Health Economics 101 and Paul Krugman's Praise of John Edwards' Universal Health Care Plan

[Time for change]

As someone with limited background in economics (I’m referring to me, not Krugman), I have found Paul Krugman’s explanations of economic issues to be as lucid and straight forward as any I’ve ever read. As a physician who developed and taught a course in “Measuring and Managing Health Care Quality and Costs”, I do have some relevant background in economics at least as it applies to health care – and I can say that Krugman’s discussion on the economics of health care makes a world of sense to me.

This post first discusses basic principles relating to the economics of health care in the United States, especially as it relates to the question of what would be a good national health care policy. That discussion relies heavily on Paul Krugman’s discussion of the issue, from his book, “The Conscience of a Liberal”.

Then, with those principles in mind, I discuss Krugman’s assessment of the health plans offered by the presidential candidates. This involves a discussion of the health plans of the three leading Democratic candidates and a discussion of the Republican candidates’ “plans” as a group. The reason that the Republican “plans” are discussed as a group is that they are all virtually worthless, so there little reason for going into much detail with them. I can only speculate why Krugman chooses to address the plans of only the three leading Democratic candidates – I suppose that he doesn’t want to dilute his message by talking about candidates whom he considers to have little or no chance of winning the Democratic nomination. Most of us recognize that Dennis Kucinich has put forth the best national health care plan of all the candidates. Based on the principles that Krugman discusses, he would undoubtedly agree with that statement in theory if he chose to discuss it – though he does believe that plan to have problems with political viability. That being said…


HEALTH CARE ECONOMICS AND POLITICS 101

The woeful state of health care in the United States

Despite the fact that the U.S. spends 53% more per capita than the next most costly developed country and more than twice as much per capita (more than $6,000 in 2004) as the median health care cost among developed countries, the U.S. health care system is rated by the World Health Organization as only the 37th best in the world.

The main basis on which the U.S. health care system is rated so poorly compared to most of the world’s developed nations is the large percentage of uninsured people in our country, who can neither afford health insurance nor catastrophic health care. The United States is, in fact, the only developed country that doesn’t offer its citizens universal health care. About 15% of Americans are currently uninsured, representing about 47 million U.S. citizens. That accounts for a substantial part of the explanation for why life expectancy in our country lags behind most other developed nations: a 2000 World Health Organization report showed the United States to rank 24th in world life expectancy, and a 2006 report showed our world ranking dropping to 27th. A 2006 report on infant mortality rate, which is a more sensitive indicator of the quality of a nation’s health care than total life expectancy, ranked the U.S. as having the 2nd highest infant mortality rate among the developed nations of the world.

The bottom line is that, compared to other developed countries, the U.S. spends far more on health care and yet has a comparatively inferior health care system.


The reason why the U.S. health care system is so expensive yet inferior to that of most developed nations

There is a single cause that underlies most of the excessive cost of health care in the United States, as well as its inferior quality. That cause is the fact that most health care insurance in our country is supplied by private corporations.

The main goal of private insurance corporations in the United States, as with all corporations, is to make a profit. They attempt to increase their profits in two ways that result in reduced health care: They attempt to withhold health insurance from unhealthy people, and they refuse to honor health care claims from their insured clients whenever they can get away with it.

These practices not only reduce the health care that people receive, but they also increase its costs. Weeding out unhealthy health insurance applicants costs a lot of money. So does fighting over health care payments with patients or health care providers. And health care providers too spend a lot of money fighting over payments with insurance companies. All of these things, plus the several layers of bureaucracy that are often involved with these systems, increase administrative costs and therefore drive up the cost of health care. The end result is that 31% of health care costs in the U.S. are administrative costs.

And that is not the only reason for the high health care costs associated with private health insurance. There are also perverse financial incentives involved, such as refusal to provide preventive health care and the use of inefficient systems (such as outpatient CT scan facilities).

All of these problems would be greatly reduced or eliminated with a government sponsored single-payer health system. When a government accountable to its people is responsible for providing health care, then the goal is to provide health care rather than to make a profit. The result is greatly reduced administrative costs and better health care for less cost.


Political barriers to government sponsored universal single-payer health care

Before considering what an ideal universal health care system would consist of it is worth while to consider the political barriers to a government sponsored universal single-payer health care system:

Insurance corporations
Insurance corporations make huge profits out of the current health care system. Every American who receives health insurance directly from the government (as in Medicare or Medicaid) represents reduced profits for insurance companies. Consequently, insurance companies are bound to provide fierce political opposition to any plan for increasing the government role in directly insuring people. They were a major factor in the defeat of the Clinton health plan in the 1990s.

Pharmaceutical corporations
Pharmaceutical corporations also make huge profits out of our current health care system. U.S. citizens pay much more for prescription drugs than do citizens of other developed nations. An accountable U.S. government that supplied health insurance directly to its citizens would be likely to put an end to the excessive costs of prescription drugs in our country because it would have the power to bargain down prices.

Right wing ideologues
Right wing ideologues began to take control of the Republican Party in 1980, with the election of Ronald Reagan to the Presidency. After the election of 1994 they had substantial control of Congress. Right wing ideologues are intent on reducing the role of government in our country by dismantling FDR’s New Deal. Therefore, it would be a horrendous setback for their goals to have universal national health care legislation enacted in our country. Ironically, the right wing ideologue William Kristol explained the reason why passing a universal national health care plan is so important to our country (although he meant his explanation in a negative way). In a Wall Street Journal editorial in 1993, he wrote:

Passage of the Clinton health care plan in any form would be disastrous. It would guarantee an unprecedented federal intrusion into the American economy. Its success would signal the rebirth of centralized welfare-state policy.

In other words, as Paul Krugman points out, the main fear of the right wing ideologues is not that universal health care will fail, but that it will succeed.

Uninformed ordinary Americans
Lastly, another political barrier to the passage of universal national health care is uninformed ordinary Americans. Specifically: They are concerned about cost – not understanding that the costs would be less, not more; and they are concerned that a universal health care plan would interfere with their choice of health care provider – a belief which the above noted categories of political opposition vigorously try to encourage.


The components of a practical universal health care plan

Krugman recommends four components for a national universal health care plan, which he feels represents the best compromise between an ideal plan and a plan that that will reduce the political barriers to the point where the plan is likely to be enacted into law. The first three components are based on economic and medical reasons, and the fourth component is based on political viability:

Community rating
Community rating means that insurers are prohibited from charging different premium prices for different patients, based on their health status. This principle is necessary because without it, insurance companies can deny care to or charge prohibitively expensive prices for people with preexisting medical conditions or other risk factors. Thus, community rating is necessary to ensure that health care is available to everyone.

Subsidies for low-income families
Adequate subsidies for low-income families are necessary in order to ensure that all Americans can afford the health care insurance that they need.

Mandatory coverage
In the absence of mandatory coverage there will always be some people who will choose not to purchase health insurance even though they can afford it. Under the community rating rule they could then purchase health insurance if they get sick, thus driving up the cost of health care and making it more expensive for everyone else. Or, they would receive health care in emergency rooms at taxpayer expense, which would also drive up health care costs for everyone else. Thus, the rationale for mandatory coverage is based on an economic argument. Without it, some people will game the system, thus increasing costs for everyone. Mandatory health insurance coverage is analogous to the principle of mandatory taxes.

Public-private competition
Though Krugman says that, for many of the reasons discussed above, a government sponsored single-payer universal health care plan is the best and least costly plan we could have, he feels that such a plan would probably not be politically viable at this time. Thus, he is afraid that if our next President tries to push such a plan through Congress it will encounter the fate of the Clinton health plan of 1993, and we will then be without universal health insurance for several more years.

To make the plan more politically viable, Krugman suggests that people be given the choice of purchasing government provided insurance or purchasing insurance through a private insurance company (or sticking with their current private plan).

