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While we are mandating..can we mandate peace and impeachment?

Now here is reality:

I am one of the 48,000,000 medically uninsured in the United States, (and this figure doesn't factor in the millions who are under-insured!)

I saw an ad in the paper the other day to sign up for Blue Cross/Blue Shield so I called for a quote.

I gave them my birthdate, told them I have no pre-existing conditions, do not smoke and that I have not had insurance since the last employer I had offered it to me (1985).

I was told I'd have to pay $400/mo. (that's about half of my rent) for coverage that would not start for a year because I "could" have "pre-existing" conditions. The deductible (after I paid them almost $5,000 for NOTHING) would be $1500/year NOT including any needed medications.

It ought to be a crime. I wonder how much money the medical insurance companies have contributed to the "top-tier" candidates such as Obama, Clinton, Giuliani etc.?

Dennis Kucinich is the ONLY candidate who cares about the well-being of the American People and the planet. And he is definitely electable. All we need to do is VOTE FOR HIM!

Yep, Obama's plan sucks, but let's face it, they all suck because they don't deal with the problem: private, for-profit insurance. Obviously, we need a 'single-payer' system like they have pretty much every other civilized country.

Krugman advocates (in many previous articles) such a not-for-profit, universal payment mechanism, and yet he won't talk about the one candidate for the Democratic nomination who calls for it: DENNIS KUCINICH.

Which leads me to ask Paul: "How serious are YOU about fixing out health care system?"

I read with some interest the discussion about payment mechanisms. I would like to take exception to the idea of taking it out of general revenue. We started that up here in Ontario in '95, and IMhO hasn't worked so well. The problem is twofold; one is that it becomes impossible for the citizenry to really get a good handle on what they're paying for their healthcare, and two is that it makes all other priorities of government compete with health care, with a consequence that other priorities (infrastructure, education, etc) tend to lose out, esp. considering the boomer demographic and what stage of life it's entering.

I think the older system we had up here worked better. The Ontario Health Insurance Plan was a non-profit corporation wholly owned by the crown, and given a monopsony on paying for health care. It was given the power to collect insurance premiums from all working people by a payroll tax. This was good for several reasons.

First, it meant that health care wasn't competing for public dollars against other worthy priorities... and as can be seen by your experience in the US, people who can afford to pay will pay anything when they think they need to. In broad demographic terms, the inclusion of OHIP into general tax revenue has meant a progressive bleeding of other priorities like universities, good roads, and so on as the interest of the baby boom has moved from work and education for themselves and their children into who's going to keep them healthy at the ends of their lives.

Second, the net effect was that OHIP functioned under a "from each according to their abilities, to each according to their needs" mandate; there was no need to come up with complex subsidy programs (and complexities like that end up creating a group of people who try to game them) because while it wasn't part of general tax revenue, it was still payed for by a tax (and a progressive tax at that). Not only that, but as the population and economy grew, more money became available to serve those people's health needs without the need to raise levels of taxation.

Third, it allowed the people of Ontario to see and get a sense of how much health care really cost, because all they had to do was look at their stubs and/or their return at the end of the year. This also meant that if costs started to rise very high due to externalities (in this day and age, read drug costs) they could see it and bring pressure to bear on the appropriate stakeholders to rein in costs.

Finally, OHIP was engaged in the conversation; they could (and did) say things like "we need to build a new hospital in northwestern Ontario. We're going to need to raise X$ to do so, so we're going to raise premiums by a half a point for two years to pay for it." This kept people (all people) engaged in the process of both receiving care and how it was paid for. It also reinforced the communality of the people of Ontario; the sense that we were all in it together when it came to common goals.

Under the law here, non-profits can't make a profit, but they are allowed to retain some of the money they raise to deal with capital expenditures, and of course in the health care field those are large. However, the calculation of such levels of capital are not particularly difficult; any decent actuary and accountant should be able to give you a good ballpark given a few weeks to look at past data.

jake123 December 8th, 2007 10:59 pm - You may have a point about paying for universal health care via a payroll tax versus financing it from general tax revenue , and I believe in a pragmatic approach to financing health care - not a one-size-fits-all approach which would introduce dramatic inefficiency.

Bear in mind though that as I suggested in my earlier post on Mr. Krugman's commentary - one of his regular "out-of-touch" efforts at economic bean- counting to protect a self-destructing economic order - on Dec 7 at 4:33 pm, we are living in a surreal economic and political environment here in the U.S. which has been building in its "surreality" since Reagan and his cohorts began wrecking the American Way of Life - with only occasional squeaks and squeals of protest from neo-Keynesian economists like Paul Krugman - in 1981. (Even Mr. Krugman admits that his public career began in Reagan's Administration.)

