The Occupy Tea Party Platform, Part II: Obamacare

Health care reform and universal health insurance is one of those issues that has popped up time and again in American politics for decades, dating back to Lyndon Johnson’s Great Society and the enactment of Medicare and Medicaid, if not further. Both Richard Nixon and Bill Clinton tried and failed to enact their own reforms. In that context, love him or hate him (or his plan), the fact that Barack Obama was able to pass anything, in the most polarized political climate since at least the Civil War, is nothing short of astounding.

The spiraling costs of health care pose such a threat to the long-term viability of the federal government, especially as the baby boomers retire, that this should be an issue that both sides of the aisle can agree on. In practice, a lot of people, especially on the right, seem to be unclear as to what the issue actually is, seeing the health care debate as being less about health care and more about the role of government in our lives, and there’s a lot of disagreement over where to fix the problem. (It doesn’t help that “Obamacare” has become a bogeyman that has arguably overshadowed the actual contents of the bill.) A lot of Democrats made insurance companies into the scapegoat, calling for the government to institute a public option to force insurance companies to keep premiums down and stop discriminating against people with pre-existing conditions (the people who most need it) in the name of profit, if not take over the health insurance system entirely and adopt a single-payer system.

While I’m sympathetic to the Democrats’ stance, I’m still not convinced that repealing the health insurance industry’s anti-trust exemption wouldn’t have done a lot to solve those problems even on its own, without further government intervention in the marketplace. Ultimately, Obama wasn’t able to pass any form of public option, and the bill’s ultimate solution to the problem of the insurance industry could be seen as an adoption of my viewpoint. Perhaps the centerpiece of the bill is the establishment of an “exchange” with which individuals and businesses could compare and contrast various health plans. But this was coupled with numerous requirements for qualifying health plans and a universal coverage mandate. During the debate on the bill, while watching C-SPAN I saw Republican lawmakers denounce the “exchange” as sufficient to constitute a “government takeover” of health care, raising the specter of the government deciding which insurance plans you’ll have a “choice” from. The “exchange” comes across to me as more of a shadow free market than an actual one, one the Democrats didn’t have enough confidence in not to include instructions to insurance companies on what to do and what not to do on top of it.

I can see why the individual mandate, probably the most controversial specific provision, was included. Most young, healthy people consider themselves invulnerable and don’t think they’ll need health insurance for anything. Requiring them to get health insurance means they’re covered if they turn out to be wrong, while their healthiness makes them the insurance companies’ ideal customer and makes it easier for them to cover more marginal customers for less, possibly having the result of lowering insurance costs overall. Republicans have been most vocal in decrying the mandate, but even Keith Olbermann, then still with MSNBC, called for the mandate to be stripped after the public option died, claiming that with the mandate but no public option the bill amounted to a massive gift to the insurance companies. I suspect that betrays his lack of faith in capitalism and the free market more than anything else, but in any case I can definitely see a scenario where requiring everyone to get health insurance causes high and inelastic demand, theoretically allowing insurance companies to drive prices to the moon.

At any rate, all the emphasis on insurance may be at least slightly misguided anyway. A larger problem may involve the quality of care itself and how it’s delivered to patients. There’s little research on what treatments offer the best bang for the buck; doctors are presently paid based on how often they’re used, not with a constant salary, encouraging overtreatment; and there needs to be effort to encourage healthier lifestyles so people aren’t so reliant on the health care system in the first place. (This last may come up in later entries in this series.) Republicans would rather focus on tort reform, claiming that fear of malpractice suits is what drives up costs; I’m not convinced by Wikipedia’s analysis which focuses on the effect of the actual rather than perceived risk of malpractice. And we’re running the risk of shortages in doctors and nurses in the future. The health care legislation does confront many of these problems, though they’re clearly in the background compared to insurance reform.

This is too complex an issue for me to figure out what the best approach is, so I may revisit it later. My impression is that the health care bill is superior to the status quo ante, and any better reform would need to build off at least some of its provisions, and if the Republicans repeal it without providing some sort of replacement there may be some people who feel a bit betrayed. But I can’t help but wonder what might have happened if we had instituted a true free market, rather than one imposed by the government. As it stands, it may well turn out that the health care legislation will give more power to both government and business, and while I’d like to see how it plays out before making any rash decisions, if it does end up repealed we should insist that it be replaced with a bill that empowers patients first and foremost by encouraging, rather than stifling, innovation in all areas of health care. Perhaps it includes an individual mandate, perhaps not, but if it includes it it does so only if it’s been established that, combined with other reforms, it will improve health care costs and quality of health for all Americans, rather than serving as a giveaway to insurance companies.

Why I’m undecided about the public option

I’m a bit of a bleeding-heart liberal. Maybe it just comes with the territory of living in Seattle. But I try to keep my ears open to the ideas of competing political ideologies.

So as much as I think the health care system needs reform and as much as I align myself more with the Democrats’ priorities than the Republicans’… I’m still not sure how big a fan I am of the Dems’ leading proposal to combat the depredations of the health insurance industry, the public option.

Don’t get me wrong. I’m all for making sure as many people as possible have health insurance and that the people who need health insurance the most aren’t excluded and the health insurance system doesn’t attempt to cover only the people who won’t actually use their service, and I could be swayed to the side of the public option as the way to do that. I’m just not entirely convinced the public option is the way to go on that front – even though many countries outside the United States, especially in Europe, go even further and have nationalized health insurance completely.

The idea behind the public option is to create competition with the insurance companies (although many proposed public options in Congress would be open only to people who can’t afford insurance otherwise, making it more of a safety net than true competition) so they would have to stop raising rates to the moon lest people bolt to the public option, without artificial regulations against such things that would require enforcement and might be circumvented. Much as I like the idea, I’m not sure how insurance companies could ever compete with something backed by the government. (Even though the US Postal Service allows the likes of FedEx and UPS to exist.)

Here’s the thing: The health insurance industry currently enjoys exemption from anti-trust regulations.

That’s been mentioned a few times in this debate, but I’m not sure anyone really appreciates its significance. Capitalism and the free market may be riddled with problems, but we haven’t even tried it yet when it comes to health care. If we lifted the health insurance anti-trust exemption, which has proven itself to not be in the public interest, and made it as easy as possible to change health insurance plans, and created things such as co-ops to ensure there would be someone doing whatever we wanted done, we wouldn’t need the public option to create competition or even lift the ban on banning pre-existing conditions. Health insurance cost too much? Someone else is probably charging less. Can’t get insurance because of a pre-existing condition? Someone else will take you in. Had insurance dropped once you got sick? Someone else will cover you.

