When I think back to the presidential debate last night, one moment stands out in my mind more than any other. And, no, it wasn't McCain calling Obama "that one". It was the discussion following Tom Brokaw's question "Is health care in America a privilege, a right, or a responsibility?"
Health care came up several times throughout the debate, but here I thought the answers were most telling. This is in spite of the fact that I took issue with the way the question was phrased. Specifically, I felt that the third choice ("responsibility") was unnecessary and just gave the candidates an easy cop out. Guess which one McCain chose:
McCain: I think it's a responsibility, in this respect, in that we should have available and affordable health care to every American citizen, to every family member. And with the plan that--that I have, that will do that.
But government mandates I--I'm always a little nervous about. But it is certainly my responsibility. It is certainly small-business people and others, and they understand that responsibility. American citizens understand that. Employers understand that.
But they certainly are a little nervous when Sen. Obama says, if you don't get the health care policy that I think you should have, then you're going to get fined. And, by the way, Sen. Obama has never mentioned how much that fine might be. Perhaps we might find that out tonight.
No solutions. No departure from our broken health care system. Just a continued reliance on employer-based health care.
Obama, on the other hand, charts a new course--boldly stating from the very first sentence of his answer that health care is a basic right:
Obama: Well, I think it should be a right for every American. In a country as wealthy as ours, for us to have people who are going bankrupt because they can't pay their medical bills--for my mother to die of cancer at the age of 53 and have to spend the last months of her life in the hospital room arguing with insurance companies because they're saying that this may be a pre-existing condition and they don't have to pay her treatment, there's something fundamentally wrong about that.
So let me--let me just talk about this fundamental difference. And, Tom, I know that we're under time constraints, but Sen. McCain threw a lot of stuff out there.
Number one, let me just repeat, if you've got a health care plan that you like, you can keep it. All I'm going to do is help you to lower the premiums on it. You'll still have choice of doctor. There's no mandate involved.
Small businesses are not going to have a mandate. What we're going to give you is a 50 percent tax credit to help provide health care for those that you need.
Now, it's true that I say that you are going to have to make sure that your child has health care, because children are relatively cheap to insure and we don't want them going to the emergency room for treatable illnesses like asthma.
And when Sen. McCain says that he wants to provide children health care, what he doesn't mention is he voted against the expansion of the Children's Health Insurance Program that is responsible for making sure that so many children who didn't have previously health insurance have it now.
Obama's answer provided what was probably the most emotional moment of the debate--when he spoke of his mother's death--but, more importantly, it was relatively heavy on substance, at least for a presidential debate. And, I'd say that Obama was right on target, although he doesn't go into a great deal of detail (for more on his health care plan, see my earlier post on the topic). The bottom line is that in a modern, developed, 21st Century society, health care needs to be thought of as a basic human right. If the right governmental framework is in place, adequate health care certainly can be delivered to all. This is not only a moral imperative but an economic one as well: efficiently delivered universal health care saves money over the alternative.
To his credit, McCain certainly makes a good point that Obama hasn't spelled out exactly what the penalty would be for having uninsured children; however, Obama's plan is based on the premise that affordable health care will be made available for children through a variety of avenues, so that this mandate should exist solely to push parents into action, and not to punish them.
As Obama points out, McCain did vote against the expansion of the State Children's Health Insurance Program in August 2007, along with 30 other Senate Republicans (Maverick? I don't think so). Despite this, the bill passed the Senate and the House, but was later vetoed by President Bush. In fact, due to this Republican resistance, Congress had to pass a watered-down stop-gap measure that December just to keep SCHIP from expiring.
McCain was on the wrong side of that battle, and he has given us no reason to believe that he's going to reverse course and offer any real health care solutions if he were to become president.
CNN has a full transcript of the debate here.
The 'responsibility' option wasn't 'unnecessary'. It was a deliberate choice - by Tom Brokaw - to imply that poor health was the result of irresponsibility.
It is necessary in the minds of these people that those needing health care they cannot afford themselves be portrayed as negatively as possible.
Actually there was a stroke of genius in the response (not the bit that's quoted though) where Obama said that people would be given the opportunity to access the same program he and McCain, as Senators, have.
If you expand the Senators' health care plan some hundred thousand times, you have government-provided health care insurance.