But I should correct that sentence above - the "wrecking" began under that sweet-voiced, obserquious, non-threatening - but Establishment Liberal - Christian President Jimmy Carter, who installed Paul Volcker as Federal Reserve Chairman. Volcker began the wrecking job of de-industrializing the American economy and "renovated" pre-New Deal American capitalism by shutting down the economy, forcing its unemployment rate to near-depression levels of 10% and raising longterm interest rates to 18%.

Since then, a situation has arisen in which the income of most Americans in the lower four-fifths of income earners has dropped while the upper 20% has risen sharply - the upper 1% astronomically.

Paul Krugman and the most of the rest of the "American Prospect" crowd of Establishment Liberal "intellects" - maybe I would except the founders Robert Reich and Robert Kuttner here - care not a hoot for that fourth-fifths of Americans - they are concerned, as liberals since the New Deal have always been, with "rescuing capitalism from its [Free Market, Utopian Capitalist] rescuers" - to borrow a phrase from J.K. Galbraith, who did - it can been seen from his writings- care about people who pull a paycheck for a living. (This also goes for the comfy crowd at the so-called Center for American Progress.)

Mr. Krugman, I can only guess, was born in that upper 20% of income earners (and wealth holders), perhaps among the goodly many of them who are "of independent means." So he makes a poor advocate for a health insurance system which would benefit working people. His brand of liberalism has been useless over the last quarter century and that is why it is on its way out - along with a species of venerable but dull and impotent journalism of liberal "equivocating fact and opinion" such as practiced by media outlets like the New York Times, for which he works - doubtless for the half-million dollars a year this dying newspaper pays to the somnolence-inducing crew who populate its op-ed page.

That paper was effectively emasculated as a force of social amelioration under the overrated editorship of a vehement reactionary and bigot, A.M. Rosenthal, and never has recovered and never will, recover to the status of an enlightened daily journal of world and natonal news it held for two decades or so after World War II.

(But you can still find some good recipes for brownies and sesame noodles, and some heart-warming stories about dogs, cats and horses in the pages of New York Times, I must admit.)

The overtaxed 80% American people who are disenfranched by both the Reagan-Bush reactionaries and by the Paul Krugman's of the so-called "liberal media," are already burdened with too many "do-this-or-else" mandates from a government which increasingly represents directly only the interests of a small minority of economically affluent Americans, most of whom have "solid-gold" connections to the corporate and financial oligarchy which has come to rule our country in the last quarter century - and that includes a national health care system with the mandate the estimable Mr. Krugman - a self-described "liberal with a conscience" - speaks of in this op-ed, posted on a putatively "progressive," democratic, news and current affairs site, Commondreams.

That is what I think distinguishes the United States from Canada. Take for example this article from the Bloomberg News website last week, which is all breathless about the 2.7 BILLION dollars in fees a hedge-fund honcho "earned" over the space of a mere 9 months betting that the subprime mortgage market would implode http://www.bloomberg.com/apps/news?pid=20601109&sid=arAno4KAi9Es&refer=home

That this character managed to collect that amount of money in fees alone, doing little or nothing economically productive, possibly a great deal of economic harm, testifies to the surreal political and economic environment in the U.S. in 2007 I refer to. This kind of income is being raked in (not "earned") by these deal-doers who practice their "craft" of using the global commodity and financial markets as a rich-man's private casinoe, in a metropolitan area where children are still growing up in third-world poverty not 20 miles from the sheltered offices of these hedge fund "geniuses."

Mr. Krugman should mention all of that in his surreally-out-of-touch Times columns, but he doesn't - nor does the loss of millions of manufacturing jobs since Bush took office bother Mr. Krugman at all - after all, he's not one of those scruffy working class people at the bottom of the income/wealth-holding heap. Mr. Krugman - to borrow a quote from a real estate operator I know worth $300 million - is "well taken care of." (Bob Kuttner, I admit, is in touch with the economic reality in a way that Paul Krugman isn't and it shows in Kuttner's latest book. And Robert Reich even published a commentary in mid-August of 2007 - which I don't think made it on to the Commondreams site - called "Stop the Hedge Fund Casino" - here it is http://www.timesonline.co.uk/tol/comment/columnists/guest_contributors/article2284389.ece?openComment=... Somehow, that Robert Reich commentary could be published in a Murdoch newspaper in Britain - but not in the United Staes. Nor did any so-called "progressive" or "left" U.S. blogs or news sites pick it up. "Surreal" -yes that's the word. )

So it may be that a payroll tax is the ultimate way to go on single-payer health care in the long run even in the U.S. - but not until the ridiculously self-destructive assymetries in wealth and income in the U.S. are ironed out -- by jacking up estate taxes, and income taxes and introducing an assertive wealth tax to boot - on the most affluent, and our crazy military-industrial-national-security-state apparatus is shut down or at least cut back drastically - and that won't happen until we have a true social democratic party such as Canadians have in their Liberal Party to protect their citiizenry from predatory and exploitative corporate and financial capitalists.

