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Universal Health Care is Good for Business

What we should be pushing is:

"Universal Health Care is good for business"

Companies do not manage health care well, it's a distraction and a headache, it's not their core competence.

Health care benefits make employees stay who should leave and make it hard for good employees to move around. Mobility drives our economy. 401(K) programs have let employees move their retirement around to great benefit and eased pension fund management for employers. Universal Health Care will do the same thing.

Not only that, employer selected health care programs tend to be cheaper and riskier against employees' health - which hurts companies long term when employees aren't treated and miss work. (And employees worried about health care and treatment aren't exactly focused on their jobs).

These arguments are as convincing as anything Hillary mentioned on O'Reilly and they can play well to the important business crowd (unless hating corporate America is one of our self-fulfilling needs).

How much time do corporations spend on Social Security? On 401(K) plans? On Health Care? Which model lets companies focus more on business?

[And yeah, click the Tip Jar/Recommend Button and I'll wag my tail 3 times]


Comments (139)

I agree. I think both candidates are just going about it wrong. That's just me.

I understand that everyone needs to be covered to bring down cost, so Obamas plan won't work quite right,

However I Also know that I don't actually trust insurance companies to lower costs. So being honest mandates scare the holy living hell out of me. The Clintons haven't shown themselves to be big on regulation. So we end up trusting these companies.

Actually, one contrary point - Barack doesn't rely on number of people in his plan to bring down costs.

While it is true that volume will lower plan premiums somewhat, the greatest savings will come from streamlining processing infrastructure and administrative functions as well as implementing information technology in a meaningful fashion across the entire medical industry. By focusing on single payer systems that free up providers to provide health services instead of insurance administration, our medical providers will be able to better manage delivery costs in the long term.

I find that best thing about Barack's plan is that it starts us down that path. As more people get on board, sweeping changes become possible as ordinary citizens start pressing their representatives to do more. But mandates and government-run plans will face stiff initial resistance from mainstream republicans who are suspicious of big government programs regardless of potential good. That is basically what killed Hillary's plan in 1993 - inflexible mandates.

We can instead promote a non-profit health care delivery system (Medstar and Kaiser Permanente are just two examples) supported by a single-payer non-profit insurance delivery system (think Fannie Mae) that may be something all parties can agree on. It could go a long way toward solving our problems and put on the path toward a health care system that works for every American.

Time to think outside the box on health care and follow what other countries have spent billions to perfect - non-profit health care, managed by government standards and delivered by private organizations and medical providers.

Seems fairly straightforward if our "leaders" would remove their lips from the corporate ass.

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(unless hating corporate America is one of our self-fulfilling needs)

This shouldn't even be a parenthetical statement. Corporate America is an issue that Dems can't seem to reconcile.

I wish you would write more about the O'Reilly interview, Desidero. I'm interested to know what you thought about it.

I was surprised because in the 90's it looked like Democrats were getting better at combining populist and corporate goals, and then Gore ended up running against business in 2000, mainly because of running against Bradley but also I think to separate himself a bit from Clinton - not from disagreement as much as being his own candidate.

I thought Hillary did well to get off Wright as quick as she could, gave a reasonable answer on health care, looked comfortable and traded jokes well (much better than her last appearances on Letterman & the Daily Show). Mostly she just came across as solid and likeable, and her point about reaching across the aisles is important even as she says she's going to keep fighting. There will be the audience who would just as well choose her as McCain at this point, and if she wins the whole thing, having some of the venom against her defanged could be a big help (though I won't bet the bank on that one). Of course it looked like a bit of a love-a-thon even with O'Reilly's sometimes tough comments. Such is the nature of propaganda. Watching part 3 now.

Well, lookie there, 2 comments not my own, 4 Recs not my own, almost survived to make the big list but will be eaten up by a "Cindy McCain was addicted on painkillers when she adopted in Bangladesh" ravel guide, a "Hillary was too furious with some congressman and that's why we don't have health care", another post on a 33-year-old rape case with some supposedly over-the-top cross-examination of a 12-year-old in a rape case. 2 Meta posts on TPM and then a couple more on Blumenthal. Not much room for health care and energy policy.

