This is almost enough to make me switch from Obama to Hillary. I wonder if the health care lobby has gotten to Obama. ********** Clinton, Obama, Insurance By PAUL KRUGMAN Published: February 4, 2008 The principal policy division between Hillary Clinton and Barack Obama involves health care. It’s a division that can seem technical and obscure — and I’ve read many assertions that only the most wonkish care about the fine print of their proposals. Skip to next paragraph Paul Krugman. Go to Columnist Page » Blog: The Conscience of a Liberal Blogrunner: Reactions From Around the Web But as I’ve tried to explain in previous columns, there really is a big difference between the candidates’ approaches. And new research, just released, confirms what I’ve been saying: the difference between the plans could well be the difference between achieving universal health coverage — a key progressive goal — and falling far short. Specifically, 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. Let’s talk about how the plans compare. Both plans require that private insurers offer policies to everyone, regardless of medical history. Both also allow people to buy into government-offered insurance instead. And both plans seek to make insurance affordable to lower-income Americans. The Clinton plan is, however, more explicit about affordability, promising to limit insurance costs as a percentage of family income. And it also seems to include more funds for subsidies. But the big difference is mandates: the Clinton plan requires that everyone have insurance; the Obama plan doesn’t. Mr. Obama claims that people will buy insurance if it becomes affordable. Unfortunately, the evidence says otherwise. 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. An Obama-type plan would also face the problem of healthy people who decide to take their chances or don’t sign up until they develop medical problems, thereby raising premiums for everyone else. Mr. Obama, contradicting his earlier assertions that affordability is the only bar to coverage, is now talking about penalizing those who delay signing up — but it’s not clear how this would work. So the Obama plan would leave more people uninsured than the Clinton plan. How big is the difference? To answer this question you need to make a detailed analysis of health care decisions. That’s what Jonathan Gruber of M.I.T., one of America’s leading health care economists, does in a new paper. 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. Over all, the Obama-type plan would cost $4,400 per newly insured person, the Clinton-type plan only $2,700. That doesn’t look like a trivial difference to me. One plan achieves more or less universal coverage; the other, although it costs more than 80 percent as much, covers only about half of those currently uninsured. As with any economic analysis, Mr. Gruber’s results are only as good as his model. But they’re consistent with the results of other analyses, such as a 2003 study, commissioned by the Robert Wood Johnson Foundation, that compared health reform plans and found that mandates made a big difference both to success in covering the uninsured and to cost-effectiveness. And that’s why many health care experts like Mr. Gruber strongly support mandates. Now, some might argue that none of this matters, because the legislation presidents actually manage to get enacted often bears little resemblance to their campaign proposals. And there is, indeed, no guarantee that Mrs. Clinton would, if elected, be able to pass anything like her current health care plan. But while it’s easy to see how the Clinton plan could end up being eviscerated, it’s hard to see how the hole in the Obama plan can be repaired. Why? Because Mr. Obama’s campaigning on the health care issue has sabotaged his own prospects. You see, the 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. If Mr. Obama gets to the White House and tries to achieve universal coverage, he’ll find that it can’t be done without mandates — but if he tries to institute mandates, the enemies of reform will use his own words against him. 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. http://www.nytimes.com/2008/02/04/opinion/04krugman.html?_r=1&hp&oref=slogin
she is the second largest recipient in the Senate of health care industry contributions. http://www.michaelmoore.com/sicko/checkup/ take it for what it is. are those contributions because of her views, or are they intended to sway her opinion?
Never mind. Most Americans have developed a habit to vote against their own interests. I don't see anything different this time around.
Obama and Krugman have had a feud about this for a few months. Here is what Krugman wrote in June of last year about the same Obama plan: http://firstread.msnbc.msn.com/archive/2007/11/30/490207.aspx "First, the good news. The Obama plan is smart and serious, put together by people who know what they're doing. "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. "Since Medicare has much lower overhead costs than private insurers, this competition would force the insurance industry to cut costs -- making our health-care system more efficient. And if private insurers couldn't or wouldn't cut costs enough, the system would evolve into Medicare for all, which is actually the best solution. "So there's a lot to commend the Obama plan. In fact, it would have been considered daring if it had been announced last year. "Now for the bad news. Although Mr. Obama says he has a plan for universal health care, he actually doesn't -- a point Mr. Edwards made in last night's debate. The Obama plan doesn't mandate insurance for adults. So some people would take their chances -- and then end up receiving treatment at other people's expense when they ended up in emergency rooms. In that regard it's actually weaker than the Schwarzenegger plan. "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. Call it the timidity of hope. "On the whole, the Obama plan is better than I feared but not as comprehensive as I would have liked. It doesn't quell my worries that Mr. Obama's dislike of 'bitter and partisan' politics makes him too cautious. But at least he's come out with a plan. "Senator Clinton, we're waiting to hear from you." [Clinton unveiled her plan a few months later.] Here's some info on the feud: http://www.washingtonpost.com/wp-dyn/content/article/2007/12/11/AR2007121100593.html The Obama fact-check response (obviously biased): http://www.barackobama.com/factcheck/2007/12/07/fact_check_krugman_didnt_alway.php Take it all for that it's worth.
as much as the clintons have problems with honesty, the health care issue is something i trust them on. The Clintons arent dumb. They know that if Hilary doesnt pass her health care reforms, she's toast in 2012.
http://www.healthcentral.com/healthcare08/ Very cool graph portraying each candidate's stance on health care issues including (in each tab on the left): healthcare reform, the uninsured, drug prices, prevention, technology, and stem cells.
On Hillary Clinton: "She is highly intelligent, has real experience and is an attractive candidate. But she is terrified to act on her beliefs. In fact, she seems so conditioned by what she sees as political constraints that one can barely tell where her beliefs begin and where those constraints end."
Per Krugman: Mandates and Subsidies Much Better than Subsidies Alone "The American People will take Socialism, but they won't take the label." - Sinclair
i would love to see an explanation of the cost differential. i have a hard time believing overhead would add 80% from an entitlement to voluntary. 30-40%? absolutely. 80%? the model is doing things that aren't discussed.
On this issue, I liked Hillary's and Edward's plans more than Obamas. However, His plan is still far better than what we have now, and this campaign isn't about one issue.
didnt hillaroid come out and say she wanted mandatory health care for everyone - to the point of even garnishing ones wages to force them to pay for it?
Germany and other developed countries have been doing fine with that model for years, why can't the most powerful and richest country do it? Just because the profit margin of those insurance and pharmaceutical companies can't be limited to a reasonable level? If people can afford 200 bucks for coffee and donuts every month, why can't they, as middle class, pay a proportional 200 bucks for their health insurance? Why are people ok with mandate car insurance, but not mandate medical insurance for OWN health? Just because the country won't let anyone die, so you just refuse to pay and decide to rip off other tax payers if something happens? So far, US is the only developed country doesn't have a universal health care program. Maybe everyone else is wrong, as usual.
I would happily trade my car insurance for health insurance. Lord the savings.... And car insurance is huge racket and I hate it.
she freaks the crap out of me with the whole, "if you don't have health insurance we'll garnish your wages." that's not choice...that's a george orwell book. give people better choices with regard to health care...not this. can you imagine the bureaucracy necessary to enforce this??? how the hell does the fed government know if i have an individual policy or not?? what would it take for them to find out and monitor it?? to put in place an agency to deal with garnishment, etc.?? no, thanks. i hope hillary gets her ass handed to her tonight.
