Playing Politics with Health Care
Washington Dispatch: A major union supporting Hillary Clinton has slammed Barack Obama for not including mandates in his health care plan. But AFSCME has argued that mandates make health care unaffordable.
December 20, 2007
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Last April, Gerald McEntee, the international president of the American Federation of State, County, and Municipal Employees (AFSCME), took a seat in a congressional committee room and testified before a House subcommittee on the pressing need for health care reform. Noting the growing number of uninsured and soaring health care costs, he declared, "America's working families demand relief from this crisis." He laid out his principles for the universal health care coverage that his powerful union favored. He also made clear what his union opposed when it came to health care reform, most notably so-called individual mandates. McEntee explained,
The Massachusetts reform model attempts to achieve near-universal coverage through the use of individual mandates that require those without access to coverage through their jobs to buy coverage in the individual market. Although there are subsidies to help low-income families, many working families will be forced to pay much higher prices for coverage. The most recent estimates for coverage under this initiative for a family with an income of $50,000 would include a $7,000 premium and a $2,000 deductible. Health care costs that approach 20 percent of total family income are unaffordable and unacceptable to working families and they will ultimately doom this plan to failure.
This opposition to mandates is standard fare for AFSCME. In August 2006, at its annual convention, the union adopted a "Health Care Reform Blueprint for 2007-2008" that called individual mandates "incompatible with AFSCME's principles and long term interests."
But policy principles gave way to political needs. In late October, AFSCME endorsed Hillary Clinton, whose health care plan prominently features a mandate. This week, AFSCME helped Clinton assail her primary rival, Barack Obama, for holding a position it holds itself. AFSCME's national office distributed a flier in Iowa blasting Barack Obama for not mandating coverage, saying Obama took "the timid way out, offering yet another band-aid solution." (In underhanded fashion, the attack flier was designed to look like it came from the John Edwards campaign, not the Clinton camp.)
The mandate issue has become one of the few matters of policy debate in the Democratic race. Obama, Clinton, and Edwards have all released plans that they claim would provide universal health care coverage. The proposals put out by Clinton and Edwards each contain a mandate, which would force healthy individuals to buy insurance in order to put more money into the system to cover the sick. Obama's plan does not include such a proposal. In one recent debate, Clinton attacked Obama for eschewing a mandate: "He talks a lot about stepping up and taking responsibility and taking strong positions. But when it came time to step up and decide whether or not he would support universal health care coverage, he chose not to do that." (The AFSCME flier echoes this criticism.) Obama replied, "The only difference between Senator Clinton's health care plan and mine is that she thinks the problem for people without health care is that nobody has mandated—forced—them to get health care. That's not what I'm seeing...What I see are people who would love to have health care. They desperately want it. But the problem is they can't afford it."
It is Obama's statement from that debate that is most in synch with Gerald McEntee's testimony to Congress from earlier this year. Is AFSCME playing politics with health care? We contacted the union's press office to get an answer, and no one returned our call and email.
David Corn is the Mother Jones Washington D.C. bureau chief. Jonathan Stein is a reporter in the Washington D.C. bureau.
Comments:
You're way off on this.
First, McEntee's testimony regarding the MA plan does not say he opposes mandates in general. It says he opposes this mandate because it doesn't provide enough funding for low income people. One of the major differences between the Clinton plan and the MA plan is a vast expansion of public programs like SCHIP and Medicaid to ensure affordability.
Further proof? In that very same testimony, McEntee praises Congressman Stark's plan. Stark's plan, of course, is universal health coverage with an individual mandate (“AmeriCare Health Care Act").
Finally, the blueprint you link to makes the case even clearer. It says:
"In the absence of federal solutions, states will continue to initiate their own reforms of the health care system, especially reforms targeted to the most vulnerable populations. Some of these reforms, such the reforms adopted in Massachusetts in 2006 which rely on “individual mandates,” are incompatible with AFSCME’s principles and long term interests. Others, such as proposals to expand S-CHIP, are worthy of the union’s support. AFSCME must carefully weigh its involvement in state based reform based on whether our participation advances the union towards its ultimate goal."
