Dean Baker (Center for Economic and Policy Research) on the competing health care policies:

[Stop Cornyn]

All three contenders have proposed a national healthcare system that is a variant of the plan developed by Yale political scientist Jacob Hacker. The basics of the plan are to require that all firms either insure their workers directly or pay a fee to the government. The government then uses this money to heavily subsidise insurance for low- and moderate-income families. It also establishes an expanded Medicare-type public plan that people will have the option to buy into. In addition, it reforms the private insurance market, most importantly by requiring that insurers not discriminate based on pre-existing conditions.

Both Clinton and Edwards would impose a mandate that everyone buy into this system. Obama has claimed that he would not require a mandate. As a practical matter, the healthcare system that any of them are able to put in place will depend on the arms they twist and the pressure they can bring to bear against the insurance companies, the pharmaceutical industry and other powerful actors who will be hurt by real reform.

Any serious plan will require a mandate - this directly follows from its requirement that insurers take all comers. Without a mandate, no one would buy insurance until they had serious bills. This would be like letting people buy car insurance after an accident, and then sending the company the bill. That doesn't work.

http://www.alternet.org/election08/71650/

[sandnsea]

1. Medicaid can be retro-active

Lots of people get qualified for Medicaid after medical emergencies. That's nothing new. Obama has simply said we've got to make sure this is affordable before we put mandates on people. It's the caring way to approach this. He doesn't want to bankrupt people or cause them to have legal problems if we don't get a truly affordable health plan.

[Stop Cornyn]

2. Excluding the poor from universal health care is "the caring approach"? LOL!

:rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl:

[sandnsea]

4. You're laughing at being a liar?

You ought to be ashamed.

[Stop Cornyn]

11. No, I'm laughing at your hilariously implausible spin. No health care = most caring! Who says the

writers' strike killed political comedy!

[sandnsea]

15. That's a lie

What kind of ethics do you have that you think lying about policies is acceptable? Obama isn't keeping poor people from having health care. Why do you say that? It's a lie.

[Stop Cornyn]

16. Oh, you think it will be RICH people who go without coverage under Obama's plan? Ha, Ha, Ha!!!!!!!!!

:rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl:

[sandnsea]

17. I am serious, what is wrong with you?

People dying is not a joke.

[Stop Cornyn]

20. People dying isn't a joke; you suggesting that Obama's plan is anything but the least compassionate

health care plan IS a joke.

But the joke is on the American workers.

[sandnsea]

23. Do you know anything?

Or is all you can do is repeat personal attacks?

[Stop Cornyn]

24. I know you'd attack any candidate besides Obama who offered such a half-assed health insurance plan.

[sandnsea]

25. Biden, Dodd, Kerry... no

They don't have mandates. I attacked Edwards' mandate in 2003. The only reason I support Massachusetts' mandate is because the state can react more quickly to need, and it guarantees the funding will be provided. But if they don't make the premiums affordable, then I don't support it there either. Mandates before the details are proven is a horrible idea.

[Selatius]

3. I am rather leary of forcing people to purchase for-profit health insurance plans.

The notion of corporate welfare is something I'm not too fond of, yet if forced to choose out of the three, I would say Edwards plan is most acceptable because, as Paul Krugman said, it actually leaves open the door to transition to a single-payer format, which is the format France uses. France, coincidentally, is ranked as the world's best according to five criteria by the World Health Organization. Per capita, they spend half as much as Americans, yet they have achieved universal coverage with first world level quality of care.

[sandnsea]

5. France has a public/private system

It's not exactly single payer.

http://www.moving-to-france-made-easy.com/french-health-insurance.html

[Selatius]

6. It's single-payer to citizens and perm. residents, as opposed to travelers

If you go to France, they won't cover you automatically, hence why you must have private health insurance here in the US before going over there to deal with medical emergencies/contingencies. After three months of staying, then you can apply for state health insurance following the guidelines. In any situation before that, you use health insurance from the country you came from, such as the US.

I've heard of no French person buying private insurance to replace public health insurance. I have heard of people buying private supplemental insurance to cover any shortfalls public health insurance doesn't cover, however. As it states on the page, state health insurance will cover 70 percent, and you are free to purchase private supplemental insurance to cover the remaining 30 percent. It's still technically single-payer, as it satisfies the main criteria of a single government-run entity handling billing and negotiating rates for patients. Private health insurance is only involved as far a supplementing the base level of care the state-run health insurance entity already provides.

A public/private system would be akin to what Massachusetts has where the government enforces rules on mandatory purchase of private health insurance as the main vehicle of care. In France, the government compels no one to purchase private supplemental insurance. That's left to the discretion of the individual patient.

[sandnsea]

9. It is not 100% single payer, controlled, like Canada

People have to pay up front. There are both govt and private health care providers. They pay about 8% for the basic health plan that covers 70%, and then buy insurance for the remainder and whatever else the basic plan won't pay. It's very controlled, but all of Europe does not have out and out free health care like we are constantly led to believe. Different countries have different plans and there's no reason for us to not consider what will work best here.

http://www.frenchentree.com/fe-health/DisplayArticle.asp?ID=197

[Selatius]

21. See, that's why I dispute the notion that any health care is "free"

If you paid Social Security tax in France, you're also paying a good chunk out to state-run health insurance. "Free" paints the mistaken notion that you get something for nothing, and I generally recommend reformers to avoid that term, since Republicans have continuously used that tack in painting it as another "welfare queen" proposition, and it simply is misleading for uninformed people.