This would have two political advantages over a single-payer plan. First, it would be less expensive in the sense that it would require less taxes to pay for it. Economically, that advantage would be only apparent rather than real. What we would save in taxes would be more than cancelled out by out-of-pocket expenses for those who purchased private rather than government insurance. But Krugman believes that it would be more politically palatable because it would be less expensive up front, and many voters would not recognize the cost savings of a single-payer plan, given the propaganda that would be sure to come from political opponents.

The other political advantage of giving people the choice of government vs. private insurance would be that such a plan would be less susceptible to accusations that people wouldn’t be able to exercise their choice of doctor. Again, we are talking about a perceived rather than a real problem. Single-payer plans are perfectly capable of allowing people to choose their own doctor. They require that everyone obtain their insurance through government, but can still allow complete freedom of choice of doctors. Nevertheless, Krugman feels that a single-payer plan is likely to be a political liability, given the distortions that are certain to be introduced by political opponents.

I don’t know how valid Krugman’s concerns of political viability for single-payer health plans are. But nevertheless, his idea for compromise seems quite worth while to me. True, a single-payer plan would be less expensive and provide better medical care than a plan where a choice is allowed between government and private insurance plans. Undoubtedly, many people would initially choose private insurance, and for the reasons discussed above, private insurance is more expensive and leads to inferior health care compared to government provided insurance.

However, Krugman’s idea of an ideal compromise plan would almost certainly lead to a single-payer plan or something very close to it before very long. Before long, people would recognize that government insurance is superior to private insurance, with respect to both cost and quality. As people recognized this they would switch to government insurance. And when enough people did this the insurance companies would just fade away.


KRUGMAN’S EVALUATION OF THE PLANS OF THE PRESIDENTIAL CANDIDATES

Paul Krugman feels that it’s imperative that we get universal national health insurance (more on that below). He also believes that in order for it to happen any time soon, our next President must address the issue thoroughly and accurately during this presidential campaign, so as to prepare the American people for it. Consequently, he has been following and commenting upon developments very closely, perhaps more closely than any other journalist:


Krugman praises Edwards’ plan

In February of 2007, with the unveiling of John Edwards’ health plan, Krugman wrote an editorial about it in the New York Times. He began by saying that promises of universal health insurance don’t mean much unless accompanied by specific details. He likened rhetoric without details to George Bush’s promises of “compassionate conservatism”.

Then he said, “And former Senator John Edwards has just set a fine example”.

He noted the details in Edwards’ plan that were similar to other good proposals. And then he added “But Mr. Edwards goes two steps further”. After describing those steps and why they’re good ideas, he concludes by saying:

So this is a smart, serious proposal. It addresses both the problem of the uninsured and the waste and inefficiency of our fragmented insurance system. And every candidate should be pressed to come up with something comparable.

Yes, that includes Barack Obama and Hillary Clinton. So far, all we have from Mr. Obama is inspiring rhetoric about universal care – that's great, but how do we get there? And how do we know whether Mrs. Clinton, who says that she's "not ready to be specific," and that she wants to "build the consensus first," will really be willing to take on this issue again?

To be fair, these are still early days. But America's crumbling health care system is our most important domestic issue, and I think we have a right to know what those who would be president propose to do about it.

Krugman describes the Obama plan as second best

With the unveiling of the Obama plan in late May, Krugman had this to say:

Back in February John Edwards put his rivals for the Democratic nomination on the spot, by coming out with a full-fledged plan to cover all the uninsured. Suddenly, vague expressions of support for universal health care weren’t enough: candidates were under pressure to present their own specific plans. And the question was whether those plans would be as bold and comprehensive as the Edwards proposal.

Last week Barack Obama, after getting considerable grief for having failed to offer policy specifics, finally delivered a comprehensive health care plan. So how is it?

Krugman goes on to mention a bunch of good points about the Obama plan. Then he concludes:

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. 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 joins the game

When Hillary Clinton finally came out with her plan in September 2007, Krugman had this to say about it:

Senator Clinton delayed a long time before coming out with her own plan – a delay that created a lot of anxiety among health care reformers, and may, as I’ll explain in a minute, be a bad omen for the future. Still, this week she did deliver a plan, and it’s as strong as the Edwards plan – because unless you get deep into the fine print, the Clinton plan basically is the Edwards plan. That’s not a criticism; it’s much more important that a politician get health care right than that he or she score points for originality. Senator Clinton may be politically cautious, but she does understand health care economics and she knows a good thing when she sees it.

With regard to the long delay in the Clinton plan, Krugman has this to say:

Even if the Democrats take the White House and expand their Congressional majorities, the insurance and drug lobbies will try to bully them into backing down on their campaign promises. That’s why the long delay before Senator Clinton announced her health care plan made supporters of universal care, myself included, so nervous – a nervousness that is not completely assuaged by the fact that she finally did deliver. It’s good to know that whoever gets the Democratic nomination will run on a very good health care plan. What remains is the question of whether he or she will have the determination to turn that plan into reality.

Krugman nails the Republican plans

Krugman sums up the Republican “plans” as a group:

There won’t be a serious Republican alternative. The health care plans of the leading Republican candidates, such as they are, are the same old, same old: they principally rely on tax breaks that go mainly to the well-off, but will supposedly conjure up the magic of the market. As Ezra Klein of The American Prospect cruelly but accurately puts it: “The Republican vision is for a world in which the sick and dying get to deduct some of the cost of health insurance that they don’t have – and can’t get – on their taxes.”

But the G.O.P. nominee, whoever he is, won’t be trying to persuade the public of the merits of his own plan. Instead, he’ll try to scare the dwindling fraction of Americans who still have good health insurance by claiming that the Democrats will take it away. The smear-and-fear campaign has already started

Krugman calls out Obama on his use of right wing talking points to criticize his rival Democrats

Then just last month Krugman decided that he had heard enough of Obama’s attacking the more solid plans of his rivals from the right, and it was time for him to respond to those attacks.

Obama’s attacks on his Democratic rivals center on the provision that the purchase of health insurance will be mandatory under their plans. As I explained above, the mandatory provision is needed for the economic health of a universal coverage plan. But Obama criticizes that provision with his complaints that: a mandatory provision would be unenforceable; some people will not be able to afford it; and on ideological grounds (the government shouldn’t tell people what to do).

With regard to his claim of unenforceability, we have had mandatory purchase of auto insurance in this country for a very long time (for the same reasons that it is needed for health care), and that’s worked out pretty well. And mandatory health insurance has worked out quite well in European countries.

With regard to the claim that some families wouldn’t be able to afford health insurance, that is well addressed in the Edwards and Clinton plans by subsidies for those who otherwise couldn’t afford it.

With regard to the ideological objection, that’s just plain right wing rhetoric. The mandatory provision for health insurance purchase can be considered the equivalent of a tax – such as we require for our Social Security program.

Worse than the limitations in Obama’s own plan are the charges that he is leveling at his rivals. Krugman explains the dangers of that:

My main concern right now is with Mr. Obama’s rhetoric: by echoing the talking points of those who oppose any form of universal health care, he’s making the task of any future president who tries to deliver universal care considerably more difficult.

I’d add, however, a further concern: the debate over mandates has reinforced the uncomfortable sense among some health reformers that Mr. Obama just isn’t that serious about achieving universal care – that he introduced a plan because he had to, but that every time there’s a hard choice to be made he comes down on the side of doing less.

SOME ADDITIONAL THOUGHTS

Thoughts on negative attacks against democrats using right wing talking points

I have previously expressed my poor opinion of the practice of Democrats who attack their Democratic rivals on unjustified grounds during their campaigns. What is even worse is when those attacks come from the right. When that happens Republicans are given a gift. Their talking points are given credence by the fact that they can be shown to come from the mouth of a prominent Democrat. That not only hurts our chance of having a Democratic President in 2008, but it is bad for the specific cause in question – in this case health care – as well. That is bad for the Democratic Party and bad for our nation.