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If I could rec more than once, Desidero, I would. The Obamanauts are freaking because he's flaming out before their eyes. Some have kicked into high Hillary-hate mode to comfort themselves or to simply deny the obvious. Some you refer to are just plain nuts; always have been, always will be. A few may be too stunned right now to know what to say.

Thanks for the post and for the O'Reilly observations. If you had been more inflammatory, I'm sure you would have gotten more responses (if not more recs; they are hopelessly stingy). Maybe it's just that you didn't mention Hillary in the title.

If I had the time, I'd write a post about O'Reilly myself. One of my favorite moments was when Hillary said the word No seven times in a row to him. I was so amazed that I replayed it so I could count the Nos. Can't even remember what the topic was. Sanctuary cities?

I thought the interview was genius in many ways. The best short-term result will likely be reflected in the margin in Indiana.

Yeah, not many people read between 2:30AM and 8AM. Plus when folks start arriving at 8AM they push their stories out first and THEN read the lists.

Been there, done that. Best time to post is about 10AM.

I agree with this post (albeit for a slightly different reason) and I read your posts since they are usually of good caliber but the constant complaining about your victimization is really getting to be a turnoff.

Not implying any type of perfection in myself but you really just need to get over yourself. Shrug it off, check your objectivity and keep on topic. I think you will find a much more positive response overall after a couple posts.

Nice Post Des

I think the Dems were getting momentum, even had a few CEOs speaking out about it.

It all kind of fizzled when Bush got elected, it seems.

Not true, workerbee.

The cozy relationship that the Clintons developed with Wall Street and especially the financial sector in the 90's, continued quite well post-Clinton presidency.

Who do you think is so desperate to put the Clintons back in office?

By the old definitions, Hillary has joined the vast, right-wing conspiracy!

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You look like you are in love, clearthinker. Are you?

LOL! (Loving Out Loud)

Factless drivel, as usual.

Awww.... workerbee... at least thank me for getting this blog back on track to make the recommended list after it had unfairly went into obscurity because of the types of posts that Desidero mentioned.

I really am sorry you are always so angry! Have a great weekend!

You arte altogether too fond of declarations sans facts.

I'm not angry, I just never tire of pointing your lack of substance and intellectual laziness out.

If you had a problem with my statement, fine. Just don';t pretend your opinion is any better than my decidedly more mature one.

Just don';t pretend your opinion is any better than my decidedly more mature one.

More mature? Like all the times you said my posts were "BS"? Like all the times that you try to demonize me by calling me names such as "troll" and "shill"?

But I still have hope for you, workerbee. You did, after all, incorporate my comment to you into your TPM-aholic logo.

Have a good weekend!

Once again, factless drivel.

I won't mention that time you went into a dark thread and admittted to pushing child porn. How easy was that?

You rely too much on your perceived "reputation." I'm afraid it doesn't impress me.

I'm considering flagging this and reporting it to TPM for being out and out malicious and false.

You really are twisted... and not in a good way.

That's a very serious charge, workerbee.

Everyone take a deep breath-- that was a joke in order to illustrate a point, not an actual charge.

Reading over this comment and her subsequent comment that seems to be the case, but this is not an acceptable way to make one's point. This crosses a line of civility that should not be crossed.

I feel your pain (re: exposure), Desidero!

On the meta-TPM post, I did have an extensive comment on perhaps why no one wants to "recommend" energy posts.

Of course, no one really commented on that comment. They did find lots to delight in on my one-liners elsewhere in the thread, though!

Sigh.

By the way, I disagree that the Dem's are running anti-business. Here in CA, you will find that most Dems are quite pro-business. Only way to get good jobs is to support business! However, I do agree that some Dems in, say, the rust-belt, tend to be more stereotypical in their reaction to business.

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Here in CA, you will find that most Dems are quite pro-business.

And here in the Northeast, Dems are pro-finance. Which makes sense, yes, clearthinker? Because that's the "business" on this coast. So before you critique HRC's immersion in Wall Street, make sure you think (clearly) about that angle before you post (or someone might bite your ankles). ;-)

However, I do agree that some Dems in, say, the rust-belt, tend to be more stereotypical in their reaction to business.

What do you mean by "stereotypical"?

Have you lived outside of CA?

I've lived in a multitude number of major cities in the US (both coasts) with significant time in many other cities (repeat business trips, etc.)

