I prefer HR 676 over all other health care plans, but here's why Edwards' plan is second best:

Edwards' plan creates non-profit health care markets which allow for-profit private insurance companies to co-exist with a non-profit public health care program along the lines of Medicare (which is important because it allows the objectors to opt out of public health care plan if they want to and this choice undercuts their opposition to the plan) but MOST IMPORTANTLY these health care markets force the for-profit private insurance companies to compete directly against the non-profit public health care program based on Medicare. Most health care experts predict that the for-profit private insurance companies will be unable to successfully compete directly against the non-profit public health care program, which is how Edwards' plan will evolve into public single-payer universal health care.

Obama's and Hillary's plans do not have this feature.

Here is why you need Edwards' and Hillary's mandates, even though Obama pretends that you don't.

Edwards and Hillary would also eliminate the ability of health care coverage providers (whether private or public) to exclude an applicant based on prior medical conditions. You can imagine what this would lead to: if a person doesn't need to have insurance unless and until he gets sick, he could just go without any insurance and then wait to buy insurance until the day he feels really sick or gets badly injured. You can't do this today, of course, because your day-before-buying-insurance illness or injury would be excluded as a pre-existing condition. But since Edwards and Hillary would both eliminate the right of insurance companies (both private and public) to exclude coverage based on pre-existing conditions, they would create the nightmare that many would drop off their health care plans to avoid paying premiums only to re-sign up for insurance once they get sick. This is one reason why coverage has to be mandatory.

More fundamentally, without the mandates, no health care plan will be universal. Many people who "go naked" with respect to health insurance become a burden on the public health care system when they suffer a major illness or injury and obtain their medical care from the emergency room under the Emergency Medical Treatment and Active Labor Act. The mandates in Hillary's and Edwards' plans re-allocate these burdens. Where people get their health care coverage from their employers, the employers get tax incentives to ameliorate that burden; where people buy their own insurance, they get it at a reduced cost and they get tax incentives to defray the cost; where people cannot afford to buy insurance and don't get it though their employer, they become eligible for government-provided coverage. If car insurance was like health insurance under Obama's plan (i.e., it was not mandated), people would elect not to have car insurance because they couldn't afford it. Under this system, those uninsured drivers (or people without health insurance under Obama's health insurance plan) are a burden on the system because the damage they cause doesn't vanish just because they are uninsured -- instead, the costs to the system from the uninsured raise the costs for the insured. In the car insurance context, this mis-allocated cost is properly re-allocated to the greatest extent possible by making insurance mandatory. It would have the same effect under the mandates set out in Edwards' and Hillary's plans. Whether or not Obama thinks mandates "are a good idea," mandates are the only way to ensure that coverage is truly universal, the only way to ensure that the mis-allocated burden on the system from the uninsured is properly re-allocated as nearly as possible, and the only way to stop the inevitable situation under Obama's plan that the uninsured will be the working poor. If Obama thinks this is a bad idea, that's an excellent reason to support another candidate.

Plus, under Edwards' plan, the vast majority would get their health care coverage through their employer, and for those who don't, Edwards' plan subsidized coverage for everyone making $100,000 a year or less (including a 100% subsidy for the poorest people).

Here is an excerpt from a good article:

Health markets would offer traditional plans from private companies such as Blue Cross-Blue Shield, Aetna and Cigna, as well as a government-run plan similar to Medicare, the federal health-insurance program for the elderly. The public-sector plan would resemble Canada’s single-payer system, in which insurance is publicly funded to control costs but doctors and hospitals remain private.

“The idea is to determine whether Americans actually want a private insurer or whether they would rather have a government-run ... single-payer plan,” Edwards said. “We’ll find out over time where people go.” The mix of market and government initiatives makes Edwards’ plan much harder to attack than Clinton’s early 1990s plan, said Leif Wellington Haase of the Century Foundation, a liberal-leaning think tank. “In this plan, the changes happen much more gradually,” Haase said. “Each element has a market element that deflects the attack. I think it’s a very smart political document.”

Although Haase thinks the Edwards plan does not go far enough, conservatives fear it would take the country too far toward government-run care. “It sets up a slippery slope to move toward a single-payer, government-run health care system,” said Mike Tanner of the Cato Institute, a conservative-leaning think tank. “He realizes that Americans are not going to take that in one bite.” Tanner contends that under Edwards’ parallel system, private insurance would be unable to compete with a taxpayer-funded system. The single-payer system, Tanner argued, sounds good. But it would not be popular with citizens because it would ration treatment for expensive and long illnesses, and would discourage pharmaceutical companies from developing new drugs. “Single-payer systems are good if you are not sick,” Tanner said. “They provide routine care at low cost. But they don’t provide intensive, expensive medicine for people with serious illnesses.”

http://www.popmatters.com/pm/news/article/38815/in-a-crowded-field-edwards-health-plan-sets-him-apart/

Here is an excerpt from another good article:

All three contenders have proposed a national healthcare system that is a variant of the plan developed by Yale political scientist Jacob Hacker. The basics of the plan are to require that all firms either insure their workers directly or pay a fee to the government. The government then uses this money to heavily subsidise insurance for low- and moderate-income families. It also establishes an expanded Medicare-type public plan that people will have the option to buy into. In addition, it reforms the private insurance market, most importantly by requiring that insurers not discriminate based on pre-existing conditions.

