January 18th, 2008

Harold Pollack, one of the rising stars of health services research, has a long diary up on Daily Kos reflecting on the state of the health care problem and defending Barack Obama’s approach to dealing with it, including Obama’s reluctance to endorse a mandate. Nut graf:

Our medical and public health system is a mess. It won’t be fixed until we choose a Democrat who can actually win the presidency, and who can then assemble a working majority to get things done.

On the mandate point I think Obama is being somewhat disingenuous. He says that people are uninsured because they can’t afford insurance, but that’s true only of some. Lots of uninsured folks are adverse-selecting young immortals. But it’s not hard to fathom the general-election politics of this, and Obama seems now to be saying that there would be a financial penalty for waiting to join the system.

In any case, Harold’s piece is worth a careful read.

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