His plan makes affordable healthcare to anyone who wants to buy it and mandates it for children.  If you're in favor of garnishing young middle class americans, already straining under the burden of the shrinking economy, in order to mandate coverage for every person, then, Hillary is your candidate.  If you come to realize that the only plan with a chance to make it through Congress is a plan that allows certain people to opt out if they are in financial difficulty, with a backend payment required if they need service, then Obama is your man.

Thank you!

Great diary. Thanks for posting. This is just one of the many reasons why I support Hillary to make the changes this country needs. She has the experience and leadership to get the job done.

Only Hillary's plan brings universal care that requires that all sign up or retain a plan, in order to make it economically viable.

My question to BOTH sides is why do we have to pay?  I hear over and over again that we ALL have to pay in order to make it "economically viable"  No one in Canada pays. No one in England pays. No one in Sweden pays. No one in France pays. Yet somehow all those health care plans seem to be "economically viable".

Why do we constantly settle for less than we need and less than we deserve?  The argument over whose plan is better, when BOTH plans are totally inadequate, is nothing more than the lesser of two evils.

I am sick of the bullshit we tolerate in this country.

Does Hillary really intend to make or break her entire campaign on the trivial difference between hers and Obama's medical care plan. Is that the only issue she has?

Pretty lean basis for wanting to get nominated, but then again, whatelse does she have? Obama has a better one: he is not a Clinton and everything that has meant for the Democratic party including Clintonism, Corporatism, triangulation with the Republicans, and so on.

It was for no small reason that Bill Clinton's core staff left him after the first term.

It is startling how very little you know about healthcare in general and Clinton's plan in particular. It saddens me greatly that the Obama campaign does not encourage it's supporters to actually know of what they are talking about.

Just so no one is confused by David Brooks' dramatic hagiography of Tennessee Blue Dog Democrat Jim Cooper who survived Hillary Clinton's "icy stare" during the health care showdown during the '90s:

1.)

Jim Cooper was Obama's chairman in Tennessee. Prior to Hillary Clinton's big win over Obama in Tennessee, Cooper said:

"I am not surprised about Obama's big win in South Carolina and I believe it will carry over into Tennessee. The big Test will be super Tuesday."

As everyone knows by now, Clinton won big in Tennessee, and--despite the massive onslaught against her by Maria Shriver, John Kerry, Ted and Caroline Kennedy--Clinton prevailed on Super Tuesday, taking California by a big margin.

Cooper got the cold shoulder from Hillary Clinton on the health-care debate in 1994 because Cooper was against mandates, and wanted Clinton to go with the right-wing's Big Insurance plan for "choice" --a talking point Obama uses on health care. Cooper was wrong not to support Hillary Clinton's health-care plan in 1994, and he was wrong about Tennessee and Super Tuesday.

2)

Jim Cooper LISTED AS A BUSH DOG DEMOCRAT AT OPEN LEFT:

http://www.openleft.com/showDiary.do?dia ryId=1073

Jim Cooper TN-05 has been involved in Tennessee politics for a very long time. First elected in 1983 to TN-04 he served in this seat until he ran unsuccessfully for the Senate against Fred Thompson in 1994. In 2002 Cooper won the newly redistricted TN-05 (formerly TN-04, the result of an additional seat in Tennessee) and has served that district since. Cooper has staked out positions contrary to traditional Democratic values such as abortion, gay marriage, and the PATRIOT act.

Cooper is a member of the Blue Dogs. He votes with the Democratic Party 86% of the time. This is lower than any other Democratic member of the Tennessee delegation, even though he votes with the Party on key votes more than his conservative counterparts in TN-04, 06, and 08. In the 109th and 110th Congresses he has voted against the party on 5 key votes. His Progressive Punch Index is 71.93. Davis is a member of the Armed Services, Budget and Oversight and Government Reform committees. The majority of his fundraising comes from individuals (60%), but 77% of his PAC money comes from business.

3)

In 2007, As a member of the Blue Dog Democrats, Tennessee Rep. Jim Cooper Voted Against Health Care for Poor Kids paid for by higher taxes on Big Tobacco:

The Blue Dogs attempted to block a Democratic initiative in the U.S. House to provide health insurance to 5 million children of the working poor in this country by raising cigarette taxes. The bill did pass the House. Crone has the list of Disagreeable Dogs, which includes Middle Tennessee's own Jim Cooper.

