An Internet hub with domestic and international news, analysis, original reporting, and popular features from the left, center, indies, centrists, moderates, and right

That Mighty Wave of Electoral Change & Why Hillary Clinton Never Saw It Coming

01aocean_wave.jpg

Hillary Clinton is a notorious control freak. Fifteen years ago, that resulted in the Hindenburg-like crash of her national health-care initiative, while more recently it was planted audience questions.

After years of meticulous planning, Clinton launched her presidential campaign on January 20, 2007 with the words “I’m in. And I’m in to win.” It must have seemed to her like a can’t miss proposition or something awfully close as the strongest Democratic candidate and with the Republican Party in disarray. She could be forgiven thinking that it would be she taking the oath of office exactly two years hence.

Further down in a CNN story on her announcement it was noted that Senator Barack Obama was filing papers to form a presidential exploratory committee. That news probably gave Clinton little pause since she would face competitors who probably would be more challenging, including John Edwards, Christopher Dodd, Bill Richardson and Joe Biden.

Nor is it likely that Clinton was concerned when Obama threw his hat into the ring three weeks later, drawing on a strategy devised with David Axelrod, his campaign chief of staff, in stating solemnly that “I recognize there is a certain presumptuousness — a certain audacity — to this announcement. I know I haven’t spent a lot of time learning the ways of Washington. But I’ve been there long enough to know that the ways of Washington must change.”

In fact, Clinton probably viewed Obama’s message as rank naivete. The mainstream media certainly did not take him particularly seriously and many pundits dismissed the message as a rhetorical high-wire act.

But now, some 13 months later, Clinton the control freak has lost control of her own destiny and is paying dearly for the kind of arrogance and hubris that has been a hallmark of the Bush administration.

Yes, she can hunker down and redouble her efforts on the stump. Yes, her presumptive firewall – voters in the delegate-rich Texas and Ohio primaries on March 4 – may stand and deliver. Yes, Obama may commit a gaffe of such magnitude that he is stopped dead in his tracks.

But the nomination suddenly and not implausibly seems to be Obama’s to lose as his message draws in one demographic group after another with every succeeding round of primaries and what initially was a fairly narrow base grows into a robust coalition.

In hindsight — and although the extent of this phenomenon can only be seen in hindsight — it’s not hard to understand why Clinton is eating Obama’s dust these days:

Clinton’s advisors didn’t have a clue that just beyond the range of the naked eye, and certainly beyond their smug experience as political establishmentarians whose big paydays arrive with quadrennial regularity, a mighty wave of Americans thirsty for change was building. A wave that would break on the electoral shore with such force that would obliterate practically everything standing in its path and drag out to sea all but the most hearty swimmers on its riptide.

Clinton herself certainly wouldn’t have had an inkling of that as she approved a campaign strategy in which she would position herself as Ms. Inevitable, her high negatives be damned, and her competitors would play themselves out nipping at her well-financed heels.

Although Obama surely believed in his hope-and-change mantra, I don’t think that even he understood the implications of beginning his improbable run just as that wave was breaking. This is because even if he understood that there might be sentiment for change that could be harnessed to his benefit, the profound hopes, fears, rack, ruin and war weariness packed into the wave could not be fully comprehended a year ago, while the energy that he has accrued from it is simply astounding.

Astounding in no small part because many of us in the punditocracy, myself included, never made much effort to put faces on the misery and ill will that George Bush has visited upon the land. They were an abstraction, not men and women, whites and blacks, rich and poor, struggling middle-class stakeholders, small businesspeople and disabled returning war veterans, who make the wave so powerful.

So now Clinton is clinging to the jetty, and her message of experience and nipping and tucking to fix what ails Washington seems paltry next to Obama’s bold vision of generational change.

The wave has broken. Will Clinton be able to fight off the riptide?



37 Responses to “That Mighty Wave of Electoral Change & Why Hillary Clinton Never Saw It Coming”

  1. jdledell says:

    Shaun – Well said. I was a Richardson supporter and never gave much thought to Obama. I consider myself a policy wonk and even though I agree with most of Clinton's policy prescriptions, the thought of Bush-Clinton-Bush-Clinton turned my stomach. It wasn't until I started to listen to Obama that I realized how much i hated our current Washington political atmosphere and approach to managing America. Obama has touched that part of my soul that yearns for something different. He is the only one who has recognized that we in America are not only on the wrong track, we don't even know where the train station is.

    I am realistic enough to know that Obama cannot accomplish all he or I would wish and dream for, but he will at least lead us to the right train station so we, and his successors, can find the right track.

  2. superdestroyer says:

    If Senator Obama really has a new, different way of doing things, then why are his policy proposals almost identical to Senator Clinton and so boilerplate Democratic?

  3. cosmoetica says:

    SD: you simply never look at details. One of the reasons why Obama is popular with Rs is that, unlike Hill, who proposes top down bureaucratic solutions to myriad problems, Obama wants to empower local governments and private orgs and charities thru gov't, to work from the bottom up, so that most $ is not lost thru middlemen and grafters.

    Of course, will it work is the q. But the Repub's malign neglect and the Dems' gov't as nipple tack surely have failed, so a 3rd way is needed.

