Individual Mandates and Universal Health Insurance

I want to spend some more time digging into Schwarzenegger's health care plan before analyzing it in full, but a quick point on the early reactions: I'm hearing a lot of hating on the individual mandate* -- and I don't get it. Some are complaining that the mandate "criminalizes the uninsured," others are saying ""The uninsured shouldn’t have a financial penalty onto top of the health and financial consequences of being uninsured." So let me try and say this clearly: Single-payer health care is an individual mandate. The enforcement mechanism, in that case, is taxation. If you don't pay your taxes, you're breaking the law. If you decide to withhold the portion of your taxes that go towards health care, you're a criminal. In fact, there is absolutely no universal health care system that wouldn't include a mandate of some kind -- that's how you make it universal. Indeed, without a mandate, you can't have a decent health system: If the healthy can opt-out until they get sick, coverage will be unaffordable for everyone. For a risk pool to work, it needs members at low risk.

The question with an individual mandate is subsidization and affordability. If we pass a law levying an individual mandate and subsidizing premiums down to $50 a month, there'll be few complaints. A mandate with no subsidization, however, is an impossible burden on millions of families. When evaluating an individual mandate, that's where liberals need to focus: The generosity of the subsidies. The Wyden Plan, for instance, subsidizes up to 400 percent of the poverty line. The Massachusetts plan subsidizes up to 300 percent. The Schwarzenegger plan subsidizes up to 250 percent. That looks too low, and I'll talk more about it later today. But for now, folks need to keep in mind that you can't simultaneously demand universal health care and reject mandates. Universal health care is a coverage mandate -- whether the enforcement comes through tax receipts or proof of premium payment is not a relavent distinction. Either one can be an overwhelming burden on the poor or the foundation of a progressive, generous system. The focus, always, should be on telling the two apart.

*An individual mandate is a law forcing the purchase of some minimum level of health insurance.

--Also at Tapped

Hey Arnold!

This article on Schwarzenegger's halting, halfhearted attempts to bring universal coverage to California neatly encapsulates the central hurdle facing Republican reformers: Taxes. You simply cannot cover a new segment of the population without the addition of some revenues. And since Schwarzenegger's advisors are already ruling out funding streams as minors as cigarette taxes, you've got just about no place to turn.

The example of Massachusetts has, in some ways, been destructive here, as governors have looked to that state and then done some throat-clearing about replication. Problem is, Massachusetts was a rare case that didn't need new revenues. As I explained in this article, a previous wave of progressive health reform had already created a massive fund to care for the uninsured in the Commonwealth -- which meant the Roney plan only had to redirect revenues, not create new ones. Add in a huge hospital-industrial complex, a very low number of uninsured residents, the threat of an expansive, universal care ballot measure, and the government's withholding of a $750 million health waiver, and you've got an easy path to change.

That said, there is something to the federalist strategy on universal health care, wherein various states give it their best shot and create models for the rest of the nation. Problem is, it's hard for states fund such experiments. That's why I've some affection for Russ Feingold's idea (mp3), which would guarantee a handful of states tens of billions to institute such plans. I'd amp up both the money allocated and the number of states included, but it's an interesting compromise proposal that could, in a Democratic Congress, make it through the legislative process with few enemies, and even attract a presidential signature.

In Praise of Division

David Broder's gushing encomium to Arnold Schwarzenegger's newfound moderations has already been rightly, resoundingly mocked throughout the blogosphere. Broder's belief that Schwarzenegger's election-year conversion to a liberal agenda "demonstrat[ed] in the most dramatic way possible the value of political independence" is so naive as to be hilarious, particularly coming from an ageless political observer like Broder. Schwarzenegger's actions demonstrate the value of being liberal in a liberal state. Had Arnold gone independent in the opposite direction, as he had in the preceding period, we'd all be buzzing with excitement over incoming governor Phil Angelides.

That said, there is an interesting dynamic that Broder fails to note. When the legislature is controlled by one party and the governor hails from the other, election year conversions on the part of the executive can actually be much more successful. Say you have Democrat Gray Davis and a Democratic Congress. Gray wants to herald the election by passing some major global-warming bills, a minimum wage increase, and various other do-gooder bills. Republicans want to deprive him of the accomplishments. And so they do: They filibuster, they block, they hold up in committee. They keep the legislation from happening, as it both offends their ideology and harms their political chances.

Now let's say you've a Republican governor with a Democratic legislature. He spends part of his first term trying to govern from the right, and is stymied at every turn. Come election year, polls show him behind, so he decides the minimum wage really isn't that bad after all, and while some warmth is nice, he doesn't really want the planet cooked. So he pivots and begins pushing a liberal agenda. The Republican Party in his state, completely yoked to his success, will not block the legislation. They need him to succeed, and win reelection. And the Democrats in the legislature want the bills. And the governor wants the accomplishment. It's a much smoother process that sets up incentives allowing divided governments to pass a whole lot more legislation than governments dominated by a single party.

