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About Universal Health Care
Forget it.
In fact forget about significant health care reform. With Obama supporting the bailout, and $700 billion about to leave the deck, there will not be cash nor political support for doing anything about health care. And it's long not a priority. We will be tightening our belts for the next 4 years. Oh well, it was a nice thought while it lasted.
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Comments (43)
Barack doesn't support a $700 billion bailout. He supports giving the American people a slice of the pie for our cash. He thinks that with more time, this could have been an opportunity to do more. It is also $350 billion and a review in five months.
No more blank checks.
The elephant in the room that Barack can't even mention and expect to be elected is taxes. We have a regressive tax policy in this country and until we return to at least the 1960s for our top tax rates, there would never be enough money to do anything we really need done.
The only way anything will be done is if Obama is able to use the bully pulpit to drive a national movement toward a more common sense approach to governing.
We can fix this shit with the right leadership. If it doesn't materialize come January 20, 2009, then I guess we are in for a long, hard stretch just as you surmise.
October 1, 2008 11:16 AM | Reply | Permalink
Obama never has been for universal health care. I didn't and don't expect him to do anything about it.
October 1, 2008 11:20 AM | Reply | Permalink
I don't think that's correct. I definitely recall him saying that if we were able to start form scratch, a universal single-payer system would be the ideal solution. Being the pragmatist he is, Obama has adopted his present non-ideal approach as being the most likely to actually be enacted in to law.
Which tells me that if the political will to move more towards a single-payer system makes itself evident Obama would happily move there.
October 1, 2008 12:08 PM | Reply | Permalink
Politically, the 1001 social groups & netroots people & labor constituencies should be gearing up, now, for a push after Obama's elected. And make it "single payer." The piecemeal thing bleeds money, kills constituency-building. Set the table for Obama to tackle a few big, simple, solid projects. Make health one of them.
October 1, 2008 12:45 PM | Reply | Permalink
I agree. Perhaps, rather than shy away due to the Wall Street bailout maybe Dems. should push for single payer health-care as an equitable reward to the middle-class for bailing out the rich.
October 1, 2008 2:07 PM | Reply | Permalink
Er, guys, actually single payer would sorta bail out a lot of corporations large and small constantly struggling with rising health insurance premiums.
The last effort during the early Clinton administration was most definitely boosted by many big corporations getting on board. Remember, Bill Clinton's early (pre-inauguration, I think) "it's the economy stupid" economics conferences where all the bigwigs kept saying fix health care, fix health care, fix health care? It wasn't like the auto companies that paid for those Harry & Louise ads. They wanted health insurance off their hands.
Most businesses don't like being forced to be in the health insurance business. Even your neighborhood doctor doesn't like it.
October 1, 2008 7:58 PM | Reply | Permalink
Right you are Bev,McCain's a much better choice if we want affordable health care!
October 2, 2008 10:00 AM | Reply | Permalink
The last chance we had for serious health care reform fifteen years ago. I have no idea whether the bailout is a good idea or not, but with or without the bailout the Iraq war will have taken a whole lot more than 700 billion off the deck. And with or without the bailout the damage to the economy is very real, and will have to work itself out in one costly way or another.
Not that attempting to achieve universal health care by patching up the current insurance system was ever a good idea anyway. That's what you get when politicians try to promise universal health care without using the poisonous words "tax increase".
October 1, 2008 11:31 AM | Reply | Permalink
We had a chance for universal health in 1947, when our close allies instituted it, and Truman proposed it.
A large enough topic like that needs breathing space, and Iraq, etc., have been sucking up the air for the last 8 yrs. That Obama will not likely deliver it soon is not a useful point to make.
October 1, 2008 11:41 AM | Reply | Permalink
The healthcare system is bad right now (I am involved in the system), but I think it will have to get much worse before people have the required will to make the painful changes that will improve the system. Just wait until the current primary care doctor shortage gets a lot worse over the next 5 years. When no one can find a primary physician maybe things will change. I hope so, I am a primary physician and like most of my colleagues would prefer to be doing something else right now.
October 1, 2008 12:35 PM | Reply | Permalink
Ah. The mournful sound of the bagpipes. The ever-gloomy wing of the Demoscottish Party on the march? Screw that. Try this:
1. The social & economic drivers for creating health care are not always prosperity/peace. Sometimes, people hit hard times & the pressure rises. Depends how they're organized, who's in charge, etc. See: Canada - a poor prairie province led the way.
