One of the most striking features of the health care reform was that it was passed over the unanimous opposition of the Republican Party. This has all sorts of implications, not yet fully understood by anyone (certainly not me). To start with, it’s now clear that talk of bipartisanship, distinctions between moderate and hardline Republicans and so on, has ceased to have any meaning. If their failure to stop the health bill works against them, we may see occasional Republican votes for popular legislation that is going to get through in any case. Obama’s Employment Bill got only 6 Rep votes in the House, but passed the Senate 68-29 (or maybe 70-28) in what the NYT correctly called a rare bipartisan vote. At least the reporter on this piece, Carl Hulse, has caught up with reality, unlike the general run of Beltway pundits who still think that Obama should be pursuing bipartisanship.
In many countries, a party-line vote like this (at least on one side) would be nothing surprising. In Australia, for example, crossing the floor even once earns automatic expulsion from the Labor party and guarantees political death on the other side. But the US has never had a really tight party system, largely because, until recently,the Democrats (and before them, the Whigs) were always split on racial issues.
One problem arising from this is that the US system is more vulnerable than most to the kinds of crises that arise when one party is determined to prevent the other from governing. Passing a budget requires a majority in both Houses of Congress, and the signature of the President. If the Republicans win a majority in either House in November, it’s hard to see this happening. A repetition of the 1995 shutdown seems highly likely, and, with the financial system still very fragile, the consequences could be disastrous. The 1995 shutdown didn’t turn out too well for Newt Gingrich, but it doesn’t seem to have pushed him in the direction of moderation, and the current crop of Republicans make Newt look like a RINO.
A couple more thoughts.
The Republicans have become the Party of No in another sense. Having been the party of initiative since the election of Ronald Reagan in 1980, they are back to their more accustomed role as the party of reaction. The change can probably be dated back to the 2004 election, when Bush failed to privatize Social Security or maybe even in 2003 when electoral pressure pushed him into introducing the Prescription Drug Subsidy (a pork laden monster as you’d expect from Bush, but still an expansion of the welfare state).
The shift is certainly evident when you compare Obama’s first year in office with Clinton’s. Clinton was introducing policies demanded by the Republicans and their response (the Contract with America) was that he wasn’t doing nearly enough. Now, the Republicans have nothing of their own to offer, except more tax cuts (and, I guess, more torture). They are truly the Party of No.
Finally, a partial defense of Ezra Klein, who copped some flak from Glenn Greenwald for his suggestion that the uniformly negative Republican vote spelt an end to special interest votebuying. As Greenwald points out, this is false, and the big lobbies got to write large sections of Obama’s bill.
But, I think, Klein is right in observing that a particular kind of votebuying, what you might call ‘retail’, is on the way out. In a system with disciplined political parties, there’s not much point in buying individual members of Congress. Instead, interest groups have to work at the wholesale level, convincing party and factional leaders that their interests should be looked after. Unlike retail votebuying his is something of a zero-sum game, since whatever helps one party harms the other. Since politics is inevitably about competing interests to a large extent, interest groups are never going to go away. But there’s a case to made that it’s better tohave them work at the wholesale/party level, where the voters can hold the entire party to account.
John Quiggin 
“Now, the Republicans have nothing of their own to offer, except more tax cuts (and, I guess, more torture)”
You forgot war. They can offer more of that also (say, with Iran or similar). That should help them think of more good excuses to torture people more.
It was good to see the vote yesterday – and then to see the win at all costs tactics of the GOP, whereby they attempted to recommit the bill. Of course, they ain’t finished yet. Yells of it isn’t constitutional sounded out, so no doubt some legal timewasting will be in the offing.
PS: Isn’t the English language rich with words for nearly any occasion, what with gems like “offing”, and “the”.
PPS: Douglas Adams provided some absent words, my favourite being “abilene”, although “chicago” comes close. My copy of “The Meaning of Liff” (correct spelling) as apparently gone the way of the dodo, but I’m fairly sure Adams also had a word for the spot behind the knee.
Should be a warning to all those in Australia who think a directly elected head of state would be a good thing.
@sdfc
?????????!
The house minority leader’s wrap up speech on the bill was a classic of the paranoid style in American politics! He didn’t actually say ‘death panels’, but it was clear he really seems to view this rather limited, generally corporate-friendly legislation as the deathknell of American Liberty (with the capitals!). I have no idea how anyone could hope to work with such people, nor why the US media constantly urges Obama to appease them.
