Why I’m Voting For Barack Obama

Sorry for the disappearing act.  I was in the process of writing about other topics, but then I was sucked into the vortex of “OMG.  What the heck is going on with our economy?”  There was much research on what I thought they should be doing, much listening to the talking heads, a little of the “wow, my 401K has tanked - thank God I’m not retiring anytime soon”. 

Plus, my husband and I bought a car and then went to Florida for the weekend.  (No, not on the Great Schlep.) I was slightly concerned about the economy freefalling right when we needed a car loan, but it turns out that we were OK. *whew*

So instead of the other topics that I planned on blogging about, you will first get a little discussion of the economy. I’m not an economist, but I have several musings on the topic. I hope that you will enjoy.

First up…

For your listening pleasure, I have two excellent NPR interviews with Michael Greenberger, a former director at the U.S. Commodity Futures Trading Commission. Truthfully, I had to listen to them a couple of times, but this guy is excellent.

Our Confusing Economy, Explained

Fresh Air from WHYY, April 3, 2008 · Perplexed by the U.S. economy? You’re not alone. Law professor Michael Greenberger joins Fresh Air to explain the sub-prime mortgage crisis, credit defaults, the shaky future of other types of loans and what we can expect from the U.S. financial markets.

This is the one that I was listening to on my way home from physical therapy that kept me in the driveway for quite some time until they took a break and I could run into the house to continue listening to it.

Was ‘Adult Supervision’ Needed On Wall Street?

Fresh Air from WHYY, September 17, 2008 · The bankruptcy of financial services giant Lehman Brothers and the 500-point drop in the stock market on Sept. 15 have sent shock waves through the financial community. Michael Greenberger, a former director at the U.S. Commodity Futures Trading Commission, tells Terry Gross that the government’s decision to bail out AIG is a sign that the economy is “teetering on the brink.”

“The Fed and the Treasury are very, very worried about the stability of the economy,” Greenberger says. “They’re worried about what this means to Main Street, about what it means to you and me. … In the absence of this rather dramatic move I think they believe that we would enter something much deeper, possibly, than a recession.”

If AIG had failed, Greenberger says, the average citizen’s savings accounts and checking accounts could have been in jeopardy. But he warns that the bailout is a “50-50 proposition” and that other banks might follow.

Greenberger insists he is not a pessimist about the economy; he says that “intelligent leaders” — coupled with government aid, transparency and regulation — can enable the American economy to transcend its current troubles. But he has harsh words for the companies that were engaging in questionable practices — and for the government that turned a blind eye to the potential consequences.

Greenberger asserts that the fact that there was “no adult supervision” of Wall Street will cost the American public in the long run.

“The $85 billion will come out of the United States Treasury. And either we’re going to fund that from China or you and I are going to have to pay for it through taxes,” he says. “[As] a lot of people are saying now: We privatize profits; we socialize losses.”

They are both great, but if you had to listen to one, listen to the last one. It is enough to make you want to have Superman come in, turn back time, and let you burst into Congress in Dec 2000 and say stop!!!!!!!!

When I was reading the introduction to the NPR series on Health Care, this piece of the article really jumped out at me:

Our reporters and producers said nearly every person they talked to was astonished to learn that in the United States, health care isn’t automatic — or required — and that medical bills are the most common reason for bankruptcy.

“We have in Britain, as in most of Europe actually, health care systems that are based on the principle of social solidarity,” Sir Michael Rawlins told NPR. He runs the National Institute for Health and Clinical Excellence, which determines which drugs and treatments will be paid for by the government.

“We look after each other when we’re sick, and that’s very precious to us in Britain and other parts of Europe, too,” he said. “And that’s what we find so difficult to understand about your system — you don’t have that.”

Is there a moral element to this health care debate? Do we have an obligation to our society as a whole to stand together on certain matters?

I believe that there are certain things that should be held apart from the free market as items of great importance to our functioning as a moral society. Education, caring for our elders, caring for orphans, caring for the disabled, caring for the mentally ill, and caring for the sick are things that I place in this category.

In this category of health care, the US currently has structures in place to care for most of the children under 18, the disabled, and most of the people over 65. It is in the between place of 19-64 that we are on our own. I am seeing more and more people who are failing to get the health care that they need because they can’t afford it.

For eduction, we chose as a society to provide a free eduction to all people and then mandated it when we saw that it was a benefit to society to have educated people who would be our workers. One would think that it would be a benefit to society to have people who are healthy in our workforce. One would think it would be so beneficial that it might even become a mandate.

Elizabeth Edwards wrote a very lengthy article in the August 2008 edition of Sojourners magazine. I think that the whole thing is worth a read as she does a wonderful job in describing the pitfalls of a free market health care, but I will pull out a couple of the key paragraphs that I think fits this topic the best.

In the landscape of the health-care debate, two very different paths lie in front of us. Which one we choose will speak volumes about who we are as a nation and what values we hold dear. Our choice will determine what we say to women like Sheila—whether we say, “We are with you. Your challenge is our challenge too, and we will help you face it,” or simply shrug and say, “Sorry, you’re on your own.” That’s the moral choice we face today and which path we walk down is up to us.

…

NOW THAT WE understand what is really meant by “individual markets” and “consumer-directed care,” we can ask the larger question before us: Do we, as a nation, believe in insurance or not? The principle behind insurance is risk-sharing—the idea that healthy people with lower risks and lower cost should subsidize care for sick people with higher risks and higher costs.

We do this in part because the reality of life is that while you may be in the healthy category today, you could land in the sick category tomorrow—and because of factors out of your control. You could get hit by a bus or have something else happen that requires urgent care. God forbid that should occur, but if it does, you’ll be really glad others are pitching in to subsidize your costs.

We do this for practical reasons, but we also do it because it’s the right thing to do. Our society is based on the idea that we’re all in this together. If you’re born healthy and disease-free, great. But others are not so lucky, and part of your responsibility as a member of this society is to help them out.

…

When we band together, we can make this system work. Right now, it’s not working nearly as well as it should. But our response should not be to abandon our principles—it should be to embrace them even more tightly, and fashion a system that more fully reflects them. Universal health care does just that.

