Random Thoughts on Last Night’s Democratic Debate

I didn’t realize the ABC debate was last night. Knowing about them normally wouldn’t change my lack of desire to watch them, but I was in an angry stupor from watching the Redskins destroy the Seahawks themselves. I was in a mood to watch something that would make me angry, so I stuck around when I turned it on. I missed the Republican portion of the “1 Night, 2 Parties” scheme because of the game, but really, so what? There’s only one guy there I’d consider voting for, and I’ve already explained several reasons why I won’t vote for him. Even then, none of them stands a decent chance of winning, unless the Democrats stay as stupid and spineless as they’ve proven over the last few years. Based on last night’s debate, they could go either way.

I’m writing from memory, as I didn’t take notes and don’t feel like reading the transcript. With that, the candidates:

Sen. Barack Obama
He knows it will sell to claim that we can fix Social Security by eliminating the wage cap. I have no doubt he also knows this is disingenuous to any claim of fairness. Social Security is already progressive, aside from being obscenely ineffective. “The rich” do not receive the same return on their taxes. Their benefits are means-tested to shift some of their taxes to “the poor”. Eliminating the wage cap will only make the system more progressive. Any talk of “the rich” paying their fair share is a lie.

Sen. Obama was very effective at answering the likability question. He managed to disarm the crowd and moderator with talk of the Redskins and general chit-chat. In the talk of writing, he showed what Clinton said.

It proves nothing about his ability to be president, of course, but as Sen. Clinton said, people voted for Bush because they would like to have a beer with him. I don’t think Clinton misunderstands the value of this point; she’s just incapable of exuding likability.

Also, his honesty that a cap-and-trade system would cause harm was good. He’s wrong about cap-and-trade, but at least he’s only partially delusional.

Sen. Hillary Clinton
I didn’t like her before, and I don’t like her after. I didn’t learn anything new about her other than she really, really believes her own marketing and the silly idea that wanting something to happen in Washington means it’s a foregone conclusion. And, she’s scared. She spent the entire evening attacking Sen. Obama with rambling, non-linear attacks that left him with too many opportunities to pick and choose his rebuttal. He did. Even Edwards defended him. She’s toast, so I’m done worrying about her.

Gov. Bill Richardson
He has a decent notion of what a principle might be, which is a welcome change. But he’s mental on foreign policy. I’m not sure he has a great grasp on domestic policy, either. I found myself thinking, “I like him. Too bad he’s not doing better.” Then I remembered that the vote is for president. No.

Former Sen. John Edwards
He’s gotten slicker, in the most non-complimentary way. He’s a snake-oil salesmen to his core. It’s very personal for him, as he reminded us many, many times. Government can do anything if the president just cares hard enough.

He’s a complete economic populist. I don’t understand how people find his pitch reasonable. He wants to fight for all American people against the evil corporations and special interests. And “the rich”. Right, but aren’t they Americans, too? This is how he demonstrates that equality isn’t about equal. I’m not interested.

I also thought he had the stupidest mistake of the night. The other candidates should’ve jumped on him when he gave examples that he doesn’t hate all corporations. AT&T? The same AT&T that helped the Bush Administration circumvent the Constitution and spy on Americans without warrants? Surely helping its workers unionize (Really?) isn’t comparable. Caving to a calculated talking point rather than expressing an in-depth understanding of an issue is not a quality I want in a president.

Finally, Edwards used the case of Nataline Sarkisyan:

Doctors for 17-year-old Nataline Sarkisyan wanted to give her a liver transplant, but her insurer, Cigna HealthCare, initially denied their request on grounds that the transplant was too experimental. Nataline, a leukemia patient, was in intensive care at UCLA suffering from complications of a bone marrow transplant.

Stripped of backgrounds and reduced to sound-bite scale, Natalie’s story sounds like it could have been scripted by Michael Moore. But as the Los Angeles Times noted, Cigna had “tough calls” to make. It was far from clear that the requested liver transplant would do any good. Even Natalie’s doctors at UCLA judged that she would have had a 65% chance of living six more months — not a strong chance of long-term success.

