The 20% (Of All Of Us) Obama Can't Afford To Abandon or Lose

Last night I was reading another story about how, EVEN now - when Hillary Clinton has bowed to pressure and endorsed Obama, still, approximately 20% of the likely Democratic voters
refuse to say they will vote for him
.

Well, that 20% figure keeps coming up again and again, and I think that it represents the 20% of Americans who have chronic illnesses.  As we know from Austan Goolsbee, Obama's healthcare plan, like Jim Cooper's 1994 plan, Tenncare, and the MA state healthcare plan, a consistent 20% of those currently uninsured are uninsured because chronic illnesses have rendered insurance very expensive for them.

That 20% are the chronically ill and many of them are also the so called 'uninsurables'. Basically, they are people with often common, but increasingly expensive illnesses. Their only common denominator is that as the price of drugs rises, and the political and economic clout of the American middle class declines, their often manageable conditions are increasingly seen as costing 'too much' to treat by insurers. Which means that people who were doing okay last year, find that this year, they get left out in the cold, abandoned.

And apparently, also abandoned by Obama. (Hillary would have covered them, and limited out of pocket, uncovered expenses too, which means the difference between bankruptcy and solvency for millions of people)

These illnesses can be common illnesses like athsma, hypertension, etc. but they typically require drugs to manage them. When people lose their jobs, if they dont find another job in a short period of time, and COBRA runs out, or they cant afford to pay the full cost of their insurance, which is often more than they realize it is, then they become forced to look for insurance on the so called open market. Everyone who shops for individual insurance pays a lot, but some find it almost impossible to get. basically, that group is everyone who has been using the healthcare benefits, sometimes even the perfectly healthy. People who have been to the doctor more than around once a year often find that they have to pay more for insurance. Obama basically classifies normal families as families without health issues.

What happens, though when you don't have a chronic illness, but you have seen the doctor for things that come up. Self employed or even employed people whose employers dont buy insurance for them, people who have had spider bites or people who have called the doctor over minor medical issues find themselves paying far more for insurance.

This is perfectly legal, just like charging people more for drivers insurance who have tickets is. It enables the insurance companies to charge 'normal families' less, they say.

They feel that this is not 'discrimination' it is how the insurance business works. (But it has the effect of making middle class people these days terrified of seeing the doctor. THAT IS NOT THE WAY THINGS SHOULD BE! But it is, and even if Obama can overcome the WTO rules and implement his plan in 2012, Obama proposes to keep it that way. Insurance is priced by risk, to the insurer. Or if he forces them to insure everyone who asks of the same age at the same price, insurance costs will go up a lot of everyone. Thats the obscene cost of not havig a mandate! Its unavoidable!)

That is the hard reality of risk-priced insurance.

But, what about the 20%? Again, that 20% isn't just the stubborn. Its the same percentage of us who know we are being abandoned. yes, we are expensive. But more and more people fall into the category every year. You may be well now, but its likely that even you, the reader, will be one of us soon. We are all in that 20%.

That includes both those who to insurance companies are 'uninsurable', and those who they might insure, if they paid what they consider to be a fair price. (The raw cost to treat them plus the profit margin, plus a buffer that is related to the likelihood of a flareup that could cost still more)

That is what Elizabeth Edwards was talking about when she mentioned that neither she nor Senator McCain would be able to buy insurance if they were not rich. Why? Because both she and Senator McCain are cancer survivors. Once somebody has had cancer, they find it hard to switch jobs, they cant do anything that risks a period in which they dont have insurance. If they get laid off, they often find it very hard - often impossible to find insurance because they are not a risk, they are a known loss.

Thats why Hillary's mandate was such a great idea because IT WOULD HAVE ENABLED A PLAN THAT WOULD COVER THAT ONE FIFTH OF US WHO HAVE CHRONIC ILLNESS.

Now, Obama's advisor Austan Goolsbee
said
that neither Obama nor Hillary could afford to do it, but Hillary did the math and showed that she could, with her mandate. Nobody is arguing that it is possible any other way.
Not even presumptuous nominee Obama.

What I find is interesting, is that THAT 20% seems suspiciusly close to the 20% who refuse to vote against their own interests and vote for a small chance for adoption, eventually of a healthcare plan that probably will not help them! Can you blame them!? NO.

Would you put a loaded gun to your own head and pull the trigger?

Again and again, we see this 20% figure.. for example..

http://online.wsj.com/public/article_pri nt/SB119681696156513818.html

"On the campaign trail, Mrs. Clinton has attacked Mr. Obama for his plan, saying it betrays the Democratic principle of universal coverage. Her campaign has demanded that he take down an advertisement that claims his plan "covers everyone."

Mr. Obama has replied that her attacks are more about politics than substance; they didn't come, he noted, until she lost ground in the polls. But his advisers don't dispute her central charge. Rather, they claim Mrs. Clinton's plan would also"leave millions without coverage".

------

Then, today, we see another 20% reference - "Obama's bounce is the result of growing unity among the Democratic Party. Eighty-one percent (81%) of Democrats say they will vote for Obama over McCain. That's the highest level of party support ever enjoyed by Obama. Still, three-out-of-ten voters are either uncommitted or could change their mind before Election Day. Fifty-six percent (56%) of those swayable voters are women and most earn less than $60,000 a year."

Obama adviser Austan Goolsbee argues that if Mrs. Clinton's health plan is enacted, she will have to waive the mandate for millions of people. That is because, he says, there isn't enough money for subsidies to make health insurance affordable enough for people to buy it.

"You can't put in a mandate until health care is affordable," he says. He predicted that a Hillary Clinton administration would wind up exempting 20% of the uninsured, or about 10 million people. That is the percentage of uninsured adults who were exempted in Massachusetts, the only state to try an individual mandate.

That view may not be true. Ken Thorpe, a health-policy expert at Emory University who has advised all three major Democrats, said he ran cost estimates for the Clinton plan at the Clinton campaign's request, and found there should be enough money to make insurance affordable for all. He said he ran three scenarios with varying levels of subsidies -- from $100 billion a year to $120 billion a year. The campaign chose one in the middle: $110 billion.

