My (current) take on healthcare reform

Some folks on the left are saying "public option or bust" - no healthcare reform without the public option. I am not so sure this is the right way to go, or even if the public option is such a great deal. Some thoughts on current proposals:

1. Healthcare reform can include a condition of "no pre-existing conditions". This in itself would be a huge improvement over the current state of affairs.

2. #1 necessitates a universal mandate to be "fair" to the insurance companies; if they have to take the sick, they should have adequate "pay-in"s from healthy people.

3. #2 implies federal subsidies for those who can't afford to pay insurance premiums, including expansion of Medicaid.

4. #3 means the money has to come from somewhere - possibly efficiencies in Medicare, including getting rid of "Medicare Advantage" - which would be a loss for insurance companies, but better use of our tax dollars.

5. Removal of annual/lifetime caps on out-of-pocket expenses would be great (what's that about half of current bankruptcies occurring due to medical bills?)

All of these five objectives seem pretty good to me.

Now, #3 can also be taken to mean "we need a public option" to avoid insurance companies increasing premiums/denying care to increase their profits (which already happens). But how will a public option work? Say it can't deny care as freely as private for-profits. That means insurance premiums will likely rise each year (or else we get rationing of care*). Otherwise, the public option operates at a loss, which means subsidies are needed from the federal government to keep the public option solvent. Which means private companies could be driven out of business, and we eventually get to single-payer (if you are a liberal)/a government take0ver of healthcare (if you are a conservative).

* Unlike what Tom Coburn says, a non-profit public option will be less likely to ration care than a for-profit private insurance company for the same premiums.

Couple of other thoughts:

1. If you really want single-payer, say that and work for it - don't be try to force a backdoor entry with the public option.

2. One alternative I like is a universal, minimum-benefits/catastrophic insurance public option. Private companies can offer this level of service, as well as better coverage for higher premiums.

3. If I understand correctly, the public option and other reforms don't even come into effect till 2013 (coincidentally, *after* POTUS election.) So if a triggered-public-option is offered that also comes into effect in 2013 if insurance companies don't clean up their act - why not? One answer offered is that the trigger may be too hard to press (Senator Ben Nelson has already said "we don't want a hair-trigger." We don't want an inoperative trigger either.) So the devil's in the details - the language of the trigger has to be very clear - and impose stringent rules on private insurers.

4. I think the "fees on insurance companies' "Cadillac" plans" is a chicken-s*** way of raising individual taxes, and I am annoyed that liberals like Schumer/Rockefeller and Max Baucus are proposing this. These fees *will* be passed on to the consumer, and likely to *all* consumers. This is a backdoor tax, and I'd rather see a tax on individuals with these Cadillac plans; "if you want this gold-plated option, you gotta pay for it."

I'd love to hear President Obama say #2 in today's speech; it seems similar to what some proposals say, but the message coming out of DC is way too complex and doesn't state this as clearly as I think I have.

As for #3 - I'd be open to setting up non-profit co-ops *now*, and evaluating their performance in 5 years - if they don't work, amalgamate the co-ops into a public option in 2013.

National political environment assessment by GOP agency

Wilson Research Strategies, a Republican outfit, just released an assessment of the national political environment for May. (via @PatrickRuffini)  Mainly, they say while Obama remains personally popular, folks are not as supportive of his policies, which, they say, makes him like Carter and not Clinton.  Also, apparently Obama is not helping Congressional Democrats, which leaves them optimistic about the GOP's chances of regaining control of the House in 2010 - assuming the GOP develops an overarching response to the Obama administration, rather than a piecemeal approach.

A few questions and observations:

1. Slide 10 - "independents beginning to have doubts" - Obama's approval rating among Independents is relatively steady at ~60% (slide 9), so this statement isn't correct.

2. The "Obama is most polarizing President" meme - slide 11 - has been hashed over many-a-time.  In short, Obama is more popular among Democrats than any previous President, and the Republicans these days are just the hard Conservative core (e.g. the Arlen Specter party switch), so obviously they don't like anything Obama does.

