Republican but I won't pledge it or expect a pledge to vote for Obama in return.

        HRC supporters obviously have the right to vote for whoevever they want and it should depend on who I or other Obama supporters would vote for in a different scenario.  If you think McCain will be better for this country than Obama, you should vote for McCain regardless of what anyone else pledges to do.

        Trading votes is undemocratic.

      •  I tend to ignore and dismiss (0+ / 0-)

        rabid supporters of ANY candidate, who are too thin-skinned to handle criticism of their guy or gal, and prone to making attacks on the other candidates and their supporters. These people are not supporters so much as they are idiots and trolls and emotional basket cases drawn to politics as much by loneliness and other emotional issues as by actual concern for the issues. I've come across relatively few such supporters of any candidate, but when I have, it's invariably been an unpleasant experience. I suggest that you and others stay away from them, and stick to having intelligent and respectful discussions with emotionally balanced, civil and honest people. They do exist.

        I just changed my sig line again because some other bozo asked me to.

        by kovie on Mon Feb 04, 2008 at 12:55:15 AM PST

        [ Parent ]

      •  I basically agree (1+ / 0-)
        Recommended by:

        with all your points but one - you have a user name, you have a uid and you have an opinion.  Sorry, baby, but you're a kossack!

        The enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage others retained by the people. - 9th Amendment

        by TracieLynn on Mon Feb 04, 2008 at 06:48:21 AM PST

        [ Parent ]

    •  Obama said he wasn't sure his supporters (0+ / 0-)

      would support Clinton. got lots of air time yesterday . . . .

      •  He was referring to the kinds of swing voters (1+ / 0-)
        Recommended by:

        that he seems to be getting that would be unlikely to vote for Clinton. The real question though isn't whether they'd actually vote for her--chances are that they wouldn't--but rather whether they'd actually vote for him. I'm guessing that some would, but many others would not, and it's more dissatisfaction with their GOP candidates than love for Obama. However, because some of them would likely vote for him, his assertion does have some merit, I think, so long as it's taken to mean such swing voters, and not otherwise reliable Dem voters--the vast majority of whom will, I believe, vote for the party's nominee no matter who it is.

        Put simply, there appear to be substantially more possible Obama voters who would not vote for Hillary, than vice-versa. That's what his point was, I believe.

        I just changed my sig line again because some other bozo asked me to.

        by kovie on Mon Feb 04, 2008 at 12:50:37 AM PST

        [ Parent ]

      •  O was right (0+ / 0-)

        because O attracts I's and moderate R's that HRC wouldn't attract.

        But on the other hand, HRC attracts some I's and R's that he wouldn't get (professional women), so that factor works both ways, I think.

        When liberals saw 9-11, we wondered how we could make the country safe. When conservatives saw 9-11, they saw an investment opportunity.

        by onanyes on Mon Feb 04, 2008 at 02:44:42 AM PST

        [ Parent ]

  •  I recommend this for the sake of CHANGE (0+ / 0-)

    in diary configuration.

  •  What is the change we can believe in, exactly? (2+ / 0-)
    Recommended by:
    miriam, splashy

    Obama is firmly committed to not working for actual universal health care.  Why should liberals vote for him?  This is the single biggest domestic issue for many of us.  Should we have to wait until the 45th president to achieve truly universal care?  I don't think so.  We have an opportunity now.  Why would we pass on it?

    Inhofe is a wacko with a 46% approval rating: He's vulnerable.

    by tmendoza on Mon Feb 04, 2008 at 12:05:16 AM PST

  •  Krugman goes the way of Bill Clinton (1+ / 0-)
    Recommended by:

    for me. Heroes of the past who've now devalued themselves.

    Who controls the past, controls the future. Who controls the present, controls the past. George Orwell

    by moon in the house of moe on Mon Feb 04, 2008 at 12:09:18 AM PST

  •  Some things that Krugman left out (6+ / 0-)

    I spent the $5 required to download the paper on which Krugman based his column, and there were some important things that he left out.

    First, the paper includes the following acknowledgement, which Krugman nowhere admits (either in this column, or any of his others that I've seen:

    But mandates are politically unpopular, so politicians may want to focus instead on ensuring that everyone who wants insurance can afford to have it.

    The major objection to mandates is that including them in a plan effectively paints a gigantic target on the plan, and tells the opponents of ANY real reform, "Here's where to shoot."  The screams of anguish from Hillary supporters about the Obama mailer pointing out that mandates would force people to buy insurance that they didn't think they could afford are mild compared to what's coming.  Apparently, Hillary has really learned nothing from her previous experience with trying to get health insurance reform enacted.

