My Super Tuesday Issues: Health Care and Small Business

I've watched nearly all the debates and countless hours of Meet The Press, The Situation Room, Hardball and Washington Week. And there are still several nagging issues my two Democratic candidates fail to answer to my satisfaction: health care and increased taxes on small businesses. As an independent magazine publisher and owner that both employs and targets mostly 20-somethings, my perspective on the health care debate is specifically informed by the proximity to these Gen-Y citizens. Our company subsidizes employee healthcare and has done so for a decade or more now. But the recent debate between Obama and Clinton -- specifically the Obama stance that mandatory coverage is not needed -- really fails to meet reality head on. Obama claims that anybody who could afford health insurance would surely purchase it. This has not been my experience and I'm unsure if he really believes this or is stuck in a misstatement of his own creation.

Over the years, I can count dozens of 20-something friends, employers and acquaintances that routinely skip out on insurance. Seen as a remote need and a mundane life expense, these healthy young individuals would rather fund something else in their lifestyle and who'd blame them? Who really thinks they're going to end up in a hospital at 25? Even the employees I insure -- especially the guys -- seem to rarely even visit the hospital for check-ups or preventative care. And many -- easily a relevant portion of the millions of uninsured -- feel that the risk of getting caught without insurance in an emergency room is worth the several hundred dollar per month in savings. You don't have to look any further than to the millions of un- and under-insured motorists on the roads. It's obviously partly an issue of costs, but one can't deny the simple issue of personal risk management. The only problem is that this ends up costing everybody else when the proverbial chickens come home to roost and something goes wrong. You and I pick up the tab in the form of taxes and medical costs.

My only guess as to why Hillary Clinton hasn't done a better job of poking a hole in Obama's borderline erroneous claim that virtually all of the uninsured are so due to financial hardship, is that it would come across as just one more mean-spirited tag her haters could use against her: "Hillary doesn't care about the poor huddled uninsured." But some have recently argued that Obama's plan to allow anybody to "opt out" of insurance (seemingly without any real penalty, though he floated the totally unrealistic concept of back-premiums during a recent debate) will make his plan massively more expensive in the long run. And more disturbingly, it's been said that his plan will stall or have to be re-done to a mandated system (vis a vis Clinton) in order to get passed and make fiscal sense. To me, universal health care, like auto, can only mean mandatory coverage.

But I'm not letting Clinton off either. She, along with Obama, still don't get that who they describe as wealthy people in this country -- myself, it seems -- are largely entrepreneurs, small business owners and sole proprietors. The age-old Democratic war drums that play to the hearts of the middle class unfortunately castigate the most vital sector of the American economy. By not even addressing the effects of a tax increase on those making over $250K annually -- which, as a business owner of an S-Corporation, isn't a huge amount of pre-tax income when you consider that this is your salary, and profit margin -- Democrats dismiss me and the millions of others who'd like to be proud party loyalists. Against my financial interests, though I continue to vote along party lines if only to sleep better at night. Democrats are fortunate this year to have such an electrifying field, but in any other year, they'd probably be poised to lose (again) since the migration of business owners from the party (assuming they had them in the first place) has been unfortunate. It's easy if you're Warren Buffet, to say that you don't need a tax break. Try staying afloat in the predatory and unsupportive business environment of California. It isn't easy and I can thank my democratic leadership for largely allowing these negative conditions to grow.
I'm undecided as to my vote today, even though I remain proud and supportive of both Democratic candidates. I just hope they'll find a more authentic and realistic voice on these two subjects sometime before the general election. They'll need to do this for the party, for me, and for the country.

Comments

[SEQUOIABISON]

Although I am a strong Obama supporter, I think both Hillary and Baracks Healthcare plans are abominable.

What they both do is continue to make the Insurance companies the main focus for our health.

We cannot allow For-Profit corporations decide what is best for us. These people only care about the bottom line and paying stock dividends to their investors.

We must join the rest of the civilized world and do what is best for the American people not stockholders.

Tweaking the system around the edges is only going to help shy rocket costs and help the Insurance and Drug companies add to their bottom line.

What we need is Not For-Profit Healthcare or Medicare for all citizens not just Seniors.

[StephenSmoliar]

I am beginning to feel that this debate has lost touch with the most important economic issue, which is proposition that, in the long run, health MAINTENANCE costs less per capita than health CARE. In other words it costs less to finance regular check-ups that can lead either to preventing certain maladies or to catching them in earlier stages when treatment is likely to cost less. I am not sure if there is a hard-and-fast argument to confirm this proposition; but my own life style has accepted it as true for as long as I have been on my own. I would say that early detection of my prostate cancer was sufficient to justify it.

I suspect that one reason why debates will not speak in these terms is that the very concept of "health maintenance" has now been fouled up beyond all recognition by the HMO businesses. I am not suggesting that this is the reason why your 20-something friends are so negligent of their health care; but I WOULD suggest that a national culture that has suppressed the "true semantics of health maintenance" at least contributes to the problem. Needless to say, a reformed health care system that mandated regular physical check-ups would face a lot of attack on grounds of being too paternalistic; but a more integrated system would at least have the leverage to experiment with incentive programs.