2. In the US, the left/liberals have an historic opportunity. People - Left-Right, even Religious Right - recognize and are outraged at the greed & selfishness of the wealthy. The "Bail Out" sets up the perfect political conditions for a movement to say, "Now... you're gonna do something for us."
3. There are going to be hundreds of major manufacturers who'd like to grow, but are strangled by Health Care costs.
4. There's money, and lots of it. the range of taxes which can draw back some of the ill-gotten wealth, to tax additional hyper-incomes, or to draw down speculation are huge. I'm gonna keep linking this article til my face falls off.
5. The budget is not gonna be in balance, or anywhere near. Fiscally, now that we're all used to thinking in terms of $700 Billion as being a real number, arguing that, "Josh & Jennifer Cubicle need a little something for the effort" gets easier. Especially when you say, "And it's only gonna costs $100 Billion, which we're gonna peel off the fattest asses in the land."
Do Ya, Do Ya, Do Ya want some health care? If so, time is ripe.
October 1, 2008 12:41 PM | Reply | Permalink
Also worth noting that in the past 2 weeks Obama has moved to frame health care reform as part of the solution to the economic crisis. The question is whether people will buy in (and require their representatives to buy in) to a long-term plan.
October 1, 2008 12:49 PM | Reply | Permalink
I do believe, if it's pitched correctly, that we can get many if not most of the Fortune 500 on board. Healthcare costs are strangling American competitiveness, and have been for some time now. Get that constituency over the hump and it's close to a done deal.
And keep hammering on the notion that Willard Romney's "mandatory purchase" plan - which is being sold under multiple guises in different places - is little more than a welfare program for the insurance industry.
October 1, 2008 1:04 PM | Reply | Permalink
Well, in that Bill C clip from today he says health care costs 16% of GDP, far more than 11% average. That's a fair chunk of change to work with, if restructuring is to be done.
October 1, 2008 7:01 PM | Reply | Permalink
Yep. I heard 15% on NPR the other day. 15% overhead costs in our system today, with it's overlapping bureaucracy and red tape.
And, for comparison? For single-payer, overhead would be about 3%. Or so they said.
I'm sick of the right's arguments against this. Two notes. Over and over again.
1. "That would be socialized medicine!" So what? Call it whatever you want. Call it shit on a stick, if it works better, do it.
2. "We want to leave government out of decisions that should be between Americans and their doctors." Well, isn't that a grand idea. To bad it's not what's happening. Convenient amnesia of the constant middleman - the inept, thieving, corrupt insurance companies. Story. I have a rather large head. My father has a rather large head. (Seriously. No hats for us.) My son has a rather large head. My doctor was concerned, though I told him it was in the family. He advised a neurological exam and CT. Ok, fine. Everything was fine, and they determined it was "benign familial macrocephaly." Great. Carry on. Me and my doctor wanted to continue on with our normal childhood visits, etc. EXCEPT. My insurance company sends me a letter saying they won't renew his insurance (we were changing deductibles) because of his benign familial macrocephaly. Some idiot, with no medical background, in a cubicle somewhere, with apparently no Google skills, saw that and freaked! We can't insure this person! Look at this rare disease he has! Me, and my doctors had to go through the pain in the ass appeal process (which something like 90% of people don't know to do) to explain to them that benign familial macrocephaly means "big heads that run in family."
If anything, it makes more sense to develop a better health care system in this country now. It's crippling us. 50% of bankruptcies. 15% of the population uninsured. Premiums going up. It's unsustainable.
October 1, 2008 10:18 PM | Reply | Permalink
The insurance side is just pure scam. I'd argue the same applies to other insurance policies. Auto insurance where I live is public, it works great, it's completely simple, and it's a lot cheaper than elsewhere. In any real effort on health care, there is no reason why the overall cost to the economy should not come down.
Re: "big head" condition.... I feel your pain. I have a condition in which my skull appears to have grown thicker with each passing year. The doctors say my brain has been compressed down to the size of a walnut. On the plus side, the surrounding shield of solid bone means I am no longer required by law to wear a helmet.
October 2, 2008 12:10 AM | Reply | Permalink
Yes, I definitely agree. Universal healthcare died when Kuchinich did not win the nomination.
I still hold out hope for universal health insurance as proposed by the final contestants.
The Democrats will have sufficient margins to be able to pass such legislation. The only challenge is to show the people how the expenditure pays for itself, both in terms of the nation's well-being as well as the corollary concrete financial gains (or diminished financial ruins.)