Unfortunately, finance is not "business" in the usual sense -- e.g. doesn't increase wealth for the country overall. That doesn't mean I'm against it, but it does mean I'm against it being the major business sector in the country.

In fact, these days the financial sector is tied closely to the Dems, as in the Clintons. There is a reason they chose to move to NY -- besides just the ability to carpet bag there.

There is an excellent new book from Kevin Phillips out called BAD MONEY. Highly recommended.

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Agreed about finance as a "business," which is why I put it in quotes upon first reference.

Have you lived in the rust belt?

And can you define what you mean by "stereotypical"?

These aren't trick questions, btw. Just seeking clarity. ;-)

hee hee hee. Your excellent questions will be ignored. If you push it, you'll be subject to a condescending bout of hominem attacks.

You, however, will do better than I did. Good luck with that.

Just notice when you posted your reasonable questions and when you'll likely (maybe after this) get an answer.

I note C'Ville Dem didn't either. Or anyone else.

In the interests of getting your thread some attention, Desidero, I attached this at the bottom of Genghis's well-viewed blog.

I make no apologies for this as his post will drop off in a few hours anyway, but perhaps this will resurrect the discussion here.

which, clearthinker, is the only reason i found this post. i don't have anything to add to the discussion at the moment, but i think desidero makes some great points, and i hope that this thread gets bumped up to the rec list so i can find it again when i'm home tonight have time for contemplation. (also, by adding this comment, i'm sneakily assuring i'll be able to find the thread again from my own profile... ha ha!)

(also, by adding this comment, i'm sneakily assuring i'll be able to find the thread again from my own profile... ha ha!)

Indeed, sneaky! Although it's possible to bookmark the URL, as well. And I have a whole file of book marked posts at TPM for this reason!

Happy to see you over here!

My thanks. I completely missed this. Sanity, sweet sanity.

And a lot of businesses screw over their employees on health care options. Particularly the small ones. I had to fight tooth and nail to get a PPO rather than an HMO at one of the places I worked.

I think the most important things are ensuring portability and making sure they can't deny you for "pre-existing conditions." I have a friend who has diabetes. She's had it since she was a kid. Well when she turned 18, and got a job, they denied her b/c she had a pre-existing condition. It's wrong, and it's insane.

And portability is huge. People just don't stay in the same jobs for long, as they used to.

And I agree about the mandates. I understand that in theory, they have to be in place in order to keep costs down across the board, so we don't end up paying for the uninsured. But other than that, what specifically are they going to do to cut costs? I've read about the electronic records and whatnot, but I don't know enough about the industry - will that really make the difference?

I also have serious doubts that a mandate will ever get passed.

Excellent questions. Good luck with that.

Well, Desidero, I tried... but Genghis' meta-meta-post (just why did he do that?) is now taking up a precious spot.

Sigh.

I just linked from that post back to this one. Maybe the rise of one will trigger the rise of the other...

Smart thinkin'! We CA'ers always find a way...

Sorry. That was not my intention. I would have been quite happy to displace the second "hoosiers are worthless" post. But it rises stubbornly ahead of superdel.

For the record, because I know that it disappointed you, I wrote the superdelegate post to make a point, not to be funny, so I don't regard it as frivolous, though you may to differ.

Anyway, desi has made the list now, and I'm glad for that.

Hey, I was just tryin' to get the posts about substance noticed... all politics is local, being an activist, etc. etc.

For what it's worth, there will be a multitude of ways to interpret what happened to your secondary post, although I suspect I know what you will argue.

And a lot of businesses screw over their employees on health care options. Particularly the small ones. I had to fight tooth and nail to get a PPO rather than an HMO at one of the places I worked.

Some of these comments are too easy to just "blame it on business". I've worked at several universities -- where the health care options are often worse than in the true business world.

You are lucky to have gotten your PPO. Most businesses (and universities!) would have said "take it or leave it".

It appears you have never owned a business. But regardless how it looks, small business owners usually are always working very, very hard to get you your next paycheck. To expect gold-plated health care from your employer (especially a small business), in 2008, is naive and smacks of an entitlement attitude.