They're against STATE mandates, not federal mandates, because states don't have the ability to provide enough subsidies from public programs. The federal government does, and that's precisely what Clinton's plan does.
Posted by:Partially ImpartialDecember 21, 2007 6:52:37 AMRespond ^
In the context of the Clinton and Edwards plans the criticism of mandates seems inapt. They both have the option to enter medicaid. Not everyone is forced onto the private market to meet the demands of the mandate. Even if there is some need standard to opt-in to medicaid that could be set in a way to make sure that those who cannot afford private health insurance still get health insurance.
Posted by:PatrickDecember 21, 2007 11:41:19 AMRespond ^
Yes, the problem with the MA plan is that the subsidies weren't high enough and people were mandated to buy 'unaffordable' coverage.
One pro-union effect of mandates will be to dilute the number of workers who casually accept temp jobs that provide no health insurance. Companies use temps essentially as scab labor, sometimes dismissing permanent workers and staffing almost entirely with temps.
If temporaries are mandated to buy affordable insurance, the attractiveness of 'temping' will dry up. Reducing the supply of casual 'temp' personnel will remove a barganing chip that companies can use to pressure unions on health coverage and other employee benefits.
Posted by:CanaanDecember 21, 2007 11:56:55 AMRespond ^
I think if men really want to go on dates together, then they should have to pay their own way, and no one's healthcare premium should be used to pay for it. If you REALLY want to stop things from getting screwy, though, then let's see the union angle subtracted from any discussion on the cost of healthcare. You shouldn't have to make a payment on someone else's Lexus to get that allergy prescription...free healthcare isn't a good model, either, but I think that every state and county should have what amounts to a chapter of Our Lady Of The Poor Indigent Bast... so that people that can't afford pimpy-primpy healthcare can still be seen without ending up owing the national debt of kryzgistan for the dubious privilege
of being administered unto by corporate-sponsored doctors who might succumb to the temptation to enhance their stock holdings by prescribing exotic and unnecessary medications to people too stupid to know what they're being given
and too trusting to ask questions...
Posted by:BertDecember 21, 2007 2:07:46 PMRespond ^
We have a Representive from Wyoming who
has missed over 51% of the votes. Both
her and her husband are milking the
tax payer funded health care system
for everything its worth. Please
send in Anderson Cooper.
Posted by:Disgusted WyomingiteDecember 21, 2007 3:31:39 PMRespond ^
So... No one has yet said what measures would enforce people getting the health coverage that's mandated for them.
Would our wages be garnished, and applied to a plan we did not choose? Would we be waterboarded for not backing our "Great" (no longer) nation's efforts to make even more HMO stockholders and insurance industry executives filthy rich on our hard-earned (harder all the time) money?
You can tell I have no great sympathy for the rich that run this country into the ground to pay for their toys, but note that if the healthy were also drawn upon to support healthcare for the poor, as both Clinton and Edwards want to do, we approach a single-payer system supported by taxes.
Make it national, and make it government-run. Any other approach ENSURES that fraud, corruption, and unfair preference will rule the process.
Posted by:Dan MortensonDecember 21, 2007 4:23:54 PMRespond ^
The two reporters have got it all wrong. Mass Health, does and will work and it will not charge some one making 50,000, 20% of their wages for health care. Where did you get your figures; from a 1996 report on mass health care it seems.
In any case there are mandates and there are mandates; the Mass mandates contain wording to the effect that if you don't have health insurance by the end of 2007 your income tax refund will be withheld from you and taken by the state. Another mandate that will come about, once Hillary becomes President, is the percent of profit Health insurance providers are allowed to make selling a basic social necessity.
But the most efficient way for universal health care to work is to provide Medicare to all US citizens on a universal basis using Medicare to set rates for medical and prescription coverage and the cost of health insursance. If the insurance companies want to participate they will do so at the rates set by Medicare or fade off into the dust bin of history.