Here is my take on the candidate’s health plans. I’ll make it short and sweet for you. Barack Obama’s health plan give more bang for the buck and covers more people than John McCain’s plan. McCain’s “market-based” plan will dangerously leave more Americans without health care or less coverage. And, I believe that Obama’s plan will also be easier to put into place.

Part 1: More bang for the buck & covers more people:

Senators John McCain and Barack Obama have presented very different plans to reform health care in the United States. Last week, the Urban Institute/Brookings Institution Tax Policy Center (TPC) provided what appears to be the first evaluation of each plan’s effect on costs and coverage outcomes. While the TPC findings are preliminary, there is a wealth of information contained in them; some of their implications, however, may not be immediately apparent even to those relatively well-versed in the U.S. health care debates. The punch lines of the TPC analysis can be stated relatively simply:

* Efficiency. Over the 10-year period analyzed by the TPC, Senator Obama’s plan provides far greater “bang-for-the-buck,” spending far less per capita for its coverage of the uninsured population.

* Cost. The costs of the plans over the 10-year period are in the same ballpark: the Obama plan costs roughly $1.6 trillion, while the McCain plan costs $1.3 trillion.

* Coverage. The Obama plan makes a much bigger dent in covering the uninsured population. On average over the 10-year period, the Obama plan covers over 47% of the forecasted uninsured population, while the McCain plan covers less than 5%.

–Economic Policy Institute Policy Memorandum #126 “Obama health plan outperforms McCain plan in coverage and efficiency”, May 23, 2008

Are you kidding me? $1.6 trillion to cover 47% of the uninsured versus $1.3 trillion to cover less than 5%?

Part 2: John McCain’s “Market-based” health care

If John McCain’s plan went into place, there would be no incentives for employers to cover their employees. We’d all be tossed out to find our own plans. This is where we will find out what a cold lonely place the free market is and why we should never be put into this position when it comes to something this important.

First, some workers—likely those who are young and healthy—will decide to decline their employer’s insurance to seek out plans in the individual market. The remaining workers in the ESI pool will thus have higher average health costs, causing their premiums to rise. When premiums rise, other workers may leave the pool, worsening the problem.

Second, employers may decide to stop offering insurance as it becomes more expensive and less valuable to their entire workforces. Additionally, small employers who were offering insurance to their workers to gain the tax advantage themselves will no longer see a benefit to offering and might stop sponsoring coverage.

Some of the people who lose coverage through their employer will simply lose coverage altogether. The individual market subjects individuals to the whims of the insurance industry: poor information about policies, discriminatory pricing, coverage waivers, refusal to pay for pre-existing conditions, and denial of policy renewal. To make matters worse, other parts of the McCain plan remove many of the (already insufficient) consumer protections that currently exist in state regulations—such as mental-health parity and “guaranteed issue” (the requirement that insurance companies offer insurance to all comers).

–Economic Policy Institute Policy Memorandum #126 “Obama health plan outperforms McCain plan in coverage and efficiency”, May 23, 2008

Another dangerous part of John McCain’s plan is that he would like to “open up the health insurance market to more vigorous nationwide competition”. Sounds great. More competition = cheaper rates, right?

Opening up the health insurance market to more vigorous nationwide competition, as we have done over the last decade in banking, would provide more choices of innovative products less burdened by the worst excesses of state-based regulation.

– “Better Health Care at Lower Cost for Every American” by John McCain, in Sept/Oct 2008 issue of Contingencies magazine

Yup. Just this last week, I’ve been noticing the results of what less regulation has brought about in the last decade to Wall Street. People having their retirement nest eggs wiped out by the choices the Wall Street executives have made while they escape away on their billion dollar golden parachutes. Do we really want that in health care?

Elizabeth Edwards spoke about what less regulation has done in the credit card industry in an article for the August issue of Sojourners:

Another danger of the individual market approach is that, just as the gold speculators of the Wild West clustered in the most profitable locations, insurance companies would be free to cluster in whatever states offered them the loosest regulations. This is exactly why the credit card companies are mostly located in either Delaware or South Dakota—and we know how well this has turned out in recent years.

Here’s how it happened. In 1978, the Supreme Court ruled that banks must follow the regulations of their home states, including the laws governing interest rates. South Dakota, sensing an opportunity, lifted its interest rate cap altogether, and Delaware followed suit shortly thereafter. Credit card companies flocked to those states, because then they were allowed to advertise and sell cards to people in New York that were governed by the far looser laws of South Dakota or Delaware.

Today, insurance companies are required to follow the laws of the states where their plans are sold, not just the laws of the states where their companies are based. However, conservatives are proposing to change that and allow insurers to choose the state laws they want to be regulated by. The companies wouldn’t even have to move to that state—they could simply file paperwork there, and voila! they get to operate under looser regulations.

And, unless she had ESP, she had no idea that Wall Street was about to come close to a Great Depression collapse last week requiring the biggest government bailout in history. I do not want my health care subject to the whims of more executives trying to make the best decisions for their own pocketbooks.

It gets worse. Unlike Barack Obama’s plan, John McCain’s would let insurance companies “cherry-pick” the youngest and healthiest people and then refuse to take anyone with pre-existing conditions. People like my dad.

Not only that, but John McCain’s proposed yearly tax credit of up to $5,000 for a family is nowhere near the average cost of $12,100 for a family of four. How will families struggling to make ends meet afford to pay for that? That’s nearly an extra $600 a month.

Part 3: More likely to put into place:

The way the individual races are going, it is extremely likely that the Democrats will be in control of both houses in Congress. I would hope that a president in the same party will have an easier time working with Congress to get this much-needed legislation passed.

I also believe that, since Barack Obama’s plan builds on our existing setup of employer-sponsored health care and public insurance, it will be an easier choice than to drastically change the tax code like John McCain’s plan would. I could be wrong. HealthCare.com lists several difficult challenges faced by both candidates.

So, dear readers, please read up and make your own determinations about what you would like to see enacted by the next president. Remember that you are voting for yourself and for the whole of society. But more on that in my next post.