3. Slide 14: Are Obama's ratings more like Carter or Clinton?  No comparables are provided.

4. Slide 16: Only 6% think negatively of Obama for "not reaching out to Republicans."  Clearly, Obama doesn't have to worry about appearing partisan!

5. Slide 17: WRS says support for Obama's economic policies is soft.  But only 21% oppose President Obama's economic policies!  The rest either support Obama and/or his policies (knowing or hoping they work), or support Obama for what he's trying to do, though they doubt his policies will work.  (And I thought teabaggers were a MAJORITY of the population! /snark)

6. Opposition to bailouts and impact of teaparties in slides 22-23: I sure would like to see non-Rasmussen polls for these questions.  Ras has a known house effect in favor of Republicans, even going so far as to pen an anti-Obama WSJ op-ed while claiming to be an independent pollster. [See Mark Blumenthal/Charles Franklin for a detailed explication of Rasmussen's WSJ claims.]

However, it is an interesting look at one Republican viewpoint, and it definitely is a way for Republicans to frame the debate so that they regain power.  Question is, will they be able to overcome, in particular, the Obama administration, which has proved very adept at communicating their policies with the public.  As proof, see #5/Slide 17.

Hail to the Chief! [President Barack Hussein Obama!]

Just watched the Inauguration.  I am really glad President Obama used his full name, even though the usher announced him as Barack H. Obama.

Chief Justice Roberts sped through the first few words of the Oath, which caused Obama to stumble for a bit.  A little levity lightens the occasion!

Obama's speech was sombre, listing the challenges we face, but he also made it clear that America was ready to lead - foreign leaders and entities opposed to freedom and democracy beware!  It wasn't a great speech - not quite his race speech or the DNC-2004 keynote or his speech after the NH primary - but the occasion was momentous in itself, and Obama didn't need to add to it.

The Inaugural poem by Elizabeth Alexander left me a little underwhelmed... The closing prayer by founder of the Southern Christian Leadership Conference, the Rev. Joseph Lowry, was quite good toward the end - "We ask you to help us work for that day when black will not be asked to give back, when brown can stick around, when yellow will be mellow, when the red man can get ahead, man, and when white will embrace what is right."  I wish I could find C-Span's HD transmission - watched the Inauguration on CBS-HD, but the voice-over commentary by Katie Couric et al. was annoying (less so than CNN, I must note.)

A historic day, a new beginning.

End of an election

President(-elect) Barack Hussein Obama.

Wow.

Landslide, baby, landslide!  Popular vote by 6.34 million, or ~5% according to CNN as of 0200 Mountain time, Nov 5.  Electoral votes: Obama 349, McCain 159, as per Pollster.com's aggregate of the different networks:

- CBS/Fox/NBC/AP have called IN for Obama.

- NE's CD-2 EV is still outstanding as per Pollster.com.  So are MO, NC, MT.

- At least CNN has called MT for McCain.  So McCain's up to 162.

- The AP has not called GA for McCain (via an excellent diary at dkos) - apparently because approximately 600k early votes cast in metro Atlanta are still outstanding, which is almost twice McCain's 245k lead.

- Obama's ahead in NC by 12k votes out of 4.2 million cast.  Looks like Obama has won NC!  So Obama's up to 364 EVs.

Yes. We. Did.

p.s. 11/5 PM: I just remembered my post - made almost a full month back - that Obama's EV upper limit was... 364!  This was similar to Larry Sabato's prediction, except he called MO, while I called... IN!  In fact, Sabato's prediction was exactly like the final Pollster.com leads, including the pick of MO rather than IN - per the Pollster trendlines, McCain was ahead a hair in IN (R+1.2, actual D+0.9), while Obama was ahead in MO (D+1.2, actual R+0.2).

Did I just beat the Crystal Ball, with a tremendous assist from Pollster.com, but with the considered pick of IN instead of MO?  Yay!