There would be no great lost if health insurance providers were to fall off the earth and Medicare type health insurance were to handle all health care in this country. There is already a national network which services tens of millions of members and its expansion would be done primarily with the computer. As time showed the efficiency or lack there of of this federal system adjustments could be made as needed. One thing is certain and that is that health insurance providers are ripping off the public to the tune of billions of dollars; take William McGuire, for instance. This former CEO of United Health walked of with 1.7 billion dollars in options when he retired from his post. Fortunately the federal government has fined him some 685 million, but even so he gets to keep 800 million dollars of subscribers monies for being a "good boss". You see he modified the rewards programs at United Health so that all execs could earn huge option awards and bonuses. Most health insurance providers function in a similar fashion. So the real cost for health insurance really is the cost of health insurance and this cost is inflated by a large percent to fatten the coffers of health insurance execs much like oil corps. execs are fattening their bank accounts at our expense.
The arguments about universal health care are meaningless unless we address the real problem of its costs and that cost is directly related to the terribly inflated premiums that the GOP led federal government has allowed by not acting to provide some sort of oversight on health care costs as is the case, of course with the cost of oil.
One way to provide a quick fix to the corporate abuses of the past 7 years is to kick the GOP out of Washington on their worthless duffs and install a large majority Democratic Congress and Hillary Clinton as the first woman President of the United States. Not only will you make history and also show the world that we are truly a democracy, but we will take the first step to correcting the grievous wrongs of the Bush era. Give her and the Democrats a chance to straighten this government out; you will be very glad you did!
Posted by:Al ComstockDecember 21, 2007 5:46:47 PMRespond ^
As retired member of local 1732 I am stumped on that one. My original impression of the mandate scene is that the premiums would be partially subsidized for low income people. Now it looks like another one those half-assed unfinished things such as when they discharged mental patients to make them more "independent" but did not follow up with outpatient and neighborhood supervision.
Posted by:GPFrankDecember 21, 2007 7:41:26 PMRespond ^
THe Turks are bombing Kurds over the border in Iraq! I just read that! Another reason this occupation is a fraud, US and other soldiers cant even secure those borders. This Iraq thing is a waste of treasury money and that is reason number one to get them out.
Posted by:NikeDecember 22, 2007 12:00:14 PMRespond ^
I am under the belief that Mr.Gerald McEntee and the Clintons are friends. As a member of this union I also called and never got any reply.
Posted by:Mildree KishDecember 22, 2007 12:47:36 PMRespond ^
This is so much politicing posturing, There are only a small few that not not believe some sort of health care reforms are needed. What finally comes is anybodys guess, but under President Clinton I personally don't think there will be any kind of significant reform. The candidate with the best health plan is Dennis K., single payer ala Medicaid, taking the obseen(sorry, spelling) profits raked in by insurance companies.
Posted by:MikeDecember 23, 2007 4:16:16 AMRespond ^
The key question is mandating WHAT? As long as the mandate is for the purchase of insurance policies, which do not guarantee that any care of any kind will actually be provided, then the mandates do not address the root cause of the problem. Health care dollars should be spent on healthcare services. Everything else is simply unnecessary use of scarce resources.
The other elephant in the room that has not been addressed here or anywhere is that professional nurses provide 95% of ALL healthcare service to patients. Yet nurses are at the mercy of employers and a hostile NLRB. Nursing "leaders" are employed by healthcare organizations and are not chosen by nurses, and their decisions overwhelmingly favor administration at the direct expense of nurses, nursing care and patients. Even the national organization which purportedly represents nursing leaders is a subsidiary of the American Hospital Association. It has no affiliation or loyalty to the national professional nursing organization, The American Nurses Association.
The divide and conquer strategy to keep nurses fragmented, internally fighting and effectively impotenet, is wreaking havoc with patient advocacy, patient education, patient empowerment and patient safety. The research by Linda Aiken and the Institute of Medicine clearly shows that mortailty rates increase significantly in the absence of nursing care provided by a nurse educated at the baccalaureate level or higher.
The dormant blog, Universal Health, is required reading to educate one about these issues.
http://universalhealth.wordpress.com
Posted by:AnnieDecember 23, 2007 9:27:42 AMRespond ^
Let's do a "Hugo Chavez" on Healthcare.
