Clinton or Obama -- On Health Care the Difference is Big

There has been extensive coverage in the mainstream media and blogosphere about the health care proposals of Senators Clinton and Obama. This issue is important to me because I am a passionate advocate of health care for all and because the way the candidates deal with it points to a major reason I'm supporting Hillary Clinton for President: She'll get results.

New York Times Op-Ed Columnist Paul Krugman closed his Monday column about the political and economic differences between the two Democratic candidate's health care plans by explaining that, "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."

Krugman makes a strong statement and it's based on two points: the first is that Clinton's plan provides universal coverage (through an individual mandate), and Obama's plan does not cover everyone and does not include an individual mandate (except he does have one for children, which suggests he understands its usefulness). On this the experts agree -- Obama's plan leaves 15 million people uninsured while Clinton's plan leaves no patients behind. According to the Wall Street Journal, "Outside experts agree that number is in the ballpark." Obama has acknowledged this fact, saying that "Fifteen million sounds like a lot ... I'll have 97 percent covered." The Washington Post notes that the "Obama plan could leave a third of those currently uninsured lacking coverage."

Krugman's second point is that Obama uses campaign rhetoric -- straight from the pages of the right-wing, anti-government playbook -- that demonizes mandates to the point where he would have a difficult time as president accepting a proposal that has one. The ideological intensity of Obama's critique is a serious problem because an individual mandate is an effective mechanism for covering everyone. It's far from the only way -- but it is one way and it has lots of political support. If you're trying to bring people together around a solution, ruling out something as big as this may well rule out your chance of success. In this way, says Krugman, "Mr. Obama's campaigning on the health care issue has sabotaged his own prospects" of winning reform as president.

The case in point is Obama's recent direct mail piece (PDF), which is misleading about Clinton's plan and his own. Ezra Klein of the American Prospect says that Obama is "fear-mongering" and "demagoguing universal health care." For example, Obama fails to mention that Clinton's plan guarantees coverage for all. And while he says that affordability is the key issue, he neglects to note that her affordability provisions are stronger and more specific than his. Obama also fails to note that his own plan has an individual mandate.

The nonpartisan factcheck.org has done a thorough analysis of Obama's mail piece that you can read on their site. Krugman and others note that Obama's mailer is also reminiscent of the infamous "Harry and Louise" ads that the insurance industry spent millions on to kill national health care reform in 1993.

Jonathan Cohn from the New Republic, commenting on Obama's mail piece, explains that "a presidential candidate who believes in a reform has to avoid making statements that could undermine that reform down the road. And that's precisely what Obama has done here. Even he has admitted, in some instances, that a mandate might be necessary in order to get everybody into a universal health care system. (And he already has one for kids.) But this mailer -- with all of its unmistakable echoes of Harry and Louise -- makes that task much harder."

"In the end," says Klein, Obama's "plan is not universal, does not attempt to be, and is probably less generous in its affordability provisions than Clinton's. And even so, I wouldn't really care, as it's still a pretty good plan, except that he's decided to respond to the inadequacies of his own policy by fear-mongering against not only a better policy, but the type of policy he's probably going to have to eventually adopt. It's very, very short-sighted."

The substantive difference between Clinton and Obama on health care is that Clinton will cover everyone and Obama will not. There's no reason to hope that every man, woman and child in our country will be covered under Obama's plan because that's not what he intends to do. When it comes to health care, the difference is clear: Obama's plan sets us back. Clinton's plan moves us forward.

Comments

[Barrack69]

Duh! Mandatory health insurance is what the two democratic contenders are pushing. Sort-a like mandatory car insurance, but with extremely high premium payments. Where do the premium payments come from? Out of your paychecks in the form of a Medical Tax.

Better yet. Quit your jobs and go on welfare. Universal healthcare is welfare. How about universal housing. Universal jobs. Universal food. Universal education. One size fits all. No leaving the system.
Basically everybody works for room and board. If the government doesnot give it to you, then you dont need it.

What will Universal Healthcare cost? Think of what you pay for Universal Car Insurance then factor that by 10+

[Barrack69]

Somebody needs to fact check the FactCheckers!

FactCheck.org? Are you kidding me? Anybody read Newsweeks article "Wrong Paul" by Factcheck's Joe Miller. A total hit/smear piece on Ron Paul. 100% factually wrong. The Paul Camp is contemplating suing for libel.

FactCheck.org is sponsored by Annenberg/UPenn. The article raises serious journo accountability issues for FactCheck.org

Somebody needs to fact check the FactCheckers

[HAP]

Dear Sir, I appreciate your well-written posting, but I think you are mistaken, as argued in my own essay. You overstate the likely effectiveness of the Clinton plan, and do the opposite with Obama's. Plus, Obama is more likely to get elected to accomplish anything.

http://www.huffingtonpost.com/harold-pollack/an-open-letter-to-paul-kr_b_84952.html

[Thagan]

No one is considering consolidation of the health-care insurance industry in recent years. Health insurance has gone up 78% since Bush took office. The only power consumers have over cost is choice. Mandates will lead to consumer abuse. Where is the incentive to lower cost if every is "mandated"? Reform first.