I am bound to ask, "Is no supporter of Mr. Cooper here in Middle Tennessee going to step up to ask our elected representative to be a better advocate for children of the working poor?"

http://enclave-nashville.blogspot.com/20 07/08/tennessee-democrat-jim-cooper-vote d.html

BOTH Hillary and Obama have universal health plans, that is there plans have a goal of universal coverage.  But neither of them will get 100% coverage.  No plan does.  Not even the single payer plans in Europe.

Hillary has a mandate. Barack does not.  Hillary's mandate has no enforcement rendering it more symbolic than meaningful.  She refuses to say, when asked, how she would enforce it.  And no policy is perfectly enforceable.  

Both plans will cover 95-98% of Americans with ot without a mandate.  The question is

Do you start with a mandate and subject all Americans to reporting requirements from the IRS and a bureaucracy to collect penalites?  Do you coerce Americans into buying coverage?  The Massachusetts experience suggests that a mandate before there is affordable coverage will leave even more without coverage.  A mandate will also require a minimum benefit plan that is affordable. In MA it is a $2,000 deductible health plan.  In CA, the minimum benefit proposed was a $5,000 deductible health plan.  This is hardly "good" or "comprehensive insurance.

Or do you cover 95-98% and try to find out who remains uncovered?  Obama will cover more than Clinton with his policy to allow adult children up to age 25 to stay on their parents health insurance.  If there are "free riders" -- people who could afford to buy coverage but don't, we can sign them up when they come in for care.  Enrollment at the point of service is much easier than having the IRS try to track down people and get them to pay for something they don't have.

The fact is that most Americans want affordable health insurance.  Obama's first priority is making it affordable and finding ways to get everyone covered that does not involve punitive policies like coercion and force.

The experience of the Netherlands is instructive.  They have a single payer plan with automatic enrollment and no premium.  They cover 98%.  They decided to adopt a mandate to try to get the last two percent.  It didn't work.  They are still at 98%.

Universal coverage measured in terms of 100% of all people in a population getting enrolled is a myth.  And without a single payer system getting to 98% may be hard.

And while a mandate may force a few more people to sign up, it will  NOT get us to 100%.

The truth is that neither plan will deny coverage to any American.  Both plans will make coverage more affordable.  Every single American can enroll in the plans both have proposed.  No one is excluded or left out. They are BOTH universal.

Does the Obama campaign take out the critical thinking chip in supporter's brains when they sign up?

I've never read such moronic arguments from people, who clearly can't get their brains in gear!

Health Care experts have looked at both plans and Obama's leaves out 15 million people. Hillary Clinton's doesn't. Hillary Clinton's plan costs half as much as Obama's proposal.

And, Obama mandates that parents pay to enroll their children in his health care proposal, so what's his problem with mandating young adults to opt in as well?

The economy of scale when everyone pays in, is what keeps Clinton's costs lower than Obama's costs.

It's truly staggering to see people willing to TAKE whatever the right-wing says about this. It's cheaper when everyone opts in to the plan, there is no problem with mandates when people pay into SOCIAL SECURITY or MEDICARE is there?

Are we putting elderly people into jail these days for refusing to pay into Social Security or Medicare? And, the premiums for Medicare go up every year.

No, these Obama arguments are pitiful. Truly pathetic. We get what we are willing to FIGHT FOR. As for me, I'm willing to support the candidate who is willing to FIGHT FOR UNIVERSAL HEALTH CARE FOR THIS COUNTRY.

No other candidate need apply.

Jonathan Cohn, who's written a highly recommended book about health care in this country investigated the 15 million figure and found it to be basically a good number, according to economists who studied the plans:

Gruber is a highly regarded economist who specializes in precisely these kinds of issues. Although he served in the Clinton Administration and is generally identified with Democrats, politicians of both parties have sought his advice. Back when Governor Mitt Romney was setting up his universal health care plan for Massachusetts, he brought Gruber into the process. Today, Gruber continues to serve on the board of the Connector, which is overseeing the Massachusetts plan.  

