In his column today Paul Krugman on “The Mandate Muddle,” Krugman points out Barack Obama’s wrong-minded position on universal health care and the need to “include a requirement that everyone have health insurance — a so-called mandate.”
Krugman points to an imaginary scenario where Obama is elected president and in preparing to “unveil his plan for universal health care,” his “health policy experts have done the math, and they’ve concluded that the plan really needs” to include a mandate. ” “Without a mandate,” Krugman says, “they find, the plan will fall far short of universal coverage.”
Worse yet, without a mandate health insurance will be much more expensive than it should be for those who do choose to buy it.
The gist of Obama’s reticence on including a mandate appears to be that he knows “if he tries to include a mandate in the plan, he’ll face a barrage of misleading attacks from conservatives who oppose universal health care in any form.” But now, Obama has set himself up in a position where “he’ll have trouble responding” to the conservatives, because he has “made the very same misleading attacks on Hillary Clinton and John Edwards.”
For the sake of clarity, Krugman explains the divide is deep “between Republicans and Democrats on health care,” and although Obama’s plan is “weaker than the Edwards or Clinton plans,” it is still “very much on the Democratic side of that divide.”
In using right wing talking points, which Obama seems hell bent on doing with his rivals, particularly Hillary Clinton, Krugman notes, Obama has “been giving credence to false talking points that will be used against any Democratic health care plan a couple of years from now.” He’s not helping the cause and he’s making false claims to boot. Claims that the right have touted forever and a day.
One of the biggest false claims is that “people won’t be able to afford the insurance they’re required to have — a claim usually supported with data about how expensive insurance is.” But, Krugman notes, “all the Democratic plans include subsidies to lower-income families to help them pay for insurance, plus a promise to increase the subsidies if they prove insufficient.”
And interestingly, “the Edwards and Clinton plans contain more money for such subsidies than the Obama plan.” So while Obama claims to have the better plan that will help more people get healthcare insurance, sadly low-income families who “find insurance unaffordable” under the plans offered by the Democratic contenders , will “find it even less affordable under the Obama plan.”
Krugman points to the reports on the latest meme in the news on the “limitations of the Massachusetts plan to cover all the state’s uninsured,” and says the Massachusetts plan is “actually doing much better than most reports suggest.” The “difficulty of enforcing mandates” in Massachusetts stems “from the fact that the state hasn’t yet allocated enough money for subsidies.” But, as this press release shows from The Commonwealth of Massachusetts, they are making great headway with their enrollment.
Krugman goes on to point out that “Obama is storing up trouble for health reformers by suggesting that there is something nasty about plans that “force every American to buy health care.”” Krugman is right and he explains why:
Look, the point of a mandate isn’t to dictate how people should live their lives — it’s to prevent some people from gaming the system. Under the Obama plan, healthy people could choose not to buy insurance, then sign up for it if they developed health problems later. This would lead to higher premiums for everyone else. It would reward the irresponsible, while punishing those who did the right thing and bought insurance while they were healthy.
Here’s an analogy. Suppose someone proposed making the Medicare payroll tax optional: you could choose not to pay the tax during your working years if you didn’t think you’d actually need Medicare when you got older — except that you could change your mind and opt back in if you started to develop health problems.
Can we all agree that this would fatally undermine Medicare’s finances? Yet Mr. Obama is proposing basically the same rules for his allegedly universal health care plan.
Krugman ends by saying that his “main concern right now is with Mr. Obama’s rhetoric: by echoing the talking points of those who oppose any form of universal health care, he’s making the task of any future president who tries to deliver universal care considerably more difficult.” And honestly after all the years Democrats have fought to make health care available to all Americans, the last thing we need is one of our presidential candidates undermining the fight.
Sadly, as Krugman points out the “debate over mandates has reinforced the uncomfortable sense among some health reformers that Mr. Obama just isn’t that serious about achieving universal care — that he introduced a plan because he had to, but that every time there’s a hard choice to be made he comes down on the side of doing less.”
Instead of being progressive, Obama’s stuck in regressive mode. He’s not helping the cause for health care for all Americans, he’s hurting it. And, I have to say on a personal level, as one of those American’s who simply can’t afford health care insurance, I’m not impressed. In ’04, I felt as many did that Kerry had the best plan available. I went on the record here saying in September that Clinton’s plan “may be the ticket,” and I stand by that still. Healthcare should not be an option for Americans, it should be a right.