Let me start by saying that I believe that deep down both Barack Obama and Hillary Clinton want single payer healthcare. Believing single payer to be unachievable at this moment, they've both offered alternatives, Hillary going the mandate route, which requires everyone to buy in to a healthcare plan in order not only to make sure everyone is insured but also in order to lower costs for all; Barack Obama has decided to mandate healthcare for children but not adults, instead relying on people's sense of personal responsibility to buy in once costs are low enough.
This is how Obama used to describe the difference he had on the issue with Hillary Clinton and John Edwards (whose plan was also a mandate plan) in his stump speech (paraphrase):
My opponents think the government should force you to buy healthcare. I believe that the reason people don't have healthcare isn't that they don't want it, it's that they can't afford it.
The line would often get a big cheer but I haven't heard it lately. In the wake of John Edwards's departure from the race, Hillary has been hitting Barack harder on the fact that her plan offers universal healthcare while his, by definition, does not. So Obama has changed his rhetoric on the stump, now throwing the term "universal" around with abandon when describing his healthcare plan, as he did both the other night at the Virginia Democratic Party Jefferson Jackson dinner and at today's University of Maryland rally. What's worse, he used fear mongering to attack Hillary's plan, saying flat out "she's going to go after your wages," referring to the tricky enforcement of a mandate healthcare system.
This is extremely problematic, for one thing, because Democrats using right-wing scare tactics on healthcare against other Democrats will, as Paul Krugman has pointed out, set back the universal healthcare cause. I mean, look at this Q and A from the FAQ on his plan from his website:
Q: I don't want the government telling me what doctors to see or what treatments to get. Will the Obama plan force these kinds of decisions on me?A: Senator Obama agrees with you. His plan will not tell you which doctors to see or what treatments to get. Under the Obama plan...no government bureaucrat will second-guess decisions about your care."
"Government bureaucrat" as villain? Are you kidding me, who wrote this, Karl Rove?
But there's another problem that Obama's supporters will have a problem coming to terms with, which is that it's simply intellectually dishonest.
Obama doesn't inherently have a problem with mandates. What he conveniently leaves out from his criticism of Clinton's plan is that he thinks mandates are perfectly fine for children.
From his website:
Mandatory Coverage of Children: Obama will require that all children have health care coverage. Obama will expand the number of options for young adults to get coverage, including allowing young people up to age 25 to continue coverage through their parents' plans.
Whose wages will he be going after to enforce that, I wonder?
But just on a basic logic level, if you don't either cover everyone through a government system or require buy-in through a mandate system, how in the world can you call your plan "universal?" Well, if you're being honest, you can't and Obama knows it, which is why there's no mention of the term "universal" anywhere on his website. Really, look for it.
He talks about "health care for all" and "available to all" because in his perfect world costs will be low enough and the uninsured will be compelled to buy in, but honestly, there's a whole population of young healthy and not necessarily poor people out there who don't have healthcare by choice; they're not dis-incentivized by the cost necessarily, it's that they're healthy and don't need healthcare...until they do. I applaud Obama's efforts to make healthcare more affordable to those who can't afford it, but without mandating that people buy healthcare insurance, you can't guarantee they'll take advantage of the lower costs and you certainly can't credibly call your plan universal.
Unless Senator Obama actually proposes a universal healthcare plan, I'd ask him to stop referring to it as such in his speeches (and in this new radio ad.)
As Paul Krugman puts it:
But as I’ve tried to explain in previous columns, there really is a big difference between the candidates’ approaches. And new research, just released, confirms what I’ve been saying: the difference between the plans could well be the difference between achieving universal health coverage — a key progressive goal — and falling far short.
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