Health care: 22 million reasons to support Hillary

[johan helge]

Krugman thinks 22 million more people will be insured with Hillary's health care plan than with Obama's (http://www.nytimes.com/2008/02/04/opinion/04krugman.html?_r=1&scp=1&sq=krugman+gruber&st=nyt&oref=slogin):

"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."

[Johnny__Motown]

1. So, if 22 million people don't want his plan, how will you force them to join hers?

And how much is it gonna cost to create and fund this enforcement entity?

[johan helge]

I don't know

but I assume mandates is like a tax - everyone has to pay (for health insurance). But I think Hillary (contrary to Obama) has specified that no family should pay more than a certain percentage of the family income for health insurance (Krugman is my source here, can't find the link).

[Johnny__Motown]

12. Nice, so you are gonna tax people so you can force other people to buy something they don't want

real nice

[johan helge]

14. Every one wants health insurance.

No one wants to pay for it - but every one should - according to their means (just like for taxes). Hillary, contrary to Obama, has specified that health insurance should not exceed a certain percentage of family income (Krugman is my source, can't find the link).

[Johnny__Motown]

18. Well, since everyone wants health insurance, and Obama lowers cost at least $300 more than Clinton

Plus you don't need to finance an enforcement entity for Obama's plan.... then how in hell can you defend Hillary's mandate?

you are not making any sense.

[johan helge]

28. Universal health care is the big thing

"Obama lowers cost at least $300 more than Clinton" - how do you know?

The big thing with mandates is that it every one gets insured, in other words, universal health care. And one big thing about universal health care in my view, is that it will be a difference between Dems and Repubs that every one can grasp, and that may give the victory to the Dems this time. Another is that it will be a blow to right-wing ideology, to show that the Democrats can solve one of the biggest problems for ordinary Americans - the fear of losing their health insurance.

Ok, thanks for the debate, gotta go (my daughter is vomiting!).

[Johnny__Motown]

85. Clintons claims to lower cost 2200 and Obama 2500 and neither dispute those numbers

That is where I get the 300 from

Mandates need to be clearly defined before anyone should support them.

Can you answer the questions I have poised concerning them? NO. Why not? Because Hillary has not answered them, and she has been pushing mandates since 1993.


She is wrong, always has been and just can't admit it. This is clearly a pattern with her. She will always try to prove she is right even when we all know she wasn't. IWR is another example.

[johan helge]

90. I assume those numbers are average reductions in yearly health insurance costs?

Sounds reasonable: Hillary insures twice as many uninsured as Obama, but her plan costs tax payers only roughly 25 % more. So she can't subsidize THE AVERAGE health insurance so much as Obama.

But that's the average: Contrary to Obama, Hillary has specified that health insurance should not exceed a certain percentage of familie income. That way people can afford the health insurance in her plan.

[enid602]

20. health care

I've had health insurance my entire adult life, and I hope to have it the rest of my life. How or why people can say it's something being foisted on people is beyond me. Are we Democrats, or what?

[Johnny__Motown]

21. Then once again, why do we need a mandate?

[KhaOZ]

24. You're the man. Just thought i'd let you know.

[Johnny__Motown]

25. The MAN.. What Kind Of Sexist Crap Is That? Couldn't a woman ...

KIDDING, Honestly


and thanks for the little ego boost

[enid602]

29. health care

Do you see millions of Spaniards, English, Canadians, Swiss, Germans, French, Belgians, Italians, etc complaining because they have universal health care? Oh, that's right, it's now a 'choice' issue. I wonder how many actually poll the people who don't have health care.

[Johnny__Motown]

38. That did not answer the question, why do we need a mandate if everyone wants health care.

Also, I honestly don't care what Spaniards, English, Canadian, Swiss, German, Belgian, Italian or others did in their country. This country is unique and is not European (or canadian which is still similar to the U.K. in many ways).

This argument just leads to people pointing out countries that don't have mandated health care and the circular arguments from there on are endless.

Lets deal with our country, not other countries.


Again, if everyone wants health care why do we need a mandate?

If 22,000,000 people don't want to sign up for health care then how will you force them to do it? How much will that cost and where will those fund come from?

If you have no idea how to answer those questions then you may want to reconsider your faith based belief in mandated health care.

[rodeodance]

55. i suppose there are some who do not want to purchase a plan--Who ends

up paying when serious health problems set in?--the people--you.

[Johnny__Motown]

78. It will be easier to deal with them once they are in the system, fine them for back premiums....

Nothing punitive, just make them pay up the back premiums


Besides this, I would rather have my premiums go up (or not go down as far) than to allow this unethical limit on personal freedom.

How about people who's religion does not allow them to accept certain types of medical care? Will they be forced to pay for coverage they know they will never use? OH, what was that? You never thought of that? Maybe you should think a bit longer before you sign up for limiting freedoms.

[rinsd]

94. Limiting freedoms? What kind of right wing bullshit is that?

[johan helge]

41. Because it gives 22 million more people health insurance

Why do these 22 million need a mandate? I don't know but: Contrary to Obama, Hillary has specified that health insurance should not exceed a certain percentage of family income (according to Krugman some place on his blog). This makes it affordable. And, of course, poverty makes people take the chance - skip health insurance in the hope that they won't need it.

In civilized countries, all get health care - and all (or almost all) pay taxes. Mandates is just another name for this principle.