If it turns out that isn't enough money to make health premiums affordable, Mrs. Clinton would have to spend more on subsidies, one of her health-care advisers said.

But, the adviser said, it is wrong to assume that 20% of Americans will be exempted. It is impossible to say for certain, because the campaign has not explained how large the subsidies will be or who will qualify for them.

The Obama plan does some other things to get people insurance. It allows adults up to age 25 to stay on their parents' insurance even if they aren't in school. And it attempts to lower the cost of insurance overall through a reinsurance plan, whereby the federal government would cover some expenses of some of the most costly patients.

Outside experts note that the Clinton and Obama plans propose spending about the same amount of money, while Mr. Obama uses some of his to pay for the reinsurance plan -- an initiative that could cost tens of billions of dollars. That should help lower premiums across the board, but it means there would be less available for direct subsidies."

also read this from 1994, Episode 1 of the universal healthcare saga.. This is an election post-mortem by Columbia Journalism Review lamenting the lack of objective coverage on the two health plans, Clintons and Cooper's "Clinton-lite".

http://backissues.cjrarchives.org/year/9 4/2/clinton.asp

"But what was missing from the coverage of Cooper's bill was solid analysis of how the bill would affect ordinary people -- analysis the polls say the public wants. As of late December CJR found no stories that explained how the plan would affect those Americans who are not insured and who still might not be if Cooper's plan becomes law. There was not even agreement among news stories on the number of people the plan would leave without insurance. The Palm BeachPost reported that Cooper "predicted [his plan] would provide insurance to nearly as many of the 37 million uninsured Americans as Clinton's plan." (Clinton's plan covers 100 percent of the uninsured.) The Washington Post quoted Cooper as saying his plan would cover "60 percent of the uninsured" (leaving 40 percent uncovered), while the Los Angeles Times noted that, "by Cooper's own estimate, the bill would not cover about one-fifth (or 20 percent) of those currently lacking health insurance."

No one pinned Cooper down on the numbers or interpreted them through the pocketbooks of families who would be affected. The bill calls for subsidies to help some families buy insurance, but what would happen if a family was too rich for the subsidies but too poor to buy coverage on its own? How would the family get insurance? Plenty of stories, however, quoted Cooper's solution: come back in a few years and pass another law to help these people out.

"Where were the stories that examined whether the Cooper plan would actually reduce costs of the health care system? Health care purchasing cooperatives are the main instrument of cost containment, but in Cooper's plan only employers with fewer than 100 workers are required to obtain coverage through them, if they want to continue deducting the cost of health insurance for their workers. This arrangement would leave all other employers free to operate outside the mechanism for curtailing costs and to continue the status quo, if they wished. The Congressional Budget Office found that the earlier version of Cooper's bill would actually increase costs of the health care system, at least initially, a point reported by The New York times and The Washington Post in February 1993, but ignored in the latest wave of Cooper promotional pieces."

('Come back in a few years', eh?

We thought that is what we were doing this time around. We have waited since 1994, how long will the next wait be?

I think that persistant 20% represents the people who realize they may have to wait forever if we dont attack this problem now.

Wait a few years, eh?

Thats the same solution as the one Obama seems to be proposing by default, since he has not made any committment at all to the chronically ill. In fact, logic dictates that reductions in cost for the 'normal family' he mentions may come at the cost of INCREASING costs to the chronically ill. (Plus, he will have to overcome the hurdle of renegotiating WTO agreements that prohibit many cost cutting proposals like setting up an alternative healthcare system competing with private industry, which industries are going to say discriminates against them.)

I am looking for more info besides the Public Citizen report on the WTO agreement and how it regulates industries involved in foreign trade. There isn't much on the net. I will post more as I find them.
http://findarticles.com/p/articles/mi_qa5433/is_200101/ai_n21481314/pg_1
see page 33 material on GATS Article VIII, Monopolies and Exclusive Service Suppliers
American Journal of Public Health.. Global Trade and Public Health -- Shaffer et al. 95 (1): 23 ...
http://www.ajph.org/cgi/content/full/95/1/23

Tags: 2010 elections, adverse selection, Betrayal, denial, mandate, twenty percent, universal healthcare (all tags)

Comments

78 Comments

Mind the gap from your conclusions leap.

Well, that 20% figure keeps coming up again and again, and I think that it represents the 20% of Americans who have chronic illnesses.  

Correlations and causations and all that.

Besides that, Democrats in need of healthcare aren't delusional enough to believe McCain would better provide for them than Obama. Don't insult these people.

by Firewall 2008-06-08 03:57PM | 0 recs
Re: Mind the gap from your conclusions leap.
Gap?
It's a Chasm!
by Kysen 2008-06-08 03:59PM | 0 recs
Re: Mind the gap from your conclusions leap.

Speaking of Chasm (TOTALLY RANDOM ASIDE):

There is a GREAT online flash game (point and click type) called Chasm, I recommend it to anyone who likes puzzles and wants to kill a few hours.

It's here:
http://www.abc.net.au/gameon/chasm/chasm game.htm

by Kysen 2008-06-08 04:02PM | 0 recs
Its a lot more logical conclusion than most

of the denial I see from the Obama camp.

Lesser of two evils is not a winning election strategy!

by architek 2008-06-08 04:02PM | 0 recs
architek, there are only 2 camps now

the Obama camp, and the McCain camp. Which are you in?

by Travis Stark 2008-06-08 04:32PM | 0 recs
Re: architek, there are only 2 camps now

I think the evidence would suggest otherwise.

by SophieL 2008-06-08 04:48PM | 0 recs
And what evidence would that be?

by Travis Stark 2008-06-08 05:49PM | 0 recs
Re: And what evidence would that be?

Look around, read some of the comments. There are still more than two camps.

by SophieL 2008-06-09 04:35AM | 0 recs
Re: Like Catfish, Architek

You are becoming boring and loathesome.

It's over.  Deal with it.  You can't change the fact that your candidate lost.

Save your criticisms until (if) Obama gets into office.  Until then you look like a bitterman.