As I had mentioned before, I have felt for some time that we need a national health care system. However, it is hard to research the ins and outs of what other countries do. They almost all have a different way of doing things. And what would be best for our country? My public school/private school theory needs a little more specifics.

NPR had a very interesting series of programs on different countries and how they do health care. It gave me lots of things to think about and then I spent a bit of time debating this with people at work and my husband. All of the universal health care systems have their pluses and minuses and they are all different.

No doubt you’ve heard that the United States is the only developed nation without a universal health care system that provides care for all.

The result is that 47 million people in the United States lack health coverage. It’s one reason the U.S. ranks 29th in the world in terms of life expectancy and at or near the bottom of most international health care comparisons.

What you might not know is that many of the universal health care systems in Europe provide high-quality health care to all residents, at a much lower cost than what people in the United States spend on health care.

Waiting times for care aren’t all that different from the United States, and Europeans use the same high-tech medicine, only more sparingly.

Indeed, the countries of Western Europe rank higher on most measures of good health.

The cost to achieve better overall health in those countries is far less than you’d expect. Spending per person is about half what’s spent in America, which in 2007 was around $7,000 a year.

–Intro to NPR series - Health Care for All

My husband feels that a single-payer health care system like the one our Canadian neighbors have or like the one we have with Medicare is the way to go. (There is no NPR special on Canada or Australia, but they have one on England.)

I found the one on Japan’s intriguing. They are just over 1/3 of the population of the US, are technology-happy, have a multi-payer system, and the government makes it one of the most affordable systems by controlling the costs. I found the one on Taiwan’s fascinating to see what a country starting from scratch picked out.

What would you pick? Have you followed the health care experiment going on in Massachusetts to see what is happening in the US with universal health care?

I’m not sure whether I would advocate for a single-payer or a multi-payer system if I were to design something from scratch. I really liked Taiwan’s and how they were able to keep costs down so dramatically with their administrative policies. I think that is something that we can learn from and I was pleased that Barack Obama’s health care plan includes an “investment of $50 billion toward adoption of electronic medical records and other health information technology”.

But, we can’t start from scratch since we already have a crazy system in place. Both candidates have ideas on how to get us health care reforms and I will be exploring them in my next post.

Remember that question that I asked you before? What would you pick? You actually have the power to select one with your vote. It is that important.

One of the things that I heard growing up was that the reason that no one should support a nationalized health care system is that doctors would leave the country so they could make money elsewhere.

Check this out:

Indiana University Study Finds Majority of U.S. Physicians Favor National Health Insurance Support Has Grown 10 Percent Over Past 5 Years

April 1, 2008

INDIANAPOLIS — The largest survey ever of American physicians’ opinions on health-care financing has found that 59 percent of doctors support government legislation to establish national health insurance while only 32 percent oppose it. A similar survey conducted by the IU researchers in 2002 found 49 percent of physicians supporting national health insurance and 40 percent opposing it.

The 2007 survey results demonstrate a significant change in the level of support for national health insurance. Nearly every medical specialty showed an increase in levels of support for national health insurance. With the exception of radiologists, anesthesiologists and surgical subspecialists, a majority of every medical specialty now support national health insurance.

The nationwide survey queried 2,200 physicians and was conducted by the Indiana University School of Medicine’s Center for Health Policy and Professionalism Research (CHPPR). The results appear in the April 1 issue of the Annals of Internal Medicine.

The latest survey indicated that 83 percent of psychiatrists, 69 percent of emergency medicine physicians, 65 percent of pediatricians, 64 percent of internists, 60 percent of family physicians, and 55 percent of general surgeons favor government action to establish national health insurance.

There are more than 800,000 doctors in the U.S., so this 10 percent increase in support for national health insurance represents at least 80,000 physicians who have changed their minds about national health insurance, study authors Aaron E. Carroll, M.D., M.S., assistant professor of pediatrics and director of CHPPR, and Ronald T. Ackermann, M.D., MPH, assistant professor of medicine and associate director of CHPPR, report in their Annals of Internal Medicine paper.

“Many claim to speak for physicians and represent their views. We asked doctors directly and found that, contrary to conventional wisdom, most doctors support national health insurance,” said Dr. Carroll.

“As doctors, we find that our patients suffer because of increasing deductibles, copayments, and restrictions on patient care,” said Dr. Ackermann. “More and more, physicians are turning to national health insurance as a solution to this problem.”

–Indiana University

Here are some facts about health care from the National Coalition on Health Care. I only listed the bullet points, but you can find the full page at Facts on Health Insurance Coverage.

The National Coalition on Health Care is the nation’s largest and most broadly representative alliance working to improve America’s health care. The Coalition, which was founded in 1990 and is non-profit and rigorously non-partisan, is comprised of more than 70 organizations, employing or representing about 150 million Americans.

This is staggering.

Who are the uninsured?

• Nearly 47 million Americans, or 16 percent of the population, were without health insurance in 2005, the latest government data available.
• The number of uninsured rose 2.2 million between 2005 and 2006 and has increased by almost 9 million people since 2000.
• The large majority of the uninsured (80 percent) are native or naturalized citizens.
• The increase in the number of uninsured in 2006 was focused among working age adults. The percentage of working adults (18 to 64) who had no health coverage climbed from 19.7 percent in 2005 to 20.2 percent in 2006.1 Nearly 1.3 million full-time workers lost their health insurance in 2006.
• Nearly 90 million people - about one-third of the population below the age of 65 spent a portion of either 2006 or 2007 without health coverage.
• Over 8 in 10 uninsured people come from working families - almost 70 percent from families with one or more full-time workers and 11 percent from families with part-time workers.
• The percentage of people (workers and dependents) with employment-based health insurance has dropped from 70 percent in 1987 to 59 percent in 2006. This is the lowest level of employment-based insurance coverage in more than a decade.
• In 2005, nearly 15 percent of employees had no employer-sponsored health coverage available to them, either through their own job or through a family member.
• In 2006, 37.7 million workers were uninsured because not all businesses offer health benefits, not all workers qualify for coverage and many employees cannot afford their share of the health insurance premium even when coverage is at their fingertips.
• The number of uninsured children in 2006 was 8.7 million - or 11.7 percent of all children in the U.S. The number of children who are uninsured increased by nearly 610,000 in 2006, the second year that the number of uninsured children increased.
• Young adults (18-to-24 years old) remained the least likely of any age group to have health insurance in 2005 - 29.3 percent of this group did not have health insurance.
• The percentage and the number of uninsured Hispanics increased to 34.1 percent and 15.3 million in 2006.
• Nearly 40 percent of the uninsured population reside in households that earn $50,000 or more. A growing number of middle-income families cannot afford health insurance payments even when coverage is offered by their employers.