True, France could go all the way and cover costs 100-0 instead of 70-30, but they, for whatever reason, opted for the 70-30 route, and that's fine. That simply means you pay the other 30 percent out of pocket, or you can stop that by buying supplemental private insurance. While you may not consider it single-payer à la Canada, it could be that I generally have a looser definition of single-payer.

[sandnsea]

22. Considering we have Medicaid and Medicare

Which is a single payer formula for the poor, disabled and elderly - we have a public/private system too. Ours just doesn't extend to the entire population. There's doesn't extend 100% to who is covered. Other countries have their own differences. There's no reason to insist on one particular method of getting everybody coverage, as long as it's affordable and really provides care. 8% is an awful lot to pay when you still have to pick up 30% of your medical or another insurance policy.

[Selatius]

26. I think we're miscommunicating over differing definitions.

I define single-payer as meaning that there is one entity alone that exists in terms of negotiating prices for medications and medical treatments. Of course, I'm speaking of the population as a whole, not as segments. Otherwise, it wouldn't make it sense to have "single-" in "single-payer" in there unless we are talking about segments of the population, such as the poor. Then in that context it really would make sense to use "single-payer." However, Medicare/Medicaid are two entities that negotiate prices for a portion of the population as a whole. Several private insurers negotiate for those who do have insurance, and everybody else is without. In the American system, there are several insurance entities that negotiate prices both private and public, not one. As a result, you get costly duplication of activities and excessive amounts of bureaucracy because each negotiating entity operates according to their own standards, and because of the opaque nature of many of these activities, there's been a lot of guesswork over how much insurance fraud is responsible for inflating prices.

In France, you get only one entity that negotiates prices, and this was done for the basic reason that an insurance monopoly has far superior bargaining power in terms of negotiating prices with private hospitals and pharmaceutical companies than a smaller entity like Cigna or Etna could ever possibly hope to attain. Also, since the monopoly in France happens to be a state-run entity, there is no fiduciary burden of trying to generate a profit for shareholders, which can cut costs even further. Private supplemental insurance in France does not exist to negotiate prices. It only exists to cover what Sécurité Sociale doesn't.

Basically, the reason I favor the state-run single-payer format is to maximize bargaining power and save people money as well as cover everybody. By keeping private insurance as the primary vehicle in terms of providing coverage to people, you necessarily incur greater costs because of the profit mark-ups. However, unlike the French system, I do not favor a payroll tax to fund such an insurance scheme, given the regressive nature of payroll taxes in general. I think this is why French unemployment is higher than in the US: Regressive payroll taxation. I prefer it is funded through a progressive tax code, and funding revenue should be planted in a trust fund emulating what was done with the Social Security Act, and the system should operate using the Social Security Board of Trustees as an example to emulate. If possible, I would like this state-run entity to cover 100 percent of the costs, but if that isn't possible, I wouldn't mind 70-30 or 80-20 or something in that ballpark.

[Stop Cornyn]

7. Edwards plan includes a non-profit health care market feature which causes private insurers to bid

against a non-profit public plan that is based on Medicare.

Edwards does not force anyone to purchase anything from any for-profit insurance company.

[killbotfactory]

8. "Without a mandate, no one would buy insurance until they had serious bills. "

WTF? Does this guy know how fucking stressful it is to be without health insurance because you can't afford it?!

[sandnsea]

10. No they don't know

They're theorists. They've got no clue what it's like for real people. Obama does, which is why his organizing at the community level is so important. He talked about it in his interview with that newspaper in New Hampshire. We can't put people in the position of breaking laws by requiring unaffordable health insurance. We have to get it affordable first, and once the majority are in, we can consider mandating the stragglers. ONLY if it's affordable.

[killbotfactory]

12. It's a small but VERY important distinction

mandates AFTER it's affordable and regulated, if we can even get that far.

[sentelle]

13. here's the thing

Ins. companies don't have to discriminate based on pre-existing conditions. all they have to do is price you out of the market. This way, with a mandate, the ins. companies won't touch you, AND you can owe the government for not doing insurance.

Unless the Insurance companies are non-profit, and are able to put the insured first, this will not work. Corporations are prohibited to put the insured first. (they must put STOCKHOLDERS first, i.e. they must maximize stockholder value, meaning give the insured the shaft).... can anyone name a insurance company that is not a corporation?

Either way, we, as americans, lose.

[sandnsea]

14. If we regulate the insurance benefit

the way Obama wants to, then we don't have the pre-existing problem and we also have a mandated package of benefits so people know they will get coverage and not be rejected the way they are now. Obama does have some details in his plan that does make it superior.

[sentelle]

18. regulation is the stifling of competition

At least thats what the other side will say.... we may as well have 'socialised medicine'

I haven't seen that regulation helps, when those being regulated have a cozy relationship with those who regulate.
Like the drug companies, and electric companies for instance.

[sandnsea]

19. Insurance should insure

That's a basic expectation that I don't think anybody would disagree with. People accept those kinds of regulations. Removing the pre-existing criteria would also remove most rejections, as would creating a federal catastrophic pool. Just have to beat them, that's all.

Doing nothing because there is no perfection certainly isn't an answer.

[Czolgosz]

27. Obama's health insurance plan is the weakest part of his campaign.