[Johnny__Motown]

77. I do not equate "Gives" and "Forces upon" it forces health insurance upon 22 mil. people

Once again, setting it as a percentage of income will encourage people to work "under the table" to lower the amount they will pay for her plan.

Also even using Clinton's numbers her plan is approx. $300.00 more expensive per year per person.

You still are not equating Universal availability with universal care.



Mandate is the same as Dictate (root word for Dictator), not principle.


You admit that you don't know why they need a mandate. MAYBE THEY DON'T. Perhaps they will choose to sign up without being forced into it. If you try to force people to do something most will resist simply as a reflex.

Lastly, she has been working on this since at least 1993 and possibly longer. She still won't tell us anything about her mandate.

How will it be enforced? How much will it cost? How will it be funded? How will it be regulated? How effective can we expect it to be?

Until you know why we need a mandate as well as all the other questions about it I strongly suggest you rethink your faith based support for this unethical limit on personal freedom.

[johan helge]

83. Obama has made progressives sound like Repubs

when they talk about health care. Mandates is essentially the same as taxes - every one must pay, and every one gets health care. And on average, lower income groups benefit from this. That's why Repubs don't want mandates/taxes, and try to hide this by talking about freedom. Freedom to not have health insurance - what's that? No wealthy people use that "freedom".

Mandates means that every one gets health care, and that poor people get it heavy subsidized.

[Johnny__Motown]

84. Poor people already get Medicaid or Medicare, please study up on this a little

[johan helge]

87. Ok, what I said applies to

low-income groups that now do not have satisfactory health insurance.

[rinsd]

93. And both candidate envision a massive expasion of both.

In addition to creating their own public health plans.

Study up indeed.

[rodeodance]

59. in and attempt to provide health care for ALL.

[Johnny__Motown]

86. But the premise is that everyone wants it, so why do we need to mandate what everyone wants?

[rinsd]

98. So why does Obama mandate health coverage for children?

[rinsd]

92. Why does Obama need a mandate for children?

[rinsd]

91. How do you think Obama is gonna subsidize his healthcare?

WTF is with the rw argument about taxes?

[johan helge]

7. I don't know

but I assume mandates is like a tax - everyone has to pay (for health insurance). But I think Hillary (contrary to Obama) has specified that no family should pay more than a certain percentage of the family income for health insurance (Krugman is my source here, can't find the link).

[Exilednight]

70. Here's my problem with both plans, and why I support Obama's

Both allow for private health insurance companies which are private corporations that have to turn a profit. My tax dollars will be going to line someone else's pockets that are doing nothing for me.

I will not be able to afford either, unless they bring costs down substantially.

Under Hillary's plan I have no choice. I will have to make tough choices just in order to pay for my health care.

Under Obama's plan, I don't have to make that choice.

Yes, I will opt to not have health insurance instead of having my electricity turned off, or my phone, or heating oil, or not buying food.

Yes, I want health insurance, but I don't want a bill forced on me that I can't afford.


*edit - I will buy Obama's plan if I can afford it.

[johan helge]

104. Contrary to Obama, Hillary has specified that

the health insurance cost should not exceed a certain percentage of family income. With mandates, health insurance must be affordable, of course.

And if you don't want private insurance, you can buy government insurance in Hillary's plan.

[WillYourVoteBCounted]

34. Three times is a charm

She only got two tries back in the 90's.

[yourguide]

2. Big NY times story on whats going on with HRC camp

http://www.nytimes.com/2008/02/24/us/politics/24mood.html?hp

I am out of posts, can someone post a new thread, 2 page article



To her longtime friends, Senator Hillary Rodham Clinton sounds unusually philosophical on the phone these days. She rarely uses phrases like “when I’m president” anymore. Somber at times, determined at others, she talks to aides and confidants about the importance of focusing on a good day’s work. No drapes are being measured in her mind’s eye, they say.

And Mrs. Clinton has begun thanking some of her major supporters for helping her run for the Democratic presidential nomination.

“When this is all over, I’m really looking forward to seeing you,” she told one of those supporters by phone the other day.




*snip*

[dchill]

3. "Krugman thinks 22 million more people will be insured...

with Hillary's health care plan than with Obama's"

I think Krugman - whom I respect - is just a little naive here. It wouldn't seem to me that Hillary has any better chance of getting universal health care passed now than she did in 1993.

[johan helge]

11. But Congress is Democratic now, isn't it?

And: Was the 1993 plan universal health care (i.e. mandates)? The need for universal health care is bigger now than in 1993, because, I think, less people get heath insurance through their job than in 1993.

[DadOf2LittleAngels]

13. Congress was democratic in 1993 as well..

[johan helge]

15. Ok, but to get universal health insurance, you

at least need a President who wants it. And universal health care is probably much more accepted by the voters now than in 1993.

[DadOf2LittleAngels]

35. Nope sorry to say its not...

Its a hot button issue but just like the get out of Iraq / Impeach * mania that propelled the dems to power in 2006 once the election is over the reality will set in..

[johan helge]

43. Perhaps so, and perhaps not.

But a President working for universal health care is of course the first step in getting it. And the need for it is so strong and so obvious, that the issue won't go away, especially not if a President has worked for it.

[Yurovsky]

80. Well, universal care is certainly the answer ...

but still no one (outside of perhaps Dennis Kucinich) has really pushed that, if memory serves me (and it often lets me down...).