It's not a pretty sight.

by LtWorf 2008-06-08 05:51PM | 0 recs
Re: Mind the gap from your conclusions leap.

20% = 3.6 million votes( 18 million votes for her). now if it 20% that will vote mcCain... there in lies a problem.

we have also see how many independents now have changed their mind after Wright issue and 'bitter ' comment. even though pundits said wright did not hurt him...

obama's 2nd half losing streak started at PA. just 2 weeks prior to PA the wright issue broke ( I think , correct me if I wrong) . But heh- adding to the confusion was OH and TX which he lost before the wright issue.

so bottom line, I'm a go Hillary for VP. why risk it?

by aliveandkickin 2008-06-08 05:20PM | 0 recs
Re: Mind the gap from your conclusions leap.

Well, I'm assuming that if Bill would agree to complete transparency re: the foundation donors, the library donors and his income over the last eight years, she would be amongst the finalists. So far, we've seen no evidence to suggest that there is a willingness to open the books, so I can only assume that it will be a sticking point.

by Poor Yorick 2008-06-08 06:14PM | 0 recs
Re: Mind the gap from your conclusions leap.

I'm chronically ill with pre-existing conditions, absolutely uninsurable, and I don't feel abandoned by him at all.  I'm supporting him with all my Democratic heart.  

by whognu 2008-06-08 04:44PM | 0 recs
Me, too.

I support Obama despite my pre-existing conditions. My wife with RA supports Obama. I guess we're in a different 20% than those the diarist was claiming to speak for.

by edg1 2008-06-08 05:48PM | 0 recs
Re: Mind the gap from your conclusions leap.

How dare you contradict the assertions of the Architek?!

by username 2008-06-08 06:17PM | 0 recs
Re: Mind the gap from your conclusions leap.

"Correlation and causation"?  You give the OP too much credit.  This is more like "The human body has 2 kidneys.  The human body has 2 lungs.  Therefore you can breathe with your kidneys."

by username 2008-06-08 06:15PM | 0 recs
The problem is

that you premise is wrong.  CBS this week had Obama winning Democrats 80-12.  Rasmussen also has Obama at 80 among Democrats.

Obama' percentage among Democrats is higher than Gore's was at this point.

Obama is not bleeding Democrats.

by fladem 2008-06-08 09:03PM | 0 recs
by lollydee 2008-06-08 04:02PM | 0 recs
The uninsured?

THAT'S the 20%? Really?

Let's see.. who will more likely change their insurance prospects for the better.. McCain or Obama.. hmm...

by rhetoricus 2008-06-08 04:04PM | 0 recs
Re: The 20% Obama

You know, you're taking the insanity of a single issue voter to a whole new level.

Look, I hate to break it to you, but you've got two choices.  One guy will do, at the absolutely most charitable, a little to lower prices for individual policies.  The other guy will try like hell to get us closer to universal health care.

You will not have any other options this year.  If you want true UHC, then when President Obama makes this a big issue, lobby Congress to pass the version you would prefer.

Your war is not over, but you will absolutely never win it by digging into the candidate who wants something fairly similar to what you want.  All you'll do is help McCain, who is not your friend on this one.

Do not let the perfect be the enemy of the good.

by Reaper0Bot0 2008-06-08 04:08PM | 0 recs
Presumptive..

..

by architek 2008-06-08 04:13PM | 0 recs
Re: Non responsive

by interestedbystander 2008-06-08 08:45PM | 0 recs
Re: Presumptive..

Unrepentant liar and shill.

Hey, this is fun!

by Jay R 2008-06-09 01:00AM | 0 recs
Re: The 20% Obama Can't Afford To Abandon or Lose

Whatever.  This is getting tiresome, to say the least.  

Don't want to vote for Obama and his health care plan?  Fine!  Just be prepared to swallow whatever crap health care plan McCain and the republicans have to offer.

by rf7777 2008-06-08 04:12PM | 0 recs
If McCain gets his way, we might not be able to

withdraw our healthcare sector from WTO DOHA round jurisdiction because it would be prohibitively expensive.

So the issue may become moot.

This seems as if it would be a good issue for Obama to bring up, but, not a peep.

Why?

by architek 2008-06-08 04:15PM | 0 recs
ZOMG!

He wants the sick people to die, thereby furthering his nefarious eugenicist agenda!!!

Geez, dude.  Just give it up.

by username 2008-06-08 06:20PM | 0 recs
Re: The 20% Obama Can't Afford To Abandon or Lose

Due respect, but according to you guys, the 20% figure was more like 40% a week or two ago. Give it another couple weeks, and Dems will be voting for the Dem nominee at rates higher than Republicans are voting for McCain.

As far as healthcare, I agree with everything that's been said here - two choices: one candidate who will fight to provide healthcare to all Americans, and another who more or less supports the status quo. I know you don't like to hear it, but it's the truth.  

by authority song 2008-06-08 04:13PM | 0 recs
Presumptive?

So, you presume that Obama wont have to address any difficult questions at all, not even after the convention?

by architek 2008-06-08 04:18PM | 0 recs
Re: Presumptive?

That's not at all what I said, and I hope once he gets into office you hold his feet to the fire on whatever issues are most important to you. I know I will.

Healthcare is not terribly important to me, since I am a) relatively healthy and b) fortunate enough to have coverage through my job. Don't get me wrong, I support a single-payer system, but more for abstract economic reasons than tangible, personal reasons. So I hope you'll forgive me for not joining you on this particular issue.

One thing that's important to me that Obama has not addressed nearly enough to my liking is education reform. I believe strongly in fair access to education and I know we don't have it now. I want incentives for colleges to a) more more coursework online, eliminating geography for those who can't move and b) eliminate tuition costs for all students. I'd also like to see the community college system revamped entirely and made into a world-class network of trade schools focusing on 21st-century industries, as well as a place for those looking for redemption for poor high school grades or those getting a late start in formal education.