The Obama infomercial

Just watched the Obama infomercial on MSNBC (the local CBS and NBC affiliates are showing it at 7.00 PM MT - delayed an hour.)

I thought Obama said he would mention specific spending cuts to pay "over and above" his spending plans, but I didn't hear said cuts.  Will have to listen to it again.  Update: the only specific cut appears to be ending the War in Iraq.  While I'd have liked to see more, I understand some people might find specific domestic cuts unpalatable.  Anyway, I am not such a deficit hawk - I think both candidates will be deficit-spending.  I would rather the money be spent regenerating the American economy (particularly through non-conventional energy sources), than on wars against Iraq, Iran and Russia.

I initially thought the ad would use stories from only battleground states when it started with Missouri and New Mexico, but Kentucky also made an appearance. [So did Ohio, as I watch a delayed broadcast on the local Fox station, post-World Series.]  I also liked the appearances by Governors Strickland, Sibelius, Kaine, Deval Patrick and Richardson, and Senators Durbin, McCaskill, and Biden.  I was pleasantly surprised at the (personal!) endorsement by Google CEO Eric Schmidt.  I do wish a Republican - like Senator Hagel or even General Powell - had made an appearance.  If Hagel does not want to endorse McCain, and he's not running for re-election, what's keeping him from coming out for Obama?

Obama on his mother's fight against the big-C and the insurance companies was incredibly touching.  Michelle speaking about Obama doing a good job as father was excellent as well.

Overall, the infomercial was well-produced, and I was glad to see lots of diversity.  But more importantly, with the quick turn - within the first few minutes - to regular American families (a Caucasian family trying to make ends meet, an elderly African-American couple with the husband taking a new job at Wal-Mart to pay for his wife's medical expenses, a retired Caucasian whose pension was dramatically reduced due to corporate fiscal mismanagement, a Hispanic single mother with two jobs), Obama demonstrated that this election is not about him.

It is about all of us.

Update: The video!

Coda: McCain says the ad was paid for with broken promises.  In short: "Waaaah!  Obama didn't let me gain a vast financial advantage via the RNC-DNC fundraising gap!"

[Updated] Voter statistics in Boulder County

Decided to look up the voter statistics in Boulder County today.  Here's what I found at the CO Secretary of State, updated as of 10/23/08:

Total MIB requested - 120k out of 182k "active registered voters" (I have no idea what inactive RVs are!)
Total MIB received - 39k (Boulder County Clerk says 47k as of today, 10/25/08)
Early voters - ~6k (BCC says 9k as of today)

UPDATE: A more comprehensive, nationwide summary by Michael McDonald is here.

The third debate

The third and final Presidential debate ended earlier this evening, with pretty much the same results as the earlier two debates.  Neither candidate scored a knock-out, and so McCain has not done much to change the state of the race - which doesn't bode well for the Republican.

The most enduring image of the debate for me was McCain's reaction to Obama's statement that Joe the Plumber would pay ZERO fines if Joe didn't buy health insurance for his (future?) employees.  McCain gaped aghast - he clearly was not expecting that!  Video via kos:

I am so happy to have that video... On a second watch, McCain's reaction is simply b-e-a-u-t-i-f-u-l.

It was also surprising to see the Democrat argue against wasteful spending of taxpayer money - like buying mortgages at face value, or higher health care costs due to ER visits by uninsured people.

Outside of that, though, I thought Obama could have socked McCain at least a couple of times.  For instance, after Obama said "zero" fines for JtP, McCain just continued to spout his "will have to pay fines" line.  Obama could have simply said, "didn't you hear me, John?"  Or when McCain said toward the end "so if there aren't enough vouchers, lets not do it?  I understand!" - Obama could have said "vouchers are your only solution to education; I have a much more comprehensive approach - including charter schools - because the youth are America's future."  Or about ACORN (this might be a too-subtle point, but let's not underestimate voters) - "you could register Mickey Mouse or one guy 23 times, but Mickey Mouse is not going to vote, and a guy can vote only once!" [After all, McCain did say "democracy is endangered by ACORN!"]