[johan helge]

88. Hillary's plan is universal care, but not single-payer. Here's why:

Krugman about this (http://krugman.blogs.nytimes.com/2007/10/07/why-not-single-payer/?scp=1&sq=krugman+single-payer&st=blog):

But there are very good political reasons for going with the Demoplan {i.e. Hillary's plan}: basically, it looks like something that could actually happen early in the next administration, while enacting a single-payer plan like the Conyers plan or the PNHP plan, excellent though those plans are, might take a very long time.

The public-private competition in the Demoplan is crucial, by the way, because it means that the Demoplan isn’t locked into the inefficiency of the private insurance system – it could evolve into single-payer over time.

Of course, the insurance industry will understand this, and fight the plan tooth and nail; the political logic of the Demoplan does not rest on the idea that AHIP will be fooled. Instead, there are two crucial advantages.

First, because most health insurance costs will continue to be paid out of premiums, the Demoplan doesn’t require a big tax increase – in fact, it can be financed simply by letting the high-end Bush tax cuts expire. I know, I know, the taxes that would support single-payer aren’t a true cost, because they would simply replace premiums and in most cases be lower than those premiums. But we’re talking about legislation, not reality.

Second, the Demoplans offer choice – so that people won’t feel that they’re being forced into a government plan. Over time, I suspect, many people will choose the government plan or plans – but they’ll have the option of staying with those wonderful people from the private insurance industry.

In an ideal world, I’d be a single-payer guy. But I see the chance of getting universal care, imperfect but fixable, just a couple of years from now. And I want to grab that chance.

[Yurovsky]

105. Something better than nothing no doubt ...

but I still have problems with potential penalties for people who do not want to purchase something they may not be able to afford and quite possibly will not need (at least for a long time). While I realize there may be subsidies or rebates provided to lower income individuals, I doubt they would accurately take into account the significant differences in cost of living in various parts of the country. I've lived in Florida & the northeast, where you cannot purchase a home for less than $350k, while I have relatives who live in Mississippi who can purchase a new home for $100k. So a $50k a year income in Mississippi would make someone comfortably middle class and able to afford these premiums, while that same income (even double) in NY or S. Fla would make it far more challenging. Not sure how the folks in California could manage.

[johan helge]

106. Health care is based on the principle that

those who don't need it pay most of the bill for those who do (few can afford the whole bill themselves). Every one should get care if they need it, so every one should pay (according to their income). In other countries this is called taxes, in the US mandates. As people should be penalized for not paying taxes (according to their income), they should be penalized for not contributing to the health care system they have access to.

[Occam Bandage]

4. Krugman's becoming a broken record.

[donheld]

42. A warped broken record at that.

[Sanctified]

5. Forcing everyone to buy their own healthcare is not universal healthcare.

In my opinion that is called Universal Insurance Company Care, the only ones who will benefit are the insurance companies.

[johan helge]

9. People can also buy goverment insurance -

and the government insurance may as time goes by force more and more health insurance companies out of business. Now the Democrats always try to increase the number of insured. With this plan, virtually every one will be insured - the Democrats can concentrate on increasing the number of government-insured.

[juno jones]

17. But will every doctor/hospital be mandated to accept that govt insurance

or will they be allowed to pick and choose like they do now? The clinics that currently accept govt insurance are horribly underfunded and have waiting lists years long. I have heard no mention of this topic.

I'm willing to pay the money but I want the same system the Canadians have, where I know I'll be getting care on par with other, higher-earning people and I cannot be refused or swindled by for-profit players.

[johan helge]

22. I don't know so much about this - but I'm sure

Hillary does what she can to remedy this things. Obama does not, since he does not promote universal health care (i.e. mandates).

[johan helge]

23. I don't know so much about this - but I'm sure

Hillary does what she can to remedy this things. Obama does not, since he does not promote universal health care (i.e. mandates).

[juno jones]

27. delete n/t

[RC]

10. Bingo! That is the major problem with health care in this country.

The For Profit Insurance Companies. Get them entirely out of the equation. They are blood sucking leaches - parasites on those in need.

[johan helge]

45. It's politically impossible to get single payer care just like that.

It won't happen. But Hillary's plan has a chance of gradually evolving into single payer care.

[Sanctified]

76. It won't evolve into single payer simply because it gives too much power to the Insurance Industry,

It's a pipe dream to think that the insurance industry will cooperate with a system that will eventually be their demise. The plan that Hillary has in place will never evolve into a single payer plan because elected officials will be reluctant to bite the hand of the health care industry.

[johan helge]

89. Of course the insurance industry will fight Hillary's plan

- because they are afraid of the competition from government insurance. You can of course say that the insurance industry will always be too influental, universal care is an impossible dream. But you can never be sure of this.

As I see it, universal care is possible. Firstly, there are no serious arguments against it - it's both cheaper and gives care to more people than the system today. Secondly, I think less and less employers will insure their employees. That will steadily increase the need for universal care.

[Yurovsky]

51. Ain't that the truth ...

forcing healthy people of limited means to buy something they may never need is insane. What should they go without? Food? Rent? Transportation? Clothing? Those are the hard choices that young, healthy low/moderate-income Americans would be forced to make.