What concerns me just as much about Barack Obama is his tendency to attack the Democratic Party in general. Here is a link to a post where I discussed that issue, and I won’t discuss it further here.


Thoughts on “bipartisanship”

“Bipartisanship” may sound to many like a good idea in theory, and certainly espousing it tends to make a politician sound “moderate”. But when dealing with a group of far right ideologues such as those who have taken over today’s Republican Party, it’s not always such a good idea. Krugman devotes the last page of his book to this issue:

The central fact of modern American political life is the control of the Republican Party by movement conservatives, whose vision of what America should be is completely antithetical to that of the progressive movement. Because of that control, the notion, beloved by political pundits, that we can make progress through bipartisan consensus is simply foolish. On health care reform, which is the first domestic priority for progressives, there’s no way to achieve a bipartisan compromise between Republicans who want to strangle Medicare and Democrats who want guaranteed health insurance for all. When a health care reform plan is actually presented to Congress, the leaders of movement conservatism will do what they did in 1993 – urge Republicans to oppose the plan in any form, lest successful health reform undermine the movement conservative agenda…

To be a progressive, then, means being partisan – at least for now. The only way a progressive agenda can be enacted is if Democrats have both the presidency and a large enough majority in Congress to overcome Republican opposition. And achieving that kind of political preponderance will require leadership that makes opponents of the progressive agenda pay a political price for their obstructionism – leadership that, like FDR, welcomes the hatred of the interest groups trying to prevent us from making our society better.

The crucial importance of universal health care to our country

Krugman ends his chapter on health care by discussing why it is crucially important that we get universal health care:

The principal reason to reform American health care is simply that it would improve the quality of life for most Americans…

There is, however, another important reason for health care reform. It’s the same reasons movement conservatives were so anxious to kill Clinton’s plan. That plan’s success, said William Kristol, “would signal the rebirth of centralized welfare-state policy” – by which he really meant that universal health care would give new life to the New Deal idea that society should help its less fortunate members. Indeed it would – and that’s a big argument in its favor…

Getting universal care should be the key domestic priority for modern liberals. Once they succeed there, they can turn to the broader, more difficult task of reining in American inequality.

[papau]

1. Excellent post - I agree re Krugman's honesty and solid information - wherever the

universal health debate facts posted by Krugman were in areas where I have worked (as an actuary), what he has said has been exactly as I know the facts to be.

[Time for change]

4. Thank you -- The other book of Krugman's that I read, "The Great Unraveling", was also excellent

It was all about how the Bush economic policies (which were just being initiated at the time) would hurt our country terribly.

[DaLittle Kitty]

73. As A Health Care Professional Krugman Has IT Right On Health Care and Edwards!

:)

[NC_Nurse]

2. Thank you for posting this.

I particularly like the part on about the reason for mandatory insurance. I have tried to explain why this is necessary on some threads, but
I felt that my explanation was not adequate. I hope that people read this.

I like Edward's plan the most of all the candidates. I hope that his continuing in the race will help to at least influence other candidates to move in
the direction that he proposes.

K&R.

[Time for change]

69. In all probability Edwards already HAS influenced the other candidates

I think it's likely that Clinton and Obama wouldn't have come up with one if he hadn't. Clinton's is almost exactly like his. Obama's has many of the components but lacks the mandatory provision, which makes it a lot less economically sound. Obama also doesn't provide as much help to poor people as Edwards' plan does.

[Demeter]

3. Speaking Truth Is Never Bad

Keep on doing it, everyone!

[HCE SuiGeneris]

5. K & R

Thanks for this TFC

[Cynical Idealist]

6. Cogent, succinct explaination of candidates on health care

Your posting is exactly what we need more of during our "democratic" campaigns. Real discussion of the differences between the candidates on the issues in easily understandable language.

Would that this kind of approach to our political campaigns be the norm rather than "like-ability" questions and media choosing a few candidates to promote.

I'm a fan of Krugman too - as well as a John Edwards supporter. Why Edwards? Because I believe he's running to change the playing field on behalf of regular people - be they poor, working class, middle class, professionals, etc. Not all politicians have that as their mission. And I think he's smart enough, tough enough, and passionate enough to make a difference.

[Time for change]

70. Thank you very much -- and welcome to DU

:toast:

[SammyWinstonJack]

7. K&R!

[madrchsod]

8. the only plan that makes any sense is dennis`s

the "top three" plans are designed to insure the insurance and drug companies. we have "centralized welfare-state policy” in existence today and that is called medicare and medicaid. what a cruel joke on the american public

[Time for change]

12. Edwards' plan is not designed to insure insurance companies and drug companies

It is designed to provide universal health care for the American people.

Would you care to explain how you came to your conclusion, or is it more fun just to make dogmatic statements.

[eridani]

9. You'd think that Krugman, being an economist, would understand $5000 or best offer

That's what I'd put in the paper if my bottom line price was $3000 for my used car. Ask for $3000, and you are guananteed to get less. Demand single payer, and you might get something like Edwards is offering as a way to hold off cutting insurance companies completely out of the picture. Start out with where Edwards is, and the first things to get compromised away will be the provisions against cherrypicking and claims denial. If that happens, all you get is another Massachussetts disaster.

When will policy wonks and politicians quit being such fucking cowards and ASK for all of what they want? They may not get it, but what they do get will be much better than they'd get starting off with a weak-kneed apology for the lowball offer.

[Time for change]

13. Would you care to explain what you think is so bad about Edwards' plan

other than the fact that it isn't 100% what you want?

The way I see it, his plan cuts insurance companies out of the picture at maybe 60% to start with. The only people who would use insurance companies in his plan would be those who chose to do so, out of ignorance. As it becomes apparent that the insurance companies are a bad deal, people wouldn't use them any more, and they would eventually be cut totally out of the picture. What's wrong with that idea?

[hfojvt]

84. it's a political argument that if you ask for Edwards' plan

you get something less. The fault is not with the plan, it is with the negotiations about the plan.

The way I see it though, asking for single payer is gonna make you lose. It's like an ad that tries to sell an 89 Oldsmobile for $150,000 or best offer. You get no offers. Any candidate who proposed single payer would get clobbered with the S-word. Socialism, socialism, socialism.

[Time for change]

87. Right

I'm not certain that single payer wouldn't pass, but why take the chance if you have a better chance with something that's almost as good? The last time health care was defeated (94) we had to go without even another try for 14 years... and counting. I don't think we want a repeat of that.

[eridani]

91. The problem is that 80% of the goddam population is ignorant! And will stay that way too

That's because 20% of the population in any age demographic accounts for 80% of the expenses. Really expensive illnesses are like house fires--they probably won't happen to the average person, but they could happen to any average person. In any given year, fully HALF the population has no health care expenses at all. Guess what? Most of those folks report satisfaction with the cost of health care and their insurance unless they personally know someone with a horror story.

Therefore all of this complete and total HORSESHIT about "markets", from Edwards and anybody else except Kucinich, is completely irrelevant. You can't have "markets" for products that people don't use. Most people will never have to use their health insurance in a way that will cause their insurance companies to turn down their claims for the reason of excessive expense (and diminished profits). There are markets for iPods because when people buy them, they use them, and then tell their friends about what they like and don't like about them. The people in SiCKO all HAD insurance, remember?

Now, if Edwards had started out pushing single payer, we might wind up with a less than ideal plan that would be better than what we have now. If you want to sell your used car for $3000, ask for $5000. As it is, starting out with a compromise guarantees and end product that is totally fucked up, say, the Edwards plan without the rules about cherrypicking and claims denial. That equals Massachussetts, which equals absolute disaster for the low income but not quite poor enough. Even at its best, Edwards still allows the outright continued theft of dollars from the total health care money pool by insurance companies. Don't do that, and you don't have to raise taxes to subsidize a public plan.