    That's why O's ways are not boilerplate Dem, and there are Obama Repubs.

    When next you take time away from your racial theorizing, take a look at some of the policies enumerated.

  4. superdestroyer says:

    Cosmetica,

    Please give an concrete example of the heavy hand of the government.

    Look at healthcare. The federal government will create another round of healthcare regulation including an expensive Guaranteed eligibility, federal determination of benefits, federal control of health insurance marketings, federal subsidies (read taxpayer subsidies), federal mandates on treatment of chronic diseases, federally mandated reporting of quality data (the malpractice attorney full employment provisions), federal mandates on health care information systems (more money for high tech companies to sell continuous upgrades), and more federal mandates on hospitals, physicians, medical equipment suppliers, and drug companies.

    I fail to see the bottom up approach to his health care proposals but see a very heavy hand of the federal government that benefits trial lawyers, computer companies, and many other special interest groups.

    I also fail how a former black special interest attorney and Democratic politician from a one party city (Chicago) is really going to find a third way.

    As a civil rights activist and a state senator, Senator Obama had more than a decade to improve the schools in Chicago. His children's attendance at an elite private schools tells me more about what he can accomplish than all of the revival sermons that he gives.

  5. cosmoetica says:

    SD: Hillary wants to use existing insurance and governmental infrastructures to solve problems, like healthcare. On that score, Obama is fairly the same, whereas Mccain has no ideas at all.

    But, with the mortgage crisis, Obama is looking to get local and private agencies to take over foreclosed properties and in turn use tham as low income housing. Hillary on the other hand, wants to bail out many folk who have bad credit histories and will likely just default a few years down the line. Of the 100% who'd receive her help, let's be generous and say 25% of those might get back on their feet, but the other 3/4's would just be the problem again, in a few years.

    Obama, on the other hand, thinks that the deadbeats (of which there are many- they are not all 'victims') should be weeded out, and the banks should, instead of throwing good money after bad, use their losses to not extend the mortgage crisis, but use it to help with honelessness and poverty.

    That is a good ides, one that Hill or Mac have never thought of. When I heard both O and his wife speak of such I knew they were ahead of the curve. This is why Hill's claims of O's lack of substance is BS.

    As for healthcare, I think Obama's plan has flaws like Hill's, but he is more open to amending his plan, hopefully to use the existing Medicare infrastructure and expand it outward. Both O's current plan and Hill's plan, not to mention Mac's feeble ideas, would create NEW bureaucracies, whereas a Medicare expansion would not.

    As for a third way, I just outlined it, and if you listen to his speeches and read his arguments online, he has many other such ideas. Will all work? No. I don't think his healthcare plan is great, but it's better than what exists.

    The point is he's the only one of the three with new ideas and actively trying to seek them, rather than the failed policies of the past. And, BTW, even the World Bank admits the best anti-poverty programs are those wherein the money goes directly to those in need, not as handouts, but seed loans for enterprises. Obama understands this. Hill and Mac do not.

    As for trying to blame Obama for any probs in his state's schools. That's typical BS. How many legislators are there in the Illinois houses? And it's HID fault? Statements like that show that yuou have more in common with the idea-less past Hill and Mac represent.

  6. superdestroyer says:

    cosmoetica ,

    In reading the Obama website on health care, I thought it read like something a legislature would write instead of a chief executive officer. Every proposal will need to be introduced in Congress and a method decided on how to do it.

    Senator Obama even makes the same proposals that have already begun to fail in Mass. and the same proposals that will allow people to game the system and stick others with the bills. Increased mandates while cutting costs used to be called voodoo economics when Republican supplier-siders proposed it but it is called visionary when a Democratic candidate does it.

    If Senator Obama could not find a way to legislate for better schools in Chicago while in the Illinois State Senate even though he had young children who would soon be entering schools,, I believe it shows the limits of his I doubt that as chief executive officer of the U.S., he will really be able to legislate.

    I read his victory speech from the other night. It read like a list of promised future entitlements that will be paid for by someone else. He has asked for to sacrifice except from upper middle class and rich whites. Not exactly something that indicates a new method of thinking or visionary leadership. My guess is that he knew his kids would be attending private school before they were even born and why pick a fight with the teachers unions when poor schools and lousy teachers would never affect his own children.

  7. cosmoetica says:

    SD: 'Every proposal will need to be introduced in Congress and a method decided on how to do it.'

    So, unlike most politicos who speak as if they are being elected dictators, he is realistic about the process, and is willing to listen to other opposing and new ideas. And this is BAD?

    You then cite some probs, which I acknowledge with both his and Hill's plans, yet in the above, you chide him for being open. You simply cannot have your cake and eat it. This shows he is not a demagogue, and is open to change. Again, a positive. Do you really believe that any Prez- even the deified Lincoln reincarnate, could ever know all and solve all. You try things, but the key is to CHANGE when they fail. D and R Prezes in the past are both guilty of no change, with W the worst example of this trend.

    'If Senator Obama could not find a way to legislate for better schools in Chicago while in the Illinois State Senate even though he had young children who would soon be entering schools,, I believe it shows the limits of his I doubt that as chief executive officer of the U.S., he will really be able to legislate.'