He hasn't talked about it enough and I don't think his plans go far enough - but I know he'll be a damn sight better than John McCain on the issue. So I'll get him in office and pressure him when he's there, when he owes me for my vote and my money.

by authority song 2008-06-08 04:29PM | 0 recs
Re: Presumptive?
That's not at all what I said,

Not important.  That's what The Architek wants you to have said, and that is all that matters.
by username 2008-06-08 06:21PM | 0 recs
Re: The 20% Obama Can't Afford To Abandon or Lose

Architek, as a die-hard Clinton supporter, I mean this in the kindest possible way:  you're nuts.

I'd be surprised if more than a fraction of one percent of voters are holding off from supporting Obama at this point because of health care.   A few percent may, in fact, as some in the Obama echosphere suggest, be racist.   A great many more are simply pissed that once again the woman gets screwed and that there's a widespread double-standard, both among Democrats and in the media.  Probably not a few are just so pissed off about the cult-like approach of the Obama true believers that they're looking at travel brochures and residency requirements for Outer Mongolia.   And some, like me, think the whole change/transformation/unity/post-partisa n soup is a crock of shit but, unlike me, haven't yet sucked it to commit to vote for Obama in November.  (It's the latter group I'm interested in speaking with.)

But please don't project your own single-issue fervor on to everyone else.  There are always a multitude of reasons.

by InigoMontoya 2008-06-08 04:18PM | 0 recs
Ulaan Bataar is beautiful this time of year..

Seriously..

;)

by architek 2008-06-08 04:20PM | 0 recs
Cult

Would it be possible to drop the cult stuff.  If you think we (Obama supporters) are full of crap, fine.  Just give reasons.  I'm too old and too roadworn to have that kind of language used to describe my reasoning.

by mady 2008-06-08 04:37PM | 0 recs
Re: Cult

The Obama is wonderful, aren't you inspired, he is so transformative, he's leading us to a transformative future, and if you don't agree than you just don't understand, and, besides, the Clintons eat live kittens for breakfast and there's no difference between them and McCain and how dare you not appreciate Obama, for he is awesome in his Wonderfulness and is the Anointed One.

That cult stuff.

by InigoMontoya 2008-06-08 04:49PM | 0 recs
Re: Cult

Not why I supported him, not why my family did.  Is a great way to disconnect from any useful discussion.

by mady 2008-06-08 04:51PM | 0 recs
Re: I saw similar attitudes

My passion for Clinton never led me to claim that she was flawless or to indulge in tripe about "transformation."

by InigoMontoya 2008-06-08 05:26PM | 0 recs
Re: Two Words Indigo

Harriet Christian.

SHE did more to project that cult meme on Clinton supporters than anything an Obama supporter did.

Get off it it.  Folks were scary on both sides.

by LtWorf 2008-06-08 05:55PM | 0 recs
Re: I saw similar attitudes

I believe you when you claim to not be part of the Clinton Cult. A more apt description is that you are a member of the Anti-Obama Cult, i.e. those who cultishly believe that denigrating Obama is an honorable, even religious, thing to do.

by edg1 2008-06-08 05:56PM | 0 recs
Re: The 20% Obama Can't Afford To Abandon or Lose

I posted to this on another thread last night.  I am reposting that here with the addition of a statement below it from Obama's website under his healthcare platform:  

Architek,

I've just finished work and I'm really beat, and I want to respond to your health care questions with my take on Obama's plan, Clinton's plan and what really needs to happen, which is neither, but universal single payer.  

I don't know if you were around when Medicare was passed.  Johnson passed it (one of our great presidents in my book, Vietnam notwithstanding).  It seemed improbable/impossible until it was a done deal.  By the way, it was originally designed as coverage for all Americans but the "socialized medicine" stupid tag stuck and it was pulled back to cover the elderly and disabled.  It took 20 years to get there.

Finally, I think, the idea of federally insured (one way or another) health coverage is starting to seem "natural."  I believe that after 60 years of proposing this, people are finally feeling "natural" with the idea of it.  I also think that the differences between Hillary's plan and Obama's are not great, Obama goes the route of heavier protection by government, Clinton by the workplace, and neither offer the kind of single-payer plan we need.  My feeling is that going down this road in an economy where people do not even have the sort of jobs that can be mandated to pay will make providing Federal guarantees the only route possible and will lead to a single-payer system (Medicare works).  

Furthermore, this is Hillary Clinton's dream, a healthcare system that works for everyone, and she wields a great deal of power in spite of the primary loss, and I feel strongly this process belongs to her if she wants it, in whatever role she chooses to play.  

I understand you have a personal situation that makes this all the more pressing an issue, not even an issue but a desperate reality.  I am in that place too.  I wish you would look at the next Democratic presidency as deserving of your support because we are the ones who cooperatively, House, Senate, Executive, undertand the need to get this done, particularly with the economy tanking and this just adding to the desperation of people who are losing jobs, finding food difficult to buy, etc.  

I wish you would take another look at Obama's health care policies, and also assume that he will not be working unilaterally if he wins this election; and he must or too much is just going to go down the tubes.

An addendum from his website:

"Comprehensive benefits. The benefit package will be similar to that offered through Federal Employees Health Benefits Program (FEHBP), the plan members of Congress have. The plan will cover all essential medical services, including preventive, maternity and mental health care.

Affordable premiums, co-pays and deductibles.

Subsidies. Individuals and families who do not qualify for Medicaid or SCHIP but still need financial assistance will receive an income-related federal subsidy to buy into the new public plan or purchase a private health care plan."

I think mandates on companies are useless because those worksites that could afford to honor mandates already offer their employees plans, the smaller companies cannot.  I think it is a responsibility of government to provide either universal single-payer or a mechanism from the government, as in Obama's platform above, to help individuals purchase insurance.  

by mady 2008-06-08 04:20PM | 0 recs
Some questions..

