Michael Corcoran: Corporate Media Takes a Side in Debate over 'Entitlements'

Originally published at Truthout

Michael Corcoran

March 30, 2011.

Corporate Media Takes a Side in Debate over 'Entitlements'

Pundits and politicians have often said that the thought of cutting Social Security and Medicare are, as Chris Cillizza of The Washington Post described them, the "third rails of American politics. Nobody wants to touch them." This, Cillizza argues, is an unfortunate trend, since chopping these staples to the United States ever-thinning safety net, is the "obvious fix" to our nation's budget problems. "The simple solution is to make cuts to two large government entitlement programs: Social Security and Medicare," he notes.

Despite this often repeated claim that cutting Social Security and Medicare is never discussed in American politics, in reality, the media is relentless in its perpetuation of the myth that cuts to these programs are needed - and right away. In recent months, the media has served to amplify the ideological claims of elites that use the recession - caused by large financial institutions' reckless behavior - as an excuse to further burden the nation's poor and elderly, even as the rich continue to benefit from massive tax breaks and bailouts. The question the media pose is not whether Social Security and Medicare should be cut, but when and how. But there is no debate as to who should sacrifice to balance the budget: the poor and the elderly.

In recent months, especially since President Obama's National Commission on Fiscal Responsibility and Reform released their initial report on deficit reduction and the GOP took over the House, the corporate media has excluded views of labor or working class-people, ignored alternative proposals to cutting these programs - such as various forms of revenue increases, all more popular with the populace - and perpetuated the falsehood that Social Security is in the throes of a deep crisis and is responsible for our budget woes. The idea that those on Wall Street who caused the financial crises - and the extreme revenue shortfalls that followed - should be asked to help pay a little more of their massive profits in an age of historically-low taxation on the rich is, indeed, the true "third rail" in the media.

Corporate Media, Corporate Agenda

To close followers of the economics of the mass media, it comes as no great surprise that the media is effectively serving as a communications arm of corporate America - the media is corporate America. And the corporatization of the media has only grown this year. In a few weeks, media activists will meet in Boston for Free Press's National Conference on Media Reform. Among the major topics to be discussed are the increasing corporate domination of the media; increased consolidation with the merger of NBC and Comcast; the passing of Citizens United, which served to createan effective "stimulus package" for media companies due to increased political ads; the battle over net neutrality, which will determine if corporations will dominate the web at the expense of independent web sites and the attempted desecration of public media, further enabling corporations to control information in the United States.

So, it comes as little surprise that the same media that supported the urgentpassing of the Troubled Assets Relief Program, the most massive example of upward redistribution of wealth in US history, and are currently singing itspraises as an unmitigated success, would then ask for the nation's fiscal woes to be "fixed" on the backs of working-class people.

This sentiment does not merely come from the opinion makers, but the news pages of the major national papers, which continue to perpetuate the myth that Social Security is in crises. Consider the appraisal of New York Times reporter Jackie Calmes, who said Congress was tasked with the "unsustainable combination of fast-growing entitlement programs like Social Security and Medicare and inadequate tax revenues." The Washington Post's news pages, likewise, push the same flawed narrative. Reporter Lori Montgomery concluded that "budget experts say it would be difficult to significantly reduce future deficits without addressing the rising cost of Social Security."

It appears the Post ignored "budget experts" who offered a differing view. For example, the Center for Economic and Policy Research (CEPR) and its co-founder Dean Baker - one of the only economists to predict the housing bubble that the media missed out on - have shown that the program is solvent at least until 2037, giving us decades to tweak policies to make sure those who receive benefits in 2038 get 100 percent benefits.

But, the likes of Baker are rarely given a platform in the US mainstream media, where the expert pundits represent an incredibly narrow range of opinions. On shows such as "Meet the Press," conservative Democrats, such as chairman of the Democratic Leadership Council Harold Ford, often, absurdly, appear on the show as representatives of the left.

Consider the panel discussion on the show after the release of the deficit reduction report. The panel included Newt Gingrich, Alan Greenspan on the right and on "the left," Ford and Vanity Fair's Bethany Maclean (not exactly a modern-day Eugene Debs). Ford used the platform to give right-wing talking points and bash the left. "As long as you don't allow the far left and the far right, again, to crowd out the predominant middle, we can get a lot of this done," he said. "If that means making tough choices on Social Security - I'm 40, I'm willing to give mine up and I think a lot of people my age who may reach a certain income level are willing to do the same."

Host David Gregory was convinced by the wisdom of cuts to entitlements. "I don't see why, for instance, some of these suggestions, Harold, on Social Security are going to be demagogued to death," Gregory said. "Why, in 50 years, people can't look at raising the retirement age and have that be a serious discussion point?"

The Real Social Security Crisis

While the likes of Ford and Gregory may be able to endure cuts to Social Security, statistics show current and future retirees cannot. In fact, the real Social Security crisis is not that the program is insolvent - as noted above, it is in decent fiscal shape - but that the benefits are no longer sufficient to enable many people to live decent lives.

As CEPR reports, "the vast majority of near-retirees will rely on Social Security for the vast majority of their income in retirement," and therefore "cuts in Social Security imply large cuts in income for a population that is already not especially wealthy." The real debate in the media ought to be over how to increase benefits, so we can provide retirees with a dignified life.

Raising benefits should not be viewed as a radical idea. Contrary to media hysteria, Social Security is not reckless overindulgence in social welfare, but rather a modest (relative to other countries) pension program, that could be improved in the richest nation in the world. According to a report from the Organization for Economic Co-Operation and Development (OECD), our federal pension system offers quite meager benefits, compared to other developed nations in the OECD. Social Security accounts for about 16 percent of our total public expenditure, which is lower than about 80 percent of all developed nations.

In fact, there are many changes we can make to increase Social Security benefits - the most obvious of which is to implement more progressive taxation. Currently, Social Security taxes are capped at $106,000. This means that someone making $1 million a year is only paying Social Security taxes on about 10 percent of their income. If we removed the cap, the program would remain solvent for 75 more years, according to theCongressional Budget Office. Another option would be a tax on financial speculation, a modest tax on Wall Street trading that could raise $1 trillion in revenue over the course of a decade.

In fact, Baker estimates that raising Social Security by 25 percent would cost about 1.5 percent of GDP, about 66 percent of which would be covered by a financial speculation tax. To put this into perspective, the increase in defense spending just from 2000 - 2010, accounted for 1.8 percent of GDP. "This seems affordable to me," Baker said in an email.

Indeed, wealthy people can afford the tax. According to a study done by an economist for the Federal Reserve Bank of San Francisco, between 1979 and 2005, mean after-tax income for the top 1 percent increased by 176 percent, while the bottom 20 percent saw an increase of 6 percent only. With the extension of the Bush tax cuts, this trend seems likely to continue. But the idea of raising taxes, even slightly, on the rich is out of the realm of acceptable discourse in the media.

The Real Health Care Crises

Media attacks on Medicare are also fallacious. The general argument portrayed in the media is that the inefficiency of Medicare is causing costs to rise at a fast rate, adding to the deficit and thus, it must be cut. But Medicare is actually more efficient than private health care plans - its cost is rising 8.3 percent annually per beneficiary for Medicare, compared to 9.3 percent for private plans. The increase has a lot to do with the increase of people over the age of 65, not flaws with the program.

But rather than cutting Medicare, as pundits proclaim we must, the media should target on the real villain of the deficit: the exploding health care costs associated with the US's broken private health care system. Public plans such as Medicare are actually more efficient than private plans, since they have considerably less administrative waste. In fact, as this graph shows, if you replaced the US wasteful system - which costs about 17 percent of GDP, almost double of the average developed nation - with any public system from any OECD country, the deficit would be eliminated.