Why is the number of uninsured people increasing?

• Millions of workers don’t have the opportunity to get health coverage. A third of firms in the U.S. did not offer coverage in 2006.
• Nearly two-fifths (38 percent) of all workers are employed in smaller businesses, where less than two-thirds of firms now offer health benefits to their employees. It is estimated that 266,000 companies dropped their health coverage between 2000-2005 and 90 percent of those firms have less than 25 employees.
• Rapidly rising health insurance premiums are the main reason cited by all small firms for not offering coverage. Health insurance premiums are rising at extraordinary rates. The average annual increase in inflation has been 2.5 percent while health insurance premiums for small firms have escalated an average of 12 percent annually.
• Even if employees are offered coverage on the job, they can’t always afford their portion of the premium. Employee spending for health insurance coverage (employee’s share of family coverage) has increased 143 percent between 2000 and 2006.
• Losing a job, or quitting voluntarily, can mean losing affordable coverage - not only for the worker but also for their entire family. Only seven (7) percent of the unemployed can afford to pay for COBRA health insurance - the continuation of group coverage offered by their former employers. Premiums for this coverage average almost $700 a month for family coverage and $250 for individual coverage, a very high price given the average $1,100 monthly unemployment check.
• Coverage is unstable during life’s transitions. A person’s link to employer-sponsored coverage can also be cut by a change from full-time to part-time work, or self-employment, retirement or divorce.

How does being uninsured harm individuals and families?

• Lack of insurance compromises the health of the uninsured because they receive less preventive care, are diagnosed at more advanced disease stages, and once diagnosed, tend to receive less therapeutic care and have higher mortality rates than insured individuals.
• Regardless of age, race, ethnicity, income or health status, uninsured children were much less likely to have received a well-child checkup within the past year. One study shows that nearly 50 percent of uninsured children did not receive a checkup in 2003, almost twice the rate (26 percent) for insured children.
• The uninsured are increasingly paying “up front” — before services will be rendered. When they are unable to pay the full medical bill in cash at the time of service, they can be turned away except in life-threatening circumstances.
• About 20 percent of the uninsured (vs. three percent of those with coverage) say their usual source of care is the emergency room.
• Studies estimate that the number of excess deaths among uninsured adults age 25-64 is in the range of 18,000 a year. This mortality figure is more than the number of deaths from diabetes (17,500) within the same age group.
• According to one study, over a third of the uninsured have problems paying medical bills. The unpaid bills were substantial enough that many had been turned over to collection agencies - and nearly a quarter of the uninsured adults said they had changed their way of life significantly to pay medical bills.

What additional costs are created by the uninsured population?

• The United States spends nearly $100 billion per year to provide uninsured residents with health services, often for preventable diseases or diseases that physicians could treat more efficiently with earlier diagnosis.
• Hospitals provide about $34 billion worth of uncompensated care a year.¹⁴
• Another $37 billion is paid by private and public payers for health services for the uninsured and $26 billion is paid out-of-pocket by those who lack coverage.¹⁴
• The uninsured are 30 to 50 percent more likely to be hospitalized for an avoidable condition, with the average cost of an avoidable hospital stayed estimated to be about $3,300.14
• The increasing reliance of the uninsured on the emergency department has serious economic implications, since the cost of treating patients is higher in the emergency department than in other outpatient clinics and medical practices.
• A new study found that 29 percent of people who had health insurance were “underinsured” with coverage so meager they often postponed medical care because of costs. Nearly 50 percent overall, and 43 percent of people with health coverage, said they were “somewhat” to “completely” unprepared to cope with a costly medical emergency over the coming year.

Getting Everyone Covered Will Save Lives and Money

The impacts of going uninsured are clear and severe. Many uninsured individuals postpone needed medical care which results in increased mortality and billions of dollars lost in productivity and increased expenses to the health care system. There also exists a significant sense of vulnerability to the potential loss of health insurance which is shared by tens of millions of other Americans who have managed to retain coverage.

Every American should have health care coverage, participation should be mandatory, and everyone should have basic benefits.

– Facts on Health Insurance Coverage, National Coalition on Health Care

I was just telling friends the other day that sometimes I feel badly that my views started to change due to selfish reasons. But, I suppose that most of us change or refine our world views when we come into contact with different situations.

I never started to think about health care and a national system until the tech bubble burst. My consulting company started to falter and paycheck frequency became infrequent. I called the Labor department and they couldn’t help me because I lived in Pennsylvania, but I was paid from a California bank. I called the Unemployment department and they couldn’t help me because I seemed to still be employed and had a hope of a paycheck.

I started thinking about whether or not I would start my own one-woman programming business. The big hurdle was health insurance. I would think “I would totally start my own company if there was a national health care system that made sure I was covered.” Around this time, my sister and her family lost their health insurance and a national health care system was even more on my mind.

I started thinking about our public school system. It is not perfect by any means, but it ensures that all Americans get some level of education. People who want something different send their kids to private or charter schools. And richer areas have better public schools than poorer areas.

What if our health care system had the same thing? A guaranteed coverage for everyone and then if you wanted something different, you could pay for it? It seemed logical to me.

Something has gone wrong in America when millions of people are just one medical emergency away from bankruptcy and financial ruin. How many of us are sure we can get quality health care when we need it for our children, our loved ones, and ourselves? Something needs to change.

