Showing posts with label Candadian healthcare. Show all posts
Showing posts with label Candadian healthcare. Show all posts

Thursday, December 18, 2008

Where do you see yourself in two years?

update 4/29/09: Nudging towards Bethlehem

Barack Obama has a little to do list for the next two years (courtesy of Time):

When voters look at your Administration two years from now, in the off-year election, how will they know whether you're succeeding?

I think there are a couple of benchmarks we've set for ourselves during the course of this campaign. On [domestic] policy, have we helped this economy recover from what is the worst financial crisis since the Great Depression? Have we instituted financial regulations and rules of the road that assure this kind of crisis doesn't occur again? Have we created jobs that pay well and allow families to support themselves? Have we made significant progress on reducing the cost of health care and expanding coverage? Have we begun what will probably be a decade-long project to shift America to a new energy economy? Have we begun what may be an even longer project of revitalizing our public-school systems so we can compete in the 21st century? That's on the domestic front.

On foreign policy, have we closed down Guantánamo in a responsible way, put a clear end to torture and restored a balance between the demands of our security and our Constitution? Have we rebuilt alliances around the world effectively? Have I drawn down U.S. troops out of Iraq, and have we strengthened our approach in Afghanistan — not just militarily but also diplomatically and in terms of development? And have we been able to reinvigorate international institutions to deal with transnational threats, like climate change, that we can't solve on our own?

And outside of specific policy measures, two years from now, I want the American people to be able to say, "Government's not perfect; there are some things Obama does that get on my nerves. But you know what? I feel like the government's working for me. I feel like it's accountable. I feel like it's transparent. I feel that I am well informed about what government actions are being taken. I feel that this is a President and an Administration that admits when it makes mistakes and adapts itself to new information, that believes in making decisions based on facts and on science as opposed to what is politically expedient." Those are some of the intangibles that I hope people two years from now can claim.

I find this agenda both staggeringly ambitious and refreshingly modest. Modest, because many of the benchmarks bespeak new beginnings, tangible and positive changes of approach, rather than completely transformed institutions. "Have we made significant progress....Have we begun a decade-long project...have we begun an even longer project...have we strengthened our approach?" The broad goal, too, is in this vein: "I want the American people to be able to say...I feel like government's working for me." That's, again, both modest and transformative. It puts the country on the path to solve problems that (as Obama's been pointing out for two years) we've failed to deal with for decades -- healthcare, climate change, growing income inequality.It's a bid to roll back "government is not the solution, government is the problem," the battle-cry of The Great Risk Shift. The goals are huge, but the approach is incremental.
UPDATE, Feb. 16: Obama once again emphasizes making a beginning on a broad front of interlocking issues.

Saturday, October 04, 2008

Obama launches final assault on "the ownership society"

This blog has noted on multiple occasions that a key part of Obama's rhetorical project is to move this country's center to the left -- to portray redeployment of government resources to shore up the middle class as a matter of fairness, a restoration of balance, a renewed commitment to shared prosperity.

Now, aided by the cratering economy, he's opened an end-game assault to assert the corollary: that McCain's plans to further privatize healthcare, privatize social security, and pile up more tax cuts for the wealthy are "radical." The agenda of "the ownership society" is radical. It has denuded, by stages, the middle and working classes of core protections and resources.

Today Obama made this case in Newport News, Virginia with a detailed attack on McCain's health plan. Master of exposition, he explained how the plan would 1) give a tax break with one hand and a tax hike with the other; 2) make employee-provided healthcare more expensive by driving the young and healthy into the individual market; 3) drive businesses to drop their healthcare plans as they're stuck with older and sicker plan members and lose their tax deduction; and 4) gut strong state regulations by allowing insurers to sell plans across state lines, giving them an incentive to domicile in states with weak healthcare mandates. The result: a "radical" further erosion of existing health insurance:
So here's John McCain's radical plan in a nutshell: he taxes health care benefits for the first time in history; millions lose the health care they have; millions pay more for the health care they get; drug and insurance companies continue to profit; and middle class families watch the system they rely on begin to unravel before their eyes. Well, I don't think that's right. I don't think we should settle for health care that works better for drug and insurance companies than it does for hard working Americans. I don't think that's the change we need. We can do better than that.
Next, Obama tied this "radical" further privatization of healthcare (driving tens of millions from employer-based to individually purchased plans) to McCain's healthcare record and the overarching ideology of the "ownership society"to which McCain subscribes:
In the end, it's not surprising that Senator McCain's plan isn't a vast improvement on the same failed policies of these past eight years. Remember, Senator McCain voted against expanding the Children's Health Insurance Program - a program that provides health care for millions of children in need. He voted against protecting Medicare 40 times over the course of his career. And he supported a massive cut in Medicare that would have raised premiums and out-of-pocket expenses for seniors while weakening the care they depend on.