1.) Obama's ""National Health Insurance Exchange" is a health insurance risk pooling mechanism. (Hillary Clinton's healthcare plan would have been too, obviously) However, under WTO rules, "a new risk pooling system that has the effect of stopping foreign insurance firms from establishing new insurance businesses - for instance, because as a start up they cannot meet the requirements set for access to a risk pool of prospective U.S. clients - qualifies as a WTO-forbidden restriction on market access, even though that is not the intent of such a policy"

It seems to me that this will take years, so we need to start a dialogue on how we will do it now. Also, if you read a diary I posted yesterday, a provision of McCain's healthcare proposals could have the effect of locking us in to the WTO jurisdiction rules forever. This is a problem that we should be looking into as Democrats and using as an issue against McCain. That we have not, makes me nervous about our seriousness on reducing costs.

2.) Obama claims that he will make insurance companies quote everybody a 'fair price' and that if they can pay that 'fair price' that 'they cannot be turned away'

This could have two possible outcomes, if it is undertaken without both a mandate and a premium cap.

a.) It would result in the chronically ill being quoted prices that were still too hgh for them to afford, so it would have zer impact in making insurance affordable for them.

b.) If Obama decides to force insurance companies to ignore risk and only price insurance by age, then the overall cost to buy insurance would multiply by at least 100% for everybody, making insurance for the vast majority of purchasers more expensive than it is now in most US states.. (some already do this, and insurance is very expensive there)

I agree with you, single payer is a more common sense solution, but Democrat after Democrat has told me that it is impossible, SO I am trying to figure out HOW Obama will do what he says he will.

I just can't figure out where the money will come from. Does he have a magic hat?

I have read Obama's sketchy publications on healthcare, and Ive seen the lingo that clues me in to the loopholes I have described. Others - experts who do this kind of analysis for a living,  have explained to me that I am right.

:(

by architek 2008-06-08 04:48PM | 0 recs
Re: Some questions..

Okay, this is my take.  We are heading with a new adminstration, whether it was Hillary's or Obama's, towards a New Deal Solution level crisis situation.  This is rapidly becoming, for myriad reasons, 1930, and this election the election of 1932.

Therefore, the unaffordable, I believe, is going to become the inevitable within a short period of time. I think this presidency is so extremely important because right now crisis = opportunity, and nowhere does that apply more than in establishing universal health care.  Since Reagan, every president including Bill Clinton, has been disabling the New Deal social infrastructure and philosophy.  It is time to take that back for the Democratic party and for the middle class and poor of this country.  

I believe we have hit a situation where only that level of reform is going to make any difference at all in our citizens' lives.  Whether it was to be Obama or Clinton, there is a hunger for healthcare, a decent energy policy, etc. (the list of emergencies goes on and on).  

I would put your faith not in Obama, not in Clinton, but in the potential for the crisis we all are in (as you personally are) to make it possible to institute radical changes in the social contract over the next few years.

by mady 2008-06-08 05:02PM | 0 recs
I hope so..

A good start would be a level of honesty on the difficulty and an appeal for understanding and help, not a set of promises that could not sustain themselves.

I see Obama's plan as a delaying tactic, exactly like Jim Coopers was in 1994.

And it succeeded.

The economy was pretty bad in 1994 too, or don't you remember.

by architek 2008-06-08 05:22PM | 0 recs
Re: I hope so..

It succeeded?  Hillary wouldn't negotiate.  Had they actually employed his plan (much less one that was a blend of the two) we'd have had UHC years ago.

Please, please understand that compromise isn't an evil if it gets you closer to your goal without closing the door on eventually getting it all.

What happened in 1994 was as much Hillary's fault as anyone else's.  I hope she learned from her mistakes.  

by Reaper0Bot0 2008-06-08 05:31PM | 0 recs
succeeded in delaying..

succeeded in killing it, is what I meant..

If that wasn't obvious, I'm sorry..

Thats what everyone saw as happening and it was intentional..

I don't remember 1965 but I do remember 1994.. and it was clearly torpedoed by the right, WITH THE ASSISTANCE OF RIGHT WING DEMOCRATS..

by architek 2008-06-09 03:51AM | 0 recs
Re: succeeded in delaying..

If you read the analysis, you would realize that Cooper's 'plan' wasn't universal healthcare as it would have left around one fifth of Americans (those who needed it the most!) without any care at all, because 'it was too expensive'.

Are you trying to say that is universal healthcare, because it isn't. You keep making these same misstatements and you also ignore the same inconvenient truths over and over again, which makes me think you are pretty well organized in your OPPOSITION to UHC.

Do you really think that adopting something that would crash and burn and create a huge amount of pain and alienation, as well as help dehumanize and marginalize one fifth of all Americans (because their costs would go UP) would be helpful to the long term goal of all Americans? I think its a step on the road to evil.

>It succeeded?  Hillary wouldn't negotiate.  Had they actually employed his plan (much less one that was a blend of the two) we'd have had UHC years ago.

>Please, please understand that compromise isn't an evil if it gets you closer to your goal without closing the door on eventually getting it all.

>What happened in 1994 was as much Hillary's fault as anyone else's.  I hope she learned from her mistakes.  

by architek 2008-06-09 06:19AM | 0 recs
Re: I hope so..

I completely agree with you there.

This is a political campaign, however, and every single candidate walks the fine line between honesty and not disturbing the cocoon that many people walk around in to avoid hearing the truth.  I am not sure that any candidate in a long while has had the gumption to do that; I hope Obama does.

Remember Carter in his sweater talking just about conservation, and the repercussions of that.

Roosevelt did it.  I was looking at his campaign and he was detailed about the level of change that was going to happen when he became president.  I think Obama must do it to a greater extent than he has been even with the risk that entails.

by mady 2008-06-08 05:34PM | 0 recs
There you go again.. BLAMING THE VICTIM

Okay, now we are getting somewhere. Thanks for admitting the existence of this cocoon.

Thats a term I have used too.

BUT- Naive, struggling people don't create that cocoon. LYING POLITICIANS DO.

THEY DO IT TO PREVENT PEOPLE FROM DEMANDING WHAT THEY ACTUALLY NEED TO SURVIVE.

and so they will keep spending when they really can't afford to. Destroying their chances of happiness in the future to do so.