– DividedWeFail.org

Fast forward six years and I’m even more convinced that this is something that America needs as soon as possible. I’m going to highlight my family in this post as an example of what I think the average American family is dealing with.

Here is my family structure:

• Dad (61)
• Mom (60)
• Me (35) — Married to “M” (34)
• Sister “R” (33) — Divorced. Has the following kids:
  • “A” (14)
  • “L” (5)
  • “B” (3)
• Sister “E” (31) — Married to “S” (34)

Of the entire list of people in my family, only me, my husband “M”, and my nephew “A” currently have health insurance. This is the thing that terrifies me the most in this world because (1) by not getting regular check ups and tests we have no idea if there is an issue before it might be too late and (2) any one medical disaster could wipe them out. I love them so much and want them healthy and with me forever.

#1 - My parents: My dad and mom had health insurance until March. My dad lost his job and they weren’t able to afford the COBRA payments. This is not unusual.

Losing a job, or quitting voluntarily, can mean losing affordable coverage - not only for the worker but also for their entire family. Only seven (7) percent of the unemployed can afford to pay for COBRA health insurance - the continuation of group coverage offered by their former employers. Premiums for this coverage average almost $700 a month for family coverage and $250 for individual coverage, a very high price given the average $1,100 monthly unemployment check.

– National Coalition on Health Care

In this economy, it has been really hard to find another job, even one that would pay him a fraction of what he is worth. My mom is a stay-at-home mom and is watching “L” and “B”, but has also been trying to find a job to provide this coverage for the two of them. As she said to me, my dad cannot be without medical coverage since he has so many health issues.

Last month, my dad was in a motorcycle accident. He broke 6 ribs and his shoulder. He was really lucky, not only to be alive, but also because the accident happened on his motorcycle which has auto insurance. My dad always had really excellent coverage on his vehicles because he saw that it only takes one devastating accident to lose everything.

He was in the hospital and then they discharged him straight from the ICU. My whole family felt that it was too early and, sure enough, several days later he was back in the hospital. This time they kept him until he actually should have been discharged. I really believe that they discharged him early the first time because he didn’t have health insurance and then kept him the right amount the second time because they were afraid of lawsuits.

But what if my dad’s medical emergency was something else? If he fell off the roof, I’m hopeful that they have enough homeowners insurance to cover that. What if it were a heart attack? He would have to rely on the McCain advisor’s universal health plan of showing up to the emergency room without health coverage:

But the numbers are misleading, said John Goodman, president of the National Center for Policy Analysis, a right-leaning Dallas-based think tank. Mr. Goodman, who helped craft Sen. John McCain’s health care policy, said anyone with access to an emergency room effectively has insurance, albeit the government acts as the payer of last resort. (Hospital emergency rooms by law cannot turn away a patient in need of immediate care.)

“So I have a solution. And it will cost not one thin dime,” Mr. Goodman said. “The next president of the United States should sign an executive order requiring the Census Bureau to cease and desist from describing any American – even illegal aliens – as uninsured. Instead, the bureau should categorize people according to the likely source of payment should they need care.

“So, there you have it. Voila! Problem solved.”

– Dallas Morning News, August 27, 2008

But what if it were something else? Maybe he has a diabetes setback that is not an emergency situation. Maybe he needs medication for a sinus infection. He would either have to pay for this out of pocket or go to the emergency room.

It will be 4 years until my dad is eligible for Medicare benefits. So, yes, this situation terrifies me.

#2 - “R” and her kids: “R” moved to Florida and in with my parents after her marriage fell apart and it became too difficult to try and work when the combination of just daycare expenses (heavily subsidized by Catholic Charities) and rent was more than she took home in her paycheck. When she was in NJ, her children were covered under NJ’s CHIP program, but she was uninsured.

She found a job, but it did not cover health benefits at all. This is not uncommon. Only 60% of US employers provide any sort of health coverage. (source DividedWeFail.org)

The percentage of people (workers and dependents) with employment-based health insurance has dropped from 70 percent in 1987 to 59 percent in 2006. This is the lowest level of employment-based insurance coverage in more than a decade.

– National Coalition on Health Care

She quit her job recently to go back to full time school and is eligible for her children to be covered under Florida’s CHIP program. Last time I called, she had been on the phone on hold all day trying to set this up.

Again, what happens if something tragic were to happen to her or her children? I am seriously worried for her health because she has not been to a doctor in years for a checkup. What if she were to get something terrible like cancer and no one diagnosed it? She is the sole support of her two youngest children.

There is no way that I believe that providing health coverage for her to have yearly checkups is more expensive than if they find out that she has cancer, puts a burden on the hospital system to treat it, and then she leaves two little children to survive on Social Security survivor’s benefits.

#3 - “E” and “S”: “E” moved to Florida last year with her husband. She is fully employed with a good job, but they have her categorized as a part-time/contract worker so they do not have to pay for her health care benefits. Her husband “S” is not employed.

“S” has had medical issues throughout their marriage, but since “E” does not have medical coverage for the two of them, he has had to go to the ER instead of seeing a doctor or they have to pay out of pocket for a doctor’s care.

They at least have seen a doctor in the last two years. But, what if “E” became pregnant? How will they pay for it? Medicaid?

About four million babies are born in the United States each year, and Medicaid pays for more than one-third of all births. The number involving illegal immigrant parents is not known, but is likely to be in the tens of thousands, health experts said.

– New York Times, November 2, 2006

Medicaid might pay for the birth, but it will only cover the first year of health insurance for the baby. What happens after that? “E” makes too much money to have the child covered under the current CHIP levels. Will the child then have to go uninsured?

This is a huge problem and not just for my family. I was talking to a friend yesterday about how he jokes half-seriously with his mom that she should marry someone from Canada in a marriage of convenience so her illnesses would be covered under the Canadian single-payer health plan.

It gave me a brilliant idea. First, my grandmother needs to apply to become an Irish citizen. Then, my mom can apply since her mom is now an Irish citizen. Then my dad and sisters can apply based on my mom. Then, we register “L” and “B” as Irish citizens because “R” is now an Irish citizen. Then, if someone in my family gets really sick, we can send them to Ireland to be covered under their national health care system.