All this is a long-winded way of saying that, without a clear "vision statement of a healthy society," arguments over who pays how much for what are not going to signify very much in the long run; but, since those arguments (rather than the welfare of the electorate) are the bread-and-butter of politics, I know better than to expect politicians to get beyond them.

[honeybee49]

"Under Obama's plan, people under the age of 25 will be covered under their parents' insurance." That's it right there, isn't it--the whole Obama demographic, not to mention the overweening assumption that "people under 25" necessarily even HAVE parents, or even one parent. Must be why Hillary has the overwhelming support of working-class and lower-middle-class families whose daughters and sons don't remain economically dependent on them until they're 25 years old. Nice to see, though, that some of the young O-bots still like something about their Boomer parents--their (putative) ability to provide free health insurance. (They probably imagine that their parents won't be paying anything extra for it.) Clearly, Obama's political function is to exploit and absorb the rage of the young while constraining the old and keeping politics safe for Wall Street and the multinationals.

[CoolCal]

Admittedly, the Democrats as of late appear to be a more palatable choice in terms of which bureaucrats I'd rather be on the other end of the great shaft of the Government's bayonet. But if you insist, as most Democrats do, on being the party of rationality, or pragmatism, why continue to foster this slavishness to party-line voting, when you seem to profess here that these supposed altruists want nothing more than to punish you for your ill-gotten gains. Granted, the Republicans offer similar paternalistic tripe that makes this a purely hypothetical argument. It just always baffles me that Democrats I know will unashamedly vote along party lines without a second thought as to the policies of the candidate as they relate to the people and the moment, simply to affirm the benevolence of the liberal ideology. I can't think of a less rational or pragmatic behavior.

[RusStyles]

I think there are problems associated with mandated or voluntary, affordable healthcare. No what path you take, everyone will not buy coverage, albeit for different reasons. So, it's a matter of picking your poison/cure. What both are proposing is quasi socialized healthcare, though a softer version. Socialized medicine clearly flies directly in the face of a capitalisitc model. So what Barack is (perhaps) attempting to acclimate or steer Amercians-­-increment­ally--towa­rd some new hybrid version of socialized medicine.

What no candidate has emphasized with sufficient clarity is the critical need for prevention. Wellness programs should be established in all schools, and companies. This is the real key to fixing our healthcare system.

[Independent voter]

If health insurance were free, everybody would have it, so there are obviously some cost related issues.

Lowering the cost of healthcare by breaking the lobbyists grip on government and changing the way that new drugs are marketed to physicians by tall blonde women will help, but somebody must pay. There is no other option.

Hillary had the opportunity to implement universal healthcare with a Democratic President, Senate and House in office and accomplished ABSOLUTELY NOTHING. NADA.

Some interpret this dismal failure to mean that hillary has the experience necessary to deliver the goods.

I see it quite the opposite. A unique record of failure and disappointment cloaked in secrecy under the lock and key in the clinton library does not inspire confidence.

It's kind of like standing in a cab line at O'Hare and one cab is shiny and new and another cab is rusted, dented, worn out, beat to shit and the doors are hanging off of it.

I think I'll take my chances with the new cab.

[LetheaBu]

"As an independent magazine publisher and owner that both employs and targets mostly 20-somethings..."

How many insurance advertisements run in your magazine targeting the seemingly "untapped" youth market? You don't need to take away the basic human rights of the poor and the young in order to get them insured. All you need is a clever advertising campaign. And believe me, as a member of the American youth, it pains me to say it.

[waynepj3]

Under Obama's plan people under the age of 25 will be covered under their parent's insurance. Plus, if health insurance was 20 bucks per month people would pay for it. Mandates dont work. Its a band aid that does not address the real reason why people dont have coverage. If you impose a mandate, have they pay a fine...you wind up with people with less money AND STILL DONT HAVE HEALTH INSURANCE. We mandate auto insurance in CA but we still have uninsured motorists. The reality is, unless you have a system like in France where you pay taxes and government provides healthcare...not every single person will be insured.

[hopeless277]

With the occupation of Iraq and the tax cuts for the rich, you can kiss your healh care good-by. The Republicans have finished off what was left of America. They have purposely stolen every red cent plus $500 billion from the U.S. taxpayer and now can sit back and pick at the bones of our once great country. Remember, Enron ran our energy department before they got busted. These are the type of people in the Republican party. They sit back and watch children starve to death so they can collect their charm bracelets to melt down for their wives jewelery. So no one will get health care unless they can afford it. And they will not be able to afford it because the Republicans stole them blind. Nixon started it. Reagan instutionalized it. Cheney perfected it. Why do you think he was smiling so much at the SOTU? They have won. We're all just to stupid to know it yet.

[camb94]

I think you are right about health care, but I still like Barack and think that the only way to get a universal plan moving forward is to leave it optional. Yes, there will be those who will opt out, and they shouldn't, but there are too many vested interests who are truly afraid of "socialized" medicine to go about it any other way. Let them opt out now. When the costs are too high, then you can force everyone to at least buy catastrophic insurance.