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Peter Daou

Peter Daou

Posted: November 30, 2007 09:17 AM

The "Fundamental Weakness" of Sen. Obama's Health Care Plan


Note: I'm the Clinton campaign's Internet Director

As Hillary said on Wednesday: "If we don't get universal health care, then we will be betraying the Democratic Party's principles. And it's important that those who will caucus on January 3rd understand this difference. Senator Obama's plan does not, and cannot, cover all Americans. He called his plan universal, then he called it "virtually universal," but it is not either. When it comes to truth in labeling, it simply flunks the test."

Paul Krugman today: "From the beginning, advocates of universal health care were troubled by the incompleteness of Barack Obama's plan, which unlike those of his Democratic rivals wouldn't cover everyone. But they were willing to cut Mr. Obama slack on the issue, assuming that in the end he would do the right thing. Now, however, Mr. Obama is claiming that his plan's weakness is actually a strength. What's more, he's doing the same thing in the health care debate he did when claiming that Social Security faces a "crisis" -- attacking his rivals by echoing right-wing talking points. ...

"The fundamental weakness of the Obama plan was apparent from the beginning. Still, as I said, advocates of health care reform were willing to cut Mr. Obama some slack. But now Mr. Obama, who just two weeks ago was telling audiences that his plan was essentially identical to the Edwards and Clinton plans, is attacking his rivals and claiming that his plan is superior. It isn't -- and his attacks amount to cheap shots. ...

"Although he declared, in his speech announcing the plan, that "my plan begins by covering every American," it didn't -- and he shied away from doing what was necessary to make his claim true. Now, in the effort to defend his plan's weakness, he's attacking his Democratic opponents from the right -- and in so doing giving aid and comfort to the enemies of reform."

More on the differences between Hillary's plan and Sen. Obama's plan on the Fact Hub:

"Sen. Obama claims there is no significant difference between his health care plan and Hillary's health care plan. But unlike Hillary's American Health Choices Plan, Sen. Obama's plan is not universal. Even Sen. Obama admits that his plan is not universal, and does not guarantee coverage. Experts estimate that Sen. Obama's plan will leave 15 million people uninsured. Sen. Obama has offered a variety of explanations for failing to cover all Americans. Sen. Obama's spokesman claims that requiring coverage should be left to the states; Sen. Obama's advisor says mandates are too ambitious and unpopular with middle class voters, and Sen. Obama says that he'll figure out how to cover everyone later. But Sen. Obama's Health Care Task Force understands that Sen. Obama's plan just isn't good enough. Back in 2004, Sen. Obama sponsored legislation that created a Health Care Task Force. Now in 2007, Sen. Obama's Task Force has recommended an individual mandate to provide universal coverage."

UPDATE: Full text of letter from Clinton campaign manager Patti Solis Doyle to Obama campaign manager David Plouffe:

David Plouffe
Obama for America
P.O. Box 8102
Chicago, IL 60680

Dear David:

I am writing concerning a false advertisement you are currently airing, in which Senator Obama claims that his health care plan would "cover everyone." Your advertisement not only contradicts the judgment of health care experts, but public statements by your campaign and your candidate. Senator Obama has pledged to put "honesty first" in this campaign. In that spirit I respectfully request that you stop running this ad which is misleading voters in New Hampshire.

In today's New York Times, noted economist Paul Krugman wrote that Senator Obama proposed "a relatively weak, incomplete health care plan. Although [Senator Obama] declared, in his speech announcing the plan, that 'my plan begins by covering every American,' it didn't -- and he shied away from doing what was necessary to make his claim true."

Health care author Jonathan Cohn looked at the data and concluded that, under the most optimistic scenario, Senator Obama's plan would leave "15 million people who are uninsured." The Washington Post reached a similar conclusion, finding that Senator Obama's plan would not cover "a third" of the 47 million Americans who are currently uninsured.

Additionally, a constellation of the nation's top health care experts - including MIT's Jonathan Gruber, the Kaiser Family Foundation's Diane Rowland and the Urban Institute's John Holland -- have concluded that plans like Senator Obama's, which does not include a requirement for all Americans to have health care, would leave a substantial portion of the American public without coverage.