There isnt a day goes past in the Australian media that I dont notice Tony Abbott being our own home grown version of DR NO.
Is this what we have sunk to? The politics of tribalism and boganism where biparisanship and intellifent decision making working togther are excluded?
Me thinks so. The politics of soap opera prevails.
excuse spelling previous post
@Donald Oats
ABILENE Paradox Don – google it. Replace bipartisanship and intellgent decision making and what we see is politics hobbled by within party abilene complexes.
Its such a feature of modern politics…they play the media game for their party, not the ball for the rest of us.
May they, as inidividuals, carry their guilt through their lives and become good citizens after they retire from politics (like Fraser). Will it absolve all their sins? Do they feel guilt in any personal sense? Interesting question.
The Republican party and conservatives may stand united against the health bill. But when the political debate moves onto other issues, which it will before the next election, will they stay united? I don’t think so – the past couple of weeks have revealed a nasty, racist, dishonest, obscene side of the Tea Party movement. Not all within the Republican party are going to accommodate these people.
@conrad
You also forgot a manned mission to Mars, more star wars style initiatives, cognitive disonance and Sarah Palin.
If the Republicans win a majority in either House in November
But of course that won’t happen, because the healthcare reform bill was so popular. Oh wait. 59% of the American public were against the bill. Scratch that.
But at least we can still call the Republicans the party of “no” for their partisan opposition, can’t we? Oh wait, the bill *was* bipartisan: 34 Democrats sided with the Republicans in voting against it. Strike two.
But hey, we all know the rubes are too stupid to know what’s good for them. They need tenured government employees to tell them how to live, and the bill certainly creates a lot more of those. So don’t worry: the dumbass public will surely see the error of their ways by November and vote the statists back in with an increased majority.
Libertarian,
as they say lies, damn lies and statistics, of that 59% of the public who were against the bill, 13% were against it because it didn’t go far enough, so actually they are quite unlikely to vote for the Republicans
Martin
There was a nice quote that came out of the “great” debate
Maybe it’s for the better that there is no bipartisan policy on health reform. To quote the late American satirist George Carlin, bipartisan usually means that a larger-than-usual deception is being carried out.
Treading my usual haunts I came across this rant from one of my favourite left-liberal-Democrat shock jocks (yes there are one or two). It’s the kind of craziness that warms the heart but nevertheless doesn’t allow you to suspend belief far enough to accept it.
Keith Olbermann — The Destruction of the GOP
Still, the sentiments and the passion are something I return to everytime I shake my head once too often at the condition of American discourse.
I think the US health reforms are unconstitutional. In so far as there is a need for government intervention in the health care market it ought to be a state matter not a federal one. The US constitution is pretty clear that the federal government should have limited powers.
In terms of the actual policy I don’t know much in the way of details. However compulsory private health insurance is stupid. An income contingent HECS style government loan to those that can’t self finance their health care needs is the way to go.
@TerjeP (say tay-a)
I tend to agree. Instead, there should be compulsory public health insurance from the government, which then tenders out the supply of services in bulk to various service providers at various prescribed quality standards. This process whould be entirely transparent. A steeply progressive levy on income should fund this.
Having a state-based system would be stupid and likely to lead to much worse outcomes for all the stakeholders in the system, with the possible exception of Big Pharma and the HMOs.
Fran – in the context of the USA I’m not sure why you are critical of a state based approach. It has the merit of being consistent with the US constitution. The EU mostly leaves health care to the individual nation states and those state based solutions are frequently the subject of praise from social democrats. Perhaps you can help me understand why a state based approach in the US isn’t workable or sound.
In terms of compulsory government insurance I think it is no better than compulsory private insurance. To be fair there are some health events that are so extreme that insurance of one form or another is the only real funding option for most people. However the vast array of medical services that are used by most people are not for extreme events. Likewise most of us are not so poor that we couldn’t pay out own way for run of the mill medical services (especially if taxes were cut accordingly). A HECS style funding scheme (with the Medicare card retained as a payment system) means that most people would pay for most of their own medical services. They could still insure for extreme events or they could rely on HECS style debt (incured using their Medicare card) with modest income contingent repayment terms. Some people might die or never achieve sufficient earning capacity to pay down the debt, but nobody would be excluded from medical services due to financial constraints. Most of us, most of the time for most services would essentially pay out own way. Taxpayers would pick up the bad debts and any other slack in the system but the market would on the supply side be more subject to price signals.