[johan helge]

62. Mandates isn't more insane than taxes

Every one pays - according to their income - and lower income people on average get more than they pay for. Your post could have been written by a Republican. That's the whole problem with Obama - his health care plan has mad good Democrats believe in the Republicans' way of thinking about health.

[Sanctified]

75. I think the Government forcing people to give money to Private Corporations

is a Republican way of thinking. Democrats should be in favor of the freedom to chose how one lives ones life, everyone pays taxes because everyone uses the services that taxes provide. Not everyone uses healthcare, I for one do not have insurance because it's not provided through my employer. I am barely making enough money to live on as it is and have a very humble savings account for retirement in 30 years. I could not afford mandatory health insurance at this point, if I was required to take my savings and pay for health insurance I would deffinetely live in poverty during my retirement years.

Currently I see a doctor twice a year for checkups and pay for it out of pocket, if I need to see a doctor for an ailment I also pay that out of pocket, on average I spend $400 a year for my health care. I looked into health insurance and for the bare minimum which would not even include prescriptions or Dr. visits just emergency care it would cost $400 a month which is almost 25% of my take home salary. How is someone like me who currently lives just above poverty level supposed to make it when my forced insurance will put me below the poverty level?

[johan helge]

82. Good question,

and I don't know much about it, but: Contrary to Obama, Hillary has specified that health insurance should not exceed a certain percentage of family income (Krugman's blog is my source). So I assume that that percentage is so that virtually every one should afford it (otherwise, the mandates could not work, of course).

Mandates don't force people to give money to corporations - they can buy government insurance. And that may, as time goes by, squeeze many health insurance companies out of the market.

Mandates is just another name for the system in civilized countries: Every one (or almost every one) pays taxes, and every one gets health insurance. Are the Obama supportes aware that Obama has made them sound like Republicans on health care - opponents of universal health care?

[Rosemary2205]

6. What, specificially, are they getting for $2700 (or $4400)

it is just not possible to deliver anywhere close to what I would consider comprehensive medical care for either of those amounts within the bounds of our current medical care delivery system.

[johan helge]

8. I'm not sure, but think those numbers are costs for the government

- in addition to this comes what people pay for health insurance themselves.

[Rosemary2205]

16. Well, I have to tell you

If Hillary's plan gets me $2700 of the way and my medical care costs a minimum of $8000 a year total, then unless I have $5300 to pay the difference - I might be "insured" but I won't actually be getting medical care because I won't be able to pay my portion to actually access medical care.

They are BOTH talking about "insuring everyone" and one side or the other keeps telling me their plan "insures" more people. No one is promising to get more people actual access to comprehensive medical care.

[johan helge]

19. Contrary to Obama, Hillary has specified that

health insurance should not cost more than a certain percentage of family income.

More insured people means that more people get health care, doesn't it?

[Rosemary2205]

26. No, insurance does not mean access to medical care.

any more than having homeowner's insurance means the folks in NOLA can rebuild their homes. For profit insurance is designed to make money, not provide services.

Even opening medicare up to more people will not guarantee access to medical care. Too many places lack healthcare providers willing to settle for medicare pay alone (and those payouts are getting even smaller)- those with medicare now most often purchase supplemental policies or else pay large amounts out of pocket to obtain medical care.

Mandated insurance also does not re-open closed medical facilities in poor rural areas, does not get doctors into those areas. -- there are many barriers to getting actual medical care -- and slapping minimal insurance coverage at great expense to an individual doesn't help anyone. IMHO.

[johan helge]

81. Mandates don't solve all problems, of course

- but: I assume now many insured people don't get health care because of pre-existing conditions etc. I think mandates to a large extent will solve this, because I dont't think government-insurance will exclude people with pre-existing conditions. Because the whole point with mandates is that every one should get health care.

[bvar22]

30. And WHAT percentage of MY income will Hillary require me to pay

to the For Profit Insurance Corporations?

I don't think she has been clear on that.

So, How Much of my total income?....50%....25%...10%????

[rodeodance]

54. Do you know what % Obama's plan would require?

[bvar22]

79. Yes....0%.

Obama doesn't support a law that requires me to buy Health Insurance from a For Profit Health Insurance Corporation (which just happens to be her largest campaign contributor.....things that should make you go "Hmmmm".)

[rinsd]

95. Neither does Hillary unless you consider MediCare as for profit insurance.

Or any of the other public plans you would have acess to.

Seems the Obama supporters here rather just lie.

[anigbrowl]

33. Well, it might look that way

because more insured people does create a larger healthcare pool among whom the risks can be spread. But get this: if you have some horrible medical condition (I dunno, you're a quadruplegic or are born with some disease that puts you at high risk for cancer, for example), then the insurance company is STILL going to charge you an arm and a leg for healthcare insurance as they do now. Clinton's plan, as far as I know, has no cap on it for healthcare costs.

It's gonna be a real bonanza for the insurance companies though. 47 million new customers forced to buy their insurance products on pain of a fine. That's right, you'll pay a fine if you don't purchase insurance from a private corporation. That' sgoing to sell real well to the electorate in November, I don't think.

[johan helge]

107. That is not correct:

Here's a summary of Hillary's plan according to Krugman (http://krugman.blogs.nytimes.com/2007/10/07/why-not-single-payer/?scp=1&sq=krugman+single-payer&st=blog):

"{It is} requiring that insurance companies offer insurance to everyone at the same rate regardless of medical history; a mandate, requiring that everyone have insurance; subsidies to help lower-income people pay for insurance; and public-private competition, in which people have the option of buying into a plan run by the government."