    But more glaring is Krugman's omission of the following caveat that is present in the paper on which he bases his column:

    The second option is to move from the universal access approach in the first column to a universal coverage approach. This can be accomplished by adding an individual mandate, a requirement that all individuals obtain insurance coverage, to the universal access option. This is similar to what is required for auto insurance in many states, and was a centerpiece of the recent Massachusetts reform plan. We have no experience to date with such a mandate, so it is hard to predict the success of enforcement. But, if penalties are strong (as they are in Massachusetts, where individuals are liable for half of insurance premiums even if uninsured), the mandate is likely to be close to universal. For simplicity here I assume that the mandate provides close to universal coverage, although in practice some individuals are likely to "slip through the

    And footnote 16 states as follows:

    In particular I assume that 95% of those who would not voluntarily choose to insure are forced to insure through
    the mandate.

    The closest Krugman comes to acknowledging that these "estimates" amount to no more than WAFGs (Wild-Assed Fucking Guesses) is where he says:

    As with any economic analysis, Mr. Gruber’s results are only as good as his model.

    The problem isn't with Gruber's MODEL, it's with his ASSUMPTIONS, which Gruber (but not Krugman) acknowledges are based on no actual experience.  Any of us can pull numbers out of thin air, and justify any conclusions we want.  I can assume that people will thumb their noses at mandates, and they'll cover NOBODY who doesn't want to be covered.  (And as Gruber acknowledges, but Krugman never does, unless there are some pretty draconian penalties for non-compliance, there's likely to be widespread non-compliance.)

    I've really lost a great deal of respect for Krugman as a result of his cherry-picking Gruber's conclusions, without aknowledging the weak basis for his assumptions.

    And for the Hillary supporters who will undoubtedly insist that I made up the above quotes from Gruber's paper, you can register, pay $5, and download it from this source:

    "Those who would sacrifice liberty for security deserve neither liberty nor security." -Ben Franklin

    by leevank on Mon Feb 04, 2008 at 12:33:03 AM PST

  •  Public Insurance Like the Rest of the World (0+ / 0-)

    If either Clinton or Obama were interested primarily in ensuring ability to pay doesn't stop anyone from getting quality healthycare, they wouldn't have any new, untested, complicated plans.

    They'd just have national health insurance exactly like any other country we compete with.

    The US has the advantge over our competitors in that we can look at the track record of each of their plans, and adopt the one that suits us best. But practically all the ones that work at all discard private health insurance except as a luxury for people who want healthcare that really is beyond affordability for nearly everyone. Just like the US one does not.

    Since they don't just do that, they obviously have a higher priority: preserving the wasteful profits of the private healthcare industry.

    I don't care what Krugman says. Neither Clinton nor Obama have a healthcare plan that will work, because they're both rigged against public health. Of course no Republican does, either. So we're doomed to stand waiting probably at least another 8 years to get one.

    "When the going gets weird, the weird turn pro." - HST

    by DocGonzo on Mon Feb 04, 2008 at 12:34:38 AM PST

  •  Good diary, Susan. It appears, tho (2+ / 0-)
    Recommended by:
    linnen, splashy

    that a lot of people can't handle the facts by the experts if they don't make their candidate look good.

    It's an old favorite:  Don't confuse me with the mind is made up!

    Tell me how you spend your time and how you spend your money -- I'll tell you what your values are.

    by oldpro on Mon Feb 04, 2008 at 12:37:06 AM PST

  •  You can't charge an upfront fee (0+ / 0-)

    for health insurance. Our economy is now way too screwed up to allow it. Lots of people, like myself, just do not have the money to pay mandatory premiums. That money is going to paying for $3.50 a gallon heating oil to keep the pipes from freezing and $400 bills to keep the car running.

    This should not be a difficult concept for people to understand.

  •  Obviously, The United Healthcare Workers (0+ / 0-)

    strongly disagree. I think they know more about healthcare than Mr. Krugman. Krugman really seems to "go out of his way" to ATTACK Obama. The differences in Obama's and Clinton's health care plans are NOT that big of a deal. It makes me wonder if Mr. Krugman has some form of personal "agenda".

  •  As someone who worked on the leading (0+ / 0-)

    edge of the health insurance industry last year, I have an announcement to make.

    Krugman has officially jumped the shark.

    Obama, a true inspiration.

    by SleepingWillow on Mon Feb 04, 2008 at 01:48:47 AM PST


    Hillary would not have had her plan either. So, we still have to see how this is all going to be implemented. With a recession ahead this is for sure postponed - no matter who is going to be President. Already now, individual states have stopped their version of universial health care. Even the sponsors have pulled their own support because of the collapse of the economy. So, lots of trouble ahead. It is going to be extremely complicated to clean u p the mess Bush left to us. Most important saving of course is to get us out of Iraq.