If only our own country had a similar plan.

I wanted to put in this whole Time article because it highlights three different things that I think are important.

The first is that I like how Barack Obama is thoughtful and nuanced when he replies to questions that are complex like this issue of abortion. John McCain will give a good sound bite answer that feeds into the American short attention span, but also contradicts his other held positions (like his support for federal funding of embryonic stem cell research).

The second is that Barack Obama doesn’t shift his actual positions, even when appearing before an audience that will not particularly agree with him 100% of the time. I like that he is willing to talk to people like that. John McCain was very quick on the prepared answers that this audience wanted to hear, quite possibly because he listened to all of the questions ahead of time with his advisors.

Finally, it underlines the fact that Barack Obama knows that there is a moral aspect to abortions, is willing to limit 3rd trimester abortions, support women who are trying to keep their babies and reduce the need for abortions. These are the things that I wanted to hear.

McCain and Obama on Abortion
By Nancy Gibbs
Sunday, Aug. 17, 2008

Watching Barack Obama and John McCain handle pastor Rick Warren’s questions about abortion, you could see the whole presidential race in miniature taking shape before our eyes. The clear answer beats the clever one any time … unless you worry about the chaos that clarity can bring.

Before a friendly but still skeptical Evangelical crowd at Warren’s Saddleback Church in Lake Forest, Calif., on Saturday night, McCain won a roar of approval when Warren asked him at what point a human being gets human rights: “At the moment of conception,” McCain replied. The answer was clear, unequivocal and a great relief to restless Republicans who had endured a week of indigestion on the issue. Murmurs that McCain was flirting with a pro-choice running mate like former Pennsylvania governor Tom Ridge or Joe Lieberman had Rush Limbaugh and his army in full stampede. “The fur is going to fly on this one,” Limbaugh warned about the prospect of McCain taking social conservatives for granted.

McCain’s straightforward answer, along with his assertion that he would not have nominated any of the Supreme Court’s four liberal judges (notwithstanding that he voted to confirm all but John Paul Stevens, who was named before McCain was in the Senate), had social conservatives breathing sighs of relief. “I will be a pro-life president, and this presidency will have pro-life policies,” McCain said to cheers from the audience. “O.K.,” Warren said, laughing. “We don’t have to go longer on that one.”

Meanwhile, Obama offered an artful dodge to the question of when a human deserves rights. “Whether you’re looking at it from a theological perspective or a scientific perspective, answering that question with specificity is above my pay grade,” he said. Like many of his responses that night, it was a long, careful, nuanced plowing of middle ground. He did not suggest that the only rights that matter are a woman’s over her body. He also affirmed his moral dimensions of the issue: he noted his willingness to limit late-term abortions, provided there is an exception if a woman’s health is at risk; and he talked about finding the resources to help women who choose to keep their baby, and about trying to reduce the need for abortions in the first place. It reflected the careful effort Obama has made to reach out to the ambivalent middle, which is reflected in a Democratic Party platform that unequivocally defends the right to legal abortion but also calls for better access to contraception and comprehensive sex education. This is classic “common ground” language designed to break with past orthodoxy and reach out to independents who don’t much like abortion but who don’t want doctors and patients being carted off to jail for performing or having them.

Which is why McCain’s much cleaner answer may come back to haunt him. It’s not just that a majority of Americans favor at least limited access to legal abortion. (I’ve seen polls suggesting that a substantial minority of Americans thinks McCain himself is pro-choice, which is a natural mistake given his maverick image. Will independents like him less when they learn more?) McCain’s construction that life begins “at the moment of conception” opens a whole new set of questions. There is a world of mystery in what transpires between the moment when egg meets sperm and the point of implantation, when that fertilized egg nestles into the uterus and begins to grow.

McCain’s position has the great virtue of simplicity: a unique set of chromosomes, having been assembled, has the potential to grow into a unique human being, assuming circumstances permit. As many as half of fertilized eggs naturally miscarry, usually before the prospective mother even knows she was pregnant. But there is a roiling debate over what factors might also affect implantation, with implications for everything from fertility treatment and contraception to criminal law and human rights. I wonder if McCain knows how deeply into troubled waters he has waded.

Consider the obvious implications if rights attain the moment the egg and sperm meet: all kinds of embryo research become questionable, starting with the stem-cell research McCain says he favors. Couples who undergo in vitro fertilization and then choose not to implant all the embryos are surely violating the rights of those that are discarded or frozen. Some forms of contraception, such as IUDs and the morning-after pill, would presumably be illegal if they affect the ability of an egg to implant. Abortion opponents contend that the birth control pill itself, while designed to prevent ovulation so no egg is fertilized in the first place, may also have the effect of blocking implantation of any egg that sneaks through. Suddenly, a whole range of reproductive choices comes into question.

The eternal battle over when life, and rights, begin has been playing out this summer on the blog of Health and Human Services Secretary Mike Leavitt, who sought comments on a proposed regulation to refuse federal funds to any hospital or clinic that didn’t respect the “conscience” of its workers. This refers to doctors, nurses, pharmacists and others who refuse to perform abortions or prescribe drugs like Plan B, which they view as equivalent to abortion. By defining abortion so broadly, as “any of the various procedures — including the prescription, dispensing and administration of any drug or the performance of any procedure or any other action — that results in the termination of life of a human being in utero between conception and natural birth, whether before or after implantation,” the regulation set off a firestorm from reproductive rights groups and members of Congress. Slate’s William Saletan brilliantly toured the implications in a “letter” to Leavitt, noting that by the same logic, the government should be outlawing breast-feeding (which by affecting a woman’s hormones interferes with ovulation and, in theory, implantation), not to mention drinking coffee (can increase the chance of miscarriage), riding horseback (same) or exercising in general.

