What They Don’t Know …

One of the most surreal items on the Web today is this interview by Ezra Klein of Sen. Kent Conrad, a Democrat from North Dakota and member of the infamous “gang of six” holding up the Senate health care reform bill in order to chase some phantom of “bipartisanship.”

What comes across all too painfully is that Conrad has no idea what he’s talking about. Conrad recently read T.R. Reid’s The Healing of America, and this is what he took away from it: Conrad thinks the health care system “in France, Germany, Japan, Belgium and Switzerland, is not government-run. That doesn’t mean there’s no government involvement. But it’s not a government-run system. They have largely private insurance, with employers contributing.”

This is, um, not true. Ezra tries to explain: “In France, for instance, the insurance really is government-run. The vast majority of people are on public insurance, and there’s private supplementary insurance atop that. So too with Japan. They’re not confined to simply subsidizing the poor.”

But Conrad comes back and says “But it’s not government-run. The doctors and hospitals are private. You’re right that in France there’s more of a government involvement beyond providing money for those who can’t afford coverage. There’s a regulatory involvement in terms of what’s required by the plans. But the plans themselves, the mutuals, are not government.”

To this last statement Ezra has supplied a footnote: “The French mutuals provide supplementary private insurance. Basic insurance is provided by a program the French call Social Security.” My understanding is that the French have a public insurance system that covers all citizens with the option of purchasing private supplemental insurance if they want to.

Quoting Steve Benen:

Matt Yglesias noted that in Germany, consumers are required to purchase coverage from one of many non-profit “sickness funds” that are regulated by the government. “It’s true that this meets a technical definition of ‘not government-run.'” Matt explained. “But the extent to which the Germany system isn’t government run doesn’t extend to dealing with any of the concerns of private industry. Which is fine by me, but nothing in Conrad’s talk of co-ops and such has suggested that he’s serious trying to put for-profit health insurance out of business, which is exactly what the German model does.”

I see a whole lot of semantic noise around the term “government-run.” On the one hand, Conrad seems to want to define “government-run” health care as a system like Britain’s, in which doctors in the National Health Service are government employees. However, a system in which tax dollars are paying for citizens’ health care via some kind of government administration, but in which government is not actively involved in managing health care, is not government-run. That’s fine, but for Conrad that definition only applies overseas. As you read on, you see that he defines the proposed public insurance option for the U.S. as “government-run health care.”

And what’s even more stunning is that Conrad seems to have only recently noticed that nations other than Canada and the UK have national health care systems.

Meanwhile, there’s a new New York Times poll in which a majority of respondents “were confused about the health care argument and that Mr. Obama had not done a good job in explaining what he was trying to accomplish.” 46 percent said they didn’t know enough about the President’s health care proposals to support or oppose them. Of the remainder, 30 percent mostly support and 23 percent mostly oppose. I assume the remaining 1 percent don’t know what “health care” is.

However, as Josh Marshall points out, the same poll asked:

“Would you favor or oppose the government offering everyone a government administered health insurance plan — something like the Medicare coverage that people 65 and older get — that would compete with private health insurance plans?”

Favor 65%
Oppose 26%

Interestingly, according to the poll, support for a public option has jumped 5 points since late August and opposition to it has dropped 8 points.

This suggests to me that a large majority of Americans would favor the President’s proposals if they knew what they were. And yes, President Obama could have been more assertive throughout the summer at pushing back against the insanity spewing from the Right. But I think the larger blame for public confusion has to go to the Right, for its aggressive disinformation campaign, and news media for passively reporting the disinformation.

19 thoughts on “What They Don’t Know …

  1. The role of government, tribal to national, is to not only protect us from each other and others but to protect us from ourselves, and it’s that protection from ourselves that the American public doesn’t realize it needs.

    Obama needs to present the citizenry with FUTURE hypothetical scenarios, individual circumstances and cases, real-life scenes dramatizing the impact of, say, health care with the public option in place.

    Harry and Louise in front of their medicine cabinet in their bathroom having a conversation on what it would mean if the “government was in their medicine cabinet” probably did more to kill Hillary-care than any other one thing. Yet, the scene actually said next to nothing on how the impact of the government in the medicine cabinet would actually affect the lives of Harry and Louise.