In trying to avoid a gaffe/not lose, I think Obama let a great opportunity to KO McCain slip away.  It's just like the primaries - Obama's running out the clock, content that he has a definite lead that he has to protect.  Unlike the primaries, though, Obama has a lead in the polls - but nothing in the bag, yet.

Still, I remain cautiously optimistic...

The second debate

The second Presidential debate between Obama and McCain was supposed to be a townhall-style meeting.  But all it had in that vein was questions from voters, with some voters personally asking the questions and Tom Brokaw reading off some questions submitted via the Internet.  There were no follow-up questions, with only one somewhat extended discussion between Obama and McCain.  That was one shortcoming.

There were some good questions, and good answers - Obama mentioning the $400k AIG junket, Obama's "I'll take out bin Laden even if he's in Pakistan" statement, McCain saying "talk softly and carry a big stick."  Though Obama hit McCain hard on that last point, mentioning "Bomb, bomb, bomb Iran", McCain's promise to annihilate North Korea, and "Next stop, Baghdad!"

Earlier in the campaign, Obama hit McCain for suspending his campaign to work on the bailout plan, saying a President should be able to work on more than one thing at a time.  So perhaps in a turn of events, when Brokaw asked them to prioritize between health care, SS/Medicare and energy, McCain said "we can work on all 3!" while Obama said "first energy, second health care, and third, education" (but not entitlements!)

In response to a question about the effect of the bailout plan on ordinary working Americans, McCain gave his standard stump speech, while Obama explained how the plan would affect ordinary folk (as in small businesses may not make payroll due to a lack of credit), in addition to his spiel.  There were one or two questions where neither answered, and instead gave their standard stump speech.

Overall, though, I thought there was no clear winner (though the CNN and CBS flash polls say Obama won by a bit).  Obama came off looking very unruffled, looking intently at McCain when McCain was speaking - as the talking heads said, good body language, and most importantly, Obama looked Presidential.  I thought McCain looked old, perhaps even wheezing a little.  So all in all, Obama won.

Aside - the in-house audience was made up of undecided voters from the Nashville area.  What...?  Do Tennesseans really matter? :-)  And KeithO and ChrisM kept talking about McCain's "that one" (referring to Obama) and "not you, Tom!" (on candidates for SecTreasury).  That was stupid, and those comments barely registered on me.  On this, I am with Mike Duhaime, the McCain guy, who said Mathews should focus on the substantive issues.  Now, if only the McCain campaign itself would follow that advice...

[Update] EJ Dionne reminds me of a question that I thought McCain would hit out of the ballpark, but didn't: "As president, what sacrifices -- sacrifices will you ask every American to make to help restore the American dream and to get out of the economic morass that we're now in?"  McCain's campaign was centered around sacrifice (well, mostly military, apparently), but it was Obama who gave the much better answer.  As Dionne writes:

McCain spoke almost entirely about cutting or freezing government programs. It was a strange answer from a man whose military career was characterized by years of punishing patriotic sacrifice.

Obama caught the idealism behind the query, criticizing President Bush's call for Americans to shop after the Sept. 11 attacks. He spoke of the need for individual energy conservation; called for expansion of service programs, including the Peace Corps; and described the hunger among young people to serve their country. McCain sounded like a legislator, Obama like a president.

Update 2: Jon Stewart, one of the most astute political observers, reminds me of Obama's reply to McCain's "let folks buy health insurance across state boundaries" - that the insurance companies would move to the state with most lax regulations to reduce their cost and increase profits, like the banking industry does in... Delaware! Ummm.... with the help of regulations written by your VP? Ouch!

Obama's upper limit?