That didn’t take long: here’s the Downfall video on the Republican’s failing to block the health care reform bill. Not as much fun as “Iemma’s Dilemma”, especially if you’re from NSW, but still pretty good.
@TerjeP (say tay-a)
Ultimately, while the vast majority of health services need to be delivered locally, the funding of services and the negotiation over price and quality ought to be a monopsony. We want the best value of money possible. Allowing a patchwork quilt approach is cwertainly fgoing to leave gaps in the system that will ultimately prejudice the interests of the public, on whose behalf the buyer trades. I can’t imagine how the state of Delaware or the District of Columbia could hope to cut the same deal with providers as California might.
Ultimately, it would be better if the EU also worked this way, but given the vast size of the markets involved, the marginal advantage is probably going to be small, and given the complexities of rival tax and welfare systems, probaly too complex to work out.
Plainly, the system has to have both safety net provision and protection against collusion between service providers and service beneficiaries at the expense of the pool and frivolous use of services.
I’d arrange matters so that there was a bulk-billing option plus full rebates for expenses incurred up to $2000 for family or individual incomes in the bottom two deciles. There would be up to three years rollover of unclaimed balances. Above that the figure would be set at $1000 and decline at a rate consistent with individuals and families in the fifth decile bearing the full cost. Non-bulk-billed services would be set at 85% rebate of the scheduled fee or the average price offered for each service offered, whichever was the lower, leaving clients (subject to the above) to pay the balance up front and claim the rest back.
Item numbers for rebate would only be given to those providers tendering for not more than 20% above the average or the independently determined efficient price, whichever was the lesser. While they could charge above this, that would be a matter for negotiation with the claimant and these moneys would not be recoverable from pooled funds. People suffering from chronic illnesses (or caring for same) would be given special provisions and have a case manager appointed to them to guide them through the processes of securing the most appropriate range of services at the best price and would be given more generous (but still means-tested) provision.
People could still take out private health insurance to “top up” if they wished, but this would not be tax-deductible.
Making the system compulsory is important so that one can avoid adverse selection problems. We want everyone, including people for whom cover is not profitable at the margins, to be covered. We also particularly want those who are socially disadvantaged to get especially good care, and especially benefit from early primary care and preventive health programs, because they are much more likely to get sick and impose upon the least flexible and most expensive of services the system provides.
Oh really, how are the reforms “unconstitutional”? What is the test for the “limitation of powers”?
I mean the US has the world’s largest standing army… under control of the executive. That’s a serious concentration of power. Should the army be devolved to the state level with each US state having their own militia?
I think you are confused with the concept of separation of powers, in which the judiciary, legislation and executive branches of government have an equal and balanced role in governing.
The US constitution was designed to specifically limit the power of the executive so as to avoid a concentration of powers in the presidents role and the emergence of “tyranny”.
The system was designed in response to their experiences under the British and looked to Republican Rome as a model.
Also – the issue of “states rights” and the limitations of the federal government was somewhat settled by a little event called “The American Civil War”.
It sometimes amuses me, sometimes concerns me about how much time and attention is paid to US domestic politics in australia. I mean, who really cares? We all know that the US health system is jsut like the US political system, broken, corrupt, unaffordable. Any fix is going to be very partial and inadequate, they refuse to learn anything from anywhere else in the world, there’s not much else to know.
@wilful
Wel it is still the world’s most siginficant economy and the strongest military power. It is nuclear-armed and periodically gets complete tossers as leaders. As I said yesterday, it produces more than its share of nutbags.
It also dominates popular culture, the finance system, management theories and produces heaps of science and technology, some of which touches almost every middle class person on the planet in some way. So, what happens there, and what sort of leaders and polices they have, matters.
In health care? not really, only very distantly (thankfully). But that’s nothing like the level at which the debate is followed anyway, people’s appreciation of the minutiae of the debates is extraordinary.
@wilful
You’rereading the debate two narrowly. Whither US healthcare reform was the same question as whither the US presidency an the shape of congress at one remove. All sides in the US believed this, which is why the Repugs kicked up such a fuss.
They knew that if Obama failed to deliver, his side would fall into panic and disarray and be able to be picked off in populist campaigns. They would not be able to claim they had delivered anything of substance for their supporters and the claim that the Democrats can’t govern would be raised. The rights and wrongs of the matter were somewhat secondary. Obama could not afford to be seen as losing, and the Repugs had to win to stay in the game.
