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KAI RYSSDAL: Republican presidential candidates had their umpteenth debate this afternoon in Iowa. The Democrats get their turn tomorrow. All the usual topics were on the table. Immigration. National security. Health care, too.
In the Democratic field, mandates have become the health-care sticking point: Should Americans be required to buy health insurance? The closer the early primaries get, the more heated the political rhetoric. But commentator Robert Reich says Democrats ought to just cool down.
ROBERT REICH: Given the myriad ways universal health insurance might otherwise be organized — single payer, employer mandate, vouchers, tax credits — the Democratic consensus is striking.
All of their major proposals require employers either to provide coverage to employees or contribute to the cost of coverage; all create purchasing pools that will offer insurance to anyone who doesn’t get it from an employer; all preserve freedom of choice of doctor; cover children; and aim to save money through more preventive care, better management of chronic disease, and standardized information technology. And all subsidize lower-income families with revenues coming from letting the Bush tax cuts expire.
The one issue they’re squabbling over, mandates, is a sideshow. All plans would cover a large majority of those who currently lack insurance. So, apart from undocumented immigrants, who aren’t covered by any of the plans, mandates are relevant to only around 3 percent of the population.
Now, Hillary Clinton thinks this 3 percent is mostly young and healthy and should be required to buy insurance in order to bring costs down for everyone who isn’t. Obama thinks they’re mostly people who won’t be able to afford even subsidized premiums, so they’d just ignore any mandate. As a practical matter, the difference comes down to timing and sequencing. Clinton wants to start with a mandate. Obama doesn’t want to but says if it turns out most of this remaining 3 percent are young and healthy, he’ll go along with a mandate, too.
Now, it’s expected that gloves come off in the final weeks of a primary campaign. But by warring over mandates, Democrats are leading with their chins. It’s the least important aspect of what they’re offering. It’s also, to many Americans, the least attractive because it conjures up a big government bullying people into doing what they’d rather not. The public is ready for universal health insurance but to get it enacted after January 2009, Democrats need to start building a movement in support of the big and important reforms universal health insurance requires — on which Democrats happen to agree.
RYSSDAL: Robert Reich was the Secretary of Labor for President Clinton. His newest book is called “Supercapitalism.”
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