Nationalize the Pharma Industry and all Hospitals and Clinics. Conscript all Health Care delivery people into a Medical Army. Have the Gov't run Medical schools and decide how many and what kind of doctors to produce. Require them to serve 10 years for their education. Ban any private delivery of health services under criminal penalty. Pay for it all with a tax on the top 5% of income earners and a 1% annual Net Wealth Tax. Finally, the ultimate liberal health care fantasy!
Posted by:IsopluvialDecember 23, 2007 11:56:43 AMRespond ^
What palaver...The Congress got 2 things done this session-minimum wage and I can't remember. Ms. C could not get anyone together while a senator and she would be sure to divide the already divided congress. She nor Edwards have said how they will pay for it. Garnishment would be Mrs. c's choice and heaven knows with Edwards. God help us if we get one of the above .
Posted by:bink1December 26, 2007 3:49:24 PMRespond ^
Queen Hillary to the rescue!
Give me a break! Nothing will change under a Hillary administration. Absolutely nothing. I ask you these questions:
1. Will Hillary balance the budget? Answer: NO
2. Will Hillary change U.S. Trade Policy? Answer: NO
3. Will Hillary reduce crime? Answer: NO
4. Will Hillary reduce your taxes? Answer: NO
5. Will your life be better with Hilalry int he White House? Answer: NO, you life will be what you make of it.
Posted by:Ames TiedemanJanuary 1, 2008 9:24:03 AMRespond ^
Now SHE's waving that right hand around...is there any one running for
office that can just like, stand there
and say whatever it is that they've got
to say, kind of like you know, a
professional, clipboard or something
to keep their notes on? Kind of sad.
Furthermore, with the healthcare
thing, how long until there's a healthcare tax to go with state and
federal? There's already a Medicare
tax, can't they just bull[deleted] that one
up a couple hundred billion or something? Matter of fact, they could
just tie it all together, and pay ALL
your bills through taxes. Then, all
YOU have to do is forget to show up...
LOL
Posted by:BertJanuary 1, 2008 3:16:45 PMRespond ^
How about making the corporations that are making billions in profit step up and pay all their part time workers health care,thats a real convenient loop hole they have there,by working employees less than 30 hours or so they don't have to pay health ins.,gee I wonder who thought that one up?
Posted by:HankJanuary 8, 2008 12:42:54 PMRespond ^
to be honest with you i find no problem in health care. i have lived with an iron lung since i was about five, and no health care system helped me pay for it, i hate my life, do any of you people out there want to be my friend. im so alone
Posted by:jeffJanuary 17, 2008 9:04:21 AMRespond ^
i eat 20 double cheeseburgers every day and i seem to be fine. i wiegh 400 pounds. i think it is a very healthy weight--- ill be your friend! (i dont have any)
Posted by:Brent G.January 17, 2008 9:07:04 AMRespond ^
thank you brent g, i am 81 years old and i enjoy chatting online. Just to let you know im not a murderer. i love you brent
Posted by:jeffJanuary 17, 2008 9:09:41 AMRespond ^
please dont think im weird, i just want someone, how do you smell?? oh, im not weird, i dont think im weird, im not. ok, brent would you please meet up with me.i need you
Posted by:jeffJanuary 17, 2008 9:11:33 AMRespond ^
ok sounds good. your a guy right? (i hope so) will you bring some double cheeseburgers too. you can rub them on me. it feels good. im 12 btw. i hope you have lots of rinkles. i like to play with them. just like i do with my rolls. i stash my burgers in my rolls
Posted by:Brent G.January 17, 2008 9:14:09 AMRespond ^
yes i am a guy, and you are very creative, im glad you are that young. i really want to meet you now. will you have phone sex with me right now??? please, you+me=love 4ever!!!!!! please love me. we're so good for eachother
Posted by:jeff&brent 4 everJanuary 17, 2008 9:17:06 AMRespond ^
ok call me-- 555-555-555---- i want you so bad. we should meet at a retirement home/heaven. so then i can play with more wrinkles. maybe they will like my rolls. remember to bring cheeseburgers
Posted by:i want JeffJanuary 17, 2008 9:22:04 AMRespond ^