So - it requires "that insurance companies offer insurance to everyone at the same rate regardless of medical history".

[Johnny__Motown]

39. Well that certainly has no flaw in it, People NEVER Work Under The Table Do They?

This is just one more reason for people struggling for economic survival to commit fraud.





Yes more insured people means that more people get health care. The problem with all your assumptions is that people fall in line like sheep.

If they don't want to buy the health care they will find ways around it. You will need to create, fund and regulate some type of enforcement entity to insure that people sign up.

Until Hillary spells out exactly what the enforcement mechanism for her mandate is, how much it will cost, how it will be funded and how effective we can expect it to be I can't support a mandate. And neither should anyone else.

[johan helge]

108. I don't know what Hillary's enforcement mechanism will be

- one is of course that you don't get health care. But then her plan will be much like Obama's, because that's his and the Repubs' "enforcement mechanism".

An alternative is that you don't lose health care, but you get the same kind of trouble you get if you don't pay your taxes. I prefer this alternative, because mandates are just another name for taxes (that finance health care).

[anigbrowl]

32. So you don't know what you get out of it, but you'll vote for it anyway

Wise up Johan!

[johan helge]

67. Sorry, I forgot to check what Krugman actually wrote

- and he says these numbers are "taxpayer cost". So my assumption was right - these are government costs, health insurance premiums come in addition to these costs.

[anigbrowl]

31. Who says so? Jonathan Gruber. Who is Jonathan Gruber?

He's an economist at MIT. According to AH Goldberg, he's got a lot to do with Mitt Romney's healthcare plan in Massachussetts, which includes mandates...and isn't working out that well.

http://ahgoldberg.radioleft.com/blog/_archives/2007/10/9/3264807.html

Meantime, I would very much like to see this famous and oft-quoted paper comparing the Clinton and Obama plans - sorry, a plan 'broadly resembling' the Obama one, whatever that means.

Any clues as to what this paper is? According to Gruber's website - http://econ-www.mit.edu/faculty/gruberj/paper - the last paper he produced on health insurance was in 2003. He seems to have authored or co-authored 3 papers on health insurance:


Subsidies to Employee Health Insurance Premiums and the Health Insurance Market
with Ebonya Washington
March 2003, March 2003, NBER Working Paper #9567

Health Insurance Coverage and the Disability Insurance Application Decision
September 2002, NBER Working Paper #9148

Health Insurance, Labor Supply, and Job Mobility: A Critical Review of the Literature
with Brigitte Madrian
March 2002, NBER Working Paper #8817

There's also this, on the publications page (also accesible at his website)

The Massachusetts Health Care Revolution: A Local Start for Universal Coverage
Hastings Center Report, 36 (5), September-October 2006, 14-19

http://econ-www.mit.edu/files/978

I think it's this one, because it talks specifically about a need for mandates and so on in considerable detail...though it's worth noting that this pdf omits the commentary in the same publication from 5 other economists on how well the MA plan was likely to work.

It is worth noting that he MA plan levies a charge of $295 per month per person on businesses that can't or won't provide healthcare insurance to their employees. It's also worth noting that this is for-profit insurance: although the government subsidizes, the insurer still gets to set rates per patient. I fyou ask me, it'll be just like HMOs, only better (irony alert).


Now, I'm not blaming Gruber for the ongoing allegations about Obama's health plan. He has an excellent reputation, although I'm rather skeptical of his arguments for the way healthcare has been introduced in MA. But I do have a problem with Kurgman's quoting him (and being endlessly requoted by people that wouldn't know their economic as from their elbow) as an authorative source on Obama's plan, when Gruber's paper seems to consider only a hypothetical plan that 'resembles' Obama's and imagines outcomes with and without mandates.

Gruber clearly believes in mandates, but there's no solid evidence yet to show whether or not they work in the context of US healthcare. Right now, the costs and savings exist only in theory, and the numbers are not in yet. And his mandates seem to come with $3500/year in fines for those who can't comply. For Kurgman to say that the Gruber hypothesis 'broadly resembles' the Obama plan and then extrapolate that hypothesis to apply to the entire US and conclude that millions would end up uninsured is bogus - pure grade-A bullshit that we wouldn't tolerate for a second if a right-wing think tank offered it up to justify some Bush initiative.

Meantime, Clinton's argument against Obama's plan goes like this:

C: Your plan would leave 15 million people unable to buy insurance.
O: No it wouldn't - everyone will be able to buy it.
C: But some of them will choose not to and try to scam their way to free healthcare.

Clinton wants to have it both ways - we're supposed to feel sympathy for the poor people unable to get insured under Obama's wicked rule, but in the next breath she wants us to be angry about the people who would try and get along without health insurance if there were no mandates - those freeloaders! But if you listen carefully to what she says, she is actually talking about the *same people*.

It's a classic bait and switch argument, using two completely different interpretations of the same (imaginary) number. One minute those without insurance are victims; the next they are scammers pushing up the cost for everyone else. When challenged on one interpretation, just switch to the other, and back again.