[Time for change]

96. Edwards' plan does not allow continued theft of dollars from total health care money "pool" by

insurance companies. There is no "pool" for those who choose to buy private insurance. They do it on their own, and they will suffer the consequences. You don't think that the American people aren't aware that private insurance companies screw people? For those who don't understand that now, they'll understand that soon enough, as people begin comparing the experiences of those with private vs. public insurance.

And there is no law that says that if you don't start higher than you need to you'll have to bargain it down. It depends what the environment is. If you sell a house in a seller's market there will be no bargaining down. On the other hand, we can't afford to risk the fate of the 1993 Clinton plan, which was followed by 15 years of no progress whatsoever.

[eridani]

97. Yeah, right. Why not try applying the same reasoning to fire protection?

People who don't want to pay property taxes for the fire department should just have the option to go with a private plan. Just let them suffer the consequences of no response in case of fire, and let the whole neighborhood burn until the fire gets to a house that has paid its property taxes. My point is that most people WILL NOT EVER HAVE ANY FAWKING EXPERIENCES TO COMPARE, dammit! Just like they probably won't have their houses catch fire, either. There cannot be a "market" for products that you buy but are not likely to use.

Clinton and Edwards and Obama have learned exactly the wrong lesson from 1994. The insurance companies are Lucy, they all aspire to be Charlie Brown, and our health care is the football. Sit the insurance companies at the table and they will just snatch the ball again. Clinton's big mistake in 1994 was to leave the public entirely out of her planning. When the insurance companies turned on her, there was no one to speak up for a plan that they had no hand in crafting. The only seller's marker there will be is if we all stand up and holler for single payer. Then the PTB might try to buy us off with some sort of compromise like Edwards is offering.

[cyclezealot]

10. Krugman points out that health care US style is 53% more expensive

than our closest competitor. But, the Edwards plan raises those costs by another 160 Billion , so Edwards himself says. How is this helping our economic competitive position. All because Krugman or Edwards does not have the guts to take on the insurance lobby. / Related question. How do they figure health care costs $6000 per capitia in the US. Most Americans insurance premiums average closer to $10,000 a year. 10,000 dollars out of our pockets. ? Is that extra $4,000 just disappear into thin air. ?

[Time for change]

14. Edwards' plan does not raise the cost of health care

The plan will cost money, and it will be paid for largely by reverses in the Bush tax cuts.

The money that is paid up front by the government for the plan will be more than made up for by reduced out of pocket expenses for health care, so that the costs of health care will be reduced, though the plan will cost money to initiate.

As far as Edwards not having the guts to take on the insurance lobby, that's ridiculous. The insurance lobby hates his plan and they will oppose it every bit as hard as they opposed Clinton's 1993 plan. It will cut them totally out of the picture before long.

I don't know how the $6,000 figure was calculated. Krugman's point in using it was to show that U.S. health care was much more expensive than in any other country. So why would he try to lowball it? Keep in mind that those are 2004 figures.

Edited to add: The short answer to your question about the $6,000 is that the cost of health care is calculated by insurance premiums plus out of pocket expenses. Also, "per capita" refers to per person. So, if a family of 4 has a $10,000 insurance plan that insures the whole family, that is counted as $2,500 per capita.

[cyclezealot]

18. your own arguments says it will.

Edwards says his plan will take another $ 160 B. a year to buttress up Medicaid. money is money. Under Single payer, we'd have a net reduction of costs. Insurance companies will hardly be touched with the 25% administratives fees. That 160 B. dollars is still money, could be applied to education, infrastructure. No wonder the Repugs say the Dem's are tax and spend if we don't see an additonal 160 B is not real money. The Edwards plan probably would increase medical expenditures in the US to about 16% of GDP from 15%. . Single payer would probably drop it to like 12% of GDP.

[Time for change]

20. Both Edwards' and Kucinich's plans will result in a net reduction in costs

when out of pocket expenses are considered.

Both will cost money up front because that money is needed to pay for health care for those who can't afford it. No health care plan that results in universal coverage can possibly be put into effect without paying money up front. The NET savings are in the reduced cost for American citizens of out-of-pocket expenses for health care. In fact, single payer plans cost more money up front than those that allow the choice of government vs. private insurance.

Do you really believe that a singler payer universal health care plan can be put into effect without any up front costs? Kucinich says that he will pay for his plan through reversal of the Bush tax cuts for the wealthy. That's great. So does Edwards. Why would he have to talk about how he pays for his plan if it's free?

[cyclezealot]

51. You only think ME, I argue US.

One speech I heard Edwards say, he will take 160 billion from BUsh's tax cuts. 160 BILLION costs the US MORE, not less. It's the reason the US is so uncompetitive. And in order to keep the insurance companies screwing us with absurd premimums, which will still continue; Edwards wants to butress medicaid. .
Don't think of your pocket book, the issue is, is the system sustainable for ALL of the country. Edwards initial plan will increase medical expenses for the US 160 billion, by his last speech. Health Professionals Say the Kucinich Single Payer plan will save the whoe of the United States, 1.1 TRILLiON over a decade.
Edwards does say, he will require insurance companies to reduce administrative costs. Believe that at your own risk. That is a line of Bull ****..


Paying the price


Edwards has faced criticism for his universal health care plan, in part because it would raise taxes and could cost $90 billion to $120 billion.

Edwards said Detroit, where General Motors Corp., Ford Motor Co. and DaimlerChrysler AG's Chrysler Group spend $16 billion annually on health care costs and are expected to pay $114 billion in future retiree benefits, is indicative of health care ailments felt nationwide.

http://www.msnbc.msn.com/id/19229589/

[rockymountaindem]

53. You're not making any sense

It will raise government expenditure which will obviously have to be covered by taxes, but the premise is that even though we will be paying more taxes, our overall expenditure on health care as individuals and as a society will decrease from their current level because government-run health care would be more cost-effective. The ability to bargain for lower prescription prices is argument number one in that regard.

[cyclezealot]

54. Simply put

Single payer with the same or more likely better coverage, but at less cost to US business, US taxpayers, and to ultimately to ourselves. The ultimate guide is NOT how much your Rx costs you at the Rite Aid. It's what is the total cost to percentage of Gross Domestic Product. All costs are ultimately passed on to either the consumer or taxpayer and the only way to reduce your actual costs is to lower percentage expenditures of GDP. The Edwards /Hillary plans do not do that. We are already like double our closest economic competitor . Denmark. Which is like 9% of GDP.

[rockymountaindem]

55. They will reduce the amount of GDP spent on health care by lowering the overall cost

of healthcare services. Eliminating the profit motive for one, as well as expanding the pool of health care. If we switch to single payer, that will reduce the cost of care and lower the percentage of GDP we spend on health care annually.

[cyclezealot]

62. sure.

[Time for change]

56. The total cost of health care will be reduced under Edwards' plan

You keep on claiming otherwise, but have shown nothing to support it.

[cyclezealot]

68. Cost of a long life.

How do you get it will save cash. Here is Edwards'health care plan. Only change he makes if the Health care markets, idea and a requirement we all have to pay for private insurance. Do you have specifics as to how Edwards is going to control the Insurance Industry. It is just naive. Same old patch work bandaids from Hillary circa 1993.
$$$

The Edwards Plan achieves universal coverage by:
Requiring businesses and other employers to either cover their employees or help finance their health insurance.
Making insurance affordable by creating new tax credits, expanding Medicaid and SCHIP, reforming insurance laws, and taking innovative steps to contain health care costs.
Creating regional "Health Care Markets" to let every American share the bargaining power to purchase an affordable, high-quality health plan, increase choices among insurance plans, and cut costs for businesses offering insurance.
Once these steps have been taken, requiring all American residents to get insurance

http://www.johnedwards.com/issues/health-care/

[Time for change]

71. I think you ought to go back and read his plan

There is NO requirement that people have to pay for private insurance. Absolutely NOT.

[cyclezealot]

74. read again please

the line above the Edwards healthcare link. Once these changes have been made, a requirement that all Americans get insurance. I interpret that only one way. Edwards policies is the same as a huckster private insurance agent. not the kind of president who would be my initial choice.

