I had a request today. A good friend asked my take on a Krugman’s NY Times Op-ed piece. And so I have been lulled out of my writing hiatus, and I am back with some thoughts…
Before I give my take on his piece I must admit that Obama gets me excited – politically excited. He had me at Dreams From my Father, and even though the Audacity of Hope might seem to be political positioning his vision stirs hope for a stronger America. Tried as I might I could not resist the vision of transformational change. A change that is not guaranteed with an Obama presidency, but a possibility of a transformational change that is not possible with any other candidate.
But back to Krugman and Obama’s health plan. For anyone who has followed Krugman will know that he is not a fan of Obama’s plan. I imagine that he would say it is better than the status quo, but far inferior to either Edwards’ or Clinton’s proposals. If you look at past posts you will see that I agree.
In more detail now – Krugman charges that because Obama’s plan does not call for individual mandates his plan will fall short of universal health care. Krugman is right. He charges that Obama’s plan will cost more per person than Clinton’s (Obama’s will cost less overall, but will cover less people). I have not seen the paper Krugman refers to, but on the theory alone he is right. Obama’s plan will make insurance affordable to everyone who wants it.
But what is affordable?
It is an individual personal value judgment – affordable? That Lexus may be affordable if I plan to live in it! The truth is the young and the healthy will choose to not have insurance (adverse selection), but all of us will be stuck with their tab when they crash their car. Further, as they are not paying-in, the rest of the insured are paying for a relatively sicker pool of people.
Further, he charges that because of Obama’s criticisms of Clinton’s mandates he stands no chance of passing universal health care if he is elected president. I will concede that the chances of universal health care under Obama are slim.
Krugman is right in what he says, but he’s wrong to leave out some positives of the Obama plan. The Obama plan may be the more politically feasible. It is debatable to say what is feasible, but universal health care has gone nowhere since 1965. Obama’s plan seems to accept that universal health care is not going to happen and comes up with the next best thing. History is probably on his side.
Second, Obama emphasizes re-insurance. His plan is vague about the details, but re-insurance is an intriguing idea. Basically, the government would subsidize insurance companies that insure a disproportionate amount of the really expensive people minimizing the insurance company’s need to avoid such people. It would lower premiums and hopefully reduce things like pre-existing conditions, denial of insurance, etc.
Ultimately, Clinton knows health care. There is no doubt about it. Her plan, especially once the details are filled in, is strong – the strongest of the bunch. If she got it enacted that alone would mark her place in history, but the chances of that are small. In my estimate she would need a strong majority in the Senate (>60 seats), and it would have to be high on the agenda (first 100 days) for it to stand a chance. And can’t you just see it. The attack ads. Partisan, vindictive politics. It may not be Clinton’s fault, but partisanship seems to come with her name.
On the other hand, Obama has already all but conceded universal health care, but his chance of passing reform similar to his plan are much greater. One, he is asking for less. Two, he has the possibility to change minds, to create momentum through his soaring oratory and dream building that might – just maybe – push reform through the maze that is our legislative process.
Clinton’s proposal is stronger. Obama’s chances of enacting reform are greater.
So to answer the question that lies within my title. Obama has substance behind his masterful oratory, but when it comes to health care he is shooting for the moon, whereas Clinton wants the stars.