Debunking the Myths about John Edwards’ Universal Health Care Plan Espoused by its Critics

[Time for change]

With John Edwards in third place among Democratic candidates in the national polls (but on the rise, and doing better than anyone in head to head competition against Republicans) and our corporate news media showing great hostility towards his candidacy, it is important that false understandings about his positions be dispelled. I recently posted on DU a discussion of his health care plan, along with praise of that plan by one of our country’s most brilliant economists, Paul Krugman. Although many DUers agreed with Krugman’s assessment, my post also received several comments that were aggressively critical and indicated serious misunderstandings of Edwards’ plan.

The main purpose of this post is to try to dispel the misunderstandings about Edwards’ health care plan. I will begin with a discussion of Paul Krugman’s credentials and a brief summary of his assessment of the health care plans of the three leading Democratic candidates, and then I will proceed with attempts to dispel the myths about the Edwards health care plan.


SOME WORDS ABOUT PAUL KRUGMAN

Krugman’s credentials and political views

Paul Krugman is a professor of economics and international affairs at Princeton University and has written op-ed columns for the New York Times for many years. He has been named Columnist of the Year by Editor and Publisher Magazine and is a winner of the John Bates Clark Medal, the most prized award given to American economists.

Krugman espouses the liberal/progressive values that most DUers do. In “The Great Unraveling”, copyrighted in 2003, which is mostly a reprint of Krugman’s editorials, Krugman tears apart Bush economic policies (and Alan Greenspan too, for refusing to speak up about the Bush tax cuts) long before Bush or his policies became unpopular. In his recent book, “The Conscience of a Liberal”, this is what Krugman had to say about our current political situation:

The central fact of modern American political life is the control of the Republican Party by movement conservatives, whose vision of what America should be is completely antithetical to that of the progressive movement. Because of that control, the notion, beloved by political pundits, that we can make progress through bipartisan consensus is simply foolish. On health care reform, which is the first domestic priority for progressives, there’s no way to achieve a bipartisan compromise between Republicans who want to strangle Medicare and Democrats who want guaranteed health insurance for all….

To be a progressive, then, means being partisan – at least for now. The only way a progressive agenda can be enacted is if Democrats have both the presidency and a large enough majority in Congress to overcome Republican opposition. And achieving that kind of political preponderance will require leadership that makes opponents of the progressive agenda pay a political price for their obstructionism – leadership that, like FDR, welcomes the hatred of the interest groups trying to prevent us from making our society better.

Perhaps Krugman’s most fervent political desire at this time is that our nation enact a universal national health care plan that ensures that all Americans receive quality health when they need it. This is what he had to say about the subject in his book:

The principal reason to reform American health care is simply that it would improve the quality of life for most Americans…

There is, however, another important reason for health care reform. It’s the same reasons movement conservatives were so anxious to kill Clinton’s plan. That plan’s success, said William Kristol, “would signal the rebirth of centralized welfare-state policy” – by which he really meant that universal health care would give new life to the New Deal idea that society should help its less fortunate members. Indeed it would – and that’s a big argument in its favor…

Getting universal care should be the key domestic priority for modern liberals. Once they succeed there, they can turn to the broader, more difficult task of reining in American inequality.

A brief summary of Krugman’s assessment of the health care plans of the three leading Democratic candidates

When Edwards came out with his plan in February of 2007, Krugman reviewed the plan and then concluded in an op-ed titled “Edwards Get it Right”:

So this is a smart, serious proposal. It addresses both the problem of the uninsured and the waste and inefficiency of our fragmented insurance system. And every candidate should be pressed to come up with something comparable. Yes, that includes Barack Obama and Hillary Clinton.

Three months later, when Obama came out with his plan, Krugman had a lot of good things to say about it, though he explained why its lack of a mandatory provision made his plan inferior to Edwards’ plan. When Clinton came out with her plan in September, Krugman explained that it was almost identical to the Edwards plan. However, he expressed concern about the lateness of her commitment to universal health care, saying “The long delay before Senator Clinton announced her health care plan made supporters of universal care, myself included, so nervous… What remains is the question of whether… she will have the determination to turn that plan into reality.”

Krugman became especially concerned when Obama began attacking the health care plans of his two main rivals using Republican talking points that were inaccurate. In particular Obama appeared not to understand why health care coverage needs to be mandatory in order to ensure the economic viability of a universal health care plan. Krugman had this to say about that:

My main concern right now is with Mr. Obama’s rhetoric: 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.

I’d add, however, a further concern: the debate over mandates has reinforced the uncomfortable sense among some health reformers that Mr. Obama just isn’t that serious about achieving universal care – that he introduced a plan because he had to, but that every time there’s a hard choice to be made he comes down on the side of doing less.

MYTHS ABOUT EDWARDS’ UNIVERSAL HEALTH CARE PLAN

Before I get into the myths, I need to give a brief summary of Edwards’ plan (see above link):

The most important part of the plan is that it will make health care available to all Americans. It will do that by providing tax credits on a sliding scale, so that those who are otherwise unable to afford health care will then be able to receive it. The opening quote on the subject in Edwards’ website is

Who are you willing to leave behind without the care he needs? Which family? Which Child? We need a truly universal solution, and we need it now. The time has come for universal health care reform that covers everyone, cuts costs and provides better care.

His plan would offer a choice between government insurance similar to our Medicare system (before Bush got hold of it) and private insurance. The purchase of one or the other would be mandatory, in order to prevent people from gaming the system (see explanation for that below). No insurance company would be allowed to deny the issuance of insurance or charge more for their insurance based on pre-existing conditions or any health risk.

There's a lot more to it than that, including several mechanisms to provide better quality health care and reduce costs. But this will serve as a brief summary. With that, let’s get to the myths that I’ve seen expressed based on my single post from two days ago:


Edwards’ plan will ensure the dominance of private insurance companies and indicates his unwillingness to stand up to them

Oh, give me a break. That’s almost like saying that FDR was unwilling to stand up to big economic interests. No other candidate in the 2008 field has been more critical of insurance companies.