October 1, 2008 2:17 PM | Reply | Permalink
The obsession with coverage over cost is misplaced. If we do not do something about the rapid growth of the cost of health care then the $700 billion will look like chump change. In fact we are probably OVER paying for our current level of health care to the tune of $300-500 billion right now. Every year. Those costs are a tax on consumers, workers and businesses (an of course and offsetting windfall to the health care industry).
There is an excellent case to be made for why HC reform is both more necessary now than when we are flush with cash. And we will get it when we decide we want more efficient and better delivery of care, the net cost of which is negative. It will save us money.
October 1, 2008 2:25 PM | Reply | Permalink
I haven't seen one health insurance ad running in western Michigan or in the Indiana market near the Michigan border. Maybe they are running in Detroit or outside Southbend in Indiana. I don't know.
Some of us thought the way to get universal health insurance was to elect a candidate who promised to get it for us. Now, some of us are having second thoughts about that -- as though our candidate won't deliver on that promise if he's elected.
Someone recently asked: Why did we believe Obama could deliver health insurance when the national debt was $10 trillion, if we believe he can't deliver it when the debt is $11 trillion? Is $11 trillion the sound barrier for health insurance? Any politician who tries to get universal health insurance beyond $11 trillion will auger in?
Don't you worry, boys. Hillary Clinton is going to get our universal health insurance for us from the Senate. If Obama doesn't want it, he's going to have to veto it.
October 1, 2008 5:51 PM | Reply | Permalink
Hm, from your lips to God's own ears. That said, I guess I would be just as skeptical about the prospects for universal health care right now if Sen Clinton were our nominee. Indeed (and I know I will not make myself very popular on this thread for saying this), I would be even more pessimistic about our chances for universal health care reform if Clinton were the nominee. Still and all, I would be delighted to be proven wrong.
October 1, 2008 5:58 PM | Reply | Permalink
I guess I feel obligated to mention that Clinton said last week that she would be voting for the bailout. Whether that still holds after the recent changes, I don't know. For that matter, the most recent quotes I can find from Obama that directly deal with health care vs. bailout are these two statements:
And then from the Ol' Miss Debate, 9/26:
Supporting the bailout doesn't mean health care reform is frozen dead. No, we aren't going to get single-payer, but real health care reform is still one of the main pillars of Obama's platform, and as I noted upthread he's (rightly) tying it into the broader plan for economic revitalization. I'm willing to give him the benefit of the doubt on his sincerity here, especially given the alternative crap plan of McCain's.
October 1, 2008 6:20 PM | Reply | Permalink
Addendum (what I wouldn't give for an edit function, being an "oh yeah, and" sort of thinker):
I do hope Clinton does hammer it through the Senate. Obama will depend heavily on her support there, and visa versa -- neither acting alone could accomplish the goal. We're losing Kennedy, and our Senate and House (sorry, Pelosi) are desperately in need of a smart whip to beat good bills out of 'em.
October 1, 2008 6:46 PM | Reply | Permalink
Oh yeah, and...
October 1, 2008 6:57 PM | Reply | Permalink
I'm a crappy writer and editor, what can I say!
October 1, 2008 7:06 PM | Reply | Permalink
Odd you should mention not seeing health insurance ads. I saw one last night, right around the Senate vote, in Bronx NYC on one of the cable news channels. It was Obama, looking straight in the camera, a close up of his face. It made me look up and pay attention after it started, as we don't get many of the campaign ads here at all. It was short, like 30 seconds, mostly about how we have to reform health insurance, though it was summed up with some more general stuff about helping the middle class. It was unusually passionate tone of voice for him. Honestly, it surprised me, I thought, what the hell are they up to, running that here? I don't know what area our cable covers, maybe New Jersey.
October 2, 2008 10:44 AM | Reply | Permalink
Sadly, dear Desidero, I agree with you on this one. I was always given to scratch my head when, back in those heady early days of the primary, folks talked as if this were definitely the year when it was going to happen. This nation has seen that headline time after time, and yet time after time it ends with "not this time." I would be delighted to be wrong, but I am hard pressed to see universal health care getting its due regardless of who wins the presidency. Of course, at this point we are facing the choice of "sticking with the same crummy system" and "making it even worse," so we still have a real and serious choice in front of us, but the universal health care option is, sad to say, no longer really on the table.
