My quick analysis of health care issue. I’m certainly no policy wonk, but as someone who is concerned about health care and its delivery system, I have paid attention to their competing policies. Lately it has become popular to view the two candidates as being similar ideologically and the differences are only in tenor and perceived electability. I disagree. There are fundamental differences in the two health care plans and I’ll explain why I think Clinton’s is better.
First, Hillary Clinton’s plan calls for mandatory coverage, while Barack Obama only wants to make insurance available and affordable. He feels that nobody “chooses” to go without insurance and thus no requirement to be covered is necessary. While reducing costs will enable more people to get health care insurance, a significant number will remain uninsured yet physicians will still be required to treat them when (not if) they get sick.
Clinton has famously said, "If you don't start with the goal of covering everybody, you'll never get there… Democrats should stand for universal healthcare." This is absolutely without doubt the only realistic plan. As long as doctors and hospitals are required to care for the sick and injured, then the potentially sick and injured should be required to have the ability to pay for that care. Period.
Note that neither candidate is calling for centrally controlled health care. Both see a place for private insurance companies in the process.
Second, Barack Obama has called for an expansion of State Children’s Health Insurance Program to cover middle class kids. This is a federally funded program, administered by the individual states, to provide care for indigent children.
Hillary Clinton championed SCHIP from the beginning, but she wants to keep it only for poor folks. TO expand this program to families making $74,000 is not appropriate.
Third, Obama has called for open legislative deliberations to discuss priorities for any health care plan. Bring “all the players” to the table, he says, in order to shed light on the lobbying and finagling that normally goes on behind closed doors.
While this is a popular meme, the so-called Sunshine Statutes often bring such deliberation to a screeching halt. Deals are made behind closed doors all the time and sometimes that is the only way the individual lawmakers can claim that they fought hard for their constituents and sponsors while they may have had to compromise key issues in the smoke-filled room. The practical fact is that health care entails deeply held dogmas about the right to care versus huge industry profits and open debate may stilfe a workable solution.
I give Barack Obama credit for recognizing the obvious fact that health care is a compelling issue, something the Republican Party has missed. But I agree with Hillary Clinton that universal care is a requisite, and these deals sometimes have to be ironed out with gnashing of teeth by policy wonks and not necessarily held up for grandstanding as lobbyists watch their expensive Senators pontificate.
There are distinct differences on this issue between the two candidates, and I lean heavily toward Hillary Clinton on her thoughtful plan.
3 comments:
Yes, I agree -- Hillary wins the health care debate. She has the most comprehensive solution, and strategically, she is right to approach it with a universal orientation.
I admit though that Barack's "put the health care discussion on C-span" suggestion is seductive to me. That is because it brings the people into the process, rather than having the benevolent government and corporate health care industry making the decisions on behalf of the public. I fundamentally believe that the apathy people feel toward politics is due to their lack of engagement, and their disillusionment in their elected leadership. Transparency in decision -making (and this is quite different from the joint chiefs discussing national security) is sorely deficient in Washington. Making the health care debate a transparent one would be instructive, and it would engender a sense of public ownership in the pathway toward universal healthcare.
One more thing -- Hillary may "own" health care policy, but I think Barack owns the "good judgement in foreign affairs" tag. Well, that is unless you're a neocon nutjob and you still think this insane war and occupation of Iraq is a splendid idea.
Obama/Clinton ... Clinton/Obama: this is a good choice to have.
I understand the seduction of a C-Span debate over healthcare, but I just don't see it as feasible or prudent.
Pharma, insurers, doctors' groups, nurses' groups, durable medical manufacturers, hospital organizations, allied health providers (nurse practitioners, midwives, chiropractors, etc), seniors groups and other consumer advocacy will all be "at the table"? We'll still be arguing and debating when Chelsea is eligible for Medicare!
This would make for a cacophony of competing interests and, I'm afraid, gridlock. Lobbyists who think they have a Senator or Representative in their pocket will expect vocal support for their cause and the congress-critters will oblige with endless harangues lest they lose their sugar daddies.
Alternatively, if they emerged from the smoke-filled room with a done deal-- a series of compromises-- they can say they argued but had to concede some things even if the reality was they saw the error of their lobbyists' argument the whole time.
Open discussions on such complex issues often plays into the perceived need for entrenched advocacy groups who use fear to suck money from their constituents, which feeds the vicious cycle of money buying influence which then seeks more money...
Fareed Zakaria, in his book The Future of Freedom, discusses this at some length. At first it sounds counter-intuitive, but after some cogitation I see his point.
As for foreign policy, I may be delusional, but I still can see HRC's point about the 2002 Force resolution not being a blanket permission for the Iraq invasion. Without this resolution and the show of force, no UN inspectors would have been allowed into Iraq. I may be wrong, but I believe that Bush blinked when he launched shock and awe, and then he proceeded to completely mismanage the post-war occupation. I simply cannot blame the Senate for doing what they thought was necessary in 2002.
On Iraq:
Hey -- I don't have a personal issue with Hillary's position -- it is essentially the same as Kerry's was in 2004 and I supported him as well. It is a legitimate policy stance that she holds -- and as she has stated tonight, she adheres to a coercive diplomacy orientation. Am I in complete harmony with that? No. I personally subscribe to a slightly different paradigm in which we don't extrovert our hegemony to such a degree. But it is 95 percent close to where I stand so I fully respect it.
My view is that in a general election, I think Barack could draw a far sharper contrast against the likes of McCain on this issue. I am not talking preference or belief... just strategy.
McCain will be able to say in black and white terms that when the polls were up and when they were down, he had the same position on the war and the surge. Barack can do the same from the other end. Hillary will have to explicate the same seemingly convoluted rationale as per Kerry. Do I personally view it as convoluted? No. I actually "do" nuance.
But it will be portrayed as such because it just can't seem to be transmitted to the public in a necessary six-second, media-friendly, soundbite and will thus function as fodder for the political right.
Moreover, I think she could be hit on questions of why she didn't vote for the Levin amendment. Had she voted for Levin, then she could pivot the issue and cogently argue that the rationale for the war authorization was simply ammunition to get Saddam Hussein to comply with inspectors, and demanded more congressional oversight before an actual war took place. She's also going to have to contend with her vote for Kyl-Lieberman on Iran, which has also been deemed problematic for similar reasons as the Iraq war resolution. The latest NIE on Iran will blunt the rationale for that vote as well and could also be picked apart.
Do I hold these critiques myself? Of course not. But I think she needs to be prepared to contend with them in the general, and tonight's debate answer on Iraq was about as rambling and problematic as i have ever seen her. McCain is already bludgeoning Romney with timetables he may not have ever sanctioned; Hillary can expect similar treatment and all I am saying is that Barack will fare better on this one issue.
By contrast, I think Hillary AND Obama will have the upper hand on McCain in their discussions of all spheres of domestic policy, although I give the edge to Hill on healthcare. She simply owns that issue. I also think she can speak persuasively about the macroeconomic ills that we are facing. She is the only candidate that I have even heard utter the words "sovereign wealth fund."
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And yeah I understand the problem of a c-span participative debate on healthcare... but hey, I did say I was seduced by the notion... not that I was going to commit to it! LOL!
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