Alex Blaze

Two One last items on the LGBT issues just before Super Tuesday

Filed By Alex Blaze | February 04, 2008 6:56 PM | comments

Filed in: Living, Politics, Transgender & Intersex
Tags: Barack Obama, Hillary Rodham Clinton, Paul Krugman, primaries, Super Tuesday

[ED NOTE:] I've updated Alex's post to link back to Senator Clinton's guest post here on the Bilerico Project. I hadn't had a chance to put up the guest post before Alex posted about it.

[ED NOTE from Alex: Meh, just go to the post right above this one to talk about Hillary. This post is now just about Krugman and health care.]

The other item is Krugman's column for the NY Times today on the candidates' health care plans. You might remember that he had a bit of a falling out with the Obama campaign over health care mandates - Hillary's plan includes an individual mandate, Obama's doesn't include any mandate, Krugman thinks mandates are necessary to substantive health care reform.

He adds today:

So the Obama plan would leave more people uninsured than the Clinton plan. How big is the difference?

To answer this question you need to make a detailed analysis of health care decisions. That’s what Jonathan Gruber of M.I.T., one of America’s leading health care economists, does in a new paper.

Mr. Gruber finds that a plan without mandates, broadly resembling the Obama plan, would cover 23 million of those currently uninsured, at a taxpayer cost of $102 billion per year. An otherwise identical plan with mandates would cover 45 million of the uninsured — essentially everyone — at a taxpayer cost of $124 billion. Over all, the Obama-type plan would cost $4,400 per newly insured person, the Clinton-type plan only $2,700.

That doesn’t look like a trivial difference to me. One plan achieves more or less universal coverage; the other, although it costs more than 80 percent as much, covers only about half of those currently uninsured.

People don't like the sound of mandates - they sound like the government is forcing people to do something against their will. And, well, they are. That's probably why they're one of the biggest sticking points on health care with conservatives - they're a sign of the big-governmentness of it all, a symbol for how social-justice initiatives curtail personal freedom.

That's probably why the Obama campaign has stayed away from them - tax credits schemes that eventually end up in the hands of private insurers aren't as hard to push for as a mandate, which can be seen as the first step towards single-payer. (No, no one has backed single payer.)

Krugman recaps why an Obama presidency would mean no substantive health care reform:

Now, some might argue that none of this matters, because the legislation presidents actually manage to get enacted often bears little resemblance to their campaign proposals. And there is, indeed, no guarantee that Mrs. Clinton would, if elected, be able to pass anything like her current health care plan.

But while it’s easy to see how the Clinton plan could end up being eviscerated, it’s hard to see how the hole in the Obama plan can be repaired. Why? Because Mr. Obama’s campaigning on the health care issue has sabotaged his own prospects.

You see, the Obama campaign has demonized the idea of mandates — most recently in a scare-tactics mailer sent to voters that bears a striking resemblance to the “Harry and Louise” ads run by the insurance lobby in 1993, ads that helped undermine our last chance at getting universal health care.

If Mr. Obama gets to the White House and tries to achieve universal coverage, he’ll find that it can’t be done without mandates — but if he tries to institute mandates, the enemies of reform will use his own words against him.

But, of course, none of this might matter at all.

(If I missed any of the other campaigns' last-minute LGBT messages, let me know in the comments and they'll go up.)

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My original comments have been transferred to the Hillary post.