This reform is a long way short of adequate, but in a US context it is a substantial step forward. For us outsiders though, that Obama won probably assures him getting a second term and may signal a new and more robust approach to policy. Financial reform is next and of course there are the coming fights over energy and environmental policy. These things matter to the world.
“Obama’s Employment Bill got only 6 Rep votes in the House, but passed the Senate 68-29 (or maybe 70-28) in what the NYT correctly called a rare bipartisan vote.”
The House is normally more partisan and polarised than the Senate, and has been for some time. That is because many House members represent gerrymandered districts that are safe for either party, and so they just need to pander to their base in order to be re-elected. In the Senate the situation is different. Because Senators represent whole states, and many Senators represent states that are not an ideal fit for their own political views or many in their party, there is a greater need for bipartisanship.
@David Horton
Did you not read John’s post David? With a directly elected and hence politicised head of state these situations become a distinct possibility.
Sorry David, on re-reading perhaps I should be clearer, I was referring to John’s comments about the conflicts in the US between the executive and congress.
There is a risk that a directly elected Australian president or GG or whatever, may take his status as a popularly elected head of state as a mandate to stonewall the signing of legislation into law.
I don’t see this being a problem in the Medicare HECS scheme I proposed. And of course a state based system can handle it just as readily as a central government system. In terms of monopsony I think you over rate it’s significance. Mostly it is used to drive down the wages of health workers (eg nurses) but longer term it comes back to bite as less workers enter the industry and older workers exit. Over the long term I think a competitive market which recognised the worth of health care workers will deliver a better result than a monopsony that drives down wages for short term cost savings.
@TerjeP (say tay-a)
Not if it’s compulsory, no.
A state-based system is a central government system albeit with a smaller constituency and less portability and uniformity of service provision.
But you don’t have any basis for saying this. I wonder what US drug companies think of the PBS, for example. Oh wait … they don’t like it because they want the freedom to give customers a better deal … 😉
Strictly speaking that’s not true. Yes it is true that nurses get paid less, but so do childcare workers. Specialist doctors on the other hand, get paid very handsomely indeed. But this is irrelevant to the point of whether monopsony could drive down the cost of providing services, isn’t it? And in any event, we could, if we wished, resolve pay inequities in a more conventional way. Nurses get to bargain with their employers. Awards are made when there are disputes. These feed into the costs of service providers and the efficient cost of service.
What we really want is to cut out windfall profits to people at the top of the stakeholder pyramid — suppliers of pharmaceuticals, orthopaedic surgeons, and more — we want to prevent overservicing — which is a real problem in health care delivery. Not only is it expensive but hazardous to patients and often of dubious benefit.
Pr Q said:
The prospects for bi-partisanship policies do not appear to be bright. Obama’s health care is, as I predicted in 2008, fairly centrist in the great scheme of things (no public option, no real effort to curb insurance companies).
Obama’s legislative program, on health, education and environment, is still way more statist than Clinton’s. There is no way that the current crop of REPs will vote for it if they have the chance to vote it down.
The politics of bi-partisanship are also looking grim. You would have to bet on the REPs winning back some seats in the 2010 mid-term elections, probably regaining control of the Senate. Wikipedia reports that such elections are somewhat like by-elections in AUS, a chance to give the govt a kick in the pants.
The bum-kicking effect is likely to be exacerbated by Tea Party-animals which is exactly the kind of base-mobilising movement most likely to get out the white vote and get reactionary conservatives into office. And this type is most unlikely to produce the “let wiser heads prevail” advice most needed if financial markets head into another tail-spin.
Pr Q said:
My psephelogical instinct is that the REPs are committing slow-motion political suicide by having no positive program. Their rabble-rousing do nothingism will work in the short-term 2010, but back-fire big-time for them in the long-term 2012+. Look how Clinton bounced back from 1994 in the 1998 mid-terms.
More generally, the long-term demographics of the US electorate are working against the REPs. My commenting privileges on this blog do not extend to analysing this process but I am sure that others can work it out for themselves.
My ideological instinct is that the US will gradually embrace more welfare statism for obvious demographic reasons. I predict that Obama will reward his racial base (Africans and Mexicans) by tacking away from the Centre and more to the Centre-Left in 2012, widening and strengthening health care. He will throw a sop to SWPL brigade by putting in place some kind of wishy-washy carbon mitigation scheme.
Most voters will see that an extension of health care will not usher in the Third Reich or bring the economy to its knees so they will get used to and perhaps even demand more government services.