Even Senator Obama himself has admitted that his plan would not cover everyone, calling the plan "virtually universal." Your top health care advisor, David Cutler, acknowledged that Senator Obama's plan could leave "significant pockets" of people uninsured and said Senator Obama would "deal with that when the time comes, possibly by mandating insurance."

On an issue of this magnitude Americans are looking for more than a nice ad or a good speech. It's not enough for Senator Obama to say he covers everyone, especially when that is inaccurate. The American people need a President who will take the action necessary and fight for health care for every single man woman and child. Until the time comes when Senator Obama has a plan that will cover everyone, you should stop running this false advertisement. The American people deserve an honest debate about health care.

Sincerely,

Patti Solis Doyle
Campaign Manager
Hillary Clinton for President

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HUFFPOST SUPER USER
MacTheBlogger
Radical Independent. Keep your partisan BS.
07:47 PM on 12/01/2007
Bolderdash, we'll have to agree to disagree, but I'm glad we can do so without being combative! Here's my take:

Is it a "right" of Americans to have health care? No, no more than it's their "right" to have food and clothing. And, at least so far, no one is demanding nationalized groceries and sneakers. Look, we wouldn't need health care if we're all dead from starvation. To follow that logic, government should provide food for all of us.

However, if you feel that it's the government's OBLIGATION to create, regulate and maintain an environment in which health care can be delivered affordably and effectively, I'm with ya.

Here's where we'll disagree the most: Competition keeps costs down and innovation flourishing. Take a look at most of the Medicare Advantage PPO and HMO plans - the insurance companies often provide benefits that are light years better than standard Medicare, with NO PREMIUMS to the senior. The insurance companies, through innovation and competition, are simply more efficient than the federal bureaucracy in administering Medicare funds. And many of these plans include free preventive care (which standard Medicare does not), which will go a long way in reducing the NEED for health care.

Hopefully we can agree that, whatever the plan is, both ends of the political spectrum can cooperate in doing what's best for everyone. I think it can happen, but not until the current political environment improves.

.
06:03 PM on 12/01/2007
I suggest for those interested in alt. opinions/analysis, to read a recent article at Slate "Obama v. Clinton on "Universality'".

Obama, Clinton, & Edwards all include a version of the most important element of the "Democrat's" proposal: A government plan alternative to private insurance. Of course Kucinich's plan of "Medicare for all" is best, but lets get real, its not politically feasible & Kucinich is not running a serious campaign capable of mass support in 21st century American politics...sad but true (UFO didn't help).

The gov alternative to private insur. will slowly replace private insur. as employers drop their employee coverage and opt instead to contribute to the gov plan that their employees can buy on their own. This is offered by O, H, & E, and is the incremental step towards single payer.

Bickering over "universality": a mandate will not ensure 100% enrollment, or at least 100% payment if someone is auto enrolled as E suggests. There are 2 issues of mandate vs non-mandate. #1- Is a mandate legal, will it hold up in court? There is a mandate for car insurance, but thats because driving a car is a choice. A mandate for health insurance however, is required without a choice. If you are alive, you must have it. I can imagine a libertarian suing the Fed for forcing them to purchase private insurance because they are alive. This brings us to #2 - A mandate is a target for attack, sounds like "socialized" med. The gov is forcing you to do something. This is easy for the righties to tear apart in TV ads rivaling 1993-1994 attack.

They all have good plans, none are perfect (re: single payer). H & E plans, by mandate, may cover more people, but its also a political risk in a general election. By having no mandate, Obama's plan appeals to independents and Republicans...which of course is his appeal, a uniter willing to seek compromise.

The question is, who can sell their plan to the country? Which plan can get 60 votes needed to avoid filibuster? Perhaps mandate becomes a liability...
05:16 PM on 12/01/2007
For all those who complain about Arianna's anti-Hillary bias, you need to wake up. Over the past week or so, about half the blogs here have been written by paid Hillary operatives.

At least this guy has the courage to state it.
03:36 PM on 12/01/2007
Cut to the chase: None of the Demo candidates health care reform plans are universal or affordable.