    Again, he is one of how many Illinois legislators? And, as Prez I don't want him to legislate- and legally he cannot, but to propose ideas, and gather many people into a room and hammer out compromises. You know damned well that Hillary cannot and will not do so, and Mac is a little better, but hampered by his own lack of vision. So, this plaint is a canard, and a tired one.

    'He has asked for to sacrifice except from upper middle class and rich whites.'

    Not in any speeches I've heard. He has been aggressive in wanting to roll back the tax giveaways Bush gave. Hello?

    Your last comments are simple ad hominem.

  8. DLS says:

    The S.S. Clinton is swamped, but has not yet sunk or capsized.

    “TOP”: Texas, Ohio, and if needed, Pennsylvania. Then check.

  9. DLS says:

    “same proposals that have already begun to fail in Mass”

    They are failing. What's proposed at the federal level is papered-over incrementalism toward a federal takeover, with the ideal being the federal government as monopsony (“single-payer”). Edwards was the one among the three Dem majors who was honest about this.

    The insurance-based system is simply a variant on the early 1990s Clinton federal-takeover HMO-”alliance”-based fascistic scheme. (It's the Left in the USA that has engaged in fascism, touchy-feely style — “government-business partnerships,” industrial policy, managed cartels as we see here with health care, etc. “Single-payer” [sic] critics on the farthest left of HillaryCare were too dishonest or cowardly in decrying her plan — “shoveling vast sums of money into the furnaces of corporate greed” — by failing deliberately to call it what it was, fascistic.)

  10. DLS says:

    Obama's policy goals are nearly identical to Clinton's. The difference is in style.

  11. superdestroyer says:

    cosmoetica ,

    When Senator Obama is standing at at a rally full of blacks and college students and talks about increasing taxes on the rich, the audience knows that it is short hand for whites. Senator Obama wants to increase affirmative action (a welfare program for rich blacks, wants to increase 8a minority set asides (another welfare program for rich blacks), and is willing to give the teachers unions and government employees unions whatever they want (two career fields where college educated blacks are overrepresented and where there pay is increased to match tax increases).

    Senator Obama has gone out of is way to imply that the best way to fund massive new entitlements is to tax rich whites more.

  12. cosmoetica says:

    SD: Your characterizations of racial politicking says more about your parallax than reality. And you addressed nothing in my last post.

    DLS: Change is coming, so get used to it, in Healthcare. And, Edwards had the best plan of the 3, but it still was not far enough. Medicare open enrollment is the simplest and most cost effective way to solve this problem. Any other solution necessitates the creation of MORE government bureaucracies. The Medicare single payer idea takes the existing agency, and opens it up. It has proven to be by far the most cost-effective healthplan in the US, if not the civilized world, with a 4-5% overhead, compared to HMOs at 25-30%, and will cause the least ripples while giving the most effective coverage. All wd be the same, instead of having a few thousand payers, there wd be a single payer of all health costs.

    This will save money on the assorted industrieds in healthcare, outside of insurance- from hospitals to medical equip and drug makers, for they can streamline distributions and invoicing, reducing paper redundancies, and many other areas.

    The healthcare system will change. If you truly want to have the least gov't expense and intrusion, Medicare expansion is the best solution, by far.

  13. superdestroyer says:

    The 4-5% overhead is not true. It is a fiction created by looking at budgeted numbers in the Federal Budget. The new data collection mandates will be hugely expensive, the computerized record will be very costly because every couple of years all of the computers have to be updated and the records have to be pulled into the new system.

    A single payer system gives CMS the ability to control all of healthcare. If they do not like a procedure, a company, a drug, they just set the reimbursement below cost and everyone will stop doing it. It is like that now in oncology. The budget writers will be forced in a single payer system to keep cutting reimbursements and thus reducing supply of health care.

    Of course, there is no discussion of tort reform but in creating a ton of new mandates, the Obama Administration will create a million new reasons to sue everyone involved in health care. But, since lawyers are writing the policies, that was probably intended.

    Leave it to lawyers to create a health care industry that on one will want to work in. it will be better paying to be a GS-12 budget analyst at CMS than a nurse/x-ray tech/lab tech at a hospital. The nurse works nights, weekends, holidays, and when it snows. The GS-12 gets more time off and stays home in bad weather.

    What happens to the several million people laid off in the insurance industry, the pharmaceutical industry, the medical device industry, and the the health care industry? Remember, in those grand sermons where Senator Obama promised a high paying job for everyone while also promoting open borders and unlimited immigration. I guess he plans for using million of new immigrants to staff the healthcare industry because any native born person would have to be an idiot to work in health care under such government control and planning.

  14. DLS says:

    “Change is coming, so get used to it, in Healthcare. And, Edwards had the best plan of the 3, but it still was not far enough.”

    But, don't forget Edwards was honest and said it was a step toward “single-payer.” (I read the Iowa campaign literature before I sent it onward to my DC friend.)

    “The Medicare single payer idea takes the existing agency, and opens it up. … Medicare expansion is the best solution, by far.”

