Federal Man Date

I’ve been sickened lately to see poll results saying that the #1 voter issue is the economy. This just proves out the administration ploy to make the wars invisible. Not in the news, not in the budget, not an issue.

But the issue that I’d like to take up today is healthcare. I’ll start by dismissing the Republican approach because I don’t see one. What I hear mostly is the old shibboleths about “socialized medicine” or “Hillarycare.” Their ideas seem limited to tax deductions for insurance premiums for those able to itemize deductions, or the sort of plan Schwartzenegger proposed where everybody is marched at gunpoint into the clutches of the insurance and pharmaceutical companies.

On the other side, the bold planners are already out of the race. Foremost was Kucinich’s death penalty for insurance executives/ single payer plan, and then there was Edward’s plan that was set to evolve into a single payer plan.

The remaining candidates have proposed hybrid plans that carry some hope of passing Congress, providing that we voters elect enough Democrats to give them the courage to smite the entrenched powers.

You may have heard Clinton and Obama sniping at each other’s proposals. One thing that I heard reported recently was the fact that Clinton’s plan would REQUIRE everybody to get health insurance, an angle sure to incite many libertarians out there. Sure gives me pause…

In Paul Krugman’s column this week, he elaborated on the subject, citing studies by economists at MIT and at the Robert Wood Johnson Foundation. Here’s some:

“Both plans require that private insurers offer policies to everyone, regardless of medical history. Both also allow people to buy into government-offered insurance instead. And both seek to make insurance affordable to lower-income Americans.
But the big difference is mandates: The Clinton plan requires that everyone have insurance; the Obama plan doesn't.

Mr. Obama claims that people will buy insurance if it becomes affordable. Unfortunately, the evidence says otherwise. After all, we already have programs that make health insurance free or very cheap to many low-income Americans, without requiring that they sign up. And many of those eligible fail, for whatever reason, to enroll.

An Obama-type plan would also face the problem of healthy people who decide to take their chances or don't sign up until they develop medical problems, thereby raising premiums for everyone else. Mr. Obama, contradicting his earlier assertions that affordability is the only bar to coverage, is now talking about penalizing those who delay signing up – but it's not clear how this would work.

So the Obama plan would leave more people uninsured than the Clinton plan. How big is the difference?

To answer this question you need to make a detailed analysis of health care decisions. That's what Jonathan Gruber of the Massachusetts Institute of Technology, one of America's leading health care economists, does in a new paper.
Mr. Gruber finds that a plan without mandates, broadly resembling the Obama plan, would cover 23 million of those currently uninsured, at a taxpayer cost of $102 billion per year. An otherwise identical plan with mandates would cover 45 million of the uninsured – essentially everyone – at a taxpayer cost of $124 billion. Overall, the Obama-type plan would cost $4,400 per newly insured person, the Clinton-type plan only $2,700.

That doesn't look like a trivial difference to me. One plan achieves more or less universal coverage; the other, although it costs more than 80 percent as much, covers only about half of those currently uninsured.”

-So there’s a case for mandates. After all, we already spend enough to cover everybody, it’s just that our public health system has become a gravy train for some powerful interests. And like our foreign wars on the QT, it can be easy to ignore the fact that people are dying over unequal access to healthcare.