The health care/insurance reform bills circulating in Congress seem like they’re trying to take many different approaches to the same problem – creating an “exchange” to buy health insurance and ending pre-existing condition prohibitions and creating a public option, for example. There’s little recognition of the wisdom of FDR, who tried one thing to fix the Depression, and when that didn’t work, tried another. I’m not sure the Democrats need to take so many, and so many relatively radical, approaches to the health care system.

Now tell me why I’m wrong.

Examining the Republican Platform Part VI: “Health Care Reform: Putting Patients First”

This is continued from Parts I-V of my examination of the Republican Platform. I say I made good on my guarantee because this is before I went to bed.

The rest of the Republican platform deals with social issues, starting with Part VI, “Health Care Reform: Putting Patients First”, which will cross over with the Democrats’ favorite topic. The Republicans’ treatment of it begins with empty praise for the personnel and resources of the medical system, and the need “to build around them the best health care system. Republicans believe the key to real reform is to give control of the health care system to patients and their health care providers, not bureaucrats in government or business.” Does that mean you would junk the current private health care system that even Democrats want to retain? Is this something where privatization is not the answer?? Here are the problems the Republicans see with the current health care system:

  • Most Americans work longer and harder to pay for health care. 
  • Dedicated health care providers are changing careers to avoid litigation.
  • The need to hold onto health insurance is driving family decisions about where to live and work. 
  • Many new parents worry about the loss of coverage if they choose to stay at home with their children.
  • The need – and the bills – for long-term care are challenging families and government alike.
  • American businesses are becoming less competitive in the global marketplace because of insurance costs.
  • Some federal programs with no benefit to patients have grown exponentially, adding layers of bureaucracy between patients and their care.

Gotta love the shots taken at trial lawyers and the size of the bureaucracy. The Republicans claim “It is not enough to offer only increased access to a system that costs too much and does not work for millions of Americans. The Republican goal is more ambitious: Better health care for lower cost.” Your stance intrigues me, and I wish to learn more.

“First Principle: Do No Harm”: “The American people rejected Democrats’ attempted government takeover of health care in 1993, and they remain skeptical of politicians who would send us down that road.  Republicans support the private practice of medicine and oppose socialized medicine in the form of a government-run universal health care system.  Republicans pledge that as we reform our health care system:

  • We will protect citizens against any and all risky restructuring efforts that would complicate or ration health care.” The Republicans seem to think it’s impossible to “cover all”, as the Democrats want, and still offer complete coverage, as the Democrats want. Not sure how the Democratic plan would really “complicate” things – you choose between a number of providers.
  • “We will encourage health promotion and disease prevention.” So do the Democrats; this is presumably a defense against the notion that they wouldn’t do those things.
  • “We will facilitate cooperation, not confrontation, among patients, providers, payers, and all stakeholders in the health care system.” I’m intrigued as to how.
  • “We will
    not put government between patients and their health care providers.” Unless “health care providers” refers to private insurers instead of doctors and hospitals, I’m not sure how the Democratic plan “puts government between patients and their health care providers”.
  • “We will
    not put the system on a path that empowers Washington bureaucrats at the expense of patients.” Fair point.
  • “We will
    not raise taxes instead of reducing health care costs.” The Democrats did say their rollback of the Bush tax cuts would pay for their health care plan, but they are also concerned about “reducing health care costs” if I recall correctly.
  • “We will
    not replace the current system with the staggering inefficiency, maddening irrationality, and uncontrollable costs of a government monopoly.” Given some of the weak spots in the Democratic plan, fair point.

    Radical restructuring of health care would be unwise.  We want all Americans to be able to choose the best health care provider, hospital, and health coverage for their needs.  We believe that real reform is about improving your access to a health care provider, your control over care, and your ability to afford that care. 

    We will continue to advocate for simplification of the system and the empowerment of patients.  This is in stark contrast to the other party’s insistence on putting Washington in charge of patient care, which has blocked any progress on meeting these goals.  We offer a detailed program that will improve the quality, cost, and coverage of health care throughout the nation, and we will turn that plan into reality.

Very intrigued. You want further simplification of the system and you think the Democratic plan complicates it? Your – presumably very different – plan follows the “quality, affordable” tenets of the Democratic plan, but with less reliance on government? I want to know more!

“Patient Control and Portability”: “Republicans believe all Americans should be able to obtain an affordable health care plan, including a health savings account, which meets their needs and the needs of their families.” Well, here’s the beginnings of it, but I still want to learn the details of this “health savings account” Where would the money come from, how does it differ from a regular savings account? “Families and health care providers are the key to real reform, not lawyers and bureaucrats. To empower families, we must make insurance more affordable and more secure, and give employees the option of owning coverage that is not tied to their job.  Patients should not have to worry about losing their insurance. Insurance companies should have to worry about losing patients’ business.” The substantive parts of all of that sound good, but they sound similar to the Democratic plan. Although I don’t know how easy the Democrats make it to change health care providers.

“The current tax system discriminates against individuals who do not receive health care from their employers, gives more generous health tax benefits to upper income employees, and fails to provide every American with the ability to purchase an affordable health care plan.” Democrats did call for employers to “have incentives to provide coverage to their workers”, and all of these are fair points – and only the last, vague one mirrors the Democratic plan. “Republicans propose to correct inequities in the current tax code that drive up the number of uninsured and to level the playing field so that individuals who choose a health insurance plan in the individual market face no tax penalty.” The Democrats did say that “[c]overage should be made affordable for all Americans with subsidies provided through tax credits and other means”, but didn’t directly address “inequities in the current tax code”. “All Americans should receive the same tax benefit as those who are insured through work, whether through a tax credit or other means.” Sounds fair, but I see no incompatibility with the Democratic plan.

“Individuals with pre-existing conditions must be protected; we will help these individuals by building on the experiences of innovative states rather than by creating a new unmanageable federal entitlement.” Democrats wanted to bar insurers from barring people with “pre-existing conditions”, so they wouldn’t necessarily have to enter the “federal entitlement”, but it does consist of more of that “regulation” Republicans hate so much. I want to know what these “innovative states” have come up with; the Democrats had a similar line there as well. “We strongly urge that managed care organizations use the practice patterns and medical treatment guidelines from the state in which the patient lives when making medical coverage decisions.” Sounds somewhat obvious.

Then the Republicans start harping on semi-tangential “values” issues. “Because the family is our basic unit of society, we fully support parental rights to consent to medical treatment for their children including mental health treatment, drug treatment, alcohol treatment, and treatment involving pregnancy, contraceptives, and abortion.” Some people might disagree, but this seems reasonable to me.

“Improving Quality of Care and Lowering Costs”: And “help[ing] Americans – men, women, and children – live longer and healthier lives”.