    To me this has always been the most logical, obvious, simple thing to do (rather than invent something new), if federal health care interventionism (no longer just a radical fringe idea; it is mainstream, albeit leftist) is sought. However, it won't be a panacea. Some new bureaucracy will be created, to attend to children's and later or at the same time, also, young and middle-aged people. Also, in exchanging one set of problems for another we'll include a new problem, namely the current underpayment by Medicare to physicians and other providers. (Dialysis clinics, for example, can lose money on Medicare.) Much of this has been concealed by the practice of providers' charging others (private patients, the insured) much more; if all are under Medicare, the underpayment issue will have to be addressed; nobody can expect providers to lose money providing services under Medicare.
    Medicare also doesn't solve the junk-lawsuit problem. What affects more of us will be something we're already seeing, a rush to spend a lot of time and trouble, in the name of cost-cutting, on chronic diseases. I fear a much heavier hand by the federal government on those of us with chronic disease in the future, no matter how well we've chosen to care for ourselves, and much more intrusion that we already see by cost-concious insurance companies and “wellness” companies. There really is a threat of a serious Nanny State if people's health histories and lives are micro-managed by Washington in the name of chronic disease care and cost containment.

  15. AustinRoth says:

    Boy – talk about missed the boat.

    The whole argument about policy positions, talking points, etc., is not really relevant to Obama's success. He is riding, as Shaun put so well, a wave for change, and an attitude.

    Same thing caused me to vote for Clinton (the first time), same thing swept Kennedy and Reagan into office.

    Argue in the trenches all you want – he will win (excepting some MAJOR gaffe or revelation) based on personality.

    IMO

    p.s. – Shaun, I think that was the single best post I have ever seen from you.

  16. superdestroyer says:

    Austinroth,

    but is people are voting for Senator Obama based on personality then they are fated to be disappointed. On January 21, 2009, the budget process will still be the same. The 100,000 pages of the Code of Federal Regulations will still be the same, and the 1,000's of lobbying organizations will still be around DC.

    There is nothing in the performance or background of Senator Obama that indicates that he can really change those things. Did Washington change with President Clinton or even President Reagan? No.

  17. shaun says:

    AR:

    How nice to know that someone actually reads my posts, not just a few phrases before flying into full troll mode.

  18. Slamfu says:

    I'm with Cosmo on this one, Obama has quite clearly stating his cases and what he plans to do. The trope that he is just talk is merely a weak and unsupported talking point of his detractors, he has stated everything as clearly or more clearly than his opponents.

    But I also agree with DLS, he is not that far off from Clinton. And why should he be? They are both Dems and active in setting out policy and goals. Both are nationally recongized so need to seen in line with party goals. Both their ideas are largely good. But I also do not wish to see a Bush-Clinton-Bush-Clinton scenario set up. Just the thought of it seems patently wrong. Maybe if there were no other decent candidates then I'd go for Clinton, but Obama is certainly inspriring, and from everything I've read of him he “gets it”. From Iraq, to actually fighting terrorism, to working on education and the economy, his answers make me realize there are people out there who don't just repeat talking points.

  19. DLS says:

    Obama is The Wave, all right. He appeals to Republicans as well as Democrats, including “Democrats in Republican drag” (the most real RINOs) in the Northeast, like Chafee, who has endorsed him. (“I believe Senator Obama is the best candidate to restore American credibility, to restore our confidence to be moral and just, and to bring people together to solve the complex issues such as the economy, the environment and global stability.”)

  20. cosmoetica says:

    SD: 'The 4-5% overhead is not true. It is a fiction created by looking at budgeted numbers in the Federal Budget. The new data collection mandates will be hugely expensive, the computerized record will be very costly because every couple of years all of the computers have to be updated and the records have to be pulled into the new system.'

    On gov't and gov'y watchdog sites that I have read, all admire and consistently state how efficient Medicare is. You've made no claims to deny that. And computerized records are updated as you go along- it requires no outlay save the literal time it takes for a nurse or dr. or lab asst to punch in the info.

    'If they do not like a procedure, a company, a drug, they just set the reimbursement below cost and everyone will stop doing it.'

    I.e.- they will force dr's to actually cut waste, and there will always be plenty of dr's to step into a void. That's utter nonsense. And most dr's are for Medicare expansion because they know it will save lives, save costs of redundant paperwork and a maze of rules that each ins. co. sets up. Again, a bogus claim.

    'the Obama Administration will create a million new reasons to sue everyone involved in health care.'

    On what basis, because as healthcare goes National the gov't will, in fact, as it does in the military, exempt itself from lawsuits. Bogus.

    'What happens to the several million people laid off in the insurance industry, the pharmaceutical industry, the medical device industry, and the the health care industry?'

    Only the ins. industry would lose jobs, and they'd have to adjust like the rest of us. The rest of the infrastructure would simply be dealing with one rather than 1000s of entities. Again, bogus claim.

    DLS: Eventually, let's face it; Medicare will become the system. I say avoid a decade of waste and inefficiency and go straight to it. No system will be perfect, but as Medicare gets more involved, the gov't will, as in the military, exempt itself from nonsense lawsuits.

    AR: when a topic gets off track and ridiculous claims are made, they shd be rebutted, as I've done. But yes, one hopes that Obama rides the wave.