Where did this idea ever come from? Perhaps it came about because Edwards’ plan offers a choice between private insurance and Medicare-like government health care. Specifically, Edwards says “Health Care Markets will offer a choice between private insurers and a public insurance plan modeled after Medicare…”

For some people, even offering a choice of private health care insurance is just too much. But will that allow private health insurance to continue their dominance in the health care field that they enjoy today? Why should it? Under Edwards’ plan, anyone who chooses can have a public not-for-profit insurance plan similar to Medicare, which totally bypasses private insurance. This is what Krugman has to say about allowing a choice between private and public insurance:

The evidence suggests that the government plans, which would have lower overhead costs because they wouldn’t devote large sums to marketing, would win that competition. When Medicare began requiring that Medicare Advantage plans – taxpayer-supported private plans for seniors – compete with traditional Medicare on an actuarially fair basis, the private plans withered away… If the government plans consistently out-competed private insurers, the system would evolve over time into single-payer, as private insurers lost market share…

Unfortunately, under Edwards’ plan, those Americans who chose, through ignorance or ideology, to purchase private insurance rather than public insurance, would probably suffer for that choice, as so many Americans suffer today when insurance companies deny legitimate claims. But even the ideologues would probably learn after a while and would start opting for public rather than private insurance.


Only single-payer plans will effectively eliminate Americans losing out to insurance companies that deny legitimate claims

This objection is very similar to the one noted above. It is true that Edwards’ plan, which is not a single-payer plan (at least, not initially), allows some role for private insurance companies, at least initially. In that sense, it doesn’t completely eliminate private insurance immediately. But make no mistake about it, the insurance companies will be aggressively opposed to Edwards’ plan, for the reasons described above. Krugman has this to say about them:

It’s certain that the insurance industry will fiercely oppose reform, as it did in 1993… The fact is that no health care reform can succeed unless it reduces the excess administrative costs (not to mention their frequent denial of legitimate claims) now imposed by the insurance industry – and that means forcing the industry to shrink, even if insurers retain a role in the system. There’s really no way to buy their cooperation.

The only reason to favor the Edwards plan over a single-payer plan is “political”

Well, that’s true, but so what? Krugman himself says that on purely economic grounds a single-payer plan is superior to Edwards’ plan, primarily because with the Edwards plan at least some people will initially choose private insurance, and many of those people will suffer for that choice.

But as someone who believes that it is essential that universal health care be passed, Krugman is worried that a single-payer plan may not be politically viable enough to pass.

Edwards’ plan has two political advantages over a single-payer plan. First, it would be less expensive in the sense that it would require less taxes to pay for it. (Economically, that advantage would be only apparent rather than real. What we would save in taxes would be more than cancelled out by out-of-pocket expenses for those who purchased private rather than government insurance.) Krugman believes that it would be more politically palatable because it would be less expensive up front, and many voters would not recognize the cost savings of a single-payer plan, given the propaganda that would be sure to come from political opponents.

The other political advantage of giving people the choice of government vs. private insurance would be that such a plan would be less susceptible to accusations that people wouldn’t be able to exercise their choice of doctor. Again, we are talking about a perceived rather than a real problem. Single-payer plans are perfectly capable of allowing people to choose their own doctor. They require that everyone obtain their insurance through government, but can still allow complete freedom of choice of doctors. Nevertheless, Krugman feels that a single-payer plan is likely to be a political liability, given the distortions that are certain to be introduced by political opponents.

I don’t know how valid Krugman’s fears are about the political liabilities of a single-payer health plan. He’s an economist, not a political scientist. But for the little that we gain with a single-payer plan compared to Edwards’ plan, do we really want to take that chance? Since a national health care plan was defeated in 1993 we’ve gone nearly 15 years without another try at it. Do we really want to take that chance if we can get a very good plan that insures everyone with less political risk?


Making insurance mandatory will increase its cost

That would be true if Edwards’ plan mandated that people purchase private insurance. But quite the contrary, Edwards’ plan will give tens of millions of Americans who now have private insurance the opportunity to purchase government insurance at a lower cost. The result will be much less business for private insurers, possibly being reduced to near zero before long, unless they lower their prices and improve the quality of their product. They will in fact be forced to reduce their costs in order to compete with government insurance.

Furthermore, no universal health care plan can be economically viable unless it is mandatory. If it isn’t, some will opt out of the system until they become sick. That will increase the costs for everyone else while allowing those who originally opt out (thus gaming the system) to either purchase insurance when they become ill or receive care through tax-supported emergency rooms.


Edwards’ plan will cause a two-tiered system – a private tier for the wealthy and a government tier for the poor

That would be likely only if a health care system subsidized private insurance companies. Quite the contrary, Edwards’ plan does not subsidize private insurance companies, but rather creates competition for them where no competition currently exists (except through Medicare and Medicaid).

People should not confuse this with school vouchers, where people receive vouchers to attend private school only if they opt out of public school to attend private school. That is not what Edwards’ plan does. Those who opt for private rather than public health insurance receive nothing for doing so – except the risk of getting screwed.


The wealthy can choose private rather than public insurance and thereby avoid contributing to the support of national health care

Not true. Taxes will pay for the plan, and in fact Edwards says that his plan will be paid for through reversals of the Bush tax cuts for the wealthy. The wealthy can choose private over government insurance if they want to, just like everyone else. But they receive no advantages for doing so, and they have to pay the same taxes regardless of whether they purchase government or private insurance. Anyhow, I don’t see our Congresspersons, who all receive health care through the government, opting out of that for private insurance.


It is a crime to force people to purchase insurance – that is what we fought our Revolution against

Actually, taxes were a good part of the reason that we fought our Revolution, not the requirement to purchase insurance. But it wasn’t just taxes, it was taxes without representation. In Edwards’ plan not only will those who pay into the plan be represented, they will receive health insurance.


POLLS SHOW GREAT MOMENTUM FOR EDWARDS

This is slightly off subject, but I’ll include it here because I’m excited about the momentum indicated by recent polls for the Edwards campaign. I haven’t seen national numbers like these for Edwards since his campaign began.

I watch the Rasmussen polls closely because they’re the only polls that track candidates on an almost daily basis, as far as I can tell. Edwards’ rise in the polls in recent weeks has been substantial, especially since Saturday’s debate, which could be the critical moment for the Edwards campaign. Here are the 3-day national Rasmussen poll averages for Edwards over the past month, that is, since December 9th:

December 9-11 – 11%
December 12-14 – 13%
December 15-17 – 14%
December 18-20 – 15%
December 21-28* – 15%
December 29 – January 3** – 16%
January 4-6 – 20% (with a record 23% on January 6)

* -- No polling done during Christmas break, so this is only 3 days of polling
** -- No polling done during New Year break, so this is only 3 days of polling

It looks like our corporate news media will quickly have to find some more haircut type “scandals”. Hopefully the American public will soon grow weary of that kind of thing.