As of writing, things are looking very good for Obama - as per Pollster.com, Obama leads McCain 296-163 in the electoral vote count, including strong- and lean-Dem states, with Florida and Colorado moving in to the lean-Obama column.  Further, Obama has slender leads in New Hampshire, Virginia, Ohio, Nevada - and North Carolina!  In OH, VA and NC, use of the "sensitive" smoothing shows Obama leads from 4% to 7%, close to or beyond MOE (likely also the case for NH, but Pollster's map for NH has a bug).  The only toss-up states where McCain is ahead are Missouri and Indiana (where Obama will likely spend his third debate prep-time).  This should be Obama's upper limit - 296 strong/lean-Dem + 57 slight leads = 353 EV.  Add in Indiana, and that makes 364 EV Obama's high water mark.

Of course, Obama winning all 364 electoral votes is highly unlikely, and I will settle for 270!  In the mean time, here's the Pollster.com electoral vote map, which is now offered as an embed by the awesome Mark Blumenthal:

Obama's support among Hispanics slipping?

This is based on Gallup "key indicators" weekly pooled data, the last of which ends Sept 21.  Obama's lead among Hispanics - according to Gallup - was down to +15% from +40% a month earlier.

Support among non-Hispanic Whites (Obama-McCain): 
Aug 18-24: 37-52 
Aug 25-31: 40-50 
Sept 1-7: 39-53 
Sept 8-14: 37-55 
Sept 15-21: 42-51 (M +9; best O-margin pre-last week) 
Support among non-Hispanic Blacks: 
Sept 8-14: 93-4 
Sept 15-21: 93-3 
Support among Hispanics: 
Aug 18-24: 58-31 
Aug 25-31: 64-24 (O +40) 
Sept 1-7: 60-31 (O +29) 
Sept 8-14: 55-35 (O +20) 
Sept 15-21: 53-38 (O +15; pre-last week; lowest O-margin)

I wonder why that is - Obama losing ground among Hispanics even as he gains among non-Hispanic Whites.

Recently, Obama's campaign put out the "Limbaugh" ad [clarification] [where Limbaugh's apparently attacking Mexicans].  Politifact says the ad came out on Sept 18, and called it "pantalones en fuego" wrong (also includes the video).  That ad also comes bang in the middle of that last week for which Gallup's pooled internals are available.

One way to read that ad is that Obama's support was slipping among Hispanics in their internal polling, and so they put out this misleading ad.  Another way is that somehow, Hispanics saw the ad, and figured Obama was trying to scare them... Much as an Obama-bot I am, and as we know McCain in trying to win the nomination said he wouldn't vote for his own immigration bill, yes, that ad was trying to scare Hispanics by linking Limbaugh and McCain, and I wish Obama hadn't put that out.  Still, looking at the Gallup trends (O+40 to O+15 in one month), the first explanation seems more reasonable... We'll see over the next couple weeks if it worked, though the effect may well be lost in the economic crisis effect -Hispanics are as effected by it as anybody else.

Of course, I still haven't figured out why Obama's losing ground among Hispanics in the first place...

[UPDATE: Yes, the dkos/R2K poll shows Obama up 40 points among Latinos, and had been for a while.  But (a) I am looking at Gallup which has a longer history; (b) Gallup's pooled weekly sample has about 7000 voters; say 15% Hispanics, makes that a Hispanic sample of ~1000 voters, with a MOE of 3%.]

As I was writing this, I looked up PPP's numbers for two states where Hispanics are influential - CO (O +7) and FL (O +3).  Obama leads CO Hispanics 57-36 (PDF), but McCain and Obama are almost even among FL Hispanics (including Cubans) (PDF).  Obama's gotta win them back...

I wrote this post at dkos first, here.  I got a lot of flames, including accusations that I was concern-trolling... That if I didn't know the difference between Florida and NM Hispanics, I shouldn't comment... While all I was doing was point out that based on the Gallup data, which have a decent sub-sample size in the pooled weekly data, Obama seemed to be slipping - which might be confirmed by the release of the "pants on fire"-wrong "Limbaugh" ad (as the Obama camp's reaction to try and bring back Latinos).  Guess I am not a complete Obama-bot after all - my support isn't blind.

Start of the general election campaign...