Four years ago, President George W. Bush was able largely to avoid trudging through this treacherous ground because he had the confidence of his base (this despite a grandfather who served as a Planned Parenthood treasurer and a wife who told Katie Couric she didn’t think Roe should be overturned). He talked about promoting a “culture of life” but didn’t get down in the weeds about when exactly that life started. McCain enjoys no such benefit of the doubt, and so he had to offer blunt reassurance. But his construction of human rights beginning “at the moment of conception,” while theoretically clean, is a practical mess. It throws the entire weight of argument onto one side of the scale; a woman, whose womb and RNA are essential to the development of a fertilized egg, would be obliged to do nothing that could even inadvertently interfere with the progression from zygote to newborn. This would have, among other effects, such immense impact on access to contraception that it would all but guarantee an increase in unwanted pregnancies — and the abortions that McCain opposes. I suppose this counts as definitive leadership; I just wonder if McCain’s definition takes him in the direction he really wants to go.

The Republican plank on abortion is unequivocal on their support for life:

Faithful to the first guarantee of the Declaration of Independence, we assert the inherent dignity and sanctity of all human life and affirm that the unborn child has a fundamental individual right to life which cannot be infringed. We support a human life amendment to the Constitution, and we endorse legislation to make clear that the Fourteenth Amendment’s protections apply to unborn children. We oppose using public revenues to promote or perform abortion and will not fund organizations which advocate it. We support the appointment of judges who respect traditional family values and the sanctity and dignity of innocent human life.
–quoted from LifeNews.com

I definitely give the RNC kudos for their affirmation of the dignity and sanctity of life. 

The thing that I would like to know is why did they pull out a similar clause in their plank about working to reduce the number of abortions? The same group of evangelicals and Catholics who worked on the pro-life language at the DNC worked for similar language at the RNC. The draft of the plank contained the following statement:

We invite all persons of good will, whether across the political aisle or within our party, to work together to reduce the incidence of abortion;

However, before the plank was approved, the Republican platform committee removed that statement. The groups committed to working to reduce the number of abortions in America sent this letter exhorting them to put it back in.

Here is where I have become very cynical about the Republican party and their true commitment to being pro-life.

Since I was 8 years old, the majority of the time spent in office has been with Republican presidents who “rallied the base” on culture war issues, primarily abortion. Yet what has actually happened? The majority of the Supreme Court has judges appointed by these presidents and many cases have come before them on this issue and Roe v Wade is still standing.

Let’s remember back to Planned Parenthood v Casey. This account is from Wikipedia (not a primary source), yet it is how I remember it happening.

The case was a seminal one in the history of abortion rights in the United States. It was the first case which provided an opportunity to overturn Roe since the two most liberal Justices, William Brennan and Thurgood Marshall, were replaced with the Bush-appointed Justices David Souter and Clarence Thomas. Both were viewed as ostensible conservatives compared to their predecessors. This left the Court with eight Republican-appointed justices - five of whom had been appointed by Presidents Reagan or Bush, both of which were well known for their opposition to Roe. Finally, the only remaining Democratic appointee - Justice Byron White - had been one of the two dissenters from the original Roe decision.

At this point, only two of the Justices were obvious supporters of Roe v. Wade: Blackmun, the author of Roe, and Stevens, who had joined opinions specifically reaffirming Roe in City of Akron v. Akron Center for Reproductive Health and Thornburgh v. American College of Obstetricians and Gynecologists. Given these circumstances, even most pro-choice advocates expected Roe to be overruled and were gearing up for a subsequent state-by-state campaign against the passage of particular anti-abortion laws.

I remember pro-life groups gearing up for it as well. However, the Supreme Court upheld the core right to legal abortion in Roe v. Wade.

Douglas Kmiec recently wrote:

The Republicans are dug in on seeking the elusive 5th vote to overturn Roe, but even with all the past Republican appointments to the Court, that is unlikely. And in any event, overturning Roe does nothing directly to save a life; it merely tosses the issue to the states which may or may not affirm life.

Catholic teaching tells us when we reach an impasse for life, we need to seek out another way - to make at least some progress in building up the culture of life.

So, the cynical side of me wonders why the Republican leaders are waiting on the “elusive 5th vote” and happily rallying the base every election cycle on this issue without setting out a plan to reduce abortions. Why all or nothing? Could it be that they don’t really want abortions to be restricted and that very conservative judges suit their corporate-minded values just fine?

And then we have John McCain. The John McCain running to be the Republican presidential candidate in 1999/2000 is a very different John McCain of late.

“I’d love to see a point where [Roe vs. Wade] is irrelevant, and could be repealed because abortion is no longer necessary. But certainly in the short term, or even the long term, I would not support repeal of Roe vs. Wade, which would then force X number of women in America to [undergo] illegal and dangerous operations.”
– Interview with the San Francisco Chronicle, August 20, 1999.

“John McCain believes Roe v. Wade is a flawed decision that must be overturned, and as president he will nominate judges who understand that courts should not be in the business of legislating from the bench.”
– McCain for President (2008) website

Hmm. Then there is the matter of a VP and the Supreme Court appointees that you get to pick out.

McCain reiterated that he would not have an abortion “litmus” test for a running mate or Supreme Court nominees.
–On CNN’s “Late Edition,” August 22, 1999

This time around, he kept trying to pick a VP who was pro-choice. He wanted Senator Joe Lieberman. He wanted former Pennsylvania governor and homeland security secretary Tom Ridge. CNN reported that “one Republican insider said McCain campaign manager Rick Davis has called several state party chairs and indicated that Ridge will be the Republican vice presidential pick this cycle.”

After Pat Buchanan threatened to lead a walkout at the convention and McCain felt the intense pressure of social conservatives like Rush Limbaugh to not pick a pro-choice VP, he eventually capitulated.

I strongly feel that John McCain is trying to play both sides of the field on this topic.  A Pew poll in July found that 56% of people did not know where he stands on abortion. The proud Hillary supporter who did a commercial for her support for John McCain was asked about his pro-life stand and she said she supported John McCain because of his pro-choice viewpoint. He is trying to have his cake and eat it too.

Regardless of his position this year, it seems like the abortion issue is not a top priority to him. How much work would he do to reduce the number of abortions? How much would he do to make abortion illegal in the US? Will this be the top issue when he nominates Supreme Court justices?