  2. Kent Conrad is a tool. He must have been inhaling too much cow manure up there in North Dakota. His brain apparently doesn’t work right. As far as Obama explaining his position more clearly, I couldn’t agree more. He has done a very poor job on that score. I have said that the public option could be reduced to three words – MEDICARE FOR ALL!

  3. As most tea-baggers, he doesn’t grasp the differences between the two major moving parts in this humongous machine we call healthcare — paying the bill vs. treating the patients. His ignorance does not seem to be feigned, willful or manipulative as it is with the various Senators and Prepresentatives from Aetna, Wellpoint and BCBS.

    Please Conrad, go tell the right that single-payor is not government run. No one will stand in your way. It’s a good thing. We’ll let doctors alone to do their doctoring. It won’t be government run. We can stop calling it single-payor too. Maybe something like “Doctors in charge” plan might be more appealing.

    We all promise not to let Nancy Pelosi near the operating room or even a single patient. Harry Reid too.

    Maybe that will put the minds of your constituents at ease.

  4. If nothing else from this Health Care “debate”, we have seen how truly stupid many of our elected officials are. I for one thought that if you are a Senator, you should have something on the ball, no chance. As ditherinly stupid as my next door neighbor. Parliament of Whores, however, we get the government we deserve. I’ve got Feingold and Kohl, which is good, and Sensenbrenner in the House, which is bad.

  5. Is it just me, or is anyone else still amazed/gobsmacked/bumfuzzled by Obama’s utter failure to produce a 5-minute video or a 2-page presentation telling what exactly he wants?

    I am a pretty big Obama fan. I even put a fresh sticker on my car and have written and called Senators and Congressmen in favor of a public option. Yet I think NPR did a better job than Obama in presenting what the systems are like in other countries and what we should be aiming for.

    Nothing that has come out has in any way resembled the quality of the campaign. I downloaded and printed his long campaign document and read it. No such creature seems to exist for health care.

    The fact that Conrad doesn’t know what he is talking about testifies to one of two possibilities: he is not sitting close enough for an insurance lobbyist to get a hand up his hiney, or he doesn’t know because he doesn’t want to know. The recent Will Ferrell video also says something about this.

  6. I think it’s fair to blame Obama for part of the confusion. He’s been notably wishy-washy on the public option, for whatever political reason. Had he, all along, been saying, “we should have a government administered insurance plan like Medicare for everyone”, people would be more supportive. He has been vague, which has allowed the stupid and the evil to spread chaff and disinformation.

    It is a sign of the failure of our political process that one of the key players involved in this issue can, at this late date, claim that he learned anything new from TR Reid’s book, while simultaneously showing that he didn’t understand a thing in TR Reid’s book.

    Conrad: ignorant, stupid, vile, or all of the above? And why will he suffer no consequences for this demonstration of his limitations?

  7. I don’t think Conrad is a tool. I think it’s worse than that. Granted, one helluva lot of stuff — usually just argy-bargy — crosses the desk of a member of Congress every day. But when you have so many members of Congress sitting behind the desk who a) are intellectually lazy, b) hope their staff is doing their thinking for them, c) expend most of their efforts on reelection from the moment they move into their office, and 4) prefer in any event to “keep it simple and stupid”, thus kissing off the American voter — you’ve got a wholly non-representative system.

    We don’t know what the hell they’re talking about? Sometimes that’s true, but it’s hardly the whole problem. It’s that they don’t know (or care) what the hell we’re talking about!

    I’m in Medicare and am writing about this stuff all day long and it’s become clear to me that Obama has something to answer for here. He’s been repetitive and almost too much in the public eye without actually clarifying who the average citizen (my puzzled, younger neighbors, for example) would be dealing with if they’re in a government-run health care pool.