  21. DLS says:

    Funny,

    “Obama is looking to get local and private agencies to take over foreclosed properties and in turn use tham as low income housing”

    This is no business of the federal government whatsoever. However, what are the FEMA hurricane refugees going to do if they must leave their toxic trailers?

  22. DLS says:

    “Eventually, let's face it; Medicare will become the system.”

    That's where I'd put my money.

    “the gov't will, as in the military, exempt itself from nonsense lawsuits”

    The providers won't be exempt (sovereign immunity) because they will remain nominally private, not government employees. Government is merely the payer, not the employer, you understand. It's not just to make the idea more palatable to a government-suspicious public that the proponents typically insist the providers will remain private (“this is NOT government health care,” they say with a straight face). It's to preserve the lucrative lawyer loot-fest, too.

  23. superdestroyer says:

    cosmetica,

    You should look up the case of Zevalin. The drug costs $25K and when CMS lowered its reimbursement to $16K, the company basically decided it cannot survive. Thus, patients will have to use less effective treatments with more side effects because CMS wants to save money. If the government is the only ensurer When CMS sets the reimbursement rate, the government will be deciding who succeeds and who fails. In health care, there is no reason to make any investment that cannot pay for itself in less than a year. CMS will change the reimbursement each year and there is no way to manage the financial risks.

    Also, Medicare uses other parts of the government to do things like collections, debt service, and price negotiations. One reason Medicare looks cheap is that the rest of the government absorbs some of the costs. Most pro-nationalized health care watch dogs like to ignore those costs. Also, Medicare costs are growing faster than inflation, so it is hard to claim that its management is so great.

    While reading BarackObama.com, Senator Obama has a long list of mandated reporting, quality reporting, and medical controls to follow. Not only does that make it very easy for malpractice attorney's to identify the easiest targets, it creates many more ways that hospitals can fail to cross an “t” or dot an “i.” Ever failure to complete paperwork, is a reason to sue and increases the dreaded overhead for the hospitals.

    If CMS sets the price for everything, there will be fewer drugs, fewer devices, fewer jobs in health care, fewer jobs in the drug industry (remember how the Democratic Party wants to off-shore the pharmaceutical industry), and millions of people laid off in the insurance industry.

  24. superdestroyer says:

    DLS,

    Low income housing is a tremendous joke. What happens is that a luck few lottery winners get to purchase housing at below market rates. In a couple of years, they sell their housing at full market rates. The lottery winners get a huge, government created windfall and in the long run, it creates no additional low income housing. Of course, the government administrators get to pat themselves on the back and speculators (read attorneys) get to reap the benefits.

  25. DLS says:

    Look at Medicare Secondary Payer if you want to concealing of costs through cost-shifting. In the case of dialysis providers, they want the extension (and cost-shifting) and are lobbying for such extensions, because Medicare underpays them while they can charge about three times as much in the private sector. (This is why a number of large corporations, including the Detroit auto makers, don't want the extension!)

    http://www.renalbusiness.com/articles/taking_si…

    http://www.aakp.org/press/press-releases/2007/D…

    (The Medicare ESRD Program is a 30+ year old extension of Medicare to those under age 65 and has long been a program worth examining and tracking. Did you know that for those under 65, Medicare only covers transplant immunosuppressant drugs for three years? The #1 cause of graft failure is failure to follow immunosuppressive protocol, and the #1 cause of failure is inability to afford the medication. [There's an extreme case of affordability as a problem in health care today.] In the case of kidney patients, the result is return to or going to dialysis, which is more expensive than the costs of the drugs to extend the life of the graft, particularly when hospital and other costs for dialysis-related complications are concerned. Medicare ESRD only works against its own goals, but is more expensive than it need be.)

  26. DLS says:

    “Low income housing is a tremendous joke.”

    Yes, and a cruel joke when it's financed by and benefits syndicates of doctors and dentists and such. My points were that while the feds shouldn't be involved in what Obama wants, at the same time there are people left in need of housing by a mistake by, yes, the federal government (or businesses exploiting the hurricane).

  27. Slamfu says:

    The main issue I see with conservatives is that they don't think any gov't program works at all when in fact many work just fine. THe VA before the Bush admin screwed it up, the post office, and Project Match via HUD(low income housing in CA) are fine examples. Unemployment has helped just about anyone at some time in their lives, and social security is perhaps the single most important and effective gov't program ever.
    ts why we don't allow monopolies.
    Also, a good deal of conservatives just assume that market forces will correct for things when there are many things it won't work on. If a certain commodity is of a must have variety like say medical assistance, things that you generally don't have a need for but MUST pay for when you need it, then market forces don't come into play. Prices will skyrocket when your services are so valuable people will literally empty their savings and put up their house if they have to to get it. This flies in the face of the idea of a free market where buyers and sellers are on a relatively even footing, with neither holding too many of the cards. Get rid of that premise and you've undermined the ability of the market to balance things out. This is the state our medical system is in.

    Insurance companies tend to come in on the side of medical care customers in order to balance things out. However this is just adding another layer of industry that needs to make a profit to the whole process, essentially adding overhead which seems justified at the beginning of the cycle so normal people can get a fair shake. However, as is happening now, the for profit nature of HMO's and the need to balance resources on the part of hospitals are driving the process into an absurd state, and people now depend on the insurance carriers as they formerly had to depend on the hospitals because without them they are screwed.

