Sign up or else

An individual mandate is a requirement that everybody obtain insurance either by purchasing it or signing up for a public program like Medicaid. Clinton has a mandate in her plan, saying it’s the only way to make sure everybody ends up insured. Obama does not have a mandate, saying he wants to get his other reforms in place first — making sure, among other things, there’s actually affordable insurance available. Then, he says, he can evaluate whether a mandate is even necessary.

Now John Edwards is getting into the scrum. Like Clinton, Edwards has always said he’d call for a mandate but was generally vague about how, exactly, he proposed to have government enforce it. Yesterday, while campagning in New Hampshire, he said a little more. According to an ABC News account, Edwards said during a speech that “Every time you go into contact with the healthcare system or the govenment you will be signed up.” Then, during a press conference, he elaborated thusly:

Basically every time [people] come into contact with either the healthcare system or the government, whether it’s payment of taxes, school, going to the library, whatever it is they will be signed up.

A reporter asked Edwards what would happen if somebody wouldn’t sign up. “You don’t get that choice,” he responded.

This explanation still leaves a lot unexplained. A key question (maybe the key question) in designing a mandate is what happens to people who don’t heed it. If the penalty for non-compliance is just a minor fine, a lot of people will inevitably ignore the mandate, figuring it’s cheaper to pay a few hundred bucks a year than to buy insurance. If the fines are sufficiently severe, then most people will probably comply. But, of course, imposing such fines is also a lot more controversial politically — which, presumbly, is why Clinton has avoided getting too specific and even Edwards is filling in the details slowly (thereby giving Obama an opportunity to question how solid their respective promises of universal coverage really are).

The New Republic 11/27/07
http://blogs.tnr.com/tnr/blogs/the_plank/archive/2007/11/27/edwards-gets-into-the-mandate-scrum.aspx

John Edwards, Frozen Caveman Lawyer

This week, presidential wannabe John Edwards revealed health-care ideas that would blast drug research and development in this country right back to the Stone Age. At the core of Edwards’ plan is a scheme to strip patent protection from breakthrough drugs to get them more widely distributed with lower costs.

That whooshing noise you hear is the sound of all venture capital exiting the industry. Say goodbye to breakthrough drugs, because if Edwards has his way, there won’t be any. Research budgets at pharma giants like Pfizer (NYSE: PFE) and Merck (NYSE: MRK) and at biotech firms like Genzyme (Nasdaq: GENZ) and Millennium Pharmaceuticals (Nasdaq: MLNM) will dry up if this plan goes into effect. Once again, we see that common-sense economic policymaking has no place in presidential politics.

Patents are critical in new drug development. They are the only financial incentive that makes drug research a viable undertaking. This is simple reality. Drug development is wicked expensive and incredibly risky. Companies cannot embark on such ventures without appropriate financial compensation. Patents are a key part of a system where drug companies are paid for the risks they take. This has led to the creation of important new medicines over the past few decades and has made the U.S. drug industry the best in the world.

more

http://www.fool.com/investing/high-growth/2007/11/15/john-edwards-frozen-caveman-lawyer.aspx

Edwards ad does not describe a plan to ask members of Congress to cut off their own health insurance

In a phone interview from New Hampshire on Tuesday, Edwards acknowledged that a president would not have the power to unilaterally pull health care coverage from federal employees or members of Congress. “The president has two powers: One, he can submit legislation to Congress, which is what I would do. And second, he has the power of the bully pulpit.”

Edwards said that if any members of Congress resisted, he would go to their home districts to press for the legislation. “I will name names and go to their congressional districts or Senate states and make sure that their constituents know they’re defending their own health care and not passing health care for America.”

Asked whether the ad was clear about his intentions, he replied: “It’s a 30-second ad.”

University of Iowa communications professor Bruce Gronbeck, who studies political rhetoric, watched the ad and said it does not describe a plan to ask members of Congress to cut off their own health insurance. “Not at all,” Gronbeck said. “The ad is saying he’d just cut them off. It’s pretty clear.” Gronbeck also said he was skeptical that representatives and senators would vote to cancel their own insurance.