The reason so many people ask Gruber's advice is that he has developed a model, based on past data, for projecting how various policy changes will affect the number of people who obtain health insurance. It is similar to the model used by both the Congressional Budget Office and the Treasury Department. (You can read more about him in this Washington Post story.) Since all three of the leading Democratic contenders, including Obama, were known to be have sought his input this campaign cycle, I figured that made him a particularly reliable source of guidance.

Gruber told me that his projections showed that, without an individual mandate, a program of very generous subsidies and market reforms would bring in close to half the uninsured population. Adding a child mandate, he said, could bump it to two-thirds. Since Census figures showed around 45 million uninsured, I asked if that meant roughly 15 million would still lack insurance. He said that sounded about right. I put that figure in my story (although, in my quick translation of our conversation, I explained the step-by-step math incorrectly--saying that the starting baseline for coverage without a mandate was one-third, not one-half). I didn't attribute this to Gruber directly, though I'd cited his work elsewhere in the article, since that part of our discussion had been on background. He's since made these views public.

*

It was a crude, back-of-the-envelope calculation based on a projection. And all projections contain some uncertainty because they make assumptions, some of which might turn out to be wrong. In other words, the figure should not be treated as gospel.

On the other hand, figures like these also represent the best available information we have for evaluating policy proposals.  And a projection like Gruber's is no less reliable, certainly, than a lot of the other numbers campaigns routinely throw around. Take, for example, Obama's promise that his plan will require only $50 to $65 billion a year in new revenue once fully phased in--because he anticipates generating huge savings from better management of disease and use of information technology. It's a number the campaign has provided. It's reasonable to put at least some stock in it because they likely reflect the influence of David Cutler, a Harvard economist who studies health care extensively and is also widely respected for his intellect and honesty. But if you're going to take that figure seriously, then, it seems to me, you certainly have to take Gruber's figures seriously, too.

And, more important, Gruber's views are hardly out of the mainstream. Over the last few days, I've had the chance to do something I couldn't with that first-day story: consult several other leading authorities. One of them is Len Nichols, an economist who worked on the 1993-94 Clinton health care effort and today heads up the health policy project at the New America Foundation. "Every reasonable model out there ... will show you that the kind of subsidies that we could do, 50 percent or so, are going to get you half," he said. "The way you go from half to 15 [million] is the kid mandate."

These days, Nichols is probably the most visible promoter of individual mandate schemes in Washington. And, for those who want to see hidden agendas at work, Gruber's advocacy of individual mandates is also well-known. Then again, in both cases, they've reached that conclusion based on their respective research histories. If they have a bias, it's in favor of a policy as opposed to a candidate--a policy that they happen to believe is right.  

Still, for the purists out there is always somebody like John Holohan, who directs the Urban Institute's Health Research Center and, as best as I can tell, has no direct connection to the presidential campaign. Holohan commands universal respect, too, having worked on these sorts of problems for two decades. And he's pretty much where Gruber and Nichols are on this question. Without a mandate, he told me, "Obama would still leave about 22 million, 23 million, but he has a mandate for children, about 9 million uninsured kids, so assuming you get most of them, you get pretty close to 15 million."

Just to be sure this sentiment wasn't purely a project of Washington group-think, I contacted Altarum, a non-profit health care research institute based in Ann Arbor, Michigan. They hadn't modeled a plan like this specifically and warned that, without more details, they couldn't be precise. But with those caveats out of the way, analyst George Miller and economist Charles Roehrig sent me an e-mail explaining that "We've done some very crude hand calculations that suggest that the estimate of 15 million uninsured under an Obama-like plan (no individual mandate, coverage of all children, incentives) is in the right ball park."

http://www.time-blog.com/swampland/2007/ 12/the_15million_question.html

Experts: Without Mandate, No Universal Health Care
11/26/2007 3:01:43 PM

Sen. Obama does not think that having an individual mandate is an essential part of any plan for universal health care. The experts disagree:

