From my point of view, Barack Obama’s and Hillary Clinton’s health plans have more similarities than differences, but there is one fundamental point of departure between the two proposals: Hillary would impose an individual mandate, requiring everyone to buy health insurance. Obama would not.
He argues that his plan is more pragmatic on a political level. Any proposal that includes an individual mandate, he believes, simply won’t get enough support to actually get through congress and to his desk.
But Obama also believes that his plan will result in de facto universal coverage: Since everyone really wants insurance, they’ll rush to buy it if it’s affordable.
Paul Krugman disagrees:
“An Obama-type plan would also face the problem of healthy people who decide to take their chances or don’t sign up until they develop medical problems, thereby raising premiums for everyone else,” Krugman said in a New York Times column recently.
Despite my oft-neglected inner libertarian telling me not to force people to do the right thing, I’m tempted to agree with Krugman. A lot of people won’t get coverage, even if it’s inexpensive. That’s clear even now, as many middle class people who can afford coverage have opted out of the system. Still, Obama has a point about the slim likelihood of a mandate making it through our dumb congress. I’m at a loss.
Observation: It seems that Hillary’s plan is more hopeful, doesn’t it? Isn’t Obama supposed to be the hopeful, “yes, we can” candidate? I think he is, but this issue appears to be an exception. Or is it? I suppose that Obama is hopeful that people will opt to get coverage. Clinton is hopeful that congress can do the right thing and pass health care reform that includes a mandate.
Cynical, defeatist thought: They’re both delusional.
I’m in the tank for Obama.
Having said that, from a purist point of view—we want to cover everyone—, Clinton’s health care plan is better. But, I think it would be far more difficult to get through Congress.
Obama’s, on the other hand, actually stands a chance of passing Congress, which needs to be weighed into the equation.
It’s a tough call. Both plans have merit, and arguments behind them. Clinton’s is more universal, Obama’s might be more realistic both in political terms and practical terms.
Is it a determining factor in choosing a candidate? Depends on whether or not one believes that supporting a health care mandate is a necessary precondition for supporting a candidate in a Democratic primary.