Both Clinton and Edwards would impose a mandate that everyone buy into this system. Obama has claimed that he would not require a mandate. As a practical matter, the healthcare system that any of them are able to put in place will depend on the arms they twist and the pressure they can bring to bear against the insurance companies, the pharmaceutical industry and other powerful actors who will be hurt by real reform.

Any serious plan will require a mandate - this directly follows from its requirement that insurers take all comers. Without a mandate, no one would buy insurance until they had serious bills. This would be like letting people buy car insurance after an accident, and then sending the company the bill. That doesn't work.

http://www.alternet.org/election08/71650/

If we vote for second best, we'll end up second in the GE.

can get it passed.

want it passed" -- he just doesn't believe we can get it passed with this congress. I wish I disagreed, but I believe he's right. We couldn't even get SCHIP expanded, for gods' sakes!

It seems to me like he's trying to play both sides. No matter his platform, the media would have called him a "front runner" because of '04. If he really wanted single-payer, he could have campaigned for it. I don't know if not getting it passed is a valid argument, since no one has tried yet. The bill has an awful lot of cosponsors, and I think the american people could get behind it if the discussion was handled correctly. Unfortunately the media would do all they can do axe it, but I don't think we should be afraid of them - at least not on principle.

If a fight for it was publicized, there' be an awful lot more people bugging their congressmen to vote for it than there would be asking them to vote against it. Some congressmen could get nailed to the wall by their constituents for voting against it, and these are generally people who value their jobs, and in some cases even want to faithfully represent their districts! Perhaps you're right and it's a vote-loser, but I think it's too important to not fight for.

But they can't even get it out of sub-committee.

Why I *LOVE* this plan. It is the baby steps that reality needs to get us there.

were more.

with a public program?

I'm not aware of any who think that, much less "most". The idea that this would somehow evolve into a single-payer plan is just absurd. Edwards just says that to fool gullible people who don't know any better. At the same time, he makes arguments for why single-payer would be bad. It's just his version of triangulation.

agreed on this point and I have never seen one health care analysts reach the contrary conclusion.

Off the top of my head, I can recall reading the argument that private for-profit health insurance wouldn't be able to compete with a non-profit public parallel system from Kip Sullivan, Paul Ginsberg, Mike Tanner, Grace Liem ... There are at least two or three more, but it's late and their names escape me.

and it looks like he comes to the same conclusion I do:



I couldn't find an analysis from any of the others on this. I'll take your word that some of them think it's a possibility, but I really disagree.

I should point out that I still think it's a good plan. I just don't think it's a backdoor to single-payer.

a bit out of context because Sullivan says that the Edwards plan is the second best after HR 676 (which I exactly what I said in my thread title). Sullivan is a die-hard advocate of public single-payer care (on the HR 676 model) -- and I am too -- but we are failing to pass HR 676 and Edwards is really the only candidate who's offered an intermediary step toward that ultimate goal.

Edwards gives no details whatsoever regarding the public portion of his plan. He or his handlers just threw this public portion part in there to perturb and confuse the single payer debate.

There can be markets for iPods because there is an obvious way for consumers to know if they are any good or not. There cannot be markets for health insurance because there is no fucking way of knowing whether they are any good unless you get expensively sick, and that happens to only a minority of the population.

I can guarantee you that people will "prefer" cherrypicking private insurance that undercuts the price of government plans. Private plans can afford to lowball prices because not many of their customers will ever be in a position to find out how they resist paying out claims. The end result will be that the government pays for sick people and that the privateers continue to collect money from the healthy and use as little of it as possible for care, thus depleting the available amount of money to spend on actual care.

Since privateers hate the Edwards plan anyway, whythehell does he go for being hung for a lamb instead of for a sheep? I say keep asking for a pony, even if you will eventually accept a kitten.

"Obama will make available a new national health plan to all Americans, including the self-employed and small businesses, to buy affordable health coverage that is similar to the plan available to members of Congress."

"The Obama plan will create a National Health Insurance Exchange to help individuals who wish to purchase a private insurance plan. The Exchange will act as a watchdog group and help reform the private insurance market by creating rules and standards for participating insurance plans to ensure fairness and to make individual coverage more affordable and accessible. Insurers would have to issue every applicant a policy, and charge fair and stable premiums that will not depend upon health status. The Exchange will require that all the plans offered are at least as generous as the new public plan and have the same standards for quality and efficiency. The Exchange would evaluate plans and make the differences among the plans, including cost of services, public."

Obama's plan has the competition you say is beneficial, PLUS a method of regulating private insurance. AND it doesn't force anybody into bankruptcy with mandates before we're sure it's affordable. Obama's plan is better, by far.


http://www.barackobama.com/issues/healthcare/

set of people. It will solve neither crisis in health care. It won't insure everyone, nor will it lower costs in any appreciable way.

He is not going to mandate people into bankruptcy and homelessness. He has already said that once we're sure the plan will work and that everybody can afford it, he'll consider mandates to bring in any stragglers.

without mandates insurance will become more expensive, not less.

Pulling catastrophics out will bring costs down. Subsidies to bring the majority in will also bring costs down.

You're being lied to and I don't know why you're buying into it. Hillary is not a diva.

We've come so far! Now, our "top" candidates all sound like Rockefeller Republicans.

Why fight for what the people need when we can settle for what the corporations want?

NIXON NOW.

any and all credibility.

NOT Republicans.

It's a sad day when the top Democratic presidential contenders all make Richard Nixon look like a flaming liberal.

(see sig and avatar)