But, as Fairness and Accuracy in Reporting has documented, the narrow ideology of the mass media does not even allow for a discussion of public health care. In a study of news coverage during the debate over federal health care reform, the organization concluded that out of "hundreds of stories" that mentioned health care reform "all but 18 of these stories made no mention of 'single-payer' ... and only five included the views of advocates of single-payer - none of which appeared on television."

The Media Agenda

As noted above, it is neither surprising, nor conspiratorial, to suggest that media companies - owned by large corporations - would produce information that would benefit their own institutions. This is precisely why the increasing corporate stranglehold of the media is such a topic of concern for media activists and why alternative media sources are so crucial to our democracy. The coverage of Social Security and Medicare in recent months is a perfect example of the narrow, ideologically driven agenda of the corporate media that is serving to help the rich dismantle important social programs.

The Limits of Healthcare Debate

Published at Znet


New York Times' columnists Gail Collins and David Brooks did something that almost never happens: they discussed why single-payer is never even considered by mainstream media and Washington politicians. The absence of even occasional debate over the merits of single-payer is especially disheartening given the fact that is the most obvious cure for what Republicans and Democrats alike agree at the two most fundamental problems with US healthcare today: the skyrocketing costs and the fact that so many are left without insurance at all.

But the debate, held in a recurring online feature, was incredibly problematic. While Collins rightfully acknowledges that since "a third of the cost of health care is in administration, and the problem with reorganizing health care has to do with all the multitudinous plans and policies, a single-payer system would be far and away the most cost effective answer."

"We don’t talk much about it because it isn’t politically possible. But it isn’t politically possible because we don’t talk about it," she said.

Brooks response, however, is very short-sighted.

"Democratic politicians throw around statistics claiming that Medicare has much, much lower administrative costs than private insurers. I’ve been told by various economists that this claim is three-quarters trickery. It’s a lot cheaper to administer a targeted population that uses a lot of care than it is to administer a large population that uses little care per capita. Plus you can save a lot of administrative costs if you don’t actually regulate treatments that much," he said.

But what about every other industrialized nation in the world? Many of them -- Canada, the UK, Tawain (which is based on the Medicare)-- have a single-payer system, while all other developed countries essentially share the basic idea of single-payer: a centralized funding mechanism that guarantees coverage to all while controlling costs.

In each of these instances the countries pay significantly less than the United States on healthcare as a percentage of GDP and on administrative costs. The United States spends now about 16 percent of GDP on healthcare, while the average expenditure for a country in the countries in the Organization for Economic Co-operation and Development, is about half of that.

Brooks claims that the sheer size of the US makes single-payer non-viable, but he doesn't explain why, only claiming that, "There is no way something that big and complex and dynamic can be run out of Washington."

Why not? He does not say. Having a large population is a factor in healthcare spending, and healthcare needs -- although when pooled together it also provides leverage that smaller countries do not have -- and it obviously isn't working by having for-profit private insurers run the show. But he seems not only willing, but adamant that this system must be preserved. This is despite the fact that government -run systems within the US - Medicare and the Military healthcare system -- are the most efficient and have the highest satisfaction levels.

A national Commonwealth Fund survey, for example, found "Medicare beneficiaries reported greater overall satisfaction with their health coverage, better access to care, and fewer problems paying medical bills than people covered by employer-sponsored plans. The findings bolster the argument that offering a public insurance plan similar to Medicare to the under-65 population has the potential to improve access and reduce costs."

It is sad that Brooks is perpetuating this myth that preserving for-profit private insurance companies -- bound by law to put the bottom line for shareholders above all else, including the public good -- to be the primary vehicle for health insurance is vital, without providing any evidence. Given how infrequently this topic is discussed in the US media, even though the public supports single-payer in virtually every public poll taken on the subject, that the concept was dismissed so fallaciously by a columnist for an elite national papers is rather troubling.


As a report done by Fairness and Accuracy Reporting showed in a survey of articles about healthcare for a week in March:

Over the past week, hundreds of stories in major newspapers and on NBC News, ABC News, CBS News, Fox News, CNN, MSNBC, NPR and PBS's NewsHour With Jim Lehrer mentioned healthcare reform, according to a search of the Nexis database (2/25/09-3/4/09). Yet all but 18 of these stories made no mention of "single-payer" (or synonyms commonly used by its proponents, such as "Medicare for all," or the proposed single-payer bill, H.R. 676), and only five included the views of advocates of single-payer--none of which appeared on television.

Of a total of 10 newspaper columns FAIR found that mentioned single-payer, Krauthammer's syndicated column critical of the concept, published in the Washington Post (2/27/09) and reprinted in four other daily newspapers, accounted for five instances. Only three columns in the study period advocated for a single-payer system (San Diego Union-Tribune, 2/26/09; Boston Globe, 3/1/09; St. Petersburg Times, 3/3/09)."

Why the media is so complicit in narrowing the debate so it favors the interest of insurance companies is worthy of examination. The fact that the public supports single-payer -- even in the face of this media blackout -- is also rather telling of how persuasive the argument for single-payer truly is.

The Left and Barack Obama: The good, the bad and the empty

It was somewhat amusing to watch Hillary Clinton as her campaign, once widely thought to be invincible, began to fall apart. Facing the increasing likelihood of losing the nomination to Mr. Hope himself, Clinton took to outright mockery in describing the junior senator from Illinois and his seductive narrative of hope, unity and change.

“I could just stand up here and say ’Let’s just get everybody together, let’s get unified,’” she told supporters at a rally in Providence, Rhode Island. “The sky will open, the light will come down, celestial choirs will be singing and everyone will know we should do the right thing and the world will be perfect.”

At this stage of Clinton’s flailing campaign, the move comes off as desperate. With polls showing a likely Obama triumph, the Clinton camp has had to pull out all the stops – including accusing Obama of disloyalty to Israel in the latest Newsweek cover story. Still, we have to admit: she has a point. While Obama’s stump speeches speak glowingly of dramatic change, his policies fail to match up; in fact, his policy positions are, in many cases, barely distinguishable from those of Clinton. And on some crucial domestic issues, he is actually outflanking her from the right.

Of course, there are some positives about the Obama phenomenon. First, he is clearly preferable to Clinton, whose record (in the senate and as first lady) on trade, welfare, gay marriage, the War in Iraq, and media regulation has been horrendous. Obama, a one-term Senator with a background as a community organizer, is far less entrenched in the Washington establishment than Clinton. Further, he opposed the invasion of Iraq and supports some level of diplomacy with Iran, Venezuela and other countries that have typically poor relations with the US.

More important, I think, is the mass outpouring of grassroots support that Obama has received. While I doubt very much that Obama is the vehicle for change his supporters think he is, the fact that millions of Americans have donated time, money and sweat into trying to make this country a little more humane, speaks volumes about the American peoples’ desire for change. This shows the very real potential for more significant social movements to succeed in the not-so-distant future.

And, this happens at a time when the conservative movement, once monolithic in its control of all three branches of government, is collapsing due to poor leadership and a sharp disconnect with the American public on foreign and domestic policy.

These are all positive things. But we lose out by romanticizing Obama’s platform –which is still well to the right of the majority of the public on virtually all of the crucial issues.

Obama and foreign policy

Since the executive branch has far more influence over foreign affairs than it does over domestic issues, it makes sense to begin there. As I noted, Obama opposed the invasion of Iraq from the beginning, But Obama’s record since that vote has been pretty dismal.