[Time for change]

82. Do you understand the difference between private for profit insurance versus

government not-for-profit insurance?????

Edwards' plan offers a choice between the two.

If you think they're the same thing, then I guess we have nothing more to talk about.

[cyclezealot]

83. where does it say a "government non profit plan"

It does say quote. straight from the Edwards website.
*

"Making insurance affordable by creating new tax credits, expanding Medicaid and SCHIP, reforming insurance laws, and taking innovative steps to contain health care costs.
Creating regional "Health Care Markets" to let every American share the bargaining "

**
a government non profit plan does not need new tax credits or expand Medicaid or SCHIPS.

[Time for change]

86. Page 4

"Health care markets will offer a choice between private insurers and a public insurance plan modeled after Medicare."

[cyclezealot]

90. page four.

Appreciate your providing that link. You'd think it would appear in the summary. Did not see the link to page four. Missed that. Sorry. Still have not changed my mind. Edwards thinks Insurance companies will play nice he is mistaken. His plan properly administered would end their gravy train. Won't happen. Edwards' cost savings are not assured the way the Conyers Health care plan assures. And,many , we oppose the privitatization of Social Security. Is there not a parallel here. You do not think draining the needed resources the public non profit plan would need would jeopardize the kind of quality needed for this likley, now underfunded program . Sort of like Bush's overpayment to Medicare's Plan D. The real intent of Bush's Plan D is to start defunding Medicare itself.

[Time for change]

93. Edwards does not think the insurance companies will play nice

He has made that absolutely clear, and his plan does not depend on the insurance companies playing nice.

His plan does not drain resources from the government to pay for private insurance. Just the opposite. His plan will result in tens of millions of Americans switching from private to government not-for-profit insurance. In addition, it will results in tens of millions of Americans who currently have NO insurance receiving government not-for-profit insurance. That is a huge advantage over what we have now. Billions of dollars will be devoted to providing subsidies for those without health insurance being able to now receive it.

This is not a DEfunding of Medicare. It is just the opposite. It is a plan that will allow tens of millions of Americans to receive a Medicare like program.

[cyclezealot]

95. If his not for profit plan were all that efficient

there would be no need for Schips and Medicaid and whatever else . Did not Krugman say , he still prefers the Conyers bill. !
There is no doubt I read the story Edwards said 160 billion from Bush's tax cuts will be converted to enhance Medicaid. That is not efficiency. That is stated on the Edwards plan in his website and its simple to Google news reports of new taxes needed to impliment Edwards plan. A simple google will result in pages of options.
You may be right about long term efficiencies , but it likely will take a decade in the change over before Insurance companies are tamed.
***

Edwards's healthcare plan entails tax increase
By Associated Press | February 5, 2007

WASHINGTON -- Democratic presidential candidate John Edwards said yesterday that his plan for universal health care would require higher taxes and cost up to $120 billion year.

"Yes, we'll have to raise taxes. The only way you can pay for a health care plan that costs anywhere from $90 to $120 billion is there has to be a revenue source," the former North Carolina senator said.


http://www.boston.com/news/nation/articles/2007/02/05/edwardss_healthcare_plan_entails_tax_increase/

[cyclezealot]

19. The only reason Krugman favors the Edwards plan

is because it is likely less politically do able. B.S. It takes a strong leader and Edwards all but says he is not up to the challenge. A FDR type would get this done. But, there are no FDR's. As Krugman recenlty wished for . A new FDR . Krugman will not get his Christmas wish this year, with Edwards.

[Time for change]

21. There is nothing wrong with trying to make a plan politically viable if you don't have to

give up too much to do so. When the Clinton plan of 1993 failed we ended up with no national health insurance at all (except for Medicare and Medicaid, which were already in place) for 15 years... and counting. Do you want to see that happen again?

As far as "an FDR type would get this done", you might recall that the New Deal contained no national health care whatsoever. Even FDR had to consider political viability when pushing through his plans.

[cyclezealot]

52. It was reported FDR wanted a National health care plan

but WWII got in the way. Who knows what would have happened had he lived beyond WWII. / As to the Edwards plan being politically do able. Krugman says the Single payer plan is better. If we institute a plan that keeps the insurance companies in the drivers seat and is financially un -doable; I'd rather just let the present system continue until the rot brings about real change.

[Time for change]

57. Edwards plan does NOT keep insurance companies in the driver's seat

Quite the contrary.

[cyclezealot]

61. believe that line if you want

your premiums will still go to private insurers. You think they can be muzzled, believe that if you want. I don't Google Edwards Health care plan. It will lead you to his policy positions. It talks about Medical Insurance markets. I don't buy it.

[Time for change]

75. Bullshit.

Nobody has to have private insurance in his plan. From the plan at Edwards' website:

"Health care markets will offer a CHOICE between private insurers and a public plan modeled after Medicare."

If you don't believe him, why don't you explain how you understand his plan better than he does.

[Leopolds Ghost]

38. Forcing everyone to buy a commodity raises the cost of that commodity for everyone

Including those who already have it.

If you guys don't understand that, you need to go back to high school.

Demand elasticity. Cartel economies.

Even Hitler and Stalin didn't do this.

This would be a monstrous act of government overreach.

Forcing people to buy insurance, especially from a private entity, is a crime.

[Time for change]

40. A major cost of health care today comes from the fact that the good majority of people who have

health care in this country purchase it through private insurance, which is loaded down with administrative costs, many of them aimed at finding ways to make a profit (such as denying care to those at high risk and denying valid claims). By taking over much of this function by government, the Democratic plans will reduce costs.

So I take it that you don't believe that we should have universal health care for our people?

[Leopolds Ghost]

58. Mandating Americans to purchase private health insurance is fascism, not UHC.

Edwards plan does not universalize Medicare. If it did, there would be NO FREAKING MENTION of "requiring Medicare-ineligible families to purchase health insurance from a list of private providers".

That is what "Mandatory (not Universal) Health Insurance" MEANS.

It means mandating private citizens to do what they didn't or
couldn't do on their own.

It is an ALTERNATIVE designed to FORESTALL UHC.

Subsidizing a select few poor people and forcing the remainder
(thru collection agencies, according to all three plans) implies
the creation of a stratified health-care network.

[midlife_mo_Jo]

94. Then they can opt into the government run Medicare type program

If no one is to be excluded based on illness or past history, we would have no incentive to purchase a plan UNTIL we became ill! That is a recipe for disaster which is why everyone has to pay into their country's health plan in countries like France. it's not optional. (Of course, the poor would have to be subsidized.)

[OzarkDem]

23. Do you have a link?

Re: your info about Edwards plan raising costs by another 160 billion. Thanks!

[Naturyl]

11. A key quote right here:

"In other words, as Paul Krugman points out, the main fear of the right wing ideologues is not that universal health care will fail, but that it will succeed."

Exactly. Repukes really aren't sincere about their alleged fears that single-payer health care will be poor in quality, etc. They know deep down it will be more than adequate. Their real fear is the dreaded WELFARE STATE. The effectiveness of single-payer health care is much less important to them than the precedent it sets. Visions of people being taken care of by the eeeeeeevil government and other "socialist" horrors fill their heads.

If single-payer is adopted, what's next? A guaranteed minimum income? In my dreams, and their nightmares.

[Time for change]

15. Do you really think they fear single-payer health care more than Edwards' plan?

I doubt that very much. They probably fear it more because it's more likely to pass. It provides enough subsidies so that all Americans will be able to get the health care that they need. Any American who wants to bypass the insurance companies and get their health care insured directly from the government is free to do so. Anyhow, it is likely to lead to single-payer health care in a very short time, as those people who have private insurance switch over to government insurance when they realize they're getting screwed. Either that or the insurance companies will have to offer a deal that is comparable to what the government offers. Do you really think that the right wing ideologues don't hate that idea?

