Posts Tagged ‘Der Spiegel’

What Would Republican Health Care Reform Look Like?

Wednesday, November 4th, 2009

Edit: I see a few people have linked to me since Obama’s little debate with the House Republicans in which he backed up the point I’m making here, that his health care plan is:

similar to what many Republicans proposed to Bill Clinton when he was doing his debate on health care.

That’s the point I was making with this post as well. But some people have apparently taken this post as some sort of evidence of Obama’s nefariousness – as proof that he’s selling out. pm317 wrote on Hillaryis44 that people should, “Tell your bluest of blue friends who are still supporting Obama to read this little piece…” I think they should read this piece – but it stinks of partisanship to presume any Republican suggestion is wrong.

This piece points out that Obama has adopted much of the Republican framework for dealing with health care – picking up on the work of liberals such as Jacob Hacker and Peter Orszag. This framework was broadly endorsed by John Edwards, and then Hillary Clinton, and then Barack Obama during the campaign. The plan Obama is pushing attempts to combine the best elements of the conservative Republican plans with the goals and certain important elements of liberal alternatives. As a liberal, I acknowledge that this plan is modest – tinkering even – but this is its strength rather than weakness.

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Yesterday, the Republicans released their health care plan. However, as Ezra Klein points out it isn’t an actual plan to fix health care as much as a plan to get people to stop asking them what their plan is:

The bill is framed in terms of Republican attacks on the Democratic bill, not in terms of its own aims or methods. Which is fine, and to be expected. If I were a Republican, I wouldn’t spend my time crafting a health-care reform plan, either. Republicans don’t have the votes to pass a bill, and they know it.

So what is the Republican approach to health care reform?

In an interview with the German weekly Der Spiegel, Charles Krauthammer gives a typical response, lecturing Obama:

On health care, the reason he’s had such resistance is because he promised reform, not a radical remaking of the whole system.

Though this is a common claim by right wingers attacking Obama, it clearly isn’t true. Obama’s health reforms take great pains to preserve the current system – and is indeed based largely on two conservative attempts to reform health care in the past. The hope of liberals is that this reform could establish a structure: health insurance market with a public option, that could gradually be opened up to the rest of the population if it was successful. But that isn’t what we’re talking about now.

Given that his criticism of Obama’s health care position is that it is “a radical remaking of the whole system,” you would think Krauthammer would offer a few conservative measures. But if that is what you think, then you have misunderstood the right wing. Krauthammer proposes to entirely tear down the current system: “It is absolutely crazy that in America employees receive health insurance from their employers,” he says, and proposes we gut this system by eliminating the tax break for health insurance and eliminate the prohibition on interstate insurance (which would effectively strip any regulation from insurance companies as the state with the least regulation could attract these companies in a race to the bottom…) By any standard, and whether you agree with them or not, these are radical measures that would completely remake our system of health insurance – and they were also the two cornerstones of the proposal by the McCain campaign.

What Krauthammer either doesn’t know or attempts to elide is that Obama’s health care plan has two prominent historical predecessors: Richard Nixon’s proposal in 1974 and the Dole-Chafee bill sponsored by the Republicans as an alternative to Bill Clinton’s approach in 1993. If you want to figure out what Republican health care reform might be, this is where to look. One of the key things to realize when looking at these plans is that we currently have a hybrid system: with the elderly, veterans, and the poor receiving government-provided health insurance; many of the employed receiving employer-provided health insurance; and those left out either without health insurance or using the much more expensive and less stable individual health insurance market.

1974: Nixon’s Plan

At the crest of the liberal era, Richard Nixon attempted to reform health care. He called his plan CHIP, or Comprehensive Health Insurance Plan, and its goal was to solidify the hybrid system that existed. He proposed expanding eligibility for Medicaid, expanding Medicare to cover prescription drugs, subsidizing the poor to get insurance, incentivizing employers to provide health insurance, and eliminating discrimination on the basis of preexisting conditions.

