Healthcare and why Obama should be President w/ POLL

I am, and have been, enthusiastically in favor of universal health care. I've thought the best thing said about it in the past decade was the line from the west wing about deleting the words '65 and over' from the Medicare act (more on that later).

But Hillary Clinton's plan is not Universal Health Care. Neither is Obama's, and neither was Edwards', for that matter. Those plans are all variations of (semi)Universal Health Insurance plans, which are entirely different animals.

In this diary, I want to talk for a bit about the debate, and how, despite certain attacks seen here on Dkos and in the editorial pages of the New York Times, I believe the small, but substantial, difference between the two candidates is a strong demonstration of Obama's superior leadership abilities, as well as showing that Obama, not Clinton, will get us closer to the Holy Grail of single-payer health care.

::more over the flip::

Lately, it seems mandates have become a sort of litmus test for many, including the heretofore imminently respected Paul Krugman, with many on the extreme side of the argument going so far as to pillory anyone not in favor of mandates as a closet Republican-lite, or worse. But many of us have issues with mandates, and it's certainly not because we're in the pocket of the insurance or healthcare industries (I definitely haven't gotten my check, yet). A few of my personal problems include:

Medicare, Part D (redux): Bush's prescription drug benefit was, quite simply put, a windfall to Big Pharma. It forced seniors to enroll in a program which has serious flaws, and did nothing to address the skyrocketing cost of these medications. Merely, it just transferred more debt to our children's generation in the name of corporate profits, without doing much more than giving certain politicians a photo-op. I see far too many parallels with Hillary's plan here.

How can you mandate someone into a system which is as broken as our current healthcare system?  Are we simply to trust that the bill will be written in such a way that gives the people adequate protection from a predatory industry?

Well, sorry, I saw that show when it was called NAFTA, and I didn't like the third act so much.  But even assuming that the bill is written is a way that guarantees good care, and protects the low and moderate income people that would be hard pressed to add anything to their household budget, as it is, there is another problem.

Who's going to pay for it?: The Massachusetts plan has been put up as an example of a workable mandate plan, but, as many have pointed out, it leaves around 20% uncovered. This is because there are many more for whom paying the premium would be a hardship than there is money to pay for those people. Thus, exemptions were created, and the 'mandate' plan began to look suspiciously like an 'access for all who want it' plan in practical application.

Our national fiscal situation is dire, as we all should know. Where will we get the money to pay for those who's income is not enough to handle the added expense of insurance premiums? And, despite what some would have you believe, sane fiscal policy is not a 'right wing talking point'. It is called good government. But this question brings me to my final criticism of mandates, which is:

It has roughly zero chance of making it through congress: Even assuming we make big gains in this election, to get something like this passed, we would need a 60+ majority that was strongly in favor of it. When you factor in the many red state dems who would face diamond-producing pressure to defect on this issue, as well as the all out opposition with which the GOP would undoubtedly assault the plan, the numbers just aren't there. What is infinitely more likely is that it would be another failure, putting the cause of UHC back for another few years, if not another decade.

::

Barack Obama's plan, on the other hand, while having flaws of its own (the free rider problem is still an issue), has a much greater chance of making it through congress, in that it lacks that hot button issue of mandates. Also, as demonstrated by his ethics reform package, Barack is much more suited towards building the type of broad coalition that will be necessary towards getting any sort of health care reform through congress. This is New Deal level stuff here, people, and 50+1 ain't gonna get it done.

Barack Obama has consistently voiced his support for single-payer health care, but he seems to believe, and I agree wholeheartedly, that getting there will be an incremental process, and his current plan should be seen as a first step. An achievable first step.

And this is why I believe this shows a good preview of how Obama's Administration would function. You take one of our most highly idealistic goals (true UHC), ascertain the realistic political landscape, and come up with a plan which we can achieve realistically, and which moves us closer to that idealistic goal.

Far from being the substanceless dreamer he is accused of, this issue demonstrates Barack Obama to have a strong pragmatic methodology, which will be manifested in his administration in a steady march towards the progressive goals we all share. He will be able to put together the type of coalition necessary to achieve those goals, and he will go after them in such a way as to make them achievable.

And that, mi amigos, shows yet another reason why Barack Obama should be our next President.