“Prevent Disease and End the ‘Sick Care’ System”: Sound like Obama calling for “a health care system, not a disease care system”? “Chronic diseases – in many cases, preventable conditions – are driving health care costs, consuming three of every four health care dollars. We can reduce demand for medical care by fostering personal responsibility within a culture of wellness, while increasing access to preventive services, including improved nutrition and breakthrough medications that keep people healthy and out of the hospital.” The Democrats cited a similar stat and vowed to “promote healthy lifestyles and disease prevention and management especially with health promotion programs at work and physical education in schools. All Americans should be empowered to promote wellness and have access to preventive services to impede the development of costly chronic conditions, such as obesity, diabetes, heart disease, and hypertension.” How would the Republicans “foster[] personal responsibility within a culture of wellness”? Why do I have a sinking feeling those “breakthrough medications” are a giveaway to pharmaceutical companies? If you need them great; ideally, you don’t need them.

“To reduce the incidence of diabetes, cancer, heart disease, and stroke, we call for a national grassroots campaign against obesity, especially among children.” The “party of small government” should know that a “grassroots campaign” started by government is a contradiction. “We call for continuation of efforts to decrease use of tobacco, especially among the young.” I will never understand how people my age could possibly start smoking despite being bombarded all their lives by messages about how bad it is and considering how bad it stinks. We’ve been on an anti-tobacco crusade since, what, the 70s now? Do you think maybe we should start thinking about changing tactics, or at least adopting new ones?

“A culture of wellness needs to include the treatment of mental health conditions.  We believe all Americans should have access to affordable, quality health care, including individuals struggling with mental illness.  For this reason, we believe it is important that mental health care be treated equally with physical health care.” These three sentences are almost redundant and give the impression that the Republicans are committed to mental health when they give no specifics.

“Empower Individuals to Make the Best Health Care Choices”: “Clear information about health care empowers patients.  It lets consumers make better decisions about where to spend their health care dollars, thereby fostering competition and lowering costs.  Patients must have information to make sound decisions about their health care providers, hospitals, and insurance companies.” Question is, will they even look at that information? I don’t think I saw anything in the Democratic platform concerning this. This may be the most substantive part of the Republicans’ alternate plan so far, but because many Americans get their coverage from their employer, it lacks a foundation.

“Use Health Information Technology to Save Lives”:

Advances in medical technology are revolutionizing medicine. Information technology is key to early detection and treatment of chronic disease as well as fetal care and health care in rural areas – especially where our growing wireless communications network is available.  The simple step of modernizing recordkeeping will mean faster, more accurate treatment, fewer medical errors, and lower costs.  Closing the health care information gap can reduce both under-utilization (the diabetic who forgets to refill an insulin prescription) and over-utilization (the patient who endures repetitive tests because providers have not shared test results).

There’s a germ of substantive policy in there. The Democrats did call for, more specifically, “driving adoption of state-of-the-art health information technology systems, [and] privacy-protected electronic medical records”. All pretty common sense stuff.

“Protect Good Health Care Providers from Frivolous Lawsuits”: It’s Take-Shots-At-Trial-Lawyers Time!

Every patient must have access to legal remedies for malpractice, but meritless lawsuits drive up insurance rates to outrageous levels and ultimately drive up the number of uninsured.  Frivolous lawsuits also drive up the cost of health care as health care providers are forced to practice defensive medicine, such as ordering unnecessary tests.  Many leave their practices rather than deal with the current system. This emergency demands medical liability reform.

And that medical liability reform would be…? This is another thing the Dems don’t touch on, and it’s starting to form the germ of lowering the cost of health care, at least as described. But more is still to come.

“Reward Good Health Care Providers for Delivering Real Results”:

Patients deserve access to health care providers they trust who will personalize and coordinate their care to ensure they receive the right treatment with the right health care provider at the right time.  Providers should be paid for keeping people well, not for the number of tests they run or procedures they perform.   The current cookie-cutter system of reimbursement needs restructuring from the view of the patient, not the accountant or Washington bureaucrat.

That certainly sounds reasonable – do you reimburse providers more for keeping costs down? Well, you don’t say that. And what about what the Democrats call “insurance discrimination”? This sounds like a way of doubling that – one way to get “paid for keeping people well” is to keep out the people who aren’t!

“Drive Costs Down with Interstate Competition”:

A state-regulated national market for health insurance means more competition, more choice, and lower costs.  Families – as well as fraternal societies, churches and community groups, and small employers – should be able to purchase policies across state lines.  The best practices and lowest prices should be available in every state.  We call upon state legislators to carefully consider the cost of medical mandates, and we salute those Republican governors who are leading the way in demonstrating ways to provide affordable health care options.

Um… okay, this is an odd proposal. Does this mean that one or two states will be providing the health care for the entire nation? Wouldn’t this render state-by-state policies meaningless? Why don’t you just take away the state-by-state policies and pass the best ones on a national level? Don’t you like the states?

“Modernize Long-Term Care Options for All”:

The financial burdens and emotional challenges of ensuring adequate care for elderly family members affect every American, especially with today’s aging population.  We must develop new ways to support individuals, not just institutions, so that older Americans can have a real choice whether to stay in their homes. This is true not only with regard to Medicaid, where we spend $100 billion annually on long-term care, but also for those who do not qualify for that assistance.

And those new ways would be…? I’m not even sure what you would look at here.

“Encourage Primary Care as a Specialty”: “We believe in the importance of primary care specialties and supporting the physician’s role in the evaluation and management of disease.  We also encourage practice in rural and underserved areas of America.” No word on how, though. The Democrats provided more detail on how they would support primary care workers, but surprisingly, didn’t mention the last sentence either in my Part I or in their “rural America” section.

“Funding Medical Research”:

We support federal investment in basic and applied biomedical research.  This commitment will maintain America’s global competitiveness, advance innovative science that can lead to medical breakthroughs, and turn the tide against diseases affecting millions of Americans – diseases that account for the majority of our health care costs. The United States leads in this research, as evidenced by our growing biotechnology industry, but foreign competition is increasing.  One way government can help preserve the promise of American innovation is to ensure that our intellectual property laws remain robust.

So, would big bad government actually directly fund this research? Certainly the Democrats talk about that. “[E]nsur[ing] that our intellectual property laws remain robust” certainly sounds good. The Democrats support research as a way of enhancing their health care plan, not so much as a way to fight diseases in and of itself. They accused the Republicans of stonewalling “biomedical and stem cell research”, but the GOP mentions “biomedical research” here and doesn’t mention anything that looks like a control (although I’m not done with the section yet).

“Federal research dollars should be spent as though lives are at stake – because, in fact, they are.” I guess big bad government is getting into the spending business, but this certainly makes it sound like a worthy cause. “Research protocols must consider the special needs of formerly neglected groups if we are to make significant progress against breast and prostate cancer, diabetes, and other killers.” What are these “formerly neglected groups”? Are they Democratic special interests? What are we talking about here?