I did indeed make it sound that way. My apologies. What really ended up happening was that I took on the additional costs. I just wanted the option of having it as part of the group plan, and had a struggle getting my boss to listen to the idea of even opening up a discussion in which we could make that an option. I should not have generalized to all small businesses. My stepdad is a small business owner and he does great things to help out his employees. (Sometimes to the detriment of his own bottom line!) It was really more of a reflection on my former boss. She consistently misinformed my coworkers regarding the options, misled them about FMLA, among many other things and other serious problems that we all had with her.

Anyway, I shouldn't have let one bad experience overshadow my comment. Again, my apologies.

Great follow-up, Hilarym. I get you!

I LOVE your new avatar. Positively brilliant.

All praise goes to CAPaige. She made it for me.

And thanks!

Hi guys and gals, I'm very pleasantly surprised to see this thread has a little life in it - I hadn't checked it all day once it fell off - appreciate the extra work to redirect. Perhaps once the nominee is decided the rest of the crowd will have time for what seemed like super-important issues this campaign.

Anyway, Health Care stands more chance of passing if it's not seen as another drag on business.

Congrats! It made the list!

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EX-fucking-ACTLY...

But, but, but, socialism, and welfare, and and free market, and and TAXES...

WTF is an insurance premium, and a co-pay, and other out of pocket expenses if not a TAX?
A de facto health care tax that does not ensure coverage, does not ensure treatment, does not ensure affordability, and often leads to desperation (financial or otherwise). Honestly, if any sane, realistic person was forced to pick a small handful of things that a government MUST ensure/provide/oversee wouldn't health care be right up there with Security/military, infrastructure, and human rights?

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My only caveat from a Hillary/Obama standpoint is to consider if Obama's non-universal (arguably?) plan is deliverable (ie more or less likely to be enacted into law) and is Hillary's plan deliverable (ie more or less likely to be enacted into law)?
I would also like to know if Obama would consider adopting Hillary's plan if he were president and a case was made that it was doable, and conversely if Hillary would adopt Obama's plan if hers was proven to be undo-able...
I wonder why some debate moderator didn't ask those (slightly unfair perhaps) questions?
I wonder what important debate questions were asked instead of these questions?
Hmmmmmmmm.

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There will be no savings with a universal plan, and that is the painful truth. Health premiums will not go down and taxes will have to go up to pay for the coverage. We've seen this in MA. Their plan is already over-budget.

The people getting screwed are the ones who have good coverage at work (ie the middle class), who will see their taxes raised. So far the plans I've looked at only benefit the poor. They do nothing to address the other major issues that affect the costs of health care.

And these are excellent points. Fortunately, we have a model in MA to at least try to draw conclusions from.

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"They do nothing to address the other major issues that affect the costs of health care."
(not snark)
Such as, foreign policy? Or what specifically in relation to heath care costs?
Health care cost structure is a "gamed" reality that was helped to its present dysfunctional level in no small part by the path chosen by Nixon et al (admittedly editorialized by Michael Moore in Sicko, but still the fact remains).
It's not to say that a patient/needs centered approach is without its problems, not the least of which is the probability of cost spirals (in the absence of prudent management), this is a logical extension of what Nixon was talking about and Moore editorialized; if the "game" is setup so the profit is in providing good (plentiful, or deluxe, how ever you want to define "good") care costs will spiral.
In essence the current "system" is an extension of a model that was minimalist on public good/patient care philosophy, and assumed that self interests would balance in a "free" market to ensure that the best health care system for America would emerge (now, by accepting that assumption, little political capital was consumed, as the health of profits is easier to measure than the health of the public).
It is a broken business model because it is a CONFLATED business model, not because it is "wrong" or "undesirable" to have individuals and corporations making oodles of money off of health care (service provision, support, technology, quality measures, and so on), hell, make it bigger, make it better, make it faster, make it work (that's the American way isn't it?).
The present model conflates cost containment with business opportunity and assumes the market will find a middle ground. BUT, 21st century public health issues include words like "pandemic" (which has a way of starting with poor people who have little or no access to health care, and spreading to whomever, wherever.) Why do insurance companies even WANT to be in the business of NOT paying legitimate claims? (I know, it sounds so RETARDED and NIEVE)What I mean is this, how is insurance different than service provision? An autobody repair shop might not want to fix a car correctly after an accident because if they can scam the customer, they pocket money for services they haven't provided, but if that accident claim is being paid by an insurance company, the service provider wants to (on paper anyways) do a DELUXE job (hey, they're paying for it), the customer wants a deluxe job, and the insurance company says "wait, cost contain, cost contain..." --fair enough, but if the car doesn't get fixed, the customer ISN"T going to keep paying premiums and the insurance company is NOT going to make (more) money. Every legitimate claim that is paid out by an insurance company (with appropriate cost containment) is an ADVERTISEMENT for the very core service that they are selling (ie. piece of mind). Not paying is NOT good business, it's racketeering.
Governments role? Referee/oversee the games, (TWO games) 1st game is service provision (access and structure of medical care,services, devices, and drugs), the 2nd game is the "marketization" of the "piece of mind" (including piece of mind of cost containment ie. "TAX" containment) industry. (the second game is where a uniquely American solution is possible, universal health care that is NOT socialist).