Dr. Stuart Knechtle, who heads the liver transplant program at the University of Wisconsin, Madison, says transplantation is not an option for leukemia patients because the immunosuppressant drugs used in such procedures tend to spur the growth of cancer cells (he was not commenting specifically on Nataline’s case).

Clearly Edwards is saying that universal/single-payer health care would’ve approved the transplant. Fine, make that argument. But now explain to me how that lowers the cost of health insurance. There will be other tough cases. The choice is rationing or extensive experimental care. We’ve currently opted more to experimental than rationing, which is why our costs are higher than other countries. But we get something for that. We can’t have both. So which is it?

I don’t walk away from the debate with a different opinion on how badly single-payer health care would go. Health care reform, as it’s currently discussed, is a populist effort. Politicians do not have it in them to say “no” to any requests. Everyone and everything is validated as worthwhile. Such thinking has consequences and they’re predictable.

One final point on Sen. Obama regarding health care. He touted his plan’s lack of a mandate for adults (he mandates for children), saying that adults can choose. Agreed, but why is that not transferable to every other policy proposal? Why do I not get a choice with Social Security, for example?

4 thoughts on “Random Thoughts on Last Night’s Democratic Debate”

  1. Clearly Edwards is saying that universal/single-payer health care would’ve approved the transplant.
    Based on what I’ve read of the case the reality is that a universal/single payer health care system probably wouldn’t have approved the transplant either. If it was a case of her just needing a transplant then certainly she’d have got it. The issue was her specific medical conditions (particularly being in a coma and unlikely to recover from that) mean that most of the world’s health care systems just wouldn’t have approved the procedure. Especially if there was somebody else who could have had the liver.
    Personally, coming from Europe, I’m pro-universal care (at least at a basic level and particularly for preventative medicine) but it doesn’t do anybody anygood on either side of the debate to come up with strawmen arguments.

  2. Personally, coming from Europe, I’m pro-universal care (at least at a basic level and particularly for preventative medicine) but it doesn’t do anybody anygood on either side of the debate to come up with strawmen arguments.
    I support universal medical care too (through a single-payer system), but unlike a lot of folks, I don’t support coverage for what’s sometimes called “preventive medicine”.
    I don’t even believe the term “preventive medicine” is correct or appropriate.
    Medicine and medical treatment are something that should only be given to people who have some sort of disease, injury or abnormality.
    Attempting to expand the definition of medical treatment to individuals who aren’t sick is a mistake.
    If you want to have yourself vaccinated, for example, you should pay for it yourself.
    Not everyone agrees that vaccines are sufficiently safe or that the risk associated with their routine use is acceptable.
    Subsidized medical care should target people who are indisputably in need of such care and stay away from questionable undertakings like mass vaccination programs.

  3. The issue I have with the use of the term “insurance” is that it suggests you are hedging risk against something that might not happen to you. The reality of living a normal life is you will need medical treatment. The probability of needing medical treatment is 100% and short of allowing insurance companies to discriminate on genetic grounds you have to handle that some how.
    I can’t really agree with you about preventative medicine.
    There are a lot of things which have no symptoms associated which can be picked up in routine exams which become really expensive later: high blood pressure, high cholesterol, diabetes etc…
    I found out I had a high BP by accident in a screening. I took steps, and now I don’t. All a lot cheaper than having an MI.
    “Not everyone agrees that vaccines are sufficiently safe or that the risk associated with their routine use is acceptable.”
    Can’t agree with you on this as I do over circumcism. Yes, there are risks, but frankly they are quantifiable and small, especially in comparison to the risks of catching some of the common childhood diseases that we used to have; measles (London recently had an outbreak which killed kids), polio, TB, whopping cough (there’s an outbreak in Seattle at the moment).
    Let the vaccination rate drop enough and kids will start dying of things that have been unheard of for more than a generation. The US already has some of the worst infant mortality rates in the industrial world, it really shouldn’t, not when it spends more on health care than any comparable country.

  4. Personally, I’m with Daveon regarding vaccinations. The argument surrounding public health, rather than individual health, is valid. And I think the cost-benefit weighs heavily in its favor. I’m content that a society can handle a small free-rider problem with vaccinations, but the basic truth is that those diseases will return – brutally – when the vaccination rates drop low enough.

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