Now come the political flashpoint issues.

Taxpayer-funded medical research must be based on sound science, with a focus on both prevention and treatment, and in accordance with the humane ethics of the Hippocratic Oath. In that regard, we call for a major expansion of support for the stem-cell research that now shows amazing promise and offers the greatest hope for scores of diseases – with adult stem cells, umbilical cord blood, and cells reprogrammed into pluripotent stem cells – without the destruction of embryonic human life.  We call for a ban on human cloning and for a ban on the creation of or experimentation on human embryos for research purposes.

“Whatchoo talkin’ ’bout, Democrats? We love stem cell research! We just don’t like embryonic stem cell research that destroys life.” No permutation of the word “clone” appears in the Democratic platform, but I don’t know enough about cloning to know where the controversy is, other than religious and philosophical questions. What’s your position on “embryonic human life” that would be “destroyed” anyway? There are no mentions of assisted suicide in the Democratic platform either: “We believe medicines and treatments should be designed to prolong and enhance life, not destroy it.  Therefore, federal funds should not be used for drugs that cause the destruction of human life.  Furthermore, the Drug Enforcement Administration ban on use of controlled substances for physician-assisted suicide should be restored.” What’s your stance on people suffering from incurable terminal illness, other than brushing it off with “let’s do more research so it becomes curable”?

“Protecting Rights of Conscience”:

The health care profession can be both a profession and a calling.  No health care professional – doctor, nurse, or pharmacist – or organization should ever be required to perform, provide for, or refer for a health care service against their conscience for any reason.  This is especially true of the religious organizations which deliver a major portion of America’s health care, a service rooted in the charity of faith communities.

What’s this referring to, abortion? Since most of these services can be gotten elsewhere this seems reasonable, especially as a logical outgrowth of the First Amendment.


Its projected growth is out of control and threatens to squeeze out other programs, while funding constraints lead to restricted access to treatment for many seniors.  There are solutions. Medicare can be a leader for the rest of our health care system by encouraging treatment of the whole patient. Specifically, we should compensate doctors who coordinate care, especially for those with multiple chronic conditions, and eliminate waste and inefficiency.

Most of the Democrats’ talk about Medicare comes closer to the end of their platform, in a part I haven’t gotten to yet. For now know that they want to “allow[] Medicare to negotiate for lower prices” which would be one way to cut costs. This proposal sounds reasonable and logical so far. “Medicare patients must have more control of their care and choice regarding their doctors, and the benefits of competition must be delivered to the patients themselves if Medicare is to provide quality health care.” Sounds good, but don’t know what to make of it and keep in mind we’re talking about seniors. “And Medicare patients must be free to add their own funds, if they choose, to any government benefits, to be assured of unrationed care.” That sounds reasonable as well, at first glance, but it means rich people would get better care than poor people. “Finally, because it is isolated from the free market forces that encourage innovation, competition, affordability, and expansion of options, Medicare is especially susceptible to fraud and abuse.  The program loses tens of billions of dollars annually in erroneous and fraudulent payments.  We are determined to root out the fraud and eliminate this assault on the taxpayer.” Sounds good, but how do you plan to do that and what long-term structural reforms do you plan to institute without rendering Medicare at risk to economic downturns and changes in government? And didn’t you just say “the benefits of competition must be delivered to the patients” and now you’re calling Medicare “isolated from…free market forces”?


Our Medicaid obligations will consume $5 trillion over the next ten years.  Medicaid now accounts for 20-25 percent of state budgets and threatens to overwhelm state governments for the indefinite future.  We can do better while spending less.  A first step is to give Medicaid recipients more health care options.  Several states have allowed beneficiaries to buy regular health insurance with their Medicaid dollars.  This removes the Medicaid “stamp” from people’s foreheads, provides beneficiaries with better access to doctors, and saves taxpayers’ money.  We must ensure that taxpayer money is focused on caring for U.S. citizens and other individuals in our country legally.

The Democrats have even less to say about Medicaid; they mention extending it to more HIV-positive Americans and then don’t mention it again until a section titled “Virgin Islands” virtually at the end of the entire platform! So presumably they’re willing to let the Republicans’ doomsday scenario happen. The idea of letting Medicaid beneficiaries buy whatever health insurance they want with their Medicaid dollars certainly sounds like a good idea. One more sentence of harping on illegal immigration at the end there.

“Building a Health Care System for Future Emergencies”:

To protect the American people from the threats we face in the century ahead, we must develop and stockpile medicines and vaccines so we can deliver them where urgently needed.  Our health care infrastructure must have the surge capacity to handle large numbers of patients in times of crisis, whether it is a repeat of Hurricane Katrina, a flu pandemic, or a bioterror attack on multiple cities.  Republicans will ensure that this infrastructure, including the needed communications capacity, is closely integrated into our homeland security needs.

I seem to recall the Republicans may have mentioned this before, back in their national security discussion. This sounds like an important thing to do, to the extent you kind of wonder why we’re not doing it already.

We’re under 4,000 words, let alone 5,000, but the section on education started going so long it wasn’t particularly plausible to stick it in this part without either threatening the 7,000 word barrier, or causing a contradiction by breaking in the middle of the education section for the GOP but not for the Democrats (with a firmer break with the latter to boot). So more Republican fun is still to come… and you may see two Democratic examinations before the next Republican examination.

Examining the Democratic Platform Part I: Preamble, the Economic Crisis, and Health Care

(Note: This series should contain curly quotes because I composed it in Word. If it comes out as gibberish instead, or if there’s weird formatting or other unnecessary junk, let me know.)

I mentioned two weeks ago that I was encouraged by Barack Obama’s apparent commitment to fighting global warming at the last debate. (Incidentially, the way the first two presidential debates went down I was kind of hoping for more foreign policy questions at the ostensible domestic policy debate on Wednesday.) But how much is the rest of the Democrats’ platform worth fighting for in other races? In the start of a series, I take a close look at the Democrats’ platform as a public service and find out which party is really the best for me and, perhaps, for most Americans.

The first question, of course, is: Can we get through the 59-page document? We can, but it’s a lengthy work and so this is going to be more than twice the size of any of my prior posts – about 6,000 words – and it’s still going to be a multi-part series that’ll be released in stages (aiming for closer to 5,000 words per post) throughout the week. I’m thinking this’ll be a four-part series just on the Democrats. I’ll also throw in my analysis of the Republican platform (which believe it or not is even longer), probably while this is still going.

The document’s lengthy preamble begins with a bunch of stuff that few would argue with, but presented as the special charge of the Democratic Party:

We believe that every American, whatever their background or station in life, should have the chance to get a good education, to work at a good job with good wages, to raise and provide for a family, to live in safe surroundings, and to retire with dignity and security. We believe that quality and affordable health care is a basic right. We believe that each succeeding generation should have the opportunity, through hard work, service and sacrifice, to enjoy a brighter future than the last.

