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Archive for February, 2008

The following is a section from Paul Krugman’s The Conscience of a Liberal. The book is full of excellent insights and provides a brief history of the twentieth century political economy. One of the major claims of the book is that universal health care–one with a mandate for coverage–is the essential step in reducing social/economic inequality.

I like this section–actually the final one in the book–as it expresses the need for a strong candidate who can argue for her (ahem!) policy proposals and fight off the conservative attacks. We don’t need a message of uniting the country–as if Dems and GOPs could agree on the need for universal health care–but we do need our own strong partisan.

On Being Partisan

The progressive agenda is clear and achievable, but it will face fierce opposition. The central fact of modern American political life is the control of the Republican Party by movement conservatives, whose vision of what America should be is completely antithetical to that of the progressive movement. Because of that control, the notion, beloved of political pundits, that we can make progress through bipartisan consensus is simply foolish. On health care reform, which is the first domestic priority for progressives, there’s no way to achieve a bipartisan compromise between Republicans who want to strangle Medicare and Democrats who want guaranteed coverage for all. When a health care reform plan is actually presented to Congress, the leaders of movement conservatism will do what they did in 1993–urge Republicans to oppose the plan in any form, lest successful health reform undermine the movement conservative agenda. And most Republicans will probably go along.

 To be progressive, then, means being a partisan–at least for now. The only way a progressive agenda can be enacted is if Democrats have both the presidency and a large enough majority in Congress to overcome Republican opposition. And achieving that kind of political preponderance will require leadership that makes opponents of the progressive agenda pay a political price for their obstructionism–leadership that, like FDR, welcomes the hatred of the interest groups trying to prevent us from making our society better.

If the new progressive movement succeeds, the need for partisanship will eventually diminish. In the 1950s you could support Social Security and unions and yet still vote for Eisenhower in good conscience, because the Republican Party had eventually (and temporarily) accepted the New Deal’s achievements. In the long run we can hope for a return to that kind of politics: two reasonable parties that accept all that is best in our country but compete over their ability to deliver a decent life to all Americans, and keep each other honest.

For now, being an active liberal means being a progressive, and being a progressive means being partisan. But the end goal isn’t one-party rule. It’s the reestablishment of a truly vital, competitive democracy. Because in the end, democracy is what being a liberal is all about. 

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Debate Watch Party

Join Ohio for Hillary tonight at Sully’s downtown to watch the debate!

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A Good Question

The long advocacy for universal health-care coverage by Democrats has earned a base of public support, but it has also provided an easy focus for political attacks. Although universal coverage will protect businesses and families from unmanageable costs, it will also increase government spending considerably and increase government involvement in health care.The strategy you have adopted as candidates is the same one that Democrats have used for decades without success (including in 1993, when I was a health policy adviser in the first Clinton administration). You have both designed plans that aim to minimize government costs and to minimize changes for Americans with good health coverage, while still constructing a safety net of coverage for the growing millions without insurance.This approach, however, inevitably increases the complexity of our Rube Goldberg health system. It has made your policies difficult to explain. It has failed to prevent charges that you are promoting “socialized medicine.” And it has cost you the enthusiasm of Americans who want a simpler, tax-based, Medicare-for-all system.

How do you persuade supporters of single-payer health care that your proposals are worth fighting for? And how can you assure the rest of us that the costs and complexities of your plans are actually manageable?

— ATUL GAWANDE, a general surgeon, a staff writer for The New Yorker and the author of “Better: A Surgeon’s Notes on Performance.”

Tonight marks possibly the final debate between the Democratic candidates. As I’ve said all along, health care is the issue I’m voting. That said, I wouldn’t support a candidate only on health care; s/he has to be the whole package. Hillary Clinton has said that a single-payer system would be best, but she doesn’t think it’s politically possible. I don’t know if that’s true, but I do know that her alternative proposal is more ambitious and far-reaching than her opponent’s. But the truth is that we don’t know what either candidates’ plans will look like; we can only go on what policy experts predict.

Ralph Nader’s announcement Sunday morning throws a wrench in the whole election. Nader represents my political views far better than the Dems (I’m not really a Democrat–they’re often the lesser of two evils), and he supports single-payer (Medicare for all) health insurance. I imagine that some of the fervor over the Dems–especially the candidate of empty signification–will ebb over the course of the election, and support will weaken significantly when the Republican attack dogs come out (particularly among youth, who may be tireless, but certainly can’t focus very long on one thing, especially if that one thing becomes difficult and substantive).

So what will those of us who want more than empty promises of change, more than a rock-star-like icon, more than the probable front-runner could deliver do? We won’t have to make that decision until after next Tuesday–there’s still a chance to do the right thing–but if the tide of media hype pushes the celebrity into the position of nomination, there is a choice.

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So glad SNL is back, so glad their guest host helped dedicate the show to bitches, so glad to hear some sense about Hillary!

Tina Fey is my hero.

Update: The video has been removed from YouTube, but you can see the whole “Women’s News” clip here.