In other words, Senator McCain's plan reflects the same bankrupt philosophy he's subscribed to for the past three decades in Washington: take care of the healthy and wealthy, and good luck to everyone else. They call this the Ownership Society, but what it really means is - you're on your own. Your job doesn't give you health care? The market will fix it. Pre-existing condition? Tough luck. Insurance company won't pay for your treatment? Too bad, you're on your own.
He also made the quite legitimate (contra Factcheck.org) connection between McCain's approach to healthcare and his longstanding support for banking deregulation:
Finally, what John McCain doesn't tell you is that his plan calls for massive deregulation of the insurance industry that would leave families without the basic protections you rely on. You may have heard about how, in the current issue of a magazine, Senator McCain wrote that we need to open up health care to - and I quote - "more vigorous nationwide competition as we have done over the last decade in banking." That's right, he wants to deregulate the insurance industry just like he fought to deregulate the banking industry. And we've all seen how well that worked out.
He went on to describe in detail how the "race to the bottom" would work if health insurance companies were free to bypass tough state insurance mandates.

This is the ultimate red meat for Democrats. In the next month, Obama should be using all his verbal gifts to make the Republicans "own their failure," as he put it in his Convention speech. That means reclaiming the center. Bush is a radical. Cheney is a radical. McCain is a radical. The ownership society means "you're on your own." "I'm always for less regulation" means "anything goes" for businesses. Poll numbers in the 20s for Bush and an on the question "is the country moving in the right direction" show that Americans have bought the basic outlines of this critique since shortly after Katrina. It's time to reap that harvest.

Thursday, February 14, 2008

Why Daniel Henninger is Depressed

As one of the WSJ editorial page's chief ideological warriors, Daniel Henninger is easily depressed these days. Here's what he has to say about Obama's latest speech:
Listen closely to that Tuesday night Wisconsin speech. Unhinge yourself from the mesmerizing voice. What one hears is a message that is largely negative, illustrated with anecdotes of unremitting bleakness. Heavy with class warfare, it is a speech that could have been delivered by a Democrat in 1968, or even 1928. [snip]

Here's his America: "lies awake at night wondering how he's going to pay the bills . . . she works the night shift after a full day of college and still can't afford health care for a sister who's ill . . . the senior I met who lost his pension when the company he gave his life to went bankrupt . . . the teacher who works at Dunkin' Donuts after school just to make ends meet . . . I was not born into money or status . . . I've fought to bring jobs to the jobless in the shadow of a shuttered steel plant . . . to make sure people weren't denied their rights because of what they looked like or where they came from . . . Now we carry our message to farms and factories."

It ends: "We can cast off our doubts and fears and cynicism because our dream will not be deferred; our future will not be denied; and our time for change has come."

I am not saying all of this is false. But it is a depressing message to ride all the way to the White House.
Let's get this straight. To rally the country to deal with widening income inequality, a health system that leaves 45 million people uninsured and another 30 million underinsured, a massive transfer of risk of all kinds onto individuals,and the wage pressures imposed by globalization is to be 'depressing.' To tell the country 'yes we can" deal with these major social ills, to say that the American dream and the American ideal calls us to share opportunity, share risk, and yes, share wealth more equitably is to purvey "a vision of the United States that is quite grim and could wear thin in the general election."