October 1, 2008 5:54 PM | Reply | Permalink
Why are you on line tonight? You have a one point lead in MO now. Get back out on the streets! :)
October 1, 2008 6:58 PM | Reply | Permalink
Cut defense spending by 50%. If the spending is not providing jobs in the US and protecting the US, cut it.
October 1, 2008 6:21 PM | Reply | Permalink
Let me just repeat this point: If we do not fix the health care cost growth problem the budgetary implications are extremely grim and will make this bailout, the Iraq war, whatever else you got seem like chump change. And that's just the the governmental budget side. personal and company budgets are going to take a huge whack too.
We already waste more in our system now than we are going to spend in the bailout.
October 1, 2008 6:50 PM | Reply | Permalink
I'm real weak on economics, have no idea of the sophisticated economic consequences of the bailout plan, but from what I know of the basics of the "bailout," I just don't think your "not enough money for it" is going to be the result as to something like health insurance and health care cost reform.
We are not "spending" $700 billion, that much I know. We will be paying big interest on the debt for a while, that much I know. There will be a recession, that much I know.
What does that mean with health care costs skyrocketing as boomers start tapping into Medicare for lots of new knees etc.? And as employers keep trying to cut coverage for working people as premiums go up? Because they simply can't afford it or they will go out of business>
Could just as easily cause outrage that something be done once again to deal with health care. Remember that it's in bad times that more people start demanding this stuff.
Maggie Mahar was arguing a couple months ago on this very site that health care reform wouldn't come easily because polls showed most people were happy enough with their current coverage and were afraid reform would take it away from them or make their own coverage worse. So as they endure cuts in coverage by their employers, or the threat of it, the support for single payer goes up. Happened exactly that way the last time.
October 1, 2008 8:14 PM | Reply | Permalink
Keep in mind, single payer really is "socializing" health care, though that's not a politically smart way of selling it. It's not spending money that's not already being spent, it would be shifting it from lots of private parties spending it (many who don't want to be doing so,) to the government spending it. The businesses making money off health care, no other industries, are the ones who strongly don't want it. The consequences of taking a lot of the profit out of health care are what would be the basic thing being considered by economic planners. But I don't think most other businesses like having to subsidize that industry and its profits. Losing a lot of paperwork pushing jobs in health care might be more of a consideration than government "finding" the money for it. The money is already there, being spent every day.
October 1, 2008 8:24 PM | Reply | Permalink
An addition to clarify the rambling points I made above.
You say:
The problem is that this an incorrect assumption to base your fears upon about other programs. $700 billion is not "leaving the deck."
See Paul Krugman, Sept. 30:
Where Will the Money Come From?
...But, people ask me, where will we get the money? Won’t we have to borrow it from the Chinese?
Actually, no.
Ten years days ago, I explained that the Paulson plan would actually move money in a circle. No outside financing would be needed....
You have to understand what that will do to know what the political situation will be regarding other spending. I admit I don't understand what it's going to do. But it's pretty clear to me that it's not going to be a simple situation of "we already spent $700 billion." Because that's not what they are doing at all.
Actually, if the bailout happens to work on the economy better than expected, then, as I mentioned above, it may be much less likely to get health care reform moving, because too many people are reasonably satisfied right now with the status quo of their own coverage. Conversely, if it doesn't work well at all, and with that more employers continue to cut coverage or even just complain about the cost of it, then you will have much more support from switching from maintaining for-profit health care to non-profit health care for all.
October 1, 2008 10:31 PM | Reply | Permalink
This part above supposed to be in blockquotes, is from the Krugman piece:
October 1, 2008 10:33 PM | Reply | Permalink
This is not quite right, AA. Krugman is talking about immediate cashflow - it's a more technical point. He gets at the real, longer-term economic reality in those pieces you link where he says, "In the long run, of course, it will come from you — the taxpayer." He also then says, "So is all this magic? No, over time Treasury has to pay interest & principal on the bonds it issues; the value of the bonds comes from the fact that people believe the US government can do that, which ultimately comes from the government’s ability to raise taxes. If investors lose faith in that...."
So we will pay for it. It may be worth it, economically (I'd argue it is), but it will cost.
October 2, 2008 12:20 AM | Reply | Permalink
I mentioned that in my first comment, that we'll be paying a lot more interest on the debt.
October 2, 2008 10:33 AM | Reply | Permalink
This is one of the dumbest things I've read here in ages. It displays an absolute lack of understanding not only of what's being proposed, but of what the central banking system does in general.
