2012 as a healthcare referendum

If Obama wins, Obamacare becomes a permanent part of the national landscape. If Obama loses, no one is going to try health care reform again for a long, long time.

There’s so much at stake this year it’s hard to focus on any one thing as “most important.” But Ezra Klein makes a strong case that health care is plenty important enough to make this an historic election. If Obama wins, Obamacare becomes a permanent part of the national landscape. If Obama loses, no one is going to try health care reform again for a long, long time.

Author: Mark Kleiman

Professor of Public Policy at the NYU Marron Institute for Urban Management and editor of the Journal of Drug Policy Analysis. Teaches about the methods of policy analysis about drug abuse control and crime control policy, working out the implications of two principles: that swift and certain sanctions don't have to be severe to be effective, and that well-designed threats usually don't have to be carried out. Books: Drugs and Drug Policy: What Everyone Needs to Know (with Jonathan Caulkins and Angela Hawken) When Brute Force Fails: How to Have Less Crime and Less Punishment (Princeton, 2009; named one of the "books of the year" by The Economist Against Excess: Drug Policy for Results (Basic, 1993) Marijuana: Costs of Abuse, Costs of Control (Greenwood, 1989) UCLA Homepage Curriculum Vitae Contact: Markarkleiman-at-gmail.com

5 thoughts on “2012 as a healthcare referendum”

  1. Well, since there’s been as yet no proclamation out of the White House that property is theft, and Obama still hasn’t called on us to expropriate the expropriators, I’m voting for Romney, so as to give all my stuff to rich people who don’t need it.

    It’s just logical.

  2. What’s at stake is far greater than health care.

    Because of systemic forces (inheriting an economy in collapse, which is impossible to magically fix in four years, being foremost among them) Obama may lose this election. As a result, here is what will happen, in order of concern:

    1. Republicans in all three branches of government will coalesce around a conservative agenda and pass legislation at a rapid rate. This will make them look highly productive–which they’ll then tout in the next election as evidence that Democrats are ineffective and Republicans are effective. The American public, without much perspective on systemic problems of governance, will buy this argument.

    2. The newly enshrined Republicans will systematically erase and/or revise every Obama accomplishment to make it look like he was a failure. They will make him into a hyper-Carter, and his name will be reviled in American politics for a generation.

    3. Breyer and Ginsburg will likely retire from the Supreme Court. Two staunch conservatives in the Scalito vein will be put in their place, leaving a strong majority of five against a weak minority of three (and I mean that the liberals on the court are more tentative than the conservatives are already, plus they will be in a minority.) This will create the strongest, most activist, and staunchest conservative court in American history.

    4. Major parts of ACA will be dismantled by the Spring, leaving far fewer people covered than if it had never been enacted at all.

    5. Large parts of Medicare will be privatized or voucherized by the Spring, leaving our elderly (and our future) at risk.

    6. Environmental regulations will be scaled back drastically. Offshore drilling will be widely expanded, as will drilling in certain areas of national, public lands. Mining will also be increased, including mountain-top removal mining. Fracking (which has unproven environmental and health effects) will be increased. And as goes America, so goes the planet. If we fail to create meaningful environmental regulation, global climate change will increase.

    7. Etc etc.

    This is perhaps the most important election in history for progressive values, and losing it will mean that powerful forces will have gained the upper hand. Despite the fact that majorities of Americans side with progressives more than conservatives (and that demographically the Democrats are supposedly on the rise), we will inexplicably have the most conservative government in American history.

    This election is effectively a referendum on the entire 20th century in American politics. If the GOP wins, they will attempt to repeal everything we created politically as a nation since Roosevelt. If Obama wins, we can strengthen these things well into the future. This one counts.

  3. “Given the choice between a Republican and someone who acts like a Republican, people will vote for a real Republican every time.” I don’t know if Harry Truman really said that, and it doesn’t matter. But it is true.

    1. KLG, I suggest that you read the first comment carefully and look in a mirror. If acting like a Republican includes ACA, ending Don’t Ask Don’t Tell, equal pay legislation, Dodd-Frank, appointing pro-choice judges, and suspending the deportation of people who would benefit from the Dream Act, then all I can say is that the real Republican running this year doesn’t act very much like a Republican.

  4. Mark, thank you for the response, but I’m too old to look in the mirror very much. I did read the comment and have been reading and hearing similar things for nearly four years. Constantly. I am perforce aware that there is a big difference between the Current Occupant and his opponent. However, by “looking forward” at all costs, the president has placed his electoral chances and our future in considerable jeopardy. In a series of simple minded political calculations he essentially abandoned those of us who elected him, by December 2008, in favor of God knows what. Well actually we do know. What is funny, but not humorous, is that the president did not know that no matter what he did, his “friends” in high places were not going to really like him (and that includes the Congress). Lloyd Blankfein and Jamie Dimon are savvy businessmen, no doubt. And that’s that. Truth be told, Barack Obama lost me with that remark, which was as tone deaf as anything a president has said in my political lifetime dating back to the early 1970s. Blankfein and Dimon, and by extension all of their MOTU friends, don’t care what the president thinks of them even if they pretend to pout when he “hurts their little feelings.” And, please, tell me this. If a Republican Administration could put several thousand bankers in prison after the S&L crisis, why is it that Obama’s Department of Justice can’t manage just one after their hypertrophied latter-day equivalents essentially blew up the world? Oh, that’s right. We must look forward.

    Anyway, what I most remember from 2009 is that ACA was placed in the hands of Mac Baucus’s factotum, you know the woman from the insurance companies? What we have now is something arguably better than what we had before. But health insurance is not health care and never will be as long as the insurance companies make their money by denying care rather than paying for it. Who I would like to hear from in the RBC is someone not covered by a platinum-plated health care benefit plan and similar pension offered by UCLA, Chicago, Berkeley. Mine are silver- and bronze-plated, so I am one of the fortunate few remaining and not your guy for that. Is it 2014 yet? Our fellow RBCer Matt makes a series of good and useful points; they are all important. But when was the last time the president mentioned anthropogenic climate change? Or is he just waiting for the right time? That might be a valid political calculation in Idiot America, so I’ll leave it there.

    I expect the president to squeak through, and I certainly hope he does. The stakes are high, which is something the president should have realized before this fall. We are near contemporaries, you and I. After Barack Obama wins and gets down to the business of that light of his eyes, “The Grand Bargain,” with that pr*ck Alan Simpson and pudknocker Erskine Bowles, I trust the RBC will raise holy hell. Right? I voted for the first time as a 19-year-old in the midterm election of 1974. In 38 years of voting for, and supporting with (to me) real money, Democrats at every level, what we have come to is a President who brings up, apparently unbidden, raising the age of eligibility for Medicare to 67. That was all of a piece. Something is not working here. The only other candidate on the ballot in this, my native state, is Gary Johnson, so I’ll vote for the president and he will lose by 10-15 points. You’ll vote for him and he’ll win by 10-15 points. Ditto for Professor Pollack. Here’s hoping the RBCers in Virginia, Ohio, Wisconsin, Pennsylvania, and Florida prevail.

    One other thing of ostensible parochial interest to me but nevertheless important. Walk across campus and talk to your scientist friends. According to a colleague with whom I work who is the Director of Public Policy of a major organization of biologists, the current administration thinks NIH and NSF have “enough money.” I suppose they also think that we will vote for them no matter what given the alternative. They are probably right about that. As a retired scientist friend notes, the work will get done somewhere. Probably China. So what’s the big deal? Right? Francis Collins and his legion of Program Officers can pick the “winners” ahead of time and American Science will be just fine. Wrong.

    Keep up the good work!

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