Des Moines Register 11/14/07
http://desmoinesregister.com/apps/pbcs.dll/article?AID=/20071114/NEWS09/711140389/-1/caucus

Edwards and wife exploit her cancer in Iowa mailer

TPM Election Central 11/14/07
http://tpmelectioncentral.com/2007/11/edwards_mailer_in_iowa_reiterates_his_threat_to_take_away_congress_health_care.php

Edwards’ pharma charges “grossly misleading”

“You’ve seen these ads. You know who’s paying for them, right? You are,” Edwards reportedly told the gathering. He went on to claim that medicine makers spend “twice as much” on marketing and administration as they do on research.

But that’s not true. U.S. drugmakers shelled out more than $55 billion on medical research in 2006, according to market research firm IMS Health. That compares to just $12 billion companies spent on sales, promotion to doctors, and ads targeting patients.

snip

In arguing that Big Pharma spends more promoting itself than researching cures, Edwards’ speechwriters conveniently lumped “marketing” and “administrative” costs together. That’s grossly misleading.

In most Fortune 500 financial reports “administrative costs” or “general expenses” are often catchall categories for anything that isn’t related to the direct costs of manufacturing or sales. It often includes, for example, office leases and accounting costs.

Unfortunately for them, many drug companies use a combined line item in their financial reports for sales and administrative costs, which is probably the source of the oft-repeated myth that high marketing costs are the primary culprit behind rising drug costs.

As for Edwards’s idea of a two-year moratorium on advertising for newly introduced drugs? That might be wise for, say, medications with long lists of side effects. But it’s hard to get policy wonks to pay attention to worthwhile proposals as long as politicians are chasing bigger headlines.

CNN Money 10/30/07
http://money.cnn.com/2007/10/29/news/companies/edwards_drug_ads.fortune/?postversion=2007103010

“Instantly” Edwards to end war, enact universal health care, and overhaul energy system

It’s a bird, it’s a plane …

Like other Democrats, Edwards named his top three priorities as ending the war in Iraq, enacting universal health care and overhauling the American energy system. “Those are three things instantly I would do,” he said.

Edwards also ripped fellow Democrat Sen. Hillary Clinton, who leads most polls nationally and in New Hampshire by a wide margin, for taking campaign contributions from federal lobbyists and for her recent vote in favor of naming Iran’s Revolutionary Guard a terrorist group. Edwards barely mentioned Sen. Barack Obama.

Both Edwards and Clinton have proposed universal health care plans that mandate insurance for everyone, while Obama has proposed a plan that requires coverage only for children. Edwards, who was first to propose a plan, called Clinton’s a “carbon copy” of his but said he is better positioned to negotiate because he has the “clean hands of not taking money from lobbyists.”

“Senator Clinton has over the years has taken millions of dollars from lobbyists and defends the status quo system,” he said. “She just basically says the system works and her argument is, ‘I’m experienced, I can operate within the system.’ “

Clinton spokeswoman Kathleen Strand questioned the line Edwards has drawn. He takes money from state lobbyists and from a variety of industry groups; according to a Washington Post roundup, he’s taken more than $8 million this year from lawyers and law firms, including some that also employ lobbyists.

“It is disappointing that instead of taking the opportunity to lay out his ideas to New Hampshire voters, John Edwards is consistently choosing to engage in misleading, desperate attacks against Senator Clinton,” Strand said.

Concord Monitor 10/26/07
http://www.cmonitor.com/apps/pbcs.dll/article?AID=/20071026/FRONTPAGE/710260384

Edwards health plan could not possibly succeed

America’s health care system has three fundamental problems: cost, quality and access. Why do we have these problems? What do the Democratic presidential candidates propose to do about them?

Health care spending per capita is growing at twice the rate of growth of national income. If that trend continues, health care will crowd out every other form of consumption by the time today’s college students retire.

snip

Now consider the health plans of Hillary Clinton, John Edwards and Barack Obama. There are three important questions to be asked of each one:

Does the plan force anyone to choose between health care and other uses of money?

Does the plan force any provider of care to compete for patients based on price and/or quality of care?