Specifically, Nixon’s plan included:

  • A form of the Indepedent Medicare Advisory Council called the Professional Standards Review Organization, both being independent technocratic bodies composed primarily of doctors which would be charged with ensuring quality care while “helping to bring about significant savings in heath costs,” to use Nixon’s phrase. (Under Obama, this group would be significantly checked by Congress, and Obama has specified one way that excess treatments could be minimized – by compiling medical knowledge about best practices into a non-binding database.)
  • A commitment that health insurance would “cost no American more than he can afford to pay,” in Nixon’s words, which specifically meant subsidizing health insurance for the poor who could not afford it and were not provided it through their employers.
  • A commitment to build “on the strength and diversity of our existing public and private systems of health financing” and to harmonize “them into an overall system,” as Nixon said.
  • The banning of discrimination on the basis of preexisting conditions.
  • The standardization of a basic level of health insurance including setting maximim out of pocket costs per year and setting a minimum level of what would be covered.
  • A federally issued “Health-card” which would be “similar to a credit car” and “be honored by hospitals, nursing homes, emergency rooms, doctors and clinics across the county” and would include “identity information on blood type and sensitivity to particular drugs.” (Obama’s plan contains no such thing, probably to avoid concerns of federal overreach and the hysteria which accompanies talk of a national identification card.)

One of the great regrets of Ted Kennedy’s life was that he did not take the deal Nixon offered him on health care. It’s also noteworthy that Nixon at this point was insistent on strengthening the employer-provided health insurance system and the government-provided health insurance system. He also pushed the idea of HMOs which Bill Clinton’s plan was later demonized for encouraging as well.

1993: The Dole-Chafee Bill

In 1993, some Republicans believed they needed to come up with an alternative to Bill Clinton’s health care plan (in contrast to the, “Just Say No” approach advocated by Will Kristol at the time, and again today) – with 20 Republican Senators eventually introducing to great fanfare the Dole-Chafee bill. This bill was flawed and politically impossible to get through Congress given the many interests it offended – from labor to the elderly to big corporations. This was because it’s main goal was to undermine the employer-provided health insurance system and to a lesser degree the government-provided health insurance system. The Republicans saw these as distancing individuals from the cost of their health care decisions and thus as two of the main drivers of increasing costs – though they did not acknowledge or attempt to fix any of the problems which made the individual health insurance market untenable for most. This bill included:

  • An individual mandate enforced by a penalty imposed on those who did not comply.
  • A government voucher to purchase health insurance for individuals to up to 240% of the poverty line. (Which is more generous than the Senate Finance bill which only offered subsidies for families up to 200% of the poverty line.)
  • A cap on how much health insurance could be deducted as a tax credit (similar to what the Senate Finance Committee proposed recently, which Republicans denounced as raising taxes.)
  • The removal of the tax credit for all private health insurance plans that did not provide a “federally guaranteed package of health care benefits.” (Which is more radical than anything Obama is proposing – and a greater reach of the government into the private sector.)
  • The elimination of discrimination on the basis of preexisting conditions.
  • Financing through cuts in Medicare Part B and the limits in tax credits discussed above.

“Obamacare”

Compare the above to the plans now circulating in Congress and backed by Obama.

They have many of the same goals:

  • reducing the growth of health care spending;
  • eliminating the holes in our insurance system and insuring the uninsured;
  • eliminating abuses by the health insurance industry.

They have some similar mechanisms to achieve these goals:

  • regulation of health insurance industry;
  • individual mandate;
  • subsidies for those who cannot afford insurance;
  • technocratic panels.

The health care reforms being proposed today are based on the same framework as the two Republican plans of the past with one main exception: they provide a mechanism to allow the individual market to work more effectively. The health care reforms today attempt to preserve the current system – which is deteriorating year by year as more and more people are priced out of health insurance – while alleviating the worst problems and providing a separate and regulated market in which individuals could choose between different health insurance models.

While both the Nixon and Dole-Chafee bills sought to change the health insurance industry through pure government regulation and intervention. The Democratic proposal working its way through Congress now adds two elements – one from the left and one from the right. They propose creating a Health Insurance Exchange – a market for health insurance. On this exchange, one could choose a publicly-run insurance plan.

The model the Democrats are working on now clearly owes a great deal to these two Republican attempts at health care reform. It’s a shame that Republicans have now taken to demonizing Obama’s plan on many of the very grounds that would necessarily be at the core of an actual conservative attempt to tackle health care.

[Image by Civil Rights licensed under Creative Commons.]

Henry Kissinger on Obama

Wednesday, July 8th, 2009

The German weekly Der Spiegel ran an interesting interview with Henry Kissinger about the Treaty of Versailles and Barack Obama’s foreign policy. There are those who simply condemn Kissinger as a war criminal and choose to ignore his opinions – but by most accounts, his tenure as Secretary of State and National Security Advisor under Presidents Nixon and Ford were a virtuouso performance as he exercised American power at a time when many saw it being diminished. I do not seek to defend Kissinger’s green-lighting of the Chilean coup or his sabatoging of the Paris peace talks with Vietnam to ensure Richard Nixon’s election in 1968. This last act was certainly treason – and his role in Chile led to the reign of the convicted war criminal, Augosto Pinochet and the removal of the elected leader of that country.

