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February 4, 2008

Podcast: Patrick Today in Lowell on Obama

by at 4:08 pm.

I went to the event with Governor Patrick today at Brew’d Awakening in downtown to listen to him speak about Barak Obama ahead of tomorrow’s Super Tueday vote, including here in Mass.

Patrick was eloquent as usual and addressed the crowd about Obama’s experience (he has been an elected official twice as long as Clinton) and he talked about Obama’s leadership qualities and judgment. I took some photos, but more importantly, I recorded the almost 17-minute speech and Q&A with the Governor.

You can see some of the photos here, and click below to listen to the podcast.

If you want to get involved today and tomorrow, you can contact the Obama campaign at 617-981-0642.

 
icon for podpress  Patrick Speaking on Obama in Lowell [16:45m]: Play Now | Play in Popup | Download

9 Responses to “Podcast: Patrick Today in Lowell on Obama”

  1. waittilnextyr Says:

    The Governor highlights the issue of “mandates” when he makes the analogy if mandates work, we could mandate away homelessness by mandating everyone buys a house. So it is the same to a different degree with healthcare.

    Actually reducing the cost of the insurance is the larger issue, and from Obama’s website (www.barackobama.com) we find one way to at least remove some cost from the insurance costs, although the federal government must step in (a better use of some of the $12B per month spent in Iraq):

    “Reducing Costs of Catastrophic Illnesses for Employers and Their Employees: Catastrophic health expenditures account for a high percentage of medical expenses for private insurers. The Obama plan would reimburse employer health plans for a portion of the catastrophic costs they incur above a threshold if they guarantee such savings are used to reduce the cost of workers’ premiums.”

  2. Mr. Lynne Says:

    On mandates:

    The rational behind mandates is this: If you adopt a single payer system, it works on an economic level because of the elimination of adverse selection. If you come to the political conclusion that you’re not going to get a single payer system, but will have to account for private insurers in your system, then some kind of reform to keep costs down. The mechanism among private insurers that keeps cost up (and claims denials as well) is adverse selection. Of course, the adverse selection is part of the whole business plan of a private insurer. But if you legislate away adverse selection, the risk then becomes that people may only buy insurance when needed, at which point it ceases to actually be insurance. The result destroys the system by making insurance merely an overhead waste item with pricing that can’t actually achieve any of cost benefits of spreading risk… which is the whole point. Mandates correct that flaw. Both are necessary in this particular reform scheme… eliminating (or regulating) insurer’s ability to risk select policy holders, while ensuring that the population as a whole will be unable to opt-out of the risk spreading mechanisms that will make anything in the healthcare system affordable.

    Or, as Ezra so aptly puts it:

    The insurers can’t risk select applicants, [and] the applicants can’t game the system.

  3. joe Says:

    Neither Hillary’s nor Obama’s plan is going to survice contact with Congress. Back on forths on policy like this isn’t terribly important to me, since the debate over the particulars of policy is going to happen for real after the next president takes office.

    Which changes the question to process: who will be able to put together a real health care bill with the Congressional leadership and get it through?

  4. Mr. Lynne Says:

    If Krugman is right, then Hillary might be better positioned to enact something if that’s all you want. Furthermore, if universality is the ultimate goal (and single payer being the best form for it), then Obama’s plan does nothing to lay down the foundation that will get us there, where Hillarycare gets us started.

    I’m not really decided yet, but I am interested in this issue. If the last twenty years has taught us anything it should be that policies matter!

  5. Patrick Murphy Says:

    I have not heard an argument yet over the constitutionality of mandating that an individual buy a private service. It is not comparable to auto insurance (you can choose not to drive a car) or seatbelts (you do not have to pay monthly premiums for them to work some of the time for some types of accidents).

    The great majority of people without health care are not out to “game the system” but see the system as gaming them with largely unaffordable premiums, co-pays and deductibles, and dubious benefits. As waittilnextyr points out the question then centers around cost both for the individual and the program.