    In conversations with my conservative friends their usual response is to ask if I want a gov't beaurocrat deciding my health coverage. My response is that my other choice is an accountant for an HMO that actually has a financial incentive to let me die on the cheap, you tell me.

    Either way you slice it healthcare in this country is getting very cumbersome and so expensive all you can do is hope you have insurance and that your company can cover it. The system is working now but getting less viable every year. Something needs to be done and market forces are not going to fix things unless you can somehow restore the balance between customer and provider.

  28. DLS says:

    “THe VA before the Bush admin screwed it up, the post office”

    The VA has improved over several years — it was the source of horror stories and in fact is still fuel for opponents of 100% federal health care. If a patient dies, “you can't sue me and you can't fire me — I'm Civil Service!” The Post Office is legendary as a source of complaint, which is why the private parcel firms have established themselves as such enormous businesses.

    “Unemployment has helped just about anyone at some time in their lives, and social security is perhaps the single most important and effective gov't program ever.”

    Actually, many of us have never collected unemployment even when unemployed temporarily, and Social Security in its current form is doomed, and the same is true for Medicare, as the Trustees have described for years (see below). Social Security is a form of guaranteed minimum income for the elderly and disabled, but as a retirement plan it's not only unsustainable but constitutes the equivalent of a truly horrible return on an “investment” represented by the payroll taxes that are paid by citizens. Social Security and Medicare are already the budget monster within the monstrous government we have in DC already — already, because in order to continue somewhat as we are doing now, much more growth is needed:

    “Social Security could be brought into actuarial balance over the next 75 years in various ways, including an immediate increase of 16 percent in payroll tax revenues or an immediate reduction in benefits of 13 percent or some combination of the two. Ensuring that the system is solvent on a sustainable basis beyond the next 75 years would require larger changes. … The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 requires that the Medicare Report include a determination of whether the difference between total Medicare outlays and dedicated financing (such as premiums and payroll taxes) exceeds 45 percent of total outlays within the first 7 years of the projection period (2007-2013 for the 2007 Report). The Act requires that an affirmative determination in two consecutive reports be treated as a 'funding warning' for Medicare that would, in turn, require a Presidential proposal to respond to the warning and expedited Congressional consideration of such proposal. The 2007 Report projects that the difference will surpass 45 percent in 2013 and therefore makes a determination of excess general revenue funding. Because the 2006 report also made such a determination, a 'Medicare funding warning' is hereby triggered … In 2081, the combined cost of the programs will represent 17.6 percent of GDP. As a point of comparison, in 2006 all Federal receipts amounted to 18.5 percent of GDP. … A more immediate issue is the growing burden that the programs will place on the Federal budget well before the trust funds are exhausted. … Note that neither the redemption of trust fund bonds, nor interest paid on those bonds, provides any new net income to the Treasury, which must finance redemptions and interest payments through some combination of increased taxation, reductions in other government spending, or additional borrowing from the public. … When the statutory SMI general fund revenue requirements are added in, the projected combined Social Security and Medicare general fund revenues needed in 2081 equal 10.1 percent of GDP. A similar burden today would require nearly all Federal income tax revenues, which amounted to 10.8 percent of GDP in 2006.

    To put these magnitudes into historical perspective, in 2006 the combined annual cost of HI, SMI, and OASDI amounted to 40 percent of total Federal revenues, or about 7 percent of GDP. That cost (as a percentage of GDP) is projected to double by 2042, and then to increase further to nearly 18 percent of GDP in 2081. It is noteworthy that over the past four decades, the average amount of total Federal revenues as a percentage of GDP has also been 18 percent, and has never exceeded 21 percent in a given year. Assuming the continued need to fund a wide range of other government functions, the projected growth in Social Security and Medicare costs would require that the total Federal revenue share of GDP increase to wholly unprecedented levels.”

    http://www.ssa.gov/OACT/TRSUM/trsummary.html

    I would suggest trying other examples.

  29. cosmoetica says:

    DLS: '”Obama is looking to get local and private agencies to take over foreclosed properties and in turn use tham as low income housing”

    This is no business of the federal government whatsoever. However, what are the FEMA hurricane refugees going to do if they must leave their toxic trailers?'

    If local authorities and state authorities abdicate their roles the Fed has every right to step in to help citizens.

    SD: 'If CMS sets the price for everything, there will be fewer drugs, fewer devices, fewer jobs in health care, fewer jobs in the drug industry (remember how the Democratic Party wants to off-shore the pharmaceutical industry), and millions of people laid off in the insurance industry.'

    You are noted for specious claims. But, even assuming some drugmakers stopped making drugs in this country, Obama wants to also negotiate with canadian drugmakers to compete with American drugmakers. Again, this is more BS stirred up by people w no real world experience with drugs and pharmaceuticals.

    SD: 'Low income housing is a tremendous joke. What happens is that a luck few lottery winners get to purchase housing at below market rates. In a couple of years, they sell their housing at full market rates. The lottery winners get a huge, government created windfall and in the long run, it creates no additional low income housing. Of course, the government administrators get to pat themselves on the back and speculators (read attorneys) get to reap the benefits.'