That's what Arnold was able to do. His "independence," while completely opportunistic, actually allowed for much more liberal legislation than a Democratic governor could have passed. Had Bustamante been wielding the pen, Republican legislators would have blocked his agenda. As it is, Arnold decided to go liberal but, being a Republican, could do it without his party's outright opposition. Neat trick, and one that's had good results for California.

Ah-nold Is Definitely a Girly Man

By Pepper of the Daily Pepper

Governor Arnold Schwarzenegger blocked Warren Beatty and Annette Bening from entering one of his campaign rallies.

In his heyday, Schwarzenegger fought off all manner of bad guys and always made a big show of being exactly the same as his stage persona. Unlike other actors, who didn't want to be stereotyped, Schwarzenegger reveled in being the tough guy both on and off the screen. He shouldn't have done that. Because Schwarzenegger has just demonstrated that he is afraid of the same guy who was in Ishtar.

If Schwarzenegger is so afraid of Beatty, what would he do if Rob Reiner, another Hollywood heavyweight who has considered throwing his hat into the ring, showed up? Reiner is a big guy who hangs out with Howard Dean. All Reiner would have to do is give a Dean yell, and Mr. Tough Guy will go scurrying right back to his hotel suite in Sacramento.

I may sound dismissive of Beatty because I think that Hollywood has done more than its fair share of hurting the liberal cause (Are you listening, Jane Fonda and Ben Affleck?). That said, Beatty's wife, Annette Bening, got in a soundbite worth sharing:

"You have to have a wristband to listen to the governor?" Bening asked. "He represents all of us, right?"

Thank you. The stage-managed Republican Dickery is about to stop, at least in California. As long as it doesn't turn into Democratic Dickery. Pam makes a good point about Schwarzenegger and Beatty: "Boy, this got ugly. What egos...oh, wait, they're actors."

The First Sign of First-Lady-Itis

By Pepper of the Daily Pepper

It happened to Laura Bush, and now it's happening to Maria Shriver. Sooner or later, one of these women has to ask why they are being forced to sit at the children's table for the holidays.

A recent LA Times article asks where Maria Shriver has been while her husband Arnold Schwarzenegger stumps for his ludicrous special-election initiatives. Some think she isn't honoring the Kennedys. Some think she isn't honoring her husband. I just wish she's find her spine and say something. But both Shriver and Queen Laura have been shunted off to deal with "women's issues" as defined by the Republican party. To the Republicans, "women's issues" means "children's issues."

The LA Times describes how Maria has been relegated to hanging out with the little ones while Big Daddy does his job:

On a recent morning, Maria Shriver had a roomful of admiring listeners hanging on her every word. Unfortunately for her husband ... none of them was old enough to vote. Shriver was addressing a fourth-grade class at Charles W. Barrett Elementary School in South Los Angeles as part of a campaign to improve disaster preparedness among children.

-snip-

In this election, she has been mostly absent from the trail, devoting herself to other causes, including highlighting the role of women in California history and raising awareness of obesity in children.

There's nothing wrong with wanting to brighten a child's day, but why oh why must First Ladies in general stick to the "it's all about the children" script so closely? Mix it up for a change! Her fights don't even have to be about abortion or feminism. It hasn't occurred to conservatives and to the Republican Party as a whole that women might be concerned about fair wages, or better preventitive health care. Why is it that people have to assume, "Oh, she's a woman. She must be interested in children." These days, politicians no longer have to kiss babies to win because their wives do it for them.

And, I'd also like to ask, do you think this problem applies to both liberals and conservatives? Do female politicians tend to get stuck at the children's table?

Turn Left

If 2005 was the Arnold's Year of Reform, it looks like the embattled Governator is readying to make 2006 his Year of Liberalism:

Beyond the push to repair roads, ports and hospitals, Schwarzenegger has told his staff members he wants to cover the estimated 6.6 million Californians who have no health insurance. Officials said they are considering a variety of options, such as putting more nurses and doctors in schools and expanding prevention programs with the help of federal waivers.

They are also looking at programs being debated and implemented in other states, such as a Wisconsin plan to grant vouchers for buying basic health insurance paid for with a payroll tax. One idea would require all Californians to obtain health insurance, much as drivers are required to have car insurance.