Kaiser Family Foundation's Diane Rowland: 'An individual mandate is the only alternative to government provision of coverage if you hope to achieve universal healthcare.' "Diane Rowland, executive vice president of the Henry J. Kaiser Family Foundation, which studies health policy, said it had become broadly accepted `that an individual mandate is the only alternative to government provision of coverage if you hope to achieve universal coverage.'" [New York Times, 11/25/07]

*

Urban Institute's John Holahan: 'Implementing universal coverage requires an individual mandate.' John Holahan, Principal Researcher at the Urban Institute wrote, "Implementing universal coverage requires an individual mandate, which may or may not be combined with an employer mandate. Implementing them would make insurance accessible and affordable, and reduce the number of uninsured by about one-third. Covering the remaining two-thirds is only achievable if health insurance is made mandatory in the state." [Urban Institute, Report for the Blue Cross Blue Shield of Massachusetts Foundation, October 2005]

*

MIT's Jonathan Gruber: 'Without a mandate you never get those people covered.' "The mandate is crucial. `Many of the uninsured are voluntarily uninsured in the sense that they could get insurance today . . . but chose not to because they don't need it,' Gruber said. `Without a mandate you never get those people covered.'" [Investor's Business Daily, 7/31/07]

*

New American Foundations' Len Nichols: `Programs that do not require participation will never approach universality.' Len Nichols, director of the New American Foundation, testified before the Senate budget committee, "There are only three analytically credible ways to cover all Americans: (1) tax-financed single payer/Medicare for all; (2) employer plus individual mandates to purchase private health insurance; (3) individual mandates alone. Programs that do not require participation will never approach universality." [US Fed News, 6/26/07]

*

United Hospital Fund: 'An individual mandate is required to achieve universal coverage.' According to the Journal News, the United Hospital Fund in conjunction with the Commonwealth Fund "released a report in December that outlined a long-term `blueprint' for universal health-insurance coverage in New York." The report specified, "Ultimately, an individual mandate is required to achieve universal coverage." [The Westchester County Journal News, 8/15/07; United Hospital Fund Blueprint for Universal Health Insurance, December 2006]

*

California Medical Association: `There will be no significant improvement in health care coverage without some type of mandate.' In a report from the California Medical Association, "These two realities - the inherent limits in participation associated with voluntary approaches, plus the inability to address marketplace discrimination - has led CMA to conclude that there will be no significant improvement in healthcare coverage without some type of mandate....an individual mandate would be the most viable approach to expanding health care coverage." [California Medical Association, Individual Healthcare Mandate, July 2005]

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Brookings Institution's Henry J. Aaron Bruce & Virginia MacLaury: 'An individual mandate, as in Massachusetts, would be necessary to assure full coverage.'

According to a statement produced by Henry J. Aaron Bruce and Virginia MacLaury, Senior Fellows at the Brookings Institution, "Furthermore, unless subsidies to low-income households shield them from nearly all out-of-pocket risk, many will not willingly buy insurance (if they must pay much of premium cost) or use ostensibly covered services (if they are exposed to significant deductibles). An individual mandate, as in Massachusetts, would be necessary to assure full coverage." [CQ Congressional Testimony, 9/11/07]

*

Kaiser Family Foundation's President Drew Altman: 'We can only have a big national debate about health care reform if there's a mandate that Congress can't duck.' Drew Altman, President of the Kaiser Family Foundation, said, "This is important because we will only have a big national debate about health care reform [if] there's a mandate that Congress can't duck." [The National Journal, 9/8/07]

*

The Washington Post: 'Obama plan could leave a third of those currently uninsured lacking coverage.' "Mr. [Obama]'s plan is less bold than the [John Edwards] model. Mr. Obama would require parents to obtain coverage for their children, as Mr. Edwards proposed in 2004; Mr. Edwards would mandate coverage for both children and adults. Edwards's approach is preferable to Obama's because it is less susceptible to being undermined by the cost-shifting created when the uninsured end up being treated at emergency rooms.

Mr. Obama argues that the problem of the uninsured is mostly a matter of affordability, in which case solving the price problem would do the trick. If not, he says, a mandate could come later, when costs have been driven down enough to make it fair. Still, the Obama plan could leave a third of those currently uninsured lacking coverage. [Editorial, The Washington Post, 6/9/07]

http://facts.hillaryhub.com/archive/?id= 4369