Why do we only have MA to look at? How about every developed country in the world, since they all have some form of universal health coverage (except us, of course). We pay more for medicines, for hospitalizations, for preventive health care; for EVERYTHING because we have a for-profit system. (Oh! and also because the lobbies of pharma and health care court our very own Congresspeople to protect themselves).

We don't have to invent the wheel. We can cherry-pick from all the successful programs in the world and use the parts that would work here. As long as there is a middle-man (insurance company) whose job it is to stand between the person and his/her health care, and to make money doing it, we are wasting money, and getting worse care in the meantime.

Our health system is needlessly complicated: pre-auth's, copays, deductibles, paperwork, approvals, denials, different levels of coverage if you have had the bad luck to be ill. Why? For profit. Why else would co-pays go UP to have a mammogram if you have had breast cancer?

But the title of this post is right for another reason: If we had a universal health care system all businesses could compete with the businesses all over the world who don't have to have a secondary business of insurance broker.

First, our values and mores aren't the same as other countries. We aren't Sweden or France, for example.

So it's good to have MA, a US State, as an example to study which is a better picture of what such a system will look like here.

Second, you can't simply cherry pick. Systems are complex things and parts at one place affect parts at another. It would be nice to do things that way, but it's not a practical statement.

Lastly, there are good things about our system -- so good that Canadians like coming here to get health care if they can afford to pay. For example, wait times are shorter in the US. And when it comes to health, short wait times are critical!

Before everyone thinks about how complex our present system is, and how it would be better if only we had universal health care, most states require you to carry car insurance.

In CA, there is no price difference between reputable companies -- and if an uninsured motorist hits you, your premiums go up. Even if you aren't at fault.

As Brooke pointed out, a lot of the Universal Health Care plan will hurt the middle class.

Insurance is a big business and part of the financial sector. Health care costs of everyone (including business) has gone up dramatically -- and service has gotten poor.

Being a medical doctor isn't the cash cow it used to be.

Much of the real woes comes from our being a litigious society. So every one of those juries who awards life-altering large sums of money to people, is helping to change society so that only the lawyers make money and no one wants to underwrite policies.

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Agreed. Litigation. I would also point out though that we are good when we get sick. We are not good at staying healthy. Taiwan is a new country, looking for a way to build a HC system. They chose nothing from the US because its not a system, its a market, with no thought out plan to maximize the helath benefit for every citizen's dollar. It does provide a world class market to heal the already sick, but does regrettably little in the more inexpensive, efficient, and long term, more healthy proactive health management. We can have both, and if you see my post below, it doesnt need to cost us another penny.

I would also point out though that we are good when we get sick.

Another excellent point.

As a culture, we tend to like to panic our way out of problems: for example, ignore science education until Sputnik; ignore issues of oil until the OPEC embargo, etc.

We treat our country like we treat our bodies!

Consistency is at least something we have. Sadly, in this case.

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Yes. And as you stated, we are different from Europe. When people buy into all we have stated here it still breaks down. Even if the total healthcare expense doesnt increase through universal coverage, people are reticent to let other sicker people free ride. Under a national system, other countries pay out of taxes, which are proportional to income, not health. Everyone imagines their own HC expense going up and subsidizing poor sick folk. What they dont realize is once it gets going, EVERYONE could actually pay less. Preventive care is a powerful tool.

Clearthinker, I'm not sure I got your point. Mine was that looking at one state that DOESN'T have universal health care, and could not have the volume and scale that would be needed to make such a system effective is not useful for a new US-wide system.