    Not if there are mandates written into the property agreements that the homes will be occupied by the recipients for X amount of years. This is something that has been done for years, and successfully, around the country in areas that have been devastated by natural disasters and rebuilt. Again, a false argument meant to feed on people's latent suspicions and resentments toward the poor. Next….

    Slamfu, you have it correct. People like DLS and SD argue because they have a set of biases based upon emotion, then look to exceptional cases to back up their claims. case in point. Medicare and Soc Sec are far and away the most successful government programs ever created, and the only reason either are in trouble is because Congress dips its filthy paws into the SS trust fund whenever it wants to pay for pork barrel waste and Medicare is in trouble because the gov't utterly refuses to stop the gouging in the drug and insurance industries.

    Perfect example of DLS's exceptional-based arguments: 'The Post Office is legendary as a source of complaint, which is why the private parcel firms have established themselves as such enormous businesses.'

    The USPS actually is very close to the parcel companies in terms of delivery times and lost packages. Its major problems stem from day to day mail, which is smaller, as well as bulk mailings which often fall apart and get lost more easily. That said, neither Fed Ex nor UPS are close to perfect in packages, either. Next….

  30. DLS says:

    “If local authorities and state authorities abdicate their roles the Fed has every right to step in to help citizens. “

    False statement. (At least you didn't choose a worse word, such as “duties” or the ever-misused “responsibilities,” for “what I want.”)

    In this case, obviously the federal government has no role in the Obama program encroaching into what the state or local governments are doing (even where it may encroach, it is properly the last, not first, resort). To relocate the hurricane refugees whose lives were made worse by the federal government's mistakes is a separate issue (or at least, should obviously be recognized as a separate issue).

    “People like DLS and SD argue because they have a set of biases based upon emotion”

    Mirror talk. You are describing a common characteristic of yourself.

    “Medicare and Soc Sec are far and away the most successful government programs ever created, and the only reason either are in trouble is because Congress dips its filthy paws into the SS trust fund [additional emotive language deleted mercifully]“

    Medicare and Social Security are unsustainable in their current forms. Presumably you didn't read the Trustees Report summary (the easiest and fastest reading, which I made available; you're welcome) The structure of these programs are the true defect, which makes them doomed by demographics. Once the programs begin to run deficits, either benefits will have to be reduced, other spending will have to be reduced to pay benefits in full, or more revenues will have to be found through additional taxation or debt. There is no (honest) denial. Current misbehavior by Congress makes things worse (not just swiping the money but misusing the funds to engage in dishonest accounting when describing the financial condition of the federal government), but the programs themselves are unsustainable.

    “Perfect example of DLS's exceptional-based arguments [sic]: 'The Post Office is legendary as a source of complaint, which is why the private parcel firms have established themselves as such enormous businesses.'”

    The private parcel companies have made a fortune specifically because of disenchantment with the Postal Service. That is not emotion, but fact. Even the emotion embedded in and elicited from the most notorious Fed Ex commercials of the past was never the real issue; the issue was dissatisfaction with the Postal Service. (And don't bother trying to be dishonest also about the VA, object of a past campaign entitled “I Am Not A Number!” for good, factual reasons…)

    “Next….”

    After your disposal — how ironic. [dusting off my hands]

  31. DLS says:

    Next I'll probably encounter a dishonest denial of Amtrak's problems and that common horror stories (including my own numerous experiences) with Amtrak, full of factual details, are “emotional” [sic]. [sigh]

  32. DLS says:

    “However this is just adding another layer of industry that needs to make a profit to the whole process”

    Eliminating this will achieve a one-time cost saving, but it won't last. Even if the scope of the program weren't enlarged, the aging of the population and growing expense of medical care (with rising expectations accompanying it, incidentally) will devour the initial savings before long.

    The main thing other than this added cost, though, is that in addition to all the junk lawsuits and lawyer sharks, doctors, if you ask them, will tell you they cannot stand the insurance companies, not only the game-playing with reimbursement, but also the need to engage in multiple procedures and forms of paperwork for the same treatment given to different people with different insurers. This issue of differences (the kind of thing Cosmo is likely these days to dismiss as “making an emotional biased statement”) is actually the best argument in favor of Medicare for everyone, because this means one system, rather than fifty if the states each ran their own programs. (Nothing's holding them back, but having one standard is an advantage — I even know conservatives who wouldn't mind full nationalization of all government and abolishing the state governments altogether or just using them as a hierarchical intermediate stage between the “national” government and districts or counties.)

    Having separate state programs introduces travel-related problems as well as a lack of a single standard (fifty kinds of procedures and paperwork; probably more than in a consolidated HMO system), and worse, introduces the risk of “welfare magnet” migration as some states' programs would doubtlessly be better for the patients and more attractive than other states' programs; the states would have an incentive to reduce or de-improve rather than grow and improve their programs (the so-called “race to the bottom”).