One 2008 prediction of mine that hasthus far failed to materialise: I argued that Obama would tend to strip resources from the warfare state and funnel them to the welfare state. This has not gone through the formality of happening, both arms of the state are growing. I dont see how the US treasury will be able to foot all these bills without raising taxes. Maybe the Chinese will stump up.
I predict that Obama will win convincingly in the 2012 elections, doing better than Bush in 2004.
All bets are off if we get a repetion of GFC.
I just want to go over my Obama model in to weaken or strenghthen assumptions in the light of evidence of his first couple of years.
In NOV 2008 predicted Obama would at least try to follow a Centrist bi-partisan politics in his first term, a prediction that has been largely confirmed:
My prediction that Obama’s health care policies would be tokenist was less than half-right.
The Obama health care reform bill is pretty moderate but it is a genuine move towards a “grand idelogical committment”. This implies that there Obama has some policy substance to add to his considerable political style. I have adjusted my model of Obama to reduce its “spin” component. The guy is the Real Deal, although only a moderate one.
So I am going to stick with my prediction that Obama will tilt his policies more to the Centre-Left in 2012+:
Its pretty clear that he will have to work on Independents “to build a robust political consensus”. I am not sure how he is travelling with this demographic. They have to be convinced that he is the real deal.
Obama has no hope of swinging conservatives. In NOV 2008 I correctly predicted something like the rise of Right-wing Tea-Party-animal movement:
Clearly though the Tea-Party-animals are not as strong as the Contract-with-America congressman. They have failed to stop healthcare reform. So we know for sure that the US Right is much weaker in 2010 than it was in 2004.
In NOV 2008 I also predicted that Obama’s steady as she goes Centrism would confront the Right-wing REPS with political oblivion:
The REPs have done nothing in the past couple of years to inspire confidence.
They are now unable to mount an effective opposition to Obamaism. They have no a coherent ideology. Its fun to see how rock-ribbed individualist REPs are demanding that Obama keep his hands off their Medicare.
Nor do they have a convincing leader. Rush Limbaugh, Sarah Palin, Bobby Jindal?!.
I conclude that the US polity will default towards a moderate Centre-Left policy position as the US Right largely exhausts itself in futile stunts and demographics work their relentless political logic in the DEMs favour.
Fran,
Medicare HECS does not need to be mandatory to work. It just needs to be universally available. In the same sence that prior to the Rudd reforms HECS for higher education was universally available but alternate funding options were permitted. In fact under my Medicare HECS model I would pitch for a rather high repayment rate for higher income earners to encourage them to opt out or else to claw back the funds rapidly. And the system would not preclude people paying cash for medical services or using private insurance. I would see it as a payment method that was available to all but mainly used by those with financial constrains or extreme medical expenses. Not a payment system that was mandatory and certainly not an insurance scheme. Mandatory and insurance are the wrong approach, optional and universal are the way to go.
I think you’re missing the point. A state based approach to socialised medicine honours the US constitution which says the federal government should do next to nothing. Doing it federally further undermines the relevance of fundamental US law and incrementally enables a lawless federal government. If it must be done by the Feds then the proper approach would be to amend the constitution. At least with prohibition the constitution was amended to create the relevant power. Once power is available by ignoring the constitution the shackles on government become dangereously loosened. Not that this initiative is the first to tilt the US in that direction.
The other point is that state based initiatives are ultimately more accountable.
@TerjeP (say tay-a)
That sentiment is obsolete and recalls days when the states resisted a Navy even though people were being ransomed by Barbary pirates.
Really, as we have seen since those days, the states are largely a bastion of resistance to progress in the US. Pretty much every small bit of progress has required Federal intervention and every reactionary organises around “states rights”.
Pr Q said:
The US party system tightened up in the past generation because BOTH parties polarised on issues of class/race. No bi-partisan consensus could have survived the monumental cultural revolutions of the sixties and seventies without substantial re-aliggnment.
That said, it does considerable injustice to moderate post-war REPs to paint them as monolithically opposed to civil rights. From the fifties through mid-sixties the REPs were actually far more pro-Civil Rights than the DEMs. Wikipedia reports the partisan break down on the final vote:
Betcha didn’t know Nixon also supported de-segregation in 1958 as Vice-President and promoted Civil Rights at least in his first term.
This raises the interesting question of what happened to US society from 1964 through to 1968 that made the REPs swing so wildly to the Right, at least on cultural issues. They did not so much split on this issue as totally flip. Did aliens abduct their moral conscience? Its a puzzlement, for the life of me I can’t figure it out. [scratches head thoughtfully].