You say we can't cherry-pick because we are different than Sweden and France. What do you mean? As far as I can see, the biggest hurdle we have is that there is not a firm concept of the "common good" here, which there is in those countries. Well, "every man for himself" just isn't working. We could learn a lot from other places that have comprehensive public transportation systems, good public health and better longevity than we have. Having a healthy populace is certainly as beneficial for every citizen as having an educated populace.

Yes, most states do require car insurance. Why is that? Is that for the common good? No, it is for the insurance companies, but we all accept it. We need to re-orient our thinking, and realize that when we have to stand in line at the drug store to get flu shots, and call that "Public Health," we are in ridiculous trouble.

When I say "Cherry-pick," I mean sitting down with a look at all the systems in other countries, what works and what doesn't, and choosing what would translate into success here.

The other way to do this, which someone at the old TPM suggested, and is a completely brilliant (because it is so simple) idea for starting this process:

First of all, rename Medicare to something like USHealth. Then, every year, decrease the age by one year that a person can be included in that system. All the while revamping it to include things that apply to a younger and younger demographic. Get rid of the unworkable (and Big Pharma generated) prescription plan, and allow all providers to negotiate with drug companies like they do everywhere else in the world.

Oh, and have funds like they do for children damaged by required vaccines, for those who are injured medically -- NOT from malpractice, but from innocent events.

As to multi-million-dollar malpractice cases, they would become unnecessary and could be capped, because people with terrible injuries could actually be taken care of, instead of needing a huge award to get their care.

What is wrong with that? As a starting point, that is. The people who would be left jobless when all insurance companies close their doors could be retrained to start up our newest industry: alternative fuels R&D and production. Seems like a win/win to me!

See below. Unfortunately, the lil' check box somehow unclicked while I was posting my reply!

First, our values and mores aren't the same as other countries. We aren't Sweden or France, for example... Much of the real woes comes from our being a litigious society.
I disagree with this. The values, mores, and litigiousness of our society are results of existing power structures, not their causes. Do you believe it is the spirit of the people that gives us McDonalds and SUVs? These are simply functions of the powerful controlling propaganda, advertising, supply chains, and laws-- unchecked by meaningful opposition. The opposition is there, but it is simply not powerful enough to make a meaningful difference. For example, would you consider the former Yugoslavia a "warlike" society, or Darfur a "genocidal" society, or Palestine a "suicidal" society? As you said yourself, systems are complex-- people are complex as well, as I'm sure you would readily grant.
Do you believe it is the spirit of the people that gives us McDonalds and SUVs?

Yes, most definitely. If people didn't want them, they wouldn't exist.

Example 1: McDonalds from time-to-time offers salads, etc. and pushes them in advertising. It's a losing proposition for them. People keep claiming they want healthy choices, but when given them, they opt for the greasy hamburger instead!

Example 2: SUV sales are way off (finally!) due to oil prices. No amount of advertising or automanufacturing agenda will be able to raise sales.

Our litigious society could end tomorrow if people, as a group, acted more responsibly and didn't try to "score from the man" in compensation and acknowledged that sometimes "shit happens". (Do you really need to sue MacDonalds when you spill coffee on yourself? Do you need to sue that shop owner when you slip in front of his store on ice?) But as Genghis' threads show, people want an authority to come in an make restrictions to alleviate their personal responsibilities for their own actions.

Australia's is useful.

I didn't like the mandate idea of Hillary's plan, until I watched the PBS Frontline documentary "Sick Around the World." The program spotlighted five capitalist democracies (Japan, Germany, UK, Switzerland and Taiwan) with universal health coverage, but they all do it differently from each other. One thing in common: all mandated. It made me rethink that aspect. Here's a link to PBS for anyone interested:

http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/

That said, Obama's plan sounded a bit like an idea I like that I'm sure I didn't come up with (heheheh) but probably read somewhere, and that's to expand Medicare to kids up to age 12 and lower the adult age to 55. Play with that for a couple years, then move the age limits again. And maybe do it once more. This way you break it in gradually, get people used to it, they see that it works, they like it, and they want more. There's reason to think it would work, as Medicare is fairly well-run right now. So it's not like the US doesn't know how to do this. Obama starts by mandating coverage for children.