That is really evil..

by architek 2008-06-09 06:23AM | 0 recs
BREACH OF Fiduciary duty

http://en.wikipedia.org/wiki/Fiduciary_d uty

The fiduciary duty is a legal relationship between two or more parties (most commonly a "fiduciary" or "trustee" and a "principal" or "beneficiary") that in English common law is arguably the most important concept within the portion of the legal system known as equity. In the United Kingdom, the Judicature Acts merged the courts of Equity (historically based in England's Court of Chancery) with the courts of common law, and as a result the concept of fiduciary duty also became usable in common law courts.
"     A fiduciary is someone who has undertaken to act for and on behalf of another in a particular matter in circumstances which give rise to a relationship of trust and confidence.[1]     "

A fiduciary duty is the highest standard of care at either equity or law. A fiduciary is expected to be extremely loyal to the person to whom he owes the duty (the "principal"): he must not put his personal interests before the duty, and must not profit from his position as a fiduciary, unless the principal consents. The fiduciary relationship is highlighted by good faith, loyalty, and trust, and the word itself originally comes from the Latin fides, meaning faith, and fiducia.

When a fiduciary duty is imposed, equity requires a stricter standard of behavior than the comparable tortious duty of care at common law. It is said the fiduciary has a duty not to be in a situation where personal interests and fiduciary duty conflict, a duty not to be in a situation where his fiduciary duty conflicts with another fiduciary duty, and a duty not to profit from his fiduciary position without express knowledge and consent. A fiduciary cannot have a conflict of interest. It has been said that fiduciaries must conduct themselves "at a level higher than that trodden by the crowd"[2] and that "[t]he distinguishing or overriding duty of a fiduciary is the obligation of undivided loyalty."[3]

by architek 2008-06-09 06:26AM | 0 recs
Re: There you go again.. BLAMING THE VICTIM

The problem is, the placid majority tend not to want to hear difficult information unless they too become in crisis.  I don't know if what is going on today constitutes, yet, the kind of crisis that makes people open to hearing about those kind of changes (sorry, best word I can think of) without running back to the GOP in panic.  I'm thinking it does and I'm thinking Obama is exploiting that in a general way (promise of transformational change) but needs to exploit it with more specifics.  

I also belive that some of this is coming, and unfortunately what comes out in the campaign (McCain is already tossing around Obama's record on taxes, you know tax and spend, would have loved Roosevelt) encourages timidity with regard to talking about spending on this stuff not boldness.  The difference is I trust his underlying agenda and you do  not and I'm not sure anything will change that except his getting into office and one of us being proven right.

I have never argued "you can't vote for McCain, he sucks, you are a Democrat, blah blah."  But for people with healthcare issues in particular (my sister  is one, she works as an adjunct at a college, has no coverage and a modest income and chronic health problems, and pays a huge percentage of her earnings to basic health coverage and is starting not to be able to afford to do that) like you, not voting Democratic in this cycle is not even leaving the door open for positive change.  I would vote or Obama for no other reason than I am positive healthcare reform, whether enough or not enough, is at the top of his agenda and not even in McCain's.  I do it for my sister and for you if nothing else.

by mady 2008-06-09 06:45AM | 0 recs
Re: I hope so..

Neither of the candidates health care plans will make it through congress as proposed. Neither candidate is proposing a plan that works like social security rather they both depend on private insurers making them less then the ideal solutions but solutions that have a better chance of getting through.

Had Hillary worked with Cooper and congressional members of her own party the healthcare initiative she was heading would not have wound up a complete and total failure. We might have made the first step back then.

This will not happen in one shot. It will be an evolutionary process requiring a series of legislative measures. There is absolutely no evidence in the real world to suggest that healthcare positions are having any effect on any significant number of Clinton supporters reticence on Obama. All the polling and the public statements of that segment show that the problem is anger over sexism and treatment of woman especially in the media in this primary season.

Anyone concerned about healthcare will not be considering any Republican. The more of the government Democrats control the more comprehensive a healthcare plan we will get. McCain would veto anything that looked like either of the candidates proposals. The chronically ill have more a vested interest then any to see that Obama is president and Democrats win big downticket.

by hankg 2008-06-08 11:15PM | 0 recs
Re: The 20% Obama Can't Afford To Abandon or Lose

I have to wonder if the diarist is even familiar with Obama's health care proposal, or if they are simply repeating the (former) talking points from the Clinton campaign.
Obama was and is pushing for universally AVAILABLE health care with a government funded option. The idea is that the government funded option is the insurer of last resort, and helps to push the Insurance prices down so that they are affordable for all Americans.

I know a lot of people are pro-mandate, and there are positives and negatives to that idea. But the concept that the "under 60,000" per year crowd would be automatically covered due to a mandate is incorrect. What the mandate would do is FORCE those people to pay for the medical insurance. If they didn't pay, there would have to be some sort of penalty for NOT paying. At this point, our government would be backed into the position of garnishing the wages of minimum-wage 22 year olds to force them to pay for health care.

Not only that, but a health care mandate would be damn near impossible to get through congress, even a democratic congress. FORCING everyone to buy something . . . anything, from private corporations is a scary proposition. Yes, we do it with car insurace, but people have the option not to drive. They don't have the option not to LIVE.

Also, likely most people who couldn't afford it would choose to NOT pay or insurance in spite of the mandate. Now, instead of just being without health insurance, they are without health insurance AND breaking the law. (The closest estimate for these people is about 15 million Americans. Right about the same number as wouldn't purchase insurance under the Obama plan.)

It's true that Hillary never specified what the penalty would be for ignoring the mandate. But without knowing the penalty, how do we know how effective the mandate would be? If it's too lenient, it's meaningless. If it's too harsh, it would look like the government is kicking the poorest while they're down.

I know that a lot of people here support the mandate, so how about it? How would we correct the problems listed above?

by EvilAsh 2008-06-08 04:26PM | 0 recs
Re:

Although I oppose universal healthcare and am supporting Obama in spite of his plan, I'm still going to have to call bullshit on this.  Every presidential election, about 10-20% of Democrats vote for the Republican nominee.  I suppose they were disillusioned single-issue healthcare voters too, eh?

by XoFalconXo 2008-06-08 04:33PM | 0 recs
What must be...

acknowledged is that we do need single payer, universal health care.  But, to do it right must take time.  