[FogerRox]

1. 1st rec,

[regnaD kciN]

2. The myth of the "sliding scale"...

It will do that by providing tax credits on a sliding scale, so that those who are otherwise unable to afford health care will then be able to receive it.

Before anyone accepts such a meme, it's useful to look at one state where such an "individual mandate" plan has been implemented, Massachusetts. When Mitt Romney and the Democratic legislature compromised on a plan containing a requirement for all residents of the Commonwealth to purchase insurance, they also promised that the Commonwealth would provide partial funding, based on a "sliding scale."

No doubt, many lower- and middle-class residents figured that, under such a sliding scale, they would wind up having to pay little or none of their insurance costs. It was only after the plan became law that they discovered otherwise.

Under Massachusetts' sliding scale, full state funding of coverage is only provided for people at or below the federal poverty line...which is quite low indeed. Partial support of any amount is only available to those below three-times the poverty level, which is still not that far into the "middle-class" category -- and, needless to say, the sliding scale means that those at that upper limit get only a relatively small amount, while those at twice poverty level have to pay 50% of private insurance plans (which can run well over $1000/month in premiums for a family), and so on. And people are required to purchase coverage, or they will eventually be subject to a surtax of around 50% of the cost of premiums.

So, in other words, the primary "individual mandate" plan now in existence translates into required high premiums, with government assistance available in relatively small amounts (if at all), to most people. Would a similar national plan, as espoused by Edwards or Hillary, be equally bad? Hard to tell, since neither of them have released specifics on what their sliding-scale plans translate to for Americans of each income level. But, absent any reassurance -- in terms of specifics -- that an "individual mandate" plan will indeed make coverage available at reasonable prices to all (and, based on another thread here on this subject, I would see "reasonable prices" as something far closer to $50/month than $1000/month), I think voters would be justified in viewing such plans with deep suspicion -- and that's no "Republican talking point."

[Time for change]

3. So is your point that

all sliding scales are the same or that Edwards is no more honest than Romney?

Obviously some sliding scales will work well, and others won't. I didn't do the math, but Krugman referred to Edwards' subsidy plan for those with low income as "generous" -- his implication being that this will represent a far better deal than is currently the case and will make good quality health care available for everyone.

[eridani]

8. The MA propsal started out with far more generous subsidy provisions

They got dramatically cut back during the compromise phase of the legislation. what do you suppose is going to happen to generous proposals that Edwards starts out with? If they are generous enough, they might be adequate--who knows? At any rate, starting out with demanding single payer is a better strategy--more likely that compromise proposals will stay generous.

[Time for change]

11. So you're trashing his plan on the basis that it MIGHT be cut back during the legislative process

You have no idea whether that will happen or not.

The whole package could just as well go down the drain and doom universal health care for another decade or two by making it single-payer. But you're willing to risk that because you know how it's going to turn out.

[eridani]

12. But you and Edwards and Krugman are sure that single payer is doomed

Why? The same political forces are arrayed agaisnt both. I say ask for a pony, even if you'll accept a kitten.

[Time for change]

16. No -- Unlike you I don't claim to know everything

I guess you missed that part, so I'll cut and paste it for you:

I don’t know how valid Krugman’s fears are about the political liabilities of a single-payer health plan. He’s an economist, not a political scientist. But for the little that we gain with a single-payer plan compared to Edwards’ plan, do we really want to take that chance?

No, I don't claim to know how politically viable a single-payer plan would be, but since Edwards' plan seems to me to be about 95% as good, and is likely to evolve to single-payer before too long, I don't see why it's necessary to risk losing universal care for another decade or too.

But I would still vote for a candidate who had a single payer plan. In fact, I have said that I would vote for Kucinich if he seemed politically viable by the time of the Maryland primaries:
http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=389&topic_id=988702&mesg_id=988702

But since that doesn't appear very likely at this point, I'll probably vote for Edwards instead.

As far as the same political forces being arrayed against both plans, that's not the point. But I guess you missed that part too, so I'll cut and paste it for you:

The only reason to favor the Edwards plan over a single-payer plan is “political”

Well, that’s true, but so what? Krugman himself says that on purely economic grounds a single-payer plan is superior to Edwards’ plan, primarily because with the Edwards plan at least some people will initially choose private insurance, and many of those people will suffer for that choice.

But as someone who believes that it is essential that universal health care be passed, Krugman is worried that a single-payer plan may not be politically viable enough to pass.

Edwards’ plan has two political advantages over a single-payer plan. First, it would be less expensive in the sense that it would require less taxes to pay for it. (Economically, that advantage would be only apparent rather than real. What we would save in taxes would be more than cancelled out by out-of-pocket expenses for those who purchased private rather than government insurance.) Krugman believes that it would be more politically palatable because it would be less expensive up front, and many voters would not recognize the cost savings of a single-payer plan, given the propaganda that would be sure to come from political opponents.

The other political advantage of giving people the choice of government vs. private insurance would be that such a plan would be less susceptible to accusations that people wouldn’t be able to exercise their choice of doctor. Again, we are talking about a perceived rather than a real problem. Single-payer plans are perfectly capable of allowing people to choose their own doctor. They require that everyone obtain their insurance through government, but can still allow complete freedom of choice of doctors. Nevertheless, Krugman feels that a single-payer plan is likely to be a political liability, given the distortions that are certain to be introduced by political opponents.

PS -- If you respond to this post, will you please read it first?

[eridani]

21. This perceived liability stuff is nonsense

The same distortions thrown at single payer will be thrown at the Edwards plan. Why be hung for a lamb instead of a sheep?

[Time for change]

24. Arrogance

"an attitude of superiority manifested in an overbearing manner or in presumptuous claims or assumptions".

[eridani]

70. The arrogant people are the ones who think that insurers will accept--

--the no claims denial and no cherrypicking clauses of the Edwards plan, but not single payer.

[eridani]

72. The "liittle that we gain"

If you think that the gain would be small, imagine having several for profit fire departments competing with a public one.

[OzarkDem]

26. Mass plan doesn't / can't control cost of health care

As president, Edwards has the power to take action to lower health care costs in ways that don't harm consumers. He has the ability to lower the cost of Medicare even further by making pharma companies compete. States can't do that like he can the reason why we need to do health care reform at the national level.