For starters, Obama has voted repeatedly to fund the war he opposed. As Dennis Kucinich noted last year,

“[Obama's] voted to fund the war at least ten times, each time, it's like reauthorizing it all over again. If they keep voting to fund the war, it's not credible to say they are for peace.”

In fact, just when members of the newly-elected 110^th congress were beginning to square off against Bush over Iraq legislation lst March, Obama made a point to cave into the president, asserting that he does not want “to play chicken with our troops,” by threatening to cut of funding for the war.

And even now that Obama is trying to run as the anti-war candidate, he still refused to say he would have the troops out by 2013.

Obama defended his record to reporters. "I have been very clear even as a candidate that, once we were in (Iraq), that we were going to have some responsibility to make it work as best we could,” he said.

On foreign issues other than Iraq, Obama offers even less substantive change. For starters Obama is an unambiguous interventionist. When Obama gave a speech at the Chicago Council on Global Affairs outlining his foreign policy views, Robert Kagan, one of the world’s foremost hawks, who along with Bill Kristol co-founded PNAC, wrote glowingly about it.

“America must ‘lead the world in battling immediate evils and promoting the ultimate good.’ With those words, Barack Obama put an end to the idea that the alleged overexuberant idealism and America-centric hubris of the past six years is about to give way to a new realism, a more limited and modest view of American interests, capabilities and responsibilities.”

One can only imagine Kagen, a staunch unilateralist, also enjoyed Obama’s expressed willingness to “attack inside Pakistan with or without approval from the Pakistani government.” Obama’s piece in Foreign Affairs should likewise put to rest any idea that he is seeks to lessen the United States’ interventionist ways. In this piece he praises Roosevelt and Kennedy for building strong militaries and asserting US dominance around the world.

In terms of the Middle East, it comes as no surprise that Obama has taken a very assertive pro-Israel stance: all Democrats take a pro-Israel stance, especially ones that hope to become president.

But when Obama gave a speech in front of AIPAC, he was so egregious in his pandering that he drew jubilant praise from some of the most hawkish supporters of Israel in the media today. Samuel Rosner, arguably the most pro-Israel voice at Haaretz, said Obama was “as strong as Clinton, as supportive as Bush, as friendly as Guliani. At least rhetorically, Obama passed any test anyone might have wanted him to pass. So, he is pro-Israel. Period.”

Marty Peretz, the editor-at-large of the New Republic, and a chronic apologist for Israeli war crimes, was also impressed. He said of the speech:

“I believe he must have satisfied (nearly) all of those who had been skeptical of his grasp of the Israeli conundrum. Very much satisfied them. Me, included. (His was an extremely sophisticated analysis.) And he must also have disillusioned all of those who'd hoped--like the lefty blogosphere--that he'd be oh-so-sympathetic to the self-inflicted Palestinians.”

Indeed, Obama was no such thing. He said that Israel was "our strongest ally in the region and its only established democracy," He added, "we must preserve our total commitment to our unique defense relationship with Israel by fully funding military assistance and continuing work on the Arrow and related missile defense programs" which would "deter missile attacks from as far as Tehran and as close as Gaza."

“As if the starved, besieged and traumatized population of Gaza are about to develop intercontinental ballistic missiles,” noted Ali Abunimah in Electronic Intifada.

Further, David Sirota has noted Obama’s connection to at least one big-wig in the defense industry.

“Buried at the very bottom of a New York Times story marveling at Barack Obama’s ability to shakedown wealthy Chicago scions for big cash, we find out that one of the Illinois senator’s biggest donors is the family that owns one of the largest defense contractors in the world, General Dynamics. What a shock, then, that Obama hasn’t discussed our bloated military budget even though polls show the public wants that budget reeled in.”

And this is just scratching the surface of Obama’s non-progressive ways. As Paul Street observes, Obama voted to reauthorize the USA PATRIOT ACT, gave his valuable support to neoconservative Sen. Joe Lieberman (I- CONN) as he faced off against his anti-war challenger Ned Lamont, voted to approve Condoleezza Rice as secretary of state and opposed Sen. Feingold’s move to censure Bush for his illegal wiretapping of US citizens.

Obama and Domestic Policy

As bad as his foreign policy positions are, they are still unambiguously to the left of Hillary Clinton and John McCain. The same can not be said of his domestic platform, where Obama has been especially disappointing. His policy positions, in some cases are to the right of Clinton’s.

For starters, as Robert Kuttner observed in an excellent article for the American Prospect, Obama has strong ties to Richard Rubin, former chairman of Goldman Sachs and the chief economic strategist for Democrats throughout the Clinton years. Rubin represents the old neoliberal thinking that dominated the 90s; he is also a key player in the Hamilton Project, which as Kuttner notes, is dedicated to promoting “free capital movements.” They also flirt with privatizing social security.

That Obama has solicited the help of Rubin is a sure sign that, despite the countries growing antipathy for neoliberalism, he will not be endorsing any kind of substantively different economic word view. Kuttner writes:

“If the Rubin doctrine again dominates the Democrats' pocketbook program, it will once again blunt the Democrats' (now resurgent) appeal as the party of the common American.”

And indeed the extent of Obama’s Rubinization is evident in his campaign. On health care, he favors a plan that, while similar to Clinton’s, is slightly less ambitious. This is mainly because Obama concedes his plan, which unlike Clinton’s (and Edward’s) plans do not require one buy insurance, will leave a few million without insurance; Clinton claims her plan cover everyone, which, as Harvard’s Steffie Woolhandler notes, “is pure fantasy.”

Reasonable people can disagree over which nominee’s flawed plan is less bad.None of these candidates are anywhere close to the public on health care. 56 percent of the country said they would support a single-payer plan “like Medicare” to our current program. Further, the country is willing to pay higher taxes to see such a plan implemented. What’s more, there is a bill, HR676, which would provide Medicare for all. It has more than 80 cosponsors in the House of Representatives, but Obama, like a lot of Democrats, will not go near it.

But what is especially unsettling about Obama on this issue, is the angle he has taken in critiquing the other’s health care plan. As Paul Krugman observed in the New York Times:

“[L]ately Mr. Obama has been stressing his differences with his rivals by attacking their plans from the right — which means that he has been giving credence to false talking points that will be used against any Democratic health care plan a couple of years from now …. by echoing the talking points of those who oppose any form of universal health care, he’s making the task of any future president who tries to deliver universal care considerably more difficult.

Obama has used the same approach on Social Security. He continues to perpetuate the right-wing myth that Social Security is in some kind of fiscal crises. These talking points are designed by conservatives to dismantle one of the lasting relics from the New Deal, and Obama, by repeating them, only helps this myth gain traction. “Everyone knows Social Security, as it’s constructed, is not going to be in the same place it’s going to be for the next generation, Democrats, Republicans, liberals, conservatives,” Obama told Tim Russert on Meet the Press.

Krugman, again, takes issue with this assessment.

“But the ‘everyone’ who knows that Social Security is doomed doesn’t include anyone who actually understands the numbers. In fact, the whole Beltway obsession with the fiscal burden of an aging population is misguided. As Peter Orszag, the director of the Congressional Budget Office, put it in a recent article co-authored with senior analyst Philip Ellis: “The long-term fiscal condition of the United States has been largely misdiagnosed. Despite all the attention paid to demographic challenges, such as the coming retirement of the baby-boom generation, our country’s financial health will in fact be determined primarily by the growth rate of per capita health care costs.”

Indeed, Obama has literally taken to praising the vision of Ronald Reagan who he views as a man of bold ideas.