If this is not a top priority and he gets elected, then the American people went with the all or nothing choice that most likely will never happen.

Once upon a time, there was a guy named Solomon who had a tough decision to make. I would give the Solomon of the year award to Barack Obama for his negotiations on the abortion plank of the Democratic party platform.

I can’t think of too many things that are more polarizing than abortion. Maybe the Iraq War? It all started in January 1973 when the Supreme Court decided Roe v Wade when only 4 states had abortion on demand. Possibly the abortion debate would be less polarized if the states all got to figure out when to legalize abortion based on when their populations became more accustomed to the idea. Much like gay civil unions are being handled now. Or maybe not since it does seem to boil down to a life and death decision for many people.

Barack Obama took a Democratic party that was even more polarized than US society in general. You have the very pro-choice group who did not want to give an inch on making the platform inclusive. Then you have the very pro-life group that felt like they did not have a voice at all in their party’s platform. For those of you who do not remember Planned Parenthood v Casey, the first real opportunity to overturn Roe v Wade, remember that the Casey in that suit was Bob Casey, the Democratic governor of Pennsylvania. (I participated in a huge rally in DC, so it was something that I remember well.) The same year, when Casey wanted to speak about abortion at the 1992 Democratic Convention to give a voice to this point of view, he was rejected. Interestingly enough, although Governor Casey passed away, his equally pro-life son Senator Bob Casey Jr was given a prime speaking slot at this year’s convention.

Obama made sure that everyone had their voices heard and that the best environment for an agreement was put into place. Steve Waldman, editor-in-chief of beliefnet.com called the action this way:

The Obama forces engineered an interesting and potentially important compromise. It moved the platform in the pro-choice direction on a few things in order to get pro-choice forces to agree to a key request from pro-life liberals: language affirming and supporting women who choose to carry the baby to term instead of having an abortion.

The Democrats had always talked about “freedom of choice” but usually spoke only of one choice, having an abortion. Pro-life liberals are convinced that many women have abortions for economic reasons, so providing them with support could actually reduce the number of abortions more than the Republican approach of emphasizing legal restrictions. (That argument summarized here.) The platform provides the outlines of a potential Democratic argument for reducing abortion number while preserving abortion rights.

The compromise tells you a great deal about Obama’s possible governing style. He did not put forth specific language ahead of time. His team worked quietly behind the scenes with different constituencies - pointedly declining to ever have the factions in the room at the same time. The resulting compromise got support from both the pro-life liberals and pro-choicers. Like most such compromises, it can and will be criticized for not gong far enough in either direction

In fact, a few days ago, I was one of the people who accused them of “squandering” an opportunity. Now that I understand how this came down, I’m a bit more impressed with what the Obama campaign did. Once it became clear that the pro-choice forces would not agree to strong language demanding a reduction in the number of abortions — a stand that could cost the Democrats dearly in the fall — the Obama camp was faced with a choice. They could try to roll the pro-choice groups. That would have made a big splash and appealed evangelicals and Catholics, but would have alienated pro-choice groups and splintered the party. Or it could have worked toward a compromise that would gain some modest ground for pro-life forces while getting support from both sides. They chose the latter.

It’s classic Obama, really. Ultra-pragmatic, consensus-buidling, favoring incremental steps in the right direction over broad culture war battles.

Waldman’s “public” Wall Street Journal article with a detailed account of the compromise can be found here: http://blogs.wsj.com/politicalperceptions/2008/08/19/the-real-story-of-the-democrats-abortion-plank/

You can read both the current and previous planks of the Democratic party here in this article at the Washington Post: http://voices.washingtonpost.com/the-trail/2008/08/13/conservative_dems_hail_party_p.html

Tony Campolo was one of the evangelicals working on the pro-life side of the plank negotiations with various other groups. He recently wrote a blog post about his experiences and why he felt, as a Christian, that he had to strive “to be the ‘leaven’ that permeates both parties with biblically-based judgments and values derived from Christian beliefs”. The whole article is worth a read, but I wanted to pull out this one bit:

These achievements were lauded by Democrats for Life and by the Catholic Alliance for Life. While at the Democratic National Convention, religious leaders of other faith traditions personally thanked me for my efforts. Even leaders of some pro-choice organizations hailed this compromise, claiming that at last they could find some common ground with pro-life advocates.

Purists, on the other hand, have had hard words for me, claiming that I should not have been involved in any way with a political party that is pro-choice. While I understand their desire to settle for nothing less than the overturning of Roe vs. Wade, I nevertheless believe that my decision to work for abortion reduction was a good one.

Consider these questions: If 10 children are drowning in a swimming pool, and you can only save six of them, should you save the six? Or, should you wait until help arrives that can save them all, even if you know that the six you could save will be lost in the meantime?

Douglas Kmiec, a Pepperdine law professor and former Catholic University law school dean who served in both the Reagan and elder Bush administrations, said in a press conference “the plank would help get the abortion debate out of the rut it’s been in, with both sides entrenched in their positions over Roe v. Wade and too little attention given to the task of reducing abortions.”

“While the platform still falls short of the Catholic ideal, we live in this world and we pursue the art of the possible, and if we move to protect even a single life then we’ve done a good thing,” he said. “Anything that recognizes Roe v Wade as legitimate is unacceptable from a Catholic point of view, but we live in the real world. Our faith is not unexposed in our pocket, but rather meant to transform the political process as it exists. This gets us beyond Roe. Roe has turned out to be a legal dead end, and a moral dead end.”

You can read the article that Mr. Kmiec wrote in Catholic Online about the drafting of the plank and how it relates to the Catholic faith here: http://www.catholic.org/politics/story.php?id=28865

All of the work by many good people of faith to create a commitment to reduce the number of abortions in America and the willingness to listen by the Obama campaign has Rev. Joel Hunter, Republican and the former president-elect of the Christian Coalition, commenting that the Democrats “could arguably steal the title of the pro life party.”

So, cheers to you Barack Obama. You’ve given us something to work towards that we can all agree on and opened up a place to start the discussions anew.