The latest issue of NEJM, released online tonight, has articles by both Obama and McCain on their overall health care proposals. (These are available for free download after site registration at: http://www.nejm.org/ )
As you'd expect, Obama's proposals cover many more aspects of health care, and he explains how he'd finance them. Unfortunately, he too seems to be content to stick with the current insurance companies/plans, although he does provide for an option that would provide an incentive for companies to offer competitive rates.
I'd argue that it is definately not a "right". We have a bill of rights, and "free healthcare for everyone" is not listed.
Also not listed as rights:
Food for everyone.
Clothing for everyone.
Housing for everyone.
I wouldn't call them "rights", i'd call them "necessities". You NEED them, but it isn't the government's responsibility to provide them to everyone.
I agree that there should be "affordable" healthcare for everyone, which is definately not the case right now.
We recently had a baby, via c-section. we got the bill the other day for the stay.
total cost: $12,000+
there's a line on there "negotiated by insurer", "-$8000"
then a line "paid by insurer" "-$3700"
then a line "you owe" "$300"
so someone without insurance would have to pay $12000? just by having an insurer, $8000 of cost magically disappeared? That to me is a broken system.
Do either Sen's McCain or Obama plans have something about fixing the craziness we already have? or just funding the craziness?
You should look into the ninth amendment to the Bill of Rights, John.
So, since people don't have a "right" to food, clothing, or shelter, if they can't provide them for themselves, they deserve the consequences, whatever those may be?
The Declaration of Independence lists the three "inalienable rights of man." They are "life," "liberty," and the "pursuit of happiness."
Without food, clothing, and shelter, you cannot have "life." Doesn't it follow, therefore, that people have a right to these things, even if a "right to food" is not explicitly stated?
I think Obama was right on target in this debate. He is clear about his plans. I am kind of tired about the stabs and jabs they took at each other, though.
Obama is still a bit light on policy - Clinton's was rather better. But his policy is light years ahead of McCain. I was hoping for a West Wing like 'medicare for all' moment from Obama, but perhaps next time.
If the Democrats really want to put the screws on McCain (and the GOP generally), then they could do a lot worse than having a billboard quoting the two candidates -
McCain: Healthcare is a responsibility
Obama: Healthcare is a right
Says it all. And its difficult to accuse the other side of wanting to 'socialise' medicine when you've just nationalised the banks...
I'd argue that it is definately [sic] not a "right". We have a bill of rights, and "free healthcare for everyone" is not listed.
The USA has signed the UN Declaration of Human Rights. Go look up what that document says.
And besides, the Bill of Rights is not an exhaustive list! Where's the clause again that says the rights not mention in the Constitution "remain with the States, or with the People"? (And I'm not even an American.)
so someone without insurance would have to pay $12000? just by having an insurer, $8000 of cost magically disappeared?
Remember the guy who managed to shoot a nail into his head and survived? Pulling that nail out cost him sixty kilobucks he didn't have, and he wasn't insured. I don't think he has repaid all those debts yet.
That is a broken system.
I also say that Universal Health Care is an economic necessity. Untreated illness due to the inability to afford to see a doctor at early stages of illness creates a heavy cost to business, in terms of sick time, contagion for people who come to work when they are ill and lost work due to extended illness that could have been otherwise treated early.
Uninsured people who use the emergency rooms as their health care option force hospitals to pass on their costs to the insurers who cover the insured; to the property taxes of the county in which they are located.
Hospitals have increased labor costs as well, by having to hire ever larger pools of accounts receivable specialists who need to fight the bureaucracies of adjusters who work for insurance companies, and that again raises the standard costs of health care.
Doctors at small clinics spend as much as forty hours per week, in addition to their hours of practice, trying to justify to non-medical personnel in the adjuster's pool the cost of a medically-approved procedure.
The only way we will ever be able to move to a sane health insurance environment is to talk cost and benefit, rather than "privilege, right or responsibility." Framing it through the personal gives the wealthy the opportunity to say "I have worked hard to afford good coverage, and so should everybody else have to."
I'm absolutely support Obama's politics. And I'm very happy, he is our president!
I was hoping for a West Wing like 'medicare for all' moment from Obama, but perhaps next time.