  33. DLS says:

    “the idea of a free market”

    And consider the word “ideal” when describing this: Nearly innumerable sellers and buyers, all with knowledge of what we need or what the patients need, demand is ideally elastic (for medical care???), and then there's the lefty and real-world late Vickrey, the economist: “Willingness to pay implies ability to pay…”

    This is far from the case in health care. Not that sane principles all should then be thrown away (which would be a real case of emotive behavior and decision-making) but some common sense is in order — just as we know that when looked at critically or cynically, normal standard American libertarianism is the “honor system.” Does that always work?

    Y'all's turn…

  34. Slamfu says:

    Well DLS, its important to note that in one week the USPS handles more volume of packages than UPS and FedEx combined in a year. All in all, its performance is pretty damn impressive.

    And while you perhaps have not ever used unemployment, there are millions of americans who live paycheck to paycheck for whatever reason, and lose their jobs for short periods of time before finding new ones. This provides a very viable breathing space for otherwise productive taxpaying citizens to get things back in order. Rush himself was on it for some time, maybe he can say more on how much it helped him in his less prosperous days.

    And while social security may return less than a wisely invested portfolio, you need to remember that a) people living below the median level have a MUCH harder time saving money while still covering the basics and b) not everyone is wise about handling their money but they still deserve, after a full life of productivity and tax paying, to a basic level of prosperity and c) tell it to Enron employees that lost their pensions. Shit happens to good folks, safety nets are needed.

  35. superdestroyer says:

    the biotech industry could not function if it depended on the postal service since the postal service does not handle HAZMAT. Companies that need to ship chemical reagents, biological samples, or radioactive material. But then again, the left really does not like those dirty industries and would love for them to go away (maybe to Canda or India). The corporate world does not send valuable documents by USPS since you cannot track them.

    I drive by a set of low income housing built near a waste transfer section. They were built to allow the same builder to build larger townhouses. It was a joke because the original owner made a huge windfall and now the townhouses were reselling at market value. They no longer helped poor people. However, I guess progressives would love the idea of putting heavy mandates on homeowners who are poor.

  36. cosmoetica says:

    DLS: “If local authorities and state authorities abdicate their roles the Fed has every right to step in to help citizens. “

    False statement. (At least you didn't choose a worse word, such as “duties” or the ever-misused “responsibilities,” for “what I want.”)

    When the local gov'ts do not provide their services well in disasters or martial circumstances, the Feds can come in. Yes, they have a right to protect, help, and assist the citizenry if other levels of government fail. You may not like that, but they can do it.

    DLS: 'People like DLS and SD argue because they have a set of biases based upon emotion”

    Mirror talk. You are describing a common characteristic of yourself.'

    You refute that with your absolutist statement above. Next.

    DLS: 'Medicare and Social Security are unsustainable in their current forms. Presumably you didn't read the Trustees Report summary (the easiest and fastest reading, which I made available; you're welcome) The structure of these programs are the true defect, which makes them doomed by demographics.'

    Those are written by the folk installed in the Admin who want to eliminate SS./ Most outside experts agree that Soc Sec needs, like in 83, a bipartisan tweaking to easily sustain it through this century. This is where you, of all people, are buying into big, bad gov't's claims. And to talk of emotional justification.

    DLS: '”Perfect example of DLS's exceptional-based arguments [sic]: 'The Post Office is legendary as a source of complaint, which is why the private parcel firms have established themselves as such enormous businesses.'”

    The private parcel companies have made a fortune specifically because of disenchantment with the Postal Service. That is not emotion, but fact. Even the emotion embedded in and elicited from the most notorious Fed Ex commercials of the past was never the real issue; the issue was dissatisfaction with the Postal Service. (And don't bother trying to be dishonest also about the VA, object of a past campaign entitled “I Am Not A Number!” for good, factual reasons…)'

    There was no sic needed in your intro. I wrote, 'The USPS actually is very close to the parcel companies in terms of delivery times and lost packages. Its major problems stem from day to day mail, which is smaller, as well as bulk mailings which often fall apart and get lost more easily. That said, neither Fed Ex nor UPS are close to perfect in packages, either.' which is the source of USPS dissatisfaction. Again, re: big parcels, they are virtually even in delivery satisfaction. And I never mentioned the VA, so why are you arguing w me over it?

    Again, a typical tack: evade, misattribute, add in BS like a sic, and no real discussion needed. BTW- good point re: the volume of USPS, Slam.

  37. Slamfu says:

    “the biotech industry could not function if it depended on the postal service since the postal service does not handle HAZMAT”

    Well good for them. My point wasn't that the USPS can handle any shipping needs. . It was that it does process a tremendous amount of postage, does it under budget, and does it pretty damn accurate. All signs of a functional gov't agency that does whats its supposed to do. And lefties are just fine with dirty industries, we know they are needed and not all of us are card carring members of ELF, as long as they aren't in violation of environmental regs and or cutting corners and polluting willy nilly.

    And yea, there will be shady developers trying to fleece the system, there always are. But to make the leap from that to assuming the entire program is a waste is just silly. I know for a fact it does some good. What we need is aggressive corruption hunters nailing those who do fleece the system, beaurocrats and businessmen alike, to the wall.

© 2003-2011 The Moderate Voice | Site design by Elegant Themes | Site customization, hosting, and security by Mode Equity