But existing alongside these amoral acts – and underlying these acts – are an understanding of power – as it is, rather than as it should be. Kissinger saw – with Nixon – that by persuading China to seperate itself from the Soviet Union’s world order, he would strengthen America’s hand significantly – and help end the stalemate that the Cold War had become. With Richard Nixon succumbing to alcoholism late in his term, it was Kissinger who single-handedly ran America’s foreign policy – managing crises and coups d’etat throughout the world.

Unsurprisingly to some (Stephen Walt had already described Obama’s foreign policy as “Kissingerian“), Kissinger seemed to have a more substantial understanding of Obama’s foreign policy approach:

Obama is like a chess player who is playing simultaneous chess and has opened his game with an unusual opening. Now he’s got to play his hand as he plays his various counterparts. We haven’t gotten beyond the opening game move yet. I have no quarrel with the opening move.

Unlike Ahmadinejad’s useful idiots from McCain to “Smart” Girls to Ajami, Kissinger credits Obama for having a strategy, while witholding judgment about its effectiveness.

Kissinger offers a revealing criticism of Wilson’s Fourteen Points and America’s role in the Treaty of Versailles – which also rather neatly contradicts the Bush doctrine:

The American view was that peace is the normal condition among states. To ensure lasting peace, an international system must be organized on the basis of domestic institutions everywhere, which reflect the will of the people, and that will of the people is considered always to be against war. Unfortunately, there is no historic evidence that this is true.

And of course Kissinger also came out with this quotable line:

I believe more suffering has been caused by prophets than by statesmen.

[Image by DarthDowney licensed under Creative Commons.]

Will Bin Laden Endorse McCain?

Monday, September 8th, 2008

Do you remember when the Bin Laden tape in 2004 was spun by Fox News and the right-wing as a Bin Laden endorsement of John Kerry?

If – as Charlie Black, a top Washington lobbyist unti McCain put him on his payroll, admitted – it is the conventional wisdom that a terrorist attack before the election would “be a big advantage” for McCain in the election and help get him elected…

And as McCain’s policies of military over-extension, fiscal irresponsibility, and continued occupation and war in the Middle East fit nicely into Al Qaeda’s master plan

Wouldn’t that logically make any terrorist attack on American soil, or any surprise videos putting Bin Laden front-and-center, an effective endorsement of McCain?

Just asking…

Iraq Leader Maliki Supports Obama’s Withdrawal Plans

Saturday, July 19th, 2008

Der Spiegel is headlining this over their interview of al-Maliki.  Haven’t read the whole interview yet, but the key passage seems to be:

US presidential candidate Barack Obama talks about 16 months. That, we think, would be the right timeframe for a withdrawal, with the possibility of slight changes. Of course, this is by no means an election endorsement. Who they choose as their president is the Americans’ business.  Those who operate on the premise of short time periods in Iraq today are being more realistic. Artificially prolonging the tenure of US troops in Iraq would cause problems.

(I actually had this story ready to post before Drudge ran with it as his weekend headline and before every other news source picked it up – as my reddit submission suggests.  Unfortunately, my WordPress account wouldn’t let me post anything and I wasn’t able to fix it until today.)

Since this interview has been making headlines, an official spokesperson for al-Maliki has explained that there was a translation error.  The generally understood explanation for this backtracking is that the White House put a great deal of pressure on al-Maliki to walk it back – which so many news sources are still leading with a variant on headline above.

Berlin Loves Obama

Thursday, July 10th, 2008


[Picture by Wolfgang Staudt.]
Der Spiegel broke the story last week that Obama might be making a major speech in Berlin, perhaps before the famous Brandenburg Gate where President Ronald Reagan called on the Soviet Union to tear down the Berlin Wall.

Just yesterday, Der Spiegel reported that in an effort to avoid taking sides in the American election Angela Merkel, the German chancellor, had decided that:

an invitation would also be extended to John McCain.

I get a lot of pleasure out of that idea – based on the reports of Obamania in Germany.  I’m sure McCain would not be foolish enough to put himself in this position – but if he did – and he attempted to give a speech in Berlin the contrast would likely be enormous.

A German friend of mine tells me that in Berlin, you can often spot people wearing pins or shirts or scarves with Obama’s name, face, or logo them.  Tens of thousands of excited and enthusiastic Germans crowding to see Obama give an historic speech, seeing in him a new hope for America, versus a drab few hundred who might go to see McCain.