Few Americans are likely to disagree with any of this. I’m also breaking out this paragraph and its attempt to broadly characterize the American people as a whole, as it shows how the Democrats see America:

A great nation now demands that its leaders abandon the politics of partisan division and find creative solutions to promote the common good. A people that prizes candor, accountability, and fairness insists that a government of the people must level with them and champion the interests of all American families. A land of historic resourcefulness has lost its patience with elected officials who have failed to lead.

These are mostly empty platitudes, although I’m finding myself more tempted to break out some of them and criticize them this go-round than I did on my first attempt. The Democrats then move to the “historic” “list of failures of this Administration”, and while some people might have problems with some of the statements of fact, they probably wouldn’t argue that they’re bad, with the main exception early on being the line about “instigat[ing] an unnecessary war in Iraq before finishing a necessary war in Afghanistan,” which might attract pacifists wondering if any war is “necessary”. The Democrats follow that up with the “false promises that got us here”, and again, few would probably argue with the interpretation of the facts if they agreed on the facts: “They said they would be compassionate conservatives, but they failed to rescue our citizens from the rooftops of New Orleans, neglected our veterans, and denied health insurance to children.”

These are not just policy failures. They are failures of a broken politics –a politics that rewards self-interest over the common interest and the short-term over the long-term, that puts our government at the service of the powerful. A politics that creates a state-of-the-art system for doling out favors and shuts out the voice of the American people. So, we come together not only to replace this President and his party –and not only to offer policies that will undo the damage they have wrought. Today, we pledge a return to core moral principles like stewardship, service to others, personal responsibility, shared sacrifice and a fair shot for all –values that emanate from the integrity and optimism of our Founders and generations of Americans since. Today, we Democrats offer leaders – from the White House to the State House – worthy of this country’s trust.

It all sounds good, but the question we have to constantly keep in mind is, can we trust the Democrats to bring this change? Or is it just trying to campaign for our vote so they can continue the bad old politics of the past? The Democrats immediately launch into an outline of their plan, and while it starts out with stuff no one would disagree with…

The Democratic Party believes that there is no more important priority than renewing American leadership on the world stage. This will require diplomatic skill as capable as our military might. Instead of refusing to confront our most pressing threats, we will use all elements of American power to keep us safe, prosperous, and free. Instead of alienating our nation from the world, we will enable America –once again –to lead.

This makes sense – there’s no reason to piss off the rest of the world, and quite a few reasons not to. We’re willing to use diplomacy to get what we want, but we also have “all elements of American power” at our disposal. Again, “all elements of American power” would probably piss off the pacifists, but overall, this is fairly uncontroversial. But in the next paragraph comes a line where more than just radicals are likely to jump off:

For decades, Americans have been told to act for ourselves, by ourselves, on our own. Democrats reject this recipe for division and failure. Today, we commit to renewing our American community by recognizing that solutions to our greatest challenges can only be rooted in common ground and the strength of our civic life. The American people do not want government to solve all our problems; we know that personal responsibility, character, imagination, diligence, hard work and faith ultimately determine individual achievement. But we also know that at every turning point in our nation’s history, we have demonstrated our love of country by uniting to overcome our challenges—whether ending slavery, fighting two world wars for the cause of freedom or sending a man to the moon. Today, America must unite again –to help our most vulnerable residents get back on their feet and to restore the vitality of both urban centers and family farms –because the success of each depends on the success of the other. And America must challenge us again –to serve our country and to meet our responsibilities –whether in our families or local governments; our civic organizations or places of worship.

Wait, wait, wait. The American ideal of self-reliance is “a recipe for division and failure”? Does that mean we can’t do anything without the intervention of government? But “The American people do not want government to solve all our problems,” they admit. So which is it? Okay, I’m willing to consider that the Democrats are saying they just want government to pick Americans up when they fall down, and let this go for now. But this whole “America must unite again” rhetoric sounds euphemistic, as though the Democrats are painting their impending power-taking as a movement of the people. And how can the Democrats say “America must challenge us again” when they at least want to be part of the “us”? The Democrats then go back to platitudes no one disagrees with:

And so, even when we disagree, we will work together to move this country forward. There can be no Republican or Democratic ideas, only policies that are smart and right and fair and good for America –and those that aren’t. We will form a government as decent, candid, purposeful and compassionate as the American people themselves.

This is the essence of what it means to be a patriot: not only to declare our love of this nation, but to show it –by our deeds, our priorities, and the commitments we keep.

If we choose to change, just imagine what we can do. What makes America great has never been its perfection, but the belief that it can be made better. And that people who love this country can change it. This is the country of Abraham Lincoln, Susan B. Anthony, Martin Luther King Jr., Cesar Chavez, and Rosa Parks – people who had the audacity to believe that their country could be a better place, and the courage to work to make it so. And this Party has always made the biggest difference in the lives of the American people when we summoned the entire nation to a common purpose.

Of course there are people who think that America really is great simply because it’s the best nation that ever was and ever will be, but really, that’s sort of splitting hairs. Citing such legends of American history as Lincoln and MLK is either a brilliant attempt to parry that perfectionist view, or the Democrats trying to elevate their status by trying to equate themselves with these great Americans with that last sentence. Or both. But I’d like to hear more about this idea that “this Party has always made the biggest difference in the lives of the American people when we summoned the entire nation to a common purpose”. When have the Democrats “summoned the entire nation to a common purpose” to make a “difference in the lives of the American people”? World War II was an attempt to prevent a difference in the lives of the American people, and JFK’s go-to-the-moon challenge was more symbolic than difference-making.

That’s essentially the end of the preamble, so let’s move on to Part I, “Renewing the American Dream”. It starts with a review of the state of the economy as of August, when the platform was adopted.

For months the state of our economy has dominated the headlines–and the news has not been good. The sub-prime lending debacle has sent the housing market into a tailspin, and many Americans have lost their homes. By early August, the economy had shed 463,000 jobs over seven straight months of job loss. Health, gas and food prices are rising dramatically.

But the problem goes deeper than the current crisis. Families have seen their incomes go down even as they have been working longer hours and as productivity has grown. At the same time, health costs have risen while companies have shed health insurance coverage and pensions. Worse yet, too many Americans have lost confidence in the fundamental American promise that our children will have a better life than we do.

We are living through an age of fundamental economic transformation. Technology has changed the way we live and the way the world does business. The collapse of the Soviet Union and the advance of capitalism have vanquished old challenges to America’s global leadership, but new challenges have emerged. Today, jobs and industries can move to any country with an Internet connection and willing workers.

