This is what Republican nominee John McCain had to say about health care reform in his acceptance speech last night: 

My health care plan will make it easier for more Americans to find and keep good health care insurance. His plan will force small businesses to cut jobs, reduce wages, and force families into a government-run health care system where a bureaucrat stands between you and your doctor.

1. As Ezra Klein puts it: Spoken like a man who, on the one hand, has never used an HMO, and on the other, has never been off government health care a day in his life, and is healthy enough to run for president at 72. 
2. Also, it is of course, just another outright Republican lie; acutally two lies: On the one hand, McCain’s plan does not even make a pretense of trying to reduce uninsured or underinsured. To the extent it makes any claims, false as they are also, it is about cost control.  On the other hand, Obama’s plan does nothing to force people into a government plan.  Remember his is the plan among the Democrats that does not have mandates for adults.  At best, it tries to offer a public option for those that cannot get covered in the private for-profit sector.
3. Still it is a good example of how even after pre-compromising and offering a “respectable moderate” plan that keeps the private for-profit insurance companies front and center, the Democrats will still get attacked as if they actually had proposed Single Payer.  If you are going to take the heat, at least offer the benefit.  Sigh.

 Meanwhile, this article in todays Washington Post suggest that as governor in Alaska, Sarah Palin has been a knee-jerk free market fundamentalist with a typical misunderstanding of the reality of “competition” in the health care sector.  Basically she wanted to do away with “certificate of need” regulation, ostensibly so free market competition could lower costs and increase access, which just happened to coincide with the interests of some of her big donors.  As it failed to work (paging the Dartmouth Atlas) she created an advisory panel, packed with some of the same special interests.  When even they suggested changing course, she over ruled them.  I guess like Bush/Cheney, we would not want to listen to any, you know, experts.

So what else did you take away from the Republican convention?

I will review where we have been, are, and are going. And why speaking personally I support (more and better) Democrats, but also why even in the face of the “poilitically feasible” argument, we need to keep fighting for real national care, which means single payer.

As previously discussed, Obama opposes mandates for adults and as the AP says:

…aims to achieve something close to universal coverage by making insurance more affordable and helping struggling families pay for it.

The platform makes a rhetorical movement in the right direction:

The party now declares itself “united behind a commitment that every American man, woman and child be guaranteed to have affordable, comprehensive health care.”

My interpretation is that Obama moved his language closer Clinton’s language in general to a more explicit goal of universality, but without any explicit incorporation of individual mandates. This all has to do with what their relative positions were during the primaries, fall-out from the Obama “Harry & Louise-like” advertisements against mandates and the Clinton/Krugman disappointment with Obama over all that. Obama’s plan was rightfully criticized for not even trying for adult universality, though their criticism of mandates forcing people to buy private insurance had validity too.

Unfortunately:

Under any system in play, most people would still put out money for [to buy] health insurance [from the same private for profit companies] as they do now, but they would get help [government tax payer public subsidy to the private for profit health insurance companies] when needed.

That was a common feature of the plans put forward by Obama and Clinton in the primaries. But she would have required everyone [used police power of the state to force people to give money to the private for profit insurance companies] to get insurance while his plan makes it mandatory only for children.

As reported:

Advisers to Obama and Clinton both told the party’s platform meeting they were happy with the compromise, adopted without opposition or without explanation as to how health care would be guaranteed.

Yeah there is that little detail… how, with neither mandates nor actual universal national guaranteed, everybody in, nobody out, coverage and care.

In return for the guarantee, activists dropped a tougher platform amendment seeking a government-run, single-payer system and another amendment explicitly holding out Clinton’s plan as the one to follow.

A few comments on that:

First, it is interesting that the Wyden/McCain approach of getting rid of the tax subsidy for the purchase of insurance through employers, popular among some, does not seem to have been at all in play here. Single Payer was at least part of the discussion. That is because we actually have some grassroots and activism. Hurray for us.

Second, note the use of the deliberately misleading shorthand description of “government-run, single-payer system” which falsely leads the average reader with the impression that your doctor is going to “government run”. In fact, under single payer, the service delivery side (doctors, clinics, hospitals) remains completely private sector. What is guaranteed is that you and your family DO have access and INDIVIDUAL CHOICE of doctor, clinic and hospital. More real choice then you have now with the insurance companies. As we have learned since 1994 with the so-called HMOs and MCOS is that it is private for-profit insurance model that leads to loss of access to and individual choice of doctor.

Thirdly, well okay, we did not have the votes in this committee to get single payer endorsed today. The fight goes on.

And here are some reasons why the fight for real National Health Care needs to go on:

An Obama White House will propose whatever it will propose, but they are signaling (shouting) that they are very open to whatever/anything that can pass congress.

Hopefully regardless of what comes out of the White House and out of the Senate, and whatever pull there is to the right from AHIP/Pharama/For Profit Hospitals/Republicans/etc…. that there will also be a serious pull to the left/single payer side from the House with Conyers’ HR-676 being the leading bill there. That is one reason single payer advocacy has to stay in the game, to get as good a bill as we can passed in the short term.

My prediction is that some sort of “reform” will pass in 2009-2010.

If it leaves the private for profits in place, then it will fail, for some mix of four reasons: Not only will it not achieve universal coveragte (all people) or comprhensive coverage (all needed care vs. too many excluded conditions/services, private companies still playing denial of care games), but it will wind up being too expensive in total out of pocket costs to individuals (premiums, deductibles, copays, uncovered conditions/expenses, coverage refusals/denials of care, still go bankrupt if actually get sick), and it will not control costs nationally (e.g., percent of GNP going to health care).

Which leaves for 2012 and beyond the question of who is blamed for the failure?

Is failure going to be (falsely) interpreted politically and publicly as being due to failure of entire liberal model of (incomplete) public reform? In which case the right/conservatives/republicans win and we go backwards to a pure private for-profit model (Giuliani, McCain).

Or is blame correctly assessed as being due to the failure of having left the private for profits in place (and even haved forcibly subsidized them via mandates)… and therefore that the need is to get them out of the game and finally going to single payer national health care.

That is the other reason single payer advocacy needs to stay in the game. To get the a real solution passed as soon as possible.

P.S.:

For those who are interested in this subject there are two new great books just coming out this week:

“10 Excellent Reasons for National Health Care”
Edited by Mary O’Brien and Martha Livingston

“Do Not Resuscitate: Why the Health Insurance Industry is Dying and How We Must Replace It”
by John Geyman