[Naturyl]

16. I never suggested they don't fear Edwards' plan.

They probably do, and they should.

Edwards has a pretty good plan. You mentioned a lot of the reasons why. There's plenty for right-wingers to hate, especially the part where anybody who can't afford it is subsidized.

[Time for change]

17. Sorry, I jumped to conclusions on what you were suggesting

After going through the 3 responses above yours my blood was boiling.

[Canadiana]

22. Meh on the Edward's health care plan.

It's pretty good I guess. The fact is HMO's should not exist. As long as they do, THEY will be making decisions and not doctors. Profits should not be made from health care...PERIOD.

All of the top candidates do not say this simple fact. They dance around it and say all this "shared responsibility" and "mandatory coverage" shit. The government should pay for health care!!

[Time for change]

25. Under the Edwards plan

and the Kucinich and the Clinton plan, and even the Obama plan to a lesser extent, the government does essentially pay for health care.

Under the Edwards and Clinton plan, anyone who chooses will purchase insurance directly from the government. They do not have to go through HMOs or any kind of insurance plan whose purpose it is to make a profit. Those who cannot afford it on their own will receive generous subsidies from the government. This will be very similar to Medicare.

The only substantial difference is that people will have the choice of purchasing (more expensive and lower quality) insurance from private insurance companies instead of from the government if that's what they want to do. Why anyone would do that is hard to understand, but undoubtedly quite a few people will do it that way because they have been conditioned by 3 decades of right wing government and talking points to believe that "government is bad". Those people who decide to purchase insurance from private insurance companies instead of the government will pay a price for that. That is regrettable, but as people come to realize that government offers better quality health care at lower cost than do the private insurance companies, the insurance companies lose a great deal of business -- unless they decide to offer a comparable product to what the government is offering.

[Canadiana]

26. I don't know if this will work

What I think will end up happening in this will even itself out into a two tiered system (we have considered this in Canada as well) You will have the rich tier and the poor tier. The private system, to survive, will have to be better in some way than the public system (though I don't understand how you "buy" insurance from the government...isnt that just taxes?).

I mean lets say rich person X makes 1 million/year. She can afford to buy rather expensive private insurance (the system where all the other rich people now pay into). Her money then, because its not taxed to pay for the health care of others (because if you want to pay into the government you can, if you don't you do not have to) will NOT be put into the government system.

I don't understand how this works out in the end. Shouldn't health care just be straight up paid for by taxes?

[Time for change]

29. You say "Her money then, because its not taxed to pay for the health care of others"

That is not the way it works.

The plan provides subsidies for those who cannot afford health insurance (govt. or private) on their own. therefore, the plan will cost money, as will any plan that provides for universal health insurance. Edwards says that money will come from reversing the Bush tax cuts on the wealthy. so, the wealthy will be taxed to pay for the system, whether they choose to use it or not.

If the wealthy choose private over government insurance that's their business, but I don't see how it will provide them with any better medical care. As it is now, all members of Congress receive their health care from the government. I don't see any of them throwing away their plans to purchase private insurance instead.

You say "I don't understand how you "buy" insurance from the government...isnt that just taxes?" It has the same effect as taxes, yes.

[Canadiana]

31. Good stuff

that does sound like a good plan because that will eliminate HMOs if it works. He will have to tax the rich HARD for it to work, as he should. Too bad he's not actually saying that because people are afraid of socialized medicine.You have to tell people straight up what this is. As a medical student I know a great deal about health care systems and am particularily interested in the moral and ethical side of things. If and when the HMOs fall, thats when it gets a little hairy ethically. Should their be private MRI clinics? Should you be able to pay for surgery? What about health care rationing..a common practice in Canada and elsewhere?

Its very interesting to me, and god I hope it works out in the USA.

[Time for change]

41. But Edwards DID say that

He said he would reverse the Bush tax cuts on the wealthy to provide funding for his plan:

http://www.latimes.com/news/politics/la-na-taxes27jul27,0,5890269.story

[Leopolds Ghost]

39. The insurance requirements are mandatory. The subsidies are not.

Supporters of this plan really are a babe in a new world.

There is no point in issuing subsidies to everyone or the
whole idea of "competition" (whose objective is to optimize
price among for-profits in an open market which anyone can
break into, for a demanded resource) is lost. Might as
well have universal coverage then. Subsidies to all are
an inefficiency.

Subsidies to certain people are a shibboleth designed to
obscure the fact that this plan is modeled after Sallie
Mae, whose primary tools are collection agencies, as
Edwards himself advocates, NOT subsidies. Unlike Sallie
Mae, the gov't would have the power to dock your wages,
like a deadbeat dad, to force you to buy private health
insurance (public health care options will continue to
be "targeted plans" under Edwards, Obama and Clinton,
i.e. available only to certain types of people.)

[Time for change]

42. He doesn't offer subsidies to all -- He offers them to those whose income is too small

to afford the health care that they need.

It's a little like the earned income tax credits.

[Leopolds Ghost]

66. Exactly what I am criticising. His plan would hurt everyone who doesn't know how to game the system

Just like most working poor can't get public housing because there is too little money to go around and they are not poor enough or don't have good credit, this "targeted subsidies for some, punitive enforcement for many"
will drive up prices for EVERYONE in private insurance by removing CHOICE
from the eqution. One may choose between plans but not choose "no sale".

This is why "no build option" was added to public private CONSTRUCTION
project evaluation. Without it the price goes up by order of magnitude.

And it would punish everyone like me who is underemployed for the exact
same system that bleeds folks like me on student loans.

[Time for change]

76. Choice is not removed it is greatly increased

As it is now, 47 Americans don't have health insurance. There are very few people who don't want health insurance. The vast majority don't have it because they can't afford it. Under Edwards' plan tax credits will be supplied on a sliding scale and everyone will have a chance to purchase government insurance at an affordable price.

[Leopolds Ghost]

37. You seem to think forcing us to posess insurance (the sort of crime for which we fought a Revolution

Is the problem that must be solved.

"Let them buy insurance."

Most people who do not have insurance either are not in a position to
afford comprehensive insurance (Medicare would not be extended to all
under this plan, it is a "targeted program") or do not wish to own
insurance. To quote the Matrix, the problem of choice
is one which seems to elude you.

"People who do not purchase insurance drive up costs for everyone else."

No, whoever wrote that is wrong and a fool. Forcing people to buy a
commodity makes demand inflexible, driving up prices arithmetically.
Economics 101.

Of course Krugman knows that and he knows the reason Insurance is backing
the Dems this year is because INSURANCE HAD A FUCKING SUMMIT MEETING AND
CRAFTED THIS PLAN WITH DEM THINK TANKS AS A VARIANT OF THE DISASTROUS 94
PROPOSAL WHICH THEY NOW SUPPORT, DUE TO RISING COST OF MEDICAL CARE THEY
WISH TO PROTECT THEIR PROFITS.

The Clinton plan was also backed by HMOs
(and opposed by the rest of the industry because it was a giveaway for
corrupt, privatized HMOs and privatization of Blue Cross/Blue Shield,
which the Clintons and Bushes specialized in creating) -- "Health Care Markets",
Enron style, as quoted in Edwards plan.

"Health Care Markets" are structured EXACTLY as Energy and Telecom Deregulation were structured.

ALL UNDER CLINTON AND BACKED BY EDWARDS AND OBAMA. THEY DO NOT ADVOCATE
RE-REGULATION, NONPROFITISATION OF BLUE CROSS, NONE OF THAT. GODDAMMIT,
DEMS HAVE TO WAKE UP. ONLY KUCINICH/GRAVEL "WIERDOES" ARE ALLOWED TO
ADVOCATE RE-REGULATION AND NONPROFITISATION OF EXISTING "HEALTH CARE MARKETS." Anyone in public life who joins them will join them as a
media designated "crackpot", denounced by the Democratic Party mainstream.