[OzarkDem]

25. Doesn't Mass offer only private insurance, not Medicare too?

Under Edwards plan, you'll be able to purchase insurance through government plans. Those will be much less expensive than private plans and a sliding scale will be much more effective.

[eridani]

4. What I don't believe is that an economist would bullshit us about tax credits

The most important part of the plan is that it will make health care available to all Americans. It will do that by providing tax credits on a sliding scale, so that those who are otherwise unable to afford health care will then be able to receive it.

Let's parse the nonsense here, shall we?

1. How in FAWKING HELL are tax credits supposed to benefit the bottom half of America--the people who pay little or no income tax, but still get stuck with payroll taxes?

2. OK, so you are now forced to pay insurance companies for insurance with inadequate subsidies, and of course that means that you will actually get CARE just because you have an insurance policy. Jeebus! Hasn't anyone on this board watched SiCKO? For those who have forgotten, all of Moore's subject were insured.

3. I'd like some learned economist somewhere to explain how there can be, even from a theoretical standpoint, a "market" for products that people don't use. Think about it. Most people will never use their health insurance for an expensive illness, so how in fawking HELL are they supposed to have the information necessary to make a value-for-money-based decision on whether or not it will serve their needs? They don't, and can't, possibly know anything about what their needs will be. Anyone who has never been expensively sick and claims to have good insurance is full of shit.

4. Mr. Political Realist thinks that there will never be the will to pass single payer, but of course there will be the political will to pass legislation like that Edwards proposes with specific clauses forbidding cherrypicking and claims denial. Right. And I'm Marie of Roumania.

5. If people with private insurance are allowed to continue to make their health care dollars unavailable to a common risk pool, wherethehell is the money supposed to come from to fund the public plan anyway? Nobody is allowed to "choose" not to pay property taxes for the fire department just beacuse they probably won't need it. Fuck "choice."


John, I actually do appreciate the fact that you have invested serious thought in the issue since 2004. Close, but no cigar. If they take out the provisions about cherrypicking and claims denial, and you have stuck us with Massachussetts. The clear result there is that the low income and chronically ill were far better off with no insurance at all.

[Time for change]

5. I'll just start with your first two points because considering the arrogance with which you express

you're opinion, you really don't deserve any response, and the substance of your remarks indicates that you didn't even read the OP.

1. You don't see how tax credits can benefit the poor people. Do you know what a tax credit is? It's not a tax deduction, it's a tax credit. That means it's the same thing as giving someone money. It could mean, depending on what a person's income is, that they get medical care for free at government expense. You don't see how that can benefit poor people? How about Medicare, do you see how that can benefit poor people?

2. Did you even read the post? Didn't I make it absolutely clear that their is no mandate to give a penny to insurance companies, subsidies or not? I'll say it again, using capital letters, so you don't miss it this time: Under Edwards' plan, PEOPLE HAVE THE CHOICE OF PRIVATE INSURANCE OR PUBLIC HEALTH CARE SIMILAR TO A MEDICARE MODEL.

Why would you insist on twisting my words to make them sound like the opposite of what I said??

[eridani]

7. We don't allow people a choice between public and private fire departments, do we?

I don't think that such choices should be allowed. People choosing private insurance means that that they take their health care dollars out of the pool that pays for health care. It will be impossible to pay for a public option without access to those dollars, unless we want to try to get China to pay for it with more borrowing. What you are actually talking about is a choice to allow people who aren't sick (and therefore don't really spend any time thinking about the details of their insurance policies) to kill off sick people.

Sorry for misconstruing tax credits vs dedution. They still won't be enough.

[Time for change]

10. Why don't you read the OP before you make any more comments?

People choosing private insurance absolutely does not mean that they take their health care dollars out of the pool that pays for health care. The health care plan is paid for with taxes, and those taxes have to be paid whether or not one chooses private vs. public health insurance.

[eridani]

14. They do too take their dollars out of the pool.

They pay their insurers (which exist in order to divert money from health care) and pay extra taxes too, a very bad deal. Did you know that Boeing has cheaper insurance costs per capita than Joes Hardware? Could that be because of the differences in the sizes of the risk pools?

Now, Vanna, spin the wheel for the $100,000 grand prize question-- what is the biggest, and therefore cheapest, risk pool of all? If you answered "the entire population" you get the kewpie doll. Breaking the population into "markets" fragments the risk pool and drives up costs.

[Time for change]

17. No, they don't

Money paid into government insurance in the plan doesn't accrue any money, since it's not a for-profit plan. You would know if you read the OP before spouting off you dogma, the government insurance in Edwards' plan is modeled after Medicare. Do you really think that Medicare makes a profit? For everyone who pays into the plan, the government is responsible for paying for their health care. It LOSES money. That's why we pay taxes to support Medicare, and that's why John Edwards' plan, and any other serious plan that results in universal coverage will cost money -- which in his case will come from reversal of the Bush tax cuts for the wealthy.

[eridani]

15. In other words, raise taxes to fatten private insurers' bottom lines

Thanks, but no thanks.

[Time for change]

18. NO

I'll make this simple for you.

The population of the U.S. is a little over 300 million. Almost 50 million are without health insurance, so that leaves about 250 million who currently have health insurance. The good majority of those have private insurance because there is currently no alternative for American citizens to have public insurance, other than for those who are eligible for Medicare, Medicaid, or VA, and some other minor programs. I estimate that maybe 70 million people are on Medicaid or Medicare. That would leave 180 Americans currently with private insurance.

Edwards' plan would allow those 180 million people to choose between sticking with private insurance or switching to government insurance. Most Americans are not happy with their private insurance, so I expect that the majority would switch over. I can't see how that number would be less than 100 million, and probably it would be a lot more.

It's true that of the 47 million currently uninsured, some of them would purchase private insurance as a result of Edwards' plan. It's hard to believe that number would be even 50% of the total, and it would certainly be far exceeded by the number of Americans who switched from private to public. So the insurance companies wouldn't make money, they would lose tons of money on the deal.

Furthermore, however many customers the private insurance companies lost at the onset of the plan, they would be bound to lose more and more as time went on and it became widely known that government insurance was superior. I'm sure you missed this discussion of the issue by Krugman from the OP, so I'll re-paste it here:

The evidence suggests that the government plans, which would have lower overhead costs because they wouldn’t devote large sums to marketing, would win that competition. When Medicare began requiring that Medicare Advantage plans – taxpayer-supported private plans for seniors – compete with traditional Medicare on an actuarially fair basis, THE PRIVATE PLANS WITHERED AWAY… If the government plans consistently out-competed private insurers, the system would evolve over time into single-payer, as private insurers lost market share…

I capitalized the important part so you wouldn't miss it again.