I quote that not to critique it but solely so we can refer to it when reading not only the Democrats’ answers to these problems, but those of other parties as well. The Democrats promptly take a potshot at Bush while building up their own record:

In the 1990s, under Bill Clinton’s leadership, employment and incomes grew and we built up a budget surplus. However, our current President pursued misguided policies, missed opportunities, and maintained a rigid, ideological adherence to discredited ideas. Our surplus is now a deficit, and almost a decade into this century, we still have no coherent national strategy to compete in a global economy.

I’m tempted to ask what these “discredited ideas” are, but we’ll move on. By the way, if these sound forced, I might have more critiques of the Democrats after looking at the Republicans’ point of view. The rest of the introduction to the part can be summed up by its single-sentence penultimate paragraph: “We need a government that stands up for the hopes, values, and interests of working people, and gives everyone willing to work hard the chance to make the most of their God-given potential.” The entire part can be summed up by the final paragraph, including the Democrats’ hope for “a new approach. One that is both innovative and faithful to the basic economic principles that made this country great.” So you’re not a bunch of socialists!
“Jumpstart the Economy and Provide Middle Class Americans Immediate Relief”: “We will provide an immediate energy rebate to American families struggling with the record price of gasoline and the skyrocketing cost of other necessities – to spend on those basic needs and energy efficient measures.” What, exactly, would this “energy rebate” entail? Would it come with conditions on how it would be spent – would people have to “spend [it] on those basic needs and energy efficient measures”? How do we know it wouldn’t just be spent on beer and drugs?
“We will devote $50 billion to jumpstarting the economy, helping economic growth, and preventing another one million jobs from being lost. This will include assistance to states and localities to prevent them from having to cut their vital services like education, health care, and infrastructure.” Would it include anything else? Would the federal government have to “cut vital services”? Surely you’re not spending $50 billion solely to keep social services from regressing, are you? Or expect that that alone would “jumpstart[] the economy” or that the impending million lost jobs would all come from state and local governments? That’s ridiculous of course, but how is that $50 billion being spent? How will $50 billion “prevent… one million jobs from being lost”? And aren’t you just throwing another $50 billion onto the national debt?

“We will quickly implement the housing bill recently passed by Congress and ensure that states and localities that have been hard-hit by the housing crisis can avoid cuts in vital services.” You just said states and localities wouldn’t need to cut certain services. Or are you talking about power and water now? And what’s in this housing bill that makes it so great?

“We support investments in infrastructure to replenish the highway trust fund, invest in road and bridge maintenance and fund new, fasttracked projects to repair schools.” Finally, some specifics. But don’t tell me that your idea of infrastructure investment is to build more highways when we need to tackle global warming head-on! Maintaining our existing roads and bridges is fine, I just want to make sure you’re not going to let up on the global warming (and congestion) fight in the face of economic crisis. Transit investment is, ideally, just as good at creating new jobs as freeway investment. And no one disagrees with the idea of repairing schools. All this requires people to maintain the roads and repair the schools, which means jobs, and it gives money to the companies supplying the raw materials and supports the economy that way as well. Not to mention the benefit of the investment itself. But is this all you’re going to do?

“We believe that it is essential to take immediate steps to stem the loss of manufacturing jobs. Taking these immediate measures will provide good jobs and will help the economy today. But generating truly shared prosperity is only possible if we also address our most significant long-run challenges like the rising cost of health care, energy, and education.” This sounds like a summary of the rest of the section – how do you “take immediate steps to stem the loss of manufacturing jobs”? The most vague statement yet!

“Empowering Families for a New Era”: This section makes clear that the Democrats just wanted to glide through the current economic crisis as quickly as possible to get to the part they really care about. Secret-socialist conspiracy theorists, start your engines! It comes complete with its own section introduction, which talks about the changing life of the American worker:

Many Americans once worked 40 hours a week for 40 years for a single employer who provided pay to support a family, health insurance, and a pension. Today, Americans change jobs more frequently than ever and compete against workers around the world for pay and benefits.

The face of America’s families is also changing, and so are the challenges they confront. Today, in the majority of families, all parents work. Millions of working Americans are also members of a new “sandwich generation,” playing dual roles as working parents and working children, responsible not only for their kids but for their aging mothers and fathers. They are working longer hours than ever, while at the same time having to meet a new and growing set of caregiving responsibilities.

Our government’s policies–many designed in the New Deal era–have not kept up with the new economy and the changing nature of people’s lives. Democrats believe that it is time for our policies and our expectations to catch up. From health care to pensions, from unemployment insurance to paid leave, we need to modernize our policies in order to provide working Americans the tools they need to meet new realities and challenges.

Wow! The Democrats are blaming one of their own in FDR! In all seriousness, let’s look at the specifics:
“Affordable, Quality Health Care Coverage for All Americans”:

If one thing came through in the platform hearings, it was that Democrats are united around a commitment that every American man, woman, and child be guaranteed affordable, comprehensive healthcare. In meeting after meeting, people expressed moral outrage with a health care crisis that leaves millions of Americans–including nine million children–without health insurance and millions more struggling to pay rising costs for poor quality care. Half of all personal bankruptcies in America are caused by medical bills. We spend more on health care than any other country, but we’re ranked 47th in life expectancy and 43rd in child mortality. Our nation faces epidemics of obesity and chronic diseases as well as new threats like pandemic flu and bioterrorism. Yet despite all of this, less than four cents of every health care dollar is spent on prevention and public health.

Remember, the Democrats essentially devoted this much effort to talking about our current economic crisis. This subsection even contains two quotes in sidebars later on!

The American people understand that good health is the foundation of individual achievement and economic prosperity. Ensuring quality, affordable health care for every single American is essential to children’s education, workers’ productivity and businesses’ competitiveness. We believe that covering all is not just a moral imperative, but is necessary to making our health system workable and affordable. Doing so would end cost-shifting from the uninsured, promote prevention and wellness, stop insurance discrimination, help eliminate health care disparities, and achieve savings through competition, choice, innovation, and higher quality care. While there are different approaches within the Democratic Party about how best to achieve the commitment of covering every American, with everyone in and no one left out, we stand united to achieve this fundamental objective through the legislative process.

That’s a lot of flaws of the current system in the penultimate sentence, and it sounds from the sentence before that that the Democrats may well support a pseudo-socialist system. I’m not sure how “covering all” can “make our health care system workable and affordable”, which sounds like it’s talking about simplifying the system by assuming if you’re alive, you have coverage, yet still “achieve savings through competition”. That sounds like it’s not socialist after all, it’s perfectly capitalist, so maybe “mak[ing] our health care system workable and affordable” refers to the other flaws on the list. But isn’t “achiev[ing] savings through competition” supposed to be the point of the current health care system? How am I supposed to know your plan will be any different? Oh wait, you don’t have a plan, you have “different approaches within the Democratic Party”. I might be able to take heart in knowing that maybe you can hash out a compromise between all of them that achieves all your goals, “covering every American” while still maintaining a competitive landscape and avoiding the pitfall of government “solv[ing] all our problems”, but for some reason I’m not optimistic.

