Browsing the blog archivesfor the day Wednesday, March 15th, 2006.


The Left Is Right on Health Care

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Health Care

Awhile back I wrote about rightie obliviousness on the national health care issue

… the Canadian Model is a bugaboo of the Right. Try to discuss national health care with a rightie, and the first sentence out of his mouth will be, “You mean like in Canada?” Then he will go off on a tirade about the problems with the Canadian system. (Unless you remind them of the underfunded British system, which is the other good “bad” example of a system with problems.)

Here’s a juicy example, although to be fair the rightie discusses the British system first and then switches to Canada. And then he throws in Cuba and comments,

The three socialized systems cited above are the cream of the crop when it comes to government controlled medical care. Clearly, your best bet is not to get sick.

Actually, they are not the “cream of the crop.” The British system has big problems, in large part because Tony Blair’s government is trying to get by on the cheap (see this PDF document, Figure One). The Canadian system also has some problems, which I discussed in the earlier post linked above. But there are several dozen countries with national health care; it isn’t just Britain, Canada, and Cuba. In fact, the only industrialized democracy in the world without national health care is the United States. In fact, just about every place on the planet where the average person owns a microwave has national health care, except the United States.

To righties, all of these systems are just one system, called “socialized medicine,” and they’re all bad, and they’re all just like Hillarycare. But in fact there are huge, whopping, substantial differences among the several systems.

There are some systems, like Britain’s, in which the government employs doctors and runs hospitals and acts as a “gatekeeper.” To use the National Health Service you go to NHS doctors, and since the Brits have very tight cost control some feel the “gate” can be a tad too narrow, as it were. Other nations have a mix of public and private systems. In France, for example, most of the doctors and hospitals are private sector. The government pays for health insurance that a citizen can take to the doctor of his choice to get basic care, and if he wants he can purchase private supplemental insurance to pay for first class treatment.

Righties seem to think that “national health care” means the British system, where you have to literally go to the government for treatment when you get sick. I personally would prefer something like the French system, in which the government doesn’t get involved in health care except to pay bills.

Last year Bradford Plumer wrote,

… the health care debate in America is never going to get very far so long as the conventional wisdom is that health care alternatives in other countries suck. Good point! But it’s also worth asking why this is the conventional wisdom. To some extent, it’s because conservatives, spearheaded by the insurance industry, have bamboozled us into thinking it’s so. … [But] Media coverage of national health care systems in other countries is dismal. … And, as a result, few Americans have even the vaguest idea of what French health care, or Canadian health care, or Swedish health care, is really like.

Recently at TPM Cafe, Matt Yglesias wrote that one reason we get nowhere in our health care debates is that the options presented to us are too limited and narrow.

Arguments against single-payer health care here seem to be two-fold. One, the idea is old and the debate about it therefore “stultified.” Two, the idea represents one pole of the debate and the name of the game is to find third way ideas. The first objection is obviously silly — that an idea is old has no bearing on its merits. The second objection, meanwhile, is easily met. Simply define the “left” pole in the debate as not something like the French or Canadian system, but something like the even more statist system they have in the United Kingdom. The “right” pole continues to be “veneration of free markets.” Ergo, the “center” position is now one in which the public sector provides health insurance but the private sector provides health care and we reject the “false choices” of those who insist we must choose between the NHS and and pure laissez faire.

Alternatively, you can define as your left pole a system like Canada’s where the government provides everyone with insurance and bans private health insurance, leaving the centrist alternative a system like France’s where the government provides everyone with insurance and then lets you buy additional insurance on top of the baseline from the private sector. Everyone can play this game.

France seems to fall between the poles either way.

“Hillarycare,” btw, was based on the German system according to Ezra Klein. It sounds way complicated.

Until we get a progressive majority in Washington ’twill all be but a dream. But in the meantime, just remember that it’s possible for a rightie to see the light and realize the U.S. system isn’t that great, after all. All it takes is for the rightie to lose his health insurance.

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Iraq Shellac

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Bush Administration, Iraq War

We learned yesterday from Insight, a Moonie Times publication, that for some time President Bush has cleared his plate of all issues except Iraq and the 2006 midterm elections. Everything else is entirely delegated. This is why, Insight reports, that Bush didn’t know anything about the Dubai ports deal until it hit the news.

Considering that his involvement with Iraq consists mostly of denying reality, and that most of his party thinks he is dragging down their midterm election chances, this pretty much means he’s not doing anything substantive at all. We don’t have a functioning president in the White House. ‘Course, we haven’t had one since January 2001; what else is new?

Speaking of presidential voids and Iraq — behind the NY Times subscription firewall today is a powerhouse of an article by David C. Unger. So far I haven’t found an alternative source for this article so that non-subscribers can read it, but I’ll keep looking. In the meantime, I’ll quote from it substantially —

If America had taken the trouble to learn more about Iraq before invading it in 2003, a lot of the problems we face there today could have been avoided. In fact, had the right questions been asked and answered accurately, the invasion might have been canceled before it began. For example, if the Bush administration had spent more time poring over the actual findings of American intelligence agencies, they might have realized then what almost everyone acknowledges today — that Iraq’s most dangerous weapons programs had been effectively shut down by sanctions and inspections, and that Baghdad was not helping Al Qaeda and had nothing to do with the Sept. 11 attacks.