....of course, Senator Obama has focused his fire on Senator McCain for the past few weeks. But with Senator Clinton's strong endorsement of Senator Obama and suspension of her campaign, the general election campaign has officially started. I applaud Senator Clinton for her excellent speech Saturday, putting her campaign in perspective but at the same time, looking ahead to the unfinished fight.

Senator Obama has launched his VP search with a 3-member committee comprising eternal Democratic VP-vetter Jim Johnson (one-time CEO of Fannie Mae), Eric Holder (ex-Deputy US AG) and Caroline Kennedy. Hopefully Jim Johnson, he who picked Geraldine Ferraro in 1984 (who was dogged by questions about her husband's taxes), will do a better job now... I wonder if Caroline Kennedy will pull a Cheney and nominate herself?! That would be one good-looking Democratic ticket :-)

My earliest memories of a conversation with an American about politics was speculation about President Clinton - Hillary Clinton. This was back in 2000, in the last months of the Bush v. Gore Presidential campaign. My room-mate, an American woman and a Republican from Virginia (who said "Cheney? people love him!"), said Americans were probably not ready for a woman POTUS. I was rather surprised - after all, the US has been in existence for over 200 years! Thankfully, this year Senator Clinton put that question to rest. In fact, after Senator McCain transformed into a cookie-cutter Republican, I supported Senator Clinton (link) - I think it is high time the USA had a woman President. Even as late as Super Tuesday (Feb 5), I thought she had the most powerful theme - when she mentioned her mother, who was born when women could not vote, and was now seeing her daughter on the verge of becoming the first woman POTUS:
"And I want to thank all my friends and family, particularly my mother, who was born before women could vote and is watching her daughter on this stage tonight."

But as the campaign continued, I decided - a woman, yes, but not this woman, who came to epitomize the status quo. And Senator Obama offered freshness, honesty, and a dramatic change from politics-as-usual. Still - I hope the Democratic VP nominee this year is a woman - and/or a woman becomes POTUS in 2016 (after two Obama terms!)

As for the current campaign, Senator Obama has a lot of work ahead of him - as many Hillarycrats (Senator Clinton's supporters) are mad. Despite Senator Clinton's strong endorsement of Senator Obama, sites like Hillaryis44 (who are still stuck in the '90s based on their photograph of First Lady Clinton rather than Senator Clinton) and groups like Party Unity, My Ass are filled with bile-spewing Hillarycrats who would rather vote McCain or otherwise enable a GOP Presidency in 2009 - all out of spite and against Senator Obama, he who stole the Democratic nomination.

Of course, this makes absolutely no sense. On the issues, Senator McCain is NOT someone Hillarycrats want elected as President - unless they would rather inflict another GOP Presidency on the rest of the USA (and the world) so Senator Clinton can run again in 2012. Further, Senator Obama has plenty of life experience, even if Senators Clinton and McCain have depicted him otherwise. Sure, Obama doesn't have much Washington, DC experience - but that's not necessarily a bad thing after the bitter partisan rancor of the last 15 years (besides, he has enough legislative experience passing contentious bills in Illinois). Finally, one could say that Senator Clinton was the victim of sexism and misogyny, as otherwise she would have won the Democratic nomination in a cakewalk the night of Feb 5. But despite any sexism/misogyny, Senator Clinton could still have won the nomination - simply by better fiscal responsibility within her campaign, and by contesting caucus states, even if the Clintons believed caucuses were undemocratic. Heck, even Mark Penn (in hindsight obviously) believes as much.

I would just like to end with a video - if folks think Either Male Candidate doesn't matter, or that Senator Obama has willingly/silently benefited from sexism and misogyny (despite the fact that he had to fight his own battles against racism and false allegations about his religious beliefs, while Senator Clinton herself seemed in two minds whether to openly speak about sexism), witness what sort of candidate Hillarycrats will be putting in the Oval Office by either not supporting Senator Obama or actively campaigning against him:



[Via Veracifier/TPM.]

Good night, and good luck.