“I think they felt like with all the excesses of the 1960s and 1970s and government had grown and grown but there wasn't much sense of accountability in terms of how it was operating. I think people, he just tapped into what people were already feeling, which was we want clarity we want optimism, we want a return to that sense of dynamism and entrepreneurship that had been missing."

Matt Stoller, a blogger from MYDD observed that Obama “agrees with Reagan's basic frame that the 1960s and 1970s were full of 'excesses' and that government had grown large and unaccountable. Those excesses, of course, were feminism, the consumer rights movement, the civil rights movement, the environmental movement, and the antiwar movement. The libertarian anti-government ideology of an unaccountable large liberal government was designed by ideological conservative to take advantage of the backlash against these 'excesses.'”

All in all, I think David Sirota may have put it best. Obama, he observes, is only

“interested in fighting only for those changes that fit within the existing boundaries of what’s considered mainstream in Washington, instead of using his platform to redefine those boundaries. This posture, comes even as polls consistently show that Washington’s definition of mainstream is divorced from the rest of the country’s (for example, politicians’ refusal to debate the war even as polls show that Americans want the troops home).”

Voting for Obama?

Steven Maher recently told me that he was surprised that consumer-advocate Ralph Nader decided to run for president. He thought Nader might endorse Obama this year.

I was less surprised. As I noted earlier, there is in fact much to be excited about in regards to the Obama campaign: he would be the first black president, he has a decent background, he has energetic well-meaning grassroots supporters and so forth. But, when you really look at what Obama is offering, it represents a lot more of the same.

This is not to say one should not vote for Obama; in most states voting for Obama makes a lot of sense. The differences between Obama and McCain are not as big as many of us would like to see, but they are different enough to affect thousands of lives. But I do not think it is credible to say that Obama has taken enough bold steps to bypass a third-party challenge from the left. His weakness on health care and the military budget alone, are reason enough to expect such efforts, no matter how futile.

Indeed, Obama’s rhetoric, if not his policies, have moved to the left. This is true of Edwards and Clinton as well. The candidates understand that the public is outraged about the economy, our failing health care system and our endless wars. And so, unlike previous elections, they feel compelled to address these issues.

This is the true lesson of the Obama phenomenon. Politicians do not bring change, people do. And the best way to facilitate change is not to get behind a candidate, but to force them to take better stands on issues.

As Howard Zinn recently wrote:

Yes, there are candidates who are somewhat better than others, and at certain times of national crisis (the Thirties, for instance, or right now) where even a slight difference between the two parties may be a matter of life and death ... Would I support one candidate against another? Yes, for two minutes-the amount of time it takes to pull the lever down in the voting booth.

But before and after those two minutes, our time, our energy, should be spent in educating, agitating, organizing our fellow citizens in the workplace, in the neighborhood, in the schools. Our objective should be to build, painstakingly, patiently but energetically, a movement that, when it reaches a certain critical mass, would shake whoever is in the White House, in Congress, into changing national policy on matters of war and social justice.

Obama's cross-party appeal?

Phil Primeau is right to point out that Barack Obama does have a somewhat curious cross-party appeal. However, this support — like Obama's campaign — seems a little empty.

For example, his piece does not point out one specific policy position that would make Obama attractive to Republicans or to anyone. This is not Primeau's fault: Obama does not care much for policy specifics, but rather enjoys vague platitudes about the "politics of hope" (his words) and "a place of stable jobs, amiable foreign relations (that is) not paralyzed by baby boomer culture wars" (Primeau's words).

Primeau mentions Andrew Sullivan's piece in the Atlantic, (Goodbye to All That, December 2007)), which, I would argue, was an assault to serious journalism and smart political engagement. In fact, Sullivan even admits that the logic behind an Obama candidacy “has little to do with his policy proposals.”

He writes:

“Obama’s candidacy in this sense is a potentially transformational one. Unlike any of the other candidates, he could take America—finally—past the debilitating, self-perpetuating family quarrel of the Baby Boom generation that has long engulfed all of us.”

This is just silly, Chris Matthews-esque politico hero worship. This worldview asserts that charisma and so-called “intangible” leadership qualities are more important that how one would run the country. And sadly it is dominant in the media’s coverage of US national politics. And we wonder why most American voters don’t really care about issues (AP IPSOS 3.11.2007). And this is without getting into the fact that Obama really has no proposals that appeal to the left either. His health care proposal is a continuing of the status quo; and he, like Hillary Clinton, is totally Rubinized with virtually no new economic ideas.

The one thing that Obama offers both the left and the right is that he is not Hillary Clinton, whose pathetic triangulations, war mongering and submissiveness to corporations irritate lefties like me, while the fact that she is a Clinton irritates conservatives like Sullivan. Hell, even Sean Hannity types occasionally speak glowingly of Obama.

And this is what I think is at the root of Obama “cross-party appeal.” Indeed, not being Hillary is a good thing. But it doesn’t make him a good presidential candidate – and certainly not a “transformational” one.

Jackson on Kucinich

The talented Derrick Jackson (who I had the pleasure of working with at the Globe) says Dennis Kucinich has it right on health care.

Dennis Kucinich rarely gets much airtime in Democratic presidential debates. That was underscored recently when ABC’s George Stephanopoulos called on him in an Iowa forum to talk about God. Kucinich said, “George, I’ve been standing here for the last 45 minutes praying to God you were going to call on me.”

With poll numbers at 1 or 2 percent, the Ohio congressman is the nudge kicking at the knees of the Democratic Party to offer more than incremental change. He deserves more attention than he gets. On healthcare, he says what Americans believe, even as his rivals rake in contributions from the industry.

You don't have to look for to find how much I agree with him ( here, here, here, here, here, here, here, here, here, here, and here).

And come to think of it, health care is not the only issue where the Kuc is right. He is, and has long been, right about Iraq. So here we have a candidate that is right on the two most pressing concerns for the country -- let alone Democratic primary voters -- who is dismissed as a fringe candidate and polls at 1-2 percent. Something is seriously wrong with the way we handle elections in this country.

The AFL-CIO Debate (In Progress): Health Care

It is worth noting that the AFL-CIO endorses Kucinich's single-payer HR 676 -- Medicare for All. It is also worth noting, and terribly disappointing, that 6 of the 7 candidates on stage tonight reject it. This is, to me, the most frustrating element of this cast.

They all claim to be on the side of labor, but only Kucinich (and Gravel, who was absent tonight) actually supports their position on the nation's top domestic concern. And while Edward's has been the most populist of the big three, it is incredibly disappointing that he has proposed an individual mandate plan. And he is actually stronger on the issue that Obama and Clinton.

Jeff Cohen wants this question asked, and I think it would be a good way to frame the health care debate.

Excepting Mr. Kucinich who co-sponsors H.R. 676, please explain why you oppose “Enhanced Medicare for All.”

How many of you have seen Michael Moore’s movie, SiCKO? If you’ve seen it, do you disagree with Moore’s thesis that for-profit insurers deform our system and that healthcare is a right, not a commodity to be purchased? If you haven’t seen it, why not?

Follow up for Mr. Obama: You’ve repeatedly stated that when it comes to healthcare policy, insurance companies should get a seat at the table, but not every seat. Should Halliburton have a seat at the table when military or foreign policy is made?

Given the venue, Olberman should have asked everyone: why do you support allowing private for-profit companies run the health care system? And why are you not behind HR 676?

Terrorism and Health Care

We have all witnessed a good deal of fear mongering coming out of the mouths of politicians and pundits since 9-11, but Neil Cavuto's attempt to link universal health care to terrorism just might surpass all others in its sheer lunacy.

Response to Emcon on Health Care

Here is a partial response to Phil Primeau's comments on health care.