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Today’s Times article, “2 Plans and Many Questions,” takes a serious look at the health care policies put forth by the Dems. From the details currently available, the major difference is on the issue of mandates: whether every American should be required, by law, to carry an insurance policy. If you read my posts, or know anything about me, I’m all for mandates. Without them, I don’t think the necessary policy provisions will be in place for everyone to truly be able to obtain coverage.

Even Obama’s own people deny his claim that his plan would cover everyone:

Mr. Obama, meanwhile, maintains in a television advertisement that his plan will “cover everyone.” That claim is disputed by some of his own advisers, including Mr. Brown, who recently calculated that the Obama plan might leave behind two million free riders.

“That’s the number we would expect to continue to be uninsured unless they’re forced to buy coverage,” Mr. Brown said.

While two million is certainly different from the Clinton camp’s claim that the number of uninsured could reach fifteen million, there’s clearly an established problem with such a plan.

The notion of “free riders” is one of the most interesting elements of the article. Free riders are people who choose not to buy health care coverage, even though they technically could afford to do so. Here’s an example:

Ms. Coons, a 23-year-old waitress who rents a room and rarely eats out, said she could probably afford a high-deductible policy if she gave up her gym membership and spent less on her amateur photography. But she chooses instead to gamble against the odds of confronting a bankrupting catastrophe.

“I’m young and in pretty good shape,” Ms. Coons said one recent afternoon, on her way to the treadmill at the Fitness Factory in Midtown Atlanta. “I looked at Blue Cross Blue Shield. But the only thing I could see myself really needing it for are prescriptions and dental because there are so many free clinics, or a hospital visit really isn’t all that expensive.”

She continued, “The insurance premium was more than what I would pay for my prescriptions, so I just decided not to deal with it.”

Ms. Coons, in this case, talks about free clinics and emergency room visits–health care options that are being subsidized so that the truly poor–the people who can’t afford, or have been rejected for an insurance policy for any number of reasons–can receive care.

Many free riders, including Ms. Coons in Atlanta, never consider that the care they receive in community clinics and emergency rooms is subsidized by taxpayers and private policyholders. “I still pay for everything,” Ms. Coons said, “and I certainly pay taxes.”

Obama denies that people like Ms. Coons exist.

I pay more for car insurance than I do on car repairs, or damage to any person or any property that I’ve ever done (I’ve never even had a ticket), but is that any legitimate excuse for canceling my policy?

Tomorrow I’m going to blog about the fetish of children and health care. Obama wants a mandate for parents to buy insurance for their kids, but there are currently numerous options for children to receive coverage. They’re not the biggest–or most expensive–group of uninsured.

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Hillary in Cincinnati

Tomorrow–Saturday, February 23–Hillary Clinton will host a Town Hall meeting at Cincinnati State Community College. Doors open at 8:00 a.m., and the program begins at 9:00 a.m. The event is free and open to the public.

In other Hillary news, she rocked the debate last night. Even though I’m a supporter of her, I went in with an open mind–after all, we need a Democrat to win in November. I was surprised at how disappointing Obama was. He seemed to merely echo everything she said, and to ham it up when he didn’t want to honestly answer a question. Plaigiarism isn’t funny; it’s not the end of the world, if you acknowledge the mistake and move on. How am I supposed to convince my composition students that plaigiarism is ethically wrong when the possible Democratic candidate for president says that he’s been giving speeches for two years, so what’s a couple of lifted lines in a couple of speeches? Shameful. And the whole business of health care? Parents need a mandate to buy health care for their children or else the system won’t work, but adults don’t need a mandate to purchase it for themselves? She really trounced him there, and I was thrilled that neither candidate would let the moderators move on from the topic of the election. The moment was a clear example of the media resisting real politics, and the candidates–for just a moment–not allowing the media to control the discourse.

But I had a clear favorite moment in the debate. Hillary promised to end discrimination of the ill. Thank you for calling it what it is. Insurance companies are legally permitted to discriminate against anyone who has a pre-existing health condition. And that means ill people can be refused health care. If you read my blog you’ll know that this is an issue I am personally invested in and affected by. I was very lucky in 2004 to be on a company health care policy; I was under 25 and still a full-time student. The number one requirement to be eligible for a lung transplant was health insurance. If my quick decline in health had happened a year later, there’s a real chance I wouldn’t have been eligible for the surgery, and that means I wouldn’t be here today.

Another moment in which Hillary proved herself to be the stronger debater–and the better candidate–was her closing statement. After Obama bumbled on about himself, displaying an arrogance that veers on disgusting at times, she brought the message right back to us:

Vote with your head on March 4th.

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Debate tonight

Watch the debate tonight at 8:00 on cnn.com (for those of us who don’t have cable TV)!

If you feel like braving the snow and cold, members of Ohio for Hillary are meeting at J. Alexander’s on Edmondson Road at 7:00, and members of SW Ohio for Hillary are meeting at Crowley’s Irish Pub in Mt. Adams at 7:30 to watch the debate.

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