Andrew Sullivan took a close look at Barack Obama and likes what he sees. Namely, Obama doesn’t shy from giving a stern talking to groups that Sullivan thinks could use a good talking to. It strikes me as a good sign that renegade Republicans, who make up about half the party these days, haven’t yet found a reason to dislike Obama. Compare this with, say, Rudy Giuliani’s problem with major fractions of his own base.
Hailing from the proudly irrelevant state of Pennsylvania it doesn’t really matter who I prefer among the Dem candidates. By May 2008 the top Republican and the top Democrat will basically be running a general election campaign. Assuming that we don’t nominate Dennis Kucinich I don’t have a problem with supporting whichever Dem the rest of the country serves up. That said, as much as I like the apparently core instinct that Obama has to reach across boundaries I don’t think that instinct will help him craft healthcare policy. Looking over Kevin Drum’s summary of Obama’s detailed healthcare proposal, it looks like he runs afoul of my standard criticism that (1) halfway measures can easily make our current system worse, and (2) the insurance biz will never line up behind a reasonable proposal so amending your plans to try to win their support (or avoid their fury) is is a fool’s errand.
Expanding on point (1), the problem with public-private mishmash proposals is that the government cannot effectively compete with private insurance plans without enabling a massive cycle of adverse selection. Private insurers will use the availability of a bare-bones government plan to dump anybody who threatens the tiniest dent in the bottom line, ensuring that the government gets stuck with the costliest clients while dirt-cheap private plans (they don’t have to insure any sick people) siphon off the young and healthy. Any plan that limits the options of private insurers to the point where adverse selection no longer becomes a problem might as well go single payer for all the support they will get from insurers and rightwing ideologues. The massive costs of insuring the least desirable cases will give government insurance a bad name and the beaurocratic paperwork of overseeing the private insurers will easily take as many resources as simply switching to single-payer. In my view these halfway plans, no matter how intricately crafted, all have the same doomed karma as Hillarycare.