Phil writes:Oh please, tens of thousands would still die from inadequate treatment even if we were as socialized as England or Canada. Both systems are bogged down with huge waiting lines; people who need surgery (sometimes of a critical nature) are constantly unable to get them in a timely and professional manner.

My Response:

Well Phil, if you have compelling data that shows the amount of death from the “inadequate coverage” in the UK etc… I would be happy to see them. Otherwise, it just conjecture. But it should be noted that on top of the 18,000 that die each year from no insurance, many more die from inadequate insurance, as the insurance companies so often reject operations, and impose unfordable deductibles on patients.

Moreover, because the cost is so high for heath care here (largely due to the profits desired by the industry, and mountains of administrative overhead that comes with it) , low-income people end up with bare bones coverage that does not protect them in the case of a serious illness. While we have 47 million with no insurance, we also have tens of millions more who are under-insured.

As to the waiting lines, if you have numbers and data I would like to see them, because studies show that the waiting lines in Canada, for instance, are about the average for most nations. And, as Catherine Arnst recently wrote in Business Week, “despite spending lots more per capita on health care, the U.S. is often as bad or worse than other industrialized nations in wait times.”

It is quite amazing how the bullshit that CATO and others spew forth into the public sphere stick. It somehow penetrates the minds of smart people, who do not even seem compelled to check the validity of the claims. It really is quite amazing.


Phil writes: Socialized medicine is absolutely atrocious, and it will do more to undermine this increasingly fragile republic than almost anything else. (Also, say goodbye to cosmetic niceties, even stuff like braces. We're going to have teeth as ugly as the Brits, shiver. I like that our "mature" ladies can get boob jobs and face lifts on the spot on the spot whenever.)

Mike writes: Not sure the above states anything worthy or retort. But I will correct you in your false claim that national health insurance – or at least a single-payer system such as they have in Canada -- is socialized medicine. It is not. It is socialized insurance – which is a big difference. Socialized Medicine is where doctors and hospitals work for the government and draw salaries from the government. This is not the case with a single-payer system which you say will destroy the country , along with the great breast implants so admiringly associated with it.

But in most European countries, Canada, Australia and Japan they have socialized health insurance, as opposed to socialized medicine and the government pays for care that is delivered in the private, but mostly non-profit sector. This is the way Medicare works in this country. Doctors are paid from government funds, but work in the private sector. The government does not own or manage the hospitals, thus your doomsday predictions about the perils of socialized medicine are entirely irrelevant.

Now before I address the rest of your point, I want to jump ahead to this comment, since it fits into to what were are talking about nicely.

Phil writes: Considering the elderly (one of the most important groups when considering public health policy), those who live in America exhibit a much greater amount of satisfaction than those in England and Canada.

Mike writes:

I can’t thank you enough for brining this up. While Americans by in large are way less satisfied with their health systems than those in Canada, Brattain, France etc… the elderly are an exception.

And of course, that makes sense. The elderly are in a – if you can believe it – single payer system called Medicare. This is exactly the type of system that HR676-Medicare for All would give to all Americans, and perhaps if implemented we would all be as pleased with our system as our elderly, and the Canadians and the France, all who are much more satisfied with their health system, and yet dedicate way less of a percentage of their total GDP to it.


And why wouldn't they be more satisfied. The data is telling.

For starters, the spend less, and live longer:



And there is our woeful infant mortality rates.



As Ezra Klein notes: "About 23% of Americans report that they didn't receive care, or get a test due to cost. In Canada, that number is 5.5%." So really even if Canadians have to wait longer (though the wait times are grossly exaggerated) for non-emergency care, what is worse: waiting for care, or foregoing care?

And the most amazing this is this: It would not cost us any more to have this type of system. In fact, when you factor in savings on administrative costs, and the elimination of the profit, a truly universal single-payer system costs about ten percent less than what we are paying now. Which, as I noted, is by far the most per capita in the world and still has us left with a public that is grossly unsatisfied with system -- so much so that 56 percent said that would prefer a single-payer system "like Medicare" to our current system. (which is quite amazing given the way politicians and the media ignore single-payer proposals)

The Crime of Omission: The Times Narrows the Health Care Debate

Yesterday's Times article, 2008 candidates vow to overhaul U.S. Health Care, does its readers a great disservice. While they outline possible "overhauls" of the health care system by 2008 hopefuls (a generous word, given that the boldest proposal among those featured, John Edward's, still keeps the system in tact, and run by the private insurers), they manage to narrow the debate in an unforgivable way, through an egregious omission.

The article fails to make even one mention of the existence of a health care plan, HR676 Medicare for All, that 1) would actually overhaul the current system and give everyone access to health care 2) is written into a bill and has 80 cosponsors, the support of the AFL-CIO, and the majority of the country and 3) was introduced by a candidate for president, Congressman Dennis Kucinich.

Kucinich is a long-shot candidate, that is true. But Sen. Joe Biden, also a hopeless long-shot, got an entire article written about him today ... just for talking. So a couple sentences about a health care plan that has massive support hardly seems out-of-place in an article about health care proposals from presidential candidates.

This is a sad example of how the media narrowly frames the debate, and in doing so, serves to thwart a healthy understanding of policy matters. It is unforgivable coming from the paper of record.

The Sicko Reviews: Part 1

UPDATE: Despite the obvious mistakes in this piece, it managed to be quoted at length, approvingly, in the business section of the New York Times. This is simply unreal.

MTV's Kurt Loder reviews Sicko, and shows an ignorance so remarkable, I am left nearly speechless.

Moore is also a con man of a very brazen sort, and never more so than in this film. His cherry-picked facts, manipulative interviews (with lingering close-ups of distraught people breaking down in tears) and blithe assertions (how does he know 18,000* people will die this year because they have no health insurance?) are so stacked that you can feel his whole argument sliding sideways as the picture unspools.

How does he know? Well, Mr Loder, if you bothered to take advantage of this wonderful invention called Google, you will learn that -- gasp! -- they actually calculate these figures. They have studies and everything! It is quite fascinating. Yes, of course, we don't know that 18,000 people will die this year. It may, in fact, be more. But we do know, thanks to the wonderful invention of statistics, how many people die, on average each year from lack of health insurance: 18,000.

What's worse, this is a commonly used statistic that as far as I can tell, is entirely undisputed.


Jesus ...

UPDATE: All right, I managed to make it down to the rest of this review and again, I can not allow such nonsense to go unchallenged.

At least when Cato or something, critique the logic behind a national health plan (or this movie) they hire people who understand policy. They obviously have different values than I do, and I would disagree with their conclusions, but they are capable of research.

The problem with many of these piss-poor Sicko reviews (this weeks review in the Weekly Dig was one of the worst articles, review or otherwise, that I have ever read in a publication that wasn't funded by a Student Government Association) is that the film critics are just that: film critics. They are not policy experts. But when they try to review a movie that is inseparable from policy, they just end up wasting valuable space.

Onward to Loder's nonsense.

The American health-care system is in urgent need of reform, no question. Some 47 million people are uninsured (although many are only temporarily so, being either in-between jobs or young enough not to feel a pressing need to buy health insurance). There are a number of proposals as to what might be done to correct this situation. Moore has no use for any of them, save one.

Loder has stooped to outright red-baiting. "One," clearly means -- oh no ... don't say it ... it can't be -- Socialism! (The next sentence begins "A proud socialist, Moore ..." ) This is all the more fitting since Moore pointed out in great detail how the tactic of claiming that health care reform is the obvious first step to outright Communism, has been employed often and in laughably absurd ways for years.