And from liberal equivocators like the estimable Paul Krugman.

I have followed Paul K for several years and his challenges to Friedmanism are perfectly calibrated to allowable fact based arguments in a 2 party system.He is brilliant and he does his homework. But here is a typical example of how he defends Dem plans for an incremental plan that is fundamentally flawed because it keeps alive the tremendous waste and antihealth motives of the health insurance business, realities the candidates don't address.

I also have strong reservations about his adherence to classical Liberal economic theory which fails to take into account the health of the planetary life support system, the ecologic balance, climate issues, sustainability. The New Deal was built on cheap oil, so the new, New Deal he longs for needs some serious re-jiggering. Too much faith in the Democratic party rather than the common good socially progressive principles of the New Deal.

Kunstler predicted the economy would start to come apart this year. Paul K was pretty blunt about the depth of the fissures in financial markets in his last article. A lot of fingers are going in a lot of dikes, can they save the markets, the dollar, the consequences of endless layers of debt?

I have followed Paul K for several years and his challenges to Friedmanism are perfectly calibrated to allowable fact based arguments in a 2 party system.He is brilliant and he does his homework. But here is a typical example of how he defends Dem plans for an incremental plan that is fundamentally flawed because it keeps alive the tremendous waste and antihealth motives of the health insurance business, realities the candidates don't address.

I also have strong reservations about his adherence to classical Liberal economic theory which fails to take into account the health of the planetary life support system, the ecologic balance, climate issues, sustainability. The New Deal was built on cheap oil, so the new, New Deal he longs for needs some serious re-jiggering. Too much faith in the Democratic party rather than the common good socialist principles of the New Deal.

Kunstler predicted the economy would start to come apart this year. Paul K was pretty blunt about the depth of the fissures in financial markets in his last article.

We need to look at the French model and move in that direction. All these plans are just tinkering at the edges of what needs to be done to ensure health care coverage for all Americans.

Obama's healthcare plan does not leave people out, it allows people to choose. Mandates require people to pay into the system, whether or not they can afford to. So let me get this straight, the working poor should be mandated to pay into corporate health insurance schemes? Lets point out what mandates really are in the first place. Krugman's twisted thinking on this is that he thinks any plan that allows healthy hardworking people to opt out of paying for other people's obesity and corporate welfare is something that "would reward the irresponsible, while punishing those who did the right thing and bought insurance while they were healthy." The irresponsible? I have mandated health insurance right now to go to school, and where do you think most of that money goes to? Why am I paying for somebody else's obesity? for their addiction to corporate candy bars? I ride a bike everyday and am in debt with college loans. Think about it. The irresponsible people are the people not taking their diet and fitness seriously, not the healthy people who are.

And Krugman, as much as I respect him, has a lot of nerve to say: "I'd add, however, a further concern: 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." Opposing the invasion of Iraq was a hard choice. Krugman knows better than to spit out this Hillary-crap. Hillary voted for the war, and does come down on the side of corporate health care insurance companies, and Obama doesn't. That's the difference. Hillary's 'mandate' is 'mandate' to fleece you. Obama realizes not everyone wants to pay for corporate's yachts and not everyone can afford to. A mandate would punish people for being poor and being healthy.

Healthcare is one aspect where Democrats need to get serious and learn to take a little self-responsibility for not having to buy a drug that is corporate's newest substitute for diet and fitness. Buy Organic! Walk to work! 'Be the change you want to see in the world' Gandhi said.

You can cancel your health insurance at any time. Opt out of every stupid capitalist ploy until the capitalist is finally starved into submission to the public will.

Insurance of any kind is just legalized extortion. Period.

Single payer + Dennis Kucinich = Coverage for ALL. Period!
Anything else is so much rhetoric and medical system welfare.

"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."

This is such bull. I am so tired of the psuedo-progressive trash generated by Krugman on this issue.

Who is "gaming" the system? Oh yeah, some evil middle class folks somewhere ostensibly are bankrupting the poor insurance companies, of course. That makes a hell of a lot of sense. Why don't you wake up? Please, or shut up.

The CEOs of insurance companies have multiple million dollar residences in places such as Beaver Creek, CO. My brother installed a computer network system in one of their "summer" houses. It had an entrance hall that was 5,000 square feet. That is larger than the square footage of the entire house we grew up in in New Jersey.

Krugman believes we Americans really need a federally mandated bill forcing us by law to pay our "free market" friends at the for profit insurance companies.

You regurgitate on about mandated corporate insurance based healthcare as if you are getting paid by insurance companies to do so.

Never had the thought that this system is already completely fleecing Americans? Who's "gaming" who? Oh yeah let's pass a law.... sure. Insurance companies are frothing at the mouth at this.