But because the state expects another budget shortfall next year, the governor's health officials said they are narrowing their focus to the state's 780,000 uninsured children and teenagers.
[...]
And the governor wants to revive a plan that Democrats torpedoed last year to install solar panels on 1 million roofs — traditionally an issue they would embrace — after being lobbied by electrical workers unions concerned about protecting jobs.

We'll see what comes of it all. The state is shockingly underfunded right now, and having just passed a $15 billion bond initiative, there's already talk of floating another. So much as I'm for these goals -- including the solar panels project, which unions myopically opposed and Democrats cravenly caved on -- we just don't have the cash for this stuff unless we raise taxes a bit. And I'm not hearing any mutterings from Arnold on that. Also, this is just a horrible, evil idea:

Whatever the governor's intentions, one element of the new agenda is already causing friction. On Thursday, Schwarzenegger launched a signature-gathering drive for a proposed November 2006 ballot initiative that would increase penalties for sex crimes. The measure would include a provision requiring sex offenders to be tracked for life with global-positioning devices.

The initiative drive will give Schwarzenegger a tough-on-crime issue to embrace next year, while forcing Democrats to take a stand on a measure they may find too harsh. Democrats faced a similar battle last year with an initiative to modify the state's three-strikes law, which Schwarzenegger opposed and which failed.

This is simple demagoguery, an attempt to whip society's most hated offenders for political gain. In a democracy, the measure of a society is not how it treats its most beloved, but how it treats its least liked. Arnold is taking an easy path towards a wedge issue by violating the constitutional rights and further heaping punishment on sex offenders. That's grotesque, not because sex offenders are good, but because the rest of society supposedly is. If you want to increase the penalties on these offenses and lock offenders up till death, put that on the ballot. But there's simply no precedent for using the state to track every step they take for the rest of their lives. Both society and its convicted must move on, or not. This, however, is simple pandering to the electorate's worst instincts.

More Against Proposition 77

Via LGM, The Editors, so far as I'm concerned, get the redistricting scheme right:

I agree that this is a great proposition, and I urge the voters of Texas to pass it. Oh, wait. The problem with this proposition, and the reason it was proposed by Republicans and opposed by Democrats, is that it asks the largest Democratic state not to redistrict for partisan gain while Republican states redistrict away, with help from the Republican Congress. Net result: a gain in reps for the Republicans on the national level, and endless headaches of the sort we’ve all come to know and love over the past decade. As far as I’m concerned, 77 and 75 are the two non-negotiable items on the agenda, as they are the most explicit attacks on Democratic political funding and leverage.

Now, this would be wrong if it was a fairer redistricting bill. That is to say, the party in power will always lose out from redistricting, having California pass such a bill makes similar initiatives more likely elsewhere, and so it makes sense that we'd take a slight hit in CA for large gains (not to mention a fairer process!) across the nation. But since the bill, with its weird "compactness" schematic, looks to be an attempt to use the urban/rural divide to reduce the potency of Democratic votes and increase the power of Republican ballots, it seems exactly the sort of powergrab The Editors tag it as. (On the other hand, Harold Meyerson makes the point that CA's urban districts are fairly compact already and, looking at the map, he seems to be right. So maybe this won't have the affects some of us fear.). In any case, it's a very tricky choice, as having the party in power force the party out of power to make these fair process concessions on the few pieces of turf it controls really smacks of disingenuousness.

To Redistrict, Or Not To Redistrict, That Is The Question

If you're trying to figure out whether or not to oppose Schwarzenegger's redistricting scheme, Brad Plumer and Matt Singer lay out the stakes. Put simply: the proposition is more partisan hackery. While the board that "redistricts" will indeed be nonpartisan, the methodology it uses is internally rigged against Democrats. It's like having an independent typist take dictation from a virulently political source.

Schwarzenegger's system relies on "compactness", which is to say it redistricts so as to make each district as geographically small as possible. For Democrats, who rely on urban voters, that's a massive disadvantage. For Republicans, who rely on spread out rural voters, that's a massive advantage. If you want competitive elections, redistrict based on competitiveness. Then you can have contested elections that pull towards the middle, just as Schwarzenegger publicly calls for. As it stands, this scheme will just create a lot of overwhelmingly Democratic districts and a bunch of lean-Republican districts. In other words, it'll maximize the effectiveness of the Republican vote and minimizes the potency of the Democratic vote.

There is, it should be said, a fairly strong argument for passing some sort of redistricting bill in California. The passage of such a proposal would make its adoption elsewhere much easier -- as Chuck Todd says, Californian initiatives are like the flu, they tend to prove contagious. And in a Republican-controlled country, more contestable districts will almost certainly be good for Democrats. More to the point, as a political writer, a dramatic increase in the stakes of midterm elections would be damn good for me. But in the end, this isn't the way to do it. If Phil Angelides takes out Arnold and proposes a redistricting scheme based on competitiveness, I'll sign right on. But with Arnold pushing a version tailored to simply elect more Republicans, I have to remain unhappily outside. I desperately want reform. But this sure as hell isn't it.

