Would a Health Care Mandate Mean Universal Coverage?

Cross-posted to Economists for Obama

Jonathan Gruber of MIT has a new NBER working paper on health insurance coverage, based largely on a simulation model. Krugman cites the paper as evidence that making coverage mandatory makes a big difference for the number actually covered.

However, if you read the whole paper (unfortunately only available to subscribers), you find that Gruber sidesteps the crucial question of how a mandate will be enforced and just assumes a mandate will work.

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Obama's GOP strategy

Obama's GOP strategy

After reading the DMR poll, I realized that Obama is campaigning for the Republican vote. His constant attacks on Democratic Party uses the exact same language the GOP. As if Democrats are to blame for a make believe Social Security crisis, our health care crisis, and weak labor laws. This is not triangulation. He is tapping out the GOP code words to the Republican base.

The first two states, Iowa and New Hampshire, allow cross over voting. The GOP race is moribund. If Obama can win Iowa and New Hampshire with the help of Republicans, then he can build momentum for the other Democratic states.

The GOP Code Words:

Attack Ted Kennedy. Obama called him "a little old" and to "get some spine."

Blame Bill Clinton for the 90's partisanship. Obama on Clinton: "It can't be the same kind of partisan battling we had in the '90s,"

Blame Hillary. Michelle Obama: "Our view is that if you can't run your own house, you certainly can't run the White House." A clear reference to Monica Lewinsky.

Blame Al Gore and John Kerry for Roves' nasty 2000 and 2004 elections. Obama said, "I don't want to go into the next election starting off with half the country already not wanting to vote for Democrats -- we've done that in 2004, 2000," Notice the similarity with his comment about the partisan 90's.

Attack Paul Krugman. Check out Obama's own website for his Oppo research on Krugman.

Joe Wilson. Mr Wilson thoughts on Obama: "In fact, Barack Obama's supposed "intuitive sense" is no different from George W. Bush's "instincts" and "gut feeling" describing his own foreign policy decision-making. We have been down this road before."

Attack FDR's Social Security. See Paul Krugman's excellent NYT's article: "Played for a Sucker."

Attack Universal Health Care. Krugman says: "Obama goes Harry and Luise." Obama's add, using the GOP code words against Hillary's health care plan, says: health care mandates "force those who cannot afford health care insurance to buy it, punishing those who don't fall in line."

Attack Unions. (especially the teachers union): As the president of the American Federation of Teachers said: "I'm taken aback that somebody like Obama would think that Oprah Winfrey has a greater right to participate in the political process than the 4 million people I represent," Oprah runs her house without union writers.

Attack Trial Lawyers. Obama attacking Edwards career choice: "That's why I didn't become a trial lawyer,"

Advertise on The Drudge Report. If you are a Republican, visit the friendly TheDrudgeReport.com to see Obama's ad specially prepared for you.

If you combine these actions and words with - his refusal to support a woman's right to choose with his "present votes" as a Illinois state senator, and his opposition to universal health care - you get a picture of a Republican. If you add his recent comment that Edwards is not fit to be the Democratic nominee because he has taken public funds, you see the cynical joke behind his claim to reform the lobbying culture. At what point do we take Obama's words and actions at face value?

Bill Clinton once remarked, that Bush's conservatism was plainly evident in the 2000 election. Bush said all the conservative code words. But he hid these under empty rhetoric of change and ending partisan politics.  

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Campaign Finance, Krugman, and the 527 Dispute

Our campaign finance system is a vile, oozing swamp of legalized corruption which needs to be drained and scrubbed clean. Nearly everything that is wrong about the U.S. government ultimately grows out of the manure from this swamp. The system persists because people in position to potentially push for reform are precisely those who have so mastered its dark arts that they can't imagine changing it (think Bill Clinton). Expecting a politician to spend 15+ years in DC and then attack the campaign finance beast is like hoping the Pope will renounce Catholicism. For longtime DC pols, raising gobs of corporate money is what they do.