[eridani]

20. Most Americans have never used their private insurance for any serious problems

When United Way did a big hoopla thing at my company and had, yet again special forms to re-enroll for another year, I was just busy and fed up. I finally got the message across--just keep it the way it is, dammit! I don't have time to fuss with looking up agency addresses when you already have that data. In otherwords, change is annoying and takes time, and and people who have employer-based insurance will probably stick with it unless it has been getting too expensive.

The Medicare Advantage plans are unfortunately still around, and draining money from the pool of health care dollars.

[Time for change]

52. Word gets around

It's fairly well known in our country today how bad private health insurance is.

Anyhow, I don't know why you insist on parroting this nonsense about "draining money from the pool of health care dollars". If a person has the choice of private vs. public insurance and they decide on private insurance, how in hell is that "draining money from any pool"? As I have pointed out, though you refuse to acknowledge it, government insurance is not-for-profit, which means that the more people that use government insurance the more money they lose. When someone opts for private insurance (under the Edwards plan), though they themselves risk getting screwed over, they certainly don't drain away any health care dollars from the pool. That's just one more person that the government doesn't have to pay for their medical care, so the government consequently SAVES money.

[eridani]

69. They pay their money to the private insurers--

--who then divert as much of it as possible to profit instead of care. If the insured are screwed over, the government then picks up the tab, and the privateers get to keep their profits.

[EOTE]

33. Wow, just wow.

[eridani]

9. What you call arrogance, I call being pissed off at going hungry as a kid--

--because my partially diaabled parents couldn't get insurance at any price.

[Lydia Leftcoast]

34. Tax credits

mean NOTHING if you don't have the money upfront to pay your premiums.

If you earn $15,000 a year (or $8 an hour before taxes), you may have to decide between your heating bill and your insurance premium in any given month. How is a tax credit going to help you then?

[Time for change]

36. They mean nothing if they cover the whole premium?

[Lydia Leftcoast]

37. But do they cover it at the point when you have to pay your premium?

If the tax credit is a lump-sum like the Earned Income Credit, then it would come only once a year and probably be used for other things, like the emergencies that occur in everyone's life.

If the tax credit meant, "Low-income people never have to pay a premium," that's different. So why not just call it a sliding scale based on income, which is what they have in Japan?

[Time for change]

47. My guess is that yes it does

I can't find a version of the plan that goes into that much detail. I'm sure that Krugman has seen the more detailed version, and he says this about it, in response to Obama's claim that Edwards' plan won't be affordable to everyone:

All the Democratic plans include subsidies to lower-income families to help them pay for insurance, plus a promise to increase the subsidies if they prove insufficient. In fact, the Edwards and Clinton plans contain more money for such subsidies than the Obama plan. If low-income families find insurance unaffordable under these plans, they’ll find it even less affordable under the Obama plan.

Clearly, if the plan allowed people to go without health care, or to go without other necessities of life in order to purchase health insurance, then it would not be accurate to say that it is affordable to everyone. Edwards says that it is, and Krugman, who's reviewed it in detail, also says that it is.

Furthermore, Edwards is the only presidential candidate that I can remember since McGovern in 1972 who has come up with a detailed plan for reducing, and even eradicating poverty. That's a centerpiece of his campaign. I don't believe that he would propose or allow a situation where people were mandated to pay for health insurance that allowed them to do without the necessities of life. Given what his campaign is all about, that would ruin his presidency if he allowed that.

[papau]

39. Hillary's clone of Edwards plan caps premium based on income - similar to Mass subsidies

[onehandle]

6. k nt

[Swamp Rat]

13. k&r

[droidamus2]

19. Mixed feelings

I have mixed feelings about Edward's plan or any plan that requires 'insurance' as part of the solution. Yes, in the end an Edward's type of plan looks as good as any and is surly better than the current system. I personally would prefer the single payer option. Why is it that when progressives/liberals try to implement something they want they always start out looking at political expediency rather than what they really think would be best. The current crop of conservatives don't do that. They decide what they want and then through media (yes that is a lot of propaganda) and other means force it down everybody's collective throats. This is why some people see liberals/progressives as weak as they start out by making a compromise before the question is even put to a vote. The idea that if a vote is lost this year you can't do it again for decades is on it face false. If universal care is what you want start out with single payer. If and only if that is defeated then the next year start over with an Edward's type system with guarantees of 'generous' aid to those who need it. At some point you draw a line in the proverbial sand and you push for a system over and over and over again until you get it passed. As was stated you can't be bipartisan with the current neo-cons so why even move in their direction. If your point is that there is no support for single payer on either side of the aisle then we have a real problem. The idea that the government option would eventually drive the private insurers out of medical care sounds good but as we know the private insurers are not above lying and using scare tactics to undercut people choosing the government option. This is basically what they have done in relation to other countries aka Canada in denigrating their single payer systems so that people are afraid to support that type of medical care. Again if an Edward's plan is all we can ultimately get so be it but if 'single payer' is what we really want and think is the best solution we should at least make a strong attempt to get it first.

[Time for change]

51. Some thoughts

1. "Why is it that when progressives/liberals try to implement something they want they always start out looking at political expediency rather than what they really think would be best."

A certain amount of political expediency isn't necessarily bad. It's been used since the dawn of our nation, and probably little could have been accomplished without it. Lincoln hated slavery all his life as far as we can tell, but if he would have made known the full extent of his hatred of slavery he never would have been elected, and slavery may have lasted for several more decades.

But that doesn't answer your question. In my opinion, one big reason why Democrats have gone for political expediency more than Republicans is that our corporate media watches the backs of the Republicans but is always ready to pounce on the Democrats. So the Democrats have to be more careful. But I agree that Democrats should be a lot more bold than they have been, especially with respect to impeaching the most lawless Pres and VP in the history of our country.


2. "The idea that the government option would eventually drive the private insurers out of medical care sounds good but as we know the private insurers are not above lying and using scare tactics to undercut people choosing the government option."

Yes, of course they will try to do that. But the point is this: If we want to kick them out, we have to get our foot in the door first. In my opinion, it will be much much easier to get them out once we have our foot in the door (i.e. Edwards' plan). Once we have our foot in the door they can use all the scare tactics they want. But all we have to do to combat that is to point to a successful government program. Scare tactics work much better when the focus of the scare is an unknown. Once we have a successful government program up and operating the scare tactics will lose most of their bite.