First of all, Moore actually does not offer only one solution. France, Canada, the UK, and Cuba have health policies that are totally different from one another. The obvious similarity, and the point Moore drove home quite well, is that they are publicly funded and universal. But this is not radical. This is true of all developed countries, sans the US. It hasn't turned the rest of the world into commies, not even close. They just treat health care as something so important, as to warrant making sure everyone has it, much the same as the US approaches firefighters, or public schools, or whatever else.

Loder, however, manages to contradict himself without hesitation.

n 1993, when one of Moore's heroes, Hillary Clinton (he actually blurts out the word "sexy!" in describing her in the movie), tried to create a government-controlled health care system, her failed attempt to do so helped deliver the U.S. Senate and House of Representatives into Republican control for the next dozen years. Moore still looks upon Clinton's plan as a grand idea, one that Americans, being not very bright, unwisely rejected.

Where to begin. First of all, Loder makes the claim that Moore supported the Clinton plan. He doesn't (Again, Kurt, try the Internet, it is really quite valuable). In fact, the Clinton plan, far from being Socialist, actually would have preserved the private health industry, which counteracts with Moore's stated goal, which he has said in every interview he has done: get rid of the private health insurance industry.

The point, was not to show support for the plan, but to show the type of reactionary opposition that was thrown at it from the right -- so reactionary and vile, so hyperbolic and absurd. Even proposing band-aid solutions, as Clinton did, is enough to get the politicians (with financial incentive from the drug and insurance companies) into a frenzy.

(Which is why, as an aside, the likes of Edwards and Obama should just back HR676 (Medicare for All) rather than have these Clinton-esque hybrid plans. Both will meet intense opposition, but the Medicare for All bill would actually be worth fighting over, and has massive grassroots appeal. When was the last time you saw a rally in the streets with people screaming for an individual mandate?)

Moreover, the Clinton bill was killed, not by the people, who never had a say in the matter, but in DC by the GOP. This was due in large part to a memo (there is no health care crises) by then political operative (now editor of the Weekly Standard) William Kristol, that ordered the GOP kill any Clinton health plan, no matter what it was, so as to not give the Clinton's a political victory.

And in fact, people have no real influence on the health care debate. If they did, than a single-payer system would not be considered politically impossible. As I have noted before, the majority of Americans support a single-payer system to our current system. It is only considered "politically impossible" because in the US corporate dollars have way more influence in matters of public policy than people do.

And even if Moore did support the Hillary Plan, than Loder would have to concede, contrary to his previous meanderings, that Moore has more than one solution he likes. It seems quite clear that Loder does not know the difference between what Clinton proposed and what they have in France or Canada. In short, he seems to know nothing at all about the issue he is writing about.


One last passage:

Moore's most ardent enthusiasm is reserved for the French health care system, which he portrays as the crowning glory of a Gallic lifestyle far superior to our own. The French! They work only 35 hours a week, by law. They get at least five weeks' vacation every year. Their health care is free, and they can take an unlimited number of sick days. It is here that Moore shoots himself in the foot. He introduces us to a young man who's reached the end of three months of paid sick leave and is asked by his doctor if he's finally ready to return to work. No, not yet, he says. So the doctor gives him another three months of paid leave — and the young man immediately decamps for the South of France, where we see him lounging on the sunny Riviera, chatting up babes and generally enjoying what would be for most people a very expensive vacation. Moore apparently expects us to witness this dumbfounding spectacle and ask why we can't have such a great health care system, too. I think a more common response would be, how can any country afford such economic insanity?

So a guy gets cancer and then has the audacity to take three months off to grow his hair back, and get well. This is a bad thing? And why is this economic insanity? Sure, generous social services can slow growth a bit, but so what? 18,000 people die a year from lack of health insurance in the US. I would gladly sacrifice a little bit of economic growth to save 18,000 lives. How do you measure wealth? Is going through life without having to worry about losing your income due to illness not valuable?

This review is just insulting. Even those who oppose the type of health reform that the entire world has and that Moore advocates, cannot possibly trust this review since the author literally offers no valid argument, and clearly does not know what he is talking about. Why would Andrew Sullivan (whose blog linked me to this review, or I would not have found it) approvingly link to such a wasted argument?

Amazingly, however, this is not the worst review. So tomorrow sometime soon, in part two of this series, I will address the aforementioned Weekly Dig article.

On Michael Moore

*Moore goes to California: the heart of the single-payer health care movement.

Michael Moore was recently in Sacramento, where Sen. Kuehl along with the help of a tireless and committed group of health care activists, are continuing to fight for a single-payer model. (SB 840 the Californians Health Insurance Reliability Act). Katrina and I wrote about this recently.

When I spoke with health care activists in the state, I was truly impressed with how smart and devoted they were to pushing the bill. Though it was vetoed by Gov. Schwarzenegger they are going to pass it again and are pressuring him to sign it. That is unlikely but even if vetoes it again, and are coming up with override strategies. If that fails, they plan to simply keep sending the bill back over and over again. The bill has massive popular support, In fact, does any type of health insurance plan have any grassroots supports other than single-payer. When is the last time you saw a rally on the street for the individual mandate? Furthermore, Schwarzenegger has put a lot of chips on the table by saying he will fix the health care problem. No legislator, however, will back his flawed plan and he will be under tremendous pressure to get something done. If if he ever werr to sign the bill, he could say he was responsible for guaranteed universal health care to the entire state -- and overnight he is an iconoclast on the issue. Indeed it would piss off his GOP buddies, but he has been willing to do that before with his stances on gays, climate change and immigration.

There are also faint whispers he may try to challenge the popular incumbent Barbara Boxer for a senate seat in 2010 and this could make him far more appealing to voters if this race were to ever happen. (Again, I have only heard whispers)

Back to Moore: The filmmaker' new movie Sicko comes out this month (it has been seen in select places). It will be interesting to see how if he mentions the Massachusetts plan or the hybrid concept in general. My guess is that he will, and he will oppose them. Moore's movie will inevitably lead to two debates: 1) How the US should handle its health care problem (I know of nobody who does not call it a problem) and 2) more tiresome arguments over Moore's credibility.

There is no doubt that Moore's in-your-face interviews with corporate PR staffers and his occasional childish jokes are often pretty off-putting and step on his some of his good points. On top of that, Moore also misses some key points by using weak examples. Consider what Robert Jensen said about Moore' segment on Bush's trampling of civil liberties in his 2004 review of Fahrenheit 9/11.

The other example of political repression that "Fahrenheit 9/11" offers is the story of Barry Reingold, who was visited by FBI agents after making critical remarks about Bush and the war while working out at a gym in Oakland. Reingold, a white retired phone worker, was not detained or charged with a crime; the agents questioned him and left. This is the poster child for repression? In a country where hundreds of Arab, South Asian and Muslim men were thrown into secret detention after 9/11, this is the case Moore chooses to highlight? The only reference in the film to those detentions post-9/11 is in an interview with a former FBI agent about Saudis who were allowed to leave the United States shortly after 9/11, in which it appears that Moore mentions those detentions only to contrast the kid-gloves treatment that privileged Saudi nationals allegedly received.

But he is far more credible than the right tries to paint him out to be. Bowling for Columbine was a smart film with a well-deserved Academy Award to show for it. Roger & Me and the Big One both highlight the very real anxiety working class people must live through in an age of outsourcing. And Moore has posted sources for all of his facts in Farenheit 9-11 online.

Others , such as Andrew Sullivan, try to paint Moore as the Ann Coulter of the left. He wrote the following not long after Coulter's infamous CPAC speech.