But … but … but … (the righties blubber), everybody thought Saddam had weapons of mass destruction. So if Bush was wrong, he can’t be blamed because everybody else was wrong too.

Matthew Barganier (hat tip to Avedon) argues that “The whole WMD construct was a fraud” and that anyone who argued that Saddam Hussein might not have had WMD was in the position of having to prove a negative. On the other hand, before the invasion the Bushies (under the direction of Dick the Dick) were working on the assumption that there were WMDs, so any evidence to the contrary was self-evidently wrong. In fact, by the time of the invasion it was pretty much universally accepted (except by American righties) that Saddam had no nuclear program, and most of the world (except for American righties) was far from certain he had anything else.

[Update: See also Murray Waas, “What Bush Was Told About Iraq.”)

If the United States had not invaded, Saddam Hussein would still be a headache for American policymakers and a nightmare for the Iraqi people. But in many ways, things would be much better. The United States would not have the bulk of its ground forces tied down in a stalemated counter-insurgency war. Iraq would not be teetering on the brink of a civil war that could ignite much of the Middle East. And Iran, which has emerged as the most worrisome threat in the region, would not have the benefit of client Shiite fundamentalist parties tightening their grip over Iraq oilfields and providing Tehran with the added security insurance of a friendly western frontier.

Lots of other people knowledgeable about terrorism have made this same argument. Michael Scheuer, for example, went so far as to say that “Without a doubt, in the war against al Qaeda, Saddam Hussein was one of our best allies.” Saddam had no intention of helping the U.S. in any way, but the fact is that al Qaeda could not operate freely in area Saddam controlled, because Saddam didn’t trust them. In furthering his own interests he furthered ours. That is, until we deposed him and left a nice power vacuum for al Qaeda to help fill.

Unger goes on to “10 Questions That Should Have Been Asked Before the Invasion,” which he lists and discusses. I’m going to list the questions but skip the discussions–

1. What would Iraq look like without Saddam Hussein?
2. Regime change or nation-building?
3. How many American troops would be needed, and for how long?
4. What about safeguarding Iraqi weapons arsenals?
5. And what about sealing the borders?
6. Would Iraq hold together as a unified state?
7. What could the British experience teach us?
8. How do we get and keep the Iraqi people on our side?
9. Once a post-Baathist Iraq took shape, how would it fit into the map of the Middle East?
10. More specifically, would invading Iraq make Iran more or less of a regional threat?

As I said, Unger provides three or four paragraphs answering each question, but if you’ve been paying much attention at all to Iraq you already know what most of the answers are.

Then he goes on to “10 Questions That Should Have Been Asked Since the Invasion.”

1. Where were the flowers?
2. Where were the Chalabi voters?
3. What can stop the looting (and the erosion of American credibility that accompanied it)?
4. Once the original game plan for political transition collapsed amid the looting and growing Iraqi ill-will , what might have been a more realistic Plan B?
5. What’s more important, on-time elections or inclusive elections?
6. Who are America’s natural allies in Iraq?
7. What would it take to get more international support?
8. What could be done to minimize the damage from the Abu Ghraib torture scandal?
9. What kind of Iraqi security forces should we be building?
10. Again — how many United States troops will be needed, and for how long?

Again, Unger provides discussion with each question; I am just listing the questions. The overall point here is that the Bush Administration either never honestly confronted these question or did so months too late to do anything constructive about them.

Finally Unger gets to “5 Questions That Should Be Asked Now.” This time he doesn’t give answers, but throws these questions at readers. Sometime in the future the NY Times will publish a selection of the answers.

1. Where should the United States draw the line on giving full military support to an Iraqi government that insists on being sectarian, vengeful and non-inclusive?

2. What can Washington to do to mitigate the advantages it is handing Iran by aligning itself with Iraq’s most pro-Iranian parties?

3. Should Washington give up on the idea of holding Iraq together as a single nation and accept an equitable partition of territory and resources as the best remaining hope for avoiding civil war?

4. If civil war cannot be avoided, should American troops stay in Iraq and risk getting caught in the crossfire in the hope of limiting the carnage, the regional repercussions and the effects on world oil markets?

5. In the long run, would the United States be better off holding out for something it can call “peace with honor” or would it be better to cut our losses by announcing an exit strategy and brokering the best deal we can?

These are hard questions, and you know that the President is not considering these questions at all. You can see that if you read the transcript of his most recent Iraq speech. He’s not even close to forming these questions, never mind answering them.

In other Iraq news, Tom Lasseter of Knight Ridder reports that “American forces have dramatically increased airstrikes in Iraq during the past five months.” This is something Seymour Hersh predicted would happen awhile back. Tim Grieve at Salon looks at poll numbers that show Americans no longer believe what Bush says about Iraq.

And do not miss this Dan Froomkin column

Yesterday brought two strong signs that even as Bush is trying — and failing — to placate the public about Iraq, he’s increasingly keen to focus attention on a new villain: Iran. …

… But if Bush’s ability to govern, in either Iraq or his own country, has been overestimated at times, the same cannot be said for his ability to campaign and stoke a nation to war.

A Bush who appears embattled, defensive and quite possibly overwhelmed inevitably leads to lower and lower public approval ratings.

But White House aides are abundantly aware that there’s something about the image of a fearless American president boldly kicking butt that seems to fill the public with an enthusiasm that transcends even the issue of whose butt it may be.

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