Basic facts: One, the only way to achieve universal health care for all Americans is a One-payer health care plan, similar to what our politicia,s and federal employees have now, which is like a 'medicare-like' government paid health care plan, that contains cost, full benefits, and administered without the profit-based system of private health insurance as the middle-man profiteer that the one-third overhead of every health care dollar spent by its customers/patients. That is the Novel in the Nutshell.

Every Democratic Nation in the World subscribes to this concept except the United States.

By pooling the costs of health care in America for everyone involved in receiving it, the cost would be one third cheaper in our monthly premiums, co-cost, and no deductibles would be needed.

Employers in America could return to a more competitive marketplace in the World of Business, because they can now play on a more even playing field with their Democratic partners. And the employees would receive continuous health care coverage 24/7, regardless of who they work for, because all workers would be health insured 24/7 by their government insured health plan, guaranteed for life. And you didn't think your government could do something for you? a change in attitude is needed!
HUFFPOST SUPER USER
MacTheBlogger
Radical Independent. Keep your partisan BS.
02:57 PM on 12/01/2007
The best model for our national health care system already exists: Medicare Advantage Plans. These plans include the best of government control & oversight with the best of the free market: competition.

In the Medicare Advantage system, the government pays private insurance companies for each enrollee. The companies are then free to include the best possible benefits, spurred on by competition, under the watchful eye of Medicare.

Would this be "free"? No. But it would be much less expensive overall than our health care system is now, it's already in place, and it allows for competition and innovation.

Of course, expecting a plan that would take the best from the American Left and the American Right would require cooperation, something not currently allowed in today's absurd political climate.

Medicare Advantage for all!
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12:42 PM on 12/01/2007
What I would like to know is how Mrs Clinton intends to enforce her mandatory health insurance laws. Wealthy people need to get a clue. People lack health insurance because they can't afford it. People who do have health insurance then have to deal with the scum sucking bottom feeders of the insurance industry. The thing that really worries me is that Mrs Clinton is aware of this and wishes to blame those who make under the median income for their poverty much as her husband and the republicans did and do.
HUFFPOST SUPER USER
nolalily
12:10 PM on 12/01/2007
I'm sorry for you as a campaign worker for Hillary. By the way, folks. If you didn't know it, KRUGMAN is an Edwards' supporter.

The truth is, none of the candidates have a perfect healthcare plan. But, the difference for many of us is simply this:

I trust that, once in Office, Obama will fashion a truly progressive healthcare plan. With Hillary, I'm not so sure.

Edwards might, but that's only if he can win. My main problem with Edwards' comes from his reputation in the past as being someone who will change his principles based on what will suit his ambitions. I'm not sure that that is still true. In fact, I'd say I've come around to liking him more, but, I have faith in Obama.
11:27 AM on 12/01/2007
There are some silly arguments going on here. If the argument is between Clinton and Obamma, Clinton has the more progressive plan. It will cover everyone or very, very nearly everyone. As to the question of how her mandates will be enforced: the same way other mandates are enforced. People pay their taxes, some may cheat and pay less than they should, but no one in America gets away with paying nothing.

If the argument is what is the most progressive plan of all, it would be Kucinich's single payer proposal. Clinton's plan may not be as good as Kucinich's, but only a rabid Hillary hater would claim it does not represent a radical improvement over the status quo, or that it's better than Obamma's plan. It also is not the gift to the insurance industry that many here claim it to be. If it was, insurance companies would not hate the plan, and they do hate it. As a previous poster noted, they would be forced, against their will, to cover people they have already refused to cover.

I consider myself a far left liberal, and am comfortable with the term "socialist" as well. I don't like a lot of the things the Clinton's have done, but to pretend they are the same as Republicans is not rational. An inability to make such clear distinctions is unhealthy. I would much rather see Kucinich or Gore, or even Edwards as President than Clinton, but if given a choice between Clinton, McCain, Guliani, Romney, Thompson or Huckabee, only a crazy person would be unable to see that Hillary is better and more progressive than anyone running on the Republican side. She should not be any progressives first choice, and despite the weakness of his health care proposal, Obamma may still be a better choice than Hillary. But he does in fact have a disappointingly weak health care proposal, that much should be clear.
07:04 AM on 12/01/2007
The "fundamental weakness" of the American voter is that they have been battered for the past 7 plus years with the politics of obfuscation and prevarication. We are now easy victims.