One small step away from the neoliberal model of user pays healthcare and nonpayers non users early death.
I applaud Obama.
Baloney Fran. California: way out in front on environmental issues, bloated public sector, very progressive education policies. Would be more at home as an Australian State than a US State. Also, flat broke due to very powerful public sector unions (did I mention Californians would feel at home in Oz?).
Texas: laissez faire, let ‘er rip, doing far better than California economically and in fact on most social metrics too (including education).
Unlike Australia, you get a pretty good spectrum in the US, precisely because the states have zealously tried to protect their autonomy against a rapacious federal govt.
California would certainly not feel at home in Australia. Australian states are far better credits.
Perhaps according to some. However I’m actually more interested in hearing feedback from you regarding what I said in comment #34.
@TerjeP (say tay-a)
@TerjeP (say tay-a)
Comparing a discretionary service — tertiary education — with an essential service — health — is not apt. Morever, edcuation serrvices have built in constraints — you have to give up work to undertake study and it costs you time. Health services not so much.
I strongly suspect that if you allowed open ended loans HECS-style that you would get massive unfunded liability and lose all control of your budget. Unless people imagine that they will be called upon to repay and in a time frame that is meaningful, the temptation simply to use disretionary services whimsically would be strong, especially in the parts of the market comprising most of the population. You’re familiar with the concept of moral hazard I take it?
In short, the system simply would not be sustainable and there would be massive overservicing.
@libertarian
Yet they spend more per capita imprisoning people than educating them. Disproportionate numbers of blacks and hispanics are under edcuated and in jail. They have a three-strikes law meaning that even trivial offences can get you 25 years in jail.
No, due to populist messing with the tax base.
Oh yes a libertarian paradise
Executions since 1976: 451 (California 13)
Executions in 2009: 24 (California 0)
I’m not sure how it would cause more overservicing than the current system which is essentially free to the user. And the government could still maintain a schedule of what amount it is willing to fund for particular services and procedures. As at present any difference in the price would need to be funded out of pocket by the individual or through private insurance. I think the moral hazard of the existing system is substantially higher.
Education is more of a public good than health care with the possible exception of vacination and the treatment of contageous diseases. As such I think the case for free medical services is actually weaker than the case for free higher education.
[Texas] Executions since 1976: 451 (California 13)
Ah, so the feds are in front because Texas executes more than them? I reject your statistic and choose my own:
[Australia] Aboriginal deaths in custody in 2003: 10 (Texas 0)
Woohoo, Texas is waaaaay better than Australia.
I love lefties. They’re so f***ing dumb.
@libertarian
California is flat broke due to the electricity debacle where the opportunity was provided by ‘reforms’ and the denouement courtesy of ‘innovators’ like Enron, and the stupid referendum imposed constraint on raising revenue. Maybe you should blame the looney people who promoted those bright ideas. Those people, there called libertarians.
So called ‘lefties’ might be none so bright but those who have been making all the running in the silliness stakes since the mid ’70s have been libertarians.
@libertarian
Libertarian couldn’t think of a pertinent observation and after offering a red herring and missing the point tried:
I love lefties. They’re so f***ing dumb.
We’re not so ‘dumb’ we miss what a conservative libertarian (TM) looks like when (s)he has no material. Libertarian’s conxession that (s)he ‘loves’ the stupid is a remarkably candid or careless admission of the conservative libertarian (TM) cultural paradigm.
@TerjeP (say tay-a)
Perhaps you do, but you’d be guessing based on nothing at all. The impediments to exercising funded education are considerably higher that in medicine. To get an education service you have to make considerable personal commitments. Not so in the case of your model of health spending. If one is not going to pay back any substantial portion of a loan, and if one’s lifestyle is not affected by it, does it really matter how large the debt is? Is not paying back $100K worse than not paying back $50K?
I see no mechanism in your system for cost control or even cost prediction.
You need to argue this claim with someone who actually proposes doing this. The issue about which service is essential/more important is a different thing entirely.
you never quit Jack.
Also, dude, “Africans and Mexicans” is not the preferred nomenclature. “African-Americans and Latinos”, please.
by the way Jack, you’re forgetting the most important element of Obama’s “racial base”: whites.
There were far more white people who voted for Obama than there were total “Africans and Mexicans” voters combined.
But I guess for old-skool Jack, “white” isn’t a race, it is the absence of race.
Race is “colored”.