From the funny world of politics, where attempts to please everybody end up pleasing nobody, we can safely assume that the very mention of something approaching universal health care will win you no friends in conservative circles. And when such a plan neither mandates universal coverage nor offers an approach to that goal, you've alienated a lot of the rest of us.
The inspirational Barack Obama has unveiled his long anticipated health care proposal, and managed to incite waves of ridicule and yawns.
One thing for certain, whatever Obama's plan is, it is not universal coverage. I, along with Oliver Willis, remain unimpressed.
Naturally, for an explanation of all things that fail to be what I want in medical care, we turn to Ezra Klein at Tapped, who has that knack for turning taking points into english. (For his nuts and bolts pimer, look here, but the real analysis is the Tapped Article):
Number one, he didn't make sure everybody is in. There is perhaps no more surprising fact about Obama's plan than that it is not universal. It is certainly sold as if it is. In his speech unveiling the proposal, Obama bragged that, "[m]y plan begins by covering every American." But it doesn't. To say otherwise is rhetorical overreach, the appropriation of a popular and broadly-supported goal without an attendant mechanism for achieving it.
There are a few ways to achieve universal health care. You can create a single-payer plan that enrolls the population automatically. This is what Canada does, and how Medicare covers the elderly. You can create an employer mandate, where the primary responsibility falls on workplaces, and smaller mandates mop up the remainder. That was the approach showcased in the Clinton reforms of the early '90s. You can create an individual mandate that charges every American with procuring health insurance, and penalizes them if they don't. This is the approach favored by Mitt Romney in Massachusetts, Arnold Schwarzenegger in California, Ron Wyden in the Senate, and John Edwards in the presidential campaign. Obama's plan offers none of these approaches.
Instead, it seeks to make care cheaper and more accessible, assuming that, if it succeeds -- and that's a big if -- Americans will enroll of their own volition. It is a plan with the potential to be universal, rather than a universal plan. In that respect, it is very much like Obama himself
Kevin Drum tries to be kinder, but as nice as Kevin is, it's hard not to state the obvious:
Still, sometimes audacity requires audacity. Hope isn't always enough.I don't think you'll see too many of Obama's supporters counting on his approach to health care win the election for them. Last I looked, 73% of Americans wanted all kids under 18 to be covered by a single-payor Federal Health Insurance Program. 63% wanted that coverage to extend to everyone. Presumably, those numbers go even higher is it is not strictly a Federally provided scheme (opposed to by the anti-socialist medicine neanderthals) but is more of a mixture leading to single-payor -- like the one offered by John Edwards.
Ezra quotes himself at his own blog, exposing the entire problem with Obama's "new kind of politics":
His is a plan of almosts. It is almost universal, without quite having the mechanisms to ensure nationwide coverage. It almost offers a public insurance option capable of serving as the seed of single-payer, but it is unclear who can enroll in it, and talks with his advisors suggest little enthusiasm or expectation that it will serve as a shining alternative to private insurance. It almost takes on the insurance industry, but asks for, rather than compels, their participation.Obama has proved he is not the agent of "transformational change" with this plan, at least not yet, anyway.
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