What Obama and his campaign are doing in regard to his healthcare proposal and his campaign in general is relying on the now well founded ( and highly Republican principle) of marketing the messenger (moviestar Reagan, cowboy Bush) fresh ideas fresh faced Obama and presuming the American people are too lazy? too ignorant? too easily distracted? to read and understand his actual policy. Skim many of the posted responses here serves only to confirm this theory.

This is a critical election. We must analyze the content of what is being proposed, not fall in love with the illusion of the candidate created by their public relations effort.

Obama's healthcare proposal and his social security proposal are right out of the rightwing playbook and not worthy of a Democrat. Read what he proposes for all of our sakes.
03:14 AM on 12/01/2007
I don't know when the Hillary Clinton campaign became a credible source, but I'm not surprised they leave out the facts. Here is another side of the story:

Clinton's plan itself will leave 15-20 million uninsured.

Clinton's criticism that Obama's plan leaves 15 million uninsured includes 7 million undocumented immigrants who are not covered by her plan either.

This is from: http://www.barackobama.com/factcheck/2007/11/30/post_2.php
Consider the argument.
02:11 AM on 12/01/2007
Mr. Daou:
No doubt, as Ms. Clinton's campaign internet director, your purpose is to spin her positions, regardless; the facts be damned! Ditto for Paul Krugman, NYT columnist.
It seems that your target audience is the lazy researcher or the potential voter who won't do his/her own research on the candidates' policies and positions.
I've done my own research and can now conclude that your piece is not entirely disinformation, but very close.
Have a nice day.
WintonyMay.
01:25 AM on 12/01/2007
Oh since you have her ear,how about doing the right thing and give us the same plan that the million dollar gas bags in DC get? Why do we get crumbs and pay at least 400 bucks a month for the priviledge????? If she is so capable maybe she could unplug her pipeline of cash for a moment and do the right thing.Kerry had it right.So please do not expect a lot of support for her measly little plan--which will not come to fruition anyway---her owners won't allow it.
01:15 AM on 12/01/2007
Lovely, the latest Clinton flack.Yes she walks on water and is the shining example on the hill that will show such inspiration.Oh and of course the only problem she has is this young man that is stepping all over her parade.Something not planned on with her march back to the WH.He is a fly in the ointment that needs to be swatted-it is obvious she really dislikes him and he is in her way.Too bad---he is a good honorable and decent man that is actually a progressive compared to the DLCer,and corporate power sellout.
11:28 PM on 11/30/2007
And just how will Hillary enforce this mandate? Will she send people to jail?
Car insurance is mandatory...but everyone here has been hit by uninsured drivers. Why do some drivers go without insurance? Because they cannot afford the high premiums.

Obama's plan is pragmatic, and yes, will require some sacrifice, which he always points out in his speeches. Hillary's plan is vague...she says she'll appoint a commission to "study the issue".

Whatever Hillary.
10:03 PM on 11/30/2007
RHETORIC: "Any health care plan that leaves 15 million Americans uninsured cannot be considered universal. And that's a very big difference," said Clinton campaign spokesman Mo Elleithee. [Des Moines Register, 11/20/07 http://desmoinesregister.com/apps/pbcs.dll/article?AID=/20071120/NEWS09/711200382/1010/NEWS08]

REALITY: "MIT economics professor Jonathan Gruber, one of Clinton's health care advisers, describes her plan as a 'universal coverage' plan, in contrast to the Obama plan, which he terms a 'universal access' plan. But he also acknowledges that the Clinton plan will not include everybody. 'Any system that does not have a single payer will not have 100 per cent coverage,' he told me, when I reached him after the Las Vegas debate. 'But you can come very close.'" [Washington Post, 11/19/07 http://blog.washingtonpost.com/fact-checker/2007/11/clinton_vs_obama_on_health_car.html#more]