  •  I think this diary makes a good point (0+ / 0-)

    I think it's true that mandates are necessary either sooner or later.

    What I disagree with though is this rhetoric about Sen. Obama being a Republican.  It's fear mongering.  There's absolutely no evidence of this and it's unhelpful in the debate.

  •  Unfortunately, this is true (0+ / 0-)

    Health care does not seem to be Obama's top priority.  I'm actually not sure what his top priority is other than ending the war (which of course is important) and reforming the government (which is important but somewhat nebulous).  I think Hillary Clinton would actually get Health Care done if she becomes President, and that would help address a lot of systematic economic problems in this country.  

  •  You are right, Krugman is right, Obama is wrong (1+ / 0-)
    Recommended by:

    thank you for excellent diary!
    It is unusual to find in friken obamakos something
    reasonable to read. Obamaniaks do not want to have your diary recommended - they are as wrong as charged.

    Also a few excellent diaries:

  •  I resent (0+ / 0-)

    the Clinton supporters' use of Krugman's columns as a baseball bat to hit everyone over the head with instead of acknowledging that all three Democratic candidates have/had universal health care plans that though they varied in some detail, are based on the same basic skeleton.  Selection of one of those plans over another is not going to doom the nation.

    They're not as committed to universal health care as they think they are if they are not willing to acknowledge that there are some deep flaws in Sen. Clinton's plans.  

    Paul Krugman is just an economist with a big megaphone.  Economists disagree all the time.  Note the letter signed by 90 health care policy specialists who point out how wrong Krugman is.  He's wrong in this case.  As a matter of fact, at one point Krugman liked Obama's plan though not as much as he liked Edwards.  T.A. Barnhart has the details.

    And note this article on Krugman vs. Krugman.  Tell me he hasn't been "bought out" by the Clinton campaign.

    Clinton supporters don't want to acknowledge that there's any holes in their candidate's health care plan.  And they're willing to be intellectually dishonest about the way they use Krugman's columns to beat every one over the head.

    Enough already, SusanHu.  If this is all you have to say, go say it elsewhere.  You're not really interested in dialog.  If you're not willing to recognize that Sen. Clinton's plan has some deep flaws and that those flaws, ie., garnishing wages combined with Sen. Clinton's very high negatives will provide the Republicans with all they need to defeat her as the Democratic candidate, you're delusional.

  •  Wrong on so many levels. (0+ / 0-)

    Hillary's plan wouldn't get through Congress if you soaked it in holy water and offered them lunch at Old Ebbit Grill.

    NO ONE is going to get everything they want from ANY plan.  EVER.

    There are restrictions on Medicare.  There are restrictions on Medicaid.  There are restrictions on my CIGNA plan.

    ALL OF THEM COST MONEY.  And that money has to come from somewhere.

    Bush's FY budget for 2009 is being released this morning.

    The OMB will have all the official budget materials on their site.

    Health and Human Services will hold a press briefing at 1pm Eastern where they will go through the "Budget in Brief".

    The budget includes $5 billion in Administrative cuts and $178 billion in proposed Legislative cuts to Medicare over 5 years.

    Medicaid will be cut (proposed legislation) $17 billion but SCHIP will be reauthorized at $18.6 billion.

    Will mandates work?  I dunno.  I've been hit 3 times in my life in my car in states with mandatory liability coverage and none of them had insurance.

    I DO know I am not well inclined to trust a government fix.  The poor's safety net - Medicaid - is an unmitigated disaster.  Largely, in part, because it was made state and not federal and the states are broke.  (Old people vote.  Poor people do not.)

    Medicare has so many problems and is now facing $178 BILLION in cuts over the next five years.

    But for Krugman to demonize Obama's plan is so spot on stupid, I'm beginning to wonder about everything he has ever written.

    I have the distinction of being called a media whore by Courtney Love. -Maynard J. Keenan

    by arielle on Mon Feb 04, 2008 at 06:15:02 AM PST

  •  Why SusanHu is wrong (0+ / 0-)

    and it is actually worse than either she or Krugman have said.  I describe it in detail HERE, but simply stated, if people can opt out and then "pay a few back premiums," NOBODY will opt in and the insurance pool will be empty. If Barack adequately described his plan, the whole damned thing is a farce.

    If you refuse to vote for OUR PARTY'S nominee in November, the blood of a thousand back-alley abortions will be on your hands.

    by dhonig on Mon Feb 04, 2008 at 08:57:09 AM PST

Subscribe or Donate to support Daily Kos.

Click here for the mobile view of the site