$700B is about 5% of GDP. Even so, it's not just "leaving the table" as you put it. This has nothing to do with health-care or health-care reform and everything to do with just throwing up your hands, calling Obama's failure before he even gets a crack at it. Totally worthless words.
October 1, 2008 10:54 PM | Reply | Permalink
Right, just like that FISA vote, he'll stick with us. I'm just a pessimist for no good reason.
October 2, 2008 2:53 AM | Reply | Permalink
An independent group has concluded that Obama's plan, if he can get it passed, would reduce the number of uninsured.
http://news.yahoo.com/s/nm/20081002/hl_nm/us_usa_politics_health_1
It's a question of will. Does he have the will to reform health insurance at least? We'll know next year.
A separate question is: What can we do to hold him to his promises and avoid a FISA-like flip flop?
October 2, 2008 7:52 AM | Reply | Permalink
I don't understand anyone who actually believed any of the presidential candidate's plans would ever get enacted as is simply by electing that candidate. Just like their plans for getting out of Iraq would not be executed as stated. They were just there to give an idea of intent.
That said, everyone who had health insurance as their # 1 interest should have known that Hillary was their candidate, that she always was the one with the great passion for it.
As you say in another comment above, though, she's still in a place to fulfill her passion. If she has a Dem president and Congress. Maybe even a better place to do it from. A president leading such a charge has to give up a lot of political capital necessary for running other things. Sometimes it seems more likely to me that it will be accomplished being led by a Congress with the President as booster. It has too much to do with every single person's life for it to be successful with top down bullying, has to come bottom up, from many constituencies screaming for it.
Maggie Mahar's posts on it here on the political will for it while the primary was still going on were quite eye opening to me. There was still a majority scared shitless of anyone doing anything because they think they will end up with worse than they have now. That's why all three major candidates chose to push incremental plans. What I was saying above is that poor financial times, especially for corporations, might change that equation. I think all the major candidates knew that, too. None of them, including Hillary, were thinking that those plans were going to be pushed exactly as written.
October 2, 2008 11:04 AM | Reply | Permalink
I think we need to keep up pressure on lawmakers starting January.
Look, health care is not just a moral/social issue, it is also crushing American companies who can't compete with Europe and Japan, which all have national health care.
GM spends more on health care than steel. Toyota has no such burden. Economists say this adds a 15% premium to American goods. Ouch.
I think we need a coalition of business & progressives & unions to push for this. The only ones against it are the GOP, health care and drug makers. And the GOP will be out of a job next year.
Health care is the #1 priority.
Also, for those universal access vs. universal coverage folks, let's get SOMETHING passed, some kind of national infrastructure to build on. It doesn't have to be perfect, it just has to be big. Like, say, expanding VA or Medicare to all uninsured. Once you establish an entitlement, they are impossible to get rid of. Instead of swinging for a home run, like Dems have been for 60 years, let's get to first base, establish national health care of some kidn, and then build from there. Obama will have two terms, so plenty of time to add on.
October 2, 2008 9:21 AM | Reply | Permalink
Precisely! Now figure out what are the economic results of the whole bailout situation and what caused it. And throw in that health care costs continue to spiral, with the boomers aging, as is happening allover the world no matter what plan the country has. Doesn't it make it much more likely that all kinds of constituencies are screaming for reform? At the time of the primaries, there wasn't much public will for it, it was looking like there wasn't much that was going to happen for at least a decade.
October 2, 2008 11:13 AM | Reply | Permalink
p.s. Previously, the realistic pols saw that it had to be incremental, that you could only do it by having a public non-profit plan compete with the the existing system, because there wasn't the will to change in the majority. That way would cost real extra money, because they wouldn't be getting the benefit of a single pool. The situation might be changed now, there might be much more will to do major rather than incremental change, which in the end would cost much less.
October 2, 2008 11:18 AM | Reply | Permalink
An example. This guy
from Small Businesses Feeling the Chill, Oct. 2
is probably going to be looking at cutting his health insurance costs, i.e., raising the deductibles, cutting the number of covered, etc.
How many of his fellows ("Small businesses in America — the 27 million companies employing fewer than 500 people and in most cases fewer than 20 people — account for half of the nation’s output") will be doing the same?
We already know that most big employers want to get out of the health insurance business, even are lobbying to do so. Small business has continued to do so because it's the status quo and they don't have as big of a voice to complain about it.
October 2, 2008 11:43 AM | Reply | Permalink
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