Sunday, February 10, 2008

Political suicide

Mike the Mad Biologist asserts that Clinton's insurance mandates are "political suicide". (And he's correct, Clinton does not have the will or the political capital to stand up against the big insurers. No one does.) It is perhaps political suicide to propose any substantive, systemic changes to our health-care economics.

Since the current system — bad as it is — is actually in place, any actual change will inconvenience someone, and those inconvenienced will, naturally (and justly), complain. Someone's ox will be gored.

The nice thing, from a political perspective, about Obama's "plan" is that it's so obviously implausible that if he were elected, he'll suffer less political damage when no substantive changes are actually effected. (In just the same way, Clinton is in the Iraq war up to her eyeballs. She'll suffer less political damage when, if she were elected, she fails to end the war.)

Clinton's plan is the only workable plan that's on the table. If we do want to make substantive changes to health-care economics, the only alternative to mandated insurance (which is effectively a tax by virtue of it being mandated) is supporting the health care system through conventional taxes, which would also political suicide. And the same political and macroeconomic arguments would be marshaled against conventional taxation. For instance, a $200/employee/month tax on businesses would have almost exactly the same macroeconomic effects as requiring all working people to purchase $200/month of insurance. (The only difference would be that my employer would have more direct decision-making power over specific health-care choices.)

I'm generally against over-thinking in politics. If progressives oppose Clinton because her plan is seen to be "political suicide", it is we who are committing suicide. We are voting against our own material interests, and if we vote against ourselves, who will vote for us?

There are some battles it's better to fight and lose than refuse to fight. Clinton, Obama and the Democratic party would definitely be in a better position today if they had fought against the Iraq war, even knowing they would lose. Health care is one of those battles. Even if we lose, even if we know we're going to lose, we have to fight it.


  1. A friend and supporter of Clinton says that Clinton is trying to "Canadianize" the healthcare system in America. With that being said, isn't that a good thing? The healthcare system in America, currently, seems so bad that only the rich can live without fear of injury over there.

  2. Mr. Mad Biologist is wrong. Mandates are the only way to get insurers on board: mandates require everyone to buy insurance. With millions more people buying insurance, the lost revenue from caps and being forced to drop "pre-existing conditions" restrictions will disappear.

  3. James,

    I actually want a Medicare-for-all healthcare system. But forcing people to fork over money to buy overpriced insurance from corporations they despise will never fly (I think health insurers poll lower than many veneral diseases).

    That's why I think mandates are awful. I think it would actually be easier to raise FICA taxes, but most Democrats will be afraid to do so because of the 'raising taxes' shibboleth.

  4. I actually want a Medicare-for-all healthcare system.

    So do I. But that kind of a plan is not on the table. We have to do the best we can with what we have. Clinton has something. Obama ain't got shit. McCain will kick the sick to the curb.

  5. Hillary's plan actually is nothing like the Canadian health care system, which is a single payer system. Her plan is most similar to that of Switzerland and the Netherlands, which mandate participation in health insurance pools whether private or public (if you are unemployed, you're covered by a public pool, otherwise you must participate in private pools).

    Hillary actually has a Medicare-like plan (call it FamilyCare) that is a public pool option under her plan (which is the Edwards plan with the serial numbers filed off). So you don't *have* to pay into the coffers of the insurance industry if you don't wish to do so under her plan.

    ObamaCare simply cannot work the way it is currently designed, for the microeconomic reasons I discussed on my own blog (specifically, the insurance company death spiral that occurs with a lack of mandates on consumers at the same time that you impose mandates upon insurers -- sick people simply do not possess the 15% of the nation's GDP necessary to provide our current level of health care). Obama designed it as eye candy for political gain, not as a serious plan. Sadly, Obama *knows* it will not work (he had the same health care economist advising his campaign as Hillary and Edwards did) -- but instead lies and says yes, it's possible to have a free lunch (i.e., have health care for all without everybody participating in paying for it).

    Sadly, it looks like I'm going to have to hold my nose in November and vote for a liar, given the way he's pulling ahead of Hillary at the moment by, well, bashing her with lies. It won't be the first time, but damn I wish there was a politician I could vote for without holding my freakin' nose...

    - Badtux the "I smell putrifying lies" Penguin

  6. But forcing people to fork over money to buy overpriced insurance from corporations they despise will never fly...

    Hence the price caps.

    Personally, I'd like to see the U.S. move to a French system, where a "basic" (actually pretty damn good) level of care is insured by a Medicare-like system, with supplemental insurances available on top of it for those who wish to purchase them from private insurers.


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