    Much like the Massachusetts system, Clinton’s plan is neither universal nor sustainable. I think the claim to universality, when coupled with either the mandate or the plan’s unsustainable cost will in fact do more to kill the chances of a single-payer plan in this country than Obama’s incremental approach (however disappointing). And on the question of process, I also believe that Clinton is too polarizing a figure perhaps to even win the presidency, but more specifically to have any health care reform success.

    A few candidates have dropped out for me to settle on Obama, but it was without reservation that I was able to cast a vote for Mimi this morning!

  6. Mr. Lynne Says:

    Absolutely right about the incongruities between mandated health insurance and mandated auto insurance.

    I completely agree that “The great majority of people without health care are not out to ‘game the system’ but see the system as gaming them.” But thats this system, not a hypothetical new system. The key is checking the incentives. Simply put, it will be awfully tempting for a 20 year old to avoid buying any insurance until he or she feels the need to see a doctor. They are choosing to go without now, and I’d expect would also choose that later. A single payer system takes care of it because it is much harder to ‘opt out’ of the taxes in question. And the tax mechanisms can be as fair or draconian as designers like. Absent a public mechanism the only way to ensure that the risk pool is formed with sufficient breadth to maintain any kind of cost savings is a mandate.

    You may well be right that “Obama’s incremental approach” will do less to “kill the chances of a single-payer plan in this country”., but mandating or regulating the risk profiles and eligibility without spreading the risk pool sufficiently has a much greater potential to make things worse, not better, by ensuring that the insurance industry would have to charge even more outrageous prices and create a bigger incentive to deny claims just to stay afloat. The subsidies we would have to shell out in order to make such plans affordable to the lower end of the income scale, aside from needing to be large just to make sense, would also enhance the ballooning of the costs of the whole system… just with indirect revenue (taxes).

    I’m probably voting for Obama,… but I really really hope he has the wisdom to listen thoughtfully to those that point out the potential train wreck his proposal could send us to.

  7. waittilnextyr Says:

    The Healthcare Industry never appeared to be a productive use of our resources from an economic point-of-view, yet we spend 15% of our GDP in that field. Indeed, a recent study implies that “good” health exarcerbates the cost problem, by extending the “service” life of individuals. Perish the thought we would make our decisions solely in terms of economics!

    But, growth in the Healthcare Industry is a mix of need (of the patients) and opportunity (by the Industry) to grow their businesses. The Medicare system centralizes the policy and the administration to provide a good balance of care and cost control, notwithstanding the unfunded liability that is developing.

    As a first step in single-payer, progressively funded healthcare, we should quickly cover every US citizen under the age of 18, and more when attending college, via Medicare. That would help young families with their private healthcare costs. Succesive steps in the process could be accomplished by including other age groups into the system.

    Then we could return to the problems of obtaining efficiencies and paying the bill! Suggestions?

  8. Mr. Lynne Says:

    Actually… Lynne said something like that last night. That a ‘path’ to single payer that might be politically ‘doable’ would be to start with kids. One of my hopes about Obama reforming his plan is that one of the ‘fixes’ being bandied about by his people is a mandate for kids. I think the problem that could happen is the ‘hand-off’ issue. Insurers oftentimes deny care on the basis that medicare will pick it up later. Of course by that time complications have set in and the cost is a lot more, but hey… it saved the private insurers money and enhanced their profitability - hooray free market! Medicare for kids may have the intended consequences of making kids more healthy on when they ‘gradueate’ to the private pool and the unintended consequences of enhancing the ‘hand-off’ bias toward claim denial for private insurers.

    But still… if people see its working and the costs suddenly go up at 18, it could create political demand by begging the questions ‘Why not 20?’, ‘Why not 24?’, ‘Why not for life?’.

    Germany has shown us that a public system and a private system can live together and even have pretty good results. But their model is one of contemporaneous public-private competition (with specialized sections of the healthcare market being handled a little differently than ’straight’ competition) and not one of ‘hand-off’.

  9. Tim Little Says:

    On a healthcare-related note:

    “A new Dutch study has found that preventing obesity and smoking may save lives but it doesn’t save money.”

    As Treehugger says, “Fat Smokers = Lower Health Costs”

    More here: http://www.treehugger.com/files/2008/02/fat_smokers_low.php

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