[DebbieW]

As a former delegate to the International Convention where Mr. McEntee was last elected to lead my union, I want him to know I have lost all faith in his judgment and leadership in the last 6 weeks. And he will not have my support in San Francisco this summer.
When he criticized Barack for considering unions a special interest group because he won't take their PAC $ I knew he had lost touch with what we're all about. We play the PAC game with PEOPLE to survive....its not a game we ever pretend we can win. Barack's campaign is doing what unions are supposed to be about at our core...building a movement from the ground up and finding strength in numbers. Maybe that's why he's so threatening to you. And if so, maybe you should be worried....because "Nothing can stand in the way of the power of millions of voices calling for change."

[Nic]

Polarizing, Divisive? Those are the M$M words at work. And,far too many of you are falling for it.
Change,Hope? No substance,no details. And far too many of you are falling for it.

[momorune]

I am wondering, why did you cite Krugman's Harry and Louise comparison when Factcheck.org stated that there is no similarity outside from the photo which shows a couple sitting down at the kitchen table to discuss health care?

Also, I think it's arrogant to dismiss the other differences. How do you know they don't matter to voters? Perhaps they don't matter to you, but that's another question.

Your purported "expert on healthcare" status is fully canceled out by your willingness to tip things to Clinton via biased writing.

[amberglow]

yup--Medicare for all--and we need to take the Fed Govt's own healthcare away from them unless they pass it. (i'm dreaming, of course--tragically)

We're not going to get anything from Obama or Hillary--Edwards was the only chance for real progress.

[SouthernVoice]

This health coverage issue is either much bigger than the candidates are putting forth or much smaller. Sometimes I wonder why we can't insure everyone at the same level that Congress is insured, or why not put everyone on Medicaid.

I have private insurance through my job and I'm always amazed that when the insurance sends their accounting, there is an amount the health care provider charges and the contracted rate, which is significantly less. The health care provider basically eats the difference.

It seems Medicare/Medicaid (I don't really know the difference but my retired mother is on one of them supplemented by insurance from the job from which she retired) works the same way. There is a health care provider charge and a Medicare/caid contracted rate and the health care provider eats the difference. Somewhere in there my mom's work insurance kicks in but I'm not quite sure how that works.

I've always wondered who pays that full price the health care providers report? Is it the uninsured?

The system is broken but there has to be a fix. If we can fund a war, certainly we can fund universal health care.

I do have concerns about what Hillary means by mandated coverage. If it's like auto insurance, it's going to be a problem. It's important to know how we're going to mandate it.

We've got to cut costs as Obama says but the insurance companies are not going to do that without a fight, a bloody one.

Both of these candidates have some work to do on this one.

[GhostOfSchlesinger]

AND the good doctor WILL NOT talk about breakage estimates with HillaryKare v07.08, which indicate that upwards of 15% of US citizens will avoid enrollment because . . .

They work under the table (hence, the WAGE GARNISHMENT to which we can all look forward); they work for employers that do the same; the make money via "other" channels; or they are transients that work multiple jobs, hence offering no clear target for garnishment.

What does that mean?

Well it means that the good doctor is WAY off and obviously stumping for his candidate - a disappointing position for a medical professional.

AND it means that we would end up paying significantly (between 25 and 55 percent) MORE for HillaryKare v07.08 than for Senator Obama's plan, which by the way let's YOU MAKE THE DECISION . . . which as it turns out . . .

Is sort of something that an OVERWHELMING MAJORITY of voters prefer.

Just a thought.

[NightAdder]

If Hillary's health care plan were to pass in Congress, it would destory the democratic party more than NAFTA did. It would make the insurance companies like the mob than ever; you either pay for their protection "or else". No matter how many safeguards Hillary says her plan will have, the working poor will benefit the least because the quality of coverage will always depend on income not morality. Extend medicare or create a single-payer system, then there will not be any need to create exotic legislation that will create more problems than solving them.

[mslindab]

What I don't hear is what will be done with illegal immigrants who want and need health care. I have heard that Hillary says they won't be covered under her program which, to my thinking, leaves her plan with less than full coverage. Especially when one considers that Hillary has said there are no illegals. How will she enforce payments from people who are in an underground economy? How many million won't be covered???

[AnninCA]

You know, this is too late.

Obama has the "image" of the liberal. He's not.

Everyone who has any real knowledge of positions and policies says the same thing. He's not progressive.

But it honestly is too late.

The press kicked off this momentum.

They gave him a pass when it would have mattered.

Now....just don't try to even pretend that you cared.

[piezoid]

WARNING Mr. McEnee you have entered a Hillary-free zone. Toxic personal vilification will now be administered. The non-believer is not of the body!

[Independent voter]

Hillary had 14 years to deliver ANYTHING on univeral healthcare.

With a Democratic President, Congress and House she delivered NOTHING. Absolutely NOTHING.

To make matters worse, she did NOTHING like Secret Squirrel - in the dark behind close doors. And then to really compound this dismal failire, she convinced heartless hubby bill clinton to hide her failure under lock and key.

Doing NOTHING qualified to do something

Jeez!


And now, when asked about the implementation details of HillaryCare V2, she obfuscates.

When asked what will happen to people who won't buy insurance from her handlers at Cigna and UHC she says - and this is really telling - "we'll have to see".

Well see this hillary (hand waving, not all fingers raised)

Hillary has a better chance of laying an egg than delivering universal healthcare.

You should be ashamed - or paid by the clintons