I heard Pravda is hiring, why don't you send them your resume.

Hey! If you can solve the insurance problem by mandating that people buy insurance then why not extend this wonderful idea to other problems. World hunger could easily be solved by mandating that people buy enough food to keep themselves fat and sassy. Homelessness could be done away with by mandating that everyone provide themselves with a residence which meets a strict code of minimum health and safety requirements. Even death could be conquered by mandating that people continue living (which of course would be catastrophic). Why bother with insurance at all? Just mandate that people stay healthy and pay for birth of their children out of pocket. See. All the worlds problems could be mandated away with the stroke of a pen. Sooooooo easy!

Dennis Kucinich has the best plan. Accept no substitutes!

There's a rather straightforward to the solution to the issue of financing the inevitabiility of single-payer health-care in the U.S.: pay for it out of regular government revenues, just the way we pay for our wasteful, bloated, destructive military industrial complex, or for a federal highway system which functions as a surreptious subsidy to the highway, motor vehicle and real estate industries.

As I write, people around the world who follow the news are noting how the Pentagon has taken over U.S. foreign policy absolutely - so that for all intents and purposes, the State Department might just as well be disbanded Its latest "innovation": an African Command, so as to justify warmaking and destruction in Africa, where we are now vying with global Islam and China for domination.

Our wars in the mideast have cost a trillion dollars so far - and are heading for a second trillion. We are overextended as a nation in pursuit of the impossible goal of runing a world that no sensible nation would dare take up the task of policing. And,the bought-off, cowering politicos in D.C. who purport to represent "the general welfare" of the American people penny-pinch when it comes to health and education - but have voted and will continue to vote this wasteful "wealth-for-pillage" apparatus which came into existence during the Second World War and which has metastasized ever since in size.

Here's a suggestion: begin the arduous work right now of challenging a military-industrial-national-security state apparatus which will, if left unchecked, eventually engulf and destroy what is left of the American way of life, and all of our liberties, scale it down drastically in size - and use the wealth and manpower rescued from an outmoded militarism and police state to fund universal single-payer health care for the American people.

Sounds utopian - but its not quixotic, like our rapacious power elite's delusion of "covering the earth" with American "utopian capitalism."

The DL argument is nonsense - the reason it's required is to protect the other guy, and a deeper look at the stats reveals that more than 40% of insured drivers carry liability only, which means they're screwed if they're injured in a wreck anyway.

If forced health insurance really worked like auto insurance, if I had the flu and passed it on, my policy would protect the victim of my ill health, but not me: I'd be on my own.

Forcing, er, mandating all to buy health insurance is not only as un-American as it gets - but it serves only to continue to enrich the ins. cos. and Big Med and Pharma, because most will never use their insurance, because most of us get through life without major, multiple disasters.

Once you elect your Democratic president and Congress, then you educate them about single-payer and why you want it. You cannot expect them to educate you about the virtues of single-payer and get elected at the same time. Elections do not work that way in a corporation-infested country. The 30-second ads kill the messenger.

The problem for me with these private plans is that they are telling me who I can see - not my Naturopathic Physician. Alternative health care is getting bigger in this country, but left out of the discussion.

The arguments about how the U.S. health care should be best handled reminds me of the mass transit debates that rage on and on and on in Seattle. It has been argued back and forth for year after year as the cost of doing anything constructive goes up and up and nothing happens. Every mornings commute is a jam of autos miles long stop starting for hours.
So it seems to be shaping up for the National health care debate-in the end nothing constructive will be done, maybe some kind of tax credit that tax payers will need a CPA to figure out if they are eligible and if so for what.

Professor Krugman is simply wrong about most of this. The point of a mandate is to make universal health care universal while keeping the private health insurance business in the black. Everyone who can afford it will have private healthcare or else.

As a professor of economics, he should know better than to talk about car insurance (a private good best provided through a competitive free market) with health insurance (a public good best provided by a well-regulated monopsony -- single buyer).

As for the Swiss and Dutch systems, they are far removed from the mandates currently under discussion in the US. In Switzerland, the private healthcare insurance is a top up to the national system. As for our Dutch friends, this is straight from the Wall Street Journal of September 7, 2007, "Health insurance is subsidized by the state. 'Insurers get risk-equalization payments for patients with about 30 major diseases.' Thus, people who are sicker receive a larger state subsidy than healthy individuals." And employers pay most of the premiums.

Obama uses the talking points of the right. His health care plan is to the right of Clinton and Edwards. His war plans are no different from Clinton's.

Any minute now the left will start calling him a whore, slut, ice-queen, bitch, etc. and start commenting on his laughter, cleavage and fashion sense. If he responds, he'll be called a crybaby. Either way he'll either be too manly, or not manly enough. Something gendered anyway.

Oh no wait, they only treat Clinton that way. Wonder why?