It's All My Fault

By Ezra

Guess the LA Times didn't find my op-ed convincing. They came out today in favor of Prop. 75, the "paycheck protection" initiative, arguing that the state's public employee unions ought to be weakened and the proposition passed. They do this admitting that the law is poorly written (the "issue education" loophole) and its backers motivated by bad faith. And since the paper promises to support future acts to clean up our campaign financing system in more equitable ways, they sidestep the moral question of whether the governor should use the initiative process to strike back at political enemies. All in all, not very convincing stuff. The paper is assuming a position of false naiveté, pretending that the only issue at hand is the simple question of whether they would like public employee unions to have more or less power, and that Prop. 75 is not a single salvo in a much larger war between special interests, competing ideologies, political powerhouses, and disconnected strategists.

The governor could have pushed for clean elections, for ethical reforms, for the total overhaul of campaign financing so that all special interests are ejected. I would have supported him gladly. But he didn't. Prop. 75 is not about paycheck protection, it's a cynical attempt to utilize individual passivity to weaken certain unions. The social science data on opt-in versus opt-out is clear. Whatever the individuals think about the program/cause, having to opt-in will result in much lower participation rates than opting-out. Currently, all union members can opt-out, but few do. When they all must opt-in, the numbers doing so will be dramatically lessened, not for reasons of ideology, but because of laziness. It's the same principle at work behind those who want to make 401(k)'s opt-out rather than opt-in, only here it's being used to punish political enemies.

As it happens, the act is poorly written and likely to be wholly ineffective, it'll just force unions to engage in advocacy through loopholes. But that doesn't excuse the LA Times here. They're supporting a bad act based on some faux-innocent outlook as to its origins, purpose, and effects. Governors should not hijack the initiative process to punish political enemies and respected papers should not support them when they do. The LA Times is making a mistake.

Arnie at the Carny: Or, the Tale Too Bold for the Enquirer

By Pepper

I thought about titling this article "Why Ah-nold Won't Win" in honor of the salon Neil started explaining why Hillary won't win. But I've got my eye on Ah-nold now that he plans to run again. In its heyday, the National Enquirer used to trash everyone, the bigger the better. I first caught wind of Gary Hart's Monkey Business and Clinton's Gennifer Flowers through the Enquirer (yeah, I had a subscription - wanna make something of it?). Then their publisher - AMI - wanted Schwarzenegger for their muscle magazines, and the Enquirer sheathed its claws for the Republican big boy.

Per the LA Times: "Soon after Arnold Schwarzenegger entered the 2003 recall campaign, a tabloid publisher that was recruiting him as a consultant tried to suppress a risque 1983 Playboy video starring the future governor."

Now its time to satisfy all those inquiring minds who want to know. The video, "Carnival in Rio," is available all over the web, and we should wield it as a weapon since Ah-nold is running again. A picture of Ah-nold and a Phallic Carrot awaits after the jump!

The film was released on Laserdisc and is reviewed by Doug Pratt of DVDLaser.com, who sums of "Carnival in Rio" thusly:

An honest-to-goodness travelogue, narrated by an honest-to-goodness Arnold Schwarzenegger, the hour-long 1983 program follows Schwarzenegger around Rio de Janeiro during carnival time as he gets on quite intimately with his two Brazilian hostesses--who pose topless in a couple of sequences--participates in carnival activities, and generally makes a rousing fool of himself, to the delight of all.

"Carnival in Rio" made waves in 2003, and the San Francisco Chronicle decided to see what all the fuss was about. At its best, the movie is sexist (what involving Ah-nold isn't?) and demonstrates Ah-nold's cultural insensitivity. As Chris McGowan told the Chronicle, "I'd say it's more embarrassing rather than horribly offensive. He's kind of like the gringo from hell." McGowan's full review is available here.

The tape that AMI tried to buy up is elusive, but AMI couldn't erase all traces of this mess. Thank goodness for the Internet. There are three copies available at Amazon. You can buy it on eBay as well. It makes for the perfect holiday gift.

One of the highlights of the film involves Ah-nold teaching a woman how to eat a carrot. A screenshot of Ah-nold and the Phallic Carrot is available at Brooklyn's Rooftop Shots, courtesy of the men at the Found Footage Film Festival, which shows clips of Ah-nold's magical trip to Brazil.

Just my luck, the Found Footage Film Festival will be at the Parkway in Oakland tonight, and I'll be back (ha, ha) with a full report at the Daily Pepper!