It is total bullshit, and I think she has a good laugh at the credulity of her supporters every time she gets away with it. I certainly have, but what was an entartaining campaign joke, amusing only to those of us who are political/economic junkies and expect such campaign shenanigans, is now turning into a dangerous lie as Clinton tries to make this false dichotomy the centerpiece of her argument against Obama.


One more time, folks: When Hillary Clinton tries to milk sympathy for 15 million victims left uninsured by Obama's plan, and incite outrage against millions of freeloaders who'd push up the cost for everyone else, she is talking about the *same - hypothetical - number of people* and just offering two different interpretations of it.

It's a scam of you, the voters.

And although I'm not going to address it here (maybe in another thread, but it's a bit of a project), her mandated healthcare plan is little more than a free gift to the insurance companies - all the risk stays with the taxpayer, and all the profit goes into the pockets of the insurance companies, and the consumer/patient will get no more choice or control over their healthcare than they did from HMOs ten years ago. Her healthcare plan is a sucker bet, but we want healthcare reform so bad in this country that a lot of people are willing to be suckered.

[johan helge]

56. Krugman on Massachusetts

Krugman (http://krugman.blogs.nytimes.com/2008/02/02/misinformed-on-massachusetts/?scp=1&sq=krugman+massachusetts&st=blog):

While we’re talking about health care reform: I’ve been getting a fair bit of mail from people who have heard that things are going very badly in Massachusetts. And there have, indeed, been some very downbeat reports in the media lately.

The problem is that they’re all wrong. People are confusing an increase in costs that was largely (not completely) anticipated — after all, the plan is supposed to cover more people, and subsidize their coverage — with a cost overrun.

The fact is that the plan does seem to be making a serious dent in the number of uninsured. One thing that has come to light is that there may have been more uninsured people in Massachusetts to start with than previously estimated, so there’s a steeper hill to climb. But claims that it’s all a disaster are based on nothing but bad journalism.

[Egnever]

36. Thats what the fine will be?

ouch 22 million! Thank god she isnt getting elected.

[Zhade]

37. INSURANCE Care - how Clinton's plan would destroy health care.

Step One: put (costly) medical decisions in the hands of those whose job it is to DENY health care to expand the corporate bottom line.

Step Two: Watch more people die.

[johan helge]

109. In Hillary's plan, people can also buy government insurance

- in case they e.g. don't trust the private insurance companies.

[Hidden Stillness]

40. Neither One of Their Plans Solves Anything

I don't really think either one of their plans makes any sense, and don't understand how it would help us any more than forcing people, now, to buy (unregulated) auto insurance from corporations that then make it cheaper to just not declare anything, because of the "penalty" hikes. I think forcing people to buy, then not forcing corporations to serve, is disgusting and solves nothing. The only candidate who had any understanding of the issues that have to be faced, was Dennis Kucinich, with the universal, paid-by-taxes "Medicare for All" approach. One thing I will give credit to Hillary Clinton for, though, is voting against the horrific "Medicare" Part D scam, with its prescription-revolving, incoherent plans, outrageously high premiums and drug prices, and drugs not covered. Obama voted FOR it.

[johan helge]

47. Kucinich's plan is probably good but politically impossible

- that's Krugman's view, anyway (http://krugman.blogs.nytimes.com/2007/10/07/why-not-single-payer/?scp=1&sq=krugman+single+payer&st=blog):

"But there are very good political reasons for going with the Demoplan {i.e. Hillary's plan}: basically, it looks like something that could actually happen early in the next administration, while enacting a single-payer plan like the Conyers plan or the PNHP plan, excellent though those plans are, might take a very long time.

The public-private competition in the Demoplan is crucial, by the way, because it means that the Demoplan isn’t locked into the inefficiency of the private insurance system – it could evolve into single-payer over time.

Of course, the insurance industry will understand this, and fight the plan tooth and nail; the political logic of the Demoplan does not rest on the idea that AHIP will be fooled. Instead, there are two crucial advantages.

First, because most health insurance costs will continue to be paid out of premiums, the Demoplan doesn’t require a big tax increase – in fact, it can be financed simply by letting the high-end Bush tax cuts expire. I know, I know, the taxes that would support single-payer aren’t a true cost, because they would simply replace premiums and in most cases be lower than those premiums. But we’re talking about legislation, not reality.

Second, the Demoplans offer choice – so that people won’t feel that they’re being forced into a government plan. Over time, I suspect, many people will choose the government plan or plans – but they’ll have the option of staying with those wonderful people from the private insurance industry.
In an ideal world, I’d be a single-payer guy. But I see the chance of getting universal care, imperfect but fixable, just a couple of years from now. And I want to grab that chance."

[MadHound]

44. Wow, that estimated figure is going up daily

At the debate is was supposedly 15 million. Today it's 22 million, what will it be next week, fifty million?

This is just the Clinton camp getting (deliberately) sloppy with the numbers. It also goes to show that they have no clue as to what they're talking about.

[johan helge]

46. These numbers are uncertain, of course

- they depend on uncertain assumptions. But we are obviously talking about several/many million people.

[MadHound]

61. Or maybe not, as you said the numbers are uncertain

That's why I find all of this talk of millions and tens of millions a bit disingenuous. Yes, Hillary's plan mandates that everybody buy health insurance(and yes, I find this mandatory aspect to be a huge strike against Hillary's plan), but that doesn't mean that under her plan everybody will actually have health insurance. Some will fall through the cracks, some will deliberately not participate, etc. etc. Even if that amounts to a percentage point or two, that's still millions of people.