I'm not being an hysteric about Coulter. Republicans, if they are serious about reaching the people they lost in 2006, need to start distancing themselves from her. She's their Michael Moore.

I responded to this in March:

Now, there are certainly plenty of valid critiques of Michael Moore's style, and reasonable people can disagree about his politics. But to say that there is anything close to a moral equivalence between Moore and Coulter -- a racist, homophobic, simpleton -- is beyond absurd.

The Health Care Plans

A great letter in today's Globe regarding the various health care plans from the Democratic candidates.

June 5, 2007

IN YOUR May 30 editorial ("Obama's incomplete health plan"), you criticize Barack Obama's plan for health insurance and prefer the scheme put forward by John Edwards . In the last paragraph, you recognize that the truly "grand vision" belongs to Dennis Kucinich, who favors single-payer, tax-based healthcare such as that provided in virtually every other advanced nation. However, you despair of achieving this vision over the entrenched opposition of the insurance industry, and therefore promote Edwards's promise of universal coverage as more viable.

It is a sad commentary on American presidential politics that only the marginal candidate Kucinich dares propose what any dispassionate observer must conclude is the only sane approach to the present chaos. That none of the other Democratic candidates can speak openly of single-payer is a tribute to the stranglehold that corporate money has on our political system.

For newspapers like the Globe likewise to pander to the insurance industry by backing stopgap measures is a shame.

Throughout our history, we have relied upon the press not to follow office holders, but to lead them. If the Globe does not dare advocate what it knows is right, what hope is there for mere politicians?

SUMNER Z. KAPLAN
Jamaica Plain

The writer is a former member of the Massachusetts House.

Single-Payer Debate

Over at TNR, Jonathan Cohn and David Gratzer are engaging in a debate over the merits of a national health system. Today is part 1, and Gratzer is already misleading his audience.

Far from the nirvana of your essay, I found people struggling to get basic health care--since practically every surgical and diagnostic test required some type of waiting.

Cohn rightly calls claims of excessive waiting in Canadian hospitals "wildly exaggerated" in his book, Sick. And in fact, studies show that while Canada does have some long wait times on some non-emergency surgeries (such as hip-replacement), in reality wait times in Canada are quite comparable to other health care systems.

Moreover, studies show that most Canadiens are happy with their health care -- a system that "is and always has been popular in Canada." This is not true in the US, where 56 percent of Americans would prefer a government-run universal health system “like Medicare” to our current system.



And as many already know, in America, more than 45 million Americans lack insurance, and more than 18,000 die each year from this. This hardly seems like much of a debate to me.

Sick: the Debate

If you are a health policy wonk, it is worth checking out what is a substantive debate at TPM on Jonathan Cohn's latest book Sick.

Our Broken Healthcare System: Prospects for Change

growing concern

The good news: America is concerned about healthcare above all other domestic issues, supports a single-payer system, and is ready to cover everyone -- even if its means paying higher taxes. The bad news: the reason the country is so ready for change is that the current system is so horrifically flawed. As I wrote in the Globe last year.

Given that an estimated 18,000 Americans die each year from lack of health insurance, it is clear that reform is long overdue.

Even with the growing concern, and the fact that healthcare is gaining traction in the news cycle, there are reasons to be skeptical about the prospects for positive change. For example, the President's dead-on-arrival proposal didn't even pretend to provide universal coverage.

“Bush’s reform plan - fiddling with the tax system and peddling skimpy private health plans - will fail miserably,” said Dr. Oliver Fein, Professor of Medicine at Cornell University in a statement released in response to Bush’s State of The Union speech. He also noted that, like Massachusetts and California proposals that rely on private insurers, “it would leave millions without coverage.”

the 'individual mandate'

While we expect the president to offer nothing of substance on this issue, one would hope that state legislatures or Democrats may. That reform is overdue, however, does not mean it will come -- and it certainly doesn't assure that whatever plans are proposed will result in adequate care for all Americans. For example, the "individual mandate" is an idea that is gaining traction, and this is very troubling. The plan passed in Massachusetts last year, for example, is horribly flawed, and as Steffie Woolhandler told me, it is "pure fantasy" to claim it will result in universal coverage.

Still the bill was covered as if it were some kind of miracle solution. The New York Times ran a front page story that did not bother to find one source to counter the endless praise bestowed on the bill. The Globe also ran an editorial praising the "healthcare heroes" behind RomneyCare. (Thankfully a week later columnist Joan Vennochi countered with "Mitt's myth of healthcare." )

Perhaps the overly optimistic coverage of the Massachusetts plan could explain why other politicians have warmed to the idea. Governor Arnold Schwarzenegger has proposed his own plan which also works of the concept of an individual mandate, just a few months after he vetoed a bill that would have resulted in a single-payer plan saying he "cannot support a government-run health care system.”

While presidential candidate John Edward's was bold enough to suggest that we should roll back the Bush Tax Cuts to pay for universal coverage -- a step Clinton and Obama have not said they would be willing to make -- his plan is still at its core is, as Len Rodberg said, an "individual mandate with a pretty face." And indeed, Edwards is a skilled rhetorician which makes his plan sound much sweeter than it is.

a voice of reason

But fortunately there are some sharp experts on the issue of healthcare. One is Jonathan Cohn, the senior editor of the New Republic. He applauded some aspects of the Edwards proposal but rightly noted the big problem (emphasis provided by The Soapbox).

The new Edwards plan is not as far-reaching as some plans now circulating in Congress including plans that call for remaking the health care system top-to-bottom by creating a single-payer system modeled on Medicare. Precisely because the Edwards plan comes from the candidate positioning himself as the voice of working-class populism, that makes the final product just a tad disappointing.

Of course, Cohn has shown an embrace of radical change on healthcare, that most do not. In 2002, when Al Gore surprised the world by advocating for a single-payer system -- not exactly a risk-free move at the time -- Cohn came to his defense.

Is Gore nuts? Not on policy grounds. In a single-payer system, the government becomes the nation's health insurance company. Instead of paying premiums to an insurer (either directly or through an employer), each American would pay that money to the government; in turn, the government would pay the providers of medical care--i.e., mostly private doctors and hospitals--in the same way insurance companies now do.

Make no mistake: It's a radical overhaul. But single-payer also has clear virtues: As a general rule, the more people who belong to an insurance pool, the more thinly you spread the financial burden of illness, which can be devastating if you face it alone or within a small group. By definition, single-payer spreads the risk pool across the largest number of people possible--namely, everyone in the country. In addition, while people may associate government with excessive bureaucracy, single-payer systems devote far less money to administrative overhead than private insurance.

[...]

And, of course, single-payer systems by definition make coverage universal--i.e., they give insurance to every citizen as a birthright, regardless of employment status. This isn't just fair: It may also be more efficient, since it would allow people more freedom to change jobs and pursue better opportunities.

Another strong point by Cohn, whose TNR article on Gore was a strong enough defense of single-payer to be be republished by Physicians for a National Health Program, was that no matter how business-friendly a politician tries to make a universal healthcare plan --(see HillaryCare) --they will inevitably be attacked as radical socialists anyway. So why bother trying?

The lesson is that even if you don't actually propose a radical overhaul of the health care system, critics from the right will still have an easy time denouncing it as medical socialism. Indeed, critics from the right have been known to level that charge at even piecemeal health reform measures--from the State Children's Health Insurance Program (S-CHIP), which merely allows states to subsidize coverage for kids living at or near the poverty line, to HMO reform, which doesn't expand coverage at all but simply regulates the way insurance companies make treatment decisions.