3. "if 'single payer' is what we really want and think is the best solution we should at least make a strong attempt to get it first."

In politics we can't always go for the "best". With that attitude you sometimes risk losing out on the good or the very good.

[eridani]

22. See also--

http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=132&topic_id=3957066&mesg_id=3957066

[Time for change]

23. "Neither Clinton’s nor Obama’s plans get us to universal coverage. "

Was that a typo that he left Edwards out of that statement?

[OzarkDem]

28. Obama's plan is the worst of all

Clinton's plan isn't half bad, but it doesn't have Edwards component of forcing private insurance to compete with federal plans like Medicare.

Obama's is terrible, not much different than what we already have today. That's why he has so much support from the corporate community and news media.

[Time for change]

32. No argument from me there

Though I'm not at all familiar with Richardson's, Gravel's or Biden's plan, if they have one.

[eridani]

71. That's his opinion that the Edwards plan will lead to universal coverage

The very existence of Medicare Advantage has made Medicare worse by draining money away from it.

[MadHound]

27. At best it is only a half solution,

One that continues to allow the insurance industry to thrive. It isn't a single payer plan, which is the best going at this point(ask Europe), it fails to address many of the problems facing the medical community(high education costs, high malpractice insurance, etc. etc.). It deceptively uses the title of UHC, which is normally thought of as a single payer plan. It has a mandatory coverage clause. It is a two tier system, with poorer care reserved for those on the government plan while better care for those with private insurance. It keeps, and even rewards the insurance industry, something that we absolutely need to get rid of. In short, it is a half baked solution that would probably make things worse.

The best, and only true UHC, or single payer plan proposed among the candidates is Kucinich's. And frankly, Edward's plan comes nowhere close to achieving that mark.

[OzarkDem]

29. Is Medicare coverage inferior care? No.

Under Edwards plan, purchasing government funded insurance is an option that competes with private insurance. It provides the same quality coverage at a lower price, forcing private insurance to compete with public.

High education costs are addressed elsewhere in Edwards platform. Tort reform hasn't addressed malpractice insurance costs, but having a President who isn't corrupt allows a investigation into what is most likely a crooked insurance market.

Mandatory coverage is universal health care - you can't get there unless everyone participates. Giving people the option of buing into Medicare or similar federal plans makes it easier and less expensive than private insurance.

[MadHound]

30. You apparently have had little to do with the medical profession

Sorry, but Medicare is indeed inferior care. Many many doctors are currently opting out of Medicare and have done so for decades because the trade off for services performed, plus paperwork and legal restrictions doesn't add up to the miserly sum Medicare pays to the doctors. The top tier doctors normally don't accept Medicare, thus relegating it to new, inexperienced doctors, or doctors who are good enough to do without it.

So how does Edwards plan to address high education? How does he plan to address malpractice insurance, not just in the medical field, but in the educational field and elsewhere? And frankly, if you think that Edwards isn't corrupt, I've got some land to sell you in the Everglades. He may be less corrupt than others, or differently corrupt from others, but the fact that he has accepted so much money for his campaign, especially from the finance and legal sectors, means that he has ties that bind attached to him, and he is indeed corporately corrupted. The only candidate who can be thought of as not corporately corrupt is Kucinich, since he isn't receiving corporate money.

Mandatory coverage isn't UHC, sorry. It is simply forcing people, by law, to get insurance of some sort. Hell, people won't even have the option of having their company pay for part or all of their insurance, the entire burden will be on the back of the individual. Ooo, really sticking up for the working stiff there:eyes:

UHC has been synonymous with single payer health care for years and decades. It only started to be used as a euphemism for mandatory insurance this year, by the Hillary campaign. Sad, and very telling that Edwards has nicked this sort of distortion from Hillary's campaign playbook. Hmm:think:

Sorry, but this is not what this country needs. What we need is true UHC, single payer health care. That isn't what Edwards, or any other candidate excepting Kucinich is offering. What this is is simply another big boondoggle with more payouts for the insurance industry, and a two tier medical system that puts even more of the burden, especially if you want decent health care, on the ordinary person.

[Lydia Leftcoast]

35. My brother refuses Medicare because the rules are too complicated

The rule books are so thick and detailed that you can violate the law without intending to.

[OzarkDem]

40. I work every day w/ patients

Medicare works well for them, with the only change needed in Bush's prescription drug coverage program.

Patients on Medicare get the same level of cancer care as those w/ private insurance.

[Time for change]

49. What makes you think that the fact that some physicians opt out of Medicare

means that people who receive their medical care through Medicare receive inferior care.

The general consensus is that Medicare provides superior care in general to those who receive their medical care through private insurance. Medicare, being not-for-profit, means that there is no systematic effort, in fact no effort at all, to deny needed care to people.

I get private health insurance through my job, and it truly sucks. They use every trick in the book to deny care. I would much prefer to have government insurance, but I can't get it because I'm not old enough or poor enough.

[Time for change]

31. It is NOT a two tier system

What makes you think that the best care is reserved for those with private insurance? All the evidence we have indicates that Medicare is a BETTER insurance system than private insurance. And it certainly doesn't funnel money to private insurance. By introducing government to compete against private insurance, tens of million, probably well over a hundred million Americans will cancel the private insurance they now have in exchange for public insurance made available through this plan.

[area51]

38. GingrichCare

Gotta love people & candidates who are following Newt Gingrich's lead. Years ago, he said he wanted to see a law forcing people to buy health insurance. Obviously, nazi Gingrich thinks that people are just "too lazy" to buy health insurance. WTF would he know, as a rich bastard? Yet the so-call "top-tier" candidates have embraced GingrichCare insurance-at-gunpoint to punish the poor and middle class, and I believe as someone mentioned, anyone who's seen Sicko knows that even having insurance doesn't guarantee healthcare.

[OzarkDem]

41. Wrong again

Newt wants to require everyone to buy into private insurance. Edwards plan gives a choice between public and private insurance.

But I'm sure you already knew that when you posted, right?

[defendandprotect]

44. We have to end all PRIVATIZING of our government systems --- military/medical, etal

[Time for change]

54. Health care insurance is already mostly privatized

Providing government insurance to compete with it is getting the first foot in the door, and the first step towards making private health care insurance irrelevant.