Another thing in common with the five universal coverage plans is that they all negotiate prices with drug companies (and others). This is a biggie, really. And right now the Republicans won't allow Medicare to negotiate drug prices, and that amounts to a huge Big Pharma welfare program. So price negotiation is a must.

As for insurance companies, that topic is covered in the Frontline program, too. I'm thinking that they could still sell supplemental policies. My mother had great Medicare supplement insurance through her teacher's union. It didn't cost much and picked up things that Medicare didn't pay for and/or covered Medicare co-pays. But she would have been okay without that coverage, too.

Geez, this country really needs to be talking about this issue. How do we get the media to focus on this instead of the gotcha stuff?

There is a risk of confusing the issues here. We are still talking about universal health insurance in the U.S., and I do not see that changing for a couple of years. Universal healthcare would be a fully nationalised or single-payer system.

The mandate would be good, if we could judge the proposition solely on that merit. In a vacuum, Clinton definitely has the upper hand there and Obama wins in the prevention and cost reduction improvements while keeping the quality.

There is a problem with living in a vacuum, though (aside from the noise and atrocious square footage) in that it does not reflect reality.

I think a non-mandatory program is, if you will excuse me, the mandatory first step. The mandate will not go through as soon as we need it to. We could probably push it through in about X+4 years (X being some factor for the bureaucracy) but in the meanwhile, the situation would stay as it is. A non-mandatory program could be passed far sooner, X+0 or X+1 years, and I estimate that the mandate can be implemented fairly shortly after that, 4-6 years at most. (And in the meanwhile, everyone wanting the insurance is still getting it.)

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It's Friday, and I'm just getting giddy, but, you know there is no sound (ie. noise) in a vacuum right?

;-)

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...and of course as to the square footage issue...
hehehehe
the Earth itself is an abysmally miniscule percentage of the "square footage" of the universe which is of course overwhelmingly comprised of a near perfect vacuum.
Oh god, I'm sorry, your point is well taken, I'm just being a goof, lol.

*cough* You are not the one who cleans the house, are you? :)

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On the contrary, but I guess I'm probably deaf anyway, most likely from all the trolls YELLING AT ME on other threads, hehehe.
Vacuum on, my friend.

Except for UK, all the countries in the documentary are universal health insurance.

One of the things that have occurred to me about why they have both come up with their respective plans is that they are a direct reflection on the way in which they do business.

It was one quote from Senator Clinton that got me thinking about this...

I think we as Democrats have to be willing to fight for universal healthcare. And what I concluded, when I was looking at this — because I got the same kind of advice, which was, "It's controversial, you'll run into all of this buzzsaw." And I said, "Been there, done that." But if you don't start by saying you're going to achieve universal healthcare, you will be nibbled to death. And I think it's imperative that as we move forward in this debate and into the campaign, that we recognize what both John Edwards and I did: That you have to bite this bullet — you have to say, "Yes, we are gonna try to get to universal healthcare."

In keeping with Senator Clinton's "fighting" theme, she thinks that she has to start as far left on this as possible from the outset so that she has more to concede on the path through the "buzzsaw".

And I think Obama started at a point that he felt he was more likely to be able to get people to agree with, because it's more incremental change.

Mind you, she definitely is NOT starting from "as far left as possible" which would mean a single-payer system and that her proposed plan is equally universal health insurance, not -care, but this is an important point.

We can disagree on the politics side about whose method is more effective or likely to pass but it is clear to me that Clinton is not actually shooting for a mandate. She is just using it as a bargaining tool (and it may be necessary for her to do so, unlike Obama.)

Either way, we will end up with no mandate.

Point taken.

Hilarym: I really admire you. You articulate your views clearly and yet you really do have an amazing capacity for self-reflection on them. Wish all TPMer's were more like you! Have a great weekend!

Why thank you. And you have a good weekend as well.

One of the things I love about this medium of communication, and writing in general, is the time you have to reflect on things before you say them. In an in-person argument, sometimes you get so riled up and emotional that logic takes a back seat. Plus, the act of actually having to read other people's views almost forces you to actually listen, something that also sometimes gets lost in in-person debates.

Again, not every one is as enlightened as you. See the recent Genghis threads and some posts here for the quick, emotionally gratifying responses. For what it's worth, because of your enlightened demeanor, I take what you say very seriously -- and am happy to do so.