[Time for change]

43. Most of the uninsured in this country are uninsured because they can't affort health insurance

NOT because they don't want it.

Edwards' plan addresses that by providing generous subsidies to those who can't afford it.

[Leopolds Ghost]

59. Then what are the collection agencies and wage garnishment for?

Why "target" subsidies only for a select few? Targeted plans imply that
government can be relied upon to subsidize anyone who claims they can't
afford it (like me, who is undoubtedly NOT eligible but cannot afford it,
or like anyone who doesn't know how to apply). It is a scam you guys
have bought into.

"Families without insurance will be enrolled in Medicare, Medicaid, SCHIP or another targeted plan or be assigned a plan within new Health Care Markets.

Families who lose coverage will be expected to enroll in another plan or be assigned one. For the few people who refuse to pay, the government will help collect back premiums with interest and collection costs by using tools like the ones it uses for student loans and taxes, including collection agencies and wage garnishment."

--John Edwards

[Time for change]

77. So now you're quoting Edwards from John McCain's website?

Try and find anything remotely approaching what you say here from Edwards' website. I couldn't find it. Maybe you'll have better luck.

And before you put words in peoples' mouths why don't you check your sources?

[donkeyotay]

24. Thank you, TFC. I'm not sure I completely agree.

Look at the Medicare Bill and its multi-billion dollar subsidy to drug companies. Will health care reform have a similar result? Will the only thing accomplished be that taxpayers fund a new subsidy to buy insurance for those who can't afford it? Where would the savings be?

The way insurance and health care operate right now, they are an industry more lucrative than illegal drugs. The amounts of money are huge, and the game is rigged. Are you aware of the GPOs, well now the GPO, or Group Purchasing Organization, that is a monopoly on hospital purchasing? This costs us a lot of money, and that cost isn't controlled my mandating insurance. I'm concerned that the Republicans who supposedly believe in supply and demand, will only deliver us on the demand side as captive consumers, and do nothing to control the costs to us.

You mentioned auto insurance. There are plenty of people who don't carry auto insurance, and plenty of people who somehow manage to pay high premiums, and all policies carry costs for the uninsured. Mandatory insurance doesn't keep people from getting into accidents, no more than
mandatory health insurance will keep people from being bankrupted by medical costs.

The profits of the insurance companies and the GPO and such are part of where the high cost. The current political system - the same one that had no problem telling ordinary people whose jobs went to China to "compete" -now thinks that insurance's profits need protection.

I saw Warren Buffett on CNBC explaining that he financially backs both Clinton and Obama because neither one would "kill the Golden Goose". Mr. Buffett went on to recommend to investors that they not invest in American companies with a large labor component because... well, you know, we're not "competitive" enough yet. Well, there are going to be quite a few Americans who are going to need checks from the government for their health care if things like having heated houses, cars and health care are impediments to our competing with the Chinese. Maybe Mr. Buffett is having his cake and eating ours too. He wants us as policy holders but knows we're going to be too broke to afford it on our own.

Anyway, you have given an organized look at an important issue, and I appreciate it.

[Time for change]

27. Under the Edwards plan

the ability of private insurance companies to profit from health care will be greatly reduced in the short term, and likely totally reduced in the long term.

All Americans will have the choice of totally bypassing the insurance companies, and they (the insurance companies) will not be subsidized by the government. They will still be able, in the short term, to profit from those Americans who choose to purchase private rather than government insurance. But, since insurance offerred by insurance companies is both more expensive and of less quality than government insurance, it is doubtful that private insurance companies will be able to compete in the system for very long, unless they greatly improve their product, which would necessarily mean reducing their profits.

[DrColes]

28. The Government IS The Problem

The only thing that is broken in health care is the cost of health care and no one is addressing this problem. The government caused the problem with health care cost crises in America by over socializing (with mandates) medicine to the extent it is not completive.
http://www.InteliOrg.com/

[Time for change]

30. Are you aware that Medicare has far fewer administrative expenses than private insurance companies

and that therefore it offers better health care for less?

[Leopolds Ghost]

35. Competition means restructuring Medicare like they did to every other gov't agency that faces PPP

Post Office, Fannie Mae, Sallie Mae, etc. Remember, Dems allowed
Blue Cross / Blue Shield to go FOR PROFIT. This plan would kill nonprofit
insurance and customer choice (a coerced choice is not free) forever.

Just look at the British rail system, imposed by Clinton allies in Labour, dammit.

[Time for change]

44. Absolutely NOT

The government insurance offered under the Edwards plan is not for profit. It is based on the same principle as Medicare.

[Leopolds Ghost]

63. The Edwards plan would force people to purchase insurance from a private entity, like Sallie Mae.

Collection agencies and wage garnishment (the latter of which even Sallie Mae is not allowed to use) would be deployed against consumers (not citizens) who break contract with one of these private entities, whether nominally for profit or not.

The gov't sponsored entities would be TARGETED NOT UNIVERSAL.

Were they universal there would be NO NEED FOR A MANDATE, BY DEFINITION.

[Time for change]

72. Why don't you read his plan before you make dogmatic statements about it

There is absolutely no requirement to purchase health insurance from private companies. If that's what you're basing your conclusion on, you don't understand the first thing about his plan.

[Warren Stupidity]

48. Wrong board, wrong post, wrong wrong wrong.

Hey there is this wonderful movie by that nasty leftist Michael Moore called 'sicko'. You should see it, you might learn something.

[lovuian]

32. It has to be done especially if we are in a recession

the uninsured is going to skyrocket

[Larry Ogg]

33. Personally I like the Kucinich plan the best.

I also believe it represents the highest moral standard and is very workable and cost effective as other more civilized countries have proven, adding further credence and objectivity to it being the highest standard as to what is moral.

To me this is the most important sentence in your OP,

The central fact of modern American political life is the control of the Republican Party by movement conservatives, whose vision of what America should be is completely antithetical to that of the progressive movement.

And within this sentence is a most important word, antithetical.

Here’s a term out of the book http://www.cassiopaea.org/cass/political_ponerology_lobaczewski.htm">Political Ponerology:reversive blockade

Ponerology term: Emphatically insisting upon something which is the opposite of the truth blocks the average person’s mind from perceiving the truth. In accordance with the dictates of healthy common sense, he starts searching for meaning in the “golden mean” between the truth and its opposite, winding up with some satisfactory counterfeit. (Continued on page 151)

Now if you take something that is of the highest moral standard such as lets say for instance, the single payer health plan proposed by Kucinich and the exact opposite Republican plan, then apply the reversive blockade technique what do you get?

Its very interesting that you pointed this out.

I suppose that he doesn’t want to dilute his message by talking about candidates whom he considers to have little or no chance of winning the Democratic nomination.

Gee, why doesn’t Kucinich have a chance of winning the Democratic nomination, and why is his ideas made so silent? Could it be that the psychopaths running this country know about reversive blockade? I guarantee they know about it, and if there is one constant factor on the main stream media it is reversive blockade…

This does not imply that Krugman is a tool of the right and is purposely using reversive blockade techniques, it could be just as you stated, which then means, he himself is a victim and has excepted the results of the technique, something within the golden mean, which is a lesser moral, known as a para-moral.

Para-moral is one of the paralogism discussed in Ponerology. If you think about the highest objective standard possible in a given subject such as moral, logic, appropriate, truth etc. and reduce its qualitative properties you end up with a counterfeit such as para-moral, para-logic, para-appropriate, para-truth. Now you want to start having fun? Consider how paralogisms effect the ‘selection and replacement of premise’, it will become clear as to how para-moral standards in one country seem barbaric and criminal to another. In some countries it considered moral for the men in a family to kill a female member who has been brutally raped, in order to cleans their family name. Obviously in America some people consider it moral to let sick people with out health insurance die. What kind of moral standards do these people have any way, and why are they running our country?

Like I said, I like the Kucinich plan the best, but I really can’t foresee any great changes until we stop electing politicians who are para-leaders, (Hey I think I just invented a new word for conservatives) anyhow - I mean really, how are we going to pay for it, with our debt based bankrupt para-financial system?