[defendandprotect]

42. Look. . . Edwards is my candidate . . . however, despite what

Krugman may be saying, Edwards is off the track on a few things ---
his supposed effort to create "single-payer universal health care" ---
and his opinion on gay marriage ---
Oh, yeah --- also re taking Republicans into his administration!!!

We already have a single-payer health care system -- MEDICARE --
all we need to do is include everyone in that program --
and stop the Bush/GOP cuts to the programs.

Meanwhile -- what we certainly don't need is a MEANS test for health care --
that simply creates a welfare system ---
Everyone should have the same entitlement --- everyone the same care -- no matter
your income levels.

[Time for change]

46. I'm not arguing against single-payer health care

But my point is that: 1) What Edwards is proposing is pretty close; and 2) Therefore, if going for single payer might decrease the chances of passing universal health care, maybe it's not worth the risk.

You say that everyone should have the same entitlement; and Medicare for everyone. Edwards' plan provides that for anyone who chooses it. Clearly, you don't believe that. But that's what Edwards' plan says, and that's what it's designed to do.

So the bottom line question in my view is, What's more important -- getting a system where everyone gets good quality health care, or insisting in addition that it be single-payer, which may kill the whole deal? As far as I'm concerned, quality health care for everyone is the main goal. We get that first, and Edwards' plan will probably evolve into single-payer anyhow.

[defendandprotect]

53. "pretty close" reminds me of Cheney's "for the most part" on Geneva Accords ---

You can't have a mix of a privatized system and a single-payer system --

privatization defeats the very purpose of a single-payer system.

And -- how about we stop endorsing the lesser of evils ---

and/or working on fear-based arguments?


Did Edwards not mention a "MEANS" test --- when you have income tiers you do NOT have the same situation for everyone --

Let's not start out with some citizens valued differently from other citizens.

[Time for change]

59. The mixture is a private and a public system

Not a private and a single-payer system, which seems like a contradiction in terms.

Why can't you have a mixture of private and public health insurance? I see no reason why that can't be done.

You talk about a two tier system as if private health insurance is better than public health insurance, when all the evidence indicates exactly the opposite. Public health insurance is better because it's not-for-profit, so the goal is to provide health insurance, not to make a profit.

Single-payer isn't the goal -- the goal is universal health care, that is, health care for all Americans. Right now we have 47 million Americans without any health insurance at all. If they can receive the health care they need, then that is what is important. If some people CHOOSE to have private insurance instead of public insurance I don't think that's so terrible, as long as everyone has the right to good quality health care.

[defendandprotect]

43. And it's amazing how much pretense there is about "single-payer health care" ---

we would be led to believe that it's rocket science --- yet every other country has it and it works ---

Other countries have always had MEDICARE type programs ---
all we have to do is extend Medicare to everyone and make sure that they don't "Bush" the system ---

[RufusTFirefly]

45. Thank you! You addressed my two chief concerns

I'm not officially an Edwards supporter yet, but this goes a long way toward easing my worries about some aspects of his plan. As someone with dozens of Canadian relatives who are justifiably proud of their health care, I still believe that single-payer is the way to go and am frustrated that we in the States are so short-sighted that we are unable to look beyond our borders on this matter. That said, the primary impediment to single-payer is JE's primary target: corporate hegemony. I laud him for making this a real issue. The first big step in making America better is to reduce the un-checked power of corporations.

Edwards’ plan will cause a two-tiered system – a private tier for the wealthy and a government tier for the poor

That would be likely only if a health care system subsidized private insurance companies. Quite the contrary, Edwards’ plan does not subsidize private insurance companies, but rather creates competition for them where no competition currently exists (except through Medicare and Medicaid).

People should not confuse this with school vouchers, where people receive vouchers to attend private school only if they opt out of public school to attend private school. That is not what Edwards’ plan does. Those who opt for private rather than public health insurance receive nothing for doing so – except the risk of getting screwed.


The wealthy can choose private rather than public insurance and thereby avoid contributing to the support of national health care

Not true. Taxes will pay for the plan, and in fact Edwards says that his plan will be paid for through reversals of the Bush tax cuts for the wealthy. The wealthy can choose private over government insurance if they want to, just like everyone else. But they receive no advantages for doing so, and they have to pay the same taxes regardless of whether they purchase government or private insurance. Anyhow, I don’t see our Congresspersons, who all receive health care through the government, opting out of that for private insurance.

[Time for change]

48. Yes, those are two very important points

And I would be disappointed in Edwards if that wasn't the case.

I'm very glad that I was able to get that point across at least to some people, thank you.
:toast:

[progressoid]

50. Marking this for a later read...

[slipslidingaway]

55. Tax credits can be used to buy insurance from the new Health

Care Markets which will include private insurance companies according to the fact sheet at Edwards' site. It sounds as if you are saying that tax credits cannot be used to buy insurance from private companies, but the Edwards' site says you have a choice???

There is a possibility that if one's current doctor or specialist does not participate in the public plan they could use the tax credits to purchase private insurance, even if it costs them a little more.

:shrug:


"Edwards’ plan will cause a two-tiered system – a private tier for the wealthy and a government tier for the poor

That would be likely only if a health care system subsidized private insurance companies. Quite the contrary, Edwards’ plan does not subsidize private insurance companies, but rather creates competition for them where no competition currently exists (except through Medicare and Medicaid).

People should not confuse this with school vouchers, where people receive vouchers to attend private school only if they opt out of public school to attend private school. That is not what Edwards’ plan does. Those who opt for private rather than public health insurance receive nothing for doing so – except the risk of getting screwed."


http://www.johnedwards.com/issues/health-care/health-care-fact-sheet/

"Offer New Health Insurance Tax Credits: Edwards will create a new tax credit to subsidize insurance purchased through Health Care Markets, making premiums affordable for all families. The tax credit will be available on a sliding scale to middle class families and refundable to help families without income tax liability...


Third: New Health Care Markets. The U.S. government will help states and groups of states create regional Health Care Markets, non-profit purchasing pools that offer a choice of competing insurance plans. At least one plan would be a public program based upon Medicare...

Choice between Public and Private Insurers: Health Care Markets will offer a choice between private insurers and a public insurance plan modeled after Medicare, but separate and apart from it. Families and individuals will choose the plan that works best for them."