Frankly I think that anybody predicting numbers out of these plans is simply full of it. There are too many variables to make any sort of accurate prediction, even to whether or not those numbers will be in the thousands, millions or hundreds. It simply can't be forecast.

[johan helge]

74. How do you know so much about what can be forecasted?

It seems to me that Obama's plan is difficult to defend, and that uncertainty is the last straw to grasp. But it's pretty obvious that to get "virtually every one" (Krugman's expression) insured, you need mandates. Without mandates, the temptation to skip the insurance premium will be too big for many.

But mandates isn't a Stalin regime. It's just another name for the system in civilized countries: Every one (or almost every one) has to pay taxes, and every one gets health care.

[Vinca]

48. If Hillary wants to make a last ditch effort to get the nomination,

she could scrap her lousy health INSURANCE scheme and make a gutsy move by endorsing the Kucinich plan. I would certainly reconsider my stand and I'm sure many others would. Sadly, neither candidate has an edge on the health care debate because neither is brave enough to buck big insurance and promote true universal, single payer, health CARE. In all honesty, I'm surprised so many Democrats have gone over to the dark side on this issue (universal health INSURANCE).

[johan helge]

49. Check out what Krugman says about this

Krugman (http://krugman.blogs.nytimes.com/2007/10/07/why-not-sin... ):

"But there are very good political reasons for going with the Demoplan {i.e. Hillary's plan}: basically, it looks like something that could actually happen early in the next administration, while enacting a single-payer plan like the Conyers plan or the PNHP plan, excellent though those plans are, might take a very long time.

The public-private competition in the Demoplan is crucial, by the way, because it means that the Demoplan isn’t locked into the inefficiency of the private insurance system – it could evolve into single-payer over time.

Of course, the insurance industry will understand this, and fight the plan tooth and nail; the political logic of the Demoplan does not rest on the idea that AHIP will be fooled. Instead, there are two crucial advantages.

First, because most health insurance costs will continue to be paid out of premiums, the Demoplan doesn’t require a big tax increase – in fact, it can be financed simply by letting the high-end Bush tax cuts expire. I know, I know, the taxes that would support single-payer aren’t a true cost, because they would simply replace premiums and in most cases be lower than those premiums. But we’re talking about legislation, not reality.

Second, the Demoplans offer choice – so that people won’t feel that they’re being forced into a government plan. Over time, I suspect, many people will choose the government plan or plans – but they’ll have the option of staying with those wonderful people from the private insurance industry.

In an ideal world, I’d be a single-payer guy. But I see the chance of getting universal care, imperfect but fixable, just a couple of years from now. And I want to grab that chance."

[Vinca]

50. I've read this and I think Krugman is seeing things.

The difference between the 2 plans is minute and anyone with any knowledge of the system realizes the whole mess will land in Congress for them to figure out. Without a Democratic supermajority nothing is going to happen whether it's Hillary's plan or Barack's plan.

[johan helge]

53. 22 million people is not "minute"!

Congress: How do you know a "supermajority" is necessary? And even if it was: It will be a huge step forward with a President who works for universal health care. That will put pressure on the Congress, and on future Democratic Presidents. People need to hear someone of importance say I want "universal health care". That will make them understand that it is possible.

[Vinca]

57. I thought it was 15 million. Gets bigger by the day.

How do I know a supermajority is necessary? Surely, you must be kidding. Have you heard many Republicans speaking in favor of what either of our candidates is proposing? Let me remind you of the aftermath of the 2006 "we're going to end the war" election. Harry and Nancy, when faced with Republican opposition, will morph any plan into a tax deduction. Wait and see.

[rodeodance]

58. of course it is unknown-but looking brighter with probable more dems in congres and the WH.

[johan helge]

60. Krugman about Congress

Krugman (http://www.nytimes.com/2008/02/04/opinion/04krugman.html?_r=1&scp=1&sq=krugman+obama+gruber&st=nyt&oref=slogin):

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.

[samer]

99. If she did this i would reconsider as well,

sadly i don't think she will, she is funded by the health insurance lobby. She wouldn't bit the hand that feeds.

[OzarkDem]

52. K & R

[ElsewheresDaughter]

63. they threw poor Krugman under the Rethuglican Obama Bus last month along with RFK Jr and Edwards

[ORDem]

64. Krugman's been on an anti-Obama jihad for some time, his view

is not balanced. He looks at things strictly from an economist's view. Once Hillary made the "garnish wages" comment she essentially doomed her plan just like she doomed it in '93. She is politically tone-deaf and thinks she can just get her way by wishing it to be. Obama recognizes the difficulties of building coalitions and working to get things changed without applying a big hammer.

:kick:

[johan helge]

66. What's Hillary's "garnish wages" comment? (nt)

[Cameron27]

65. K&R

Posters will fight you, but unless everyone's in the plan, it won't work.

[R_M]

68. It is a good start.

Obama's plan is no good. Hillary's plan will get the ball rolling on what should eventually become
"Medicare for All".

[saltpoint]

69. No current health plan proposal will emerge without significant changes

once the 111th Congress completes its work.

Senator Clinton, if she is elected, may have better luck getting a health care plan in persuasive, supportable form than she did in the 1990s.