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Paul Krugman: View through the lense of an admirer and critic

Paul Krugman is great economist that I admired. He earned my respect on how prescient he was in predicting how the Bush Administration would use the 9/11 attack to pursue his reckless economic policies. Here's an excerpt of an article he wrote three days after the 9/11 attack:
"After the attacks, I found myself wondering whether some politicians would try to exploit the horror to push their usual partisan agendas. Then I chided myself for such an uncharitable thought. But it seems you can't be too cynical; sure enough, the push is already on to sell tax breaks for corporations and a cut in the capital gains tax as a response to terrorism.
One hopes that the White House will distance itself from this disgraceful opportunism, that it will deliver the bipartisanship it originally promised. But initial indications are not good: the administration developed its request for emergency funding in consultation with Congressional Republicans -- full stop. A Democratic contact says that his party received ''no consultation, no collaboration, virtually no information.''
I didn't want to mention this, but now is the time to draw the line. This tragedy will only be magnified if it is exploited for political gain. Politicians who wrap themselves in the flag while relentlessly pursuing their usual partisan agenda are not true patriots, and history will not forgive them".

I read this article for my International relations class at UF on how politicians use crisis to implement their pre-existing ideologies. I was amazed how accurate he was on that point. However, I am very disappointed in how he is going after Obama. In many ways,his recent  attacks seem more payback than intellectual reasoning as noted by Matthew Yglesias in his blog at http://matthewyglesias.theatlantic.com/archives/2007/12/payback.php.
I still respected him but I think he needs to stick to what he does best, i.e., in being a clear, and prescient progressive voice in the New York times.

Here's his wonderful column after the the 9/11 attack:  http://query.nytimes.com/gst/fullpage.html?res=940DE7DC1138F937A2575AC0A9679C8B63 .
Please comment and recommend this column. We can agree to disagree but stay on topic.
                           Junior Amb.

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Senator Obama,

As a constituent a multiple contributer, I am aware of your history of fighting for AFFORDABLE health insurance for illinois working families.

I know that as a former democratic chair of Health and Human services committee in the Illinois Legislature you have successfully worked to provide health insurance for working families. This is an issue that you have deep passion for; I'm aware that as a young state senator, one of your most ambitious goals was to make it CONSTITUTIONAL for every illinoisan to have health insurance as good as what Senator Lobbyists FreeRide got(lol). It failed because of a republican governor and republican majority in the Springfield. So when Paul Krugman spews untruths like "i suspect he's not serious about universal healthcare" I wonder if he's done his homework.


You're making a big mistake!

This is a communication issue: Your approach to universal healthcare is distorted by a respected progressive economist, Mr. Krugman.

You have said that YOU ARE NOT OPPOSED TO MANDATES, but don't think MANDATES SHOULD come UPFRONT before there's assurance of lower cost, afterall, folks won't purchase until they know it's affordable.

You have also said that this is all about LEVERAGE: That if you can have proof that your insurance is CHEAPER than private options, THEN you are in a good position to enforce a mandate!

As Mr. Krugman's own reader said in a response to his highly critical review of mandates, the experience of California and Massachussets suggests carrots will be better than sticks at the beginning of a healthcare reform process.

Re "Mandates and Mudslinging" (column, Nov. 30):

Paul Krugman dismisses Senator Barack Obama's points about health insurance mandates as "echoing right-wing talking points" on health care. Really?

It was two pragmatic Republican governors, Mitt Romney of Massachusetts and Arnold Schwarzenegger of California, who proposed mandates as cornerstones of their respective health reform plans.

In California, resistance to that approach has come primarily from unions and Democrats. Although I have favored the mandate component of Mr. Schwarzenegger's plan, Mr. Obama raises valid points about the practicality of immediate mandates as the path to universality.

In California, there are real questions about whether the insurance that people would be required to buy and able to afford, even with subsidies, would be worth having. Massachusetts has already had to grant waivers to many.

In addressing this issue, carrots may prove more effective than heavy-handed sticks.

John Walkmeyer
San Ramon, Calif., Nov. 30, 2007

http://www.nytimes.com/2007/12/04/opinio n/lweb04krugman.html?_r=1&oref=slogi n
It seems Mr. Krugman hasn't seen you say this despite you giving extensive interviews with New Hamsphire Editorial Boards about this.

http://www.nhelects.com/NHPrimaryVideos. asp?MultiID=70&HTitle=VLTitle

So In the INterest of neutral voters who want to get a better health care system,

I suggest that you PEN an open ed in the New York Times about your specific approach and how that will be a superior and pragmatic approach.

I know that you have emphasised that the president must allow a transparent process and that will be key to engaging americans who want affordable healthcare desperately.

Thank you for your service to our beloved country.

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