I am sure glad you are around!

One quick point abouth the business vs. "the people" aspect: I could not care less about businesses because capitalism is immoral.

But I think it is an excellent argument to put forth--it does help businesses. And they know it. For some reason I have the sense that people actually feel that the "big business" is opposing this, but they are actually already on board. Really the only people opposed to it are the Republican politicos because it would be a concession in their eyes.

Oh, and the people who think the gubmint is going to mandate prostate exams at the post office or something.

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With respect: your personal beliefs on the morality of capitalism are your personal beliefs and I respect that. But your specific beliefs are EASY rhetorical targets for those who would leave millions of people without affordable, quality health care. The moral challenge then it would seem, would be to navigate towards a workable health care (and insurance?) model that provides for those who are disadvantaged by capitalist extremism, within the "house" that is the bastion of capitalism such as America is.
[On a side note; prostate exams at the post office may actually ATTRACT as much support as it discourages, hehehe.]

My point is that however we feel about business, capitalism and so on in the Democratic party or elsewhere is irrelevant :) Let me say it again:

The business sector is already on board.

We can certainly reinforce that point in ads and so on. But we will not have to fight the "Big Business Interests(tm) and Their Lobbyists(sm)," just make sure that everyone knows that.

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Point taken.

If you really want to fight capitalism, stop consuming goods. I'm not talking about food, shelter, etc. I'm talking about all the widgets that people just "have to have".

How much does Apple producer, for example, that you need for survival? An iPod? An iPhone? Do you really need that pair of Nikes? Or a new car? &c.

There is nothing moral or immoral about a method of commerce, except slavery.

Perhaps you object to the fact that a corporation has the rights of a person. Now that would be a great starting point of a discussion and is far away from knee-jerk dogmatic rhetoric that does nothing to advance the cause and, as TorranaTony points out, allow people to be dismissive of everything that comes after the statement.

Which one of us is being knee-jerky?

My view is that, from an evolutionary standpoint, a naturist system is unsustainable beyond moderate technological advancement in a moderately- to well-established predominant species in any but nondense populations. In other words, unless mankind produces a sufficiently prevalent mutation to communality, Earth will be a cooling piece of cinder in the not-too-distant future.

On the other hand, I am also a pragmatist. This is not really the venue to discuss the matter in detail, though.

One of the reasons for the advances in standards of living since the Renaissance has been the influx of capital as a means to develop business -- starting with the Medicini's in Italy. This is the so-called genesis of "western capitalism" that continued to morph with the Dutch in the 17th century and the British in the 18th century.

So, once you are on this road, who is to say when you should stop?

If you look at OVERSHOOT by Catton, there is a great table showing how technological innovations over the years have increased the land-carrying capacity of the earth. (There is an explosion in the last 500 years when a whole new hemisphere -- hitherto "empty" by high-tech standards -- was discovered by Europeans.) So, the technology we enjoy has been a double edged sword.

But again, who is to say when you should stop innovating?

And how can the benefits of capitalism (i.e. health care, additional security from the elements, a great awakening of minds as a result of more leisure time) be considered immoral?

I don't understand your exact reference to the earth as a cinder -- unless this is simply to say nuclear war will finish us off -- but there are plenty of biological ways of finishing us off as well. Some man-made (weaponized anthrax), some natural (AIDS and Ebola). The planet isn't that fragile -- but our species is. However, our species has a singular inability for self-control. A recent TPM illustration of that was Genghis' plea for more substantial blogs -- and part of that included outside restrictions to get to that point. This is ironic: it's an admission of defeat if even TPMers -- who people laud as being a cut-above in general and like to think of themselves as progressive -- can't control themselves without an outside authority.

Almost seems like a cry for "law and order", doesn't it? And that's a traditional view from the right!

The bottom line is that the world is a very complex place and blanket statements about capitalism being immoral doesn't really advance understanding or discussion. Indeed, I was surprised by your comments because I always find your consistent appeals to reason on this site refreshing.

There is a big difference between Consumerism and Capitalism. Capitalism, from the standpoint of its critics, has to do with who controls the means of production-- not production itself. Ipods could be made communally, and consumed communally, and this would not constitute Capitalism.

ditto