We need to keep the end goal of single payer, universal care in mind.  This is not something we should rush into, if we do, it will fail.  The plans mentioned in the diary, though far form perfect, are good foundations form which w can start.

The diarist is right, the lesser of two evils is not a winning strategy, BUT, the diarist needs to acknowledge that we have to start somewhere and Obama is providing a solid stepping stone.  McCain is not, he is more, actually, he is less of the same.  

Where, diarist, do we prefer we start form? Obama or McCain?  Please, don't think of it as the lesser of two evils, think of it as which is the better starting point.

by igottheblues 2008-06-08 04:34PM | 0 recs
Obama's plan is NOT IN ANY WAY

a "solid stepping stone". Its a joke. Its a joke designed to deceive because the numbers dont add up.

Thats a very inauspicious start don't you think?

None of you have really thought about the mechanisms that would make anything like universal healthcare possible. Obama's plan just doesn't make sense in a number of critical ways and you are ignoring the plain as your face issues that I have repreatedly brought up and trying to tell me that what you say 'is true because you say so'.

That is not the way to prove anything!

You are taking Obama's minions at face value which is extremely foolhardy because DECADES OF RESEARCH IN AT LEAST 30 COUNTRIES SAYS YOU ARE WRONG.

You are in deliberate denial.

by architek 2008-06-08 04:55PM | 0 recs
First off...

way to get personal.  Second, I don't discuss in ad hominem.

Cheers!

by igottheblues 2008-06-08 05:01PM | 0 recs
Re: What must be...

Look at the history of single payer.  Man, has it been kicked around for a long time.  There even was a time in the early 20th century when the AMA advocated for it and the AFL opposed!

We do need it now and that is what we need to lobby our reps, the new president, everyone involved in the process, to get.

http://www.pnhp.org/facts/a_brief_histor y_universal_health_care_efforts_in_the_u s.php?page=1

by mady 2008-06-08 06:00PM | 0 recs
20%? That's not too unusual actually.

There are plenty of people who are registered as Dems because of local issues but who vote GOP nationally.

by LiberalDebunker 2008-06-08 04:44PM | 0 recs
Re: The 20% Obama Can't Afford To Abandon or Lose

With Obama you've got a shot at better healthcare coverage. With McCain? Nothing.

So you'd rather stay disaffected and discouraged, etc, or vote McCain in the fall, and ensure you don't have ANY hope of UHC?

C'mon....

by Yalin 2008-06-08 05:10PM | 0 recs
A shell game..

..

Thats what you are describing.

Thanks!

by architek 2008-06-08 05:14PM | 0 recs
Re: A shell game..

No, it is not.  Please look it up before you start using terms like that.

by Reaper0Bot0 2008-06-08 05:32PM | 0 recs
Re: A shell game..

And what you are talking about is shooting yourself in the head, lest you aim at the target and the bullet bounce back and graze your leg.

Seriously, I'm tired of this.  If you want health care your way- get loud about it.  Join a PAC.  Start a PAC.  Make noise.  Realize that NEITHER Clinton nor Obama's plan, if and when it gets through, are going to look a thing like they do now.  Maybe better- maybe worse.

But calling us "minions" and "Obamabots", when if you think it through, we're the ones on YOUR side.  Not the Republicans.  Single issue voter all you want, but you're in a rapidly decreasing minority.  Play on our team and you have a shot.  Insulate yourself in a corner and cry because your team isn't led by the person you want, and you might as well give up now.

by ihaveseenenough 2008-06-08 05:32PM | 0 recs
Re: The 20%

Truthfully Obama's plan is no better than McCains. He's already conceded major points in the plan so none of it is likely to get passed. He didn't fight for healthcare when he was in teh IL senate. I don't see him really doing anything about healthcare. He just doesn't seem interested in it.

by Ga6thDem 2008-06-08 06:54PM | 0 recs
Re: The 20%

That does not reflect reality or Obama's voting history in Illinois at all.

by BrighidG 2008-06-08 07:15PM | 0 recs
Re: The 20% (Of All Of Us) Obama Can't Afford To A

McCain had 30% of Republicans who wouldn't vote for him right after he clinched the nomination. Right now he has lowered that number to 16%.  

For Obmam having 81% of Democrats now supporting him, before much has shaken out, is not bad.

by politicsmatters 2008-06-08 05:47PM | 0 recs
Re: The 20% (Of All Of Us) Obama Can't Afford

Exit Polls:

2004 Kerry Dems: 89% Party ID Dems: 37%

2000 Gore Dems: 86% Party ID Dems: 39%

1996 Clinton Dems: 84% Party ID Dems: 39%

2008 Obama Dems: 81% Party ID Dems: 41.7%
And this is six months out from the GE, days after ending a hard-fought primary. I'm not worried.

Sources:
http://www.cnn.com/ELECTION/2004/pages/r esults/states/US/P/00/epolls.0.html

http://www.cnn.com/ELECTION/2000/results /index.epolls.html

http://www.cnn.com/ALLPOLITICS/1996/elec tions/natl.exit.poll/index1.html

http://www.rasmussenreports.com/public_c ontent/politics/mood_of_america/party_af filiation/partisan_trends

by Lokichilde 2008-06-08 06:08PM | 0 recs
So...

Twenty percent of the likely Democratic voters are going to vote for McCain because Obama doesn't have mandates but Hillary did.

Sounds logical to me!

From the same Rassmussen link that you provided at the top:  Obama 48, McCain 40.  And:

Obama's bounce is the result of growing unity among the Democratic Party. Eighty-one percent (81%) of Democrats say they will vote for Obama over McCain. That's the highest level of party support ever enjoyed by Obama.

I may be one of the few people here who actually DOES NOT have health care, and DOES have chronic health problems.  I've just been through this charade before.  The Clintons promised us healthcare back in the nineties.  They had eight years to do it.  They didn't.  Supposedly, if we give them eight more years (sixteen total), they will do it this time, for sure, guaranteed!  