Does the plan allow patients now trapped in schemes that ration care by waiting — Medicaid, SCHIP and emergency room free care — to have the same access to doctors, hospitals, clinics, etc., that privately insured patients have?

If the answer to the first question is “no,” the plan will not control costs. If the answer to the second question is “no,” the plan will not improve quality. If the answer to the third question is “no,” the plan will not increase access to care. And if the answer to all three is “no” — which I believe it is — the plan is hardly worth talking about.

All three plans would be costly and burdensome, and would impose new regulations and lots more bureaucracy.

Obama’s plan would cost $60 billion per year. The Clinton and Edwards plans would cost twice that much — or more than $1,000 per year for every household in America! Two hundred years from now, anthropologists will look back on our era and wonder why there was so much sound and fury over plans that from the get-go could not possibly succeed.

Charlotte Observer 10/22/07
http://www.charlotte.com/409/story/328809.html

2008 Edwards frequently at odds with 2004 Edwards

* Edwards was very sharp, needling Clinton frequently, without being overly aggressive. I think he probably helped himself the most last night, except he stumbled slightly when Russert reminded him that in 2004 he said the nation couldn’t afford universal health care, described it as “not achievable,” and “not responsible.” Edwards said he’s changed, “and so has America.” It was a subtle reminder that 2008 Edwards is frequently at odds with 2004 Edwards.

The Carpetbagger Report 9/27/07
http://www.thecarpetbaggerreport.com/archives/13021.html

Edwards Pledges Different Health Care Tactics Than Clinton

As an early proponent of universal health care coverage, Democratic presidential candidate John Edwards on Monday found himself struggling to differentiate his plan from one released last week by New York Sen. Hillary Rodham Clinton, the party’s front-runner.

snip: “Sen. Clinton appears to believe that … you can take money from health insurance and drug company lobbyists and sit at the table with them and negotiate a compromise,” Edwards said. “I absolutely reject that. That’s a classic inside Washington way of thinking.

snip: Though rejecting the roll of lobbyists and special interest groups in shaping policy, Edwards was speaking at a Kaiser Family Foundation forum sponsored by the Federation of American Hospitals and Families USA, two organizations that seek to influence the debate on U.S. health care policy. Other presidential candidates are scheduled to appear at the Kaiser Family Foundation over the next few months to discuss their health care plans.

CQPolitics.com

http://www.cqpolitics.com/2007/09/edwards_pledges_different_heal.html

Elizabeth And Hillary

She’s at it again. No, not Hillary. Elizabeth.

Elizabeth Edwards, that is. Every time you turn around, she’s attacking Hillary Clinton. And every time she does it, it makes news, as she must know it will. Mrs. Edwards gets more headlines than her husband, the candidate. And many of them aren’t about substance, but are painfully personal, the sort of attacks that aren’t going to get John Edwards elected president.

Snip:…Mrs. Edwards basically engaged in a little old-fashioned name-calling — in the process revealing the kind of naivete about the system that is precisely what caused Hillary’s first health care plan, back in 1993, to fail. The problem with the Clinton plan, according to Mrs. Edwards, is that it too closely resembles her husband’s; that Hillary is, in effect, a Janie-come-lately to the health care fight, rather than the leader she should be.

snip: Now, you can accuse Hillary Clinton of many things, and believe me, people do, but not having the courage to be a leader on health care should not be one of them. Just ask any Republican you know. She is still paying for the courage she showed in 1993, and the mistakes she made in the process. And the biggest mistake was the fantasy that the way to change the health care system in this country was to come up with a comprehensive plan all by yourself, and then expect everyone to fall in line behind it and get it enacted in its original form. The reason legislation, like sausage, is so often described as something you shouldn’t watch being made is precisely because it doesn’t work that way.

snip:…The real challenge in Washington, particularly with a divided Congress, is not in designing the most perfect package, but in acquiring the clout and experience to know how to get at least a large chunk of it enacted into law. When it comes to that sort of experience, the Clintons have it over the Edwardses, hands down.

Yahoo News

http://news.yahoo.com/s/uc/20070921/cm_uc_crsesx/op_393892