Nuptial overindulgence

Wednesday, June 25th, 2008

One German man rather overdid things at his nuptials – leading his new wife to abandon him in a field by the side of the road to sleep off his stupor.
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Obama is our excuse

Monday, June 9th, 2008

Last week, Charles Hawley, writing for Der Spiegel, declared that “The Social Democrats [of Germany] have no Obama.” This is the second article in Der Spiegel in the past month to reprise this theme.

Around the world, with David Cameron in the United Kingdom gaining strength and Gordon Brown losing it; with Silvio Berlusconi taking power again in Italy; with Nicolas Sarkozy, though struggling today, still the dominant figure in French politics; with Angela Merkel in Germany, Stephen Harper in Canada, Felipe Calderon in Mexico, Lee Myung-bak in South Korea, and Ma Ying-jeou in Taiwan – all center-right politicians – taking power in the past four years; and with Russia’s drift towards a 19th century autocracy and China’s successful resistance to liberalization, it seems that the world is drifting rightward. Since September 11 and especially since George W. Bush’s reelection in 2004, most of the leading world democracies and many of it’s leading autocracies have reversed progressive trends and generally adopted a center-right course.

But the worldwide left today has one figure it can look to – standing against this tide in one of the most rightward leaning democracies – and succeeding in ways that are redefining American politics: Barack Obama.

That is why when evaluating the state of Italian politics or German politics – liberals bemoan their lack of success, their lack of inspiration by saying: “We have no Obama.”

This seems to be an attitude that Obama himself would reject. In observing the crowds thronging to his speeches, the enthusiasm that has swept him to the nomination, the excitement in the air, the sense of hope and opportunity at long last, Obama observed to Michael Powell of The New York Times:

“I love when I’m shaking hands on a rope line and” – he mimes the motion, hand over hand – “I see the little old white ladies and big burly black guys and Latino girls and all their hands are entwining. They’re feeding on each other as much as on me….It’s like I’m just the excuse.” [My emphasis.]

Although Obama’s campaign has enabled his success, he understands that the success is not his own. It is of this particular moment in history – this American moment – and he understands that he is not the cause of this movement or this moment, but merely the excuse.

Obama himself is just an excuse to allow Americans to find themselves again, to find their way again, to reclaim their nation, to restore our values to our government. 1 What Obama’s campaign offers and his presidency will offer is not solutions imposed from Washington, but an opportunity for us to engage with our government, to affect our politics, to make America once again a government of the people. Obama is proposing modest steps – as the tinkerer he is – to make the deliberations behind health care public; to create a website that encourages citizens to provide suggestions and feedback about government programs; to encourage transparency in law-making; to create “a web site, a search engine, and other web tools that enable citizens easily to track online federal grants, contracts, earmarks, and lobbyist contacts with government officials”; to require “his appointees who lead Executive Branch departments and rulemaking agencies to conduct the significant business of the agency in public” and online; and to make as much government data as universally available as possible.

He’s providing a good excuse, but we still need to do the work.

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  1. As an aside, I can’t think of a healthier way for a leader to think of him or herself – as merely the excuse other people use to do better. []

There is no Obama in Italy

Tuesday, April 15th, 2008

Alexander Smoltczyk of Der Spiegel, an influential European newsmagazine, writes of Silvio Berlusconi’s challenger, Walter Veltroni, a dour and uninspiring liberal who lost in yesterday’s Italian elections:

“It is difficult to give them hope. But we can do it,” says Veltroni. “Obama has also done it.”

Veltroni’s campaign slogan is: “Si può fare,” or “Yes, we can” in Italian. “I met Obama in Washington,” says Veltroni. “He was different. Modern and inspiring. I wrote the foreword to the Italian edition of his book.” Perhaps it was intended as an attempt to influence Veltroni’s own destiny.

“Si può fare” are the words printed on the cardboard signs that Veltroni’s audiences wave when he speaks on their piazzas. But there is something unreal about the slogan, especially in light of the stonewalling and bureaucracy and ineptness Veltroni himself has complained about, and in light of the Italian sickness.

There is no Obama in Italy.

The article makes very clear that Mr. Veltroni was not as skilled of a politician Obama. But read the last sentence of that piece again:

“There is no Obama in Italy.”

It seems to say more, to hint at something that “Obama” means – something that we in America easily lose sight of as the bickering and knee-capping among the candidates obscures it.

“Obama” represents – to much of the world – a restoration of America, a correction to George W. Bush’s strategy, a hope that things can change, a sense that the world is righting itself.

The opportunity we have in this coming election is unique.  Which is something we can too easily forget.

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