I'd rather take my chances with Obama.  

by Dumbo 2008-06-08 06:24PM | 0 recs
Re: So...

Mojo'd for your tag line--though I think it's more properly phrased as "for whom you vote."

Not that you give a shit. :)

by Captain Bathrobe 2008-06-08 06:33PM | 0 recs
Re: The 20% (Of All Of Us) Obama Can't Afford To A

20% and shrinking. I predict in 1-2 mos from no there will be almost ZERO talk of Hillary supporters voting for McCain.

by Democrat in Chicago 2008-06-08 07:16PM | 0 recs
I'm not going to vote for McCain..

It would be nice if some pro-Obama folk addressed the actual issues I've been trying to bring up, rather than simply changed the subject.

by architek 2008-06-08 07:40PM | 0 recs
Re: I'm not going to vote for McCain..

Once you became a full-on, admitted liar in your pursuit of attacking Obama, you ceased to enjoy the right to a debate.  All you're entitled to is the ridicule and scorn you've so ably earned through dishonesty and vitriol.

Hope that clears things up for you.

by Jay R 2008-06-09 01:08AM | 0 recs
20% of the likely Democratic voters

Sunday, June 08, 2008

The Rasmussen Reports daily Presidential Tracking Poll for Sunday shows Barack Obama's bounce growing to an eight-point lead over John McCain. Obama now attracts 48% of the vote while McCain earns 40%.

When "leaners" are included, Obama leads 50% to 43%. On Tuesday, just before Obama clinched the nomination, the candidates were tied at 46% (see recent daily results). Data from Rasmussen Markets gives Obama a 94.7 % chance of winning.
Obama's bounce is the result of growing unity among the Democratic Party. Eighty-one percent (81%) of Democrats say they will vote for Obama over McCain. That's the highest level of party support ever enjoyed by Obama.

In short. This diary is retarded.

by Freespeechzone 2008-06-08 08:32PM | 0 recs
19% are pissed off.. Thats awfully close to 20%

Thanks for the kind words..

by architek 2008-06-09 03:54AM | 0 recs
No thanks for the dumb diary

that is contradicted by its own link.

by Freespeechzone 2008-06-09 08:24AM | 0 recs
Re: I have a chronic illness

Pleurisy and bronchitis for Obama here!

by Jay R 2008-06-09 01:03AM | 0 recs
Insurable/uninsurable

Applicants with abnormal spirometry values can be insurable, but it is important to identify the underlying cause of the abnormalities. While the spirometry test can point to either an obstructive or restrictive disorder, it does not diagnose the exact lung disorder. A complete history, physical examination and additional testing are essential in formulating a correct diagnosis.

Once the exact disorder has been identified, its potential for progression and severity, the applicant's smoking history and spirometry findings can be used to determine insurability.

The following items should be kept in mind when using spirometry for underwriting assessments:

1. Spirometry is not a "fool proof" test.

Spirometry is "effort dependent" which means the patient has to give 100% to get an accurate result. It is a simple test, but one that suffers from poor coaching and poor effort on the client's part in many cases. When in doubt, repeat the test. As in all underwriting evaluations, underwrite the overall applicant and not the test.

2. Make sure you know the real smoking history.

The smoking history is a crucial piece of underwriting information in the face of symptoms (i.e. shortness of breath) or abnormal spirometry findings. It is not enough to simply know that the client "used to smoke but quit." Quantify how many years smoking, how many packs a day and exact date of the client quit.

3. Spirometry rarely appears in a medical file as a routine test.

Unlike blood pressure testing, spirometry is not a routine test for 80% of U.S. practitioners. If you find a spirometry test in a medical file, you need to find out why it was ordered, even if it is normal.

4. FEV1 values of 40% or less indicate severe disease.

Applicants with a history of chronic bronchitis or emphysema and FEV1 values of 40% or less are uninsurable for individual coverage.

5. Find out the client's medications.

It is important to know what medications the patient is taking at the time of the spirometry; especially those used to treat lung disorders (i.e. inhalers, antibiotics, etc.).

by architek 2008-06-09 06:33AM | 0 recs
Re: The 20% (Of All Of Us) Obama Can't Afford To A
actually it is more than 20%.
All my family, relatives and many friends are very pro-Democratic and voted for Democratic candidates for a long, long time.
However all of them will vote for McCain in November.
by engels 2008-06-09 03:54AM | 0 recs
Re: Your friends and family
i see you are trying to joke - guess what: you failed, it is not even funny.
You will know in November: I meant people like me will defeat Obama.
We are not going to lay down and submit to danger: we will fight for our country, our way of life and our freedom.
We do not have blind trust to changeshit and hopeshit and we are not going to join any cult.
by engels 2008-06-09 10:08AM | 0 recs
Bullsh*t on not having money
Any politician who tells you that they can not pass a policy whether it is healthcare, job creation, etc because there is not enough money is lying to you. If we cut the Pentagon budget by 10%, we would have enough money for Single Payer.
If we close the hedge fund tax loophole we would gain billions of money. Of course there is plenty of money for subsidies. Obama is lying to you when he says there is not. Maybe if Obama has the guts to cut Pentagon spending and hold them responsible, we would have enough money to cover everyone. What Cooper is saying by not having enough money is that the health insurance industry profits would be at risk. What Obama is therefore saying since he agrees with Cooper and Goolsbe is that he is concern with Hillary and Edwards plan because he does not want to see the health insurance companies lose their record setting profits. I hope if Obama gets elected he puts Clinton or Edwards in charge of healthcare. Obama has only proven he would be a disaster by hiring Cooper as his healthcare spokesperson.
by harmony94 2008-06-09 05:15AM | 0 recs
Obama has only proven he would be a disaster by hi


>Obama has only proven he would be a disaster by hiring Cooper as his healthcare spokesperson.

>Obama has only proven he would be a disaster by hiring Cooper as his healthcare spokesperson.

>Obama has only proven he would be a disaster by hiring Cooper as his healthcare spokesperson.

However, it certainly helped him in the donation department, at least up until now.

by architek 2008-06-09 06:37AM | 0 recs

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