We therefore oppose those who advocate policies that would thrust millions of Americans out of their current private employer-based coverage without providing them access to an affordable, comprehensive alternative, thereby subjecting them to the kind of insurance discrimination that leads to excessive premiums or coverage denials for older and sicker Americans. We reject those who have steadfastly opposed insurance coverage expansions for millions of our nation’s children while they have protected overpayments to insurers and allowed underpayments to our nation’s doctors.

So, throwing “millions of Americans out of their current private employer-based coverage” is okay if you do provide “an affordable, comprehensive alternative”? There are socialists in the Democratic Party! Then it talks about “our vision of a strengthened and improved health care system for all Americans” – so you do have a plan!

Covering All Americans and Providing Real Choices of Affordable Health Insurance Options. Families and individuals should have the option of keeping the coverage they have or choosing from a wide array of health insurance plans, including many private health insurance options and a public plan. Coverage should be made affordable for all Americans with subsidies provided through tax credits and other means.

So you aren’t socialist! But I could easily argue that this is the system we have now only you can buy into a government health insurance plan if you can’t afford or don’t want to buy into the private options. How do the private options differ from the “coverage they have”? Where do the subsidies go, the private companies or the “families and individuals”? What would the private options have that the government wouldn’t? How can we be sure the private companies would have those things?

Shared Responsibility. Health care should be a shared responsibility between employers, workers, insurers, providers and government. All Americans should have coverage they can afford; employers should have incentives to provide coverage to their workers; insurers and providers should ensure high quality affordable care; and the government should ensure that health insurance is affordable and provides meaningful coverage. As affordable coverage is made available, individuals should purchase health insurance and take steps to lead healthy lives.

Well, I guess this answers my question. I’m guessing the government would provide low-cost health care to everyone, but it would be bare-bones crap so the private “free market” would still exist. I make it sound like a cop to HMOs that don’t wanna be driven out of business, but it also lowers how much money the government spends on health care and thus avoids ratcheting up the tax burden. Not sure what “meaningful coverage” means though, and since private companies would be “affordable” as well, all this may have a more insidious meaning than I’m reading into it. (Although the same sentence lumps “providers” in there as well, so I guess it’s also lowering the need for health insurance at all.) Still, I’m guessing it all means the government plan would be a safe haven from insurance discrimination. And didn’t I hear Obama say at the debate employers would be required to provide coverage somehow? And if it’s only “incentives” – or even if it’s not – how does that maintain the ability of families and individuals to have a choice? Wouldn’t the employer be choosing for them? Or is this talking about the employer paying for the plan the person chooses, so even after choosing the affordable plan the person doesn’t actually have to pay for it? Well, it looks from the heading of the next paragraph my first question may be answered:

An End to Insurance Discrimination. Health insurance plans should accept all applicants and be prohibited from charging different prices based on pre-existing conditions. They should compete on the cost of providing health care and the quality of that care, not on their ability to avoid or over-charge people who are or may get sick. Premiums collected by insurers should be primarily dedicated to care, not profits.

Wha… WHAT? Private insurers “should accept all applicants and be prohibited from charging different prices based on pre-existing conditions”? Either you’re undermining your “affordable” point or private insurers better hope people who actually need their services go to the government, because really, you’re talking about jacking up the premiums of everyone else. The whole point of insurance discrimination, at least the “over-charge” version (of course people shouldn’t be dropped the instant they actually need insurance), is that most of the expense of health insurance is given to a certain class of people with serious diseases (or at risk of them), so it’s only fair they pick up the tab. And “insurers should be primarily dedicated to care, not profits”? Did you even read Adam Smith and what he said makes the capitalist system work? Where’s the profit in private insurance after you’ve adopted this tack, and why would private insurers bother to get into (or stay in) the business if you’ve wiped out the profit? And you know private companies will find ways to circumvent this proposed law, and that you’ll need to jack up the tax burden at least a little to enforce it.
Portable Insurance. No one should have to worry about losing health coverage if they change or lose their job.” They might have to go through a bureaucracy though. It’s still hard to get retirement accounts to come with you to a new job, to the extent I’ve kept seeing “rollover your 401k” ads. That might be what you end up seeing in health care; if we haven’t gotten it right in retirement how are we going to get it right in health insurance the instant we start instituting it?
Meaningful Benefits. Families should have health insurance coverage similar to what Members of Congress enjoy. They should not be forced to bear the burden of skyrocketing premiums, unaffordable deductibles or benefit limits that leave them at financial risk when they become sick. We will finally achieve long-overdue mental health and addiction treatment parity.” And what do members of Congress enjoy? At least it doesn’t sound like you’re imposing this on the private companies, only instituting it in the government plan. But you’re lapsing back into vagueness. (Incidentially, the surprising detail-oriented nature of the last few paragraphs once again underscores how quickly the Dems wanted to skip the present economic crisis.)

An Emphasis on Prevention and Wellness. Chronic diseases account for 70 percent of the nation’s overall health care spending. We need to promote healthy lifestyles and disease prevention and management especially with health promotion programs at work and physical education in schools. All Americans should be empowered to promote wellness and have access to preventive services to impede the development of costly chronic conditions, such as obesity, diabetes, heart disease, and hypertension. Chronic-care and behavioral health management should be assured for all Americans who require care coordination. This includes assistance for those recovering from traumatic, life-altering injuries and illnesses as well as those with mental health and substance use disorders. We should promote additional tobacco and substance abuse prevention.

Starting to move away from insurance. “Health promotion programs at work” that will presumably be funded by the federal government… I smell cheesy gimmickry in the future of the workplace. “All Americans should be empowered to promote wellness”? So we’re all government-funded hucksters now? What “preventative services” are we talking about and are we talking about throwing Yet More Money onto the national debt? When we talk about “additional tobacco and substance abuse prevention” are we talking about more of the same sorts of things that have been going on for decades, yet people my age are, to my amazement, still taking up smoking despite hearing of its bad side nonstop their entire lives? And the lives of the older “cool” kids? Or are we talking about a change in strategy?