So if you're going to propose a large-scale change to the health care system and invite the "socialized medicine" charge anyway, you might be better off endorsing a single-payer system, which at least has the virtue of being easy to explain. Unlike, say, a hybrid public-private system, which involves all sorts of convoluted regulations, which then require all sorts of tortured explanations, the essence of single-payer can be reduced to three simple words: "Medicare for all."

I noted Cohn's vision six weeks ago when I said:

Cohn’s suggestions for implementing universal health care, which are laid out in the book’s conclusion, are unambiguously and impressively bold. He has high praise for Medicare calling it “remarkably efficient.” Moreover, he speaks glowingly about many foreign governments’ health care systems. He has high praise for France’s system (where all legal residents have insurance and the government subsidizes around 75 percent of all heath care costs), which he says may be “the best showcase for what universal health care can achieve.” He also defends Canada’s single-payer system and says stories of long lines in Canadian hospitals are “wildly exaggerated.”

Given Cohn's perceptiveness and principle on the issue, it is good to see that he is featured in the Times twice this week. As this debate moves forward, having a senior editor of TNR, who is a respected, non-divisive figure handling the issue of healthcare, is a huge improvement to the early 90s when then editor of TNR, Andrew Sullivan, helped to kill the Clinton plan with an assault from the right. Of course he has a lot of help from then Republican operative, William Kristol, but TNR's role was substantial in the pre-Internet days, when they really did drive debate in Washington.

the role of business

Today, the Times has book review on Jonathan Cohn's new book Sick: The Untold Story of America’s Health Care Crisis — and the People Who Pay the Price. In February I reviewed the same book for Campus Progress.

That the reviewer, Sally Satel, is from the American Enterprise Institute made some the critiques predictable.

Cohn is himself being unfair when he sweepingly denounces “the principles of modern conservatism” for being “conspicuously short on ... comfort or hope.” In truth, there is nothing inherently pessimistic in choice, self-reliance or limited bureaucracy — the values that underlie a market-based proposal like the one introduced by Senator Ron Wyden, an Oregon Democrat. In this plan, employers would no longer provide insurance and would instead convert those costs into a bigger paycheck, enabling workers to buy private insurance from providers who would then be forced to compete for business by offering better plans.

But still it is telling that even someone from the ultra conservative think tank (the AEI's fellows include Mary Cheney, Fred Kagan, John Yoo and Newt Gingrich) also seemed obligated to acknowledge the tragedy of our current system as highlight by the book.

The timing of this book is perfect. An epidemic of anxiety over the cost of health care has catapulted reform back onto the national agenda, and states from California to Massachusetts are now experimenting with universal coverage. It also promises to be a key issue in the 2008 election.

In “Sick,” Jonathan Cohn, a senior editor at The New Republic, lucidly shows how America’s system for financing medical care helps determine who gets proper medical attention — and who doesn’t. He tells this story through the experiences of ordinary people ...

By the end of Cohn’s narrative we’ve run the gamut of woes: the hopeless fragmentation of the mental heath system; staggering medical debt; the dependence on job-based insurance; frayed social safety nets; lousy (or no) guarantees of preventive care; selective access to medications.

In his article in last weeks New York Times Magazine, Cohn also illustrates a growing consensus on healthcare amongst strange bedfellows, big-business and the left, who for different reasons are being squeezed by the rising costs of care.

Is all of this indicative of a broader shift in the politics of health care? Perhaps. As health care has become more expensive and even middle-class Americans have become anxious that their hold on employer-sponsored coverage is precarious, politicians have been talking seriously again about making health insurance a birthright, just as it is in every other developed nation.

[...]

But it is corporate America’s interest that is most striking. For many years, the only business leaders openly calling for universal coverage were mavericks like Howard Schultz, the chairman of Starbucks, who has long preached the need for business to show greater social responsibility. The C.E.O.’s rallying to universal coverage now — particularly in the last few months — are acting not so much out of social solidarity as out of financial necessity, as the burden of financing workers’ premiums has become ever more onerous.“The refrain from business was, ‘We can’t afford to do universal health care,’ ” says Wyden, whose plan calls for shifting responsibility for buying insurance from employers to individuals. “Now the refrain is, ‘We can’t afford not to do it.’ ”

Now, that the business community has a reason to support healthcare reform does not mean that change is inevitable. They have been woefully short on specifics but would seem to be motivated to support some kind of individual mandate plan, and not what would a far better plan: HR 676 -- Medicare for All.

In the early phases of the last great debate about health-care reform, during the early 1990s, prominent business leaders sent out strikingly similar signals — suggesting they were ready to embrace universal health care, for the same essential reasons they cite now. At one point, a coalition of business leaders put out a “play or pay” proposal that would have required corporations either to insure their workers or to pay into a common fund for the uninsured. But as President Clinton’s health-care plan lost political momentum, the business community’s support for universal health care faltered and, eventually, collapsed. Is its support any more reliable now? “This is precisely the political equation the Clintons bet on,” says Jonathan Oberlander, a health-policy scholar at the University of North Carolina. “Sorry to say this may turn out to be another mirage.”

And as the Massachusetts plan is likely to show, the mandate plans -- which make health insurance, like car insurance, something one must buy -- the reason why triangulating on healthcare only perpetuates the main problem: the fact that health insurance is controlled by the pharmaceutical companies, who are paying wasteful administrative costs, turning in a profit and giving money to politicians in both major parties.

And this has some within the single-payer movement conflicted. I attended a forum for PNHP METRO in late February and there was some dissension on how to approach the Edward's plan. While virtually no one there thought the Edwards plan would pass, or for that matter would be an efficient plan even if it did, there were still questions? Do you attack the plan for its obvious flaws, and its inability to address the root of the problem (private insurance companies and a lack of a single-payer system)? Or, do you hold off on harsh criticism, knowing the plan will never be implemented anyway (even if Edwards won the presidency, the sausage making fest that is the legislative process would either kill, or alter the plan greatly,) and try to use the momentum to help build the single-payer movement?

medicare for all

It seems, the majority of members preferred the former. There is simply no question that (HR676) The United States National Health Insurance Act which calls for "Medicare for All" is the best proposal in Washington -- and the only one that aims to take down private insurers and give the US with what every other developed country in the world has: a national universal healthcare plan.

But still, there are good signs. Aforementioned polls show that 56 percent of the public has said that they prefer a plan "like Medicare" to our current system and that healthcare is the countries top domestic priority. HR 676 now has 78 cosponsors and labor is on board as well; the AFL-CIO Executive Committee has endorsed Medicare for All.

Sure the Democratic Candidates, sans Kucinich, are predictably and sadly failing to represent the will of the country. But let us not choose the candidates, let them choose us. As an editorial in The Nation said.

Voters have to demand more if they want more. Obama at least recognizes the frustration of Americans for whom meaningful healthcare reform has been a dream deferred at least since the collapse of the Clinton Administration’s bureaucratic proposals of the mid-1990s. The Clinton plan rejected single-payer and embraced a complicated hybrid that relied too heavily on the same insurance companies that had failed to make healthcare affordable and accessible. “We can’t afford another disappointing charade in 2008, 2009 and 2010,” says Obama. He’s right. But he and his fellow front-runners should recognize that as long as they avoid talking about single-payer and continue to tinker around the edges of the current system, they are players in the charade.

Something is brewing out there. Recall two years ago when virtually every Democrat currently running for President, sans Kucinich, was opposed to a timetable in Iraq. What seems a more likely cause of the latest shift? Was it that they all has some moral epiphany, or did they begin to realize that the public will not allow them to keep walking, willfully, down the road that is destroying us. Politicians don't make change unless it becomes a political liability for them not to. Right now, the winds are at our back.