[Time for change]

56. Let me explain

When I said: "Those who opt for private rather than public health insurance receive nothing for doing so – except the risk of getting screwed.", what I mean by that is that people get nothing for making the choice to purchase private insurance rather than public insurance. The money is made available to them (on a sliding scale), and they exercise the choice of whether to purchase public or private insurance with that money. Note that I also say in the OP, in briefly summarizing Edwards' plan:

His plan would offer a choice between government insurance similar to our Medicare system (before Bush got hold of it) and private insurance. The purchase of one or the other would be mandatory, in order to prevent people from gaming the system (see explanation for that below).

Now, this is the central point, since we are all concerned with the excessive influence of private insurance companies in today's health care system: As our system currently exists, the good majority of Americans who have health insurance have private rather than government health insurance. My estimate is that we have 180 million Americans with private insurance and about 70 million with public insurance (mostly Medicare and Medicaid). Those 180 million Americans have no access to public insurance. They have private insurance because they that's all that is available to them. Under Edwards' plan, those 180 million Americans will then have the option of switching to public insurance. My hunch is that at least 100 million of them, maybe a lot more, will drop their private insurance in favor of public insurance.

On the other side of the coin, we have 47 millions Americans with NO health insurance. Those people will receive subsidies from the government that will allow them to purchase health insurance, and they will have their choice of public or private. I would imagine that the good majority would choose public because public insurance is a better deal, since it is not-for-profit.

So my point is that the net effect is that private insurance companies will likely lose tens of millions of customers, very likely over 100 million. So they'll gain a few, but the net effect is that they'll lose many more. They will lose big time. It is the American people who get the subsidies, not the insurance companies.

As far a two tiered system is concerned, I see no reason why that should develop. People who suggest that do so on the basis that they consider private insurance to be better than public insurance. There is no evidence to support that. Public insurance (such as Medicare) is better than private insurance because, being not-for-profit, their main objective is to provide health care for the American people. The main objective of private insurance companies, on the other hand, is to make a profit. They put a lot of money into marketing and they often go to great lenths to deny care in order to make a profit. Why would anyone consider that a better deal than public insurance?

[slipslidingaway]

58. Thanks for the detailed reply, I wanted to make sure people

understand that tax credits can be used to pay for private insurance. Yes, the intention is to create competition and hopefully more people will choose a public system, I suspect this would be true of most people who do not currently have insurance.

Personally, I would be inclined to not switch to a public system until it had been established for quite awhile to see how the system worked and which doctors would be part of the public system.


How far we have Not come :(

http://www.pbs.org/healthcarecrisis/history.htm

"The Depression changes priorities, with greater emphasis on unemployment insurance and "old age" benefits.

Social Security Act is passed, omitting health insurance...

President Truman offers national health program plan, proposing a single system that would include all of American society."

[Time for change]

60. Nice chart

Well, I really think it will happen this time. Whether Edwards, Clinton or Obama gets in, they all have plans on the table (though Obama's needs some work), and while it probably won't be perfect, I think it will be a big step forward. Of course, if a Republican wins the presidency we can absolutely forget about it for at least another 4 years.

[puebloknot]

57. Very helpful post. Thank you! nt

[Time for change]

62. Thank you!

[John Gauger]

61. If Krugman's behind it, that's all I need to know.

My brother and I were just discussing his column and I said he should change the name to "I Told You So." (This means you, Alan Greenspan.)

[Time for change]

64. I fell much the same way about that -- Krugman is brilliant, and he has his heart in the right place

too.

Would it be too much to ask, even if Edwards doesn't win the nomination, that our next president make him Secretary of the Treasury? That sure would make me feel a lot better about Clinton or Obama.

[John Gauger]

65. Who for Secretary?

Edwards or Krugman? Krugman's a good choice. I say Edwards for Vice President. VP of late has an inordinate amount of say over policy, and though it's mostly a ceremonial position it is in the public eye. Edwards is very on-message and he talks about the right stuff. Could you imagine the VP talking every single day about the girl who needed a kidney and the man with a cleft pallet?

[Time for change]

68. I meant Krugman for Sec Treasury

If Edwards doesn't win the presidency, I would love to see him as VP. But I seriously doubt that Clinton or Obama would pick him. They try so hard to appeal to the center that I can't see them picking Edwards for VP.

[Orwellian_Ghost]

63. K&R n/t

[droidamus2]

66. A question?

Over the years I have seen good legislation watered down before passing or slowly torn apart by subsequent legislation. They is obviously a group, freemarketers, that believe private insurance is the only way to go and any government plan is bad. What is to keep these people if an Edwards plan is instituted to eventually try to kill the government plan legislatively but retain the requirement that everybody have coverage? This way they would end up with what they want by forcing everybody to purchase private for-profit medical insurance. I think anything that leaves the current insurance companies involved takes the risk of something like this happening. If there was a way to 'lock in' the program for say 10 or 20 years where no Congress or President could get rid of it maybe that would work or at least if you get rid of the government plan you also rescind the required coverage.
Don't forget about those people that keep pushing that 'privatizing' is the way to go with government services. One argument I can see them making is the medical care in the government program is costing way more than in private programs. Of course, this would be due to the fact that the government system doesn't deny care so covers a lot more need than private but they won't point that out. Just as an aside I agree with those that say 'Universal Health Insurance' is not the same as 'Universal Health Care'. You may have figured out that I am not a big fan of the current idea of 'private insurance'. On one hand they use your premiums to advertise how they'll be there for you when you need it then they turn around and do everything they can to deny you payouts and if you fight back they use your premiums to maintain a team of high priced lawyers to defeat you in court. End of Rant!

[Time for change]

67. I don't like private insurance either

You ask, what is to stop them from trying toexpand private insurance if we leave any of it in place with whatever plan is enacted. Nothing, of course. The right wing ideologues try to privatize everything, as you point out.

But look at it from the other direction. They're certainly asking the same question in reverse. As it is now, other than Medicare and Medicaid, virtually all health insurance is private. Edwards' plan would introduce public insurance to compete with the currently existing private insurance. It's very likely that that competition will completely phase out private insurance. How many people over the age of 65 today use private insurance instead of Medicare? So they're wondering, once public insurance is made available to everyone, how much longer are they going to be able to continue. Under Edwards' plan, private health insurance could be completely phased out without even any additional changes in the law, as people learn that public not-for-profit insurance is better, and switch over.

Of course the right wingers will try to reverse that or water down the legislation. What is to stop them from being successful? Only a Democratic president and Congress who are committed to health care for the American people. If we don't have that, we'll never get any plan like Edwards' enacted in the first place. It is a very large step in the right direction. And you'll note that there is no Republican proposing anything like it.