Oh and by the way, do you think it is ‘para-appropriate’ not to mention that there are conservative democrats with para-moral views, opposing moral values of progressive democrats?

K&R Dr. Dale your the best...

PS, did you get your book yet?

[Time for change]

49. Yes Larry, I got the book and I've started reading it

My habit is to read several books at a time, so it will probably take me a few weeks.

It sounds very interesting, and even more than that, it sounds like the information could be of tremendous importance -- but I haven't really gotten into the meat of it yet. I'm looking forward to getting further along with it.

[Larry Ogg]

67. I started reading it about six months ago

I got about a quarter of the way through and had to go back to the beginning and start over. I’ve repeated that process about four times, getting farther along with each one. I also spend a lot of time on the internet studying some of the psychological material that Lobachevski is referring to but doesn’t go into great detail within the book. Right now I am working on chapter four, bouncing back and forth to previous chapters when needed, but at least it’s getting a lot easier. I can’t wait till I finish it so I can start reading it all over again. I also created a dictionary in ms word, and increased my vocabulary by about 250 words, needless to say the book is very wordy.

I know you won’t have as much trouble with it as I have - with all the books you’ve read, plus being a doctor and having a psychologist father has got to be a big plus. If you can read it along with several other books in a few weeks good luck and I will be jealous. (Just kidding)

I really am excited that your reading it, and I have the deepest respect for the history you keep alive and bring light too, I think this book will show you the underbelly of the beast in crystal clarity, revealing its true corrector past and present, your future post (as in postponerology) should be quite interesting...

[Larry Ogg]

78. Woops I used a wrong word

In my last sentence, change (revealing its true corrector past and present) to (revealing its true character past and present)

Dam spell checker, ya never know what your going to get.

[Time for change]

79. Thank you Larry.

I've read a lot of books dealing specifically with the subject of evil, in an attempt to understand it better. Most of them have been somewhat disappointing. This looks like it has a lot of promise -- thanks for recommending it to me.

[Leopolds Ghost]

34. Mandatory Private Insurance. If this Plan Goes into effect, I will never vote for a Democrat Again.

"Public Private Competition" (a DLC, Clinton and Reagan meme, invented by Reaganites)

+

"Mandatory Insurance" (Remember, Insurance is a commodity, this is like
requiring Americans to purchase coffee -- something the Soviets never did)

=

Mandating American civilians (on penalty of fine) to purchase from a selected list of (mostly private) health plans, with existing plans restructured along lines of a giant private, for-profit, gov't sponsored
corporation in order to "compete", like Fannie Mae and Sallie Mae
(indeed, Edwards says that is the model) and punishment by fine and
docking paycheck (a la child support) for offenders who fail to
purchase insurance.

Any Dem who supports this Universal For-Profit Health Insurance
is a traitor to the cause of fascism so neatly laid down by Nixon
and Reagan and Bush and enabled by the Clintons, who this plan resembles.

[Time for change]

45. You prefer the Republican "plans"?

[Leopolds Ghost]

64. I don't have to choose. I won't have freedom to choose, in fact

All the plans are repulsive to any New Dealer or anyone on the civil left.

[Warren Stupidity]

50. I prefer single payer payroll tax based systems myself

but they also are mandatory. You have to require everyone to pay in, as the OP clearly explains, or people will game the system, avoiding paying in while they are healthy and then requiring us responsible folks to pay for them when they get sick. This is no different than social security pension systems - everyone has to pay in. My objection to individual mandates is that they continue to funnel huge and useless administration fees to private health insurance companies who will continue to deny coverage and 'manage' my health for their profit. At least Edward's plan offers a competitive public alternative that will be responsible to voters rather than to stock holders.

[Leopolds Ghost]

65. Individual mandates create a false choice by setting up demand inelasticity

A person is required to pay insurance at the going rate, and the
buyer loses influence at that rate. It is "company town" economics.

Remember the "company store"?

Plus, it's immoral to give non-monopoly corporations
a public charter to serve a captive consumer base.

It's mercantilism -- the system of the British and Dutch Empire
with their India Trading Cos. and Colonial Settlement Cos. and
the Railroad and Utility Concession giveaways that were modeled
after the "Enlightenment era" policies of Imperial Europe.

Concession style mercantilism -- handing out concessions
for mandatory commodities -- is immoral.

Economics 101 -- they teach you that the difference between
fascism and state socialism is that state socialism mandates
the factory to produce bread, fascism mandates the consumer
to buy bread. The one forces the price of bread to a minimum,
crashing demand and creating supply shortages. The other
instantly doubles the price of bread even for people who are
already "required" by biology to eat it.

[Leopolds Ghost]

36. Frightening Health Care Fascism

"Edwards' truly universal health care plan will ensure that every American has health insurance. He will require proof of insurance when income taxes are paid and when health care is provided. Families without insurance will be enrolled in Medicare, Medicaid, SCHIP or another targeted plan or be assigned a plan within new Health Care Markets.

Families who lose coverage will be expected to enroll in another plan or be assigned one. For the few people who refuse to pay, the government will help collect back premiums with interest and collection costs by using tools like the ones it uses for student loans and taxes, including collection agencies and wage garnishment.

http://johnedwards.com/issues/health-care/20071128-health-care-mandate

[Time for change]

47. I suppose you're against all taxes then?

[Leopolds Ghost]

60. Uninformed straw man. You don't understand freedom of contract

Perhaps you are a mercantilist who believes taxes should be used to support
government-managed, marketized, commoditized, for-profit cartel economies.

You seem to think Edwards and Obama and Clinton plans would be paid for
out of payroll taxes, a straw man and a red herring (they are an unfunded
mandate directed against citizens who have a job but no insurance.)

Don't any of you guys understand that a mandated private purchase
is, BY SCIENTIFIC DEFINITION OF THE TERM, A SUBSIDY FOR THE SELLER?

They are not required to accept you, YOU are required to find one of
them willing to insure you and EVERYONE PAYS DOUBLE because, according
to BASIC ECONOMIC THEORY, the freedom NOT to purchase (i.e. freedom of
contract) is the buyer's only economic leverage. This is called
demand/price flexibility.

I know that native anti-intillectualism has found a home in the
postmodern center-left, meaning you will probably discount half
of what I said because it's unfamiliar to anyone who didn't take
Economics in high school.

[Time for change]

80. There is no mandated private purchase under Edwards' plan

Can't you get that through your head? What is it that you don't understand about that?????

[Warren Stupidity]

46. What a well informed post, a DU treasure for the archives.

Thank you.

[Time for change]

81. Thank you so much

[alarimer]

85. It is extremely simple: extend medicare to EVERYONE

Get rid of expensive, private plans paid for by employers and by you. Cut the piece of shit insurance companies out of the picture altogether. I don't understand why this so fucking complicated. Edward's plan and the others are simply mandatory insurance. NOT HEALTH CARE. There is still plenty of incentive for insurance companies to deny claims, to deny coverage for "preexisting conditions" and you still have to pay through the nose for it.

Raise taxes on the wealthy to pay for it. And end the stupid Iraq war; that will help with costs. In any case, we could still pay premiums. But it would be on a sliding scale and no more than $50 a month per person.

[Time for change]

88. If that's what you think you don't understand his plan at all

It is NOT simply mandatory insurance. It is essentially a Medicare type of plan for anyone who chooses it. To use your type of language... What's so fucking difficult to understand about that?

[alarimer]

89. It will never work until we get rid of insurance companies

They are the poison in the well. Until everyone HAS to be on the same system, it will not work. This piecemeal approach is not good enough.

[NC_Nurse]

92. It's a first step. Insurance companies aren't going away overnight.

There are too many interests in keeping the status quo. Edward's plan would force the insurance companies to compete with a medicare type govt program.
I think that's the best we can hope in the short term.