    Somewhere along the line the President has to understand that whenever you ask an American what s/he means by “government,” you’ll get a different answer. The definition of “government” ranges across a vast territory, depending on who you’re talking with. I actually did an NPR/Kaiser poll some years ago in this area and could hardly believe the confusion about “government”! Sometimes government means their member of Congress. Sometimes they’re talking about a bureaucrat in some federal agency. Sometimes a county commissioner they’ve been up against for years. Sometimes city council. Sometimes government means to them just a president who looks dumb, lies, sets up juicy jobs for his buddies, and drags us into wars.

    So who, Kent and Sally and Frasquita and Gabo want to know, will they be dealing with if they’re “in a public option”?

  8. News Flash! Conrad finally figured out that Roskolnikoff is not the good guy in “Crime and Punishment.” And, from his summer reading list, he’s come to the stunning realization that “Winnie,’ In ‘the Pooh books’ is a bear. Imagine that?

    This Democrat rivals Bush in the man least likely to find his fucking zipper in time not to pee in the ‘Depends’ his staff makes him put on.

  9. I have to disagree with the majority on Mahablog. I think Obama’s been DAMN clear about the principles and the problems that underscore the debate. Growing costs, denial of coverage, a public option – or somethng that would serve the fucntion to prevent runaway premiums by the insurance industry.

    He has not waved a veto pen and threatened. Clinton did that and failed. He has not written the bill in the WH and presented it to Congress (a co-equal branch of governement) and demanded they pass it. Clinton did that.

    As for people not understanding what Obama wants. They must have their heads in the sand or some other dark place. Obam was on 5 talk shows on Sunday. Five. He’s done speeches to the public – to the joint sessions of Congress – town halls. He’s done everything but knock on doors.

    I am sorry if I tread on toes – the people on Mahablog who say he hasn’t been clear enough actually mean – ‘he hasn’t adopted my favorite features and declared them non-negotiable’. A big chunk of the general population works damn hard to stay ignorant, which is an argument for a restricted voting franchise. There’s people of both parties who are too dumb to vote.

    Folks, this is a democracy – not a dictatorship. ‘My way or the highway’ won’t cut it with Democrats in Congress. They don’t march in lockstep. I respect Bill Clinton – but he failed. Doesn’t that suggest a different strategy?

  10. “But I think the larger blame for public confusion has to go to the Right, for its aggressive disinformation campaign, and news media for passively reporting the disinformation.”

    I agree. Sit down and watch the teevee for 1 hour on any channel (the cable “news” channels are best) you will be pounded with ads from big pharma peddling “cures” for every ailment from limp dick (these sell the best) to restless leg (don’t see that one much anymore) back up to arterie clogging (statins are poison by the way they almost crippled me), the ever popular “depression” treatment and every god dam ailment in between. Big corporate media could not survive without these “commercials”. Does anyone really think the media is gonna give us consumers the straight dope (unintentional pun) with all that fucking ad money getting waved in their faces? And I wouldn’t call most of the reporting of bullshit “passive” they are outright participating in the effort to kill reform. MSNBC puts on a pretty good act but I’ve yet to see a considered and reasonable debate even on that channel (Ed Shultz does a lot of screaming but its all hot air). Maddow often gives rational explanations, but the effort to really sell a government plan is mediocre at best. And besides no one watches MSNBC but socialist flagburners.

    If and when this whole healthcare mess gets cleaned up it will be because the majority of corporate America will demand it. That’s what corporations do, when things like healthcare get too expensive they shluff it off to the taxpayers.

  11. “Favor 65%
    Oppose 26%”

    Gee, it always comes down to roughly the SAME 25% of crazy US Americans– the same quarter that supported Bush & Palin & torture & evolution & fundamentalism, etc. If you drew a Venn diagram of these different issues, the circles would in all cases be almost identical.

    Conclusion: Approximately 25% of the US is thoroughly batshit insane.

  12. Doug, I’m sincere in my observation about Obama’s vagueness. Yes, I think he wants to reduce costs and cover more people. But is proclaiming these general principles enough to designate a defensible program? Not to me. 36 years of teaching taught me that to assure broad understanding requires some specifics to illustrate the general principles. Of course, I’m only talking about those people who want to understand. I recognize that there are those who do not, cannot, will not understand. I had to teach them, too.