A Modernized System That Lowers Cost and Improves the Quality of Care. As Americans struggle with increasing health care costs, we believe a strengthened, uniquely American system should provide the highest-quality, most cost-effective care. This should be advanced by aggressive efforts to cut costs and eliminate waste from our health system, which will save the typical family up to $2,500 per year. These efforts include driving adoption of state-of-the-art health information technology systems, privacy-protected electronic medical records, reimbursement incentives, and an independent organization that reviews drugs, devices, and procedures to ensure that people get the right care at the right time. By working with the medical community to improve quality, these reforms will have the added benefit of reducing the prevalence of lawsuits related to medical errors. We should increase competition in the insurance and drug markets; remove some of the cost burden of catastrophic illness from employers and their employees; and lower drug costs by allowing Medicare to negotiate for lower prices, permitting importation of safe medicines from other developed countries, creating a generic pathway for biologic drugs, and increasing use of generics in public programs.

This ties back to the idea that “providers should provide high quality affordable care.” I’d like to know more about this “independent organization”; will it mean the end of misleading drug company commercials leading people to race after a brand name instead of something that might be less expensive and maybe not as side-effect-laden? Will it mean, more likely, more bureaucracy? But do the insurance and drug markets need “more competition”? Why are “safe medicines from other developed countries” currently not importable, and how will you maintain that?
A Strong Health Care Workforce. Through training and reimbursement incentives, there must be a commitment to sufficient and well-qualified primary care physicians and nurses as well as direct care workers.” No real debate here, I think, other than more government involvement. You know what I just realized, though? This goes to page 15 of 59. Now, cutting out extraneous stuff like the cover page, it’s 13 of 57, but still it’s a quarter of the whole document devoted to the preamble and health care! This will be easier than I thought!

Commitment to the Elimination of Disparities in Health Care. We must end health care disparities among minorities, American Indians, women, and low-income people through better research and better funded community-based health centers. We will make our health care system culturally sensitive and accessible to those who speak different languages. We will support programs that diversify the health are [sic] workforce to ensure culturally effective care. We will also address the social determinants that fuel health disparities, and empower the communities most impacted by providing them the resources and technical assistance to be their own agents of wellness. We will speed up and improve reimbursements by the Indian Health Service.

So… American Indians aren’t minorities? How does research reduce health-care disparities? “We will also address the social determinants that fuel health disparities” makes it sound like you can just wave a wand and it’ll disappear.
The next paragraph heading, “Public Health and Research”, is the last heading for three paragraphs:

Health and wellness is a shared responsibility among individuals and families, school systems, employers, the medical and public health workforce and government at all levels. (Wick: You said that already. You devoted a whole paragraph to it if I remember.) We will ensure that Americans can benefit from healthy environments that allow them to pursue healthy choices. Additionally, as childhood obesity rates have more than doubled in the last 30 years, we will work to ensure healthy environments in our schools. (Wick: Everybody get vague, get vague, get vague!)

We must fight HIV/AIDS in our country and around the world. We support increased funding into research, care and prevention of HIV/AIDS. We support a comprehensive national strategic plan to combat HIV/AIDS and a Ryan White Care Act designed and funded to meet today’s epidemic, that ends ADAP waiting lists and that focuses on the communities such as African Americans and Latino Americans who are disproportionately impacted through an expanded and renewed minority HIV/AIDS initiative, and on new epicenters such as the Southern part of our nation. We support providing Medicaid coverage to more low-income HIV-positive Americans.

You… kind of lost me with that lengthy middle sentence. I don’t even know what ADAP is. Wikipedia says it stands for “AIDS Drug Assistance Programs”. But it all sounds like nice rhetoric.

Health care reform must also provide adequate incentives for innovation to ensure that Americans have access to evidence-based and cost-effective health care. Research should be based on science, not ideology. For the millions of Americans and their families suffering from debilitating physical and emotional effects of disease, time is a precious commodity, and it is running out. Yet, over the past eight years, the current Administration has not only failed to promote biomedical and stem cell research, it has actively stood in the way of that research. We cannot tolerate any further inaction or obstruction. We need to invest in biomedical research and stem cell research, so that we are at the leading edge of prevention and treatment. This includes adequate funding for research into diseases such as heart disease, Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, breast cancer, diabetes, autism and other common and rare diseases, and disorders. We will increase funding to the National Institutes of Health, the National Science Foundation, and the National Cancer Institutes.

Ah yes, returning to taking shots at the House of Bush. I like how this paragraph all but equates the debate over stem cell research to the debate on evolution. I mean, “evidence-based” health care? Does stem-cell research even involve “evidence”? I thought it just involved using it to grow new tissue and plugging it in to patients. And is “biomedical” research even controversial? If so, why? The Democrats obviously feel the need not to roll it up with stem cell research, yet they’re effectively doing so all the same. Oh, and more throwing out money like it grew on trees.
A Strong Partnership with States, Local Governments, Tribes, and Territories. Recognizing that considerable progress in health care delivery has been pioneered by state and local governments, necessary nationwide reform should build on successful state models of care.” This sort of “oh yeah, give a shout-out to the local levels of government” inadvertently points out that these very organs responsible for this progress could get stomped on by a national reform system. I’d like to see what local state systems would look like after the feds got through with them.
A Strong Safety-Net. Achieving our health goals requires strengthening the safety-net programs, safety-net providers, and public health infrastructure to fill in gaps and ensure public safety in times of disease outbreak or disaster.” Par for the course: vague niceties that no one would disagree with.
Empowerment and Support of Older Americans and People with Disabilities. Seniors and people with disabilities should have access to quality affordable long-term care services, and those services should be readily available at home and in the community. Americans should not be forced to choose between getting care and living independent and productive lives.” Solving problems unrelated to health care would do a better job of bringing needed services closer to seniors, but I’m jumping back on my transit high horse.
Reproductive Health Care. We oppose the current Administration’s consistent attempts to undermine a woman’s ability to make her own life choices and obtain reproductive health care, including birth control.” Ding ding ding! Making abortion sound like a general health issue, five yard penalty, still first down! “We will end health insurance discrimination against contraception and provide compassionate care to rape victims. We will never put ideology above women’s health.” I don’t know, it sure seems like you’re shoving a lot of ideology down my throat to me. Actually this is sort of a complex issue, and I really don’t think a discussion of health care is the right place for it. I do support the use of pre-intercourse and morning-after birth control as effective and consistent with religious beliefs.
Fiscal Responsibility. As we improve and strengthen our health care system, we must do so in a fiscally responsible way that ensures that we get value for the dollars that are invested.” Or in other words, “Oh by the way, yes we do know all this will add billions of dollars to the national debt, but don’t worry, we’re gonna get ‘value’ from it so it’s all a wash!”
For the most part, the Democrats’ health-care proposal meets the goals the Dems set for it – but not all of them are guaranteed and there are legitimate concerns that it’ll all cost too much. And if the Dems’ focus on health care seems a bit esoteric to you, you’re not alone. But there are plenty more issues to come – and plenty more of the platform to examine! We’re just getting started!