Any Democratic president will have a health plan. We don't know the final form or substance of that plan. Most of that work is all ahead of any Democratic president.

The Clintons were in office 8 years. I see no health care reform from that time directed at making coverage and care easier, better, or more comprehensive.

[johan helge]

71. Krugman about the Congress

Krugman (http://www.nytimes.com/2008/02/04/opinion/04krugman.htm... ):

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.

[saltpoint]

72. I understand your points but Committee work will likely retain Democratic

numbers after the Senate races, and that is committeework true and clear.

The president may serve as vanguard or even pointguard.

But the work is a Legislative Branch initiative and their work from committee forward brands the final product.

[johan helge]

73. Ok, but of course it's important what the President wants

It will be a huge step forward with a President who works for universal health care. That will put pressure on the Congress, and on future Democratic Presidents. People need to hear someone of importance say I want "universal health care". That will make them understand that it is possible.

[samer]

96. We should not trust Hillarys health care plan...

Remember, Hillary takes more money from the Health insurance lobbyists than any other candidate on ether side. She is paid and bought by the medical companies, these corporations exist to make a profit. Her plan for Universal Health Insurance forces people to buy health insurance.

This is not like the Canadian or French system were every one is covered regardless of income or employment.

Obama on the other hand take no money from Lobbyists or the health insurance industry. $0, follow the money trail and it will explain everything.

Obama's plan is not perfect, however it is a great bridge to true Universal Health Care down the line.

Please watch the movie Sicko, it will explain this in alot more detail.

[rinsd]

97. Obama took in $500,000 from the insurance industry

http://www.opensecrets.org/pres08/select.asp?Ind=F09

He also took in over $700K from HMOs/Hospitals/Nursing Homes.

Obama & Hillary have nearly the same healtcare plan with the exception of mandates.

Obama mandates coverage for children, Hillary mandates coverage for all.

Also Hillary's plan specifically attaches premiums to income level but you've already shown that you education on healtcare extends as far as an Obama flier.

[samer]

101. Obama's support

Obama has a wide range of supporters, people that work for the health insurance industry privately donate to Obama, but these are "no strings" attached donations.

Obama take $0 for lobbyists, this is the main reason i support him.

The Canadian health care system does not mandate that Adults have universal health care, it is up to the person to go and apply for it.

A mandate to buy health insurance will not work, because people that cannot afford it will not be able to pay.

Let me ask you a question, why does Hillary's plan include health insurance companies, why doesn't she fight for Universal Health Care and not just Universal Health Insurance?

[rinsd]

103. You do realize you are relying on the same source for Hillary's lobbyist numbers don't you?

That quote you cited earlier from Sicko was using opensecrets as a source.

"Obama take $0 for lobbyists, this is the main reason i support him."

yes he just has lobbyists running his campaign, doing fundraising bundling, having their wives contribute and takes money from people who work at firms whose primary function is lobbying.

Yeah once you get past all the caveats, Obama doesn't take money from lobbyists. :eyes:

"A mandate to buy health insurance will not work, because people that cannot afford it will not be able to pay."

Obama mandates health insurance for children and both plans have massive expansion of public health plans (not private for profit insurance). Why do you ignore this?

"Let me ask you a question, why does Hillary's plan include health insurance companies, why doesn't she fight for Universal Health Care and not just Universal Health Insurance?"

Unfortunately because neither candidate sees single payer as politically viable.

[johan helge]

100. I didn't know this about the lobbyists, good point, but regardless:

In Hillary's plan, people can also buy government insurance, they don't have to go to the insurance companies.

Forcing people to buy health insurance means universal health care if you can make the insurance affordable. And Hillary does that - contrary to Obama, she has specified that health insurance should not exceed a certain percentage of family income.

So why not a single-payer system (i.e. like e.g. Canada has)? Krugman about this (http://krugman.blogs.nytimes.com/2007/10/07/why-not-single-payer/?scp=2&sq=krugman+tooth+nail&st=blog):

But there are very good political reasons for going with the Demoplan {i.e. Hillary's plan}: basically, it looks like something that could actually happen early in the next administration, while enacting a single-payer plan like the Conyers plan or the PNHP plan, excellent though those plans are, might take a very long time.

The public-private competition in the Demoplan is crucial, by the way, because it means that the Demoplan isn’t locked into the inefficiency of the private insurance system – it could evolve into single-payer over time.

Of course, the insurance industry will understand this, and fight the plan tooth and nail; the political logic of the Demoplan does not rest on the idea that AHIP will be fooled. Instead, there are two crucial advantages.

First, because most health insurance costs will continue to be paid out of premiums, the Demoplan doesn’t require a big tax increase – in fact, it can be financed simply by letting the high-end Bush tax cuts expire. I know, I know, the taxes that would support single-payer aren’t a true cost, because they would simply replace premiums and in most cases be lower than those premiums. But we’re talking about legislation, not reality.

Second, the Demoplans offer choice – so that people won’t feel that they’re being forced into a government plan. Over time, I suspect, many people will choose the government plan or plans – but they’ll have the option of staying with those wonderful people from the private insurance industry.

In an ideal world, I’d be a single-payer guy. But I see the chance of getting universal care, imperfect but fixable, just a couple of years from now. And I want to grab that chance.

[ElsewheresDaughter]

102. Obama's Top Adviser is a Lobbyist for BIG PHARMA and the Insurance industry