    In your last two paragraphs, are you (as I often find myself doing) getting ticked off enough to disregard the political realities because you just can’t take any more of the blatant obstructionism that keeps dragging red herrings across the ER doorway?

  13. BB –

    I am irritated. We have left-wingnuts screaming for single-payer – which is not on the menu. You have right-wingnuts who are opposed to anything that will help the country because success will also help Democrats. You have scum-bags claiming they are for reform when they are kicking holes in the bottom of the boat to sink it while declaring they are tap-dancing.

    And Barbara – who is a better writer on her worst day than I am on my best – decries the ‘aggressive disinformation campaign’ instead of calling it a pack of fucking lies from a pack of elected whores. Which unfairly maligns hookers who mostly provide better service more honestly than any member of our Congress.

    Worse than the left-wingnuts or the right-wingnuts or the crooks in DC is the hoard of Americans too pathetically apathetic to inform themselves about an issue people are dying from – that could kill them or a family member if they don’t get their heads out of ‘Dancing with the Stars’ long enough to learn the issues.

  14. “if they don’t get their heads out of ‘Dancing with the Stars’ long enough to learn the issues”

    Don’t worry American Idol starts soon enough. The national debate will get back on track.

  15. I second what Doug Hughes writes above: “I have to disagree with the majority on Mahablog. I think Obama’s been DAMN clear about the principles and the problems that underscore the debate…”

    I also think that Senator Conrad is being unfairly criticized. He read T.R. Reid’s book, as everyone should. Reid and Paul Krugman have pointed out that there are three basic models of health care in the world today. Here’s some of what Krugman wrote in his column of August 16th: “Let’s talk about health care around the advanced world. Every wealthy country other than the United States guarantees essential care to all its citizens. There are, however, wide variations in the specifics, with three main approaches taken. In Britain, the government itself runs the hospitals and employs the doctors…. The second route to universal coverage leaves the actual delivery of health care in private hands, but the government pays most of the bills. That’s how Canada and, in a more complex fashion, France do it… Finally, the third route to universal coverage relies on private insurance companies, using a combination of regulation and subsidies to ensure that everyone is covered. Switzerland offers the clearest example: everyone is required to buy insurance, insurers can’t discriminate based on medical history or pre-existing conditions, and lower-income citizens get government help in paying for their policies….”

    Conrad was trying to promote what Krugman would call the Swiss Model. Reid, as I recall (I’ve loaned out my copy of his book), refers to it’s German origins and calls it the Bismarck Model. There seems to be some confusion about where to put France. Krugman, as indicated above, puts France in the Canadian category; Reid, in his recent piece in Newsweek (Sep 21), writes: “But many rich democracies — Germany, France, Switzerland, the Netherlands, Japan — provide universal coverage with private doctors, private hospitals, and mainly private insurance plans.”

    The ridicule of Conrad is totally uncalled for.

  16. CMcC,
    The basic difference in insurance in all other countries where it is used as a vehicle of payment for health care is, NON-PROFIT. We are the only country that uses health insurance as an investment tool to make profit for share holders and give huge salaries to CEOs. THAT is the difference. Complex, yes but not just cured by a few regulations and subsidies. It is cured by changing it from money making to a public service and in this case that is a huge change. Sorry but Conrad IS an idiot if he thinks we can change Aetna into a Swiss Model insurance company.

  17. Complex, yes but not cured by adding a few regulations and subsidies. ( Worth repeating with corrections.) The insurance companies have a FATAL ILLNESS called maximize profit. They cannot be good vehicles of health care funding when they have no interest in health care!!!!

  18. “This suggests to me that a large majority of Americans would favor the President’s proposals if they knew what they were.”

    Which is why they should have said something like “Medicare will be available for anyone who chooses it.” Simple, understandable, and I would guess popular.

  19. dyedinthewoolliberal,
    I agree with you, and with what Felicity wrote on a prior thread. Until we deal with the capitalistic for profit basis that comprises our current health care system we’ll just be spinning our wheels looking for a solution for real affordable health care. It’s nice that these politicians can engage in their little intellectual juggling schemes to impress the masses with the allusion meaningful accomplishment but, until they get serious and address the crux of the problem we’ll be no better off then when we first began.

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