In an odd way, this free market fundamentalist response to Obama makes me happy. It shows that economic conservatives have nothing left. Only an ideologically blinkered remnant still believes that that we have not failed miserably in recent years to deal with the festering social ills that both Obama and Clinton are calling us to deal with. The FoxNews.com readers commenting on the transcript of Obama's Martin Luther King Day speech did not find his message 'depressing' -- instead they poured out their admiration with comments like these:
"Beautiful! I’m a republican but I would vote for Senator Obama over Senator McCain!"

"Obama is the most inspiring candidate I’ve ever heard. He has caused me to switch from the Repulican to the Democratic Party and I will be volunteering in has campaign. Enough of the cynicism and doubt. Go Obama!"

"I’m a republican thats going to vote for Obama. Rather be for a party that is for the people and not just the wealthy corporate elite."
Obama has devoted his adult life to protecting the rights and increasing opportunity for the least advantaged. At the same time, as his much maligned comments about Reagan demonstrated, he has absorbed the lessons of liberal excess in the '60s and '70s --he's not calling for welfare as we used to know it or a protectionist regime. Here's that rounded awareness, from his speech at a GM plant in Janesville, WI on 2/13:
Now we know that we cannot put up walls around our economy. We know that we cannot reverse the tide of technology that’s allowed businesses to send jobs wherever there’s an internet connection. We know that government cannot solve all our problems, and we don’t expect it to.
He is pragmatic and inclusive enough to drive legislation that Republicans can buy into. It is because he is not bitter, because he calls on America to do better out of a deep confidence in the country's historical success in moving progressively closer to fulfilling the ideals expressed in the Declaration and the Constitution, that Americans of every political stripe are responding to him. Here is the flip side of the vision that Henninger finds so bitter, again from Janesville:
But that doesn’t mean we have to accept an America of lost opportunity and diminished dreams. Not when we still have the most productive, highly-educated, best-skilled workers in the world. Not when we still stand on the cutting edge of innovation, and science, and discovery. Not when we have the resources and the will of a decent, generous people who are ready to share in the burdens and benefits of a global economy. I am certain that we can keep America’s promise – for this generation and the next.

And, from the beginning of the same speech, the simple credo that engenders both the criticism and the promise:

But through hard times and good, great challenge and great change, the promise of Janesville has been the promise of America – that our prosperity can and must be the tide that lifts every boat; that we rise or fall as one nation; that our economy is strongest when our middle-class grows and opportunity is spread as widely as possible. And when it’s not – when opportunity is uneven or unequal – it is our responsibility to restore balance, and fairness, and keep that promise alive for the next generation. That is the responsibility we face right now, and that is the responsibility I intend to meet as President of the United States.
A few hours after reading Henninger, I happened on (via Ezra Klein) a magnificently clear-headed debunking of myths about Canadian healthcare on ourfuture.org written by a certain Sara Robinson who has lived under both systems -- at times simultaneously, as a Canadian citizen with an American employer. The most telling part of her analysis (in Part II) focused on the national security risks posed by a healthcare system in which legions of un- and underinsured put off going to the doctor when they are ill. Robinson contrasted the swift, thorough, efficient action of the Canadian healthcare system to contain the SARS outbreak with a likely scenario had the outbreak occured in the U.S.:
If the first people to get sick were among those 75 million without adequate insurance, they probably would have toughed it out a few extra days before finally dragging their half-dead carcasses into an ER somewhere. Not only would they be much farther along in the course of the disease -- and thus at greater risk of death themselves -- every one of them could have infected dozens or even hundreds of other people in the meantime, accelerating the spread of the epidemic.
Robinson argues that a country that aspires truly to be a commonwealth is more healthy in the broadest sense:
Part of what makes a country competitive is its own commitment to the common good. I've often been impressed by the very tangible sense of civic pride and shared effort my Canadian neighbors have in the fact that they're taking the best possible care of their own, regardless of status, age, or ethnicity. Every encounter with the medical system reminds them that they're all in this together. A medical system that routinely drives families into bankruptcy or divorce court is actively destroying, rather than adding to, the essential social capital that makes the whole society function.
To free market ideologues like Henniger, that 'social capital' is a chimera. But the American electorate is ready to invest.

Related Posts:
McCain and Lieberman's Bridge to Nowhere
Will-fully Misleading?
Niall Ferguson's Fog of War
Dissing the Electorate